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OF THE 
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60th Congress 1 SENATE I Document 
 
 Sd Session j \ No. 644 
 
 y/^ i y 
 
 REPORTS OF THE 
 
 PRESIDENT'S HOMES COMMISSION 
 
 MESSAGE FROM THE PRESIDENT OF THE 
 UNITED STATES, TRANSMITTING RE- 
 PORTS BY THE PRESIDENT'S HOMES COM- 
 MISSION ON IMPROVEMENT OF EXISTING 
 HOUSES, AND ELIMINATION OF INSANI- 
 TARY AND ALLEY HOUSES, ON SOCIAL 
 BETTERMENT, AND ON BUILDING REGU- 
 LATIONS, TOGETHER WITH RESOLUTIONS 
 AND RECOMMENDATIONS ADOPTED BY 
 THE COMMISSION 
 
 if 
 
 \ P 
 
 January 8, 1909. — Read; referred to the Committee on the District 
 of Columbia and ordered to be printed with illustrations 
 
 WASHINGTON 
 
 GOVERNMENT PRINTING OFFICE 
 
 1909 
 
, ' CITY AND RE^' 
 
 PLANNliNiG 
 THE PRESIDENT'S HOMES COMMISSION. 
 
 (Appointed by President Theodore Roosevelt.) 
 
 Gen. Geo. M. Sternberg, U. S. Army, President, 
 
 Geo. M. Kobeb, Secretary. 
 
 John B. Sleman, Jr., Treasurer. 
 
 Wm. H. Baldwin. 
 Frederick L. Siddons. 
 Prof. Geo. W. Cook. • 
 Whitefield AIcKinlay. 
 Miss Mabel T. Boardman. 
 Mrs. Thomas T. Gaff. 
 
 James Bronson Reynolds, 
 S. W. Woodward. 
 T. C. Parsons. 
 Emmett L. Adams. 
 P. J. Brennan. 
 Wm. F. Downey. 
 
 EXECUTIVE COMMITTEE. 
 
 Geo. M. Sternberg, Chairman. 
 
 Geo. M. Kober. 
 Wm. H. Baldwin. 
 Frederick L. Siddons. 
 
 S. W. Woodward. 
 
 Miss Mabel T. Boardman, 
 
 T. C. Parsons. 
 Geo. W. Cook. 
 P. J. Brennan. 
 
 committee on building of model houses. 
 Geo. M. Sternberg, Chairman. 
 
 Whitefield McKinlay. 
 
 John B. Sleman, jr. 
 
 Miss Mabel T. Boardman. 
 
 committee on improvement of existing houses and elimination of insani- 
 tary AND alley houses. 
 
 S. W. Woodward. 
 T. C. Parsons. 
 Geo. W. Ck)ok. 
 
 James B. Reynolds. 
 Wm. F. Downey. 
 Whitefield McKinlay. 
 
 Wm. H. Baldwin, Chairman. 
 
 F. L. Siddons. 
 Emmett L. Adams. 
 Wm. F. Downey. 
 
 BOCIAL betterment COMMITTEE. 
 
 Geo. M. Kober, Chairman. 
 
 Emmett L. Adams. 
 Mrs. Thomas T. Gafif. 
 Miss Mabel T. Boardman, 
 
 Geo. M. Sternberg. 
 
 committee on BUILDING REGLTLATIONS. 
 
 Frederick L. Siddons, Chairman. 
 I Wm. H. Baldwin. 
 finance committee. 
 S. W. Woodward, Chairman, 
 
 Jamea B. Reynolds. 
 Mrs. Thomas T. Gaff. 
 F. L. Siddons. 
 
 John B. Sleman, Jr. 
 
 P. J. Brennan. 
 
 Miss Mabel T. P>oardman. 
 
 H. C. Macatee, Assistant Secretary. 
 GusTAvus A. Weber, Statistician, 
 
TABLE OF CONTENTS. ^^ , 
 
 Letter of transmittal ^tlH^i vii 
 
 The President's Homes Commission 1 
 
 Report of the committee on improvement of existing houses and elimination 
 
 of insanitary and alley houses 3 
 
 Elimination of insanitary houses 6 
 
 Elimination of alley houses 7 
 
 Report of the committee on building regulations 17 
 
 Resolutions and recommendations of the commission 19 
 
 Industrial hygiene and social betterment 25 
 
 Report of the committee on social betterment 27 
 
 Part I. — Industeial Hygienp:. 
 
 Chapter I. — Introduction 29 
 
 Occupations and mortality 30 
 
 Morbidity and mortality of wage-earners 32 
 
 Indoor occupations 35 
 
 II. — Occupations involving exposure to irritating dust 36 
 
 Metallic and mineral dust 37 
 
 Vegetable dust 40 
 
 Textile industries 41 
 
 Animal dust - 45 
 
 III. — Occupations involving exposure to infective matter in dust 46 
 
 Rag, paper, wool, and hair industry 46 
 
 IV. — Occupations involving exposure to poisonous dust — Lead dust.. 48 
 
 The lead industry in Massachusetts 49 
 
 Printers, type founders, and typesetters 51 
 
 Arsenical dust 54 
 
 V. — Occupations involving exposure to irritating or poisonous gases 
 
 or vapors 55 
 
 Sulphur dioxide 55 
 
 Hydrochloric acid 56 
 
 Sulphuric and nitric acid 56 
 
 Ammonia 57 
 
 Chlorine gas 57 
 
 Bleaching establishments 57 
 
 Iodine and bromine vapors 58 
 
 Turpentine 58 
 
 Petroleum 58 
 
 Benzine vapors 58 
 
 Carbon monoxide 58 
 
 Carbonic acid gas 59 
 
 Carbon disulphide 59 
 
 Naphtha 59 
 
 Nitrobenzol 60 
 
 Dyeing and cleaning 60 
 
 Rubber industry 60 
 
 Patent-leather industry 61 
 
 Aniline vapor 61 
 
 Wood alcohol 62 
 
 Chrome pigments 62 
 
 Quinine 62 
 
 Manganese 62 
 
 Brass founders 62 
 
 Arsenical fumes 63 
 
 Mercury 63 
 
 Phosphorus 64 
 
 Beet-sugar industry 64 
 
 m6^S»3 
 
 III 
 
IV TABLE OF CONTENTS. 
 
 Page. 
 Chapter VI. — Occupations involving the inhalation of organic gases and 
 
 vapors 65 
 
 VII. — Occupations involving exposure to extremes of heat, sudden 
 
 changes, and abnormal atmospheric pressure 65 
 
 Caisson disease 66 
 
 VIII. — Occupations involving constrained attitudes 67 
 
 IX. — Occupations involving over exercise of parts of the body 67 
 
 X. — Occupations involving exposure to machinery, etc 67 
 
 Coal mining 68 
 
 Railway service 71 
 
 Railway accidents 71 
 
 Accidents and injuries 73 
 
 XI. — Employment of women and children 74 
 
 XII. — Special measures for the prevention of tuberculosis among 
 
 wage-earners 80 
 
 XIII. — Measures for the protection of wage-earners 81 
 
 Sanitation of workshops and quarters for employees 82 
 
 Cubic air space and amount of fresh air per hour 83 
 
 Ventilation 84 
 
 Temperature 86 
 
 Humidity of the air 87 
 
 Lighting 88 
 
 Artificial light 88 
 
 Prevention of accidents 89 
 
 Miscellaneous sanitary provisions 91 
 
 Lodging houses and sleeping quarters 93 
 
 Permanent expositions devoted to industrial and social 
 
 betterment of wage-earners 93 
 
 XIV. — What the Federal Government may do for the promotion of the 
 
 welfare of its employees 94 
 
 German workingmen's insurance system 95 
 
 XV. — What the employer may do for the welfare of employees 100 
 
 XVI. — What the general public may do 102 
 
 XVII. — What the employee may do to contribute to his own welfare. . 107 
 
 Part II. — Social Betterment. 
 
 Chapter I. — How to keep well and capacitated for work 109 
 
 H ouse and home 109 
 
 House cleaning 110 
 
 Temperature Ill 
 
 Insects Ill 
 
 Care of the skin 113 
 
 Ablutions and baths _ 113 
 
 • Clothing 114 
 
 Bed and bedding 117 
 
 Sleep 117 
 
 Importance of good teeth 119 
 
 Habit and regularity of the bowels 120 
 
 Care of the eyes 120 
 
 Care of the ear and nose 121 
 
 IL — Alimentation and foods 121 
 
 Animal food 127 
 
 Vegetable food 132 
 
 Combination of food 135 
 
 Storerooms 136 
 
 Preparation of food for cooking 137 
 
 Cooking and eating utensils 137 
 
 Volume of food 138 
 
 Meal hours 138 
 
 Good food at reasonable cost 139 
 
 Approximate weight and nutritive value of an average por- 
 tion of some common food 142 
 
 Food value of breakfast 143 
 
 Food value of lunch 1 44 
 
 Food value of dinner 144 
 
 Food value of day's ration 144 
 
TABLE OF CONTENTS. V 
 
 Chapter II. — Alimentation and foods — Continued. Page. 
 
 Food and home betterment 150 
 
 Menus for winter months 151 
 
 Menus for summer months 152 
 
 Cooking recipes for winter menus 152 
 
 Cooking recipes for summer menus 1.54 
 
 Market price of foods 156 
 
 Quantities of material to be used 156 
 
 III. — The causes and prevention of infectious diseases 157 
 
 Danger periods in hfe. 157 
 
 Sick room, care and disinfection 162 
 
 Consumption 165 
 
 Pneumonia 173 
 
 Influenza (*'la grippe") 174 
 
 Typhoid fever 175 
 
 Causes of typhoid fever 177 
 
 Typhoid fever in the rural districts 179 
 
 Why is there more typhoid fever in Washington than in 
 
 northern cities 180 
 
 Diarrhea and dysentery 182 
 
 IV. — Infantile mortality 18 3 
 
 Maternal nursing 188 
 
 The anatomical and physiological characteristics of infants. 189 
 
 Care of the breasts 190 
 
 Frequency of nursing 190 
 
 Weaning of infants 191 
 
 Cow's milk as a cause of disease 193 
 
 Milk sediments or dirty milk 193 
 
 Production of pure milk 195 
 
 Certified milk 195 
 
 Pasteurized milk 11)6 
 
 Pasteurizing plants — milk depots 1 96 
 
 Advantages and disadvantages of pasteurized milk 196 
 
 Home treatment of nursery milk 198 
 
 Quantity of food for each feeding 199 
 
 Care of the nursery refrigerator, nursing bottles, nipples, 
 
 utensils, etc 199 
 
 V. — The prevention of permanent disabilities in children 200 
 
 VI.— The health of the city of Washington 204 
 
 Relations of water supply and sewers to health 206 
 
 Filtration of the Potomac water 207 
 
 Influence of sewers upon the health of the community 207 
 
 Decrease in death rates since 1875 ._- 209 
 
 Causes of large death rates among the colored race 210 
 
 Regeneration of housing conditions 212 
 
 The present situation 212 
 
 Congress and the health of the District 213 
 
 VII. — Sexual and moral prophylaxis 213 
 
 Vice diseases 215 
 
 Syphilis 220 
 
 Gonorrhea 221 
 
 Crusade against the social evil 222 
 
 Educational methods 225 
 
 State methods 227 
 
 VIII.— The tobacco habit 229 
 
 IX.— The alcohol question 230 
 
 Fermented liquors 280 
 
 Wines and fruit wines 231 
 
 Beers 232 
 
 Brandv 233 
 
 Rum ; 233 
 
 Whisky 234 
 
 The nation's drink bill 234 
 
 Alcohol as a foodstuff 337 
 
 Physiological effects of alcohol 237 
 
 Pathological effects of alcohol 238 
 
 Alcohol increases the susceptibility to disease 238 
 
 Effects of alcohol upon longevity 239 
 
VI TABLE OF CONTENTS. 
 
 Chapter IX. — The alcohol question — Continued. Pflge. 
 
 Effects of alcohol upon mental and moral faculties 239 
 
 Alcohol as a cause of accidents 240 
 
 Causes of intemperance 241 
 
 Poverty and drink 242 
 
 Remedial measures. .'. 244 
 
 List of alcoholic proprietary medicines 246 
 
 Recreations and inexpensive amusements 249 
 
 X. —The drug habit 251 
 
 Danger of soft drinks containing habit-forming drugs 256 
 
 Remedial measures for the victims of the alcohol and drug 
 
 habit 257 
 
 Advertised habit cures 259 
 
 The harmful effects of so-called "ethical pro])rietary medi- 
 cines, acetanilid, antipyrin, and phenacetin" 260 
 
 Thyroid extracts in obesity or antifat cures 261 
 
 The nostrum evil in general 202 
 
 Prevention of conception and feticide — Regulation of 
 
 families 264 
 
 Infanticide by systematic drugging of childi en 266 
 
 Diphtheria cures 267 
 
 Injury and death to the adolescent 268 
 
 Consumption cures 268 
 
 Asthma and hay fever cures 269 
 
 Catarrh cures 270 
 
 Skin cures 271 
 
 Rheumatism cures . .- 272 
 
 Kidney and bladder cures 273 
 
 Cancer cures 274 
 
 Epilepsy cures 274 
 
 The miracle workers 277 
 
 Other forms of quackery 278 
 
 Topical remedies 278 
 
 Prescription nostrums 279 
 
 Efficient work of the Post-Office Department and of the 
 Department of Agriculture in enforcing the law arouses 
 
 opposition 281 
 
 Conclusions and recommendations 283 
 
 XI. — Sociological study of 1,251 families 284 
 
 Living conditions 286 
 
 Income and expenditures 287 
 
 Occupations 290 
 
 Employment 292 
 
 Wage-earners' lunches 293 
 
 Sickness 293 
 
 Insurance 294 
 
 Installment payments 295 
 
 Illiteracy 295 
 
 School attendance 296 
 
 XII. — The business relations of wage-earnersN 297 
 
 XIII. — The scale of wages and the cost of living 300 
 
 Compensation of government employees 303 
 
 XIV. — Suppression of usury.'. 305 
 
 The money borrower 307 
 
 The money lenders and their methods 308 
 
 Remedy proposed 310 
 
 XV. — How to benefit the poor in the slums 318 
 
 Appendix A. Healthof employees in the Government Print- 
 ing Office, Washington, D. C, Wm. J. Manning, M. D.. 323 
 Appendix B. Regulation of dangerous trades in England. . . 328 
 Appendix C. Letters from Professor H. W. Wiley and Dr. 
 L. T. Kebler, Bureau of Chemistry U. S. Department of 
 
 Agriculture 371 
 
 Judge de Lacy 's letter 380 
 
LETFER OF TRANSMIITAL. 
 
 To THE Senate and House of Eepresentatives : 
 
 I transmit herewith reports by the President's Homes Commission 
 on improvement of existing houses and elimination of insanitary and 
 alley houses, on social betterment, and on building regulations, to- 
 gether with resolutions and recommendations adopted by the com- 
 mission, and ask that they receive the careful consideration of the 
 Congress. 
 
 Theodore Roosevelt. 
 
 The White House, 
 
 January 5, 1909. 
 
THE PRESIDENT'S HOMES COMMISSION. 
 
 REPORT OF THE COMMITTEE ON IMPROVEMENT OF 
 
 EXISTING HOUSES AND ELIMINATION OF 
 
 INSANITARY AND ALLEY HOUSES. 
 
 BY 
 
 WILLIAM H. BALDWIN, 
 
 Chairman of the Committee. 
 
 COMMITTEE. 
 
 WILLIAM H. BALDWIN. T. C. PARSONS. 
 
 F. L. SIDDONS. WILLIAM F. DOWNEY. 
 
 S. W. WOODWARD. PROF. GEO. W. COOK. 
 
 EMMETT L. ADAMS. 
 
 S. Doc. 644, 60-i 
 
REPORT OF THE COMMITTEE ON IMPROVEMENT OF EXISTING 
 HOUSES AND ELIMINATION OF INSANITARY AND ALLEY 
 HOUSES. 
 
 The report of the committee on the improvement of existing houses 
 and the elimination of insanitary and alley houses naturally relates 
 to the improvement of houses which are in any way unsafe or detri- 
 mental to the health or morals of their occupants, or in case the 
 owners do not think it worth while, or are unwilling to put them into 
 proper condition, to their demolition, in order that the health of the 
 people may not be injured by reason of them. Closely connected with 
 the latter part of the subject is the question of alley houses, which 
 may be structurally fit for habitation but which are so located as to 
 make it practically impossible to supply them with proper sanitary 
 conveniences, or to make the moral and social surroundings what 
 they ought to be. 
 
 IMPROVEMENT OP EXISTING HOUSES. 
 
 At the time the committee made its preliminary report it was stated 
 that the work of improving existing houses was being wisely and 
 effectively carried on by the board for the condemnation of insanitary 
 buildings, under the law of May 1, 1906. The evils due to the condi- 
 tion into which a large number of ihe temporary and cheap structures, 
 rendered necessary by circumstances succeeding the war, had fallen 
 was long ago recognized, and in 1872 the board of health, which had 
 been created by an act of Congress in the previous year, formulated 
 a specific ordinance covering the condemnation of insanitary dwell- 
 ings, under which in 1874, S89 were condemned, followed by 198 in 
 1875 and 371 in 1876 ; but the work was stopped not long afterwards 
 by the reorganization of the health department, in which the power 
 to condemn buildings unfit for habitation was not provided for." 
 
 The necessity for further action continued, and as early as 1897 
 definite steps were taken toward the passage of a bill providing for the 
 condemnation of buildings dangerous to the health or their occupants. 
 These efforts were continued during successive years and in March, 
 1902, the Associated Charities formed a subcommittee on the improve- 
 ment of housing conditions, of which the first purpose was stated to 
 be the passage of a law which would enable the District Commission- 
 ers, through the health department, to require the adequate repair or 
 removal of dwellings unfit for human habitation ; but each year some 
 objection to the proposed bill was made and it was not until May 1, 
 1906, after nine years of effort, that it was passed in its present form. 
 The necessity of the bill, and the care with which it had been drawn, 
 are shown by the excellence of the results obtained under it. 
 
 <» Housing Movement in City of Washington, Dr. G. M. Kober, p. 6. 
 
4 EEPOETS OF THE PBESIDENT's HOMES COMMISSION. 
 
 The board to whom the enforcement of the law is by the act itself 
 committed consists of the assistant to the Engineer Commissioner in 
 charge of buildings, the health officer, and the inspector of buildings 
 of the District, but the immediate execution of its requirements is in 
 the hands of an inspector who is thoroughly interested in his work, 
 and who has helped to administer the law in such a way as to secure 
 the necessary results with the least possible hardship to the people 
 who have been compelled by the destruction of the houses in which 
 they were living to seek shelter elsewhere. 
 
 Active work under the law was begun on July 1, 1906, and during 
 the two years ending on June 30, 1908, the results had been as follows : 
 
 
 Examined. 
 
 Demol- 
 ished. 
 
 Repaired. 
 
 Pending. 
 
 Allevs 
 
 331 
 628 
 
 213 
 332 
 
 97 
 
 127 
 
 21 
 
 Streets 
 
 169 
 
 
 
 Total 
 
 959 
 
 545 
 
 224 
 
 190 
 
 
 
 Of the 769 buildings acted on 204 had been demolished and 94 
 repaired in the first year, and 341 were demolished and 130 repaired 
 in the second year. 
 
 It will be noticed that in the year 1907 the houses demolished 
 amounted to 68.4 per cent of the cases disposed of and 72.5 per cent 
 in the second year. 
 
 It is probable that the proportion of houses demolished will be 
 smaller in future, as the accumulation of dilapidated buildings ac- 
 counts for a considerable portion of those which have been removed, 
 and the tendency as to those which remain is to make repairs. This 
 has been done in a large number of cases, and in addition many 
 buildings, equal, as far as can be determined by permits issued, to 
 three-quarters of those repaired by order of the board, have been 
 voluntarily repaired and put into proper condition by their owners 
 because they have known that if this was not done the board could, 
 and would, take action in regard to them. 
 
 The benefit which has resulted to those of the community most in 
 need of help through the salutary provisions of this law is apparent, 
 and it is a matter of congratulation that in accomplishing these satis- 
 factory results there has been so little friction or complaint of arbi- 
 trary or unjust action. 
 
 During the last year 6 cases were referred to the corporation coun- 
 sel for appropriate action in the police court. In one case the owner 
 was fined $10 for failure to demolish, and in another the party was 
 sent to the workhouse for five days for contempt of court, while the 
 remaining cases ended in proper action by the defendants. These 
 instances emphasize the sincerity with which the law has been exe- 
 cuted. 
 
 The law contains a provision for appeal to the supreme court of 
 the District from the orders of the board, and two such appeals were 
 made during the last year ; but in one case it was shown that the time 
 for appeal had expired, and the other case was abandoned, so that 
 the 9 houses involved in both were demolished without further delay 
 or any cost to the board. 
 
BEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 5 
 
 For the 94 houses repaired in 1907 no record of the number of 
 occupants was kept. The 130 repaired in 1908 contained 609 people 
 who were benefited by the improvement, an average of 4.7 per house. 
 
 The number of people whose lives have been made more comfort- 
 able by repairs voluntarily made by the owners of the houses on ac- 
 count of this law can not, of course, be determined, but it is evident 
 that a most gratifying advance in the standard of living has been 
 made and that the reproach of Washington in this respect is being 
 taken away. 
 
 This does not mean that these homes are as yet all that could be 
 desired, or that other improvQments in these and other houses might 
 not well be made ; but to interfere with the independence of citizens, 
 so long as the conditions in which they live are not dangerous to the 
 health or morals of themselves or others, would be doing an indirect 
 injury to our political and social status, and it is far better that the 
 further improvement should be worked out by other influences than 
 the strong arm of the compelling law. 
 
 In its last report the board for the condemnation of insanitary 
 buildings says: 
 
 Bad housekeeping and general neglect are responsible for a great many 
 houses being brought to the attention of the board, where, by proper attention 
 to the ordinary household duties, there would be no occasion for complaint. 
 The throwing of ashes and rubbish in the back yard, instead of placing it in 
 cans for authorized collectors, results in the yard being elevated above the 
 door in such a manner that ventilation under the floor is prevented, and it is 
 possible for water to flow in during rain and snow storms, causing the floors 
 to be damp. The habits of different tenants can be better noted in rows of 
 houses where they are occupied under the same general conditions and the 
 character of the houses is practically the same. One will be found in a 
 clean and sanitary condition; others will be found filled with a general ac- 
 cumulation of trash, with no attempt whatever to keep even within a semblance 
 of cleanliness. 
 
 In the annual report for 1907 the board called attention to the fact that some 
 provision should be made for a school wherein good housekeeping could be 
 taught, in order to teach the ignorant how to properly take care of themselves 
 and their homes, which is an absolute benefit both to the occupants and the 
 adjoining residents. Conditions have not materially changed since the above 
 suggestion was made and the board, therefore, reiterates the statement. 
 
 The inspector said that in one case where the board had required 
 a sewer connection to be made, the trench which was dug showed a 
 geological formation of 4 feet 2 inches of ashes, which had been 
 thrown into the back yard, instead of being put into the hands of the 
 collector of rubbish for removal. 
 
 This field, however, appertains rather to the work of the committee 
 on social betterment, which has a firmer foundation on which to 
 build now that the experience of two years has demonstrated that 
 a line has at last been drawn in Washington below which the con- 
 ditions of any habitation can not fall without its being torn down and 
 removed by constituted authority. 
 
 There are still many houses which need repairs, and others, through 
 the neglect of the owners, or perhaps as often through the carelessness 
 of tenants, are getting into a condition which requires attention. 
 Some, where notices are now being served by the inspector, have 
 become unfit since the law was passed, showing the need of constant 
 watchfulness ; but the present method promises to secure satisfactory 
 results. 
 
6 
 
 EEPOETS OF THE PKESIDEKT S HOMES COMMISSION. 
 
 During the last two years a special inspector has been working 
 under the authority given to require connections, where the street is 
 provided with water and sewers, so that there are now comparatively 
 few brick houses, even in alleys, which do not have both; and ex- 
 tensions of water pipes are being steadily made. Residents who fail 
 to comply with the order to connect are taken into the police court, 
 and in case of nonresident owners the District government now makes 
 the needed improvements, under the compulsory drainage act, and 
 charges the cost up against the property. 
 
 The building regulations require 8-foot ceilings as a minimum and 
 all new houses or additions must conform to this, though repairs are 
 sometimes permitted when ceilings are 7 feet 6 inches or even not 
 higher than 6 feet 5 inches, but where they are lower than this the 
 owner must either raise the ceiling or demolish the building, so 
 that such cramped sleeping rooms are being done away with. 
 
 ELIMINATION OF INSANITARY HOUSES. 
 
 As has been intimated, the demolition of houses unfit for human 
 habitation has gone on steadily since July 1, 1906, and in addition 
 to the 545 up to June 30, last, 127 were torn down in the next five 
 months, maJking 672 demolished in all, of which 245 were in alleys 
 and 427 in streets. The proportion is due partly to the fact that 
 the streets contain more houses, and partly to the fact that, 
 because no more dwellings can be built in alleys, owners repair alley 
 houses which they would destroy if they could substitute new ones 
 for them. 
 
 Up to this time the houses acted on have been mostly one or two 
 story buildings, but there are larger ones which need attention, some 
 of them residences converted into flats which accommodate several 
 families. These are being taken up and one of them in Georgetown, 
 a three-story brick, built in 1834 and known as Foxhall Mansions, is 
 now being torn down. 
 
 The committee has kept in touch with this work and there has 
 seemed to be no occasion, in view of all the circumstances, to criticise 
 the rate at which it is being carried on. In certain cases the in- 
 spector has been obliged to extend the time for the vacation of build- 
 ings to be demolished on account of the inability of the tenants to 
 find other dwellings within their means, and while there should be 
 no cessation of the activity of the board the absorption of displaced 
 tenants can not be effected with much greater rapidity. 
 
 The persons compelled to vacate the dwellings removed were as 
 follows : 
 
 Year ending- 
 
 Houses 
 demol- 
 ished. 
 
 Persona displaced. 
 
 Average per house. 
 
 Adults. 
 
 Children. 
 
 Total. 
 
 Adults. 
 
 Children. 
 
 Total. 
 
 June 30 1907 
 
 204 
 341 
 
 355 
 629 
 
 203 
 
 427 
 
 558 
 1,056 
 
 1.7 
 1.9 
 
 10 
 1.2 
 
 2 7 
 
 June 30, 1908 
 
 3 1 
 
 
 
 Total ... 
 
 645 
 
 984 
 
 630 
 
 1,614 
 
 1.8 
 
 1.2 
 
 3.0 
 
 
 The small average is due to the fact that many of the houses were 
 vacant, especially in the first year. Counting only those actually 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 7 
 
 occupied, the average number in the families turned out would prob- 
 ably be five. 
 
 Some effort was made to determine definitely what became of 
 these people, but it has been difficult to do this because they quit the 
 premises at any time after notice is served, leaving the house vacant, 
 and no record is made of them. 
 
 Of the 1,056 persons displaced in the last year 13 were white, 1 was 
 a Chinaman, and 1,042 were colored. The report for the year says4 
 
 A small portion of these tenants is going to the suburbs and rentyig or 
 purchasing cheap houses, but the large majority are remaining within the city. 
 A great many are renting the ordinary two-story brick and subletting rooms, 
 or two families rent one house between them, one taking the upstairs and the 
 other the downstairs, converting it practically into a two-family flat, but with 
 none of the accommodations usually found in a building of that character. 
 There is, at the present time, an unquestionable demand for the cheaper class 
 of houses to take the place of those being destroyed. 
 
 A further analysis of the facts shows that the houses removed 
 during the year ending June 30, 1908, were assessed for taxation at 
 $40,800 and that they had a rental value of $16,502.40. The average 
 of property in an alley which was investigated as to its assessed 
 value recently showed the land to be 35 per cent of the total, and 
 assuming that it was 40 per cent for that from which the above houses 
 were removed, and that the actual value of the property is 50 per 
 cent more than the assessed valuation, the rentals indicate a gross 
 return of 16 per cent on the investment. 
 
 The rental value figures out $4.03 per month per house; but the 
 report of the committee on building of model houses (p. 63) says 
 that not one dwelling has been erected in Washington in the last 
 five years which could be rented as low as $12 per month, and not 
 more than 15 which could be rented as low as from $14 to $16.50 per 
 month. The demolition of the houses in question, therefore, was not 
 offset, so far as these people were concerned, by any new provision of 
 which they could avail themselves, and sharing with others houses 
 too expensive for one such family, with all the disadvantageslsuch an 
 arrangement in houses not built for the purpose involves, afforded 
 about the only means of shelter in the city. 
 
 There are a few vacant houses in alleys which rent for from $8 
 per month up; but even one of these requires a considerable readjust- 
 ment of the family budget for a tenant who has been paying but $4, 
 and most of the cheapest houses which are vacant, even in alleys, rent 
 for $10 per month or more. 
 
 It is evident that such conditions, in connection with the incli- 
 nation to demand more rent from colored people who desire to occupy 
 decent houses, tend to keep rents high and render living properly on 
 the wages of a day laborer still more difficult. 
 
 THE ELIMINATION OF ALLEY HOUSES. 
 
 By far the best way to do away with alley houses is to do away 
 with the alleys by converting them into minor streets. So much has 
 been said and written about the disadvantages of the alleys of Wash- 
 ington and the evils of having scattered through the heart of the 
 city a population discredited by the very location of their dwellings, 
 and the difficulty of caring for and supervising them although really 
 
8 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 in very close contact with the best residences of the city, that the 
 problem seemed to be one requiring action rather than argument; 
 and as " the rearrangement of the building space within the larger 
 squares of the District of Columbia " was stated by Mr. Reynolds 
 to be one of the purposes of the commission recommended in his 
 report and as the work of improving existing houses and eliminating 
 other insanitary houses has been progressing satisfactorily, as de- 
 scribed above, this committee has devoted its chief energy to assist- 
 ing in the conversion of the undesirable alleys into minor streets. 
 
 Under the law of July 22, 1892, as amended on August 24, 1894, 
 the Cominissioners at the time of the appointment of the conmiission 
 had taken action in 12 cases upon the advice of a board consisting of 
 the chief of police, the secretary of the board of charities, and the 
 surveyor of the District, which had been appointed by the Commis- 
 sioners for the purpose of investigating and advising them in regard 
 to the alleys which most needed to be opened up because the conditions 
 in them were detrimental to the general welfare of the city. 
 
 As was stated in the preliminary report the progress of this work 
 had been interrupted by the decision of the Supreme Court of the 
 United States in the Brandenburg case on March 11, 1907, which 
 declared it illegal to assess all the damages on certain property as 
 provided by the existing law unless the property was found to be 
 benefited to that extent. 
 
 The Commissioners at the time expressed the intention of having 
 the law amended at the coming session of Congress so as to remove 
 this obstacle and anticipated no difficulty in doing this ; and as noth- 
 ing further could be done in such cases without this further authority, 
 the committee kept in touch with the situation and waited for the 
 necessary action to be taken. 
 
 In the first days of January last, before Congress convened after 
 the holiday recess, it was stated in one of the papers that the Engineer 
 Commissioner, who had succeeded to the office after the proceSiings 
 had been begun, had recommended that the cases in three of the alleys 
 be dropped because he had inspected them and was of the opinion 
 that the expenditure of the sums necessary to pay the damages which 
 would be incurred in opening them up as proposed would not be 
 justified. 
 
 One of these cases is Blagden's alley, square 368, concerning which 
 the chief of police and his associates on the board stated in the recom- 
 mendation for its conversion into a minor street that — 
 
 Blagden's alley, located between Ninth and Tenth and M and N streets, con- 
 tains 54 houses inhabited by a negro element who live in poverty and are a 
 source of constant trouble. The dwellings are insanitary and dilapidated and 
 afford shelter to ten or twelve persons each. 
 
 Another is square 620, as to which the board reported : 
 
 Logan's place contains 35 insanitary dwellings, which are very much over- 
 crowded, and the Inhabitants, being of a vicious character, give the police more 
 or less trouble. 
 
 Everyone familiar with these and other such labyrinths realizes 
 the security from police supervision which they afford, to say nothing 
 of other disadvantages which fully justified the recomimendation of 
 the board. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 9 
 
 There was no suggestion of any other plan, and the only reason 
 given was that it was not worth while to spend the money required 
 to do away with the wretched conditions by which the city has been 
 for so long disgraced, and as this objection, if sustained, would make 
 permanent such conditions in these three alleys, which are among the 
 worst in the city, and put the whole matter upon a different basis, the 
 committee took the subject up with the Commissioners and strongly 
 urged that no effort be spared to pursue the original plan of the 
 Commissioners, and to provide some way by which they could proceed 
 to open up such alleys as they might, after investigation, think it worth 
 while to convert into minor streets. These suggestions were cordially 
 received by the other two Commissioners, and it was understood that 
 the subject would be discussed with the corporation counsel with a 
 view to arriving at the best way of accomplishing this object, and 
 that any assistance which the committee could give would be wel- 
 comed. 
 
 The committe therefore consulted with the corporation counsel and 
 looked up the law in other places, but as one of the Commissioners 
 was compelled to go to the hospital for a considerable stay, not long 
 after this, further action was delayed. The situation, which was fully 
 reported to the commission at a meeting held January 17, 1908, seemed 
 so serious that the commission adopted a resolution urging that the 
 District Commissioners " take all possible steps toward opening alleys 
 into minor streets in each case recommended by the committee ap- 
 pointed for the purpose, and that such changes in the present law be 
 recommended by the Commissioners as will permit the conversion of 
 these alleys or any others into minor streets, to the end that all such 
 alleys may within a reasonable time be done away with;" and the 
 report of the committee, with this resolution, was submitted to the 
 Commissioners by the chairman of the President's Homes Com- 
 mission. 
 
 The principal difficulty with the present law seemed to be that it 
 required that an amount equal to the damages found should be as- 
 sessed as benefits and that this should be assessed within a limited 
 area. It was found tliat the law of 1906 in relation to the opening, 
 extension, widening, or straightening of streets, provided that the 
 jury should assess benefits not only upon adjoining and abutting prop- 
 erty, but upon any and all other lots, pieces, or parcels of land which 
 the jury might find to be benefited by the improvement. This ap- 
 parently indicated a plan by which the amounts required could be 
 raised in a more equitable manner, but as it seemed probable that in 
 many case? the damages awarded would even then exceed the benefits 
 which the jury might find, it seemed desirable to include also a pro- 
 vision by which a certain proportion of the awards could, if necessary, 
 be paid out of some general fund. 
 
 One of the Commissioners had suggested, when the Engineer Com- 
 missioner recommended that the work be stopped on account of the 
 expense, that legislation might be urged providing that the alleys 
 be opened and a certain proportion of the expense be paid by the 
 United States Government, another portion by the District govern- 
 ment, and the remainder be assessed upon the property owners in the 
 neighborhood of the improvement Inasmuch as the deplorable con- 
 ditions of the alleys have grown up under the administration of the 
 
10 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 District government, it seems proper that a considerable portion of 
 the expense of removing them should be borne in this way by those 
 responsible for them; but, as any payment for District purposes by 
 the Federal Government would be contrary to the definite policy 
 adopted by Congress, it did not seem advisable to the committee to 
 advocate such a provision. 
 
 In order, however, to expedite the passage of any bill recommended 
 and to profit by the advice of the District Committee in each House 
 of Congress, as well as to secure their cooperation in any plan which 
 might be proposed, the committee consulted with the chairman of 
 each of the District Committees as to what fair provision would be 
 most effective. The chairman of the Senate Subcommittee on Streets 
 and Avenues declared that conditions which he had himself recently 
 witnessed in the alleys of the city ought nowhere to exist, and that 
 he would be glad to do all he consistently could to remove them. 
 After full discussion he stated that if the amount to be paid from the 
 general funds of the District could be limited to 25 per cent of the 
 total damages awarded in any case, and the remainder be assessed 
 upon any property benefited, he would earnestly recommend such a 
 provision, with the full expectation that such a bill might be promptly 
 passed by Congress. 
 
 The chairman of the House committee, when consulted, concurred 
 in this view and promised similar cooperation. A meeting of the 
 commission, at which this plan was unanimously indorsed, was 
 promptly held and the recommendation for such a bill was imme- 
 diately put before the Commissioners by the committee, with every 
 reason to expect that it would be promptly acted upon, so that the 
 measure might be passed before Congress adjourned. 
 
 Notwithstanding the fact that two of the Commissioners were 
 heartily in favor of the general plan, the matter was delayed, and 
 upon inquiry it was found that the Engineer Commissioner strongly 
 objected to the plan proposed, on the ground that no jury would be 
 apt to assess in any case more than 75 per cent of the damages found, 
 and that in this way the District would be made to pay for 25 per 
 cent of the cost of opening many alleys and minor streets in property 
 where the expense should all be borne by the property owners who 
 requested it. As further investigation developed the fact that there 
 are numerous cases of this kind to which it was not intended to have 
 this provision apply, the matter was again taken up with the corpora- 
 tion counsel and a modification adopted limiting the operation of 
 this provision in each case to the conversion of alleys into minor 
 streets running through the block. 
 
 When, however, this reached the Engineer Commissioner he still 
 objected to the bill on the ground that it was likely to do injustice to 
 the District, declaring that juries would not assess greater damages 
 in any case than they were compelled to and that the only way to meet 
 the situation was to introduce a special bill in Congress for each alley. 
 
 As the special bills introduced for this purpose in reference to 
 squares 1020, 878, and 801 had received no attention and the amount 
 of effort needed to secure the passage of any bill is very great, and as 
 it would be necessary in the case of each special bill to take up the 
 attention of Congress with the objections of interested parties which 
 could better be considered and attended to by the Commissioners, who 
 
EEPOBTS OF THE PRESIDBlirT's HOMES COMMISSIOK. 11 
 
 have m<M*e immediate knowledge of the circumstances, the committee 
 still urged that the plan proposed by the bill be followed and that the 
 solution of the alley problem be not simply left to a system under 
 which it has been growing steadily worse. 
 
 It was therefore suggested that the whole subject be taken up at 
 a conference of the Ck)mmis.sioners, the corporation counsel, and the 
 committee ; but the conferences and references had taken so much time 
 that, on account of the legislative situation developed toward the 
 close of the last session of Congress, it was by this time found that the 
 enactment of the measure at that session was wholly impossible, and 
 the proposed conference was not held until May 29. 
 
 At this conference the three Commissioners, with two assistants of 
 the corporation counsel and the surveyor and two members of the 
 committee, were present. The whole subject was thoroughly dis- 
 cussed, and the objection of the Engineer Commissioner that the 
 proposed amendment might result in the payment by the District of 
 some of the damages in certain cases where they ought to be paid by 
 the property owners was considered, as well as the objection that 
 even under this provision some alleys could not be opened, because 
 the difference would still be more than the 25 per cent provided for. 
 One of the other Commissioners, however, met the situation squarely 
 by saying that, although the law might in this way work some dis- 
 advantage to the District in certain cases, he thought this would be 
 more than offset by the advantage of having a law under which the 
 Commissioners could proceed according to their judgment in so many 
 cases in which the alleys ought to be replaced by minor streets, and 
 that he was ready to recommend the proposed bill. As there seemed 
 to be no way of overcoming the objections of the Engineer Commis- 
 sioner, and no better way of meeting the difficulty, the other Commis- 
 sioner declared that the matter having now received full considera- 
 tion, he also would approve the bill. It was therefore understood 
 that the bill, which is as follows, would be promptly introduced at 
 the present session : 
 
 Be it enacted lyy the Senate and House of Representatives of the United States 
 of America fh Congress AssemUed, That section 1608 j of the act of Congress 
 entitled "An act to establish a code of law for the District of Columbia," 
 approved March 3, 1901, as amended by the act of Congress approved Feb- 
 ruary 23, 1905, be, and the same is hereby, amended to read as follows : 
 
 Section 1608 j. That said jury shall assess as benefits accruing by reason of 
 said opening, extension, widening, or straightening an amount equal to the 
 amount of damages as ascertained by them as hereinbefore provided including 
 five dollars per day for the marshal and five dollars per day for each juror 
 for the services of each when actually employed, and all other expenses of such 
 proceedings upon each lot or part of lot or parcel of land in the square or block 
 in which said alley or minor street is to be opened, extended, widened, or 
 straightened, and upon each lot, part of lot, or parcel of ground in the squares 
 or blocks confronting the square in which such alley or minor street is to be 
 opened, extended, widened, or straightened, which will be benefited by such 
 opening, extension, widening, or straightening, in the proportion that said jury 
 may find said lots, parts of lot^ or parcels of land will be benefited : Provided, 
 however, That whenever the Commissioners of the District of Columbia, under 
 the foregoing provisions, shall institute proceedings for the widening or extension 
 of any alley so as to convert said alley into a minor street through the square in 
 which said alley is located, such an amount of the total amount of damage as 
 ascertained by the jury, as hereinbefore provided, including five dollars per 
 day for the marshal and five dollars per day for each juror for the services 
 of each when actually employed, and all other expenses of such proceedings, 
 fhall be assessed by the said jury as benefits, and to the extent of such benefits 
 
12 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 upon each lot, or part of lot, or parcel of land in the square or block in which 
 such alley is to be converted into a minor street, and upon any and all other 
 lots, pieces, or parcels of land which the jury may find will be benefited by the 
 said widening or conversion of such alley into such minor street, as the said 
 jury may find said lots or parts of lots, pieces or parcels of land will be bene 
 fited ; and in determining the amount to be assessed against such lots, or parts 
 of lots, pieces or parcels of land, the jury shall take into consideration the 
 respective situations and topographical conditions of such lots, or parts of lots, 
 pieces or parcels of land, and the benefits and advantages they may severally 
 receive from the said widening or conversion of such alley into such minor 
 street. If the total amount of the damages awarded by said jury, and the costs 
 and expenses of the proceeding be in excess of the total amount of the assess- 
 ments for benefits, such excess shall be borne and paid by the District of 
 Columbia : Provided, That such excess so to be paid by the District of Columbia 
 shall in no case exceed twenty-five per centum of the whole amount of the 
 damages as ascertained by the said jury. 
 
 The commissioners are not obliged to accept an award unless they 
 think it for the benefit of the public to do so, but can annul the whole 
 proceeding, so that they can still fully protect the interests of the 
 community. 
 
 In accordance with this understanding the bill was brought to the 
 attention of the commissioners just before the opening of the present 
 session of Congress. It has received their approval and is to be 
 introduced by them with a request for its speedy enactment. 
 
 While the committee is greatly disappointed at its failure to secure 
 the expected legislation at the last session of Congress, it is to be 
 hoped that the proposed measure will be promptly passed at this 
 session, and that under it the commissioners will be able to reach 
 many cases of alleys which ought to be opened. 
 
 The facts brought out in this discussion, when considered in the 
 light of the experience in other places, suggest the advisability of 
 going still further in the endeavor to reach the difficulty. The Dis- 
 trict officials who have had the conduct of these appropriation cases 
 are all of the opinion that juries are, perhaps unconsciously, inclined 
 to be liberal in fixing the amount of damages that are to be awarded 
 to property owners and that in the same manner they are reluctant 
 to assess upon adjoining property as much benefit as it is likely to 
 receive from the change in conditions. The result of this is that so 
 far as the District is called upon to make up the differences it suffers 
 in both ways. Those whose property is partly taken receive a high 
 price for what they dispose of, while the remaining portion is made 
 more valuable by the street which is opened. Square 513 contains 
 a minor street called Ridge street, which runs through the block in 
 place of the usual alley. An investigation made two years since by 
 the committee on improvement of housing conditions in this and the 
 adjoining square, No. 512, which contains Kings court, showed that 
 the land in the interior of square 513, where the minor street had 
 been opened some years before, was assessed for taxation at an aver- 
 age of $0.41 per square foot, while the land in the interior of square 
 512 in which the alley conditions still remained, although having 
 more frontage in proportion to its depth, was assessed at $0.24 per 
 square foot, indicating, at the ordinary rate of valuation, actual 
 values in each case of $0.36 and $0.62 per square foot, more than 
 70 per cent greater in the square with the minor street. 
 
 The lots fronting on Ridge street contain 127,332 square feet, on 
 which a difference of 26 cents per square foot would amount to 
 
EEPOETS OF THE PKESIDBNT's HOMES COMMISSION. 13 
 
 $33,106, which was more than the estimated cost of opening the alley. 
 One of the last acts of the committee on the improvement of hous- 
 ing conditions was to request the action which was afterwards taken 
 by the Commissioners in regard to this square, which is the only one 
 in which the alley has been actually converted into a minor street, 
 though that in square 650, which was also confirmed by the court 
 and in which a difference about titles has been cleared away by an 
 act of Congress just passed, will now be opened also. The total 
 cost of opening the alley in square 612 was $28,851.20, less than the 
 difference in value between it and the adjoining square. 
 
 It is of course too soon to tell whether an increase to the level of 
 property values in square 513 will take place in square 512 on ac- 
 count of the improvement, but the suggestion has been made by 
 those who are familiar with the facts that if, instead of paying at 
 such a high rate for only part of the property and getting none of 
 the resulting benefits, the District would take the whole of the prop- 
 erty affected and itself receive the benefit of the enhanced values, 
 the cost to the community of removing the alley evils would be very 
 much lessened. 
 
 This brings in a principle which is new here but which is not un- 
 known in other countries, and to which it has been necessary to re- 
 sort in England in order to do away with conditions which have 
 grown up there much as those in the alleys have grown up here. 
 
 The housing of the working classes act, which was passed in 1890 
 and which superseded and improved previous attempts in this 
 connection ,« provided not only that individual houses might be con- 
 demned as insanitary, as is done under the law of 1906 here, but also 
 that an area containing streets and many houses might be declared 
 " unhealthy," and taken over by the local authority ; and that the 
 buildings might be removed, the streets rearranged and other dwell- 
 ings erected, either by agencies to which money would be furnished 
 by the local authority, or if necessary by the local authorities them- 
 selves. In fact, the law made it obligatory upon the local authorities 
 in London to provide housing accommodations for at least 50 per cent 
 of the people displaced, which has since been raised by an amendment 
 making the required provision equal to all, and in other districts 
 to such an amount as might be determined by the local authority 
 to be adequate under all the circumstances. 
 
 Under this housing of the working classes act numerous wretched 
 districts have been cleared up and comfortable and healthy dwellings 
 provided;^ and although the cost to the community has been con- 
 siderable in certain cases, where the evils to be remedied were of 
 long standing and very great, the law has done great good, and the 
 attention of those interested in the subject is being given to improv- 
 ing its operation rather than to changing it in any radical way. It 
 aims, so far as possible, to protect the interests of the community in 
 acquiring any property which has become detrimental to the well 
 being of the district, while at the same time dealing justly with the 
 owners. The method of procedure requires the local authority to 
 take the initiative, and where a loan is necessary, as it often is where 
 
 oThe Housing Handbook, W. Thompson, App., p. 1. 
 ^ Op. cit., p. 45. 
 
14 BEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 an area is acquired, the plans for this and for the improvement of 
 the area must be approved by the central authority in London. 
 
 Instead of being fixed, as here, by a jury which is subject to the 
 influence of acquaintance with those whose property is under con- 
 sideration, the values under the English law are fixed by an arbitrator 
 who is appointed by the central authority, the local government 
 board, and who is sworn to act " faithfully and honestly, and to the 
 best of his skill and ability hear and determine the matters referred 
 to him under the provisions of the housing of the working classes 
 act ; " « and it is upon his recommendation, after careful and intelli- 
 gent consideration of all the conditions and surroundings, that the 
 award is made. 
 
 It will be noticed that the situation in the District of Columbia 
 is similar to that in England, in that the District government re- 
 sembles the local authority, which can take the initiative in regard to 
 any alleys which require attention, but which can not act without the 
 consent of an authority not local, which in the case of the District is 
 Congress. % 
 
 The ordinary danger in giving to public officials, who are in entire 
 control, considerable discretion in the disbursement of public funds 
 is, therefore, removed, and it ought to be possible for Congress to 
 give such a plan a fair trial without incurring any very great risk. 
 
 The committee is convinced that the objections made to its proposed 
 amendment to the alley law by some of the District officials grew out 
 of their sincere regard for the public welfare and their reluctance 
 to consent to anything which would open the way for property owners 
 to get from the public more than they ought to receive for property 
 taken. The committee was, and is, equally averse to doing anything 
 which would open the door to an improper expenditure of public 
 money, but the very attitude of these officials, and the clean record 
 which the District government has had in the past so far as anything 
 like what is called " graft " is concerned, give ground for believing 
 it is safe to allow some discretion in this matter ; and if these officials 
 are as resolute in aggressive work as they have been in opposing the 
 recommendations of the committee, they ought to accomplish much. 
 
 If in this connection the responsibility of placing the valuation 
 upon property taken could be committed to an arbitrator duly ap- 
 pointed and responsible for his record, as a judge is, instead of to a 
 jury of citizens of the neighborhood, who act only for one particular 
 case and have no permanent responsibility, the results might be more 
 equitable. 
 
 The uncertainty of awards by a jury and the tendency to favor 
 property owners as against the District under the present system are 
 clearly illustrated by two cases which were tried under the present 
 law prior to the Brandenburg decision, when juries were expected to 
 find benefits equal to the damages assessed. Upon the second trial of 
 these cases, after the first verdict had been set aside and the jury was 
 no longer under any conservative influence in fixing the damages and 
 benefits, the damages found were much greater and the benefits much 
 smaller. If fixed after a careful study of values by some one free 
 from any connection with the property owners such irregularities 
 would be less likely to occur. 
 
 o Op. cit, App., p. 41. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 15 
 
 With some discretion allowed which would permit the District 
 officials to take all instead of part of any property for whidi damage 
 is claimed in opening an alley, or to appropriate other connecting 
 land, where it seemed to the interest of the community to do so, land 
 might be made available for the erection of the low -rental houses so 
 much demanded by the needs of men earning only laborer's wages ; ° 
 and if this could be coupled with a reasonable loan of public funds 
 under proper safeguards at a low rate of interest, in cases considered 
 proper by the District officials, the work of the Washington Sani- 
 tary Housing Company, which halts at a slightly higher rate, would 
 be supplemented, the way for reconstructive action would be opened, 
 and the alley land by which the city is now burdened might become 
 a source of satisfaction from an economic as well as from a social 
 standpoint. 
 
 Should there be any indications that any such power granted by 
 Congress was being indiscreetly or improperly used by the officials 
 of the District it could be promptly discontinued; but if the results 
 proved the wisdom of the method it could be continued and improved 
 on until the alley problem is solved. 
 
 The committee hesitates to recommend any novel or i:adical 
 measures, but calls attention to the possibilities which the difference 
 between the government of Washington and that of all other cities 
 in the country suggests. 
 
 Although the erection of any more buildings in alleys was practi- 
 cally stopped by the act of July 22, 1892, additions to the number 
 have occasionally been made by converting buildings erected on alleys 
 for other purposes into dwellings. Such an instance, in which a 
 stable had been converted into an alley dwelling and the second floor 
 occupied by two colored families, was referred to the corporation 
 counsel by the inspector of buildings in March last and an opinion 
 rendered that such action could not be prevented because the act of 
 July 22, 1892, did not apply. 
 
 In order to meet this situation a bill forbidding any such con- 
 version of other building into dwellings fronting on alleys was 
 prepared by the conmiission appointed to revise the building laws, 
 and should receive prompt attention in order that further evasions 
 of the alley law may be prevented. 
 
 In a plan proposed for improving housing conditions in German 
 cities provision is made for homes of working people in narrow 
 streets running through and connected with those portions in which 
 the residences of people of larger means are found, instead of hav- 
 ing each kind in a district by itself. Such a plan would have a 
 peculiar advantage in this democratic country, where the difference 
 should be not in character, but simply in the standard of living, and 
 would be for the convenience both of employers and employed. Such 
 
 « In many German cities considerable land acquired for the purpose of pro- 
 viding homes for the working classes is held by the municipality. (The Ex- 
 ample of Germany, by T. 0. Horsfall, p. 25.) 
 
 The example has been followed by Holland, in which Amsterdam has ac- 
 quired compulsorily 2,500 acres — nearly 4 square miles — and adopted an exten- 
 sion plan. Two other cities have each about half as much, and three others 
 have smaller quantities. (Housing Up to Date, W. Thompson, p. 194.) 
 
 Berlin had 85 square yards per capita, which would, on a basis of 325,000 
 population, be equal to more than 5,700 acres for Washington. 
 
16 
 
 a system we practically have now in the alley dwellings, in which the 
 contact with the best residences of the city is so close ; so that by the 
 conversion of these alleys into minor streets, permitting decent living 
 and encouraging self-respect in those residing upon them, we could 
 establish a healthy social circulation in the body politic by which we 
 would obtain all the advantages of the German plan while doing 
 away with the conditions which are now a constant menace to the 
 welfare of the community. 
 
 While the committee is fully alive to the perplexities connected 
 with the alley problem, it is also impressed with the necessity of 
 action in regard to it. It does not wish to enlarge on the well-known 
 reasons for opening the alleys, but it can not admit that it is not 
 " worth while," even if the process is expensive, to put the city on a 
 proper basis; and thorough constructive work is, and will be, im- 
 possible as long as so many blocks, fair on the outside, contain these 
 centers of vice and misery. To refuse to remove them because it costs 
 something is like refusing to escape blindness by the^ removal of a 
 cataract because of the fees of the oculist. 
 
 The passage of the proposed amendment will enable the Commis- 
 sioners to take up the interrupted cases and to start others, under 
 which a large number of the alleys of the city can be replaced by 
 desirable streets. 
 
 So far the way is plain, and this experience will indicate the best 
 method of reaching the others. The further suggestions are made 
 in the hope that the District government, which has certain disad- 
 vantages under whioh these evils have grown up, may be found to 
 possess also certain advantages over other forms by which, if they 
 are recognized, the evils may be done away with with less expense 
 than they could be under some other system, but the committee is 
 firmly or the opinion that in any event the alleys must go. 
 
 KespectfuUy submitted. 
 
 The Committee on Improvement of 
 Existing Houses and Elimination 
 OF Insanitary and Alley Houses. 
 By Wm. H. Baldwin, Chairman. 
 
 Washington, December 17^ 1908, 
 
 Upon presentation of the above report, the following resolutions 
 were adopted by the President's Homes Commission: 
 
 Resolved, That Congress be urged to promptly pass the amendment to the 
 code proposed by the Commissioners, allowing a difference between the damages 
 found and benefits assessed in any case of the conversion of an alley into a 
 minor street not greater than 25 per cent of the total damages, to be paid out 
 of the general fund of the District. 
 
 Resolved, That the Commissioners be urged to give prompt and constant 
 attention to the alley problem under their present plan, In order that, either by 
 the general law or by special act, all such alleys may, within a reasonable 
 time, be done away with. 
 
 Resolved, That a bill should be promptly passed by Congress forbidding the 
 conversion into dwellings of auy buildings designed for other purposes fronting 
 on alleys. 
 
EEPOBTS OP THE PBESIDBNT's HOMES COMMISSION. 17 
 
 REPORT OF THE COMMITTEE ON BUILDING REGULATIONS. 
 
 To the Presidents Homes Commission: 
 
 Your committee on building regulations begs leave to submit the 
 following report : 
 
 Immediately after the appointment of the committee it met for 
 the purpose of considering the extent and scope of its work. The 
 first conclusion reached b;^ the committee was that it was not called 
 upon to attempt any revision of the building regulations as they 
 affected the construction of houses for the poorer or least resourceful 
 classes of the community, particularly in view of the fact that, before 
 the appointment of the committee, the District Commissioners had 
 appointed a commission composed in part of officials of the District 
 government and citizens^ for the purpose of making a complete re- 
 vision of existing building regulations. The commission has been 
 in existence for nearly two years, but has not yet completed its work. 
 Your committee placed itself in touch with the commission referred 
 to, with the result that the commission courteously resolved to submit 
 to your committee such regulations as it might recommend for adop- 
 tion to the Commissioners of the District, with a view of securing our 
 consideration and criticism of such regulations. Two of such regula- 
 tions have been referred by the commission to your committee, the 
 first being the regulation touching the important questions of ventila- 
 tion and light. This regulation received the careful consideration 
 of your committee, with the result that several important changes 
 were recommended, most of which were adopted by the commission 
 and the District Commissioners. This matter has been the subject 
 of a prior report by your committee to the Homes Commission. 
 
 The second regulation submitted covered the subject of party walls. 
 This regulation proposed a uniform width for such walls of 13 inches 
 for all dwellings. It was, and is the opinion of your committee, that 
 a distinction should be made between the width of walls for a house 
 not to exceed two stories in height (and in that case it was and is be- 
 lieved by the committee that a 9-inch wall would be sufficiently wide 
 to absolutely insure structural safety and protection from fire) and 
 those for dwellings designed to be more than two stories in height. 
 In the latter cases the width prescribed by the regulation referred to 
 IS probably right. On this point, as youv committee understands it, 
 the building commission and the District Commissioners do not agree 
 with your committee. 
 
 Your committee further reports that in August last it recom- 
 mended to the Commissioners of the District the incorporation in 
 the revised Code of Building Regulations of definitions of various 
 buildings. Whether this recommendation received the approval of 
 the commission and the commissioners or not, your committee is not 
 informed. 
 
 Your committee has been embarrassed in the prosecution of its 
 work by what seems to it to be the delay on the part of the committee 
 on revision of the building regulations in completing its work. Your 
 committee made the recommendations that it did, touching the two 
 regulations referred to it as above set forth, with the reservation that 
 its recommendations were subject to its consideration of the full code 
 whenever it should be completed. Respectful suggestions have been 
 made by your committee to the District Commissioners of the im- 
 S. Doc. 644, 60-2 3 
 
18 REPORTS OF THE PRESIDENT'S HOMES COMMISSION". 
 
 portance of an early completion of the work of revision referred to. 
 It has, however, no information as to when the revision is likely to 
 be completed, and it can, therefore, make no definite, full, or satisfac 
 tory report upon the subject. 
 
 Your committee, thinking that perhaps information of advantage 
 on the general subject could be obtained from cities in England and 
 on the continent of Europe, applied to the Secretary of State to secure 
 from our consuls-general and consuls data upon the subject. The 
 Secretary very promptly complied with the request of your committee 
 and directed that the consular officers mentioned collect and forward 
 as promptly as possible the material called for, and this has been 
 coming to your committee. A considerable part of this material is 
 not available to your committee, because it is not translated into Eng- 
 lish, but information from various English cities has been forwarded 
 and is now in the archives of the homes commission. The Right 
 Honorable John Burns, chairman of the local government board and 
 a member of the present British cabinet, took more than a perfunc- 
 tory interest in the request made of him by our consul-general to 
 London, and, through the latter, forwarded material of interest and 
 value. But until your committee knows what will be embraced in 
 the proposed revision of the building regulations for this District, the 
 practical use to which the committee can put the data thus gathered 
 IS problematical. 
 
 In conclusion, your committee expresses the hope that an oppor- 
 tunity will be afforded it of making another report when it has 
 received a copy of the revised code of building regulations and has 
 had an opportunity to carefully consider the same. 
 
 All of which is respectfully submitted. 
 
 F. L. SiDDONS, Chairman, 
 Geo. M. Sternberg, 
 Wm. H. Baldwin. 
 
RESOLUTIONS AND RECOMMENDATIONS OF THE COMMISSION. 
 
 At a special meeting of the President's Homes Commission, held 
 on December 17, 1908, the following resolutions and recommenda- 
 tions were unanimously adopted : 
 
 Resolved, That in the opinion of this commission the building regulations in 
 the city of Washington should permit the building of two-story brick buildings 
 having a frontage of not less than 14 feet and walls 9 inches thick : Provided, 
 That such buildings have good foundations, satisfactory ventilation under the 
 first floor, and bathrooms with water supply and sewer connections. 
 
 Resolved, That in the opinion of this commission no apartment house more 
 than three stories in height should be built in the city of Washington, unless 
 it is of fireproof construction and is provided with elevators. 
 
 Resolved, That in the opinion of this commission the Congress of the United 
 States should authorize the loan of money, at a low rate of interest, to building 
 associations organized for the purpose of building sanitary houses for the work- 
 ing classes in the National Capital ; satisfactory real-estate security to be given 
 for the repayment of such loans and suitable provisions enacted to Insure 
 moderate dividends upon the capital invested in such enterprises, and low 
 rentals for the houses constructed, in order that they may be within the means 
 of unskilled wage-earners. 
 
 Resolved, That Congress be urged to promptly pass the amendment to the 
 code proposed by the Commissioners, allowing a difference between the damages 
 found and benefits assessed in any case of the conversion of an alley into a 
 minor street, not greater than 25 per cent of the total damages, to be paid out 
 of the general fund of the District. 
 
 Resolved, That the Commissioners be urged to give prompt and constant at- 
 tention to the alley problem under their present plan, in order that either by 
 the general law or by special act all such alleys may, within a reasonable time 
 be done away with. 
 
 Resolved, That a bill should be promptly passed by Congress forbidding the 
 conversion into dwellings of any buildings designed for other purposes fronting 
 on alleys. 
 
 The following recommendations submitted by the committee on 
 social betterment were also approved: 
 
 1. The enactment of model factory and labor laws for the em- 
 ployees of the Government and for the District of Columbia. Such 
 laws, apart from regulating the hours of labor, should also make 
 adequate provisions for the sanitation of workshops, for employer's 
 liability in case of accidents, and for a comprehensive system of 
 industrial insurance for all government employees and employees in 
 the District of Columbia. (See pp. 72-93 of report submitted Febru- 
 ary 4, 1908.) 
 
 2. The appointment by the President of a special board, composed 
 of architects and sanitarians now in the employ of the Government, 
 for the purpose of evolving model plans and building regulations for 
 government workshops and office buildings, so that no such buildings 
 will hereafter be erected without due regard to air space, ventilation, 
 light, heating, temperature, humidity, sanitary conveniences, and 
 
 1» 
 
20 EEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 other provisions, including sanitary supervision referred to in a 
 previous report, pages 71 to 83. 
 
 3. The establishment in the National Museum, and in connection 
 with museums in industrial centers generally, of -a special section 
 devoted to exhibits illustrative of the hygiene of occupations, habita- 
 tions, food, safety appliances, and other collections for the promotion 
 of industrial and social betterment of wage-earners, along the lines 
 indicated on pages 85 and 86 of the report, February 4, 1908. It 
 may be found necessary to house such exhibits ultimately in a special 
 building. 
 
 4. While it is gratifying to record a very deep interest in the public 
 schools of Washington in all matters related to social and industrial 
 life, the committee is of the opinion that even greater emphasis should 
 be given in the curriculum to manual training and domestic science, 
 because the practical knowledge thus acquired not only inspires re- 
 spect for manual labor and domestic service, but constitutes in fact 
 the foundation stone for intelligent work and home making. 
 
 5. The importance of a thorough practical training in domestic 
 science is nowhere more evident than in a study of our family groups 
 whose income is less than $700 a j^ear. While conditions on the whole 
 indicate a fierce struggle for existence, some splendid examples of 
 neat and healthful homes of thrift and happiness could be cited for 
 the emulation of less competent neighbors. 
 
 6. Since the scale of wages in certain occupations has not kept 
 pace with the cost of living, the committee recommends adequate 
 compensation of all employees, whether in the government service 
 or in other fields of activity. This applies with special emphasis to 
 married men earning less than $2 a day. No effort should be spared 
 to improve the social condition of poorly paid wage-earners, and 
 justice likewise demands an increase in the scale of salaried employees 
 in order to compensate for the increased cost of living, especially 
 when no such increase has been made within the past ten years. It 
 is believed that the principle of permanency of employment, which 
 is so well established as to large numbers of government employees, 
 should be extended to others to whom it does not now apply, so far 
 as the interests of the Government permit 
 
 7. The committee is of the opinion that the standards of living 
 could be materially improved by diminishing the expenditures for 
 tobacco and intoxicants. Taken as a whole, the families investigated 
 could add on an average at least one room to their overcrowded homes 
 if the money expended for these items were devoted to the payment 
 of rent. 
 
 In order to restrict the consumption of these harmful agents much 
 may be done by educational methods, the establishment of social 
 settlements in connection with the public schools and churches, and 
 the creation of genteel and inexpensive amusements calculated to 
 counteract the influence of saloons and evil resorts. The sale of 
 tobacco and intoxicants to persons under the age of 21 should be pro- 
 hibited by law. We also recommend greater restriction in the sale 
 of proprietary medicines containing alcohol in sufficient quantity to 
 be intoxicants, and greater restriction in the licensing of saloons in 
 residential and manufacturing sections. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 21 
 
 We also recommend the enactment of a bill introduced by Senator 
 Gallinger, making drunkenness a misdemeanor, and placing habitual 
 drunkards and drug habitues under legal restraint in the hospital for 
 inebriates in order to bring about their permanent reformation. The 
 committee believe that the provisions of the bill will be materially 
 strengthened by making the sale of intoxicants to habitual drunkards 
 a criminal offense and to hold the seller responsible for all damages, 
 when properly warned not to dispense intoxicants to minors and 
 habitual drunkards. 
 
 8. The committee believes that public playgrounds and athletic 
 fields will promote temperance and chastity, and since we are familiar 
 with the physical ravages of vice and disease and the public expendi- 
 tures incident thereto, we reconmiend most liberal appropriations for 
 all such moral and social prophylactic measures. 
 
 9. Your committee believes that* quackery and the great nostrum 
 evil are frequent causes of physical and financial impoverishment. 
 In view of the importance of the subject, we recommend the appoint- 
 ment of a special board composed of a representative of the Attorney- 
 General in the Post- Office Department, of the Public-Health Service, 
 and the chief of the Bureau of Chemistry, United States Department 
 of Agriculture, for the purpose of investigation and the formulation of 
 such additional legislation as may be deemed necessary in the interest 
 of public health and morals. 
 
 In the meantime it is earnestly recommended that the Postmaster- 
 General be requested to publish with the monthly Supplements to 
 the Official Postal Guide, a bulletin setting forth the essential facts 
 in connection with the fraud orders issued during the preceding 
 month, such bulletins to be posted in post-offices and to be dis- 
 tributed in sufficient numbers along rural delivery routes. 
 
 We also recommend that all information concerning harmful in- 
 gredients in foods, medicines, soft and alcoholic drinks which may 
 come to light during the execution of the pure food and drug law 
 be published by the Department of Agriculture in the same manner 
 as " Farmers' Bulletins " are now being published. The public is 
 entitled to be warned, and for this purpose the indisputable facts 
 should emanate from some official source. 
 
 10. The committee strongly recommends the enactment of a law 
 for the suppression of usury as contemplated by Senate bill 2296 and 
 H. R. 11772. Your committee is convinced that there is a necessity 
 in every community for pawn shops and money-lending concerns, to 
 aid persons who are unable in an emergency to secure loans from 
 banks, trust companies, or real estate brokers. It has been shown 
 that the system now in vogue is attended with gross abuses, absolute 
 extortion, and financial distress which calls for remedial action. 
 Since it has also been demonstrated by the experience of the New 
 York Provident Loan Society (a strictly business philanthropy) that 
 such operations can not be carried on at a lower rate of interest than 
 1 per cent per month, we recommend that the maximum rate of 
 interest be placed not higher than 2 per cent per month. This will 
 legalize the business, enable respectable people to enter the field, and, 
 by wholesome competition, bring about the desired result. The 
 license tax in the proposed bill should be reduced from $1,000 to $100 
 
22 
 
 per annum; a suitable reduction should likewise be made on the 
 recorder's fees on chattel mortgages involving amounts less than $100, 
 as all these expenses are placed by indirection on the borrower. The 
 execution of such a law involves careful official supervision, such as is 
 contemplated in the recommendations of Mr. James Bronson Rey- 
 nolds in the creation of the bureau of labor. 
 
 11. The creation of a bureau of labor would likewise render valu- 
 able services both to employers and employees in the supervision of 
 employment agencies, the correction of abuses connected therewith, 
 and also in the enforcement of labor laws, sanitation of factories, 
 workshops, etc. 
 
 The fact that in our sociological study of 1,217 families comprising 
 a population of 4,889, 2,202, or 45 per cent, carried life insurance, 
 and 855, of ITJ per cent, carried insurance against sickness, constitutes 
 a strong argument in favor of a* comprehensive system of working- 
 men's insurance, and adequate supervision, such as recommended by 
 Mr. Reynolds in his report to the President, April 29, 1907. 
 
 12. Our sociological mvestigation shows that out of 5,157 persons 
 enumerated 613, or 12 per cent, had been sick during the past year 
 with an average duration of 29.5 days, involving a loss of 18.083 days, 
 of work. This, together with information collected by the Board of 
 Charities, emphasizes the need of hospital facilities for convalescents 
 where the earning capacity of dependent patients after an acute ill- 
 ness may be expedited. As it is now, the recovery of such persons 
 is greatly retarded by a return to insanitary homes, insufficient and 
 improper food, etc. 
 
 13. The cases of permanent disability found in *the 1,217 families 
 are comparatively few, namely 42. Of these the age is given in 39 ; 
 3 of these were under the age of 19 years ; 14 between 20 and 49 years ; 
 and 22 were over 50 years. This does not include the cases cared for 
 in public institutions, which are taxed to their utmost capacity. 
 
 In order to reduce the number of defectives, preventive measures 
 must be invoked early in life and an able corps of teachers, medical 
 inspectors, and instructive visiting nurses can render most efficient 
 service. A recent inspection of 43,005 pupils in the public schools 
 shows that 15,304 children, or 35.2 per cent of the total examined, 
 are in need of medical or dental service. 
 
 Your committee recomimends that the study of hygiene be made 
 an important part of the school curriculum, also the appointment of 
 instructive visiting nurses in the schools, and that medical inspectors, 
 nurses, and teachers be authorized to suggest to pupils and parents 
 the desirability of securing prompt professional advice in all cases 
 where it is indicated, and especially in such instances as are likely 
 to result in permanent disability. 
 
 14. In the interest of general sanitation your committee recom- 
 mends (1) the further purification of the water supply advocated 
 by the officers in charge of the filtration plant; (2) the reclamation 
 of the Anacostia Flats for the reduction of malarial fevers; (3) the 
 enactment of a more stringent law regulating the production and sale 
 of milk and dairy products, for the reduction of milk-borne diseases ; 
 (4) the abandonment of box privies, removal of slums, establishment 
 of public baths for all seasons of the year, more liberal appropria- 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 23 
 
 tions for the health department, and a larger corps of sanitary in- 
 spectors so that the gospel of cleanliness and health may be enforced 
 within and without the homes; (5) greater cooperation on the part 
 of the police courts with the efforts of the health department in the 
 enforcement of sanitary laws and ordinances. 
 
 Some of these recommendations have been urged by the Commis- 
 sioners for years ; they are of vital importance to the health, not onlv 
 of every permanent resident, but of the chief magistrate, his cabinet, 
 the foreign ministers, thousands of public officials, the members of 
 the Senate and House of Representatives, and all citizens having 
 business with Congress, besides the numerous visitors who annually 
 pay homage to the city of Washington. 
 
INDUSTRIAL HYGIENE AND SOCIAL 
 BEHERMENT. 
 
 A REPORT OF COMMITTEE ON SOCIAL BETTERMENT OF 
 THE PRESIDENT'S HOMES COMMISSION. 
 
 BY 
 
 GEORGE M. KOBER, M. D., LL. D., 
 
 PBOFKSSOR Qif HYGIENE, SCHOOL OP MEDICINE, GEORGETOWN UNIVERSITY, 
 
 Chairman of the Committee. 
 
 COMMITTEE. 
 GEORGE M. KOBER. EMMETT L. ADAMS. 
 
 JAMES BRONSON REYNOLDS. MISS MABEL T. BOARDMAN. 
 
 WM. F. DOWNEY. MRS. THOMAS T. GAFF. 
 
 WHITEFIELD McKINLAY. 
 
 25 
 
REPORT OF THE COMMITTEE ON SOCIAL BETTERMENT. 
 
 Washington, D. C, Decemher 7, 1908. 
 
 The committee on social betterment has realized throughout its 
 work that the question of health is intimately connected with the 
 physical, social, and moral welfare of all persons whose only income 
 is the product of their daily labor. Health is the chief asset of the 
 workingman, and no greater calamity can befall him than when his 
 earning capacity is impaired or arrested by reason of sickness or 
 disability. It means in many instances the utter j&nancial ruin of 
 the family aijid is doubtless one of the most potent causes of poverty 
 and distress. 
 
 Many of the diseases are incident to occupations and environments, 
 and industrial efficiency and earning power can be promoted by 
 appropriate safeguard and adequate protection of the men, women, 
 and children engaged in gainful occupations. 
 
 It has been the aim of the committee to emphasize therefore the 
 causes and prevention of industrial diseases and also of some of the 
 principal preventable diseases, like tuberculosis, pneumonia, typhoid 
 lever, sexual diseases, etc. 
 
 The committee has also studied the standards of living in 1,217 
 families; of these 476, or 39 per cent, had a family income of $500 
 or less per annum ; 169, or 13 per cent, had an income of from $500 to 
 $600; 153, or 12^ per cent, from $600 to $700; 153, or 12^ per cent, 
 from $700 to $800; 89, or 7 per cent, from $800 to $900; 93, or 8 per 
 cent, from $900 to $1,000 ; and 94, or 8 per cent, had an annual income 
 of over $1,000. 
 
 The Insults of these fairly accurate returns concerning income and 
 expenditures and general standards of living are set forth in a 
 special report by Mr. G. A. Weber, of the Bureau of Labor, who was 
 appointed statistician to supervise the work. The data with reference 
 to the expenditures for rent, food, liquor, tobacco, sickness and death 
 (including expenditures for patent medicines), number of working 
 hours, wage-earners' lunches, insurance, installment purchases, usury, 
 etc., are of interest and importance. 
 
 In addition to presenting such topics as " How to keep well and 
 capacitated for work," the committee in its efforts to improve the 
 homes and better the lives of the industrial classes, believes that 
 special attention should be given to the question " How to live well 
 and cheaply," and for this purpose invoked the aid of Dr. C. F. 
 Langworthy, expert in nutrition of the United States Department of 
 Agriculture, who cheerfully consented to prepare a special article on 
 " Good food at reasonable cost." Miss E. W. Cross, of the department 
 of domestic science of the McKinley Manual Training School, has 
 
 27 
 
28 EEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 worked out dietaries and menus for families with an income of $1.50 
 a day . 
 
 Believing that a survey of the causes which lead up to low stand- 
 ards of living would not be complete without reference to the alco- 
 hol question, the tobacco and drug habits, the great nostrum evil, 
 and the usury evil, special studies have been made of these subjects 
 and the results, with suitable recommendations, will be found in our 
 report. Miss Mabel T. Boardman has prepared an excellent article on 
 recreation and inexpensive amusements, Mr. James Bronson Eeynolds 
 has prepared the article on the business relations of wage-earners, 
 and Mr. William F. Downey has written the article. How to benefit 
 the poor in the slums. The thanks of the committee are also due. to 
 Dr. Paul B. Johnson, Mr. K. M. Webster, Prof. H. W. Wiley, and 
 Dr. Lyman F. Kebler of the Bureau of Chemistry for valuable 
 material and to General Sternberg for a careful revision of the 
 manuscript. 
 
 George M. Kober, Chairman, 
 
PART 1 -INDUSTRIAL HYGIENE. 
 
 Chapter I. 
 
 INTRODUCTION. 
 
 In the search for the causes and prevention of diseases the interests 
 of the wage-earners have not been neglected ; indeed, it may be truly 
 said that a special department has been created, known as industrial 
 hygiene or social medicine, with a most complete and satisfactory 
 literature of its own. German authors, in 1897, issued a volume of 
 over 1,200 pages, and English authors, under the editorship of Dr. 
 Thomas Oliver, devoted 891 pages to " Dangerous Trades — the His- 
 torical, Social, and Legal Aspects of Industrial Occupations as 
 Affecting Health." The writer, during his visit to Berlin in Septem- 
 ber, 1907, met Dr. E. J. Neisser, who had just completed an " Inter- 
 national Review of Industrial Hygiene," covering a volume of 352 
 printed pages. Doctor Neisser deplored his inability to present a 
 general review of the work accomplished in the United States for the 
 promotion of the welfare of the wage-earners, since, with the excep- 
 tion of the reports of the inspector of New Jersey, no recent data 
 concerning factory sanitation were available for publication. Realiz- 
 ing the importance of the subject, not only to wage-earners, but to all 
 interested in the conditions under which our fellow men and women 
 live and work, an effort has been made in the succeeding pages to 
 supply this information. 
 
 It is, indeed, a feeble attempt towards amelioration of existing 
 conditions, when compared with the monumental volumes of German 
 and English authors. The writer acknowledges his indebtedness to 
 Doctor Neisser for the inspiration given him by his own good and 
 unselfish work, and also to all authors consulted by him, and to whom 
 credit is given in the text. 
 
 It is hoped that this study of the causes of sickness and the means 
 of promoting industrial efficiency and earning power, will fill one of 
 the obligations which the committee on social betterment assumed to 
 discharge. 
 
 A pioneer study was made by Professor Ramazzini, of Padua, as 
 early as 1700, and his nlonograph was translated into English in 1705, 
 and also into French in 1777. 
 
 In 1810 the French Government issued a decree relating to " etab- 
 lissements dangereaux, insalubres et incommodes," and in 1815 the 
 English Parliament instituted a commission to inquire into the con- 
 dition of factories, etc. In 1822 Mr. C. Turner Thackrah, of Leeds, 
 wrote a monograph " On the Effects of the Arts, Trades, and Profes- 
 sions, and of Civic States and Habits of Living on Plealth and Lon- 
 gevity." In 1833 and 1865 the English Parliament again appointed 
 commissioners, and in 1839 the "Academie des sciences morales et 
 
 29 
 
30 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 politiques de France," and subsequently Bavaria, Prussia, and the 
 German Empire directed similar investigations. As a result of these 
 efforts and numerous independent investigations, it is known to-day 
 that persons habitually engaged in hard work, especially in factories 
 and indoors, present a greater amount of sickness and higher mor- 
 tality than persons more favorably situated, and that the character of 
 the occupations influences to a great extent not only the average expec- 
 tation of life, but also the prevalence of certain diseases. 
 
 It is known, for example, that bronchitis, pneumonia, and tubercu- 
 losis are much more frequent in dust-inhaling occupations, and that 
 the sharp angular particles of iron and stone dust are more liable to 
 produce injury of the respiratory passages than coal, flour, grain, and 
 other kinds of dust. It is also known that workers in lead, mercury, 
 arsenic, phosphorus, poisonous dyes, etc., suffer especially from the 
 injurious effects, and that other occupations, such as mining, railroad- 
 ing, and those which necessitate working with or around moving 
 machinery involve special danger to life and limb. 
 
 For these reasons workers in many industries need special protec- 
 tion, and in order to render this efficient it must be provided for by 
 the enactment and enforcement of suitable laws. In 1833, 186^, 1867, 
 and 1870, England enacted the so-called " factory laws." France 
 provided a child-labor law in 1841 and in 1874 a more satisfactory 
 labor code. Germany and other continental governments enacted 
 suitable legislation between 1859 and 1886. 
 
 According to Miss S. S. T\niittelsey's " Essay on Massachusetts 
 Labor Legislation," child labor received attention in Massachusetts as 
 early as 1836. The first law as regards safety and sanitation was 
 enacted in that State in 1877, since which time all the States and Ter- 
 ritories have enacted some form of labor or factory laws. 
 
 OCCUPATIONS AND MORTALITY. 
 
 According to the United States census for 1900, of 360,739 males, 
 10 years of age and over, dying in the United States during the census 
 year, 278,147, or 77 per cent, were reported as having a gainful occu- 
 pation. Of females 10 years of age and over, there were 324,075 
 deaths and 45,491, or 14 per cent, were reported as having a gainful 
 occupation. In the ag^egate the table on page cclx gives informa- 
 tion as to the mortality by occupations tor 5,575,745 males and 
 1,587,874 females. 
 
 The death rates by occupation groups are as follows : 
 
 Occupation. 
 
 Males: 
 
 All occupations 
 
 Professional 
 
 Clerical and official 
 
 Mercantile and trading 
 
 Public entertainment 
 
 Personal service, police and military 
 
 Laboring and servant 
 
 Manufacturing and mechanical industry 
 
 Affriculture, transportation, and other outdoor pursuits 
 
 All other occupations 
 
 Females: 
 
 All occupations 
 
 Nurses and midwives 
 
 9«ryantfl 
 
 Population. 
 
 ,575,745 
 203, 104 
 424, 781 
 493,994 
 87,888 
 149,164 
 800,893 
 ,796,928 
 ,528,241 
 90,662 
 
 ,587,874 
 
 41,912 
 
 403,801 
 
 Deaths. 
 
 88,815 
 
 8,109 
 
 6,716 
 
 6,000 
 
 1,350 
 
 1,931 
 
 16,168 
 
 24,769 
 
 24,196 
 
 13,203 
 
 397 
 
 6,920 
 
 Death rate. 
 
 1900. 1890 
 
 16.0 
 15.3 
 13.5 
 12.1 
 15.4 
 12.9 
 20.2 
 13.8 
 15.8 
 6.5 
 
 9.5 
 17.1 
 
 13.8 
 16.7 
 9.8 
 12.3 
 14.5 
 15.4 
 22.6 
 13.0 
 12.1 
 
 10.5 
 11.2 
 18.2 
 
BEPORTS OF THE PBESIDENT^S HOMES COMMISSION. 31 
 
 Each of the eight large groups of occupations is subdivided, and 
 detailed information is given in 60 specified groups of employment 
 for males, and in 14 groups for females, of which we have produced 
 only 2 for females, on account of their high death rate. 
 
 Unfortunately we have no reliable occupation mortality statistics, 
 and never will have until greater attention is given this subject by 
 health officials and the Census Bureau. 
 
 In view of the importance of the subject and the tendency else- 
 where toward a more detailed classification and information for in- 
 dustries and trades, Mr. Frederick L. Hoffman ^ says : 
 
 It was reasonably to be expected that the census report of 1900 would 
 materially increase the number of specific occupations dealt with in the section 
 discussing the relation of occupation to mortality, but instead of 89 employ- 
 ments discussed in the census of 1890 only 60 are dealt with in detail in the 
 census of 1900. To make this matter worse, the details are not given in the 
 fundamental tables, but a vast majority of heterogeneous employments are 
 grouped in a purely arbitrary manner, filling space to no advantage, and re- 
 sulting in conclusions of no practical value. 
 
 He very properly objects to grouping together miners and quarry- 
 men, because according to the census of 1890 the comparative mortal- 
 ity figure of quarrymen was 469, while that for minei:s was given as 
 1 ,127 ; " and to combine two such unlike occupations is the mere pro- 
 duction of a figure which has absolutely no determining value, but 
 the use of which must lead to false and mischievous conclusions." 
 For like reason he objects to the grouping together of fishermen, 
 oystermen, sailors, and pilots, which he very properly regards as 
 three well-defined groups of employment. The mortality figure in 
 the census of 1890 for fishermen and oystermen was 543; for pilots 
 it was 630, and for sailors, 2,276. Many other combinations of em- 
 ployments, such as hotel keepers and boarding-house keepers, or 
 saloon keepers with restaurant keepers are objectionable, as it does 
 not enable the student of social questions to determine the effects of 
 alcohol upon longevity. If, for example, restaurant keepers, who 
 very generally do not engage in the liquor traffic, had not been com- 
 bined with saloon keepers, bartenders, etc., the death rate of this 
 group might not be so favorable but be more in accordance with the 
 excessive mortality rates observed in this class in other countries. 
 Mr. Hoffman points out that during the five years 1891-1895, during 
 a condition of peace, the death rate of the United States army was 
 6.6 per 1,000, and for the navy 8.3 per 1,000, and concludes from this 
 that soldiers and sailors should not have been combined. We quite 
 agree with him, as there is reason to believe that the factor of 
 environment, such as close sleeping quarters and dampness, influence 
 the life of sailors adversely. He also refers to a number of mis- 
 leading occupation death rates, because no correction is made for the 
 difference in age distribution in widely different employments. As a 
 result " the published rates do great injustice to employments en- 
 tirely healthy, while giving favorable position to employments the 
 health conditions of which are ^uite the opposite. This point is 
 readily illustrated, if comparison is made of the mortality of farmers 
 and printers, the former of which according to the census experi- 
 
 <» Quarterly Publication of the American Statistical Association, December, 
 1902, p. 172. 
 
32 EEPOBTS OF THE PEESIDENt's HOMES COMMISSION. 
 
 enced a mortality ' at all ages ' of 17.6 per 1,000, against a death rate 
 of 12.1 per 1,000 for printers. Hence, apparenUy, printers enjoy 
 a much lower mortality than farmers. Or course the opposite is 
 the case. The inaccuracy of the rates is the result of radical differ- 
 ences in the age distribution of the two employments, there being 
 11.6 per cent of farmers at ages 65 and over, while among printers 
 there are only 1.5 per cent living at this age period. * * * 
 When proper comparison is made, the mortality in farmers is consid- 
 erably below that of printers at all periods of life." 
 
 Mr. Hoffman's suggestions for improving vital statistics are 
 worthy of careful consideration. The present chief statistician of 
 the division of vital statistics. Doctor Wilbur, is a trained physician, 
 a keen student of social, sanitary, and industrial questions, and per- 
 fectly familiar with the literature and the results achieved by more 
 accurate and scientific methods of the treatment of the subject else- 
 where. We may, therefore, confidently expect more definite data 
 concerning the relative danger incident to various occupations. 
 
 MORBIDITY AND MORTALITY OF WAGE-EARNERS, 
 
 The statistics of the morbidity and mortality of various occupa- 
 tions, while far from satisfactory and subject to more or less erro- 
 neous conclusions, nevertheless indicate that persons habitually en- 
 gaged in hard work are more frequently subject to disease and pre- 
 sent a higher mortality than persons more favorably situated; and 
 this is especially true of factory employees, because their work is 
 generally more monotonous, fatiguing, performed under less favor- 
 able surroundings, and they are too often also badly nourished and 
 badly housed. 
 
 Rohe, in his " Text Book on Hygiene," presents a table of a large 
 number of persons in the State of Massachusetts whose occupations 
 were specified, the total number of decedents was 144,954; the aver- 
 age age at death was 50.9. From this tabulation it appears that 
 farmers and gardeners have the greatest expectation of life, with 
 an average of 65.29 years: 
 
 Active mechanics: Tears. 
 
 Outdoors 56. 19 
 
 Indoors 47. 57 
 
 Inactive mechanics in shops 43.87 
 
 Professional men 50.81 
 
 Merchants, financiers, agents, etc 48.95 
 
 Laborerers without special trades 47.41 
 
 Factors, laboring abroad, etc 36.29 
 
 Employed on the ocean 46.44 
 
 Females engaged in wage-earning occupations , 39.13 
 
 Among the occupations usually classed as inimical to health are 
 bleachers, bookbinders, brass founders, compositors, coppersmiths, 
 electrotypers, stonecutters, gas-works employees, white-lead workers, 
 match workers, persons employed in the manufacture of explosives, 
 firemen, potters, file makers, and rubber- factory operatives. 
 
 The following table from the reports of the Twelfth Census shows 
 the death rates per 1,000 for leading causes and for all causes in 
 certain occupations in 1900: 
 
BBPORTS OF THE PRBSIDEITT S HOMES COMMISSION. 
 
 33 
 
 Death rate per 1,000 employees in certain occupations in registration States in 
 1900, hy principal causes of death. 
 
 
 
 
 Death rate per 
 
 1,000. 
 
 
 
 Occupation. 
 
 Tuber- 
 culosis 
 
 of 
 lungs. 
 
 Diseases 
 
 of 
 nervous 
 system. 
 
 Heart 
 disease. 
 
 Pneu- 
 monia. 
 
 Diseases 
 
 of 
 urinary 
 organs. 
 
 Acci- 
 dents 
 and in- 
 juries. 
 
 All 
 causes. 
 
 MANUFACTURING AND MECHAN- 
 ICAL INDUSTRIES. 
 
 Bakers and confectioners 
 
 Blacksmiths 
 
 2.60 
 2.12 
 1.35 
 
 2.56 
 
 2.87 
 
 3.59 
 2.31 
 
 4.76 
 
 4.35 
 2.99 
 
 2.29 
 2.36 
 3.11 
 2.27 
 1.95 
 5.40 
 2.93 
 
 2.07 
 1.98 
 
 3.19 
 
 2.94 
 2.18 
 3.65 
 
 2.61 
 
 1.11 
 1.20 
 1.29 
 
 1.60 
 2.99 
 1.50 
 
 2.74 
 2.30 
 
 2.21 
 2.45 
 
 1.79 
 
 1.30 
 2.90 
 
 2.08 
 .91 
 1.01 
 2.67 
 1.24 
 1.10 
 2.26 
 
 .84 
 4.47 
 
 2.13 
 
 .90 
 1.43 
 1.77 
 
 .89 
 2.70 
 
 1.02 
 1.90 
 1.45 
 
 2.22 
 1.77 
 
 1.61 
 2.23 
 
 1.75 
 
 .93 
 2.72 
 
 1.80 
 1.01 
 1.26 
 2.11 
 1.03 
 1.59 
 2.32 
 
 .90 
 3.81 
 
 1.69 
 
 .59 
 1.28 
 1.26 
 
 .96 
 2.62 
 
 1.17 
 
 1.68 
 
 .95 
 
 2.40 
 1.72 
 
 1.73 
 1.46 
 
 2.15 
 
 1.15 
 2.09 
 
 1.77 
 1.81 
 1.32 
 .97 
 1.10 
 1.37 
 2.30 
 
 .80 
 2.97 
 
 1.54 
 
 1.13 
 1.13 
 1.37 
 
 1.47 
 
 1.49 
 
 .77 
 .60 
 
 1.45 
 1.90 
 
 .78 
 
 2.56 
 1.36 
 
 1.67 
 1.73 
 
 1.68 
 
 .93 
 8.08 
 
 1.66 
 
 .77 
 .84 
 
 2.27 
 .98 
 .83 
 
 1.83 
 
 .57 
 1.16 
 
 1.82 
 
 .88 
 1.38 
 1.31 
 
 .90 
 
 1.70 
 
 0.61 
 
 1.00 
 .33 
 
 1.37 
 .81 
 
 .64 
 1.18 
 
 .70 
 
 .49 
 1.36 
 
 1.83 
 .78 
 .66 
 .97 
 .71 
 .99 
 
 1.67 
 
 .75 
 1.98 
 
 1.28 
 
 .76 
 .51 
 .91 
 
 1.33 
 
 12.8 
 18.3 
 
 Boot and shoe makers 
 
 9.4 
 
 Brewers, diatillers, and recti- 
 fiers 
 
 19.7 
 
 Butchers 
 
 16.1 
 
 Cabinetmakers and upholster- 
 
 18.0 
 
 Carpenters and joiners 
 
 Cigar makers and - tobacco 
 workers 
 
 17.2 
 18.7 
 
 Compositors, printers, and 
 
 12.1 
 
 Coopers 
 
 28. S 
 
 Engineers and firemen (not 
 
 15 7 
 
 Iron and steel workers 
 
 Leather makers 
 
 10.7 
 12.3 
 
 
 17.5 
 
 Machinists 
 
 10.5 
 
 Marble and stone cutters 
 
 Masons (brick and stone) 
 
 Mill and factory operatives 
 (textiles) 
 
 14.9 
 19.9 
 
 8.8 
 
 Millers (flour and grist) 
 
 Painters, glaziers, and var- 
 nishers 
 
 26.6 
 16.2 
 
 Plumbers, and gas and steam 
 fitters 
 
 9.1 
 
 Tailors 
 
 11.8 
 
 Tinners and tinware makers . . 
 
 AGRICULTURE, TRANSPORTA- 
 TION, AND OTHER OUTDOOR. 
 
 Draymen, hackmen, team- 
 sters, etc 
 
 14.6 
 11.0 
 
 Farmers, planters, and farm 
 laborers 
 
 17.6 
 
 Miners and quarrymen 
 
 Steam railroad employees 
 
 3.78 
 4.10 
 
 9.6 
 
 .95 
 
 .88 
 
 .64 
 
 10.8 
 
 The following table from the report of the registrar-general of 
 England and Wales shows the comparative mortality of occupations 
 in England and Wales 1890-1892. The average mortality of all 
 males of the population between 25 and 65 years of age was placed 
 at 1,000. The mortality of occupied males was 953 and of the unoc- 
 cupied 2,215. The comparative mortality of the different groups was 
 as follows: 
 
 Occupation. 
 
 Compara- 
 tive mor- 
 tality. 
 
 Occupation. 
 
 Compara- 
 tive mor- 
 tality. 
 
 Clergymen, priests, ministers.. 
 
 533 
 553 
 563 
 604 
 664 
 783 
 821 
 845 
 859 
 966 
 989 
 
 Bricklayer, mason, builder 
 
 1,001 
 
 Gardener, nurseryman 
 
 Butcher 
 
 1,096 
 
 Printer 
 
 1,096 
 
 
 
 1,120 
 
 Grocer, etc 
 
 Cotton manufacturer, Lancashire — 
 
 1,176 
 
 Carpenter, joiner 
 
 1,384 
 
 
 Slater, tiler 
 
 1,823 
 
 Fisherman 
 
 Brewer . . 
 
 1,427 
 
 Shopkeeper 
 
 Innkeeper, hotel servant 
 
 1,659 
 
 Meoic&l practitioner 
 
 Potter, earthenware manufacturer... 
 File maker 
 
 1,706 
 
 Tailor 
 
 1«810 
 
 
 
 
 S. Doc. 644, 60-2- 
 
34 
 
 REPORTS OF THE PRESIDENT'S HOMES COMMISSION 
 
 A reasonable explanation for the excessive mortality in some of the 
 occupations will be found in subsequent pages; the high rates in 
 brewers, innkeepers, and hotel servants are believed to be due to the 
 effects of alcohol. 
 
 According to Rauchberg^ the average number per 1,000 members 
 of the " Vienna Sick Benefit Society " taken sick during a period of 
 seventeen years was 423 per annum, distributed as follows: 
 
 Occupation, 
 
 Average 
 number 
 
 taken sick 
 per 1,000 
 
 members. 
 
 Occupation. 
 
 Average 
 number 
 
 taken sick 
 per 1,000 
 
 members. 
 
 Assistant machinists 
 
 488 
 477 
 473 
 451 
 437 
 378 
 367 
 354 
 
 Ironworkers 
 
 351 
 
 Factory employees and day laborers. . 
 
 Shoemakers ... 
 
 343 
 
 Foundrymen 
 
 Tinners and bronzers 
 
 339 
 
 Blacksmiths 
 
 Cabinetmakers and wood workers... 
 Saddlers 
 
 326 
 
 JMasons and stonecutters 
 
 285 
 
 Painters 
 
 Tailors and furriers 
 
 215 
 
 Weavers and spinners 
 
 
 462 
 
 Locksmiths 
 
 
 
 
 
 Industrial diseases and industrial accidents are ever^^where assum- 
 ing more and more importance, and our knowledge should be based 
 upon accurate data. In countries like England, where reports of cer- 
 tain occupations are compulsory, it is quite possible to secure, for 
 example, reliable data as to the number of cases of lead poisoning. 
 The same may be said of the facilities afforded by the statistics of the 
 " German Industrial Insurance Institutes," which furnish not only 
 the number of deaths, but also the number of cases treated, together 
 with the age period and the duration of the disease. Similar facts 
 should be collected in this country. This is all the more important 
 when it is remembered that even with the most complete statistics, 
 it is extremely difficult to determine all the factors which influence 
 the health and longevity of operatives. Great differences are found 
 in the conditions under which the work is performed, some of which 
 are entirely avoidable, while others are not, and it is hardly fair to 
 characterize certain trades as dangerous when experience has shown 
 that no harm results when proper safeguards have been taken. In 
 the consideration of this question the personal element of the work- 
 men, their habits, mode of life, food, home environments, etc., can 
 not be ignored. There are a number of occupations in which the 
 alcohol habit prevails to an unusual extent, perhaps because of the 
 character of the work, perhaps as a result of association, and it would 
 not be fair to attribute the ill health of the operatives altogether to 
 the character of the employment. Again, many persons are engaged 
 in occupations for which they are not physically fitted, while others 
 ruin their health by vice, dissipation, improper food, and insanitary 
 environments at home. In addition to all this there are factors, such 
 as water and soil pollution, for which neither the industry nor the 
 individuals are primarily to blame. Thus, for example, the general 
 ansema of the agricultural classes in Porto Rico was attributed a 
 few years ago to their occupation and starvation, when as a matter of 
 fact it was caused by the " hook-worm disease." Recent investiga- 
 
 • Die allg. Arbeiter-Kranken und Invalidencasse in Wien, 1886, 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 35 
 
 tions conducted by Doctor Stiles appear to indicate that the same 
 disease prevails to some extent among the textile operatives in the 
 South. All this indicates the need of a thorough study of the condi- 
 tions affecting health in various occupations, not only to determine 
 the relative health risks and the causes of the undue prevalence of 
 certain diseases in certain occupations, but also to formulate rules 
 which may remove the causes or render the system better fitted to 
 resist them. In this, as in all preventive efforts, a hearty cooperation 
 of the parties interested is absolutely essential for the attainment of 
 the highest measure of success. In this instance the responsibility 
 rests with the State, the employer, and employees; each have certain 
 duties to perform, and the help of all is essential for the mitigation of 
 existing evils. 
 
 INDOOR OCCUTJPATIONS. 
 
 Indoor employment, broadly speaking, is inimical to health, while 
 outdoor work in a pure air favors health and longevity. Without 
 underrating the influence of insanitary dwellings, improper and 
 insufficient food, lack of recreation, and other factors, there is no 
 doubt that one of the chief dangers of indoor life is exposure to viti- 
 ated air. The air of dwellings and workshops is never as pure as 
 the outer air, because it is polluted by the products of respiration, 
 combustion, and decomposition, and the presence of individuals also 
 tends to vitiate the air with dust, germs, and organic matter from 
 the skin, mouth, lungs, and soiled clothing. Unless proper provision 
 is made for the dispersion of foul air and the introduction of pure 
 air there is much reason for assuming that these impurities play a 
 more or less important role in what has been designated as " crowd 
 poisoning," characterized in the acute form by symptoms of oppres- 
 sion, headache, dizziness, and faintness, while the chronic effects of 
 deficient oxygenation and purification of the blood are plainly evinced 
 by the pallor, loss of appetite, anaemia, and gradual loss of physical 
 and mental vigor. All of these effects are intensified when human 
 or animal beings are obliged to occupy rooms with an air supply in- 
 sufficient for the proper oxygenation of the blood, and as a result of 
 this habitual exposure to vitiated air we note an undue prevalence 
 of consumption in crowded workshops, dwellings, prisons, public in- 
 stitutions, and formerly also in military barracks and battle ships. 
 Even live stock shows the baneful effects of insufficient air space, for 
 tuberculosis among the range cattle of the far west, which are prac- 
 tically without shelter, is comparatively rare, while it affects from 
 15 to 25 per cent of dairy herds, which are housed, but without suffi- 
 cient regard to light and air. Improved ventilation and increased 
 air space have everywhere lessened the death rate, and it is chiefly by 
 just such measures that the rate from consumption has been reduced 
 from 11.9 to 1.2 per 1,000 in the British armies. As a matter of fact, 
 an abundance of pure air has been found the most important factor 
 in the treatment of tuberculosis, because it promotes oxygenation of 
 the blood, stimulates the appetite and nutrition, and thereby increases 
 the general resisting power of the system. 
 
36 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION, 
 
 Chapter II. 
 
 OCCUPATIONS INVOLVING EXPOSURE TO IRRITATING DUST. 
 
 It has long been known that dust-inhaling occupations predispos^e 
 to diseases of the respiratory passages, which may result in consump- 
 tion. The particles of mineral dust produce an irritation of the 
 mucous membrane of the nose, throat, respiratory organs, and eyes, 
 and the hard, sharp, and angular particles of iron and stone dust may 
 cause actual abrasions. According to Arnold'* the dust which is 
 inhaled lodges on the mucous membrane of the air passages and vesi- 
 cles of the lungs, there to be coughed up, although some of the finest 
 particles are taken up by the epithelial cells and white corpuscles and 
 carried to the nearest lymphatic glands. The coarser particles, such 
 as iron, stone, or coal dust, usually lodge upon the surface, to be 
 coughed up with the secretions. If not expectorated they will cause 
 harm by clogging up the air vesicles and interfere with respiration. 
 In the meantime not infrequently an irritation is set up, causing 
 catarrhal conditions of the mucous membrane, or a more serious 
 chronic inflammation of the respiratory organs, so common among 
 persons engaged in dusty occupations. The chronic inflammatory 
 conditions thus produced favor infection with the tubercle bacillus. 
 At all events, Hirt's statistics show that men employed in dust-pro- 
 ducing occupations suffer much more frequently from pneumonia 
 and consumption than those not exposed to dust and that there is 
 practically no difference in frequency of disease of the digestive sys- 
 tem. The relative frequency of these diseases per 100 workmen is 
 as follows:* 
 
 Cases of Consumption, Pneumonia, a/nd Digestive Disorders per 100 workers 
 
 in certain occupations. 
 
 Workers in— 
 
 Con- 
 sump- 
 
 Pneu- 
 monia. 
 
 Digest- 
 ive dis- 
 orders. 
 
 Metallic dust.... 
 Mineral dust — 
 
 Mixed dust 
 
 Animal dust 
 
 Vegetable dust.. 
 Nonduflty trades 
 
 28.0 
 25.2 
 22.6 
 20.8 
 13.3 
 11.1 
 
 17.4 
 5.9 
 6.0 
 7.7 
 9.4 
 4.6 
 
 17.8 
 16.6 
 15.2 
 20.2 
 15.7 
 16.0 
 
 Perlen in his " Inaugural Dissertation," Munich, 1887,*' discussed 
 the records of the Munich Polyclinic, where 65,766 persons were 
 treated between 1865 and 1885, including 4,177 tuberculosis patients, 
 viz, 2,801 males, 1,263 females, and 83 children. Of these, 1,425 
 patients had been engaged in occupations where they were exposed 
 to dust, as follows: 
 
 « Untersuchungen (Iber Staubinhalatlon, etc., Leipzig, 188.5. 
 •Cited by Harrington, Practical Hygiene, 1902, p. 678. 
 •Cited by Uffelmann, Handbuch d. Hygiene, 18U0, p. 587. 
 
KEPOBTS OP THE PEESIDENT S HOMES COMMISSION. 
 
 37 
 
 Occupations exposed to — Percent. 
 
 Metallic dnst 30 
 
 Vegetable dust ■ 26 
 
 Mineral dust 18 
 
 Mixed dust 17 
 
 Animal dust 8 
 
 According to the reports of the census of 1900 the consumption 
 death rate of marble and stone cutters in the United States is six times 
 that of bankers, brokers, and officials of companies, and the mortality 
 ■in 61 other employments ranges between these extremes. 
 
 The amount of dust is perhaps less important than the character of 
 the particles which compose it. The susceptibility to consumption in 
 metal workers and stonecutters can only be explained by the fact that 
 the hard, sharp, and irregular particles of this kind of dust are more 
 apt to produce injury of the mucous membranes of the respiratory 
 tract. But it is not fair to assume that the less irritating dust is free 
 from danger, for as pointed out by E. Eoth <» even the inhalation of 
 plaster of Paris or flour dust can not be regarded with indifference, 
 especially when it is preventable. 
 
 Ahrens ^ found the amount of dust for each cubic meter of air in 
 certain industrial establishments as follows: 
 
 Mg. Mg. 
 
 Horsehair works 10.0 Flour mill 28.0 
 
 Sawmill 17.0 Foundry 28.0 
 
 Woolen factory 20.0 Polishing room of foundry 71.7 
 
 Woolen factory with exhauster- 7.0 Felt-shoe factory 175.0 
 
 Paper factory 24.0 Cement works 224.0 
 
 Laboratory 1.4 
 
 Paper-factory employees 343 
 
 Mechanical industrial shops 419 
 
 Wood turners 427 
 
 Laborers in the rag storeroom of 
 a paper factory 429 
 
 According to Schuler and Burkhardt, cited by Roth, the morbidity 
 among 1,000 workmen engaged in dusty occupations, is as follows: 
 
 Bookbinders 98 
 
 Silk weavers 205 
 
 Cotton spinners 235 
 
 Printers 250 
 
 Cotton weavers 285 
 
 Type founders and typesetters 304 
 
 According to Sommerfeld, cited by Roth, the mortality in Berlin 
 of persons engaged in nondusty occupations is 2.39 per 1,000 ; of per- 
 sons engaged in dusty occupations is 5.42 per 1,000 ; the mortality of 
 the Berlin population at the same ages is 4.93 per 1,000. 
 
 Of 1,000 deaths the number of deaths from consumption in occu- 
 pations without development of dust was 381; in occupations with 
 development of dust it was 480 ; in the Berlin population at the same 
 ages, 332.3. 
 
 *• METALLIC AND MINERAL DUST. 
 
 It will be readily understood that in the cutlery and tool industry, 
 especially in the grinding and polishing departments, more or less 
 dust is evolved not only from the metallic surfaces, but also from the 
 numerous grindstones and emery and corundum wheels. This dust 
 production is not wholly avoidable, even when the wet process is em- 
 
 oKompendium der Gewerbekrankheiten, Berlin, 1904, p. 106. 
 » Archiv fiir Hygiene, 1894, Heft 2. 
 
38 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 ployed. It is known that occupations involving the inhalation of this 
 dust tend to produce diseases of the lungs, such as bronchitis, peri- 
 bronchitis, and fibroid pneumonia, but tuberculosis, is also spoken of 
 by the workmen as " grinders asthma " and " grinders rot," leads the 
 list. 
 
 Moritz and Roepke" have shown that 72.5 per cent of the deaths 
 among the metal grinders of Solingen are due to consumption, as 
 compared with 35.5 per cent among the general population. 
 
 The death returns for twelve years of the city of Northampton, 
 Mass., one of the centers of the cutlery and tool industry, show that 
 among "grinders," "polishers," and "cutlers" diseases of the lungs 
 were responsible for 72.73 per cent of the mortality, inclusive of 54.5 
 per cent of deaths from tuberculosis.^ 
 
 Hirt gives the percentage of consumption in the total number of 
 sick among different classes of workers in metal as follows: Needle 
 polishers, 60.6 per cent; file cutters, who are also exposed to inhala- 
 tion of lead, 62.2 per cent; grinders, 40 per cent; nail cutters, 12 per 
 cent. 
 
 Greenhow ^ over fifty years ago called attention to the excessive 
 mortality among the needle polishers of Sheffield. Beyer <^ found 
 that of 196 needle polishers at Remscheid only 24 were over 40 years 
 of age. The reason why this occupation is especially dangerous is 
 because the " wet process " can not be employed for small objects, 
 which moreover have to be brought more closely to the eyes, and thus 
 the chances for the inhalation of this metallic dust are increased. 
 
 The danger in all such establishments can be reduced to a minimum 
 by the employment of respirators and forced ventilation to carry the 
 dust away from the operator. The Massachusetts report, cited above, 
 states that " even when employers have provided hoods, connected 
 with a system of exhaust fans or blowers, a very large proportion of 
 grinders recklessly remove the hoods, and thus expose themselves 
 unnecessarily to this especially dangerous form of dust. They assert 
 that they prefer freedom of movement, with dust, to the protection 
 offered by hoods." 
 
 Stonecutting is regarded as a dangerous occupation, and con- 
 sumption is quite common among men engaged in the industry. Those 
 who have witnessed the various operations realize that in spite of wet 
 processes, and employment in the open air, the workmen are exposed 
 to a great amount of this irritating form of dust, especially those 
 who operate the pneumatic tools. 
 
 A collective investigation published in 1901, and cited by Roth,« 
 shows that of every 100 deaths among stonecutters, polishers, and 
 quarrymen 86 were due to diseases of the lungs, inclusive of 55 deaths 
 from consumption. Of 2,013 stonecutters examined by Sommerfield, 
 19.7 per cent were afflicted with consumption; 17.98 per cent with 
 other diseases of the lungs, and nearly all had a chronic catarrh of the 
 throat or larynx. 
 
 o Cited by Roth, p. 26. 
 
 b Report of the state board of health of Massachusetts upon the sanitary 
 condition of factories, worl^shops, etc., 1907, p. 87. 
 
 '^ Cited by Sander, Handbuch der oeffentl. Gesundheitspflege, 18S5, p. 106. 
 <* Beyer, Die Fabrilrindustrie des Reg. B. Duesseldorf, 1876. 
 • Kompendium der Gewerbekrankheiten, Berlin, 1904, p. 108. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 39 
 
 According to the report of the board of health of Massachusetts, 
 previously cited,* of 343 deaths which occurred in the city of Quincy, 
 Mass., among stonecutters during a period of about sixteen years, 41.4 
 per cent were due to pulmonary consumption; 12 per cent to other 
 diseases of the lungs ; 12.8 per cent to diseases of the heart ; 7 per cent 
 to violence; and 26.8 per cent to all other causes. 
 
 Mr. Frederick S. Crum^ calls attention to the excessive average 
 mortality rate from consumption, 205.4, in Barre, Vt., which he attrib- 
 utes to the stonecutting industry. 
 
 Millstone and slate cutting are also regarded as dangerous occupa- 
 tions. Persons engaged in glass cutting and polishing are not only 
 exposed to the inhalation of a sharp and irritating dust, but also to 
 lead poisoning from the use of putty powder, which contains 70 per 
 cent of lead oxide. In glass establishments in Massachusetts, where 
 all the cutting and polishing is done by the wet method, no dust is 
 perceptible, and the employees as a class appear to enjoy good health. 
 Gem finishers also have a high consumption and sick rate. Workers 
 in mica dust and bronzing powders used in the manufacture of wall 
 papers, fancy souvenir cards, moldings, frames, etc., are predisposed 
 to diseases of the respiratory passages, and the bronze powder in 
 addition is liable to produce headache, loss of appetite, nausea, vomit- 
 ing, and diarrhea. 
 
 It is said of the bronzing department of some of the lithographing 
 establishments in Massachusetts that in spite of the exhaust ventila- 
 tion the air is heavy with bronze dust most of the time.^' " The boys 
 who run the fine bronzing machines wear handkerchiefs over the nose 
 and mouth. They look pale and unhealthy, and all show the charac- 
 teristic green perspiration due to contact with bronze. The great 
 majority of the employees appear to be healthy." 
 
 In the manufacture of machinery and metal supplies some of the 
 operations involve exposure to dust, fumes, vapors, or extreme heat. 
 In some of the processes, where emery wheels and revolving wire 
 brushes are used, enormous amounts of fine steel and emery dust are 
 given off, unless equipped with exhaust ventilating appliances. In 
 a Massachusetts investigation covering 24 establishments the air of 
 some of the rooms was found exceedingly dusty and about one-tenth 
 of the occupants looked pale and sickly, and complained of the irri- 
 tation of the air passages by the dust. The number of employees in 
 these establishments ranges between 12,500 and 15,000. Some of the 
 establishments were models in character as regards light, ventilation, 
 and general sanitation. " The tumblers and emery wheels are pro- 
 vided with hoods and blowers which are effective and there is practi- 
 cally no dust. The rooms in which castings are dipped are properly 
 ventilated and all fumes are effectively removed. All of the machin- 
 erj^is well protected." 
 
 One brass foundry was reported where the air was heavy with 
 fumes, especially in winter, no mechanical ventilation being installed, 
 and in which the workmen have occasional attacks of " brass foun- 
 
 oPage 79. 
 
 * Quarterly Publication of American Statistical Association, December, 1907, 
 p. 465. 
 
 « Report of the State Board of Health of Massachusetts upon the sanitary con- 
 dition of factories, workshops, etc., 1907, p. SO. 
 
40 EBPOETS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 ders' ague." The following may be taken as a fair statement of the 
 hygienic aspects of the machinery and metal industry: "While the 
 nature of some of the processes is such as to warrant classification 
 of this industry with the dangerous trades, the conditions under 
 which the work is done are very largely responsible for the injurious 
 effects on the health of the employees, and these conditions are to a 
 considerable extent avoidable or at least susceptible of improvement." 
 
 The same Massachusetts investigation covered 14 iron and steel 
 foundries and 9 stove foundries. In one establishment, the depart- 
 ment in which the castings are sand blasted was found very objec- 
 tionable, as the air was heavily impregnated with flying sand, which 
 " gets into the mouth, nose, and eyes, and the employees suffer con- 
 siderably from soreness of the last-mentioned organs." In another 
 establishment this condition is very much ameliorated by a large 
 flaring hood in the center of the room with upward-suction draft, 
 the operatives wearing helmets with fine wire inserts to protect the 
 eyes, and cloths underneath the helmets to protect the nose and mouth. 
 Iq one of the stove foundries " the dust from the polishing and buff- 
 ing process, in the absence of hoods and exhaust ventilation, is so 
 thick that objects a few feet distant can not clearly be made out. 
 Many men refuse to work in this establishment in the hot months 
 on account of the excessive heat and general discomfort. In some 
 instances, however, where the necessary protection is afforded by 
 the employer, the men habitually remove the hoods and become cov- 
 ered with emery and iron particles." 
 
 In the crushing, grinding, and sifting process incident to the manu- 
 facture of emery, corundum, and sandpaper more or less fine dust is 
 given off in spite of the fact that the machines are more or less com- 
 pletely inclosed. The emery and corundum industry must be classed 
 among the trades intrinsically dangerous to health, on account of the 
 peculiarly irritating character of dust. But as is the case with other 
 dusty occupations, few of those employed can be induced to wear 
 respirators. 
 
 Coal miners, charcoal men, firemen, chimney sweeps, etc., are ex- 
 posed to constant inhalation of coal dust and soot, and though subject 
 to chronic bronchial catarrh, consumption is not especially common 
 among them. 
 
 VEGETABLE DUST. 
 
 Millers and bakers inhale flour dust, and according to Hirt 20.3 
 per cent of all the diseases in millers are pneumonia, 9.3 per cent 
 bronchial catarrh, 10.9 per cent consumption, and 1.9 per cent emphy- 
 sema (abnormal collection of air in the lungs). The tuberculosis 
 death rate according to Schuler among millers in Switzerland is 3.75, 
 as compared with 2.95 per 1,000 in the general population. Carpen- 
 ters, joiners, cabinetmakers, etc., are exposed to wood dust, and the 
 dust from hard wood is probably more injurious than that from 
 softer kinds. Dr. E. J. Neisser« refers to a wooden-tool factory at 
 Strassburg which in 1904 furnished 15 cases of sickness out of the 20 
 employees, with two hundred and eighty-eight days loss of work, 
 distributed as follows : Diseases of the eyes, 1 ; of nose, 1 ; throat, 2 ; 
 and diseases of the lungs, 6. The Massachusetts board of health 
 
 o Internatlpmil* Ueberglcht ueber Gewerbehygiene, Berlin, 190T. 
 
KEPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 41 
 
 fodnd that in the agricultural tool and implement industry a hard 
 wood called " coca-bola," which is used for tool handles, evolves a 
 very pungent and irritating dust, productive of inflammation of the 
 eyes and skin. Some persons in tne course of a week or two become 
 accustomed to its effects, while others are obliged to discontinue 
 work in the department.** 
 
 The medical inspector of Great Britain, according to Neisser, 
 reported a number of toxic symptoms which occurred among persons 
 engaged in the manufacture of weaver shuttles made from African 
 boxwood. Investigation revealed the presence of an alkaloid in the 
 wood, which acted as a heart depressant, producing a slow and inter- 
 mittent pulse ; headache, drowsiness, watering of the eyes and nose, 
 difficulty in breathing, nausea, and weakness. 
 
 Laborers in ^rain elevators and grain thrashers inhale a very irri- 
 tating dust, which may cause acute and chronic catarrh of the mucous 
 membranes. Workers in tobacco suffer more or less from nasal, 
 conjunctival, and bronchial catarrh and digestive and nervous de- 
 rangements, and although the mucous membranes gradually become 
 accustomed to the irritation of the dust and fumes, the occupation 
 appears to be dangerous, as the consumption rate ranks next to that 
 of stonecutters. 
 
 It is said that female workers in tobacco are more liable to mis- 
 carry; at all events Doctor Rosenfeld, cited by Roth (p. 166), found 
 this to be true in Austria. Dr. E. R. Tracy, of New York, reports 
 that 325 cigar makers' families visited by him had only 465 children, 
 an average of 1.43 to each family, and feels disposed to attribute this 
 to the frequent abortions among the female operatives. This experi- 
 ence is not confirmed by recent observations made in German tobacco 
 towns like Giessen, for example (Neisser, p. 125), and more extended 
 investigations are called for. Some authors maintain that tobacco 
 dust exerts a protective influence against infective agents, and instance 
 the fact that during the cholera epidemic of Hamburg in 1892 there 
 were only 8 cases among the 5,000 resident cigar makers. The Massa- 
 chusetts report previously cited, in discussing the cigar and cigarette 
 factories in Massachusetts, refers (p. 49) to the spitting habit and the 
 objectionable practice of finishing cigars with the aid of saliva. This 
 practice was observed in more than one-third of the places visited, 
 and in 18 factories the practice of biting off the end of the filler and 
 inner wrappers with the teeth was also observed. The report reiter- 
 ates the statement made to the legislature in January, 1905, as to the 
 possibility of disseminating loathsome diseases through this practice. 
 Such conditions certainly emphasize the necessity for the use of cigar 
 holders. 
 
 TEXTILE INDUSTRIES. 
 
 Operatives in cotton and flax textiles are perhaps more subject to 
 dust inhalation and various diseases of the respiratory and digestive 
 organs than those of woolen mills. The Census Report of the United 
 States for 1900 gives the death rate among 150,783 male mill and 
 factory operatives (textiles) as 8.1 per 1,000, and of the 162,932 
 female operatives as 4 per 1,000. As pointed out by Mr. F. L. Hoff- 
 
 • Report of the State Board of Health of Massachusetts upon the sanitary 
 condition of factories, workshops, etc., 1907, p. 89. 
 
42 
 
 EBPOBTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 man, it would have been exceedingly interesting to learn the death 
 rate among cotton, linen, wool, and silk workers. The phthisis death 
 rate in 1892 in Belfast « with its 30,000 persons engaged in the linen 
 industry was 4.1 per 1,000, against 1.4 for the whole of England and 
 Wales, and 2.1 for Ireland. According to Schuler and Burkhardt, 
 1,000 linen spinners furnish annually 221.6 cases of sickness; 1,000 
 weavers 202.7, while female operatives suffer even more, the sick rate 
 being 249.5 and 334.4 for the respective occupations. 
 
 Cases of sickness per 1,000 emijloyces among spinners and weavers. 
 
 Disease. 
 
 Diseases of the digestive organs 
 
 Diseases of the respiratory organs 
 
 Diseases of the motor organs . 
 
 Diseases of a constitutional character 
 
 Cases per 
 1,000 spin- 
 ners. 
 
 58.7 
 47.7 
 29.6 
 22.9 
 
 Cases per 
 
 1,000 
 weavers. 
 
 103.4 
 
 • 52.6 
 
 21.2 
 
 31.6 
 
 Arlidge ^ gives a table showing the comparative frequency of the 
 most important diseases in the case of 739 weavers, and of 676 per- 
 sons following the several other branches of the cotton industry, such 
 as winders, spinners, reelers, curlers, mill hands, grinders, etc., and 
 who for convenience sake are designated by him as machine-room 
 workers. The figures are based on 1,415 operatives who received 
 treatment as in and out patients in connection with the Preston 
 Hospital during a period of six years. 
 
 Disease. 
 
 Per cent of 
 machine- 
 room work- 
 ers treated 
 for speci- 
 fied disease. 
 
 Phthisis 
 
 Dyspepsia 
 
 Bronchitis 
 
 Varicose veins and ulcers 
 
 Rheumatic affections 
 
 Uterine disorders and displacements 
 
 Neuralgia 
 
 Throat affections 
 
 Renal diseases 
 
 Epilepsy 
 
 Heart diseases 
 
 Debility 
 
 Anemia 
 
 11.90 
 21.00 
 31.30 
 6.80 
 11. 68 
 8.43 
 4.43 
 2.51 
 2.66 
 8.40 
 5.32 
 9.17 
 2.60 
 
 It will be observed that the Swiss and English statistics both reveal 
 an undue prevalence of the diseases of the respiratory and digestive 
 organs. It has been suggested that the constrained position of weavers 
 is to a large extent responsible for the undue prevalence of dyspepsia 
 among the Swiss weavers, but other factors, like improj^er food, 
 indoor life, and home conditions should be considered. This is appar- 
 ent from the fact that the percentage of cases of dyspepsia among the 
 
 «G. H. Ferris, Journal of State Medicine, March, 1895. 
 ^ Arlidge. " The Hygiene, diseases, and mortality of occupations,' 
 1892, p. 361. 
 
 London, 
 
BEPOBTS OP THE PBESIDENT^S HOMES COMMISSION. 43 
 
 English weavers is smaller than among machine-room workers. The 
 constitutional disorders like anaemia, chlorosis, neuralgia, and de- 
 bility are likewise due to a variety of causes, chief of which are 
 vitiated air, resulting from defective ventilation of the workshops, 
 overwork, insufficient or improper food, and insanitary homes. 
 
 Uterine derangements and displacements may very properly be 
 attributed to general debility, overwork, and long standing in hot and 
 moist workrooms, and, like varicose veins and ulcers and " flat feet," 
 may be expected to develop in other occupations involving long stand- 
 ing. (See occupations involving constrained attitudes.) 
 
 The undue prevalence of pulmonary diseases among the textile 
 operators can be accounted for by a number of factors, such as the 
 presence of very fine cotton or flax dust or " fly ;" air vitiated by the 
 products of respiration and combustion, the presence of infectious 
 germs from the promiscuous expectoration habit ; faulty life and home 
 surroundings. Of these the presence of " fly " is doubtless a very 
 important predisposing factor, since it is generally admitted that this 
 dust acts as an irritant to the repsiratory passages, and sooner or later 
 prepares the way for the invasion of the germs of tuberculosis, pneu- 
 monia, etc. Coetsem describes the so-called byssinosis or " pneumonic 
 cotonneuse," but it is by no means settled whether in these cases we 
 have to deal with a typical occupation disease, or with a specific infec- 
 tion, in which the inhalation oi the cotton dust simply operates as a 
 predisposing cause. It is very probable, however, that the habitual 
 inhalation of this dust may produce disease of the lungs not necessarily 
 tubercular. 
 
 Arlidge says: 
 
 If inhaled longer, it reaches the bronchi, and sets up cough with white mu- 
 cous expectoration. The cough will be for years chiefly a morning phenomenon 
 on first rising, but it is also induced upon leaving the warm workroom. Fine 
 fibers of cotton are found, on microscopical examination, in the sputum, and as 
 these make their way into the pulmonary tissue they set up morbid action, 
 resulting in increasing density of it on the one hand and of emphysematous 
 expansion on the other. These morbid changes are accompanied by dyspnoea, 
 wasting, and debility, but rarely with hemoptysis [spitting of blood], and 
 together constitute a group of symptoms not inappropriately termed " industrial 
 phthisis." Morover, intercurrent diseases of the lungs, such as acute bronchitis 
 and pneumonia, often arise and terminate life, and true tubercular phthisis 
 is no uncommon cause of death. 
 
 The chief requirements for the amelioration of existing conditions 
 in the textile industry are efficient machines for the prevention and 
 removal of dust. The utmost care should be taken to provide the 
 most perfect methods so far devised for the removal of dust and for 
 proper ventilation. The lighting should be good, both for day and 
 night work, giving preference to electricity. The temperature and 
 huiAidity of the rooms should be regulated, and children under the 
 age of 14, or those with weak chests, should not be employed at all in 
 the cotton mills. 
 
 In the textile industry in Massachusetts analysis of the death 
 returns during the year 1905 from the three principal " mill towns " 
 shows that although tuberculosis is one of the leading causes of death 
 among mill operatives the general death rate of this class was by no 
 means abnormally high, being, respectively, 7, 8, and 10 per 1,000. 
 Tuberculosis caused, respectively, 32, 23.57, and 21 per cent of the 
 deaths. It appears also that the general death rates of the cities whose 
 
44 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 population includes the highest percentage of the textile operatives 
 compare not unfavorably with those of certain other cities which are 
 engaged in other kinds of manufacture or are more residential in 
 character, in spite of the high rate of infant mortality which appears 
 to be inseparably connected with mill populations everywhere.'* 
 
 A source of danger is the presence of infectious dust from dried 
 sputum in the air of different mill rooms on account of the indiscrimi- 
 nate habit of spitting. 
 
 The report also includes an excellent summary of the results 
 obtained by an inspection of 93 manufacturing establishments and the 
 conditions found in a certain proportion of weave and spinning rooms 
 are tabulated as follows: (1) Poor light; (2) presence of carbon- 
 dioxide and carbon-monoxide in the air; (3) nonregulation of arti- 
 ficial moisture (a) excess of moisture, undue heat or (b) no artificial 
 moisture, excessive heat; (4) more or less dust (" fly " dust from siz- 
 ing, etc.) ; (5) lack of cleanliness; (6) lack of provision for a plenti- 
 ful supply of fresh air. In the majority of mills the toilet and wash 
 rooms were found to be beyond criticism ; but in not a few " the im- 
 perative need of improvement as regards structure, location, ventila- 
 tion, and common decency " are pointed out. The number of acci- 
 dents in textile mills, considering the large number of fast-running 
 machines, is not large, during a period of almost five years at the 
 Pacific Mills, with about 5,200 employees, amounting to 1,000 classified 
 as follows: 
 
 Accidents to employees of the Pacific Mills, Lawrence, Mass., August 10, 1900, 
 
 to July IS, 1905. 
 
 Killed outright 1 
 
 Fatally injured 1 
 
 Seriously injured (broken limbs or amputation necessary) 86 
 
 Slightly injured 910 
 
 Unclassified (suffered nervous shock, but physically uninjured) 2 
 
 Total 1,000 
 
 The underlying cause of injury is given as follows : 
 
 Careless manipulation 539 
 
 Deliberate carlessness (taking chances of being injured, such as cleaning 
 
 machinery while running, etc.) 164 
 
 Inattention to surroundings 177 
 
 Carelessness of fellow-workman 51 
 
 Unforseen liability 60 
 
 Unclassified 9 
 
 Total 1,000 
 
 According to the factory inspector's statistics of the State of New 
 York (cited by Frederick L. Hoffman «) for the five years ending with 
 1905, out of 3,140 accidents in textile industries, 36, or 1.1 per cent, 
 were fatal. Of the total number of accidents 82.5 per cent caused 
 temporary disablement and 16.2 per cent permanent disablement. 
 
 In 3 mills in Massachusetts devoted to the manufacture of twine, 
 cordage, and gunny cloth from jute and hemp some of the workrooms 
 
 « Report of the State Board of Health of Massachusetts, 1907, p. 16. 
 * Bulletin Bureau of Labor No. 78. September, 1908. 
 
BEPOBTS OP THE PRESIDENT'S HOMES COMMISSION. 45 
 
 are reported to be exceedin^y dusty in spite of mechanical ventila- 
 tion and open windows. " Many of the oj)eratives wear thick bunches 
 of fiber over mouth and nose as a protection. A fairly large propor- 
 tion of the operatives show the effects of their employment, looking 
 pale and sickly." In the room where the sisal hemp is fed into 
 breakers the air is filled with dust. " In one of the establishments 
 the employees in all departments look well and strong, although the 
 air in some parts contained considerable dust." « 
 
 In 5 Massachusetts carpet and rug factories, employing about 6,000 
 persons, about 10 per cent of whom are between the ages of 14 and 16, 
 the largest of these factories shows some departments in which poor 
 light, excessive heat, moisture, and dust constitute objectionable con- 
 ditions. In one room there was '' so much fine cotton dust and fiber 
 in the air that it is with difficulty one can see across. This dust is 
 very irritating to the nose and throat." In one of the establishments 
 the children are described as very small and poorly developed for 
 their age " to be allowed to work ten hours and twenty minutes for 
 five days in the week." In another factory " about one-tenth of the 
 employees look sickly." The smallest factory employs 5iOO persons, 
 " has good light, adequate ventilation, and commendable weave rooms, 
 and the employees appear to be in good health." 
 
 One of the shoddy mills examined was poorly lighted, inadequately 
 ventilated, dusty, and ill kept; the other was light, clean, and well 
 ventilated. " Some of the women employed appeared to be in poor 
 physical condition. In the 6 felt-cloth factories examined the work 
 was found to be conducted in fairly lighted and, apart from dust, 
 adequately ventilated buildings. In each there was more or less dust, 
 especially in the picking and carding rooms; but the amount was 
 much diminished in most of them by means of blower fans." 
 
 ANIMAL DUST. 
 
 Of the several classes of dust, that from wool is considered to be 
 less irritating than flax or cotton, and horn is believed to be more 
 irritating than bone. The conditions found in some of the woolen 
 mills in Massachusetts as regards light, ventilation, and general 
 cleanliness are reported as far from satisfactory; but in the absence 
 of morbidity statistics it is difficult to determine the degree of danger 
 to which the operatives are exposed. In the boot and shoe industry in 
 Massachusetts, where there is more or less animal dust evolved, some 
 effort is being made to remove the dust by exhaust flues attached to the 
 machinery. Of the 373 factories summarized by the Massachusetts 
 board of health report previously cited, " 126 are partially, and a 
 fair proportion of these are wholly, equipped with this means of pro- 
 tection ; in 88 of these 126 one or more machines are not so equipped ; 
 and in 49 of the 88 there are rooms in which the air, apart from the 
 escaping dust, is noticeably bad. The number of machines with 
 means for efficient or fairly efficient removal of dust was found to be 
 1,630; the number either inefficiently equipped or devoid of equip- 
 ment was reported as 2,769. * * * While in general the health of 
 the employees appears to be fair to good, in 85 factories a considerable 
 
 "Report of the State Board of Health of Massachusetts upon the sanitary 
 condition of factories, workshops, etc., 1907, p. 46, 
 
46 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 proportion of them are noticeably pale and unhealthy in appear- 
 ance." The pale and poorly nourished condition of youthful em- 
 ployees is also emphasized. 
 
 The dust and moisture involved in the polishing departments of 
 the horn and celluloid industry, and the irritating fumes given off 
 by a "dip " containing glacial acetic acid, are sources of possible 
 injurious effects to the employees. 
 
 In the manufacture of derby and felt hats, apart from the exposure 
 to dust from the fur which comes to the factory clipped from the 
 skin, there is also a certain degree of danger from cyanide of mercury, 
 with which the fur is treated. In 4 felt-hat factories inspected by 
 the Massachusetts board of health, " the employees appeared to be 
 healthy." In some of the establishments visited the fumes of wood 
 alcohol in the drying department were markedly strong. " The 
 workmen stated that they are frequently troubled with headaches, 
 vertigo, smarting and burning of the eyes, and impairment of vision, 
 and that few can remain at this work longer than three or four 
 months at a time." This could readily be prevented by the use of 
 " denature^ " alcohol. In the " pouncing process," which consists in 
 smoothing off the rough hairs from the hat rim and other parts, " a 
 great deal of very fine dust is given off." 
 
 Mr. Frederick S. Crum ^ gives the mortality rate from consumption 
 in Orange, N. J., as 289.9, as compared with the average of 151.0 for 
 the 200 small cities investigated by him, and attributes this excess to 
 the fact that in 1905 there were 1,379 employees engaged in the felt- 
 hat industry in Orange. 
 
 In the brush-making industry hogs' bristles and vegetable fibers 
 are used. In seven brush factories in Massachusetts "the general 
 conditions were found to be beyond criticism and the health of the 
 employees appeared to be fair or good." 
 
 Hirt regarded brush making as a dangerous occupation, as nearly 
 one-half of the deaths among the brush makers were from consump- 
 tion, due probably to the inhalation of the sharp fragments of bristles. 
 
 There are no adequate reliable data as to effects of animal dust 
 given off in the manufacture of woolen goods, silk, feather, fur, hair, 
 horn, bone, shell, ivory, etc. It is reasonable to assume, however, that 
 the dust from all these sources is capable of setting up an irritation 
 and inflammation of the respiratory passages, though not as intensive 
 as that caused by mineral constituents of dust. In the hair, brush, 
 and wool industry there is also some danger from disease germs. 
 
 Chapter III. 
 
 OCCUPATIONS INVOLVING EXPOSURE TO INFECTIVE MATTER IN 
 
 DUST. I 
 
 RAG, PAPER, WOOL, AND HAIR INDUSTRY. 
 
 It has been held for a long time that germs of infectious diseases 
 like smallpox, anthrax, scarlet fever, tuberculosis, typhus and typhoid 
 fever, diphtheria, measles, and cholera may cling to body and bed 
 
 « Quarterly Publication of the American Statistical Association, December, 
 1907, p. 464. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 47 
 
 clothes and prove a source of danger to those coming in contact with 
 rags in the rag business and paper industry.* The danger, while per- 
 haps overrated, is nevertheless real and can be guarded against only 
 by a thorough disinfection of the rags by steam under pressure before 
 they are handled at the paper mills. 
 
 The occupation is evidently inimical to health. Of 4,857 German 
 operatives reported by Uffelmann, 50 per cent are annually taken 
 sick ; about 34 per cent of those engaged in the handling of dry rags 
 suffered from affections of the respiratory passages, and only 21.9 
 per cent of those otherwise engaged in the same establishments, all 
 of which speaks strongly for the necessity of proper ventilation and 
 exhaust flues for the removal of dust. 
 
 In this connection it is proper to refer to the dangers of the so- 
 called " rag sorters' " and " wool sorters' " disease, which are nothing 
 more or less than anthrax infection — a disease transmissible from 
 animals to man by means of wool, hides, hair, and horsehair. Two 
 hundred and sixty-one cases, with 67 deaths, were reported, according 
 to Neisser, in England from 1899 to 1904. Of these, 88 occurred 
 among those engaged in the wool industry, 70 cases among persons 
 engaged in curled-hair and brush factories, 86 in persons engaged in 
 tanneries and hide trades, and 17 in other industrial pursuits. 
 
 About 59 cases of anthrax infection were reported in different parts 
 of Europe during the year 1905. Ravenal reported in three localities 
 in Pennsylvania, during the summer of 1897, 12 cases among men and 
 60 in cattle, which were traced to a tannery handling imported hides 
 from China. Nichols reported 26 cases occurring in persons employed 
 in a curled-hair factory within three years. 
 
 The General Government recognizes the dangers by insisting upon 
 the exclusion of rags, wool, and hides coming from infected districts 
 during the prevalence of cholera, anthrax, and typhus fever and 
 their proper disinfection at all times. tVTiile anthrax is not a very 
 common disease among American domestic animals, local pustular 
 infections and carbuncle are by no means infrequent, and might well 
 be guarded against, as in some of the European countries, where 
 recourse is had to disinfection of the raw material, special blower 
 apparatus for the removal of dust, repeated disinfection of the 
 premises, and prompt treatment of all slight wounds and abrasions. 
 
 The material from which paper is made includes rags, burlap, old 
 paper, and wood pulp. The rags are chiefly imported from foreign 
 countries, arriving in a baled condition, and after opening are sub- 
 jected to a number of processes for the purpose of cleaning and dis- 
 integration. The "beating, thrashing," and "chopping" process is 
 carried on by machines and is attended by the escape of more or less 
 dust. The quantity naturally varies with the cleanliness of the stock. 
 In the observations of about 80 establishments, the Massachusetts 
 boara of health found that with the usual grade of stock, no matter 
 what kind of " duster " or " thrasher " is used, a considerable amount 
 of dust is also evolved in the " chopping " process, and in spite of 
 exhaust fans and dust pipes some dust will escape. The men engaged 
 in the collection and baling of this dust are usually provided with 
 
 "The State of Maine requires evidence of successful vaccinntion in persons 
 engaged in the rag industry or those employed in the manufacture of paper 
 from foreign and domestic rags. 
 
48 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 respirators. In a majority of the mills visited a proportion of the 
 employees are exposed to an excessive quantity of dirt, dust, and lint, 
 and in most of this majority the persons so exposed show not a few 
 who are pale and sickly in appearance. A comparison of the death 
 rate from tuberculosis, pneumonia, and bronchitis at Holyoke, the 
 center of this industry in Massachusetts, with those of the State at 
 large, showed " that the Holyoke rates were under rather than over 
 the average."" 
 
 Chapter IV. 
 
 OCCUPATIONS INVOLVING EXPOSURE TO POISONOUS DUST. 
 
 LEAD DUST. 
 
 All occupations in which lead is employed and in which particles 
 of lead may be inhaled, swallowed, or absorbed by the skin must be 
 regarded as dangerous to health. Lead poisoning in its various 
 forms, such as the lead habit, characterized by loss of weight, anaemia, 
 sallow skin, a blue line along the gums, offensive breath, a sweetish 
 taste and diminished salivary secretion, lead colic, lead paralysis, 
 wrist drop, painful affections of the lower extremities, and other 
 grave nervous diseases, is frequently seen in artisans. It attacks per- 
 sons employed in the roasting of lead ores, in the manufacture of 
 white and red lead, acetate and chromate of lead, china and pottery, 
 artificial flowers; also painters, plumbers, varnishers, type founders, 
 typesetters, file cutters, glass and gem cutters, electricians (especially 
 those employed in charging storage batteries), persons engaged in 
 enameling, dyeing, printing, working in rubber goods, weighted silk, 
 and glazing of paper, and many other occupations involving the em- 
 ployment of lead. • 
 
 Doctor Teleki, of Vienna, in 1906 reported several cases of lead 
 poisoning in females and young girls, contracted in fringe making, 
 the silk having been weighted by a solution of sugar of lead. 
 
 Of 999 employees in Prussian lead smelters during the year 1905, 
 177 suffered from lead colic or lead palsy, involving 3,056 days' loss 
 of work ; and of 4,789 engaged in zinc smelters, 50 of the employees, 
 with 2,217 days' loss of work, were thus affected. 
 
 In Europe a most marked reduction in the morbidity and mort,ality 
 has taken place during the past ten years, coincident with the enforce- 
 ment of preventive measures. The number of cases of lead poisoning 
 in England, where report is compulsory, has been reduced from 1,278 
 cases in 1898 to 592 cases in 1905. While most of the cases occurred 
 in sugar of lead works and potterias, a considerable number were also 
 reported in the other occupations already referred to. The percentage 
 of severe cases in men was 23.9, as compared with 13.9 in females — 
 perhaps because the latter have cleaner habits and possibly also stop 
 work more j)romptly upon the appearance of the first symptoms. 
 
 In Paris it is estimated that over 30,000 persons are engaged in 
 occupations involving exposure to lead, and of the 14,000 painters and 
 varnishers employed there an average of 250 are treated annually in 
 the hospitals for lead poisoning. 
 
 « Report of the State Board of Health of Massachusetts upon the sanitary 
 condition of factories, workshops, etc., 1907. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 49 
 
 File cutters are not only subjected to an irritant dust, but also to 
 lead poisoning, because the file in cutting is being held upon a leaden 
 bed " and particles of lead are inhaled with the dust and may also be 
 absorbed by the fingers in handling the stiddy." The mortality figure 
 for plumbism in 1890-1892 was no less than 75.° 
 
 The greatest danger in lead works is from inhalation of the lead 
 dust and fumes ; hence a special spray apparatus and exhausters have 
 been designed, and employees have been taught to protect their hands 
 with gloves and the mouth and nose with respirators. 
 
 In the pottery industry, where the danger arises from the glazes, 
 the flux being made of litharge, clay, and flint, it has been found that 
 the danger can be very much reduced by using only 8 per cent of car- 
 bonate of lead in the form of a " double- fritted silicate," instead of 
 the older method, in which from 13 to 24 per cent of lead carbonate 
 was employed. 
 
 Smoking should be forbidden during the working hours, and the 
 work should be done in a special suit, frequently washed. The hands, 
 face, and nostrils should be thoroughly washed with soap and water 
 upon cessation of work, and the mouth and throat rinsed with a 
 watery solution of tartrate of ammonia before eating and drinking. 
 The same rules are applicable to painters, who would likewise find it 
 of benefit to soften old paints with an alkali (weak lye) before scrap- 
 ing and to keep the handles of tools clean from deposits. 
 
 THE LEAD INDUSTRY IN MASSACHUSETTS. 
 
 The report of the Massachusetts board of health * gives a very 
 complete account of the conditions which obtain in the manufacture 
 of lead compounds in the several factories visited. " The men who 
 attend the grinding machines are of a very different class from those 
 who empty the stacks, and since they are not exposed to lead dust they 
 do not suffer from lead poisoning and are comparatively healthy. 
 Those who empty the stacks do not remain long at work. It is said 
 that this is due in part to the disagreeable nature of the work, in part 
 to the fact that they are largely roving characters, who do not care to 
 work more than a few days occasionally, and in part to the fact that 
 they acquire lead poisoning and are obliged to quit. Even those of 
 good intentions rarely^ work more than a month." 
 
 One establishment is referred to where white lead is made by the 
 " wet process," with no evolution of dust, and there is no history of 
 lead poisoning. In a " red-lead " factory, also, the general process is 
 commended, especially the absence of appreciable amounts of dust, 
 and the intelligence of the workmen, who are mindful of the dangers 
 and who, with an experience of six to twenty-five years, appear well 
 and strong. In one of the lead-oxide works more or less dust escapes 
 into the air during the transfer to the mill and packing it into barrels. 
 The men wear respirators, and each man washes carefully and 
 changes all his clothes before leaving the establishment. In another 
 establishment " all of the 40 employees appeared to be in good health, 
 and the conditions everywhere were found to be commendable." 
 
 In the lead-pipe and plumbers' supplies factories the lead fumes 
 are carried away by hoods and exhaust pipes, and in no instance was 
 it possible to trace a case of lead poisoning to faulty methods. All 
 of the employees observed the necessary precautions and appeared 
 
 « Dangerous Trades, Oliver, 1902, p. 138, 
 » Page 99. 
 S. Doc. 644, 60-2 5 
 
50 REPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 to be in good health. In the manufacture of solder the same precau- 
 tions are employed, and although in the establishment described, rats, 
 cats, and dogs appear to succumb to lead poisoning, only one case of 
 lead poisoning occurred among the employees in thirty-five years. 
 
 In the pottery industry it is said that lead poisoning is almost 
 unknown in the six establishments visited; only two cases occurred 
 a few years ago in girls who applied the glaze. A possible explana- 
 tion foi this gratifying contrast to conditions observed in French and 
 English potteries may be found in the fact " that the persons engaged 
 in this industry appear to be of good intelligence and understand 
 thoroughly the importance of care and strict personal cleanliness, and 
 that the employers provide ample means for its maintenance. " 
 
 Wire and wire-cloth making as carried on in some of the plants 
 visited in Massachusetts appear to be attended, in the opinion of 
 Doctor Hanson,® by " avoidable dangerous conditions." "After the 
 wire is hardened by being run into crude oil, it is passed through ket- 
 tles of molten lead inside the tempering furnaces and is then finished 
 and wound for shipment. From the tempering furnaces dense blue 
 fumes arise and envelop the men whose work it is to feed and tend 
 them. Occasional cases of lead poisoning occur in this department. 
 In one establishment one of the employees of five years' experience 
 shows the characteristic blue line of lead poisoning on the gums, and 
 another of fourteen years' experience, in the same room, has a history 
 of ' wrist-drop ' and other evidence of chronic poisoning. Efficient 
 mechanical ventilation is most necessary in this work, but it is not 
 always provided." * 
 
 Doctor Hanson, evidently referring to the same factory, writes : 
 
 All of the employees in this room worked eleven hours a day and had irregu- 
 lar hours for eating. There were no rules concerning the duties of the em- 
 ployers or those of the persons employed in order to avoid this serious danger. 
 On the contrary, the hoods and blowers and top ventilators for the lead and 
 other fumes were found to be distinctly inefficient, and over oije large furnace 
 there was no protection of any sort, the appliances having been broken years 
 before and none renewed, so that all the fumes mingled at once with the air of 
 the room. 
 
 In making shingle stains, pigments like chromate of lead, zinc 
 oxide, iron oxide, and Prussian blue are used, and in the two estab- 
 lishments visited the men appeared to be careless in the matter of 
 handling the pigments.*' In the manufacture of paints, colors, and 
 varnishes much of the work is done outdoors by men who have 
 worked from six to twenty years; the man who makes the lead colors 
 has worked seventeen years without sickness.** The last case of 
 poisoning at this establishment occurred sixteen years ago, ^\\\vu a 
 number of inexperienced men were poisoned with Paris green. In a 
 color and mordant factory where aniline colors, logwood, starch, 
 sodium dichromate, etc., are used, " about one in five of the employees 
 is noticeably pale and sallow, and inflamed eyes were not uncommon." 
 The latter condition is ascribed to the sodium dichromate. In the 
 manufacture of " whiting " about half of the 58 men employed in 
 three establishments visited " looked to be in poor condition." 
 
 <»"The effect of industry on health," Boston Med. Journal, No. 14, April 4, 
 1907, Wm. C. Hanson. 
 
 ^ Report of the State Board of Health of Massachusetts, 1907, p. 91. 
 c Page 106. 
 *Page 107. 
 
BEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 51 
 
 PRINTERS, TYPE FOUNDERS, AND TYPESETTERS. 
 
 The mortality of printers in England is high, being 1,096 per 
 10,000, as against 953 for all occupied males and 602 for agricultural- 
 ists.^ According to Schuler, of 1,000 Swiss type setters and founders, 
 304.7 are annually taken sick, and of printers 250. Diseases of the 
 digestive organs predominate (78 per 1,000). Diseases of the respira- 
 tory passages come next (75 per 1,000). Sommerfeld states that 
 among 38 occupations tabulated by him the printers occupy the fifth 
 rank in the number of deaths from tuberculosis. Albrecht reports 
 that the statistics of the Berlin Sick Benefit Insurance Company cov- 
 ering a period of thirty-three years show that 48.13 per cent of the 
 deaths among printers are caused by consumption.^ 
 
 This may be due in part to the fact that many weaklings engage in 
 this occupation, but the work itself is often performed in most unfa- 
 vorable environments and in an impure and dusjty atmosphere, which 
 has been found to contain traces of lead, arsenic, and antimony. Spe- 
 cial attention should be paid to proper ventilation, and particularly to 
 the collection and removal of dust from the type cases. One gram of 
 this dust has been found to contain 57.7 mg. of lead, 186.8 mg. of 
 antimony, and traces of arsenic.*' Strasesr has suggested a type case 
 with perforated tin bottom which is placed within another case, so as 
 to facilitate the collection and proper disposition of this injurious 
 form of dust. 
 
 A recent study of the " Health of Printers " by George A. Stevens, 
 in the Twenty-fourth Annual Report of the Bureau of Labor Statis- 
 tics of New York, based on the records of the International Typo- 
 graphical Union and the London (England) Society of Compositors, 
 shows clearly the very high death rate from tuberculosis among 
 printers. 
 
 The following table gives for the years 1901 to 1905 the annual death 
 rates per 1,000 from the leading causes and from all causes among 
 compositors in certain localities: 
 
 Annual death rate per 1,000 from principal causes and all causes among com- 
 positors in certain localities, for the five years, 1901 to 1905. 
 
 [From Twenty-fourth Annual Report of the Bureau of Labor Statistics, 1906.] 
 
 Death rate per 1,000. 
 
 o2« 
 
 '41 
 
 p S u 
 
 ^ s ft 
 
 «a 
 
 2. 
 
 X It 
 
 .2 ^ 
 
 bo 
 
 s3.S 
 
 a 
 
 03 <n 
 
 New York City 
 
 other New York State . 
 Total New York State. . 
 
 Chicago, 111 
 
 Philadelphia. Pa 
 
 All other United States 
 Total United States . . . . 
 London, England 
 
 3.82 
 2.54 
 3.48 
 2.42 
 3.65 
 3.38 
 3.34 
 
 2.42 
 
 .97 
 
 2.03 
 
 1.57 
 
 .70 
 
 1.07 
 
 1.30 
 
 .67 
 
 1.91 
 1.49 
 1.89 
 1.04 
 2.20 
 L33 
 1.44 
 L16 
 
 L63 
 .70 
 
 1.38 
 .98 
 .70 
 
 1.02 
 
 1.08 
 .51 
 
 1.37 
 1.67 
 1.45 
 1.44 
 1.39 
 1.37 
 1.39 
 1.97 
 
 0.99 
 .97 
 .98 
 .45 
 .52 
 .74 
 .76 
 .61 
 
 0.89 
 .61 
 
 .82 
 .72 
 
 .60 
 .64 
 .19 
 
 16.32 
 11.14 
 14.94 
 10.12 
 12.35 
 12.20 
 12.63 
 12.19 
 
 ° Dangerous Trades, Oliver, p. 151. 
 
 ^Roth Kompendium der Gewerbe-Krankheiten, Berlin, 1904, p. 56. 
 
 « Roszahegyi, Archiv, fuer Hygiene, III, p. 522. 
 
5^ 
 
 REPORTS 0^ THE PRESIDENT'S HOMES COMMISSION. 
 
 A second table gives for the same period the per cent of deaths due 
 to tuberculosis in the selected localities for compositors and for^all 
 persons 20 years of age and over. It will be seen that in all the local- 
 ities the percentage of deaths due to tuberculosis is very much higher 
 for compositors than for all persons 20 years of age and over in the 
 same communit3^ For New York State outside of New York City 
 and for London, England, the percentage for compositors is more 
 than double that for the population 20 years of age and over as a 
 whole. 
 
 Per cent of deaths from tuberculosis of the hmgs and other respiratory organs 
 of persons 20 years of age and over and of compositors in c&rtain localities: 
 1901 to 1905. 
 
 [From the Twenty-fourth Annual Report of the Bureau of Labor Statistics of New York, 
 
 p. cxxv.] 
 
 Locality. 
 
 ALL PERSONS 20 YEARS OF AGR AND OVER. 
 
 New York City 
 
 other New York State 
 Total New York State 
 
 Chicago, ni 
 
 Philadelphia, Pa 
 
 COMPOSITORS. 
 
 New York City 
 
 Other New York State.. 
 Total New York State. . . 
 
 Chicago, 111 
 
 Philadelphia, Pa 
 
 All other United States . 
 Total United States 
 
 1901. 
 
 17.7 
 11.4 
 14.5 
 14.9 
 16.3 
 
 London, England 14. 9 
 
 36.5 
 29.2 
 34.9 
 26.9 
 43.8 
 31.1 
 32. 3 
 London, England | 32. 
 
 Per cent of deaths in^ 
 
 1902. 
 
 17.7 
 10.9 
 14.2 
 14.6 
 15.5 
 13.9 
 
 17.0 
 32.3 
 20.8 
 28.0 
 50.0 
 2ii.9 
 27.8 
 26.2 
 
 1903. 
 
 17.6 
 10.6 
 14.0 
 14.5 
 15.8 
 15.3 
 
 18.2 
 10.6 
 17.1 
 28.0 
 7.1 
 24.0 
 22.2 
 36.4 
 
 1904. 
 
 16.5 
 10.6 
 13.6 
 16.0 
 16.8 
 15.0 
 
 26.6 
 21.4 
 25. 5 
 7.7 
 13.3 
 26.0 
 24.4 
 28.2 
 
 1905. 
 
 17.4 
 10.6 
 13.9 
 17.0 
 16.9 
 13.6 
 
 21.1 
 16.0 
 20.1 
 33.3 
 35 7 
 29.2 
 27.2 
 29.1 
 
 Five 
 years. 
 
 17.4 
 10.8 
 14.0 
 15.4 
 16.1 
 14.5 
 
 23.4 
 22.8 
 23.3 
 23.9 
 29.6 
 27.7 
 26.4 
 30.2 
 
 Mr. Stevens, in commenting on the high death rate from tubercu- 
 losis among compositors, says: 
 
 Scarcely any other occupation furnishes so large a quota of victims from 
 consumption. The domestic life of printers is parallel to that of other artisans 
 in equal financial circumstances. As wages go in these days, they are fairly 
 compensated for their labor, thus enabling them to have homes as healthful 
 as may be procured by the best-paid workmen in any community. Neither can 
 it be said that compositors are ill nourished and therefore rendered more sus- 
 ceptible to the insidious action of tubercle bacilli. The determining cause of 
 their susceptibility to the harmful process of the " great white plague " lies 
 in a different direction — to the neglect of sanitary precautions in far too many 
 composing rooms. 
 
 With proper attention to sanitary conditions in the composing 
 rooms the death rate from consumption could undoubtedly be very 
 materially reduced. The excellent results that have come from im- 
 proved sanitation in workrooms appears from the mortality statistics 
 for 1905 of the National Organization of Printers in Germany. 
 '' The average membership of the union in that year was 44,236, of 
 whom 283, or 6.40 per 1,000, died from all causes, while 134 of the 
 total were affected with diseases of the respiratory system, from 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 53 
 
 which the death rate was 3.03,*» tuberculosis not being separated in 
 the tabular presentation." * 
 
 The regulations of the federal council' of the German Empire 
 which control sanitary conditions in German printing houses (put 
 into effect July 31, 1897) will indicate the means by which such 
 low death rates have been brought about. The regulations are given 
 in full: 
 
 I. In rooms in which persons are employed in setting up type or manufacture 
 of type or stereotype plates the following provisions apply : 
 
 1. The floor of workrooms must not be sunk deeper than half a meter (1.64 
 feet) below the ground. Exceptions may only be granted by the higher admin- 
 istrative authority where hygienic conditions are secured by a dry area and 
 ample means of lighting and ventilating the rooms. 
 
 Attics shall only be used as workrooms if the roof is underdone with lath 
 and plaster. 
 
 2. In workrooms in which the manufacture of type or stereotype plates is 
 carried on the number of persons must not exceed such as would allow at least 
 15 cubic meters of air space (529.74 cubic feet) to each. In the rooms in which 
 persons are employed only in other processes there must be*at least 12 cubic 
 meters of air space (423.79 cubic feet) to each person. 
 
 In cases of exceptional temporary pressure the higher administrative au- 
 thority may, on the application of the employer, permit a larger number in the 
 workrooms for at the most thirty days in the year, but not, more than will 
 allow 10 cubic meters of air space (353.16 cubic feet) for each person. 
 
 3. The rooms must be at least 2.60 meters (8.528 feet) in height where a 
 minimum 15 cubic meters are allowed for each person, in other cases at least 
 3 meters (9.84 feet) in height. 
 
 The rooms must be provided with windows which are sufficient in number 
 and size to let in ample light for every part of the work. The windows must 
 be so constructed that they will open and admit of complete renewal of air in 
 workrooms. 
 
 Workrooms with sloping roofs must have an average height equal to the 
 measurements given in the first paragraph of this section. 
 
 4. The rooms must be laid with a close-fitting impervious floor, which can 
 be cleared of dust by moist methods. Wooden floors must be smoothly planed, 
 and boards fitted to prevent penetration of moisture. 
 
 All walls and ceilings must, if they are not of a smooth, washable surface 
 or painted in oil, be lime washed at least once a year. If the walls and ceilings 
 are of a smooth washable surface or painted in oil, they must be washed at least 
 once a year, and the oil paint must, if varnished, be removed once in ten years, 
 and if not varnished, once in five years. 
 
 The compositors' shelves and stands for type boxes must be either closely 
 ranged round the room on the floor so that no dust can collect underneath, or be 
 fitted with long legs so that the floor can be easily cleared of dust underneath. 
 
 5. The workrooms must be cleaned and thoroughly aired at least once a day, 
 and during the working hours means must be taken to secure constant 
 ventilation. 
 
 6. The melting vessel for type or stereotype metal must be covered with 
 a hood provided with exhaust ventilation or chimney with sufficient draft to 
 draw the fumes to the outer air. 
 
 Type founding and melting may only be carried on in rooms separate from 
 other processes. 
 
 7. The rooms and fittings, particularly the walls, cornices, and stands for 
 type, must be thoroughly cleaned twice a year at least. The floors must be 
 washed or rubbed over with a damp cloth so as to remove dust once a day at 
 least. 
 
 8. The type boxes must be cleansed before they are put in use, and again as 
 often as necessary, but not less than twice at least in the year. 
 
 « The corresponding death rate among compositors in New York City was 
 7.17; other New York State, 4.04; total New York State, 6.34; Chicago, 5.04; 
 Philadel])hia, 4.70; total United States, 5.02; and London, England, 5.50. 
 
 * Twenty-fourth Annual Report of the Bureau of Labor Statistics of New 
 York; 1906, p. cxxxvii. 
 
54 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 ITne boxes shall only be dusted out with a bellows in the open air, and this 
 work shall not be done by young persons. 
 
 9. In every workroom spittoons filled with water, and one at least for every 
 five persons, must be provided. Workers are forbidden to spit upon the floor. 
 
 10. Sufficient washing appliances with soap, and at least one towel a week 
 for each worker, must be provided in or as near as possible to the workrooms 
 for compositors, cutters, and polishers. 
 
 One wash hand basin must be provided for every five workers, with an ample 
 supply of water. The wash basin after its use by each person must be emptied. 
 
 The employer must make strict provision for use of the washing appli- 
 ances by workers before every meal, and before leaving their work. 
 
 11. Clothes put off during working hours must either be kept outside the 
 workroom or hung up in wardrobes with closely fitting doors or curtains, which 
 are so shut or drawn as to prevent penetration of dust. 
 
 12. Artificial means of lighting which tend to raise the temperature of the 
 rooms must be so arranged or provided with counteracting measures that the 
 heat of the workrooms shall not be unduly raised. 
 
 13. The employer must draw up rules binding on the workers, which will 
 insure the full observance of the provisions in sections 8, 9, 10, and 11. In an 
 establishment where as a rule twenty people are employed these rules shall be 
 inserted in the general factory regulations, in accordance with section 134a of 
 the industrial code. 
 
 II. In every workroom a notice must be posted, signed by the local police 
 authority, attesting to the correctness of the statements concerning (a) the 
 length, height, and breadth of rooms, (&) the air space in cubic measure, (c) 
 and the number of workers permitted in each room. 
 
 A copy of rules 1 to 13 must be affixed where it can be easily read by all 
 persons affected. 
 
 III. Provides for the method of permitting the exceptions named above in 
 sections 2 and 3, and makes it a condition of reduction in cubic air space for 
 each person employed as typefounder or compositor that there shall be adequate 
 mechanical ventilation for regulating temperature and carrying off products 
 of combustion from workrooms. 
 
 For an interesting report on plumbism and the health of employees 
 in the Government Printing Office, Washington, D. C., by Wm. J. 
 Manning, M. D., see Appendix A. 
 
 ARSENICAL DUST. 
 
 Arsenic is used in the manufacture of green pigments such as arse- 
 nite of copper (Scheele's green) and aceto-arsenite of copper 
 (Schweinfurt or Paris green). These pigments are used in connec- 
 tion 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 objec- 
 tionable features were observed." Keference has already been made 
 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 inhale d, but more fre- 
 quently 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 
 
 Report of the State Board of Health of Massachusetts, 1907, p. 104. 
 
HEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 55 
 
 months and years, and terminating in a general breakdown of the 
 system, preceded by skin eruptions, obstinate ulcers, and inflamma- 
 tion 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 manufacture of artificial leaves and flowers from a dredging box 
 is wholly unjustifiable. As a matter of fact, the use of arsenical pig- 
 ments should be dispensed with by the substitution of coal-tar colors. 
 The hands should always be protected with rubber gloves, the air 
 passages with respirators, and strict cleanliness of the skin and cloth- 
 ing should be observed. 
 
 Chapter V. 
 
 OCCUPATIONS INVOLVING EXPOSURE TO IRRITATING OR POISON- 
 OUS GASES OR VAPORS. 
 
 A large number of occupations involve the inhalation of irritating 
 and even poisonous gases and fumes. The danger may be very much 
 reduced by proper factory sanitation, such as (1) condensation; (2) 
 absorption by water or chemicals; (3) destructive distillation by heat 
 in a closed vessel; (4) combustion of gases that can be burned; (5) 
 forced ventilation and the discharge of gases into the air at a great 
 height. In addition to these precautions much attention must be 
 paid on the part of the operatives themselves to personal hygiene and 
 the use of respirators. Many of the employees in so-called danger- 
 ous trades do not always avail themselves of the safeguards offered 
 and are oposed to the use of respirators. We shall first briefly enu- 
 merate the less injurious, but nevertheless irritating, gases and fumes, 
 like sulphur dioxide, hydrocholic acid, and nitrous fumes, ammonia 
 and chlorine, which in small amounts cause more or less irritation of 
 the air passages and a tickling cough, while in a more concentrated 
 form they are productive of acute and chronic catarrhs and constitu- 
 tional symptoms. 
 
 SULPHUR DIOXIDE. 
 
 This gas is believed to be a blood poison, on account of its affinity 
 for oxygen. It is evolved in smelting works, match factories, and in 
 the manufacture of sulphuric acid. It is is also used as a bleaching 
 agent for cotton goods and straw hats and in the preparation of hops 
 and dried fruit. The employees, if not primarily in good health, are 
 said to suffer from respiratory and digestive disorders, heartburn, 
 and pain in the stomach, and are frequently sallow and anaemic. A 
 gradual tolerance may be established, and the danger is very slight 
 if free ventilation is provided. When evolved in the open air, and 
 hence largely diluted, it does not produce any injurious effects, except 
 in very susceptible persons; indeed, the people around Vesuvius told 
 Doctor De Chaumont that the sulphur fumes are good for their 
 health. 
 
 The Massachusetts board of health found that, in the straw -hat 
 factories visited in Massachusetts, " the employees are exposed to the 
 sulphur fumes only when the doors are opened for the removal of the 
 stock; but they do not enter until the fumes have escaped or have 
 been driven out." The men do not wear respirators in this or the 
 
56 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 other process of bleaching, which is done by immersion of the stock 
 in a chemical water bath. The men who were interviewed state that 
 " neither process causes anything more than a temporary irritation 
 of the throat, and that many of them have worked in this department 
 for many years."* 
 
 HYDROCHLORIC ACID. 
 
 Hydrochloric-acid vapors are evolved from alkali works and in 
 the pickling process of galvanizing works or otherwise, and, apart 
 from being destructive to vegetation around the immediate vicinity, 
 are also very irritating, and even in small volumes may produce in- 
 flammation of the eyes and of the respiratory passages. In a more 
 concentrated form they have produced caustic effects on the tips and 
 edges of the tongue, ulcerations of the nasal wall and throat, bron- 
 chial catarrh, pneumonia, difficult breathing, and stupor. Lehmann * 
 considers the extreme limit to which these vapors may be contained 
 in the air 0.1 of volume per 1,000, and relates a case where even 0.5 
 per 1,000 produced unpleasant symptoms in a robust man. Petten- 
 koffer,*' on the other hand, states that as much as 1 part per 1,000 
 can be borne by those accustomed to it. The workmen in galvanizing 
 works are also subjected to fumes arising from the sal ammoniac 
 thrown upon the molten zinc. These fumes are to some more in- 
 supportable than the acid fumes. Persons with bronchial troubles 
 are often obliged to discontinue the work. In an investigation of 
 three galvanizing establishments in Boston, the Massachusetts board 
 of health found that in two the ventilation was efficient and the 
 fumes were rapidly carried off. " The workmen in all three, about 
 60 in all, appeared to be in good health, and asserted that beyond 
 sneezing and coughing at times they suffered no inconvenience or 
 discomfort." 
 
 SULPHURIC AND NITRIC ACID. 
 
 The fumes of sulphuric and nitric acids probably produce similar 
 effects. Eulenberg^ believes, however, that the fumes of sulphuric 
 acid produce no special bad effects, because they sink very readily 
 and have a great affinity for the water in the air, so that they reach 
 the system in a highly diluted form. He also points out that the 
 nitrous fumes generated by contact of nitric acid with metals are 
 more injurious, in that they produce a special predisposition to bron- 
 chitis, while pneumonia and diseases of the eye have also been at- 
 tributed to these gases. 
 
 The workmen should be instructed to avoid the fumes as much as 
 possible and to anoint the lips and nose within and without several 
 times a day. Protection should be afforded by ample ventilation, and 
 all processes involving the evolution of irritating or poisonous fumes 
 should be carried on in the open air or in open sheds. 
 
 o Report of the State Board of Health of Massachusetts upon the sanitary 
 condition of factories, worlishops, etc., Boston, 1907, p. 114. 
 * Lehmann: Archiv. fuer Hygiene, vol. i. 
 •Cited by Harrington. 
 'Eulenberg, Gewerbehygiene, p. 143. 
 
BEPOBTS OF THE PBESIDENT^S HOMES COMMISSION. 57 
 
 According to the Massachusetts board of health « the corrosive 
 acids are made in such a way that practically no fumes whatever 
 escape, the work being inclosed from beginning to end. In one of 
 the largest chemical factories in Massachusetts, where 300 men are 
 employed, it is said that the workmen are exposed very little to 
 poisonous or irritating fumes and dust or contact with poisonous or 
 irritating substances. At certain points in the building acid fumes 
 in considerable strength are constantly present, but at these points 
 there is good overhead ventilation, and the workmen are rarely 
 obliged to approach very near. 
 
 Among the products of the above-mentioned factories may be men- 
 tioned hydrochloric, sulphuric acid, nitric acid, acetic acid, ammonia, 
 sodium sulphite, sodium sulphate, alum, potassium cyanide, ferrous 
 sulphate, and other iron and sodium salts; also various salts of tin, 
 arsenic, antimony, zinc, copper, etc. 
 
 AMMONIA. 
 
 Ammonia rarely causes any serious disturbance, except a tempo- 
 rary iritation of the respiratory tract, unless present in very large 
 volumes. The amount which may be present, according to Lehmann, 
 should not exceed 0.5 per 1,000. A large volume has been known to 
 cause inflammation of the eyes and bronchial catarrh, while still 
 greater concentrations, which fortunately are rare, may produce 
 difficult breathing and emphysema. 
 
 CHLORINE GAS. 
 
 Chlorine gas is generally present in the manufacture of chlorinated 
 lime, glazed bricks, and in bleaching operations, and is very apt to 
 produce, when present in the proportion of 1 to 5 parts in 100,000 of 
 air, a cachectic condition, asthma, bronchitis, caries of the teeth, and 
 acne or pimples upon the face, while in a more concentrated form — ■ 
 40 to 60 parts in 100,000 — it produces a violent cough and extreme 
 difficulty in breathing. 
 
 Hirt describes these attacks as follows: 
 
 In spite of the aid of the auxiliary respiratory muscles the entrance of the 
 air to the lungs is insufficient, and the staring eyes, the livid lips, and the cold, 
 clammy perspiration plainly show the mortal agony of the patient. The pulse 
 is small and temperature decreased. These phenomena disappear upon removal 
 to the fresh air, and a few hours later the workman is found enveloped in 
 chlorine and hydrochloric acid vapors in his accustomed place in the factory. 
 The attacks seem to be but rarely fatal, unless the volume exceeds 60 parts 
 per 100,000. 
 
 BLEACHING ESTABLISHMENTS. 
 
 The Massachusetts board of health, in its summary of five bleach- 
 eries, with about 1,200 employees, speaks approvingly of the general 
 arrangements for ventilation, and says: 
 
 The odors of bleaching powders, although observable in each of the rooms 
 where that substance is employed, were in no case so strong as to be disa- 
 greeable or to cause discomfort. In one of the establishments the persons 
 exposed to the lint dust which escapes during unbaling and stitching together 
 of the cotton cloth all looked pale and sickly. 
 
 « Report of the State Board of Health of Massachusetts upon sanitary condi- 
 tions of factories, workshops, etc., 1907, p. 103. 
 
68 EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 IODINE AND BROMINE VAPORS. 
 
 Iodine and bromine vapors may produce toxic symptoms. The 
 fumes of iodine are liable to cause catarrhal conditions of the nose, 
 eyes, and air passages, and frequent headaches, while chronic iodine 
 poisoning produces a cachectic condition, wasting of the testicles, and 
 loss of sexual power. Persons engaged in the manufacture of bro- 
 mine are said to suffer quite frequently with a form of bronchial 
 asthma, dizziness, and general weakness, while concentrated vapors 
 have been known to produce spasm of the glottis and suffocation. 
 
 Bromine preparations are used to a considerable extent in photog- 
 raphy. Schuler " describes three cases, one of which proved fatal, in 
 men who prepared " brommetyl " from wood alcohol and sulphuric 
 acid. In all of these three cases there were -pronounced symptoms 
 of nausea, spasms, and trembling of the extremities and diminished 
 bodily temperature. 
 
 TURPENTINE. 
 
 Turpentine vapors in excess may produce gastric and pulmonary 
 catarrh, slow and painful micturition and bloody urine, headache, 
 roaring in the ears, and other nervous symptoms. Schuler observed 
 among the workers in calico printing marked emaciation, loss of 
 appetite, rapid pulse, and more or less headache, which he attributed 
 to the turpentine vapors. In small doses no unpleasant symptons are 
 observed. The odor of violets in the urine is one of its remarkable 
 effects. The use of impure turpentine for cleaning purposes has been 
 known to produce obstinate eczema of the hand. 
 
 PETROLEUM. 
 
 Concentrated vapors of coal are said to produce loss of sensation, 
 and the workmen in refineries occasionally show symptoms like those 
 observed in drunken persons, fall into a profound sleep, or suffer from 
 loss of memory, dizziness, headache, and chronic bronchial catarrhs. 
 Pustular, furuncular, and eczematous affections of the hands are also 
 quite common in persons handling this and paraffin oil. The latter 
 is also true of persons handling creosote and tar, unless protected b}^ 
 impermeable gloves. The dangers from explosions in the petroleum 
 industry must also be guarded against. 
 
 BENZINE VAPORS. 
 
 Doctor Neisser, in 1907, reports an instance where three laborers 
 in a carpet-cleaning establishment in which large quantities of benzine 
 had been used were found unconscious upon the floor and had to be 
 restored by oxygen inhalation. The toxic symptoms are similar to 
 those produced by concentrated petroleum vapors, and the danger 
 from explosions and fire are of course even greater. 
 
 CARBON MONOXIDE. 
 
 Carbon monoxide, or coal gas, when present in sufficient amount, 
 paralyzes, so to speak, the red corpuscles by depriving them of their 
 oxygen and combining with the ha3moglobin, which results in de- 
 
 « Deutsche Viertelj. f. ceff. Gesundheitpflege, Bd. 31, p. 696. 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 59 
 
 ficiency of oxygen in the blood and serious toxic symptoms, which 
 may end in death by producing a rapid parenchymatous degeneration 
 of the liver, spleen, and heart. This gas is often present in gas and 
 smelting works and around coke or charcoal furnaces, and one- fourth 
 per cent by volume in the air will produce toxic symptoms, and more 
 than 1 per cent is rapidly fatal to animal life. The workmen some- 
 times, though not as often as is supposed, suffer from the chronic 
 form of poisoning, such as headache, dizziness, slow pulse, ansemia, 
 general debility, and diseases of the respiratory and digestive organs. 
 The acute symptoms of coal-gas poisoning are increased respiration 
 and pulse, violent headache, dizziness, and roaring in the ears. 
 These are soon followed by symptoms of depression, nausea and 
 vomiting, numbness, drowsiness, muscular relaxation, paralysis, sigh- 
 ing respiration, slowness of the pulse and feeble heart action, dila- 
 tation of the pupils, diminished bodily temperature, and, if continued, 
 convulsions, stertorous breathing, and death by suffocation. If deaih 
 does not occur, the patient is apt to suffer for some time from head- 
 ache, physical and mental depression, paralysis of speech and of the 
 sphincters, convulsive twitching, and general muscular weakness, 
 while pleurisy and pneumonia are also frequent. 
 
 CARBONIC-ACID GAS. 
 
 The chronic effect of carbonic-acid gas has already been alluded 
 to. Well sinkers and miners are occasionally suffocated, owing to 
 the presence of a large volume of this gas evolved from the soil and 
 which has collected in deep shafts. It is one of the constituents of 
 the " choke damp " in the mines and also present in cellars. It is 
 also a product of fermentative processes, and the anaemic and de- 
 bilitated conditions of miners, vintners, distillers, brewers, and yeast 
 makers is believed to be partlj^ due to an excess of carbonic acid, 
 which diminishes the amount of oxygen in the air. The acute symp- 
 toms are loss of consciousness and locomotion, generally preceded by 
 difficulty in breathing, headache, depression, drowsiness or mental 
 excitement, sometimes convulsions. Prompt removal of the patient 
 into fresh air will lead to rapid recovery. 
 
 CARBON DISULPHIDE. 
 
 Carbon disulphide is used in certain processes in the manufacture 
 of vulcanized india rubber, and also in the extraction of fats, and may 
 produce in those constantly exposed to it headache, dizziness, im- 
 paired vision, pains in the limbs, formication, sleeplessness, nervous 
 depression, loss of appetite, etc. Sometimes, according to Delpech 
 and Hirt, there is cough, febrile attacks, deafness, difficult breathing, 
 loss of memory, paralysis of the legs and lower part of the body, 
 loss of sexual power, which has been preceded by increased sexual 
 appetite and mental exaltation. 
 
 NAPHTHA. 
 
 Naphtha is used in the same industries, and it is not improbable 
 that the symptoms are produced by the combined influence of the 
 two fumes. At all events, there are a number of authenticated cases 
 
go REPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 of acute naphtha poisoning cliaracterized by dyspnoea, dizziness, and 
 mental confusion, with vomiting, palpitation of the heart, and hem- 
 orrhages in the fatal cases. Necropsies reveal evidence of fatty 
 degeneration of the heart, liver, kidneys, and other parts. The 
 cleaners of woolen goods, etc., with naphtha not infrequently suffer 
 from dizziness, nausea, vomiting, headache, sleeplessness, hysteria, 
 and symptoms resembling alcoholic intoxication. {See also Dyeing 
 and cleansing.) 
 
 NITROBENZOL. 
 
 Nitrobenzol, which is used in making aniline and in the manu- 
 facture of roburite and other explosives, produces headache, dyspnoea, 
 drowsiness, dizziness, nausea and vomiting, great depression, stupor, 
 and often terminates fatally. 
 
 The majority of workers in dinitro compounds in Great Britain « 
 are anaemic and suffer from difficulty in breathing and general weak- 
 ness. They are subject to a biweekly medical inspection and are 
 enjoined (1) not to touch these compounds with bare hands; (2) to 
 keep the feet in good condition (a) by bathing, (5) by shoes in good 
 repair; (3) avoidance of alcoholic beverages; and (4) by thorough 
 washing of the hands before eating and change of clothing upon 
 quitting the work. 
 
 DYEING AND CLEANSING. 
 
 Among the chemical substances employed are naphtha, gasoline, 
 wood alcohol, ammonia, various acids, bleaching agents, iron, copper, 
 and other salts, aniline dyes and other dyestuffs. 
 
 The Massachusetts board of health reported of one large estab- 
 lishment investigated: 
 
 In the naphtha-cleansing department, in spite of mechanical ventilation, there 
 is a strong odor of naphtha, and all of the men here employed are pale and 
 some of them very markedly sick looking.^ In the room in which the naphtha- 
 cleansed goods are dried, at a temperature of about 120° F., the naphtha fumes 
 are very strong. Although the men who bring in the goods remain but a few 
 minutes, some have occasionally been temporarily overcome by the fumes and 
 have shown the characteristic excitement and hysterical symptoms of naphtha 
 intoxication. At the time of visit, the man who does most of this work had 
 been engaged thereat for three months and had experienced no ill effects. 
 
 RUBBER INDUSTRY. 
 
 The Massachusetts board of health investigated 14 rubber factories 
 with about 9,000 employees." It appears that naphtha has to a ^reat 
 extent replaced the more dangerous carbon disulphide as a vulcanizing 
 agent, and in 11 of the 13 factories visited the odor of naphtha was 
 noted as only slight. In two factories it was stated that " a few girls, 
 new to the work, show the effects of naphtha and suffer from headache 
 and sometimes nausea and vomiting, but that such girls do not long 
 continue at the work. Naphtha fumes sometimes bring about a condi- 
 tion which much resembles alcoholic intoxication, and which occurs 
 most often in the room where rubber is spread upon cloth. New men are 
 
 « Cited by Neisser, 1907, p. 79. 
 
 » Report of the State Board of Health of Massachusetts, 1907, p. 109. 
 
 • Report of the State Board of Health of Massachusetts, 1907, p. 113. 
 
EEPOETS OF THE PKESIDENt's HOMES COMMISSION. 61 
 
 especially susceptible, but even old hands have sometimes to leave their 
 work at times for a breath of fresh air. * * * In 6 of the factories 
 where litharge is handled, no history could be obtained of any case of 
 lead poisoning. In two it was stated that cases occur, but not often. 
 All of the establishments, with one exception, were found to be well 
 lighted and adequately ventilated." 
 
 PATENT-LEATHER INDUSTRY. 
 
 The fumes of naphtha, amyl acetate, and wood alcohol, which are 
 given off in the manufacture of patent leather, are dangerous. While 
 no exact data are available, it is admitted by those in authority that 
 many employees can not do the work on account of inability to with- 
 stand their influences. 
 
 ANILINE VAPOR. 
 
 Aniline vapor is dangerous to health when present in the air to the 
 extent of 0.1 per cent. Hirt describes an acute form of poisoning from 
 aniline vapor, which usually results fatally. "The workman falls 
 suddenly to the ground, the skin is cold and pale, the face is cyanotic 
 (bluish discoloration of the skin), the breath has the odor of aniline, 
 the respiration is slowed, and the pulse increased. The sensation 
 diminishes from the beginning of the attack, gradually entirely dis- 
 appears, and death follows in a state of profound stupor." 
 
 The milder forms are characterized by laryngeal irritation, loss of 
 appetite, headache, giddiness, and weakness, with a rapid, small, and 
 irregular pulse, and diminished sensibility of the skin. In some 
 instances short convulsions have occurred. Prompt fresh-air treat- 
 ment is absolutely essential. 
 
 The chronic form of aniline poisoning may affect the central 
 nervous system, and cause lassitude, headache, roaring in the ears, 
 motor or sensory disturbance, or it may produce digestive derange- 
 ments such as eructations, nausea, and vomiting, or it may affect the 
 skin by causing eczematous or pustular eruptions and even well- 
 defined ulcers. Doctor Neisser (1907) reports a number of such cases 
 either in aniline factories or in dyeing works. 
 
 The medical inspector of Clayton, England, has presented a very 
 interesting report ° on the effects of aniline oil in black aniline dyeing 
 works, and also the effects upon the skin of chromic acid and the 
 bichromates of potassium and sodium in these establishments. He 
 visited 20 establishments and examined 200 employees, many of whom 
 suffered from anaemia, headache, digestive derangements, heartburn, 
 dizziness, palpitation of the heart, loss of will power, and excessive 
 mucous secretions, all of which were attributed to the toxic effects of 
 aniline. He recommends as safeguards: (1) Mechanical suctional 
 ventilation (a) at the machines where the cloth is being dyed, (5) at 
 the machines where the cloth passes through the bichromate solution, 
 and (c) at joints where there is danger from the chromate dust; (2) 
 protective clothing, and frequent washing of the working suits, lockers, 
 and dressing rooms for street clothing; (3) special lunch rooms; (4) 
 suitable wash rooms.^ 
 
 o Neisser, p. 75, 1907. 
 *_Cited by Neisser, p. 74. 
 
62 EEPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 WOOD ALCOHOL. 
 
 Vapors from varnishes have been known to produce blindness, due 
 to inflammation of the nerves behind the eyeball, and partial atrophy 
 of the optic nerve. Similar effects follow the internal use of wood 
 alcohol, and even fatal cases have been reported in consequence of its 
 substitution for pure alcohols. Doctor Neisser, in 1907, reports a large 
 number of eczema tous affections of the hands, arms, and face in 
 furniture polishers (" polisher's itch "), which may possibly be caused 
 by some of the impure alcohols. 
 
 CHROME PIGMENTS. 
 
 In the manufacturing and handling of chrome pigments, as in tan- 
 neries and various leather industries, a dust or vapor is involved 
 which causes inflammation of the eyes and even ulceration of the 
 nasal septum and elsewhere. 
 
 QUININE. 
 
 Quite a large percentage of the persons employed in the manufac- 
 ture of quinine suffer from a dry form of eczema of the hands and 
 face, which is claimed to be directly due to emanations from the boil- 
 ing solution, as the disease disappears if the work is given up. 
 
 In the so-called " polisher's itch " and in the effects produced by 
 chrome and quinine the use of rubber gloves and annointing the 
 skin with some clean oil or grease have been found most useful. 
 
 MANGANESE. 
 
 According to Doctor Neisser (1907) a small percentage of the 
 workers in manganese mills and dry pigments are affected with head- 
 ache, dizziness, loss of appetite, constipation, loosening of the teeth, 
 muscular pains, and general debility. 
 
 BRASS FOUNDERS. 
 
 The workers in brass foundries inhale a metallic dust or vapor of 
 zinc or copper, or perhaps of both, which has given rise to a train of 
 symptoms described as "brass founders' ague." The illness attacks 
 about 75 per cent of those who are new to the work, or who resume 
 work after an absence of a month or even a fortnight. There are 
 more or less severe pains in the back, and general lassitude, which 
 compels the patient to seek his bed. Usually after he has taken to his 
 bed chilliness comes on, increasing to a decided rigor and lasting 
 fifteen minutes or longer. In the course of an hour or less the pulse 
 beats from 100 to 120 per minute, accompanied by a tormenting 
 cough, corresponding headache, and soreness in the chest. After the 
 lapse of a few hours free perspiration indicates the disappearance of 
 the fever and the patient falls into a deep sleep, from which he 
 awakens with perhaps only a slight headache and lassitude. In 
 England the men who suffer this way drink freely of milk and pro- 
 mote vomiting — perhaps the best treatment for copper or zinc poison- 
 ing. A chronic form of zinc or copper poisoning, characterized by 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 63 
 
 oversensibility, formication, and burning of the skin of the lower ex- 
 tremities, tactile and motor disturbance, anaemia, cough, headache, 
 neuralgia, digestive disturbance, and progressive emaciation, is said 
 to occur among men who have worked for a number of years in brass 
 foundries. At present it is not possible to say whether the symptoms 
 of brass founders' ague are due to the copper, zinc, or arsenic, or a 
 combination of all three. Some authors believe it to be a specific 
 infection. 
 
 ARSENICAL. FUMES. 
 
 Arsenical fumes ure frequently given off in smelting processes, 
 especially copper works, and, like those of arseniuretted hydrogen, 
 may give rise to jaundice, headache, nausea, stiffness of the joints, 
 general anaemia, discomfort, and malnutrition. When inhaled in con- 
 centrated doses the fumes produce symptoms of nausea, vomiting, 
 languor, drowsiness, rapid pulse, frequent micturition, and bloody 
 urine. In serious cases the pulse becomes small and thready, skin cold 
 and clammy, and death ensues with evident signs of cardiac paralysis. 
 
 MERCURY. 
 
 The most important of the poisonous vapors in connection with 
 dangerous trades are mercury and phosphorus. Workers in mercury 
 suffer greatly from the effects of mercurial poisoning, such as saliva- 
 tion, tremor and nervous symptoms, and many fall victims to pul- 
 monary tuberculosis. Miscarriages among the female employees are 
 very common. These effects, according to Renk,** are due to the in- 
 halation of mercurial vapors in badly ventilated workshops, while 
 Wollner attributes them to the inhalation and swallowing of fine 
 mercurial dust. Of 7,221 mirror makers at Furth during the year 
 1883, not less than 2,457, or 34 per cent, were taken sick, and of these 
 60 per cent suffered from mercurial poisoning. This danger has been 
 practically eliminated in the mirror industry, but it is still pronounced 
 in the manufacture of felt, thermometers, barometers, dry electric 
 batteries, and bronzing. In Europe persistent efforts are being made 
 to reduce the danger in these industries to a minimum, and some of the 
 felt establishments no longer use the preliminary treatment of the hair 
 with mercuric nitrate. The 64 cases reported in Great Britain in 
 1906 and cited by Neisser occurred as follows: Manufacturers of 
 electric meters, 17; thermometers, etc., 16; felt and fur industry, 13; 
 gilding, 7 ; chemical works, 7 ; pow^der works, 3 ; lithography, 1. 
 
 As preventive measures may be mentioned the following: (1) 
 Change of clothing before and after work; (2) weekly washing of 
 the working clothes; (3) systematic and frequent washing of the 
 hands, weekly sulphur baths or frequent general baths, and gargling 
 at the close of work with a solution of permanganate of potassium: 
 (4) limit of Avork to eight hours per day and thorough ventilation 
 of the rooms — open doors and windows; (5) frequent cleaning of 
 floors with damp sawdust and sprinkling with a solution of ammonia. 
 
 •Renk Arbeiteii aus dem k. k. Gesimdlieitsamte, V. p. 113. 
 
64 BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 PHOSPHORUS. 
 
 In the manufacture of phosphorus matches white and red phos- 
 phorus have been used. The danger consists in the inhalation of the 
 fumes when the white substance is used, while the red or amorphous 
 phosphorus is neither poisonous nor easily inflammable. The gas 
 smells like garlic. The toxic symptoms in the acute form are difficult 
 breathing and a feeling of intense anxiety. The fumes are only given 
 off when the air contains moisture. The milder effects of phosphorus 
 consist of gastric and bronchial catarrhs, anaemia, and malnutrition, 
 followed occasionally by a painful inflammation of the bones of the 
 lower or upper jaw, due to the local action of the phosphorus, and 
 often beginning in carious teeth or in the alveolar process of missing 
 teeth. The disease may develop during the first months, but generally 
 not until four or five years after the beginning of the employment, 
 and carious teeth, with toothache, are among the first symptoms, fol- 
 lowed by swelling of the glands of the neck, alveolar abscesses, and 
 necrosis of the jaws. Formerly from 11 to 12 per cent of the employees 
 suffered. Since the use of red or amorphous phosphorus the danger 
 has been greatly reduced. Only about 2 per cent of the operatives are 
 now attacked. 
 
 Doctor Neisser reports that during the year 1906 several cases of 
 phosphorus necrosis occurred in German match factories, in which 
 the use of white phosphorus was promptly stopped. 
 
 The medical inspectors of Great Britain, from October 1, 1900, to 
 October 1, 1905, reported only 11 cases of phosphorus necrosis, the 
 reduction being attributed to improved factory sanitation. 
 
 The medical inspector of Belgium (quoted by Doctor Neisser, page 
 71) reports that during the last six years only one case of necrosis 
 occurred, and the morbidity of the employees in match factories has 
 also decreased coincident with factory sanitation, as shown by the 
 following figures: 
 
 1905. 
 
 Employees 1,114 1,182 1,226 
 
 Employees examined 7,061 8,511 9,003 
 
 Apparently healthy employees 757 1,055 1,061 
 
 Sick employees 387 127 165 
 
 Deaths 401 132 (o) 
 
 « Doctor Neisser states that the records do not disclose the fact whether or not there 
 were any deaths during 1905. 
 
 The use of respirators, thorough ventilation, the disengagement of 
 turpentine vapors to promote rapid drying and strict cleanliness, such 
 as ablution of the hands, change of clothing, and gargling with weak 
 alkaline solutions before eating and drinking are still in order as pre- 
 ventive measures. 
 
 BEET-SUGAR INDUSTRY. 
 
 In the beet-sugar industry, especially when the diffusion method is 
 employed, an explosive mixture containing probably carbureted 
 hydrogen has proved a source of danger to the operatives, and the 
 waste waters are believed to be also a menace to public health. 
 
 1903. 
 
 1904. 
 
 1,114 
 
 1,182 
 
 7,061 
 
 8,5n 
 
 757 
 
 1,055 
 
 387 
 
 127 
 
 401 
 
 132 
 
BEPOETS OF THE PRESIDENT'S HOMES COMMISSION, 65 
 
 Chapter VI. 
 
 OCCUPATIONS INVOLVING THE INHALATION OP ORGANIC GASES 
 
 AND VAPORS. 
 
 Whether the effluvia from sewers, stables, stock yards, slaughtering 
 and packing houses ; glue, candle, and soap factories ; hide depots, tan- 
 neries, fertilizer-making establishments, etc., are injurious to health 
 remains an open question. Many authors insist that the olfactory or- 
 gans are alone offended, and point to the mortality statistics, which in- 
 dicate that the average age of such employees is quite high. Others 
 hold that weaklings rarely engage in such occupations, and that the 
 effluvia, consisting, as they do, of ammonia and sulphureted gases, are 
 fully as injurious as the inhalation of sewer air, which, judging from 
 experiments in aViimals, would appear to increase the susceptibility to 
 infectious diseases by diminishing the power of resistance. Stift main- 
 tains that hydrogen and ammonium sulphides, chiefly derived from 
 decomposition of animal matter and usually present in privy vaults, 
 cesspools, and sewers, are blood poisons when present to the extent 
 of about 1 : 4,000 volumes per 100. The same author believes that the 
 inhalation of sulphureted hydrogen affects directly the terminal fila- 
 ments of the pneumogastric nerve, and through these sets up an irrita- 
 tion of the respiratory and cardiac centers — in fact, of the entire 
 medulla oblongata — and if continued sufficiently long induces paraly- 
 sis of this function. 
 
 In sewer air the danger is intensified by the excess of carbonic-acid 
 gas and deficiencv of oxygen, and special precaution should be taken 
 to exhaust the foul air before sewer employees or scavengers are 
 allowed to descend. 
 
 The general effects of the foul odors upon those unaccustomed to 
 work in the so-called " offensive trades " are nausea, vomitings head- 
 ache, loss of appetite, diarrhea, a general depression, and weakness. 
 It is true the workmen become gradually accustomed to these emana- 
 tions without any apparent injury, but even this does not justify the 
 assumption that they are of no consequence. 
 
 Every community provides for the collection and disposal of dead 
 animals, which is usually done by contract, and the animals are taken 
 to some point beyond the town limits, flayed, and worked up, so as to 
 utilize the skin, hair, bones, fats, horns, etc. There is, however, a 
 certain element of danger from the transmission of infectious diseases 
 like anthrax, glanders, and tuberculosis, and hence all such work 
 should be done under strict sanitary control. 
 
 Chapter VII. 
 
 OCCUPATIONS INVOLVING EXPOSURE TO EXTREMES OF HEAT, SUD- 
 DEN CHANGES, AND ABNORMAL ATMOSPHERIC PRESSURE. 
 
 Exposure to extremes of heat and sudden changes is injurious and 
 predisposes to a number of diseases. Stokers, cooks, bakers, black- 
 smiths, firemen, etc., are very apt to suffer from heat exhaustion and 
 thermic fever (sunstroke). The duration of life is low, and rheuma- 
 S. Doc. 644, 60-2 6 
 
66 EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 tism, eczema, catarrhal affections, pneumonia, and diseases of the heart 
 are quite common. Sailors, farmers, motormen, conductors, teamsters, 
 coachmen, and many others are often exposed to sudden changes in 
 the weather, and suffer quite frequently from rheumatism, catarrhal 
 affections, pneumonia, and Bright's disease. 
 
 The effects of both heat and cold are intensified by extreme humid- 
 ity in the atmosphere, and special precautions are necessary upon hot 
 and sultry days and in cold, raw weather. Occupations involving ex- 
 posure to dampness, especially when performed indoors, are injurious, 
 because a cold, damp air abstracts an undue amount of animal heat 
 from the body, lowers the power of resistance, and predisposes to 
 catarrhal and rheumatic diseases. It is a well-known fact that damp 
 houses favor the development of consumption. 
 
 CAISSON DISEASE. 
 
 I 
 
 The effects of compressed air on workmen in tunnels, caissons, deep 
 mines, and diving bells were formerly attributed solely to increased 
 atmospheric pressure, in consequence of which it was believed that 
 the blood received not only an excess of oxygen, but by reason of the 
 abnormal pressure was driven from the surface to the internal organ, 
 causing congestion, especially of the central nervous system. It is 
 now held that, while increased atmospheric pressure is capable of 
 producing characteristic effects upon the circulation, such as pallor 
 of the skin, ringing in the ears, bulging and possibly rupture of the 
 ear drums, the most serious symptoms are produced when the pres- 
 sure is too rapidly increased or removed by a faulty method of " lock- 
 ing in " and " locking out." 
 
 A commission of Belgian medical experts examined 166 caisson 
 workers before and after their work, the shift lasting from eight to 
 twelve hours, and found (1) that the blood-making function, as 
 shown- by the haemoglobin contents, was actually increased during 
 their work; (2) that so long as the pressure does not increase be- 
 yond 3 atmospheres (45 pounds) the men feel perfectly well and 
 perform their labor with more ease and even less fatigue than under 
 normal atmospheric pressure; (3) that men of temperate habits, 
 with a sound heart, lungs, and nervous system, suffer no injurious 
 effects, and none others should be employed; (4) the real injury 
 is done by a sudden removal of atmospheric pressure in a hasty 
 " locking-out " process, for which the workmen are often to blame. 
 
 The general rule in " locking out " should be to allow at least one 
 minute for each 6 pounds of pressure within the chamber. 
 
 The symptoms of so-called caisson disease are rarely observed until 
 the pressure equals 20 pounds, and usually do not appear for some 
 minutes or hours after emerging. In addition to the symptoms 
 already mentioned, there may be hemorrhage from the nose, mouth, 
 and ears; headache, dizziness, rapid pulse, sweating, severe pain in 
 the back, extremities, or region of the stomach, and vomiting. Par- 
 tial deafness and symptoms of motor paralysis, more or less general, 
 but most frequently confined to the lower extremities, are frequently 
 observed. Cases with pronounced head and spinal symptoms usually 
 prove fatal. The milder cases, as a rule, recover sooner or later, 
 although the muscular pains and paralytic symptoms may persist for 
 weeks, or even longer. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 67 
 
 Chapter VIII. 
 OCCUPATIONS INVOLVING CONSTRAINED ATTITUDES. 
 
 The effects of a constrained j)osition, combined with a sedentary 
 life, are very injurious. This is especially seen in weavers, shoe- 
 makers, engravers, watchmakers, tailors, lithographers, etc., all of 
 whom are obliged to assume a more or less constrained attitude, 
 which interferes with a proper distribution of the blood supply and 
 is liable to be followed by internal congestions. But perhaps the 
 greatest harm results from deficient movement of the chest and con- 
 sequent interference with normal respiration. As a matter of fact, 
 many of these artisans suffer from phthisis, constipation, dyspepsia, 
 and hemorrhoids, and all have a low average duration of life. 
 
 Among the apprentices of bakers, deformities such as " flat foot " 
 and " knock-knee " and varicose veins of the lower extremity are fre- 
 quently seen, as the result of being on their feet too long. Varicose 
 veins and ulcers are quite common among motormen and conductors, 
 while bakers, cabinetmakers, and others are also very liable to de- 
 velop abnormal curvature of the spine. 
 
 Chapter IX. 
 
 OCCUPATIONS INVOLVING OVEREXERCISE OF PARTS OF THE 
 
 BODY. 
 
 Among the diseases due to the excessive use of certain muscles may 
 be mentioned the affection called " writer's cramp," which is a con- 
 vulsive affection of the fingers. Similar fatigue neuroses, character- 
 ized by localized paralysis and twitching, are observed in copyists, 
 typewriters, telegraph operators, pianists, violinists, engravers, seam- 
 stresses, cigar makers, etc. 
 
 Pulmonary emphysema is quite common among performers on 
 wind instruments. Boiler makers' deafness and mill operatives' deaf- 
 ness may also be mentioned. The former is believed to be due to their 
 constant exposure to an atmosphere in a state of violent vibration, 
 while the latter affection is characterized by an inability to hear dis- 
 tainctly except during a noise. Public speakers and singers are apt 
 to suffer from chronic affections of the throat and paralysis of the 
 vocal chords, and watchmakers, engravers, and seamstresses, as well 
 as all others who use their eyes upon minute objects, are more liable 
 to suffer from nearsightedness and other visual defects. 
 
 Tobacco testers are apt to suffer from nervous symptoms and seri- 
 ous visual defects, and tea tasters soon become the victims of muscu- 
 lar tremblings and other nervous symptoms, the result of a chronic 
 " theine intoxication." 
 
 Chapter X. 
 
 OCCUPATIONS INVOLVING EXPOSURE TO MxVCHINERY, ETC. 
 
 Life insurance and accident policy statistics plainly indicate the 
 danger of occupations which involve contact with machinery. This 
 may be the result of individual carelessness or the negligence of 
 others. Not infrequently accidents are the result of boiler explo- 
 
68 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 sions, circular saws, belting, and flying fragments, and are due to a 
 lack of proper safety devices. ^ As might be expected, many of the 
 accidents befall children and inexperienced persons and take place 
 at night or in badly lighted establishments. Roth calls attention to 
 the accident statistics of the German Empire for 1897,<» which 
 clearly indicate that accidents increase with mental and muscular 
 fatigue. Upon the assumption that there is one accident for every 
 three working hours during the year, the average number of indus- 
 trial accidents in the forenoon between 6 and 9 o'clock was 1.10; 
 between 9 and 12 o'clock, 2.26; in the afternoon between 12 and 3 
 o'clock it was 1.02 ; between 3 and 6 o'clock, 2.11. 
 
 Professor Imbert at the International Congress for Hygiene and 
 Demography at Brussels, 1903, from an abundance of statistical 
 material arrived at a similar conclusion. According to Rubner '' 
 of 100 accidents, 41 befell children under 15 years of age, 36.4 befell 
 persons between 15 and 25 years of age, 13.1 befell persons between 
 25 and 40 years of age, and 9.5 befell persons between 40 and 60 
 years of age. The upper extremities were involved in 87 per cent of 
 the cases, the lower extremities in 7.5 per cent, and the head and 
 trunk in 5.5 per cent. During the year 1899 there were in English 
 factories 301 fatal and 19,321 nonfatal accidents, all attributable to 
 machinery moved by mechanical power.*' 
 
 Swiss statistics show that among 1,000 workingmen accidents occur 
 as follows:** Cotton spinners, 2.22; millers, 28; paper manufac- 
 turers, 31.1; carpenters, 35.2; locksmiths, 46.9; brewers, 66.7; masons, 
 80.5; blacksmiths, 93.1; metal workers, 102.1; molders, 132.2. 
 
 According to the New York State statistics, cited by Hoffman,* 
 for the five years ending with 1905, there occurred in the metal trades 
 in that State 8,456 accidents, of which 135, or 1.6 per cent, were 
 fatal, 6,397 caused temporary disablement, and 1,306 resulted in per- 
 manent disablement. In the chemical industries during the same 
 period there occurred 1,339 accidents, of which 33, or 2.5 per cent, 
 were fatal. Of the total number 91.1 per cent caused temporary 
 disablement, and 6.3 per cent permanent disablement. 
 
 Many of the accidents to metal workers, masons, miners, weavers, 
 etc., befall the eye, and Magnus attributes 8.5 per cent of all cases of 
 blindness to accidents. 
 
 Of 48,262 accidents among British miners from 1884 to 1898, not 
 less than 2,506, or 5.19 per cent, affected the eye.' 
 
 COAL MINING. 
 
 The mining of coal is, even under the best conditions, one of the 
 most dangerous industries. A report of the United States Geolog- 
 ical Survey o shows the number of men killed for each 1,000 employed 
 
 oErmuedung diirch Berufsarbeit, Internat. Kongress fner Hygieue und 
 Demographie, Berlin 1907, Band li, p. 618. 
 
 » Lehrbuch der Hygiene, 6th ed. T^ipzig & Wien, 1899-1900, p. 701. 
 
 '^ Dangerous Trades, Oliver, p, 203. 
 
 <*Bergey's Principles of Hygiene, 1904, p. 276. 
 
 « Bulletin of the Bureau of I^bor No. 78, September, 190S. 
 
 ^Oliver, p. 776. 
 
 ^Coal-Mine Accidents; Their Causes and Prevention. A pnMiminary Statis- 
 tical Report United States Geological Survey, 1907. 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 69 
 
 in the United States and in the four leading European countries, the 
 figures being averages for five years. 
 
 Number of men killed for each 1,000 men employed — Averages for five years. 
 
 Country. 
 
 Number. 
 
 France (1901-1905) 
 
 Belgium (1902-1906) 
 
 Great Britain (1902-1906) . 
 
 PrusHia) 1900-1904 ) 
 
 United States (1902-1906). 
 
 0.91 
 1.00 
 1.28 
 2.06 
 
 The following table from the same report shows the number of 
 deaths from accident for every 1,000,000 tons of coal mined : 
 
 Number of men 
 
 killed in 
 
 coal mines 
 
 per 1,000,000 tons of coal produced. 
 
 Year. 
 
 United 
 States. 
 
 Great 
 Britain. 
 
 Belgium. 
 
 France. 
 
 1902 .. ... . . 
 
 6.79 
 5.62 
 6.24 
 5.97 
 5.57 
 
 
 6.29 
 6.68 
 6.66 
 5.64 
 4.96 
 
 44.80 
 
 1903 
 
 O4.70 
 4.41 
 4.64 
 4.31 
 
 .20 
 
 1904 
 
 4.55 
 
 1905 
 
 4.17 
 
 1906 
 
 
 
 
 •Average, 1894 to 1903. 
 
 The causes of the fatal and nonfatal accidents in the coal mines of 
 the United States in 1906 were as follows: 
 
 Causes of coal-mine accidents in the United States, 1906. 
 
 Accidents due to— 
 
 Killed. 
 
 Injured. 
 
 Gas and dust explosions 
 
 228 
 
 80 
 
 1,008 
 
 732 
 
 307 
 
 
 215 
 
 Falls of roof and coal 
 
 1,863 
 
 
 2,192 
 
 
 An exhaustive analysis of mining accidents in the German Empire 
 will be found in the Statistik der Knappschafts-Berufsgenossenschaft 
 fur das Deutsche Reich, Berlin, 1897. The total number of persons 
 insured for one year during the period covered (October 1, 1885, to 
 December 31, 1894) by the work was 3,623,175; the total number of 
 accidents of all kinds notified was 278,371, distributed as follows : 
 
 Total number of accidents of all kinds notified. 
 
 Class of accidents. 
 
 Number. 
 
 Per 1,000 
 persons 
 
 em- 
 ployed. 
 
 Fatal accidents 
 
 7,721 
 
 1,427 
 
 14, 367 
 
 8,164 
 
 2.13 
 
 Accidents causing total permanent disability 
 
 .89 
 
 
 8.97 
 
 
 2.25 
 
 
 
 Minor accidents .• ... 
 
 31,679 
 246, 692 
 
 8.74 
 68.09 
 
 
 
 Total 
 
 278,371 
 
 76.88 
 
 
 
70 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 The causes of the fatal and serious accidents as calculated per 1,000 
 employees are given as follows : 
 
 Falls of rock, coal, falling bodies, etc 3.44 
 
 Transport, haulage, winding, loading, etc 2. 26 
 
 Falls from ladders, steps, or other heights . 89 
 
 Explosions .78 
 
 Machinery in motion, motors, etc . 51 
 
 Molten metal, hot and corrosive fluids, poisonous gases . 12 
 
 Miscellaneous . 74 
 
 Total 8. 74 
 
 Mr. Henry Louis, in commenting upon these statistics in Oliver's 
 " Dangerous Trades," page 516, says : 
 
 Forty-one and six-tenths per cent, or two-fifths, of all the accidents could have 
 been avoided by proper care and intelligent thought on the part of all con- 
 cerned, and, in the second place, fully one-third of the accidents can be ascribed 
 to the faults of the victims themselves. 
 
 According to Revue Scientifique « during the past fifty years there 
 were no less than 503 mine explosions in Europe, with a loss of over 
 5,000 lives. The number of men killed in the coal mines of the United 
 States is appalling, amounting to 22,840 during the seventeen years 
 ending with 1906. In 1906 the total killed was 2,061 and about 5,000 
 injured. 
 
 In the introduction to the Report of the United States Geological 
 Survey, already cited, on "Coal Mine Accidents: Their Cause and 
 Prevention," * Mr. Joseph A. Holmes says : 
 
 The figures given in this report indicate that during the year 1906 nearly 7,000 
 men were killed or injured in the coal min^s of this country, and that the 
 number of these accidents caused directly or indirectly by mine explosions has 
 been steadily increasing. * * * The increase both in the number and in 
 the seriousness of mine explosions in the United States during the past years 
 may be expected to continue unless, through investigations made in the United 
 States, such as have proved effective in other coal-producing countries, informa- 
 tion can be obtained and published concerning the explosives used, the condi- 
 tions under which they may be used safely in the presence of coal dust or gas, 
 and the general conditions which make for health and safety in coal-mining 
 operations. 
 
 According to English data, cited by Frederick L. Hoffman (Quar- 
 terly Publications of the American Statistical Association, December, 
 1902, p. 178), " for the period 1890-1892, at ages 45 to 54, the general 
 death rate of all miners was 19.6 per 1,000, and of quarrymen 25.3 
 per 1,000. For coal miners alone the death rate at this age period 
 was 19.4 ; for copper miners, 24.3 ; for tin miners, 32.2, and for lead 
 miners, 23.9 per 1,000 — indications of quite considerable differences in 
 the mortality and specific disease liability of men engaged in the 
 mining of coal and the different metals." 
 
 While tuberculosis is comparatively rare among coal miners, an- 
 thracosis (a lung disease produced by coal dust — "black lung"), 
 miner's asthma, which is really a chronic bronchitis with emphysema, 
 and simple chronic bronchitis are common affections. These diseases 
 are largely influenced by defective ventilation, for Greenhow has 
 shown that in the operatives of well-ventilated mines there is no 
 excess of pulmonary diseases.*' 
 
 « 1875, II, p. 765. 
 ^ Page 4. 
 
 ° Greenhow, third and fourth report of the medical officer of the privy coun- 
 cU, 1860-1861. 
 
REPOETS OF THE PRESIDENT'S HOMES COMMISSION. 71 
 
 Apart from large quantities of dust, the air of mines contains 
 putrefactive gases from decomposing excrementitious matter, prod- 
 ucts of combustion, especially carbonic-acid gas, which is also one of 
 the constituents of the " choke damp." In addition to all this, the 
 *' fire damp " (an explosive mixture of carbureted hydrogen with 
 atmospheric air in the proportion of 6 to 10 volumes per cent) and 
 the excessive temperature, real hard work, constrained attitude, and 
 careless use of explosives add very greatly to the danger of miners. 
 
 Much can be done to prevent accidents by the introduction of safe 
 hoisting cages, proper engineering, the use of suitable explosives, 
 and adequate inspection laws, while Davy's safety lamps, incan- 
 descent electric lights, and copious ventilation will serve to prevent 
 explosions of fire damp and aid in the purification of the air. 
 
 RAILWAY SERVICE. 
 
 Employees of the railway service, owing to a life full of hardships, 
 exposures, and responsibilities, together with irregular habits, suffer 
 not only from accidents, but also experience more or less sickness, 
 especially from rheumatic affections, diseases of the digestive and 
 respiratory organs, and injuries and disturbances of the nervous sys- 
 tem. Forty-eight per cent of the German railway employees in 1885 
 were taken sick, as follows: Rheumatism, 8.18 per cent; digestive 
 diseases, 11.12 per cent; respiratory diseases, 8.53 per cent; nervous 
 diseases, 2.73 per cent. The train hands suffered most, and the office 
 employees, of course, the least. The percentage of the different classes 
 of sick employees was as follows: 
 
 Per cent of German raihcay employees taken sick, 1885 and 1886, by occupations. 
 
 Occupation. 
 
 Train arrangers 
 
 Train hands, engineers, conductors, brakemen, etc. 
 
 Gate lieepers, etc 
 
 Switch tenders 
 
 Track watchmen 
 
 Station em phjyees 
 
 Office employees 
 
 1885. 1886. 
 
 Hedinger ° has called attention to the fact that only 8 per cent of 
 the German locomotive engineers have normal hearing, while 67 per 
 cent of the engineers and 30 per cent of the firemen have very defect- 
 ive hearing; 14.5 per cent of the track walkers also had defective 
 hearing. The percentage in all increased with the length of the serv- 
 ice. The most common affections were catarrh of the internal and 
 middle ear, which were probably due to abrupt changes in tempera- 
 ture. 
 
 RAILWAY ACCIDENTS. 
 
 The reports ^ of the Interstate Commerce Commission indicate a 
 constant increase in the number of injuries from railway accidents. 
 The number of employees killed by accidents arising from the move- 
 
 oZeitschft. des Vereins. d. Eisenbahnverwaltungen, 27, p. 25. 
 *Text of the Nineteentti Annual Report on the Statistics of Railways in the 
 United States for the year ending June 30, 1906. 
 
72 
 
 KEPOBTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 ment of trains, locomotives, or cars, as distinct from those of other 
 causes, in 1906, was 3,709, of whom 2,310 were trainmen, and 42,962 
 injured, of whom 34,989 were trainmen. The number of fatalities to 
 trainmen in this class of accidents is nearly equally distributed among 
 collisions, falling from trains, locomotives, or cars, and being struck 
 by trains, locomotives, or cars. When all classes of employees are 
 taken into account the last-named cause is responsible for the greatest 
 number of fatalities. 
 
 " Of the fatalities to passengers, collisions account for more than 
 any other single cause, although the number due to jumping on or 
 off trains, locomotives, or cars is nearly as great. In the matter of 
 injuries, however, collisions are far ahead, being responsible for more 
 than 35 per cent of the total injuries to passengers. Taking both 
 passengers and employees into account, it is seen that collisions are 
 responsible for a much higher number of deaths and injuries than any 
 other one class of accidents." ^ 
 
 Railway accidents for the years 1888 to 1906. 
 
 [From the Nineteenth Annual Report of the Interstate Commerce Commission on the 
 Statistics of Railways in the United States, p. 109.] 
 
 Year ending June 
 
 Employees. 
 
 Passengers. 
 
 Other persons. 
 
 Total. 
 
 30- 
 
 Killed. 
 
 Injured. 
 
 Killed. 
 
 Injured. 
 
 Killed. 
 
 Injured, 
 
 Killed. 
 
 Injured. 
 
 1888 
 
 2,070 
 1,972 
 2,451 
 2,660 
 2,554 
 2, 727 
 1,823 
 1,811 
 1,861 
 1,693 
 1,958 
 2,210 
 2,550 
 2,675 
 2,969 
 3,606 
 3,632 
 3,361 
 3,929 
 
 20,148 
 20,028 
 22,396 
 26,140 
 28,267 
 31,729 
 23,422 
 25,696 
 29,696 
 27, 667 
 81,761 
 34,923 
 39,643 
 41, 142 
 60,524 
 60,481 
 67,067 
 66,833 
 76,701 
 
 315 
 310 
 286 
 293 
 376 
 299 
 824 
 170 
 181 
 222 
 221 
 239 
 249 
 282 
 345 
 355 
 441 
 537 
 359 
 
 2,138 
 2,146 
 2,425 
 2,972 
 3,227 
 3,229 
 3,034 
 2,375 
 2,873 
 2,795 
 2,945 
 3,442 
 4,128 
 4,988 
 6,683 
 8,231 
 9,111 
 10,457 
 10,764 
 
 2,897 
 3,541 
 3,598 
 4,076 
 4,217 
 4,320 
 4,300 
 4,155 
 4,406 
 4,522 
 4,680 
 4,674 
 5,066 
 5,498 
 6,274 
 6,879 
 5,973 
 5,805 
 6,330 
 
 8,602 
 4,135 
 4,206 
 4,769 
 6,158 
 5,435 
 6,433 
 6,677 
 6,845 
 6,269 
 6,176 
 6,255 
 6,549 
 7,209 
 7,455 
 7,841 
 7,977 
 8,718 
 10,241 
 
 5,282 
 6,823 
 6,335 
 7,029 
 7,147 
 7,346 
 6,447 
 6,136 
 6,448 
 6,437 
 6,859 
 7,123 
 7,865 
 8,466 
 8,588 
 9,840 
 
 10,046 
 9,703 
 
 10,618 
 
 25,888 
 
 1889 
 
 26,309 
 
 1890 
 
 29,027 
 
 1891 
 
 33, 881 
 
 1892 
 
 36, 652 
 
 1893 
 
 40,393 
 
 1894 
 
 31,889 
 
 1895 
 
 83,748 
 
 1896 
 
 88,687 
 
 1897 
 
 86,731 
 
 1898 
 
 40,882 
 
 1899 
 
 44,620 
 
 1900 
 
 60,320 
 
 1901 
 
 63,339 
 
 1902 
 
 64,662 
 
 1903 
 
 76,653 
 
 1904 
 
 84, 155 
 
 1905 
 
 86,008 
 
 1906 
 
 97,706 
 
 
 
 In 1899 the English Government appointed a commission composed 
 of members of the House of LfOrds and Commons, representatives of 
 the railway companies, railway employees, experts, and government 
 officials, with a view of determining whether the accidents to railway 
 employees were so numerous as to constitute it a dangerous trade. 
 
 The following table indicates that the employment of shunters 
 (switchmen) is far more dangerous than any other occupation save 
 seamen, and that the average work on railways is almost as dangerous 
 as mining, and also illustrates the relative frequency of accidents in 
 other occupations.^ 
 
 « Nineteenth Annual Report of the Interstate Commerce Commission on the 
 Statistics of Railways in the United States, p. 112. 
 * Dangerous Trades, Oliver, pp. 199, 200. 
 
EEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 73 
 
 Number of employees killed and injured from all causes per 1,000 employed 
 
 in various occupations. 
 
 Industry. 
 
 Killed. 
 
 Injured. 
 
 Railway servants in general, excluding contractors' men, cleiks, and 
 
 mechanics 
 
 Goods guards and brakemen 
 
 Permanent- way men or plate layers 
 
 Shunters 
 
 Men porters (railway) 
 
 Seamen (merchant service) 
 
 Coal miners: 
 
 Underground 
 
 Surface , 
 
 Metalliferous mines: 
 
 Underground 
 
 Surface 
 
 Factories: 
 Textile- 
 Males 
 
 Females , 
 
 Nontextile — 
 
 Males 
 
 Females 
 
 Extraction of metals (males) . 
 
 Shipbuilding (males) 
 
 Dock laborers 
 
 1.24 
 
 2.92 
 
 1.9 
 
 6.08 
 
 1.16 
 
 5.2 
 
 1.37 
 .92 
 
 1.34 
 .43 
 
 .1 
 
 («) 
 
 31.0 
 61.0 
 16.0 
 78.0 
 63.0 
 
 .2 
 
 1.1 
 
 .5 
 
 1.4 
 
 6.2 
 2.7 
 
 13.8 
 2.0 
 16.4 
 39.3 
 67.0 
 
 a Unknown. 
 
 ACCIDENTS AND INJURIES. 
 
 The total number of deaths reported during the census year of 
 1900 was 57,513, of which 43,414 were males and 14,099 were females, 
 and the proportion of deaths from these causes in 1,000 deaths from 
 all known causes was 57.6. In 1890 the corresponding proportion 
 was 53.7. In the registration area the rate was 96 per 100,000 of 
 population. In 1890 the death rate was 91.9. The rate in the cities 
 was somewhat higher than in rural districts, and the rate for males 
 was about three times as high (125.4) as it was among females (42.2). 
 This is simply due to the more sheltered position of females and 
 because males alone are generally engaged in the more dangerous 
 operations. 
 
 The following table shows for the registration area and its sub- 
 divisions the — 
 
 Death rate from accidents and injuries during the census year in each of 
 three age groups per 100,000 of population. 
 
 Registration area. 
 
 Under 15. 
 
 15 to 44. 
 
 45 and over. 
 
 Total 
 
 67.0 
 
 89.8 
 
 150.5 
 
 
 
 Males 
 
 85.4 
 48.6 
 
 148.7 
 31.1 
 
 223 8 
 
 
 78.0 
 
 
 
 Cities . . 
 
 70.2 
 89.5 
 50.9 
 63.7 
 80.6 
 46.7 
 08. 2 
 86.1 
 60.3 
 57.2 
 72.7 
 41.8 
 
 94.3 
 
 156.6 
 33.3 
 73.4 
 
 122.3 
 24.9 
 73.1 
 
 122. 4 
 25.9 
 73.9 
 
 122.1 
 23.1 
 
 163 8 
 
 Males 
 
 250,7 
 
 Females 
 
 80.1 
 
 States 
 
 131 2 
 
 Males 
 
 187.8 
 
 Females 
 
 75.8 
 
 Cities . . . 
 
 139.7 
 
 Males 
 
 206.7 
 
 Females 
 
 77.9 
 
 Rural 
 
 122.6 
 
 Males 
 
 169.5 
 
 Females 
 
 73.6 
 
 
 
74 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 From this table we learn that the highest death rate from acci- 
 dents occurred in persons 45 years and over, and the lowest in chil- 
 dren under the age of 15, which indicates that employment in fac- 
 tories, mines, and workshops influences to a great extent the number 
 of accidents and injuries. The rates for females are the lowest in 
 all three age groups, for reasons already assigned. Woman occupies 
 a more favorable position even in childhood, on account of the more 
 reckless disposition of boys, whose rates are probably increased by 
 deaths from drowning, falls, burns, gunshot wounds, railroad acci- 
 dents, etc. 
 
 An attempt to determine the number of persons injured to 1,000 
 employed in the factories was made in the State of New York during 
 1899. The data are based upon three months' observations in a 
 selected list of factories, and are not regarded by the commissioner of 
 labor and chief factory inspector of the State as absolutely accurate. 
 
 Number of persons injured to 1,000 employed. 
 
 Industry. 
 
 Number. 
 
 Clothing, millinery, laundry, etc.. 
 
 Leather, rubber, pearl, etc 
 
 Textiles 
 
 Printing and allied trades 
 
 Food, tobacco, and liquors 
 
 Stone and clay products 
 
 Wood 
 
 Building industry 
 
 Metals, machinery, and apparatus. 
 
 Public utilities 
 
 Pulp, paper, and cardboard 
 
 Chemicals, oils, and explosives — 
 
 1.35 
 
 3.21 
 
 8.91 
 
 9.19 
 
 13.51 
 
 15.18 
 
 18.42 
 
 26.20 
 
 26. 57 
 
 37.28 
 
 41.46 
 
 44.06 
 
 Chapter XL 
 EMPLOYMENT OF WOMEN AND CHILDREN. 
 
 In the face of the many adverse circumstances under which labor 
 is often performed, it is but natural that the immature employees and 
 females should suffer most. The former not infrequently inherit a 
 weak constitution or acquire it by insanitary homes and deficient food, 
 and quite a number are obliged to enter upon active work long before 
 their bodies are sufficiently developed. Quite apart from the fact that 
 child labor is a menace to education, morals, and good citizenship, the 
 effects of premature and involuntary labor upon the health and 
 
 Ehysical welfare of the child are extremely detrimental. Quetelet, in 
 is Physique Soci^le, as early as 1869 demonstrated that the muscles 
 of the average child attain only at the age of 13 or 14 a certain amount 
 of strength and capacity for work. Up to this time the muscular 
 fibers contain a larger percentage of water, and in consequence are very 
 tender and immature. Demetjeff, cited by lliibner," determined the 
 lifting poAver of the arms and trunk at different ages of the working 
 classes to be as follows: 
 
 •Lelirbueh d. Hygiene, Leipzig uud Wicu, lUOG, p. 709. 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION". 75 
 
 Lifting power of the arms and trunk of the working classes at different ages. 
 
 Affe. 
 
 Kilo- 
 grams. 
 
 14 years 
 
 16 years 
 
 18 years 
 
 20 to 29 years 
 
 82 
 101 
 128 
 140 
 
 Age. 
 
 30 to 35 years 
 35 to 40 years 
 40 to 50 vears 
 50 to 60 years 
 
 KHo- 
 grams. 
 
 150 
 160 
 148 
 184 
 
 These figures clearly indicate that the average boy at the age of 14 
 possesses about one-half the muscular strength of an average adult 
 between 35 and 40 years of age. 
 
 As a consequence of imperfect muscular development, it is not 
 surprising that a large percentage of young persons engaged in work- 
 shops, factories, or even at the writing desk or merchant's counter, 
 develop lateral curvature of the spine and other muscular deformities, 
 not to mention general weakness and predisposition to rickets, tuber- 
 culosis, and other pulmonary diseases. All of the bad effects are nat- 
 urally intensified by insanitary environment, especially when the 
 occupations are attended by the inhalation of dust, injurious gases, 
 and impure air. The report of the commission on child labor, 
 1833-34, appointed by the English Parliament, contains many inter- 
 esting facts ; but in spite of legislative efforts Dr. Charles W. Roberts » 
 has occasion to refer to the prevalence of " flat feet," " knock-knee," 
 and the premature aged condition of youthful employees. 
 
 Doctor Roberts says: 
 
 In general conformation of body the factory children do not compare favor- 
 ably with the agricultural. In the manufacturing towns the children are 
 short of stature, have thick limbs, and large feet and hands, and are muscular 
 and in tolerable condition as to fat. They produce the impression on the mind 
 of having bodies too old for their heads (and ages). "Flat foot," with a 
 general disposition to " knockknee," is very common among the factory children, 
 while both are rare among the agricultural, among whom there is a disposi- 
 tion to the opposite state, of bowleg. 
 
 Doctor Roberts ^ examined 19,840 English boys and men. Of these, 
 5,915 belonged to the nonlaboring classes — school boys, naval and 
 military cadets, medical and university students; 13,931 belonged to 
 the artisan class. The difference in height, weight, and chest meas- 
 urement from 13 to 16 years of age was as follows : 
 
 Difference in height, weight, and chest measurement of 19,8Ji6 English boys 
 and men at specified ages. 
 
 AVERAGE HEIGHT. 
 
 Class. 
 
 At 13 
 years. 
 
 At 14 
 years. 
 
 At 15 
 years. 
 
 At 16 
 years. 
 
 
 Inches. 
 58.79 
 55.93 
 
 Inches. 
 61.11 
 67.76 
 
 Inches. 
 63.47 
 
 60.58 
 
 Inches 
 66.40 
 
 Artisan 
 
 62 93 
 
 
 
 
 2.66 
 
 3.35 
 
 2. 89 '■A 47 
 
 
 
 
 o London Lancet, 1875, p. 274. 
 
 * Cited by John Spargo, Bitter Cry of the Children, 1906, p. 96. 
 
76 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 Difference in height, weight, and chest measurement of J 9,846 English hoys 
 and men at specified ages — Continued. 
 
 _ AVERAGE WEIGHT. 
 
 Class. 
 
 At 13 
 years. 
 
 At 14 
 years. 
 
 At 15 
 years. 
 
 At 16 
 years. 
 
 Nonlabcring 
 
 Pounds. 
 88.60 
 78.27 
 
 Pounds. 
 99.21 
 84.61 
 
 Pounds. 
 110.42 
 96.79 
 
 Pounds. 
 128.34 
 
 Artisan . 
 
 108.07 
 
 
 
 Difference 
 
 10.38 
 
 14.60 
 
 13.63 
 
 19.64 
 
 
 
 
 AVERAGE CHEST GIRTH. 
 
 
 
 
 
 Nonlaboring 
 
 Inches. 
 28.41 
 25.24 
 
 Inches. 
 26.28 
 26.28 
 
 Inches. 
 30.72 
 27.61 
 
 Inches. 
 33 08 
 
 Artisan - 
 
 28 97 
 
 
 
 
 Difference 
 
 3.17 
 
 3.37 
 
 8.21 
 
 4 11 
 
 
 
 Congress, on February 19, 1907, authorized a federal investigation 
 of the subject of child labor under the direction of the United States 
 Bureau of Labor, and the results of such investigation may more 
 clearly define the need for federal legislation or indicate other means 
 adapted to regulate the evil. 
 
 During the census year of 1900 there were 1,752,187 children under 
 16 years of age employed in gainful occupations ; of these over 80,000 
 were employed in the textile industry; 7,116 in the glass industry; 
 about 25,000 in mines and quarries; 12,000 in the manufacture of 
 tobacco and cigars ; over 10,000 in wood industries ; over 7,000, mostly 
 girls, were employed in laundries; 2,000 in bakeries; 138,000 as wait- 
 ers and servants ; 42,000 boys as messengers ; and 20,000 boys and girls 
 in stores. Mr. John Spargo, in " The Bitter Cry of the Children," on 
 page 211, gives the result of his investigation covering 213 cases of 
 child labor with a view of determining the cause. He found that 52 
 children were obliged to work because their father earned less than 
 $10 a week ; in 13 instances the father was out of employment ; in 19 
 the father was sick; in 12 the father had died; in 4 the father had 
 deserted the family ; in 4 other instances he was intemperate, and in 
 1 case the father was in prison. He concludes that in these 105 
 instances the primary cause was poverty. 
 
 Of 108 other children, the causes are given as follows : School dif- 
 ficulties, 30 ; " because friends went to work," 18 ; " to get better 
 clothes," 11; " to enable parents to save," 17; sickness while in school, 
 6 ; father's laziness, 2 ; not determined, 25. 
 
 Child labor differs in degree as well as in kind. The ordinary mes- 
 senger or newsboy may not sacrifice his health, but his morals and 
 his education must inevitably suffer. And so we see different grada- 
 tions until some of the most injurious forms of child labor are en- 
 countered. 
 
 Dr. Annie S. Daniel, in speaking of her personal observations in 
 New York, tells us that a child 3 years old can straighten out the 
 leaves of tobacco and can stick together the materials which form 
 the stems of artificial flowers; at 4 he can put the cover on paper 
 
 •Cbaiitles. April 1, 1905. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 77 
 
 boxes; between 4 and 6 he can sew on buttons and pull basting 
 threads. A girl from 8 to 12 can finish trousers as well as her 
 mother. After she is 12, if of good size, she can earn more money in 
 a factory, because she will be accepted if her size justifies the evasion 
 of the law. The boys practically perform the same labor as the girls, 
 except that they leave home earlier and engage in street work as 
 peddlers, newsboys, or bootblacks. Doctor Daniel has actually seen 
 two children under 3 years of age working in the tenements of New 
 York — one, a boy 2J years of age, assisting the mother, and four other 
 children under the age of 12, in making artificial flowers. " These 
 children earn from 50 cents to $1.50 a week, obviously at the expense 
 of health and education — rights which neither the parents nor the 
 community nor the State have a right to withhold." 
 
 A feeling seems to exist in Washington that there is no special need 
 for the enactment of a law to prevent or regulate child labor, but the 
 same class of people told us years ago, that we had no slums, and 
 hence there was no occasion for the betterment of the housing con- 
 ditions, when, as a matter of fact, investigations have shown con- 
 clusively that in many respects we are as badly, if not worse, off than 
 the cities of New York and. Chicago. Those who are familiar with 
 the subject know that there is a local situation which demands legis- 
 lation. But whether the number is large or small it matters little, 
 and it is clearly the duty of every community to resort to preventive 
 measures against this hydra-headed evil. 
 
 It has been asked. What is the use of enacting child-labor laws 
 when such atrocious instances are possible in the city of New York, 
 where child-labor law exists? And it must be granted that just such 
 evils will be witnessed in New York or any other American city so 
 long as public opinion and the conscience of the American people is 
 not sufficiently aroused to demand the enforcement of the Jaw. 
 
 It has been estimated that there are in this city between 1,500 and 
 2,000 children under the age of 15 engaged in wage-earning occupations. 
 And we feel that the enactment of a suitable law would guard these 
 children and afford them a better opportunity of becoming useful 
 citizens, and the consumers would at least have the satisfaction of 
 knowing that they are not stained with the sweat and blood of help- 
 less children. 
 
 How many more of the 6,000 children between the ages of 8 and 12 
 who are not now at school are engaged in wage-earning occupations 
 we do not know. But whether they are at work because of the neces- 
 sities of their parents or because of their own disinclination to study, 
 the law should intervene and establish an effective remedy. 
 
 It has been urged, and no doubt in many instances quite correctly, 
 that child labor is encouraged by the greed of the employers, but the 
 writer is in a position to know that the business men of this city would 
 hail with delight the enactment of a child-labor law. As it is now, it 
 is not always an easy matter to refuse to lend a halping hand in appar- 
 ently deserving and pathetic cases. 
 
 It is, indeed, deplorable that so little has been accomplished in the 
 way of educating the public to a sound and full appreciation of the 
 evil consequences of child labor, and it is especially humiliating to 
 know that the District of Columbia, the seat of the National Govern- 
 ment, is the only community with the exception of Georgia, Idaho, 
 
78 REPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Nevada, and the Indian Territory, which is at present without legisla- 
 tion of some kind on the subject of child labor. 
 
 Women, on account of their imperfectly developed muscular system 
 and more delicate physique, are unfitted for hard work; nor should 
 they be obliged to work steadily in a sedentary position, especially at 
 the sewing machine or other occupations involving the use of the lower 
 extremities. Special protection should be extended to them during the 
 child-bearing period. It is a matter of constant observation that 
 women who have to deny themselves proper rest and care during the 
 six weeks before and after confinement are very liable to suffer from 
 hemorrhages and chronic uterine diseases, while miscarriages and 
 premature births are not infrequent results of overwork. Recent 
 statistics collected by Doctor Neisser (1907) indicate that such acci- 
 dents are quite frequent among farmers' wives and women employed 
 in the jewelry industry, where the motor power is supplied by the 
 feet. 
 
 INFANT MORTALITY IN RELATION TO THE OCCUPATION OF WOMEN. 
 
 Attention has been directed on another page to the high rate of in- 
 fant mortality in certain mill toAvns of Massachusetts. This subject 
 has received careful attention, especially in England. The investiga- 
 tions made by Sir John Simon and his colleagues into the sanitary 
 condition of England between 1859 and 1865 showed " that in propor- 
 tion as adult women were taking part in factory labor or in agriculture 
 the mortality of their infants rapidly increased." Among other causes, 
 Simon attributes the excessive mortality of infants under 1 year, 
 which in some registration districts was from two and a quarter to 
 nearly three times as high as in standard districts, " to occupational 
 differences among inhabitants, there being certain large towns where 
 women are greatly engaged in branches of industr^^ away from home, 
 where, consequently, these houses are ill kept, where the children 
 are little looked after, and where infants who should be at the breast 
 are improperly fed or starved, or have their cries of hunger and dis- 
 tress quieted by those various fatal opiates which are in such request 
 at the centers of our manufacturing industry." ^ 
 
 Fifty years have elapsed since Simon declared " infants perish 
 under the neglect and mismanagement which their mothers' occupa- 
 tion implies." The subject has since been studied by the medical 
 officers of the home office, the local government board, and 1,800 local 
 health boards in England. Doctor Newman has carefully surveyed 
 the facts concerning the number of females employed in gainful occu- 
 pations, the percentage of married women, the infant mortality rate in 
 towns having a low percentage of women so employed, as compared 
 with textile towns, where the percentage of female employees is high. 
 He has given careful consideration to the character and condition of 
 the work, the length of working hours, employment before and after 
 childbirth, and the sanitation of workshops. He dwells very justly 
 upon the evil effects of the added strains of factory life, such as 
 piecework, hard physical labor, injurious trade processes, fatigue, etc. 
 
 Doctor Newman tells how in some trades, like brickmaking, tin- 
 plate works, iron hollow ware, certain hardware trades, jam and sauce 
 
 « Papers Relating to the Sanitary State of tlie People of England, 1858. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 79 
 
 factories, and mat work, women are not infrequently employed in car- 
 rying or lifting weights altogether beyond their physical endurance. 
 He emphasizes the various dangers to which the female employees are 
 exposed, and sunmiarizes the direct injuries as follows: (a) Accidents 
 from machinery, materials, and other external agents; (h) injury or 
 poisoning from toxic substances, or injury from excessive dust, fumes, 
 vapor, or extremes of temperature (he refers also to anthrax infec- 
 tions in horsehair factories, tetanus in jute works, lung diseases in 
 dusty trades, and abortion in lead works) ; (c) injury through fatigue 
 and strain, long hours, insufficient periods of rest for food; (d) injury 
 derived from defective sanitary conditions, such as bad ventilation, 
 dampness, insufficiency or unsuitability of sanitary conveniences ; and 
 (e) too short a period of rest at the time of childbirth.'^ 
 
 He declares that the official reports of factory inspectors and of 
 medical officers of health reveal ample evidences of these injuries, and 
 adds: "Where the conditions resulting in these evils, coupled with 
 the absence of the mother from home, are present, the infant mortal- 
 ity is high; where they are not present it is usually low." He de- 
 scribes the general effects of the factory system at Dundee, where 
 24,879 women and girls are employed in the jute and hemp factories, 
 and another 3,000 women are employed in other textile works. One 
 quarter of the women, or about 6,000, are married, and about 16 per 
 cent of all the girls in Dundee between the ages of 10 and 14 are em- 
 ployed in these trades. 
 
 The infant mortality rate for Dundee " is exceptionally high, and 
 for the decennial 1893-1902 was 176 per 1,000 births." In 1904 there 
 were 788 infant deaths, 129 of which occurred within the first Aveek, 
 and all but four of these were medically certified as due to " prema- 
 turity and immaturity." Nearly one-half of the total number oc- 
 curred in the first three months of life. Inquiry was made into the 
 social conditions of the home life of 364 of these infant deaths. " The 
 occupations, or former occupations, of the mothers were as follows: 
 Eighty-four weavers, warpers, or winders; 105 spinners, piecers, or 
 shifters; 88 preparers; 12 sack machinists or sack sewers; 27 mis- 
 cellaneous; 20 unoccupied, and 25 concerning which there was no 
 return obtainable. Of the cases inquired into 13.2 per cent of these 
 mothers worked at the factory to within a week of childbirth. Fif- 
 teen women worked to within a few hours of childbirth." 
 
 Doctor Newman's final conclusion on the subject of infant mortality 
 in relation to the occupation of women is as follows : ^ 
 
 No doubt the factory plays a part, but the home plays a vastly greater part, 
 in the causation of infant mortality in the towns where women are employed at 
 the mills. There are two influences at work — first, the direct injury to the 
 physique and character of the individual caused by much of the factory em- 
 ployment of women, and, secondly, the indirect and reflex injury to the home 
 and social life of the worker. We can not afford to forget either of these points 
 in attempting to estimate the operations of the factory in infant mortality. It 
 is because they have not been sufliciently correlated together that fallacy has 
 arisen in the past. But even yet we have not flnished. " Infantile mortality 
 in Lancashire," writes an experienced medical officer. of health for a town in 
 that county with an infant mortality in 1904 of 222, " is, I am sorry to say, as 
 much a financial as a hygienic question." Why do married women work in the 
 mills? is the question this medical officer has reached. His answer is that "a 
 
 * Infant Mortality, George Newman, M. D., New York, 1907, 
 > Infant Mortality, Newman, p. 137. 
 
80 REPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 weaver's wages will not allow of the wife's remaining at home, considering the 
 high rents and rates, and so both go — which is the rule — and a hand-to-mouth 
 existence results even for themselves, let alone the little ones, who are left in 
 the intervals to the mercies of the nurse, who, as a rule, takes in the babies to 
 eke out her own husband's wages. Much good may be done by hygienic tuition, 
 but I am certain that the root of the whole matter with us is, as I have said, 
 comparatively low wages and high rents and rates. 
 
 In the discussion of infant mortality it would be unfair not to em- 
 phasize other facts, such as impure and dirty milk and 1-room tene- 
 ments. Of 54,047 infantile deaths which were investigated both in 
 the Old and the New World as to the character of feeding, it was 
 found that 86 per cent had been artificially fed. Neumann," in inves- 
 tigating 2,711 infantile deaths in Berlin, found that 1,792 occurred in 
 1-room apartments, 754 in 2-room apartments, 122 in 3-room apart- 
 ments, and 43 in apartments of 4 rooms and over. 
 
 It is hoped that Doctor Newman's study of the subject will result 
 everywhere in the amelioration of existing conditions, for, as pointed 
 out by the author and Sir John Simon, a high death rate of infants 
 suggests racial degeneracy and is at least " an indication of the exist- 
 ence of evil conditions in the homes of the people — which are, after 
 all, the vitals of the nation." 
 
 Doctor Daniels, in speaking of the female labor question in New 
 York, says : 
 
 That in no case in over 515 families examined by her was any woman work- 
 ing other than from dire necessity. The average weekly income from the 
 man's work was $3.81. The average rent was $9 per month. The average 
 family to be supported was 4i persons. As it requires more than two weeks' 
 wages to pay one month's rent, it is evident that the women and children must 
 work or the family go hungry. (Charities, April 1, 1905.) 
 
 Those interested in female labor as carried on in the " sweat shops " 
 of New York at the rate of $3 to $4 a week should not fail to read 
 ''The Long Day: The True Story of a New York Working Girl 
 as Told by Herself." 
 
 Chap'iier XII. 
 
 SPECIAL MEASURES FOR THE PREVENTION OF TUBERCULOSIS 
 AMONG WAGE-EARNERS. 
 
 There is abundant statistical evidence to show that industrial 
 workers pay a very heavy tribute to the so-called " white plague ; " 
 nor is it cause of wonder when the many unfavorable factors to which 
 they are subjected are considered, such as crowded and insanitary 
 workshops, deficient light, overwork, long hours in a bad air, damp- 
 ness, exposure to extremes of heat and cold, sudden changes in tem- 
 perature, and the inhalation of irritating dust, vapors, etc. All of 
 these factors are calculated to lower the power of resistance and 
 favor the spread of disease, especially when some of the workmen 
 themselves are already afflicted and are careless in the disposition of 
 their expectoration. 
 
 On the other hand, it would be unfair not to consider the influence 
 of home environment, such as unclean and crowded or otherwise 
 insanitary dwellings, insufficient or improper food, and last, but not 
 
 • Deutsche med. Wochenschrift, Leipzig, 1904, p. 1723, 
 
KEPORTS OF THE PKESIDENT's HOMES COMMISSIOK. 81 
 
 least, the bad effects of the abuse of alcohol. It has been shown that 
 alcohol not only affects the digestive and nervous functions, in con- 
 sequence of which the general nutrition of the bod^ is markedly 
 reduced, but the habit of visiting and remaining m saloons for 
 hours, sometimes till midnight, deprives the individual of proper rest 
 and exposes him to the poisonous fumes of tobacco, coal and carbonic- 
 acid gases, and other injurious agents. The preventive measures are 
 partly the duty of the State, which should regulate the air space and 
 ventilation of the workshops and dwellings and improve the working 
 conditions by forced ventilation and "wet processes" in order to 
 diminish dust production and exposure to irritating gases. On the 
 other hand, it is clearly the duty of the worlanen themselves and the 
 community at large to improve social and housing conditions. In 
 view of the undue prevalence of consumption among file cutters, 
 metal grinders, stone cutters, and cotton, flax, and tobacco operatives, 
 persons predisposed to this disease should be cautioned against 
 engaging in such occupations. Simple printed instructions should 
 be given as to the part expectoration plays in the spread of consump- 
 tion. Cuspidors in sufficient number and properly disinfected should 
 be provided, preferably one for each workman, and promiscuous 
 expectoration should be forbidden. 
 
 Chapter XIII. 
 
 MEASURES FOR THE PROTECTION OF WAGE-EARNERS. 
 
 From what has been said it is evident that the laboring classes need 
 special protection against the many dangers referred to, and this 
 should emanate from the State, the employers, the community, and 
 the employees themselves. 
 
 One of the important predisposing causes to disease is overwork or 
 fatigue, because the accumulation of waste products in the blood, 
 from muscular wear and tear, together with the expended nervous 
 energy, combine to render the system more susceptible to disease. 
 Excessive work is inimical to health, and long hours and hard work 
 are calculated to diminish the general power of resistance, and thus 
 bring about physical deterioration. Hence the necessity of laws regu- 
 lating the hours of labor and the enforcement of a day of rest as 
 contemplated by the Sunday laws. 
 
 Professor Roth's conclusions on this subject are as follows :« (1) In 
 order to prevent a state of chronic fatigue it is essential that the 
 amount of work be regulated by the capacity of the individual; 
 (2) the more intensive the work and the shorter the intervals of rest 
 for the elimination of waste products the earlier we may expect mani- 
 festations of fatigue, and the working hours must be regulated ac- 
 cordingly ; (3) other industrial dangers, like excessive heat, humidity, 
 violent concussions, constrained attitude, overexercise of certain 
 groups of muscle, exposure to vitiated air and toxic agents favor 
 premature fatigue, and should be controlled by rational measures; 
 
 « Ermuedimg dnrcli Berufsarbeit Intern. Kongress fuer Hygiene und Demo- 
 gaphie, Berlin, 1907, Band, ii, p. 620. 
 S. Doc. 644, 60-2 1 
 
82 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 (4) insufficient and improper food, vicious habits, long walks to place 
 of work, and abuse of alcoholic drinks lower the vital powers and 
 produce premature fatigue; (5) monotonous work or any employ- 
 ment involving responsibility and intense mental application are con- 
 ducive to fatigue. All of these factors should be considered and 
 controlled by suitable preventive measures, so as to avoid the chronic 
 effects of fatigue, which are generally evinced by anaemia, digestive 
 derangements, neurasthenia, respiratory and cardiac difficulties. 
 
 No child should be permitted to work in factories and wage-earning 
 occupations under the age of 14, and then only upon presentation of a 
 medical certificate that it is free from physical defects. Such children 
 should not be obliged to work longer than six hours, with a two-hour 
 interval of rest after the first three hours, so that they may be able 
 to enjoy their noon dinner. Under no circumstances should they be 
 permitted to perform night work or engage in the so-called danger- 
 ous occupations. The same may be said of indi\dduals between the 
 age of 16 and 18 years, who, however, may be permitted to work eight 
 hours a day, with proper intervals for meals and rest. 
 
 Women, even from a moral standpoint, should not be permitted 
 to work in factories or shops after sundown. The laws of some coun- 
 tries prescribe one hour for nooning, if they have their own house- 
 holds, and their exclusion from factories six weeks before and after 
 confinement, while in other countries hard labor for women is strictly 
 forbidden. 
 
 SANITATION OF WORKSHOPS AND QUARTERS FOR EMPLOYEES. 
 
 The protection of wage-earners should extend to the work and 
 workshops, and, in case the employees are housed by the employer, 
 also to the living and sleeping quarters. 
 
 A sanitary workshop demands sufficient air space for each inmate, 
 a suitable temperature, proper ventilation and illumination, general 
 cleanliness, and suitable opportunities for personal cleanliness. The 
 necessity for abundant ventilation is apparent when it is recalled that 
 men at work eliminate more carbonic-acid gas than individuals at 
 rest, and that in the majority of occupations the air is further vitiated 
 by the presence of dust and gases. 
 
 The question of illumination is not only important for the preven- 
 tion of defective vision and accidents, but when recourse is had to arti- 
 ficial illumination the additional vitiation of the air must be con- 
 sidered. Such matters, which, after all, are largely questions of 
 public health, should not be left to the individual employer, but 
 the principles of industrial hygiene which ought to be adopted should 
 be embodied in suitable laws and enforced by competent inspectors. 
 Among the most dangerous forms of workshops is one class whicli 
 most state laws entirely ignore. For example, under the law of tlie 
 State of New York relating to manufacturing in tenement houses, 33 
 distinct industries may be carried on in the living rooms of the 
 workers, because they involve hand work or simple machinery. There 
 are over 23,000 licensed " home factories " in the city of New York 
 alone. Dr. Annie S. Daniels, who made a special investigation of 
 manufacturing in tenements, says <» " that every garment worn by a 
 
 • Charities, April 1, 1905. 
 
/ 
 
 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 83 
 
 woman is found being manufactured in tenement rooms; the same is 
 true of clothing worn by infants and young children. In addition 
 to wearing apparel for men, women, and children, including adorn- 
 ments of woman's dress, the flowers and feathers for her hats, the hats 
 themselves, and neckwear of every description, she found the manu- 
 facture of paper boxes, cigars, pocketbooks, jewelry, clocks, watches, 
 wigs, fur garments, paper bags, etc., and the articles frequently 
 handled and stored in infected rooms." According to Doctor Daniels, 
 among the 150 families tabulated by her, 66 continued at work during 
 the entire course of the contagious disease for which she was attending 
 the family, and the question naturally arises. How many germs of 
 tuberculosis, measles, scarlet fever, diphtheria, and other infectious 
 diseases may be sewed in the garments made in the tenement " sweat 
 shops ? " "And last, but not least, the greatest danger falls upon the 
 workers — ^it means the loss of health, physically and morally, the 
 loss of home, because home life is impossible in a tenement workroom." 
 Apart from the occupations referred to, numerous bakeries, candy, 
 ice-cream, and milk shops ; butcher shops and sausage factories ; bot- 
 tling establishments; tailor, cobbler, and other repair shops are 
 carried on in basements under the most insanitary surroundings as 
 regards workrooms and sleeping quarters. 
 
 CUBIC AIR SPACE AND AMOUNT OF FRESH AIR PER HOUR. 
 
 Reference has been made to the baneful effects of vitiated air, which 
 are of course intensified when the occupation is attended with the pro- 
 duction of dust and irritating fumes or gases. It is known that car- 
 bonic acid is not itself a toxic agent, but an excess of this gas in the air 
 of rooms leads to a deficiency of oxygen and also to defective elimina- 
 tion of carbonic acid from the system, which can not be excreted 
 whenever the tension of carbonic acid in the air exceeds that of the 
 carbonic acid in the blood. In order that the respiratory impurities 
 may not exceed certain limits (6 volumes of carbonic acid per 10,000), 
 it has been found that an average adult requires 3,000 cubic feet of 
 fresh air per hour, and this amount should be supplied without dis- 
 comfort to the occupants. Experience has shown that the air of a 
 room can not be changed oftener than three times in one hour in 
 winter without causing a disagreeable draft; hence every occupant 
 should have a cubic air space of 1,000 feet. This is the ideal standard, 
 and section 100 of the factory laws of New York of 1901 (as amended by 
 chapter 129, acts of 1906), relating to certain manufactures in tene- 
 ments, provides " that the whole number of persons therein shall not 
 exceed one to each 1,000 cubic feet of air space." Such an ideal 
 standard, however, is not alwaj^s attainable in workshops, and it is 
 believed that for practical purposes an air space of from 400 to 500 
 cubic feet per capita will suffice. 
 
 The States of New York, Indiana, Michigan, New Jersey, Ohio, 
 Pennsylvania, and Wisconsin appear to be the only States which 
 make a definite provision on this point, and they require an air space 
 of 250 cubic feet for each employee between the hours of 6 a. m. and 
 6 p. m., and, unless by written consent of the factory inspector, not 
 less than 400 cubic feet for each employee between the hours of 6 p. m. 
 and 6 a. m., provided such room is lighted by electricity, etc. This is 
 a step in the right direction, but it would be extremely desirable to 
 
84 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 place the minimum amount of cubic air space at 400 feet for day 
 work and 500 feet for night work, unless electricity is used, in which 
 case a uniform standard of 400 feet might be prescribed. At all 
 events the question of sufficiency ought not to be left to the discretion 
 of the factory inspector. Either the cubic air space should be speci- 
 fied or the carbonic acid limited to 12 volumes per 10,000. 
 
 VENTILATION. 
 
 Ventilation, which means the removal and dispersion of bad air 
 and the introduction of fresh air, is accomplished either by natural 
 or artificial means. Natural ventilation is usually sufficient when each 
 occupant has 1,000 feet of cubic air space, the walls of the building 
 are porous or contain numerous crevices near the doors and windows, 
 the difference betwen the indoor and outdoor temperature is consider- 
 able, and the winds strike the walls directly or pass with great veloc- 
 ity over chimney flues or other openings. But as the direction and 
 force of the winds and the other factors referred to can not be con- 
 trolled, other means should be provided for ventilation. For this 
 purpose, open windows, doors, and revolving fans answer very well in 
 summer. The objection to this method are the cold drafts in winter. 
 In rooms heated with direct radiation the fresh air should therefore 
 be admitted above the heads of the occupants, either by fresh-air reg- 
 ister inlets in the walls or by the insertion of louvered or swinging 
 windows, thus an upward direction being given to the air, so that it 
 rnay impinge on the ceiling, mix with and be warmed by the heated 
 air in this situation, falling gently into all parts of the room, and being 
 gradually removed by means of the foul-air outlets, aided by exhaust 
 fans. Another simple plan is to bore slanting holes in the bottom 
 rail of the window sash, or to employ a Pullman or Bury ventilator, 
 or to insert a piece of board 4 inches wide across the window sill. 
 The separation of the sashes thus caused will provide for indirect 
 fresh-air inlets. 
 
 Artificial ventilation, which may be secured by providing (1) suit- 
 able inlets and outlets; (2) by extraction by heat, or the creation of 
 a decided difference between the inner and outer temperature; and, 
 (3) by propulsion and aspiration. Space will not permit to enter 
 into details except to say that besides the contrivances already men- 
 tioned, any of the ordinary registers in which the air passes through 
 the walls by means of a perforated iron plate and is then directed 
 upward by a valved plate with side checks will prove of service. 
 McKinnel's ventilator consists of two cylinders, one inside the other 
 and of different lengths, the longer tube, projecting above and below, 
 serves to conduct the impure air, while the outer cylinder, having a 
 larger sectional area, serves as an inlet. The outlet is protected on the 
 top with a cowl, and both tubes can be regulated by valves. They 
 are especially useful in the ventilation of one-story buildings or the 
 upper story of any building. If gas is used as an illuminant, the 
 burners may be placed immediately under the extracting tube. As 
 the warm air escapes through the inner tube a corresponding volume 
 is admitted through the interspace between the two cylinders. 
 
 The Ridge ventilators consist of openings through the ceiling and 
 roof with louvered sides and ends, protected with a small roof, the 
 opening of the air shaft in the ceiling usually being provided with 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 85 
 
 suitable registers. The fresh air is admitted by the means ah-eady 
 referred to, or by registers placed behind radiators. If the building 
 is heated by stoves, the fresh air may be admitted by inlets running 
 underneath the floor between the joists and discharging through a 
 register near the stove. 
 
 Extraction of foul air by heat is usually accomplished by placing 
 a separate flue next to the chimney flue ; the latter, if in use for firing 
 purposes, creates an upward current. If this is not sufficient it may 
 be promoted by gas jets or a steam coil placed in the flue. 
 
 The propulsion and aspiration system is especially adapted for all 
 large buildings and factories, and consists of mechanical devices by 
 which the fresh air is forced into and distributed throughout the 
 building by the use of fans or air propellers, the foul or objectionable 
 air being removed by so-called exhaust fans. A number of States have 
 made statutory provisions for the ventilation of workshops, and quite 
 a number, including California, Connecticut, Illinois, Indiana, Iowa, 
 Maryland, Massachusetts, Ohio, Oregon, Pennsylvania, Michigan, 
 Minnesota, Mississippi, New Jersey, New York, South Dakota, 
 Washington, and Wisconsin, require mechanical devices for the re- 
 moval of injurious dust or gases. Of these States several lay down 
 specific rules concerning the construction of workbenches and hoods. 
 The latter empty into air shafts connected with exhaust fans, and 
 thus extract all dust and fumes without material injury from drafts 
 to the operatives. The provisions apply especially to operations in 
 which emery wheels or belts or other buffing processes are employed. 
 The laws of the State of Michigan, acts of 1899, furnish a good ex- 
 ample of regulations of this character. 
 
 ACT NO. 202. — Factories and workshops — Blowers for emery wheels, etc. 
 
 Section 1. All persons, companies or corporations, operating any factory or 
 workshop, where wheels or emery belts of any description are in general use, 
 either leather, leather covered, felt, canvas paper, cotton or wheels or belts 
 rolled or coated with emery or corundum, or cotton, wheels used as buffs, shall 
 provide the same with fans or blowers, or similar apparatus, when ordered by 
 the commissioner of labor, which shall be placed in such a position or manner 
 as to protest [protect] the person or persons using the same from the particles 
 of the dust produced and caused thereby, and to carry away the dust arising 
 from, or thrown off by such wheels, or belts, while in operation, directly to the 
 outside of the building or to some other receptacle placed so as to receive and 
 confine such dust, and the same shall be placed in such factory or workshop 
 within three months after this act shall take effect, in the manner and accord- 
 ing to the directions and specifications as herein, in this act set forth : Pro- 
 vided, That grinding machines upon which water is used at the point of grind- 
 ing contract shall be exempt from the conditions of this act: And provided 
 further, That this act shall not apply to solid emery wheels used in sawmills 
 or planing mills or other woodworking establishments. 
 
 Sec. 2. It shall be the duty of any person, company, or corporation operating 
 any such factory or workshop to provide or construct such appliances, appa- 
 ratus, machinery or other things necessary to carry out the purpose of this 
 act, as set forth in the preceding section, as follows: Each and every such 
 wheel shall be fitted with a sheet or cast-iron hood or hopper of such form and 
 so applied to such wheel or wheels that the dust or refuse therefrom will fall 
 from such wheels or will be thrown in such hood or hopper by centrifugal force 
 and be carried off" by the current of air into a suction pipe attached to same 
 hood or hopper. 
 
 Sec. 3. Each and every sueh wheel six inches or less in diameter shall be 
 provided with a three-inch suction pipe; wheels six inches to twenty-four 
 inches in diameter with four-inch suction pipe; wheels from twenty-four 
 inches to thirty-six inches in diameter with a five-inch suction pipe; and all 
 
86 - REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 wheels larger in diameter than those stated above shall be provided each with 
 a suction pipe, not less than six inches in diameter. The suction pipe from 
 each wheel, so specified, must be full sized to the main trunk suction pipe, and 
 the said main suction pipe to which smaller pipes are attached shall, in its 
 diameter and capacity, be equal to the combined area of such smaller pipes 
 attached to the same; and the discharge pipe from the exhaust fan, connected 
 with such suction pipe or pipes, shall be as large or larger than the suction pipe. 
 
 Sec. 4. It shall be the duty of any person, company or corporation operating 
 tiny such factory or workshop, to provide the necessary fans or blowers to be 
 c'ormected with such pipe or pipes, as above set forth, which shall be run at 
 such a rate of speed as will produce a velocity of air in such suction or dis- 
 charge pipes of at least nine thousand feet per minute or an equivalent suction 
 or pressure of air equal to raising a column of water not less than five inches 
 high in a U-shaped tube. All branch pipes must enter the main trunk pipe at 
 an angle of forty-five degrees or less. The main suction, or trunk pipe, shall be 
 below the polishing or bufling wheels and as close to the same as possible and 
 to be either upon the floor or beneath the floor on which the machines are 
 placed to which such wheels are attached. All bends, turns or elbows in such 
 pipes must be made with easy smooth surfaces having a radius in the throat 
 of not less than two diameters of the pipe on which they are connected. 
 
 Sec 5. It shall be the duty of any factory inspector, sheriff, constable or 
 prosecuting attorney of any county in this State, in which any such factory or 
 workshop is situated, upon receiving notice in writing, signed by any person or 
 persons, having knowledge of such facts, that such factory or workshop, is not 
 provided with such appliances as herein provided for, to visit any such factory 
 or workshop and inspect the same and for such purpose they are hereby author- 
 ized to enter any factory or workshop in this State during working hours, and 
 upon ascertaining the facts that the proprietors or managers of such factory or 
 workshop have failed to comply with the provisions of this act, to make com- 
 plaint of the same in writing before a justice of the peace, or police magistrate 
 having jurisdiction, who shall thereupon issue his warrant directed to the 
 owner, manager, or director in such factory or workshop, who shall be there- 
 upon proceeded against for the violation of this act as hereinafter mentioned, 
 and it is made the duty of the prosecuting attorney to prosecute all cases 
 under this act. 
 
 TEMPERATURE. 
 
 It is a well-known fact that the welfare and capacity for work of 
 individuals are to a great extent influenced by the surrounding tem- 
 perature. Reference has been made to occupations involving ex- 
 posure to extremes of heat and cold, dampness, and sudden changes. 
 The human organism possesses the faculty of maintaining a uniform 
 temperature, i. e., it so regulates and harmonizes the production and 
 the loss of animal heat that the normal temperature of the blood, 
 98.2° F. is not materially affected, and in this the skin doubtless 
 plays the most important role. Whenever cold acts upon the skin 
 the irritation is primarily exerted upon the nerves, which transmit it 
 to the central organs of the nervous system (the heat-regulating 
 center) , and from there it is reflected to the nerves of tlie cutaneous 
 vessels and muscular fibers, which promptly contracts, and in con- 
 sequence of a diminished blood supply there is less loss of heat. If, 
 on the other hand, heat instead of cold plays upon the skin, we have 
 dilatation instead of contraction of the vessels, with an increased sur- 
 face blood supply and corresponding loss of heat by radiation and 
 conduction. At the same time the perspiratory glands are stimulated 
 to greater activity, more sweat is excreted and evaporated, and still 
 more heat is dissipated. One of the bad effects of profuse perspira- 
 tion is that the blood is deprived of some of its constituents. The 
 blood is taken away too long from the internal organs ; the proper dis- 
 tribution of the blood supply is interfered with, and in consequence 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 87 
 
 tone and nutrition of the stomach, lungs, heart, and other internal 
 organs is lowered. We lose our appetite and suffer from indigestion ; 
 the tone and nutrition of the stomach, lungs, heart, and other internal 
 enervation, and the system in consequence is rendered more suscep- 
 tible to disease. 
 
 While the human organism endeavors to adapt itself to extremes 
 of heat and cold, the faculty of the body to maintain the equilibrium 
 is by no means unlimited, and the heat-regulating center is liable to 
 fail or become paralyzed if imposed upon too long or too frequently. 
 This is especially the case during sudden changes of temperature. 
 It is the abruptness which offends the peripheral nerves, and the 
 ^eater the abruptness the more intensive will be the irritation which 
 IS transmitted by reflex action to other parts of the body, usually the 
 weakest parts, and may result in driving the blood to internal organs, 
 causing congestion and other mischief. Then again a cold draft 
 playing on the cheek may cause neuralgia, paralysis, sore throat, 
 bronchitis, or pneumonia, showing that cold applied locally may 
 excite disease in the neighborhood of its application or in distant 
 organs, and finally it may produce disease by checking the secretions 
 of the skin. 
 
 The most agreeable temperature for average healthy adults prop- 
 erly clothed and performing light work is between 65° and 70° F., 
 and every effort should be made to avoid extremes of heat and cold. 
 Much may be done to reduce the temperature of workshops by forced 
 ventilation and a supply of cool, fresh air. The windows should be 
 kept open during the summer nights, so that the rooms may be thor- 
 oughly flushed with fresh and cool air. 
 
 HUMIDITY OF THE AIR. 
 
 The atmosphere always contains a certain amount of water in the 
 state of vapor, which varies from 30 per cent to complete saturation, 
 or, according to temperature, from 1 to 12 grains in a cubic foot of 
 air. The degree of atmospheric humidity is of special hygienic 
 importance, as it influences to a great extent the cutaneous and pul- 
 monary exhalation of vapor and in consequence also affects the ani- 
 mal temperature. The average daily amount of water eliminated 
 by the skin is 2J pounds, and about 10 ounces by the lungs. It is 
 evident that when the air is damp it lessens evaporation, as it pos- 
 sesses little drying power, and the water from the skin and lungs 
 is with difficulty evaporated. The evaporation of perspiration, by 
 which much heat is rendered latent, is one of the chief sources of 
 cooling of the body. Consequently when the air is hot and moist 
 the humidity tends to increase the effects of the heat, the blood is 
 with difficulty kept at its proper temperature, and all the disagree- 
 able effects of a high temperature are intensified. This condition 
 may be so aggravated that the temperature of the body exceeds the 
 normal degree and causes our cases of so-called heat stroke or heat 
 exhaustion, which occurs especially on hot, sultry days. 
 
 A damp, cold, or chilly air also produces mischief, as it abstracts 
 an undue amount of animal heat, lowers the general vitality of the 
 system, and favors the development of diseases of the respiratory 
 passages, neuralgic and rheumatic affections, and aggravates the 
 severity of such attacks. We may conclude, therefore, that excessive 
 
88 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 humidity tends to intensify the effects of both heat and cold. On the 
 other hand, excessive dryness of the air is also harmful; it increases 
 evaporation, the skin becomes dry and chapped, and the mucous 
 membranes of the mouth, eyes, and respiratory passages are irritated, 
 causing so-called catarrhal conditions. For all these reasons an aver- 
 age relative humidity between 65 and 75 per cent has been found most 
 healthful, and efforts should be made to maintain such a standard 
 whenever practicable. Apart from methods calculated to accomplish 
 these results, reliable thermometers and hygrometers are required to 
 secure efficient control. State legislators would do well, instead of 
 making a general provision for sufficient heat, moisture, etc., to pre- 
 scribe a standard, at least in industries w^here such standards are 
 practicable and can be reasonably enforced. 
 
 LIGHTING. 
 
 The natural light in workshops should be sufficient so that the eyes 
 need not be strained even on cloudy days. When the light is defect- 
 ive the objects have to be brought too near. The eyes in consequence 
 converge, and the muscular strain thus induced causes a gradual 
 elongation of the anterior-posterior axis of the eyeball, and near- 
 sightedness results. In addition it is believed by specialists that 80 
 to 90 per cent of the headaches are caused by eye strain. It has been 
 found by Putzeys* that the natural lighting in temperate climates 
 will usually come up to hygienic requirements when the area of win- 
 dows, exclusive of sash frames, equals one-sixth of the floor space. 
 In order that the light may penetrate the deeper portions of the 
 room, the windows should reach almost to the ceiling and the glass 
 should be either pure white ribbed or prismatic and kept clean. Wis- 
 consin is apparently the only State which has undertaken to legislate 
 specifically upon this point, as section 3 of chapter 79, acts of 1899, 
 provides : 
 
 Every window shall have not less than 12 square feet in superficial area, and 
 the entire area of window surface shall not be less than 12 per cent of the floor 
 space of such room. 
 
 The difficulty of securing a sufficient amount of daylight in build- 
 ings located on narrow streets surrounded by tall buildings has been 
 partly overcome by glass building blocks 8 bjr 6 by 2^ inches, with 
 an air chamber in the center, used instead of brick or stone, in connec- 
 tion with steel-frame construction, but more particularly by the intro- 
 duction of prismatic glass, which refracts and diffuses the light. 
 
 ARTIFICIAL LIGHT. 
 
 No matter how obtained, artificial li^ht differs from daylight in 
 this, that it does not furnish a pure white light, the prevailing rays 
 being red, yellow, or violet. Whatever difference or opinion there 
 may be as to the color best suited to our eyes, we know that our 
 vision is most perfect under the influence of a white light, and this 
 ought to be a good criterion. One of the disadvantages of all low- 
 power illuminants is that the light is never as bright as daylight, in- 
 volving, therefore, closer application of the eyes and consequent strain 
 
 « Cited by Munson, Military Hygiene, 1901, p. 521. 
 
EEPORTS OP THE PKESIDENT S HOMES COMMISSION. 89 
 
 of the muscles of the eyeball. These remarks are hardly applicable 
 to the electric arc light and the Welsbach gas burner, the rays of 
 which, like the direct solar rays, may indeed be so glaring as to cause 
 undue irritation of the retina. 
 
 Another harmful effect of artificial illumination is the unsteady or 
 flickering character, especially seen in the electric arc light, and 
 which on account of the abrupt changes is likely to irritate the retina. 
 Another disadvantage is that the ordinary illuminants, except the 
 electric light, tend to vitiate the air by the products of combustion, 
 and also affect the temperature and humidity of the air by the heat 
 evolved. 
 
 The requirements of a hygienic light are that it should be as near 
 as possible the color of the sunlight, sufficiently ample but not too 
 glaring; it should be steady, and instead of deteriorating the air it 
 should as far as practicable be utilized to promote ventilation; nor 
 should the heat evolved be sufficiently intense to be a source of dis- 
 comfort to the inmates in warm weather. The most common methods 
 of lighting now employed are the electric incandescent lamps, arc 
 lights, mercury-vapor lights and electric bulbs, gaslight, and kero- 
 sene lamps. Of these, the electric lights, especially the mercury-vapor 
 lights, are superior to gas or other illuminants because there is little 
 or no danger from fire, there are no products of combustion, hence no 
 pollution of the air, nor are the temperature and humidity of the 
 room affected to any perceptible extent. These advantages over gas 
 or kerosene are of special importance to the inmates of the buildings 
 where the question of fresh air and temperature plays an important 
 role; hence many industrial plants find it profitable to install the 
 very best type of electric lighting, and thereby save time and money 
 by the prevention of sickness and accidents among their employees. 
 Next to the electric light, gas, especially in connection with a Wels- 
 bach or Siemen's burner, or the acetylene gas, offers the next best 
 choice. In the absence of either electric or gas light, kerosene with a 
 high flashing point should be preferred over other illuminants. In 
 all such instances suitable outlets for tlie products of combustion 
 should be provided. 
 
 White, clean ceilings and walls will be of great service not only in 
 solving the question of light, but also in general sanitation, and a 
 number of States, notably Indiana, Kentucky, Missouri, New Jersey, 
 and New York, require the walls to be limewashed or painted. 
 
 The sufficiency of artificial lighting may be approximately deter- 
 mined by observation, and quite accurately by the employment of 
 Bunsen's method and his photometer. In this country and England, 
 according to Munson, " the unit adopted for the measurement and 
 comparison of lights is a No. 6 sperm candle burning 8 grams per 
 hour and giving out a light known as ' 1 candlepower.' " Such a 
 candle contains on analysis carbon 80 per cent, hydrogen 13 per cent, 
 oxygen 6 per cent, and in combustion yields equal volumes of car- 
 bonic acid and watery vapor to the air, namely, 0.41 cubic foot. 
 
 PREVENTION OF ACCIDENTS. 
 
 About 22 States have taken steps to reduce accidents to a mini- 
 mum. For this purpose they have enacted laws concerning employers' 
 liability if they fail to provide safety devices for the movable and 
 
90 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 dangerous parts of machinery. Apart from proper screening, belting, 
 etc., the use of respirators, wire masks, and goggles are absolutely 
 essential for the prevention of accidents or injuries in many employ- 
 ments. At least 27 States require some form of protection in case of 
 fire, by means of fire escapes and doors swinging outwardly, while a 
 respectable number also insist upon inspection and registration of 
 steam boilers. 
 
 A careful inspection of steam boilers and examination of engineers 
 have materially lessened the dangers from boiler explosions, so that 
 in England there is only about 1 explosion in 6,200 registered boilers. 
 
 It has been suggested that employees who come in contact with 
 moving machinery should provide themselves with suitable clothing, 
 so fitted and arranged as to reduce the dangers to a minimum. There 
 is an endless variety of suitable patterns in the market, of which the 
 snug-fitting duck union suits properly buttoned and adjusted are the 
 best. Asbestos clothing has been recommended for firemen and fur- 
 nace operators; but as it is rather heavy, light leather suits or aprons 
 are preferable, while even ordinary clothing may be rendered practi- 
 cally noninflammable by chemical treatment. 
 
 The following views of Mr. Frederick Hoffman <» in his excellent 
 article on industrial accidents are reproduced : 
 
 The present state of American industrial accident statistics does not warrant 
 final conclusions regarding the true rate of the risk in different employments 
 nor of the approximate determination of the occupation hazard, by degree of 
 injury, for the more important industrial employments. Most of the present 
 information is limited to the facts of accidental death or injuries generally, 
 and while such data have their value they require to be made more specific 
 to throw light upon the larger problem of accident prevention and working- 
 men's compensation for industrial casualties. The importance of such infor- 
 mation has been clearly brought out in an address on " Valuation, in Actions 
 for Damages for Negligence, of Human Life, Destroyed or Impaired," by 
 Miles M. Dawson, before the International Actuarial Congress in 1903.* For 
 insurance and other purposes, however, the data presented in this article will 
 prove useful and emphasize the more dangerous trades and the present ten- 
 dency toward an increase or decrease in the risk of accidental injury in the 
 more important dangerous occupations.'' To the workingman himself there 
 is no more important problem than the most effective protection of his life and 
 health against the accident risk inherent in, or incidental to, the occupation in 
 which he is employed. Much that could be done for his protection is still 
 neglected, though many important and far-reaching improvements have been 
 introduced in factory practice during the last decade. Accurate statistics alone 
 can furnish a reasonable basis for reform. The possibilities for successful 
 accident prevention have been clearly demonstrated in the experience of foreign 
 countries and the exhibition of safety devices of the American Institute for 
 Social Service. 
 
 SOCIAL ASPECTS OF THE ACCmENT PROBLEM. 
 
 " The facts presented in this article warrant the conclusion that the 
 casualty risk in American industries is a most serious one, toward 
 the reduction of which every effort should be made. At least a more 
 
 « Bulletin of the Bureau of Labor No. 78. Washington, D. C, September, 1908. 
 
 * Proceedings Fourth International Congress of Actuaries, 1904, Vol. I, p. 929. 
 
 "A useful and suggestive work on the prevention of accidents in industry 
 has been published by the German Association of Trade Unions entitled : Un- 
 fallverhiitungsvorschriften, herausgegeben vom Verbande Deutscher Berufs- 
 genossenschaften, Berlin, 1900. Mention may also be made of a valuable 
 treatise on definition of invalidity under the title : Der Begrifif der Erwerbsun- 
 fahigkeit auf dem Gebiete des Versicherungswesens, by H. Siefart, Berlin. 1906. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 91 
 
 earnest effort should be made to profit by the industrial methods of 
 European countries. Granting that the underlying conditions are 
 often quite different, and that many of our industrial accidents are 
 the result of ignorance, reckless indifference, or carelessness, the fact 
 remains that an immense amount of human life is wasted and a vast 
 amount of injury is done to health and strength, with resulting phys- 
 ical impairment, which has a very considerable economic value to the 
 nation as a whole. If, for illustration, the accident liability of em- 
 ployees in coal mines in the United States were reduced from 3.10 per 
 1,000, which was the average annual rate for the period 1897-1906,* 
 to 1.29 per 1,000, the average rate in the United Kingdom for the 
 same period,^ the annual saving in human life would be 915. If 
 the rate of casualties of railway employees in this country were re- 
 duced from 2.50 per 1,000, which was the average annual rate for 
 1897-1906," to 0.98 per 1,000, the average for the German Empire 
 for the same period,^ the annual saving would be 1,735 valuable 
 human lives. As stated at the outset, upon a conservative estimate, 
 the total mortality from accidents in the United States among adult 
 male wage-earners is between 30,000 and 35,000, of which it should 
 not be impossible to save at least one-third and perhaps one-half by 
 intelligent and rational methods of factory inspection, legislation, 
 and control. In addition there were approximately not much less 
 than two million nonfatal accidents, that not only involve a vast 
 amount of human suffering and sorrow, but materially curtail the 
 normal longevity among those exposed to the often needless risk of 
 industrial casualties." (Hoffman.) 
 
 MISCELLANEOUS SANITARY PROVISIONS. 
 
 A number of States have enacted laws concerning general cleanli- 
 ness of factories and workshops. Most of the factory laws make pro- 
 visions for the necessary sanitary conveniences, such as privies, water- 
 closets, and urinals, and where men and women are employed separate 
 dressing rooms and water-closets are called for. Some of the States, 
 like Wisconsin, for example, specify " that when the number employed 
 is more than 25 of either sex there shall be provided an additional 
 water-closet for such sex up to the number of 50 persons, and above 
 that number in the same ratio." The author believes that there should 
 be at least one water-closet or privy for every 20 employees. 
 
 A large number of States make seats for female employees, wash 
 rooins, and dressing rooms obligator}'-, and not a few insist upon sepa- 
 rate provisions for the sexes. The importance of personal cleanliness 
 has been pointed out. In certain occupations the washing of the hands 
 before eating is important, and in occupations involving exposure to 
 poisonous dust or agents the employment of a general bath should be 
 encouraged by insisting upon the introduction of suitable shower 
 baths. 
 
 * Computed from the mine inspectors' reports of the various States. 
 
 ^ Computed from statistics included in the annual reports of the Home Office 
 entitled "Mines and Quarries: General Reports and Statistics, London." 
 
 ^ Computed from statistics shown in the Report of the Interstate Commerce 
 Commission, Statistics of Railways, 1906, pp. 42, 109. 
 
 '^Computed from Statistisches Jahrbuch fiir das Deutsche Reich, 1908, pp. 
 85-88. 
 
92 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 A few States, notably Massachusetts and Rhode Island, make pro- 
 visions for " fresh drinking water of good quality." The former also 
 regulates the spitting habit by insisting upon suitable spittoons. 
 These and other questions, like clothes lockers and lunch rooms, and 
 the time allowed for the noonday meals, which is already regulated 
 in a number of States, should receive universal attention. Much 
 industrial legislation has been enacted by state legislatures during 
 the past ten years. Commendable progress has been made in the pro- 
 vision of ventilation, heating, lighting, removal of dust, and general 
 sanitation of workshops. The need for additional improvement is 
 shown by the Massachusetts board of health's survey of the work in 
 that State, which has generally been in the lead in factory laws. 
 
 The report of the state board of health, on page 4, reads : 
 
 In many [industries] the conditions were found to be satisfactory. In the 
 emery and corundum, sandpaper, and certain other industries more attention 
 should be given to keeping the dust away from the mouth and nostrils of the 
 workmen. In the rag dusting, sorting, and cutting rooms of some paper mills 
 very objectionable amounts of dust were found, with some pale and sickly ap- 
 pearing operatives ; but there are mills using the same kind of stock where the 
 dust is kept away from the employees in a satisfactory manner, and much im- 
 provement is practicable in the former class. 
 
 The same remarks are applicable to the textile industries, and the 
 hope is expressed that the unsatisfactory conditions found in the 
 minority of establishments will be raised to" those which are now found 
 to be good. 
 
 Reference Kas already been made in these pages to the conditions 
 found in machine shops, the cutlery and tool industry, cigar, rubber, 
 boot and shoe, and other industries examined. In the boot and shoe 
 industry comment is made upon " four conditions which can be and 
 ought to be remedied." These are poor ventilation, inadequate re- 
 moval of dust from machines, the conditions of water-closets, and spit 
 upon the floors. In the majority of factories visited the ventilation 
 was found to be poor, and in many of them distinctly bad. Of the 
 rooms not especially dusty, 102 were badly ventilated and 26 were 
 overcrowded. * * * Of 84 of the many dusty rooms reported, 40 were 
 also overcrowded, 35 were dark, 21 were overheated, and 18 were over- 
 crowded, dark, and overheated. 
 
 " In more than one-third of the factories visited the conditions of 
 water-closets were not commendable; most of them were dark and 
 dirty to very dirty. In 50 establishments no spitting was noticed, in 
 173 there was some, in 115 considerable, and in 35 much." 
 
 " In some establishments lunch rooms are provided, where employ- 
 ees may eat the luncheon they have brought or may buy one ; in much 
 the larger number the employees eat in the workrooms. * * * In 85 
 factories, or 23 per cent of those visited, a considerable proportion of 
 the employees are noticeably pale and unhealthy." 
 
 In discussing the following provision in the Massachusetts laws, 
 "All factories shall be kept clean," the state board of health very 
 properly points out that " what is clean in an ax-grinding factory 
 would not be clean in a silk mill ; but the law makes no distinction, 
 and the judgment of the officer can not be received as law." The 
 board considers it impossible to specify in any law a standard of 
 cleanliness applicable to all industries, and advises " that the officer 
 should be authorized to hold all factories in any industry up to the 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 93 
 
 standard of cleanliness which he finds maintained in the factories in 
 the same industry and using the same grade of stock which are the 
 cleanest." The same method is recommended for the enforcement of 
 standards in other directions, subject to an appeal to the state board 
 of health. 
 
 LODGING HOUSES AND SLEEPING QUARTERS. 
 
 It not infrequently happens that large industrial plants and con- 
 tractors provide board and lodging for their unmarried employees. 
 Again, in a number of the smaller industries the employees not infre- 
 quently board with the family and are obliged to sleep in objection- 
 able rooms. All such provisions should come up to a reasonable 
 standard as regards salubrity, air space, light, heat, and ventilation, 
 and separate provisions should be required for males and females and 
 youthful employees. Lodging houses should come up to a certain 
 standard, and wash and bath rooms and suitable tiolet facilities 
 should be provided. Special attention should be paid to general 
 cleanliness within and without quarters for working parties, and to 
 the character and preparation of food. 
 
 PERMANENT EXPOSITIONS DEVOTED TO INDUSTRIAL AND SOCIAL BETTER- 
 MENT or WAGE-EARNERS. 
 
 It will require time and patience to bring employers and workers 
 to a full realization of the dangers incident to the various occupations 
 and to a thorough appreciation of the methods which have been pro- 
 posed in the way of factory sanitation, safety devices, ete. Good re- 
 sults abroad have been accomplished by a permanent exposition de- 
 voted to social and industrial betterm'ent for wage-earners. Such an 
 exposition was provided for by the German Parliament a few years 
 ago, and a similar effort is now being made in the city of New York. 
 The German exposition occupies a building specially erected for the 
 purpose at Charlottenburg, a suburb of Berlin, and here every safety 
 appliance which inventive genius has devised can be seen in practical 
 operation. The different labor unions appear to profit immensely by 
 the special lectures and demonstrations which are given on Sundays, 
 or, upon request, at any convenient time, by men formerly employed 
 in " dangerous occupations." Apart from safety devices for ma- 
 chinery and appliances for removal of dust and injurious gases, all 
 improved methods calculated to diminish danger, as, for example, in 
 the manufacture of white lead, etc., are illustrated by models and de- 
 scriptive text, printed leaflets being distributed free of charge. 
 Here, too, may be seen the best and most recent types of respirators, 
 wire masks, goggles, illuminating appliances, and safety working suits. 
 Inventors and designers esteem it a great honor to have their prod- 
 ucts admitted for exposition. Only meritorious objects are displayed, 
 and they are replaced by the newer and more satisfactory types. 
 One of the most interesting collections consists of a series of bottles 
 containing different varieties of dust, a series of photographs show- 
 ing the microscopical character of this dust, and, last but not least, 
 anatomical specimens and microscopical slides showing the effects of 
 dust upon the air-passages and lungs of the human subject. Models, 
 plans, and photographs of tenements and model homes for wage- 
 
94 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 earners, exterior and interior decorations, literature, and charts con- 
 cerning industrial betterment, all find a prominent place in the ex- 
 hibit. The display of foodstuffs, their nutritive and economic value, 
 together with instructive leaflets, form part of this interesting expo- 
 sition. A popular pamphlet seen at the exposition in September, 
 1907 was compiled by Professor Kalle and Doctor Schellenberg, 
 entitled " How to keep well and capacitated for work," which is sold 
 by the Society for Popular Education at 2^ cents a copy, over 470,000 
 so far having been sold. 
 
 Chapter XIV. 
 
 WHAT THE FEDERAL GOVERNMENT MAY DO FOR THE PROMOTION 
 OF THE WELFARE OF ITS EMPLOYEES, ETC. 
 
 Much excellent work has been and is being done by the United 
 States Bureau of Labor in the collection and publication of facts con- 
 cerning every phase of industrial and social betterment. These bul- 
 letins are issued bimonthly, and if carefully read can not fail to exert 
 a tremendous educational influence upon those for whom they are pri- 
 marily intended, viz, the wage-earners and employers. But while 
 much has been achieved more remains to be accomplished. It seems 
 to the writer that apart from establishing, in connection with the Na- 
 tional Museum, a permanent exposition relating to industrial and 
 social betterment of wage-earners, it is clearly the duty of the Fed- 
 eral Government to establish and adopt a standard of industrial 
 hygiene for all the government workshops. 
 
 President Roosevelt, in a message to Congress December, 1907, has 
 said : 
 
 The National Government should be a model employer. It should demand the 
 highest quality of service from each of its employees and it should care for 
 all of them properly in return. Congress should adopt legislation providing for 
 limited but definite compensation for accidents to all vi'orkmen within the scope 
 of the federal power, including employees of navy-yards and arsenals. 
 
 We regret to say that with the possible exception of the extraor- 
 dinary efforts and special precautions exercised to protect the health 
 and general welfare of the employees in the operations connected with 
 the construction of the canal on the Isthmus of Panama, the sanita- 
 tion of offices and workshops in this country proper, for government 
 employees, is not even on a par with some of the best private indus- 
 trial concerns. There can be no question that model government 
 workshops and efforts for the promotion of the general welfare of 
 the employees would prove a salutary precept and example. The 
 General Government is not in a position to legislate for the States, 
 but it can at least enact a model labor and factory law for the Dis- 
 trict of Columbia, and all of the workshops connected witli the army 
 and navy arsenals, gun factories, powder depots, clothing depots, and 
 the immense army of labor employed on the Isthmus of Panama. 
 
 Apart from strictly sanitary measures for the promotion and pres- 
 ervation of health, the Government, as a model employer, should 
 provide some adequate relief in case of sickness, accidents, or disa- 
 bility from disease or injuries contracted in the line of duty. As it 
 is now, the Government merely grants one month's sick leave to oflfi- 
 
KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 95 
 
 cials and office employees, none to workmen employed in government 
 shops, and in case of accidents the employee or his dependents have 
 no remedy except recourse to the courts of law. 
 
 While it is true that government employees in many instances have 
 banded together for the purpose of establishing sick benefit and relief 
 associations, such organizations lack official control and do not always 
 embody the most advanced principles of social and political economy. 
 
 INDUSTRIAL INSURANCE. 
 
 For reasons briefly stated, the Federal Government would do a wise 
 act, by creating the so-called industrial insurance system, for the sick, 
 for accidents, disability and old age, for its own employees and others 
 in the District of Columbia, and thus initiating a system which has 
 proved to be a veritable blessing in many of the European countries. 
 Any one who desires to become familiar with the " German working- 
 men's insurance " should not fail to read a digest in the Bulletin of 
 the Bureau of Labor No. 53, July, 1904, page 941, and Professor 
 Henderson's " Summary of European Laws on Industrial Insurance." 
 (Charities, December 7, 1907, p. 1191.) « 
 
 Under the operation of the German law, enacted in 1883, all work- 
 men employed in commerce, industry and the handicraft trades, and 
 whose wage is less than 2,000 marks (about $480) must be insured. 
 By special regulations this requirement may be extended to agricul- 
 tural and household employees. To secure the enrollment of indi- 
 viduals " for sick benefits," the employers in the industries subject 
 to the law are required to send to the proper insurance fund the 
 names of each person who enters or leaves their service. 
 
 The income of the sick funds is derived from the dues of members — 
 the amount is fixed by each local association, but can not exceed 6 
 per cent of the members' wages. The employee, pays two-thirds of 
 the dues and the employer one-third. The employee's share is de- 
 ducted from his wages and paid direct to the insurance fund by the 
 employei;, when he remits his own share. 
 
 The benefits offered by the sick funds vary in amount, but all of 
 them are required to provide the following as a minimum: (1) Free 
 medicine, attendance, and treatment. (2) In case the sickness causes 
 inability to work, the fund pays a sick benefit equal to one-half the 
 wage rate which was used in calculating the member's dues. This 
 benefit begins the third day after the disability sets in, and continues 
 for 26 weeks. Instead of receiving medical treatment at home a 
 member is entitled to treatment at a hospital, in which case an amount 
 not exceeding one-half of his daily wage is paid to his dependents. 
 Female members receive similar benefits for a period of six weeks fol- 
 lowing confinement. (3) In case of death, a funeral benefit equal to 
 twenty times the amount of his daily wage is paid to the heirs of a 
 member. 
 
 In 1904 there were 22,912 local sick and miners' provident associa- 
 tions in the German Empire with 11,400,000 members, practically 
 
 « The writer is indebted to these sources for much of the informatioa on this 
 subject and gratefully acknowledges this indebtedness. 
 
96 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 one-fifth of the population. The disbursements amounted to 237,- 
 107,000 marks (about $56,470,000). Of this amount 106,000,000 
 marks (about $25,238,000) was paid for sick benefits, and the remain- 
 der for medical and hospital treatment, convalescence and funeral 
 benefits. 
 
 ACCIDENT INSUBANCE. 
 
 Under the provisions of the laws of 1884, 1887, and 1900, all work- 
 ingmen and technical experts engaged in industry, agriculture, for- 
 estry, transportation, and coast fisheries earning less than 3,000 marks 
 (or about $715) per annum, are required to be insured against acci- 
 dent. By special enactment it may be extended to foremen and petty 
 emplo3'ers with more than 3,000 marks income. This form of insur- 
 ance is administered by associations of employers known as " mutual 
 trades associations," subject to federal supervision. In 1904 there 
 were 114 associations, including 5,300,000 establishments and 17,- 
 500,000 workmen. The workingman's share of the expense of the 
 accident insurance consists of the benefits paid out of the sick insur- 
 ance fund to the injured person during the first thirteen weeks of dis- 
 ability. The share of the employer is determined from the amount 
 of his pay roll and the danger rate of occupation. Beginning with 
 the fourteenth week the trades association provides (1) free medical 
 treatment; (2) a pension during the continuation of the disability, 
 whether the disability is partial or complete. In case of complete 
 disability the pension is equal to two-thirds of the earnings of the in- 
 jured person; in case of partial disability the insured receives a frac- 
 tion of the above pension, proportioned to the degree of disability. 
 
 In case of a fatal accident, the law provides for (1) a funeral 
 benefit of not less than $12; (2) a pension to the dependents of the 
 deceased, including parents, beginning with the day of death. The 
 widow and each child up to the age of 15 receives 20 per cent of the 
 earnings of the deceased, though the sum of these pensions may not 
 exceed 60 per cent of such earnings. 
 
 Premiums paid in 1904 were $35,592,000; disbursements, $30,- 
 552,000, viz, to 758,392 injured members, to 65,503 widows, 97,246 
 children, and to 3,647 parents of those killed. 
 
 INVALID AND OLD-AGE PENSIONS. 
 
 Invalid and old-age pensions were made compulsory under the 
 German law of 1889 (revised in 1899) for all wage-earners with an 
 income of less than $480 per annum ; the provisions may also be ex- 
 tended to include petty employers and persons in household industry. 
 The invalid pension is paid without regard to age to those persons 
 whose earning capacity has been permanently reduced to less than 
 one-third. The pension is also paid to those who have been in a state 
 of disability for twenty-six weeks and continues as long as the disability 
 lasts. To be eligible for this pension, the insured person must have 
 been a member of the " insurance institute " for two hundred weeks, 
 during which time not less than 100 payments of weekly dues must 
 have been made. If the disability has been incurred purposely 
 the right to a pension ceases and the offender is liable to criminal 
 prosecution. 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 97 
 
 In addition to the pension from the " insurance institutes " the 
 Empire grants a stipend of 50 marks (about $12) per annum to 
 invalids, as well as persons over 70 years of age. 
 
 Members are divided into five classes on the basis of wages received. 
 Each class pays a different rate of dues and receives benefits in pro- 
 portion. The lowest invalidity pension granted is $27.70, the highest 
 IS $107.10 per annum. The dues range from 3J cents per week, 
 according to the wage class in which the member is enrolled. One- 
 half of the amount is paid by the employer and one-half by the 
 employee. 
 
 The old-age pension is paid without regard to earning capacity 
 when the seventieth year of age is completed. Members must have 
 paid dues for one thousand two hundred weeks before they become 
 eligible for such a pension. In 1904 there were 40 inavlid pension 
 organizations, with 13,800,000 insured members. Premiums paid in, 
 $36,960,000 ; disbursements, $35,520,000. The average invalid pension 
 is $37.20, and the old-age pension $37.68, varying in amount with the 
 wage class. 
 
 The financial soundness of the system is secured by making the 
 employers, the guilds, and parishes eventually responsible for any 
 deficit in the various sick insurance organizations. The national, 
 state, and local governments guarantee the payment of claims against 
 the accident and invalidity insurance organizations. 
 
 SYNOPSIS OF PRACTICAL RESULTS. 
 
 The financial status of the workingmen has been improved at least 
 to the extent of the benefits received from the amounts contributed by 
 the employers and the Government. Experience has shown that 
 employers have not deducted their share of the dues from wages. 
 
 The hygienic conditions of the workingmen have been improved, 
 both on account of the safeguards which the accident insurance organ- 
 izations require employers to use and because of the special efforts 
 made by the " sick funds " to reduce the sick rate among the members 
 to a minimum. The general knowledge in regard to the preservation 
 and promotion of health, which the " sick fund organizations " have 
 disseminated by means of circulars, monographs, popular lectures, 
 etc., have exerted a tremendous educational influence in the promotion 
 of health and morals. One of the most beneficent features of the 
 entire system has been that parts of the funds of these organizations 
 are invested in model houses, hospitals, and sanitoria for the use of 
 members. The writer, during his visit to Berlin in the autumn of 
 1907, had occasion to inspect some of these workingmen's houses, as 
 well as the most complete and elaborate sanatorium in the world, at 
 Beelitz,near Berlin. The object of this is to provide the very best facili- 
 ties for the speedy recovery and the restoration of earning power of 
 the industrial wage-earner. Doctor Bielefeldt (Med. Keform, 15th 
 Jahrg, 1907, p. 238) calculates that in the treatment of 159,802 tuber- 
 culous patients between 1897 and 1906 the net gain, in spite of an 
 expenditure of 56,000,000 marks, amounted to more than 4,500,000. 
 It is interesting to note that the Prussian " insurance institutes and 
 sick funds " in 1907 alone maintained 28 hospitals and sanatoria, the 
 latter chiefly for consumptives and convalescents. One of the latest 
 features was the establishment in 1902 of a special hospital for sexual 
 diseases in the male, at Lichtenberg, near Berlin, and a sanitorium 
 S. Doc. 644. 60-2 8 
 
98 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 for nervous and anaemic female wage-earners in Pyrmont (Hann- 
 over) ; all upon the principle that it is in the highest degree good 
 economy to restore as speedily as possible the unproductive to the 
 ranks of the producers. Some conception of the good work may be 
 found by a brief description of the sanatorium at Beelitz, which was 
 erected in 1902 by the " insurance institute " of Berlin at a cost, 
 according to report of directors, June, 1907, of 15,287,994 marks. 
 Average number of patients, 413 males and 203 females; number of 
 cases treated in 1906, 4,192 ; number of hospital days, 212,457 ; expense 
 for 1906, 1,470,062.25 marks, or at the rate per capita per day of 6.92 
 marks. One portion of the institution is devoted to the treatment of 
 incipient cases of tuberculosis ; another, and entirely detached depart- 
 ment, to cases of every description requiring high-grade sanatorium 
 treatment in order to prevent premature invalidity. Each of the 
 handsome and spacious pavilions accommodates 200 males or 100 
 females ; apart from these are 4 porters' lodges for the 4 departments 
 under separate inclosures, 1 general administration building, 1 central 
 power and heating plant, 1 central bathing establishment, 1 disinfect- 
 ing plant, 3 pumping stations, kitchen, laundry, workshops, quarters 
 for medical officers, employees, bowling alleys, hothouses, stables, etc. 
 The hospital staff consists of 10 physicians and 128 employees. * 
 
 The writer was informed in September, 1907, that since the estab- 
 lishment of the " sick funds " and " insurance institutes " in Germany, 
 poverty has decreased and the number of patients treated wholly at 
 public expense has markedly diminished, as workingmen, even of the 
 humbler classes, prefer to devote their sick benefits to hospital care, 
 rather than be a charge upon the parish or country. 
 
 Income, expenditures, and invested funds of the insurance system. 
 
 Item. 
 
 Sick insur- 
 ance, 1901, 
 
 Accident 
 
 insurance, 
 
 1902. 
 
 Old-age and 
 
 invalidity 
 
 insurance, 
 
 1902. 
 
 Total of all 
 insurance, 
 1835 to 1901. 
 
 Dues of employers 
 
 Dues of employees 
 
 Subsidy of Imperial Government. 
 Interest and other income 
 
 .' $13,952,723 
 .1 31,126,584 
 
 $29,907,868 
 
 Totalincome. 
 
 2,604,130 
 
 3,743,936 
 
 $16,539,308 
 16,539,308 
 9, 008, 227 
 8,054,310 
 
 $508, 445, 565 
 
 487,147,059 
 
 51,049,907 
 
 93,588,044 
 
 47, 683, 437 
 
 33,651,804 60,141,153 
 
 1,140,230,575 
 
 Expenses for relief — 
 Cost of administration 
 
 Total expenditures 
 Inrested funds 
 
 43, 595, 450 
 .| 2,590,837 
 
 46, 186, 287 
 
 44,421,557 
 
 25, 735, 679 
 
 29,701.662 
 "4^^0^,235 
 
 28, 658, 559 
 2,843,541 
 
 31,502,100 835,009,441 
 
 239,779,652 309,020,248 
 
 EFFECTS OF THE INSURANCE SYSTEM ON THE EMPLOYER AND CONSUMEB. 
 
 The foregoing table shows that the system has materially added to 
 the financial burdens of the employer, but it is believed that they have 
 not been too heavy; at least they have not injured Germany's ability 
 to compete in forei^ markets. 
 
 One authority estimates that the amount paid by the employer for 
 accident insurance is 3 per cent of the wages, for sick insurance IJ 
 per cent of the wages, and for old-age and invalidity insurance, 1 per 
 cent, or a total of 5^ per cent of the wages added to the cost of pro- 
 duction. Doctor Lass, of the imperial insurance office, concludes. 
 
REPORTS OP THE PRESIDENT S HOMES COMMISSION. 
 
 99 
 
 however, that this burden has not been shifted to wages, nor has it 
 resulted in higher prices to the consumer, but has been made up by 
 improved methods of production. 
 
 The writer has purposely devoted much space to the German in- 
 dustrial insurance system, because he realizes that sickness and 
 funerals are the most potent causes of poverty and distress ; he knows 
 from personal knowledge that prior to 1883 Germany depended upon 
 employers' liability laws, charitable organizations, and private com- 
 panies for the protection of her wage-earners, with very questionable 
 results. While much has been achieved in other directions for the 
 prevention of disease, the most distinct gain in social-political en- 
 deavors was made by the enactment of these laws, and especially the 
 law of June, 1889, authorizing " insurance institutes " to invest part 
 of their funds in hospitals and sanatoria, thus affording the best pos- 
 sible facilities for the speedy recovery and the prevention as far as 
 practicable of permanent disabilities. 
 
 According to Zacher (Leitfaden zur Arbeiterversicherung des 
 Deutschen Reiches, 1906) , quoted by Professor Henderson, " at the 
 end of 1905 in all 70,000,000 pensioners (sick, injured, invalids, and 
 their dependents) had received $1,200,000,000 in benefits. The work- 
 men have contributed less than one-half of the premiums, and have 
 received $480,000,000 more than they have paid out. Property is 
 owned to the amount of $408,000,000, of which $120,000,000 have been 
 invested in w^orkmen's dwellings, hospitals, and convalescent homes, 
 sanatoria, baths, and similar institutions of welfare." 
 
 There is no pauperization in a method where the beneficiary con- 
 tributes such a large share to the undertaking. As a matter of fact, 
 methods in vogue in our own country are calculated to shift all of the 
 burden upon the taxpayer. 
 
 For a more complete exhibit, the following tables are reproduced 
 from Professor Henderson's article in Charities, December 7, 1907 : 
 
 SICKNESS INSURANCE (SINCE 1885). 
 
 Marks. 
 
 United States 
 equivalent. 
 
 Sickness payments. 
 
 Physicians 
 
 Medicines, etc 
 
 .Hospitals 
 
 Death benefits 
 
 Lying-in women . . . 
 Various benefits — 
 
 1888-1904 
 1905 
 
 In round numbers 
 
 ,114,629,489 
 514,803,920 
 402,757,651 
 303,061,148 
 83, 763, 839 
 36, 513, 672 
 38,414,074 
 
 2, 493, 973, 763 
 250, 000, COO 
 
 2,744,000,000 
 
 5267, 500, 077. 36 
 123, 552, 940. 80 
 96,661,836.24 
 72, 734, 675. 52 
 20,103,321.36 
 8, 770, 481. 28 
 9,219,377.76 
 
 598, 553, 710. 32 
 60,000,000.00 
 
 658, 560, 000. 00 
 
 ACCIDENT INSURANCE 
 
 (SINCE ] 
 
 18S5). 
 
 
 
 759,172,928 
 191,777,559 
 34,275.716 
 55,010.333 
 6,927.990 
 7, 747, 570 
 2,846,489 
 
 $182,201,502.72 
 
 46,026,614.16 
 
 8, 226. 171. 84 
 
 13,202,479.92 
 
 1,662,717.60 
 
 1,859,416.80 
 
 683,157.36 
 
 Payments to dependents of deceased 
 
 Medical care 
 
 
 Death benefits 
 
 Widows 
 
 
 
 
 1885-1904 
 
 1,057,758,586 
 136, 000, 000 
 
 253,862,060.40 
 32,640,000.00 
 
 1905 
 
 
 
 In round numbers 
 
 1,194, 000, OCO 
 
 286,560,000.00 
 
 
100 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 INVALID AND OLD-AGE PENSIONS (SINCE 1891). 
 
 Marks. 
 
 United States 
 equiyaleut. 
 
 Invalid pensions 
 
 Old-nge pensions 
 
 Medical care 
 
 Return of premiums 
 
 At marriage 
 
 At death 
 
 At accident 
 
 1891-1904 
 
 1905 
 
 In round numbers . . 
 
 560, 486, 961 
 
 836,472,378 
 
 55,371,747 
 
 38,025,117 
 
 13,422,508 
 
 171,201 
 
 $134,516,870.64 
 80,753,370.72 
 13,389,219.28 
 
 9,126,028.08 
 
 3,221,401.92 
 
 41,088.24 
 
 1, 003, 949. 912 
 162, 000, 000 
 
 240, 947, 878. 88 
 38,880,000.00 
 
 1,166,000,000 
 
 279.840.000.00 
 
 It is sincerely hoped that the wage-earners of this country may 
 profit by the experience elsewhere by the adoption of a similar system, 
 and thus avoid the dangers and losses to which they are now so fre- 
 quently subjected by unscrupulously managed insurance concerns. 
 
 There appears to be no good reason why the National Government 
 should not inaugurate such a system for its own employees. In this 
 connection it may be well to refer to a most successful precedent in 
 the establishment of the United States Soldiers' Home in Washington. 
 This institution was founded in 1851 with $100,000 paid as indemnity 
 by the City of Mexico. Every soldier is taxed at the rate of 12J cents 
 per month, which is deducted from his pay. This together with the 
 fines from courts-martial and forfeited pay from deserters is turned 
 into the treasury of the home. The home now owns property costing 
 over $2,500,000, accommodates 950 inmates, pays a commutation at 
 the rate of $8 per month to soldiers having dependents and unable to 
 avail themselves of the privileges of the home, amounting to about 
 $20,000 a year, and still has a reserve fund of about $4,000,000. 
 
 Chapter XV. 
 
 WHAT THE EMPLOYER MAY DO FOR THE WELFARE OF EMPLOYEES. 
 
 It has been stated at the outset that social betterment can not be 
 disassociated from industrial betterment, and it is here that the em- 
 ployer can do much for the welfare of his employees. Apart from a" 
 cheerful compliance with the laws and ordinances which may, from 
 time to time, be enacted for the protection of the working classes, it 
 is clearly the duty of the employer to promote in every way the effi- 
 ciency and earning power of the wage-earner and to pay such wages 
 as are necessary to improve the standard of living among poorly 
 paid employees. 
 
 There is no dojbt that thoughtful employers generally realize that 
 they are not only responsible for the proper technical training of ap- 
 prentices, but also for their habits, and a gratifying number of estab- 
 lishments have made every effort to surround them with all possible 
 chances for improvement, mentally and morally. There is a class of 
 youthful employees, both males and females, for whom the writer 
 begs to enter a special plea ; they are entitled to every consideration, 
 because, either as a result of inheritance or faulty environments, they 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 101 
 
 have acquired a general inaptitude; they are perfectly willing to 
 work, but awkward in all their movements — simply do not know how 
 to work — and soon exhaust the patience of their instructors. 
 
 Such persons are found seeking to make an honest living in nearly 
 all occupations, and while they may be better adapted to some employ- 
 ments than others, to discharge them without a fair trial means their 
 utter ruin. Here appears to be a field for human sympathy, and 
 special pains should be taken to teach them, by patient fellow-work- 
 men, how to handle tools and work to better advantage, whether it is 
 with the pick or shovel, at the ploughshare, the street or house broom, 
 or in the diversified employments of artisans' workshops. 
 
 INDUSTRIAL BETTERMENT. 
 
 Space will not permit to enter into details concerning efforts which 
 have been made at home and abroad in the promotion of the general 
 welfare of the working classes. At a meeting of the American Social 
 Science Association, held in Washington, April 18, 1901, Mr. J. H. 
 Patterson, Dayton, Ohio, read a paper on factory sanitation and 
 described a large manufacturing plant of which he is the head, and 
 their close adherence to the principles of hygiene and the uplifting of 
 mankind. The interior of the factory is painted in cheerful colors, 
 extra windows were made to give light, forced ventilation to afford 
 plenty of fresh air, and all dust and acid fumes are carried away by 
 exhaust fans. Bathrooms and well-furnished toilet rooms are on all 
 the floors. All seats have backs. Clean aprons are furnished by the 
 company, and a dining room where hot meals are served and a course 
 in domestic economy is conducted. The grounds around the factory 
 and the houses of the employees are healthful and attractive. " We 
 have demonstrated," said Mr. Patterson, " that this system pays the 
 employee, the manufacturer, and the buyer, in the health of one, 
 profit of the second, and the improved quality of the product pur- 
 chased by the third." Bulletin No. 31, Department of Labor, Novem- 
 ber, 1900, contains an article on betterment of industrial conditions, 
 showing what has elsewhere been accomplished, every effort being in 
 the right direction. Among the most important may be mentioned 
 (1) the increasing of industrial efficiency through industrial schools 
 and manual training classes; (2) the care for employees' health and 
 comfort by means of bathing facilities, gymnasiums, calisthenics, 
 baseball, bicycle clubs, dining and lunch rooms, the furnishing of hot 
 lunches free, or at cost, improved sanitary conditions and appliances ; 
 (3) the improvement of domestic conditions by means of improved 
 dwellings, instruction in sewing, cooking and housekeeping, in land- 
 scape and kitchen gardening, and the exterior and interior decora- 
 tions of homes; (4) the care of sick and disabled employees and their 
 families by means of free insurance, medical attendance and hospital 
 facilities, and by the encouragement of beneficial organizations; 
 (5) club organizations for social, recreative, and intellectual purposes 
 by means of free lectures, libraries, kindergartens and educational 
 classes, social gatherings, summer outings, meeting places, game 
 rooms, banquets, dances, etc.; (6) the encouragement of musical and 
 dramatic clubs and the promotion of spiritual life by means of Sun- 
 day schools and general religious work; (7) the cultivation of thrift 
 
102 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 through savings-bank facilities, building associations, or provident 
 organizations, rewards for valuable suggestions of employees, for 
 faithful service or the manifestation of zeal and interest in their 
 employment; (8) the promotion of employees' personal interest in the 
 successful co^iduct of the business by encouraging and assisting them 
 to purchase shares, financial aid to employees in case of unusual hard- 
 ships and distress, and the cultivation of cordial and even confidential 
 relations between employer and employees. (For details consult Bul- 
 letin of the Department^of Labor No. 31, pp. 1117-1156.) 
 
 It is gratifying to note that, although Washington is not an indus- 
 trial center, a large number of firms have taken steps for the promo- 
 tion of the general welfare of employees. 
 
 Chapter XVI. 
 
 WHAT THE GENERAL PUBLIC MAY DO. 
 
 There is a tendency at present among young men, the sons of par- 
 ents who have accumulated some means, to expect to live and grow 
 rich w^ithout manual labor. It is becoming fashionable to look upon 
 the mechanic with disdain, to consider manual labor degrading, an 
 evidence of low breeding, and all such nonsense. The young men 
 want to be bookkeepers, bankers, lawyers, doctors, or office holders, 
 anything which does not involve manual labor, and expect their 
 fathers to furnish the means to- attain the goal of their ambition ; as 
 a result the professions are overcrowded and men fail who might 
 have been successful in the handicrafts. Let us teach our children 
 to respect and perform honest labor, whether it is behind the plow- 
 share, in the saddle, or in the workshops. It will teach them self- 
 reliance, prudence, and perseverence. 
 
 It will be conceded that the burdens of improving industrial and 
 social conditions should not be carried by the employer and employees 
 alone. There are many phases of vital importance from the stand- 
 point of public health and humanity which should concern every 
 thoughtful man and woman. Reference has already been made to 
 the appalling and dangerous conditions under which many of the 
 trades and occupations are carried on in tenement houses. While 
 this is, in part, due to the greed of the manufacturer, because it means 
 less factory space, less rent, light, fuel, and a decidedly smaller pay 
 roll, the consumer is equally to blame, because of his constant demand 
 for cheaper goods, quite oblivious to the fact that the garments may 
 be a source of danger from infectious diseases, and are stained with 
 the sweat and blood of helpless women and little children. 
 
 During one of the presidential campaigns a clever orator referred 
 to Glasgow, and told us that 41,000 of the 100,000 laboring families 
 of that manufacturing center lived in 1-room tenements, and that this 
 one room for a family of father, mother, daughters, and sons told 
 what the wages in Scotland were and how they dragged humanity 
 down into bestiality and misery. We need not go to Glasgow for 
 such illustrations, for to our shame it must be confessed that similar 
 conditions obtain in nearly every American industrial city. The 
 effects of such conditions upon death rates will be presently referred 
 to. In the meantime, it will be readily conceded tnat the people do 
 
BEPORTS OF THE PBESIDENT^S HOMES COMMISSION. 103 
 
 not live as a rule in such quarters from choice, but from sheer neces- 
 sity. Low wages compel the working classes not only to find shelter 
 in houses unfit for human occupation, but also affect their health 
 and the health of their children by insufficient food and clothing, and 
 last, but not least, it means the utilization of child and female labor 
 in some of the most atrocious forms referred to on another page. 
 Indeed, there is much reason for assuming that low standards of liv- 
 ing, which insufficient wages tend to beget, play a very important role 
 in physical, mental, and moral degeneracy. " Physical health is the 
 basis of mental health." This aphorism of Aristotle has been proved 
 to be true by the experience of every educator. 
 
 Professor Dawson, in his study of youthful degeneracy (Pedagog- 
 ical Seminary, Vol. IV, p. 2), found among the boys and girls m 
 reform schools evidence of physical degeneracy as shown by lighter 
 weights, shorter statures, and diminished muscular power, and de- 
 clared that 16 per cent of those examined by him were " clearly suf- 
 ferers from low nutrition." It is to be hoped that the public con- 
 science may be sufficiently aroused to insist upon adequate wages for 
 all classes, and that the producer and consumer alike will be willing 
 to assume this responsibility, not as a matter of charity, but in justice 
 to the laboring classes. 
 
 In the whole range of social betterment and sanitation, especially 
 in our efforts to combat tuberculosis, no field affords better oppor- 
 tunity for philanthropic work than the erection of sanitary homes for 
 wage-earners, at reasonable rentals, the encouragement of cooking 
 schools, and the establishment of model lodging and eating houses. 
 The new York City and Suburban Homes Company has now for divi- 
 dend disbursements 4.5 per cent a year on an investment of $5,500,000. 
 The Washington Housing Companies have an investment of over one 
 million, have paid, respectively, 4 and 5 per cent from the very incep- 
 tion of the companies, and have a surplus fund of over $100,000. 
 London has more than $100,000,000 invested in model tenements. 
 
 HOUSES FOR WAGE-EARNERS. 
 
 The housing of the working classes has very properly been made 
 the subject of legislation in many countries, and is a matter in which 
 factory owners, labor unions, and the general public should be deeply 
 and mutually interested. There are several systems of dwellings 
 for artisans and laborers, viz, individual houses or cottages, a row 
 of houses under one roof, and the so-called " flats." Preference 
 should be given, when practicable, to the cottage system, but in large 
 cities unfortunately the value of real estate frequently compels the 
 erection of large tenements, and in such an event the State should 
 insist upon hygienic requirements as regards air space, light, and 
 ventilation. No home can be considered sanitary where one room has 
 to answer the purposes of a living room, sleeping room, and kitchen 
 or where the water-closet or privy is used by more than one family. 
 
 EVIL EFFECTS OF INSANITARY HOUSES AND OVERCROWDING. 
 
 The primary object of habitations is to secure protection from the 
 influence of heat, cold, rain, sunshine, and storms, and thus promote 
 the health and happiness and indirectly also the morals and culture 
 of the human race. 
 
104 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 The intluence of sanitary houses can not be overestimated. Doctor 
 Villernie, in an investigation in France from 1821 to 1827, found that 
 among the inhabitants of arrondissements containing 7 per cent of 
 badly constructed dwellings, 1 person out of every 72 died ; of inhabit- 
 ants of arrondissements containing 22 per cent of badly constructed 
 dwellings, 1 out of 65 died, while of the inhabitants of arrondisse- 
 ments containing 38 per cent of badly constructed dwellings, 1 out 
 of every 15 died. 
 
 With the present rapid transit facilities in every city, our voice 
 should be clearly in favor of individual homes ; and when this is im- 
 practicable, we should insist on broad streets and deep yards. No 
 more than 68 per cent of the lot should be covered by the house, and 
 the height of the building should never exceed the width of the street. 
 The baneful effects of tenement houses should be avoided, as infec- 
 tious diseases are more liable to spread in consequence of aerial infec- 
 tion and the more intimate contact of the occupants. 
 
 Apart from structural defects, there is no doubt that the death 
 rate is largely determined by the number of occupants to a room. 
 Russell has shown that in Glasgow, when the average number of per- 
 sons to each room was only 1.31, the mortality was 21.7 per 1,000, and 
 when the number of occupants amounted to 2.05 for each room, the 
 mortality reached 28.6 per 1,000. 
 
 According to Korosi, the mortality from infectious diseases at 
 Budapest is only 20 when the number of occupants to each room does 
 not exceed 2, but is 29 per 1,000 with 3.5 occupants, 32 per 1,000 with 
 6.10 occupants, and 79 per 1,000 when there are more than 10 occu- 
 pants to each apartment. 
 
 TJae death rate at Berlin, in 1885, among the 73,000 one-room ten- 
 ements was 163.5 per 1,000, against 5.4 per 1,000 among 398,000 resi- 
 dents occupying four or more room apartments.** The analysis of 2,701 
 infantile deaths in Berlin during 1903, investigated by Neumann, has 
 been presented elsewhere in this work. 
 
 Insanitary dwellings are to be found everywhere, and particularly 
 in older cities, erected at a time when the principles of sanitation were 
 comparatively unknown. One of the most important municipal 
 problems is to correct existing evils by the enactment and enforce- 
 ment of suitable laws. It requires, however, a strong public senti- 
 ment to bring about a complete and satisfactory reformation, as evi- 
 denced by the housing movement elsewhere, for in spite of the excel- 
 lent tenement-house laws in New York, according to Homer Folks, 
 of 370,000 dark rooms reported in existence by the De Forest tene- 
 ment-house department in 1903, some 20,000 only have been opened 
 to the light during the past three and a half years. The prohibition 
 against the use of cellar and basement rooms partly underground 
 can not be enforced, owing to the lack of a sufficient number of in- 
 spectors. The notorious Lung Block " continues to contribute its 
 horrifying quota to the annual mortality. (Charities, November 30, 
 1907.) 
 
 The writer has no hesitation in declaring that the housing condi- 
 tions of the least resourceful of people have been, and are even now, 
 more potent than any other factor in helping to swell the frightful 
 
 •Town and City, Jewett, p. 14. 
 
BEPOBTS OP THE PRESIDENT'S HOMES COMMISSION. 105 
 
 mortality from consumption and other so-called house diseases en- 
 gendered by unwholesome environment. 
 
 HOUSE DISEASES. 
 
 It has long been known that rickets, scrofula, and other chronic 
 forms of tuberculosis are especially prevalent in dark, damp, and 
 insanitary houses. The children are anaemic and as puny as plants 
 reared without the stimulating effects of sunlight. Add to this the 
 fact that dampness abstracts an undue amount of animal heat, lowers 
 the power of resistance, and favors the development of catarrhal con- 
 ditions, which render the system more vulnerable to tuberculosis, and 
 we have a reasonable explanation why these diseases prevail, espe- 
 cially in basements or houses below grade and otherwise unfit for 
 human habitation. The death rate is often double and treble that 
 of other localities, and while there are doubtless other factors which 
 determine the frightful mortality, none are more potent than deficient 
 sunlight and ventilation. Diphtheria, cerebro-spinal meningitis, 
 acute and chronic rheumatism, and bronchial affections are also more 
 frequent in insanitary dwellings. 
 
 That the same is true of infantile diarrhea is doubtless due to the 
 fact that the construction of the buildings does not protect from the 
 heat of summer, and the enervating effects of heat and the more 
 speedy decomposition of food (especially of milk) in such an atmos- 
 phere, combine to carry on the slaughter of the innocents. 
 
 The existence of disease-breeding habitations is a reflection upon 
 Christian civilization, and there should be sufficient human sympa- 
 thy to provide decent, healthful homes for our wage-earners, who 
 constitute, after all, the bone and sinew of the country; and this is 
 one of the occasions when we may well act as our brother's keeper. 
 
 The history of improved dwellings reveals everywhere a lessened 
 death rate, and the experience of the Washington Sanitary Improve- 
 ment Company is equally gratifying. During the year ending De- 
 cember 31, 1906, the apartments were occupied by 778 adults and 380 
 children, total, 1,158; births, 39 and only 16 deaths, 10 adults and 6 
 infants, a death rate of about 13.7 per 1,000 — which, with all due 
 allowance for the average age of the occupants, shows a remarkbly 
 low mortality when compared with the general death rate among the 
 white population of 15.16 per 1,000. 
 
 This regeneration of the housing conditions for the least resource- 
 ful people is the great sanitary and social problem of the twentieth 
 century. 
 
 Take away the hovels and filthy places, let sunshine and pure air 
 circulate through their homes, and teach them habits of cleanliness 
 and responsibility, and the first step toward the elevation of the de- 
 graded and the education of the ignorant will be taken, not only in 
 the warfare against tuberculosis and other diseases engendered by 
 insanitary surroundings, but also in the battle for higher moral and 
 social standards. 
 
 LODGING HOUSES OR HOMES FOR WAGE-EARNERS. 
 
 Those who have read " The Long Day " can not fail to be im- 
 pressed with the just criticism of our present system of homes for 
 
106 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 working girls. The author makes a strong plea for homes designed 
 after the Mills hotels for workingmen ; no charity, but so built and con- 
 ducted that they will pay a 4 per cent rate of interest upon the money 
 invested. "A clean room and three wholesomely cooked meals a day 
 can be furnished to working girls at a price such as would make it 
 possible for them to live honestly on the small wages of the factory 
 or store. We do not ask for luxuries or dainties. In the model lodg- 
 ing house there should be perfect liberty of conduct and action on the 
 part of the guests, who w411 not be ' inmates ' in any sense of the 
 word so long as the conventions of ordinary social life are complied 
 with." 
 
 It is to be hoped that her simple but truthful story will be read 
 and her appeal for industrial and social betterment answered. So 
 long as the conditions described in the book exist, so long will it be 
 wicked to rear magnificent and costly church edifices, and in this 
 respect Christian civilization, which should be a strong factor in 
 uplifting and regenerative influences, has been remiss in its sacred 
 obligations. To supply the needs spoken of, together with the estab- 
 lishment of cooking schools and kindergartens so that the children of 
 toil may at least have an opportunity to learn to work intelligently, 
 may be regarded as a suitable field for practical Christianity, and' 
 would do much toward narrowing the breach which now exists be- 
 tween the church and wage-earners and between capital and labor. 
 
 FOOD FOR WORKING CLASSES. 
 
 While the character and variety of food now served is very much 
 better than it was fifty years ago, it is not what it should be, espe- 
 cially in lodging houses. The chief faults consist in improper cooking 
 and the widespread error of consuming a cold dinner from the lunch 
 basket or dinner bucket. 
 
 The art of cooking and how to supply good wholesome food and in 
 proper quantities should be made the subject of popular instruction. 
 The " Ladies Sanitary Association of England " deserves credit for 
 having taken this matter in hand, especially since experience teaches 
 that nothing prevents the abuse of alcohol so much as a sufficient and 
 palatable supply of food. 
 
 The establishment of public kitchens and eating houses for un- 
 married laborers conducted upon practical sanitary and economic 
 principles would prove a great blessing; the same may be said of 
 lunch rooms where rolls, sandwiches, a cup of coffee, tea, milk, hot 
 soups, etc., may be obtained at a nominal cost, and which would 
 materially lessen the evils of intemperance. 
 
 Since coffee and tea allay thirst and are stimulants, without the 
 depressing effects of alcoholics, there is no reason why factories and 
 workshops should not supply these beverages at noon to employees 
 at actual cost. The subject of food and cooking will be discussed in 
 a special paper. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 107 
 
 Chapter XVII. 
 
 WHAT THE EMPLOYEE MAY DO TO CONTRIBUTE TO HIS OWN 
 
 WELFARE. 
 
 Sufficient has been said in the preceding pages to indicate the 
 dangers to which the working classes are exposed in many industrial 
 pursuits, and the methods proposed to alleviate the effects have also 
 been pointed out. It must be 6onceded that all remedial efforts have 
 been prompted by the true spirit of humanity and as a social duty; 
 hence it is reasonable to expect that wage-earners should show a 
 willingness to avail themselves of the various " safety devices " and 
 not underrate their importance in the protection of life and limb. 
 While it is criminal for employers not to provide suitable protection, 
 it is equally culpable on the part of the operatives to disregard all 
 such preventive measures. So, for example, it is not a pleasing reflec- 
 tion to be told by Doctor Harrington, professor of hygiene at the 
 Harvard Medical School, in speaking of respirators, that "Aside 
 from the discomfort caused, the operatives have another and a sense- 
 less objection to their use; women complaining that they are made 
 to look ridiculous, and men being moved to discard them by the 
 gibes of their more reckless fellows." In January, 1908, the writer 
 visited Frankford Arsenal and found men working in high explo- 
 sives without rubber gloves and respirators, although provided by 
 the Government. (See p. 60). Doctor Farrand, Secretary of the 
 National Association for the Study and Prevention of Tuberculosis, 
 also spoke to me of the great difficulties he and others have encoun- 
 tered in New York and New Jersey in inducing the operatives to 
 give safety devices a fair trial. 
 
PART II.- SOCIAL BETTERMENT. 
 
 Chapter I. 
 
 HOW VO KEEP WELL AND CAPACITATED FOR WORK. 
 
 It is a matter of constant observation that families, even with a 
 modest income, get along very well until sickness and death enters the 
 once happy home; and if these financial burdens and sorrow can be 
 prevented it is clearly our duty to do so, even if the " chief bread 
 winner " is not himself incapacitated for work. For these reasons 
 the writer offers a few suggestions along the lines of general and 
 personal hygiene, with the hope that they may serve to diminish 
 human suffering and distress. In doing so, while utilizing his own 
 lecture material, he is indebted for the inspiration and popular pres- 
 entation, as well as some of the subject-matter, to the valuable 
 brochure by Prof. Fritz Kalle and Dr. Gustav Schellenberg " Wie 
 erhalt man sich gesund und erwerbsf ahig, Berlin, 1907." 
 
 HOUSE AND HOME. 
 
 Special pains should be taken in the selection of living quarters, 
 no matter how humble they may be, as they constitute our abode for 
 the greater part of our life. With the excellent motor facilities, there 
 is no reason why crowded tenements should be chosen, and prefer- 
 ence should always be given to individual homes, or apartments, in 
 not exceeding two-story tenements. The Germans have an old but 
 true proverb : " Where the sun does not enter the doctor surely will ;" 
 hence dark, gloomy and damp houses should be avoided; moldy 
 spots on the walls or ceilings and a close musty odor indicate damp- 
 ness, and cheap rents should prove no inducement to occupy such 
 quarters. Leaky roofs and down spouts, or a pile of ashes against 
 a brick wall, may keep the house damp, and the causes should be 
 promptly removed. In all such instances, as well as in the occupancy 
 of a recently constructed house, it is very desirable to dry out the 
 house by heat and open windows. 
 
 Since we know that the mortality from contagious diseases in- 
 creases in proportion to the number of inmates of the rooms, hygiene 
 requires that even the most modest dwellings should afford sufficient 
 room to prevent overcrowding. Ventilation is always necessary, but 
 open windows are especially indicated at night, as nothing can take 
 the place of pure fresh air in small quarters. This may be effectively 
 accomplished without the danger of drafts by opening the window 
 in the bedrooms from the top, and those of the adjoining room at the 
 bottom. Night air, contrary to popular opinion, is not unwholesome. 
 The only danger is from mosquitoes, which should be excluded by 
 proper screening of windows and doors. 
 
 109 
 
110 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 There are many families who properly insist upon having a sit- 
 ting room or parlor, which is most commendable, if the bedrooms are 
 large enough to afford 500 cubic feet of air space for each occupant. 
 If they do not, it is desirable after proper airing of the larger rooms 
 to utilize them for sleeping purposes, for it must be remembered that 
 the air of habitations is vitiated by the consumption of oxygen and 
 the exhalation of carbonic acid. The airing of rooms is even more 
 essential in cold weather, because of the additional pollution by 
 carbonic acid from light and fires. There are a number of families, 
 unfortunately, who for various reasons are obliged to live, cook, and 
 sleep in one room, and for whom the question of fresh air is therefore 
 of vital importance. Such families should not hesitate to avail them- 
 selves of the benefit of fresh air, especially when medical science has 
 demonstrated the advantages of fresh and even cold air in the treat- 
 ment of consumption and pneumonia, provided the body is kept 
 warm by sufficient bedclothes. 
 
 The household dust is as objectionable in many respects as the dust 
 of workshops, because dust and germs always go hand in hand. So, 
 for example, Uffelmann found that while the outer air contained only 
 250 ^erms in 10 cubic feet the air of his library contained 2,900, of 
 his sitting room 7,500, of his bedroom 12,500 and the air of a living 
 room of a workingman's family as many as 31,000 germs. He also 
 demonstrated that they increased after disturbing the dust of the 
 rooms by feather dusters or by slamming the doors, showing that they 
 actually cling to the household dust. If the dust should happen to 
 contain the germs of tuberculosis, from carelessly expectorated spu- 
 tum, or which may have been carried into the house upon the soles of 
 footwear, bottom of skirts, etc., such dust may prove a source of 
 danger, especially to children. 
 
 HOUSE CLEANING. 
 
 For reasons just given, there should be no accumulation of dust in 
 any part of the premises. Hygiene, therefore condemns all carpets 
 and interior finishes which serve as dust and germ traps, such as 
 heavy cornices, elaborate moldings of door and window frames, 
 wardrobes, cumbersome draperies, and unnecessary furniture. Hy- 
 giene, on the other hand, approves of neatly polished floors with 
 small rugs, which can be easily taken up and cleaned outside of the 
 house, curves instead of cornices and angles, smooth and nonabsorbent 
 walls, instead of embossed wall papers, simplicity of furniture, closets 
 instead of bureaus and wardrobes. In brief, everything which 
 will prevent the collection of dust and germs and facilitate their 
 removal may be regarded as hygienic. So, for example, a plain, 
 tinted, smooth wall, or the varnished wall papers, which can be 
 cleaned with a damp cloth, or any smooth wall paper guaranteed to 
 be free from arsenic, are in point of health superior to the embossed 
 silk hangings and tapestries of the rich man's home. 
 
 The object of house cleaning is primarily to get rid of the dust 
 and germs. In sweeping it is desirable, therefore, to open the upper 
 windows, but to keep the door leading into the hall closed, so that the 
 dust may not be wafted back into the house. The dusting should 
 always be done with a soft, damp cloth, frequently changed. Under 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. Ill 
 
 no circumstances should the feather duster be used inside of the house, 
 as it does not remove, but simply displaces the dust. If the cracks in 
 floors have been neatly filled up, and the floors oiled or waxed, they 
 can be cleaned with a damp cloth much more effectively than by the 
 tiresome process of scrubbing, a drudgery to every neat housekeeper. 
 The kitchen, cooking, and eating utensils need special care, as un- 
 clean food and utensils are often the cause of cholera-morbus and 
 diarrheal diseases. Captain Sanderson, in the Cook's Creed, pub- 
 lished for the United States Army, in 1862, showed his sanitary acu- 
 men when he said : 
 
 Better wear out your pans with scouring than your stomachs with purging, 
 and it is less dangerous to worli your elbows than your comrades' bowels. 
 Dirt and grease betray the poor cook and destroy the poor soldier. 
 
 Every effort should be made to have clean and cool storage facilities 
 for food, and all perishable food, especially milk for infant feeding, 
 should be kept on ice whenever the temperature is above 60°, 
 
 TEMPERATURE. 
 
 The most healthful room temperature in cold weather is between 
 65° and 70°, as overheated rooms predispose to colds and should be 
 avoided. 
 
 When the house or apartment is heated by cast-iron stoves or other 
 heaters, special care is necessary not to bring them to a red heat, as 
 the very dangerous coal gas is liable to escape through invisible fis- 
 sures in the plate and joints while the heaters are red hot. It is 
 desirable to select a good-sized heater lined with fire clay, which will 
 not have to be brought to a red heat, and at the same time furnishes 
 sufficient volume of warm air. If the air is superheated it acquires 
 a peculiar odor, probably due to charring of organic dust; it also 
 becomes very dry and irritating, owing to the rapid evaporation of 
 moisture from the skin and mucous surfaces of the inmates, and in 
 consequence is apt to produce catarrhal affections, conditions which do 
 not prevail when care is taken and provisions made for the evapora- 
 tion of a certain amount of water. Coal oil or gas stoves can not be 
 recommended, unless provisions are made to carry off the products of 
 combustion. 
 
 The danger from fire, which is always a great calamity, should be 
 reduced to a minimum by preventing the accumulation of combustible 
 material on the premises, proper care of matches, and instruction of 
 the children. Coal oil, gasoline, etc., should never be used for kin- 
 dling purposes ; there is always great danger from explosions, fire, and 
 fatal burns by filling a burning lamp, or extinguishing the wick by 
 blowing over the chimney, or using a lamp when the chimney is 
 broken. 
 
 INSECTS. 
 
 Special attention should be paid to the exclusion and destruction 
 of house flies, mosquitoes, and other insects, for apart from the dis- 
 comfort produced, there is much reason ^or assuming that disease 
 germs may be conveyed by flies and mosquitoes, fleas, bedbugs, and 
 roaches. Celli,° of Rome, in 1888, demonstrated that the germs of 
 
 «A. Celli Boll. dell. Soc. Lancis, degli, ospedali di Roma, 1888. 
 
112 REPORTS OP THE PRESIDENT'S HOMES COMMISSION". 
 
 tuberculosis and other disease germs may retain their vitality after 
 passing through the intestinal tract of flies. Spillmann ^ pointed out 
 that flies caught while feeding upon the expectoration of a consump- 
 tive invariably contained viable germs, and Hoffmann * not only con- 
 firmed these observations, but also found the germs in the fly spots 
 on the walls of a room occupied by a phthisical subject. The*^ writer 
 has declared it his opinion for years that flies may carry the germs 
 on their feet, from typhoid stools and infected sources, to the food 
 and milk supply, and in 1895 ^ pointed out a number of house infec- 
 tions in this city which could not be explained in any other way. The 
 experience of the Spanish-American war appears to have fully con- 
 firmed this conclusion. In like manner, the germs of cholera and of 
 the oriental pest have been disseminated by the house fly. 
 
 Professor Stiles, of the Public Health and Marine-Hospital Service, 
 has shown that the eggs of the pork worm, whip worm, pin worm, 
 and round worm may be carried by flies to the food and there is rea- 
 son to believe that purulent affections of the eye and wound infections 
 may be thus conveyed. 
 
 The evidence that certain species of mosquitoes are the intermedi- 
 ate host of the germs of malaria and yellow fever, and that man may 
 be directly inoculated by the sting of these insects is absolutely con- 
 clusive. The efficacy of measures for the extermination of mosqui- 
 toes, and their exclusion from houses by proper screening, has been 
 abundantly demonstrated both at home and abroad. 
 
 It is gratifying to know that the mystery of yellow fever was 
 solved by the work of Surgeons Reed, Carroll, Lazear, and Agra- 
 monte of the United States Army, and Surgeons Gorgas and Keane 
 have demonstrated the best methods for the prevention of yellow 
 fever and malaria by waging an unceasing warfare against the 
 mosquitoes. 
 
 Poultry, pigeons, and household pets, like dogs, cats, and parrots, 
 ought not to be kept in the rooms, as they contaminate the air, harbor 
 insects, and may even convey disease germs. It is held by a number 
 of authors that diphtheria as observed in chickens, pigeons, and cats 
 is identical with the human disease. Parrots suffer at times from 
 a pulmonary disease, which is transmissible to man, while certain 
 forms of skin disease and itch may be conveyed by dogs and cats. 
 
 There is some evidence to show that a certain tapeworm found in 
 the dog and sometimes in children undergoes a larval stage in fleas 
 and dog lice and when swallowed unconsciously by children may cause 
 infection. 
 
 What has been said of the desirability of general cleanliness applies 
 with equal force to the basement, cellar, attic, 3^ard, outhouses, gar- 
 bage cans, etc. There should be no accumulation of rubbish within 
 or without the premises. Where no sewer connections exist, the out- 
 houses should be kept in a clean condition, and the seats provided 
 with lids so as to exclude flies. It is also a good plan to disinfect the 
 vault or receptacle with chlorinated lime or fresh whitewash, etc. 
 
 A good housewife can not only accomplish a great deal for the 
 health, but also for the comfort and morals of the family. As indi- 
 
 « Spillmann and Haushalter, Comptes rendus 105, p. 352. 
 
 *' Hoffmann Deutsche Med. Zeitung, 188S, No. 57. 
 
 ^' Iteport of tlie Health Officer, District of Columbia, 1895. 
 
BBPOBTS OP THE PBESIDENT's HOMES COMMISSION-. 113 
 
 cated by our German authors, general order and neatness, clean, 
 white, washable curtains, some potted plants, and a few suitable 
 pictures, avoiding the loud chromos, and a cheerful and refined at- 
 mosphere will do much toward keeping the husband and sons from 
 the saloons. 
 
 As a matter of fact, much may be done to transform undesirable 
 living quarters into healthful homes, while filth, neglect, and slovenly 
 housekeeping often convert even structurally good houses into verita- 
 ble hotbeds for disease germs. So, too, persons with delicate con- 
 stitutions may, by attention to the laws of health, attain to a good 
 old age, while the physical giant by a reckless life soon undermines 
 his general health and goes to a premature grave. 
 
 CARE OF THE SKIN. 
 
 The skin is supplied with a network of blood vessels and nerves, 
 and is a sensory, respiratory, execretory, and heat reflating organ. 
 As a sensory organ, it combines with the tactile functions, the power 
 of perceiving impressions of warmth and cold. The respiratory 
 functions of the skin are limited, to be sure ; nevertheless, small quan- 
 tities of oxygen are absorbed and carbonic acid is eliminated. Apart 
 from this, the skin on an average adult eliminates through the sweat 
 glands about 2^ pounds of water a day. Human sweat contains 
 about 2 per cent of solid constituents, mostly in the form of waste 
 matter or impurities, and the odor varies in different regions of the 
 body and in different races. The skin also secrets a fatty substance 
 through the sebaceous glands. As the water from the skin evapo- 
 rates, the solid matter remains upon the surface, combines with dirt, 
 harbors germs, and readily undergoes decomposition, which, apart 
 from the disagreeable odors so characteristic of unclean j)ersons, also 
 tends to mascerate the skin and is liable to produce " galling or chaf- 
 ing," pimples, and boils. 
 
 Last, but not least, the accumulation of this matter would natu- 
 rally close the pores of the perspiratory and sebaceous glands and 
 throw the work of eliminating the impurities upon other organs. 
 
 A normal cutaneous function is doubtless of great hygienic im- 
 portance, as shown by the occurrence of many diseases following its 
 suppression, because in such an event, in addition to the retention of 
 the waste matter in the blood, work is thrown upon the kidneys and 
 other eliminating organs, and these, if already weakened, naturally 
 break down. Since the functions of the skin depend not only upon 
 its anatomical intactness, but also upon cleanliness and a proper tone 
 of the cutaneous vessels and nerves, a rational culture of the skin 
 demands: (1) that it should be freed regularly from the secretory 
 products and particles of dirt; (2) that the cutaneous nerves retain 
 their normal excitability or when impaired that they regain their 
 tone; (3) that we assist the skin in its heat- regulating functions, so 
 that it may not be overtaxed. All of which may be accomplished 
 by ablutions, baths, and suitable clothing. 
 
 ABLUTIONS AND BATHS. 
 
 Regular and systematic ablutions with soap and water are requisite 
 for reasons already given, and are especially necessary when engaged 
 in dirty work or exposed to poisonous dust. In addition to the 
 S. Doc. 644, 60-2 9 
 
114 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 chemical effects of soap, vigorous friction with a brush may be em- 
 ployed, not omitting the finger nails, as disease germs have been found 
 in nail dirt. 
 
 The water used should not be too warm for the body, as this would 
 relax the skin and increase the susceptibility to catching cold. If the 
 bathing is not done in the bath tub, it will be well to wash and dry 
 part of the body at a time. In any event the surface should be wiped 
 dry and hard, especially the hair, since wet hair is calculated to pro- 
 duce colds. It is always a good plan to wash the neck and chest with 
 cold water, so as to harden the skin. 
 
 We will now brieiBiy refer to the different forms of baths. The cold 
 bath is usually taken in a tub or by means of a shower or needle bath 
 at a temperature of about 65° for adults. It should not last over 
 three minutes. Cool baths vary from 65° to 80°. Tepid baths are 
 taken at a temperature of between 80° to 90°, continued from ten to 
 fifteen minutes. Warm baths vary from 90° to 100°, and are generally 
 employed for their cleansing effect. In addition, there are steam 
 or Russian baths, the Turkish or dry hot-air baths, river and ocean 
 baths, swimming pools connected with public baths, medicated baths, 
 etc. Swimming baths are particularly useful, as they also afford an 
 opportunity for muscular exercise, and as the temperature of the 
 water is rarely above 80°. Such baths are both cleansing and stimu- 
 lating, and therefore an excellent tonic for the skin. All baths should 
 be followed by a cool douche and friction with a rough towel should 
 be employed until the skin is in a general glow. The value of bathing 
 is so fully appreciated that the building regulations of this city com- 
 pel a bathroom for every apartment offered for rent. No community 
 should fail to make provisions for public baths, both in summer and 
 winter. The beneficial effects upon the health and morals of the 
 least resourceful people can not be too strongly emphasized. The old 
 Roman baths were prominent features of the daily life of the Romans, 
 and were counted among the choicest privileges. Eleven large and 
 826 smaller public institutions adorned the ancient capital during the 
 Diocletian period, and the baths of Caracalla, the ruins of which can 
 be seen to-day, could accommodate 1,600 bathers at one time. 
 
 The following sensible rules on the subject of bathing have been 
 issued by the English Humane Society, and are well worth observing 
 by bathers : 
 
 Avoid bathing within two hours after a meal. Avoid bathing when exhausted 
 by fatigue or from any other cause. Avoid bathing when the body is cooling 
 after perspiration. Avoid bathing altogether in the open air, if, after having 
 been a short time in the water, there is a sense of chilliness, with numbness of 
 the hands and feet, but bathe when the body is warm, provided no time is lost 
 in getting into the water. Avoid chilling the body by sitting or standing un- 
 dressed on the banks or in boats, after having been in the water. Avoid remain- 
 ing too long in the water, but leave the water immediately if there is the slight- 
 est feeling of chilliness. The vigorous and strong may bathe early in the 
 morning on an empty stomach. The young, and those who are weak, had better 
 bathe two or three hours after meals; the best time for such is from two to 
 three hours after breakfast. Those who are subject to giddiness or faintness, 
 or suffer from palpitation or other sense of discomfort at the heart, should 
 not bathe without first consulting their medical adviser. 
 
 CLOTHING. 
 
 The object of clothing, apart from the moral and aesthetic aspect, 
 is to aid the skin in its heat-regulating functions. It should, there- 
 
BEPOHTS OF THE PRESIDENT'S HOMES COMMISSION. 115 
 
 fore, afford protection against heat and cold, as well as rain and 
 mechanical irritation. Clothing must be adapted to climate and sea- 
 sons, and extremes should be avoided ; as a general rule warm woolen 
 goods are best suited for winter wear, and cotton or linen for warm 
 weather. It should be understood, however, that flannels absorb more 
 dirt, odors, germs, and water than linen or silk, whilst cotton oc- 
 cupies an intermediate position. The question of wet clothing, 
 whether from perspiration or rain, is important, as the drying of 
 clothing on the body involves an expenditure of animal heat, and it 
 is not a matter of indifference whether this takes place rapidly or 
 slowly. It is a fact that a wet cotton shirt or sweater feels more un- 
 comfortable and colder than a wet woolen garment. The simple rea- 
 son is that the cotton garment dries more rapidly, but it abstracts 
 during the same time more animal heat than flannels. This fact is 
 not without a practical bearing, as it teaches that persons who per- 
 spire easily will do well to wear flannels next to the skin, and this is 
 all the more important when they are liable to draughts or abrupt 
 changes in temperature. 
 
 As a protection against cold, wool is superior to either cotton or 
 linen, and should be worn for all underclothing. In case of extreme 
 cold, besides wool, leather, fur, or waterproof clothing, on account 
 of their impermeability to air, are useful. As a protection against 
 cold winds, for equal thickness, leather and India rubber take the first 
 rank, wool the second. As a protection against rain, india rubber or 
 oiled canvas clothing is the best, but it is an exceedingly hot dress, 
 owing to its impermeability to air, which causes condensation and 
 retention of the perspiration. To overcome this objection, Dumas 
 suggests a material, which is waterproof and yet permeable, pre- 
 pared as follows : The garment is placed in a 7 per cent solution of 
 gelatine, heated to a temperature of 100° F. After immersion for a 
 few minutes it is dried in the air and after drying it is soaked in a 
 three-fourths of 1 per cent solution of alum and again dried. 
 
 As a protection against heat in the shade, the thickness and con- 
 ducting power of the material are the only factors to be considered. 
 Texture has nothing to do with protection from the direct solar rays ; 
 it depends entirely on color, and white is the best. As a protection 
 against fire, leather clothing is generally worn. The fabric can be 
 rendered noninflammable by the addition of 20 per cent of tungstate 
 of soda and 3 per cent of phosphate of soda to ordinary starch sizing, 
 while cotton or linen goods may be treated simply with starch and 
 borax, in the proportion of a teaspoonful of borax to one-half pint of 
 starch. 
 
 CLOTHING AS A CAUSE OF DISEASE. 
 
 Clothing may impair the functions of the body and cause disease 
 (1) by improper fitting, which leads to compression of blood vessels 
 and nerves and interferes with the normal position of organs and the 
 movements of the body; (2) by improper selection of material afford- 
 ing either insufficient protection or overheating a part or the whole 
 of the body; improper material may also produce irritation or inter- 
 fere with the vejntilation of the skin; (3) by wet clothing, which, in 
 drying, may abstract sufficient animal heat to cause peripheral irrita- 
 tion and reflex internal congestions; (4) by poisonous dyes, such as 
 
116 EEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 compounds of arsenic and antimony, chrome yellow, zinc chloride, 
 and some of the aniline colors. The toxic symptoms may manifest 
 themselves by general impairment of health or m local affections of 
 the skin; (5) clothing may harbor disease germs, and a number of 
 instances are on record in which itch, smallpox, tuberculosis, and 
 scarlet fever have been spread by second-hand clothing and bedding. 
 This points to the necessity of thorough disinfectioi 
 
 SPECIAL ABRANGEMENT OF DBESS. 
 
 The head dress. — As long as the head is covered with hair, the head 
 dress should be permeable and not too warm, lest headache may be 
 induced ; on the other hand, insufficient covering may produce neural- 
 gia and rheumatic affections. 
 
 The head and eyes should always be protected from the direct rays 
 of the sun, and for this purpose broad-brmimed, dark felt hats for 
 cold weather and straw or some other light-colored material for 
 summer use are the best. 
 
 For the neck. — Nothing should be worn around the neck which 
 would overheat the parts, dilate the blood vessels, and render the skin 
 sensitive. The collars should be loose fitting, so as not to compress 
 the blood vessels. The neck ought to be bared as much as possible 
 and hardened by frequent ablutions with cold water. 
 
 For the hody. — For undergarments, the union suits are the best. 
 They should secure a normal amount of warmth and be so arranged 
 as not to interfere with the free movements of the chest, or compress 
 or displace the abdominal and pelvic organs. For these reasons, cor- 
 sets and waistbands are wholly inadmissible. Suspenders should be 
 worn by both sexes, or women may wear a bodice arranged for the 
 attachment of skirts, so as to suspend their weight from the shoulders. 
 Steel corset stays and tight lacing can not be too strongly condemned, 
 because there is ample evidence that they have caused displacement 
 and disease of the abdominal and pelvic organs. 
 
 The stockings should be made of some warm, permeable material, 
 such as wool or merino, as the circulation is rather feeble in the lower 
 extremities, and the feet are more liable to perspire. They should be 
 long enough to reach above the knees and there fastened with some 
 loosely-fitting band. Tight elastic bands and other constricting gar- 
 ters are liable to produce varicose veins. 
 
 The trousers must be sufficiently loose around the waist and else- 
 where to permit of free circulation of blood. 
 
 FOOTWEAR. 
 
 Boots and shoes are intended to protect the feet from the uneven 
 and rough surfaces of the ground, from cold, wet, and even heat, and 
 must be constructed so as to meet these requirements. It is needless to 
 insist that they should be patterned after the foot. The sole of a shoe 
 should be so constructed that the great toe touches it in such a way 
 that a line projected posteriorly through the middle of this toe will 
 strike the middle of the heel. The heel should be broad and low, so 
 as not to throw the weight on the toes. Across the tread and toes the 
 sole should be sufficiently broad to permit of lateral expansion. The 
 uppers should be soft and flexible, but not too roomy, and should fit 
 
EEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 117 
 
 snugly around the ankles and insteps. Elastic gaiters are preferablf^ 
 to laced shoes. 
 
 It is perhaps needless to insist that cleanliness in body and cloth- 
 ing is next to godliness. This may be secured by frequent bathing 
 and change of underwear. It is also a good plan to use nightshirts 
 or pajamas, so as to afford an opportunity for a thorough airing of 
 the underwear worn during the day. If in spite of the general clean- 
 liness there should be indications of excessive sweatmg and dis- 
 agreeable odors, especially of the feet, a physician should be consulted. 
 
 BED AND BEDDING. 
 
 Since about one-third of our life is spent in bed, something should 
 be said of this article of comfort and necessity. As the object of the 
 bed is to promote a refreshing sleep, it should be long and broad 
 enough to permit of the necessary extension of the body; it should 
 be elastic, so as not to compress the soft parts unnecessarily, and it 
 should be warm, but not too warm. Metallic bedsteads are preferable 
 to wood, because less liable to be infected with insects; they should 
 be provided with a woven-wire mattress which admits of free cir- 
 culation of air. Upon this may be placed a mattress of hair, felt, 
 cotton, or excelsior, and pillows preferably made of horsehair. 
 Feather pillows are too heating for the head, unless a layer of paper 
 has been interposed, and high pillows are objectionable, as the posi- 
 tion of the sleeper would impede the movement of the diaphragm. 
 Sheets and pillowcases of cotton for winter and of linen for summer 
 are necessaiy to prevent irritation of the skin and soiling of the mat- 
 tress, pillows, and blankets. 
 
 The most suitable coverings for a bed are woolen blankets; they 
 are warm and their permeability admits of the escape of gases. For 
 warm w^eather a cotton quilt or comforter or even a linen sheet is 
 preferable. The bedding should be aired every morning and exposed, 
 whenever practicable, to sunlight, which is nature's purifier and 
 destroys all forms of germs. 
 
 " Feather beds " and " down quilts " are warmer than blankets, as 
 the air contained in the feathers is a bad conductor of heat, but they 
 are only suitable in very cold climates, or for anaemic and delicate 
 individuals, because they overheat the body, cause dilation of the 
 cutaneous vessels, and consequently relax and impair the tone of the 
 skin. 
 
 The sleeper should lie with his head slightly raised, preferably 
 with the body inclined to the right side. He should rise rather 
 slowly from the recumbent position, since a sudden change to the 
 erect position not only accelerates the heart's action, but also changes 
 the blood distribution too abruptly. The bed should be so placed 
 that the occupant is not disturbed by the influence of light. A sound, 
 refreshing sleep can only be had when the senses are no longer stimu- 
 lated, and light is a stimulus which acts even through the closed 
 eyelids. 
 
 SLEEP. 
 
 We are still in ignorance of the exact nature of sleep or the sus- 
 pension of automatic activity of the brain. Some authors maintain 
 
118 BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 that it is due to an accumulation of waste products in the blood and 
 central nervous sj^stem, and that it ceases with the elimination of 
 these products. Others believe that sleep results from the exhaustion 
 of the supply of intra-molecular oxygen, while still others attribute 
 it to a temporary anaemia of the brain. On the whole, there is much 
 reason for assuming that the refreshing effects of sleep are due to 
 the elimination of waste products from the system and the absorption 
 of a fresh store of oxygen. At all events, Pettenkoffer and Voit 
 found that of the 954.5 grams of oxygen absorbed by a healthy adult 
 in the course of twenty-four hours, 659.7 grams are absorbed between 
 6 o'clock in the evening and 6 o'clock in tne morning. 
 
 AMOUNT OF SLEEP BEQUIEED. 
 
 It is well known that healthy, new-bom infants sleep all day, 
 except while nursing. About the third or fourth week of their life 
 they may remain awake for one-quarter of an hour, in addition to 
 their nursing; in the seventh or eighth week they remain awake 
 one-half hour, and in the fifth month about one hour ; but even when 
 a year old a child sleeps more than half of the twenty-four hours. 
 During the second and third year it sleeps from ten to twelve hours 
 at night and from two to two and one-half hours in the daytime. 
 After the completion of the third year the necessity for sleep in day- 
 time ceases. 
 
 Uffelmann has made a series of careful observations and believes 
 that " healthy, well-cared-for children between 4 and 6 years of age 
 require eleven hours of sleep ; at 7 years of age, ten to ten and one- 
 half hours of sleep ; at 10 j^ears of age, nine and one-half to ten hours 
 of sleep; at 12 years of age, nine hours of sleep; at 14 years of 
 age, eight and one-half hours of sleep; youths between 16 and 20, 
 eight and one-half hours of sleep; adults, seven and one-half to eight 
 hours of sleep ; while the aged require a larger amount of sleep." 
 
 No hard and fast lines, however, can be drawn ; some children and 
 adults can get along with less, and others require more sleep. On 
 the whole, we may conclude that the average adult requires about 
 eight hours of sleep, and if the amount is materially lessened languor, 
 pallor, nervous irritability, and general peevishness may be observed. 
 
 Excessive sleep is harmful, as it tends to produce sluggishness of 
 the bodily functions, especially of the digestive organs. It lessens tis- 
 sue metamorphosis and favors the deposition of fat — not to mention 
 the bad effects of the prolonged presence in a polluted atmosphere. 
 
 We are also beginning to understand that the reason why an excess 
 of sleep instead of being restful to intellectual energy is rather ex- 
 haustive is: After a certain amount of sleep, even though the body 
 continues to be somnolent, the mind awakes and, in the midst of the 
 undirected, rapidly varying mental excursions which follow, as much 
 nerve force and mental energy is expended as would be necessary for 
 the more continuous thinking of regular intellectual work. 
 
 Irregularity in sleep is always objectionable. The human body 
 resents irregular habits of all kinds. Many infants sicken because of 
 irregular nursing, and we all experience unpleasant symptoms when 
 from any cause our regular meal hours are interrupted, and it is per- 
 fectly natural that such an important organ as the brain should 
 demand regularity in action and rest. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 119 
 
 Irregular bed hours are not calculated to promote a sound and 
 refreshing sleep. Since we enjoy the best sleep before midnight, the 
 hours between 10 o'clock p. m. and 6 a. m. or 11 p. m. to 7 a. m. are 
 the most suitable. 
 
 Opinions differ as to the admissibility of a nap after dinner, and 
 the question must be decided by individual circumstances. It is quite 
 certain, however, that there is no physiological necessity for such a 
 sleep in healthy children above the age of 4, nor for men and women 
 in their best years, unless they have taken an inordinate amount of 
 food. Persons in advanced age may profit by a short rest, which 
 seems often demanded by an overwhelming drowsiness; the same 
 may be said of delicate and anaemic individuals and those suffering 
 from diseases of the digestive system. 
 
 DREAMS. 
 
 In spite of considerable research the occult character of dreams has 
 not been entirely cleared up, although psychologists are agreed that 
 they constitute a manifestation of intellectual life involving the 
 expenditure of a certain amount of brain force or mental energy. 
 Practical experience also teaches that a dreamless sleep is in every 
 way recuperative, while a dreamful night produces a tired feeling 
 in the morning; hence dreams should be avoided, if possible. 
 
 There is much reason for believing that the old custom of relating 
 dreams, and the attempt to interpret them, has a bad effect on the 
 minds of all, and especially of children, as it tends to bring about a 
 similar mental rambling during sleep of subsequent nights. Atten- 
 tion has recently been called in an editorial -(Journal A. M. A., July 
 28, 1907), to the fact that children suffer more frequently from night 
 terrors, which are really overvivid dreams, on Sunday and Monday 
 nights. This is partly attributed to the fact that the children have 
 indulged in the '' imagination-intoxicating " colored supplement to 
 the Sunday newspaper with its horrors and its dream suggestions. 
 Those of us who have been brought up in rural districts and have 
 listened to dream tales and folklore and perused exciting literature 
 have learned that all of this is productive of dreams and night 
 terrors, and should be avoided. 
 
 IMPORTANCE OF GOOD TEETH. 
 
 When we recall the physiology of digestion it is scarcely necessary 
 to point out the importance of a good set of teeth in order to secure 
 thorough mastication and insalivation of the food. The temperature 
 of food and drink exerts a special influence on our teeth. It has been 
 shown that a sudden change from hot to cold in the mouth causes the 
 enamel to crack, and leads to premature decay of the teeth, because 
 the microbes in the mouth will find these fissures a suitable lurking 
 place for their destructive work. 
 
 The teeth should never be used for the purpose of cracking nuts. 
 Microbes of every description abound in the mouth, and find in the 
 presence of lodged and decaying particles of food a suitable medium 
 for their multiplication. In order to prevent their destructive effects, 
 cleanliness of the mouth is absolutely essential. This can be secured 
 by brushing the teeth with water and castile soap after each meal 
 
120 REPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 and before retiring. In case particles of food can not be thus dis- 
 lodged, a soft silk thread drawn between the teeth will accomplish 
 the purpose more effectively and wisely than a toothpick. If the 
 teeth are already painful, or show evidence of decay or of accumula- 
 tion of tartar, a dentist should be consulted. It is a wise plan to have 
 the teeth examined once a year, and as there are free dental infirm- 
 aries, the question of cost should not deter even the least resourceful 
 people. 
 
 HABIT AND REGULARITY OF THE BOWELS. 
 
 As i)ointed out by Hammond,^ when we perform an act under the 
 operation of certain impressions, there is a tendency toward the per- 
 formance of a similar act, if like influences are brought to bear upon 
 the organism. " This disposition to repetition prevails in nearly 
 every function of the body and mind until some powerful force inter- 
 venes." It is shown by the sensation of hunger and thirst which 
 occur at customary meal hours, the desire to evacuate the bowels at 
 the same hour of the day, the desire for sleep, the hour of awakening, 
 and the inexpressible feeling excited by the want of a smoke or a 
 customary stimulant. 
 
 CONSTIPATION. 
 
 When regularity of the bowels is established, the desire to go to 
 the stool returns at the same hour. If this tendency is resisted, it is 
 not long before constipation becomes the rule, with all its attending 
 consequences of ill health. The most natural remedy to correct this 
 morbid habit will be persistent effort to secure an evacuation every 
 day at a fixed hour, aided by the use of succulent vegetables and 
 fruits, and if necessary by' small doses of olive oil, cotton-seed oil, or 
 Epsom salts and water. 
 
 One of the most baneful effects of constipation is hypochondry — a 
 nervous and mental condition brought about by absorption of poison- 
 ous products in the intestinal tract, and the continued action of the 
 mind upon some one organ or function supposed to be disordered, 
 notably the heart, liver, and stomach. The disease appears most 
 commonly in irritable individuals and in those exhausted from a 
 variety of causes. Such persons are of sound judgment in other 
 respects, but reason erroneously on whatever concerns their own 
 health. In these cases, apart from correcting the digestive derange- 
 ments, it is often necessary to act upon the mind by keeping it occu- 
 pied with matters which will divert the thoughts of the patient from 
 himself. This is often readily accomplished on the golf links in 
 persons who require exercise. 
 
 CARE OF THE EYES. 
 
 It is well known that exposure of the eyes to the direct rays of the 
 sun may cause inflammation of the retina and even total blindness, 
 and similar effects may be produced by the reflected rays of the sun 
 from mirrors, sheets of water, white walls, and snow (snow blind- 
 ness) . On the other hand, defective lighting, as pointed out on page 
 88, also produces mischief, and must, therefore, be avoided in the 
 
 • Treatise on Hygiene, Wm. A. Hammond, 1863, p. 122. 
 
EEPORTS OF THE PKESIDENt's HOMES COMMISSION. 121 
 
 home as well as in the shop. Sudden transposition from light to 
 dark or dark to light is also, injurious and may cause serious diseases 
 of the eyes. Whenever there is any evidence of redness, inflamma- 
 tion, pain, watering, or " mattering " of the eyes, a physician should 
 be consulted. While free bathing of the eyes with cold water may 
 exert a preventive and tonic effect, the value of good eyesight is too 
 great to trust to domestic remedies, or even to the services of an 
 optician. Whenever there is any diifficulty in reading, accompanied 
 by pain or headache, an occulist should be chosen. When we recall 
 the number of accidents which befall the eyes in many occupations, 
 the importance of protective goggles must be apparent. 
 
 EAR AND NOSE. 
 
 These organs should be kept clean. There is danger from lodg- 
 ment of foreign bodies, particularly in children, which may impair 
 the hearing for life, especially when injudicious attempts at removal 
 have been made. In such instances it is always best to consult a 
 competent physician. The chief function of the nose evidently is to 
 arrest more or less of the dust and germs upon its mucous surfaces, 
 and in cold weather to warm the inspired air. Hence, the importance 
 of cleanliness and of breathing through the nose instead of the mouth. 
 In order to do this without discomfort, it is necessary that there be 
 no obstruction in the nasal passages, and persons suffering from 
 catarrh or other symptoms of difficult breathing will do well to 
 undergo treatment. In this connection attention should be called to 
 the advantages of so-called " deep breathing " in the open air or near 
 an open window. This is best accomplished by taking 10 or 12 deep 
 inspirations morning and evening, so as to inflate the lungs to their 
 fullest expansive capacity. This practice is believed to secure a thor- 
 ough ventilation of all the air vesicles and to increase the power of 
 resistance to the invasion of the tubercle bacillus. 
 
 Chapter II. 
 ALIMENTATION AND FOODS. 
 
 The fact that proper nutrition of the body is important for the 
 enjoyment of health has long since been recognized, and we all agree 
 that the character of food not only influences the growth and develop- 
 ment of the child, but also the health, power of endurance and resist- 
 ance in the adult, and often plays a most important, if not decisive, 
 role in the treatment of disease. 
 
 The human organism is made up of about 60 per cent of water, 19 
 per cent of protein compounds, 15 per cent of fats, and 6 per cent 
 of mineral salts, all of which are sooner or later consumed, involving 
 certain expenditures which must be covered if health and life are to 
 be preserved. 
 
 The process by which the repair of waste is supplied is called 
 alimentation or nutrition, and the entire process involved in the waste 
 and repair of tissues is called metabolism. The simple chemical 
 compounds which are appropriated by the system are called alimen- 
 tary principles or nutrients, and the simple or artificial combinations 
 of several nutrients are called nutriment or food. 
 
122 REPOETS OF THE PBESIDENt's HOMES COMMISSION. 
 
 The cause of the constant consumption of the proximate principals 
 of the body must be looked for in the functional activity of the cells. 
 We know that they take up, utilize, disintegrate, and eliminate 
 matter ; this gives rise to the generation of heat and the evolution of 
 force or mechanical power, both of which are the result of latent 
 energy contained in the substances introduced into the system as food. 
 
 The heat and vital force of the heart and other muscles of the body 
 have their source clearly in the process of oxidation of carbon and 
 oxygen, which primarily takes place in the cells; and all nutrients 
 containing carbon and hydrogen contribute to the generation of heat 
 and the evolution of muscular force. 
 
 The chief objects of food are, according to Atwater, to form the 
 material of the body and repair its waste, and to yield heat to keep 
 the body warm and muscular and other power for the work it has 
 to do. The amount of energy contained in different foodstuffs has 
 been measured in the laboratory by the amount of heat evolved during 
 their combustion by means of an apparatus called the calorimeter. 
 The unit commonly used is the calorie, by which we understand the 
 amount of heat required to raise the temperature of a pound of water 
 1® F., or if transformed into mechanical power, such as the muscles 
 use to do their work, a calorie represents force which would be suffi- 
 cient to lift one ton 1.54 feet. Atwater gives the following general 
 estimate for the average amount of heat and energy in one pound of 
 each of the classes of nutrients : 
 
 Calories. 
 
 1 pound of protein 1, 860 
 
 1 pound of fat 4, 220 
 
 1 pound of carbohydrates 1, 860 
 
 Since the supply of foodstuff or income must be regulated by the 
 consumption or outgo, it is essential that the consumption should be 
 determined. Experiments of this kind are made in an apparatus 
 called the " respiration calorimeter," and include not only a quantita- 
 tive analysis of the food, drink, and air consumed by the man and of 
 all the excretory products, which make up the income and outgo of 
 the system, but also a careful estimate of the energy represented by 
 ingested material, as well as the energy liberated from the body in 
 the various excreta, in heat and mechanical energy. 
 
 The balance of income and expenditure is thus made, and the gain 
 or loss of material of the body, with different kinds and amounts of 
 food, and under different conditions of muscular exercise and rest, is 
 determined. By means of these experiments Professor Atwater has 
 been able to verify the law of the conservation of energy as applied 
 to the animal organism, and has shown that every unit of energy 
 which enters the body as potential energy of the food will leave the 
 body in potential energy as excreta, in heat radiated from the body, 
 or in mechanical work done by the muscular system. The material 
 income of the body must balance the material outgo, and the energy 
 income of the body must balance the energy outgo. 
 
 According to the classical experiments of Pettenkoffer and Voit, 
 nearly forty years a^o, the waste products of a healthy adult weigh- 
 ing 154 pounds, during twenty- four hours, at rest amounted to 16.8 
 grams of nitrogen in the urine, 275 grams of carbon, and 2,500 grams 
 of water, while the wast« products of the same individual, performing 
 moderately hard muscular work, amounted to 18.8 grams of nitrogen, 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 123 
 
 328 of carbon, and 2,190 grams of water, and from these experiments 
 the authors named concluded that the following quantities of nutrients 
 are required during twenty-four hours : 
 
 
 Protein. 
 
 Fata. 
 
 Carbohy- 
 drates. 
 
 Man without muscular work 
 
 QratM. 
 118 
 118 
 146 
 
 Oram*. 
 
 45 
 
 56 
 
 100 
 
 Orams. 
 450 
 
 Man with moderate muscular work 
 
 500 
 
 Man with hard muscular work 
 
 500 
 
 
 
 Professor Chittenden's experiments, conducted about three years 
 ago, indicate that the nitrogen equilibrium is preserved on a daily 
 intake of 8.5 to 9.5 grams of nitrogen, or about 55 grams of nitroge- 
 nous food, so that the protein ration of Voit may be cut in two, pro- 
 vided the fats and carbohydrates are introduced in sufficient quantities 
 to bring the full value up to 2,500 or 2,600 calories. Other authorities, 
 however, believe that it would be unwise to reduce the protein ration 
 below 100 grains or 3.5 ounces a day. 
 
 One of the difficulties in the way of setting up exact standards is, as 
 pointed out by Professor Atwater, that " different individuals of the 
 same class differ widely in their demands for food and in the use 
 they make of it. Two men of like age, size, build, and occupation may 
 live and work side by side. One will eat more and the other less, 
 while both do the same amount of work, or both may eat the same food 
 and do the same work, and one will be fat and the other lean, or both 
 may have the same diet and yet one w ill be strong and vigorous and 
 able to do a great deal of work, while the other will be weak and able 
 to accomplish but little. Just why individuals differ in their ways of 
 utilizing their food and how to measure the differences and make diet- 
 ary rules to fit them exactly, are problems which the physiological 
 chemist has not yet solved." 
 
 Theie are also persons who, because of some peculiarity of the diges- 
 tive system, can not use foods which for people in general are most 
 wholesome and nutritious. Some persons can not eat eggs, others 
 suffer if they take milk, others have to avoid certain kinds of meat or 
 fruit and all these idiosyncracies indicate that the nutrition of man 
 is not a mere matter of grams of protein, fats, and carbohydrates. In 
 fact we live not upon what we eat, but upon what we digest and 
 assimilate. 
 
 The whole subject of dietary standards is still in its infancy and the 
 best we can do is to make estimates which apply to averages rather 
 than individual cases. In a general way we may conclude that the 
 needs of the economy are influenced (1) by the height and weight of 
 the individual, amounting to a difference of 40 to 50 calories for each 
 kilogram in body weight; (2) by the temperament — nervous and 
 excitable persons require more food than those of a phlegmatic tem- 
 perament; (3) by muscular activity, which involves not only an in- 
 creased expenditure of carbon, but also increased consumption of pro- 
 tein ; (4) age, in so far as during active growth there is also a more 
 active metabolism and children consume more for each kilogram of 
 their weight than adults ; on the other hand, with advancing years tis- 
 sue metamorphosis becomes less active; (5) sex influences me amount 
 
124 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 of tissue consumption only in so far as there is a difference in weight 
 and muscular activity ; an exception should be noted in pregnant and 
 nursing women, who doubtless should receive a more liberal supply 
 of proteids; (6) by temperature and climate. The injfiuence of low 
 temperatures results in increased oxidation of carbon; hence an 
 instinctive craving for more fatty food and the carbohydrates, sugar 
 and starches, during the winter months and in cold climates. In 
 the summer months and in warm climates there is a repugnance for 
 fat and a craving for refreshing food and drinks, and hence the mini- 
 mum amount of fat, about 40 grams, and between 300 to 400 grams of 
 carbohydrates with a normal protein ration will meet the require- 
 ments. 
 
 Foodstuffs are classified according to their proximate composition 
 as follows: 
 
 First. Organic, nitrogeneous, as proteids or albuminoids; non- 
 nitrogenous (a) fats, (h) carbohydrates, (c) vegetable acids. 
 
 Second. Inorganic — mineral salts and water. 
 
 Third. Food accessories, as tea, coffee, and condiments. 
 
 The first two classes of foodstuff are essential to life ; the third class 
 is important as favoring palatability and digestibility. 
 
 The true nutrients are protein, fats, and carbohydrates. 
 
 The term " protein " includes most of the nitrogeneous food com- 
 pounds, such as albuminoids, gelatinoids, and extractives. 
 
 1. The albuminoids include all substances allied in their chemical 
 composition to egg albumin, and have an average composition of N 
 16 per cent, C 53 per cent, H 7 per cent, O 23 per cent, S 1 per cent. 
 They are found in eggs, lean part of meat, milk, curds, and the gluten 
 of wheat, the leguminous plants, etc. The principles of this group 
 during digestion, with the exception of nuclein, are converted into 
 soluble peptones or alkaline albuminates and readily absorbed as 
 such ; they are the chief tissue formers of the muscles and tendons of 
 the body, but apart from this purely plastic function they also play 
 a role in oxidation and therefore in the generation of heat and energy. 
 At all events they can take the place of fats and carbohydrates if the 
 body has not enough of one or the other for fuel, but neither of the 
 latter can take the place of albuminoids in building and repairing 
 tissue. 
 
 2. The gelatinoids resemble the albuminoid group in their chemical 
 composition; they are derived from ossein and chondrin (connective 
 tissue) and are changed to gelatin on heating with water and during 
 digestion into gelatin-peptones. They are not tissue formers, but 
 serve as fuel, and thus protect the protein fats and carbohydrates 
 from consumption. Indeed 100 grams of gelatin can take the place 
 of 36 grams of albumin and 25 grams of fat, but unfortunately large 
 quantities are liable to cause nausea and diarrhea, probably because 
 the undigested particles undergo rapid decomposition. 
 
 3. The extractives, so called because they are extracted from flesh 
 by water, are known in the laboratory as creatin, creatinin, carnin, 
 etc., and are the chief constituents of beef tea and meat extracts. 
 Neither the extractives or amids found in vegetables like asparagus, 
 betain, etc., can replace or exert a sparing effect on the consumption oi 
 albumin ; they are therefore alimentary aids and not true foods. 
 
 Indeed Kemmerich, over twenty years ago, pointed out that they 
 are not free from danger on account of the large percentage of potas- 
 
EEPORTS OF THE PBBSIDENt's HOMES COMMISSION. 125 
 
 slum salt; at all events, it has been shown that animals fed exclu- 
 sively on meat extracts die more quickly from starvation than do 
 those deprived entirely of food, and Fothergill, one of the most dis- 
 tinguished English food experts, exj^ressed the opinion " that more 
 lives have been lost by a mistaken belief in the food value of beef tea 
 than by all the Napoleonic wars." Beef tea acts as a regulator and 
 stimulant of digestion and assimilation and, like the meat broths, is 
 useful in the dietary of sickness, provided we combine it with eggs, 
 farinaceous food, and small quantities of gelatin. The meat peptones 
 and fluid meat, containing, as they do, considerable proportions of 
 true nutriments, are much to be preferred, but their nutritive value in 
 the treatment of disease must not be overestimated. 
 
 4. The hydrocarbons of fats, whether derived from the animal or 
 vegetable kingdom, are emulsified and saponified by the pancreatic 
 juice and bile and finally reach the tissues, where they become an 
 integral part of the cells. Apart from aiding in the reconstruction of 
 fatty tissues, they undergo oxidation, and thus supply heat and energy. 
 Since the cells without exception contain more or less fat, it being, in 
 conjunction with albumin, the principal constituent of nerve tissue, 
 a store of adipose tissue, especially during febrile conditions, hard 
 work, or whenever the consumption exceeds the supply, is very desir- 
 able. If the supply of fat exceeds the demand, the excess is eliminated 
 in the feces, while other portions are stored up in the visceral cavities 
 and subcutaneous tissues, where it serves as a nonconductor of heat, 
 gives beauty and form to the body, and protects various important 
 structures from injury, but most important of all, if the supply should 
 be cut off, or the consumption be increased, as during febrile condi- 
 tions and hard work, this reserve fuel can be drawn upon for the 
 production of heat and energy, and thus protect the more important 
 protein compounds from oxidation. 
 
 5. The carbohydrates are nonnitrogenized principles which, in ad- 
 dition to carbon, contain hydrogen and oxygen in the proportion to 
 form water. The formula for starch or dextrose is CgHioOg and that 
 of sucrose or cane sugar C12H22O11. 
 
 The carbohydrates, whatever their source, enter the blood as sugar; 
 normal blood contains about 0.1 per cent and rarely more than 0.2 
 per cent of sugar. The liver prevents a large accumulation by stor- 
 ing it up as glycogen, or liver-starch, which under the influence of a 
 ])eculiar ferment is reconverted into sugar as the needs of the economy 
 demand, and any further excess is removed by the kidneys. The sugar 
 in the blood is carried to the tissues, where it undergoes oxidation, 
 yielding heat and energy. It is generally held that carbohydrates 
 when ingested in liberal amounts may be converted into fat. How 
 this is accomplished is not yet understood, but it may partly be ac- 
 counted for by the fact that the oxidation of sugar saves the fatty 
 and protein tissues from destruction and allows the fat in the diet to 
 form new fatty tissues. 
 
 6. The pectin substances, like pectose and pectin, found in fruit 
 and tubers, form jellies with water, are related to the carbohydrates, 
 and probably serve similar purposes in the economy. 
 
 7. The organic acids, like tartaric, mallic, citric, acetic, oxalic, and 
 lactic acids existing in fresh vegetables and fruits, fresh meats and 
 milk, are transformed in the system into carbonates and as such pre- 
 serve the alkalinity of the blood and other fluids. In the absence of 
 
126 EEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 these acids the blood becomes impoverished and scurvy is liable to 
 develop. An excess is likely to interfere with digestion, especially 
 with the conversion of starch into sugar, not to mention the laxative 
 and diuretic properties. 
 
 8. The fact that 60 per cent of the body is composed of water clearly 
 indicates that a sufficient amount must be introduced to make up the 
 loss sustained by its excretion through the lungs, kidneys, skin, and 
 feces. It is simply necessary to recall the physiological functions of 
 water in the absorption and assimilation of food, the elimination of 
 waste products, and its role as a heat regulator to appreciate that a 
 deficiency is certain to be followed hj injurious effects. 
 
 9. The mineral salts, which furnish about 6 per cent of the body 
 weight, are potassium, calcium, magnesium, sodium, and iron in com- 
 bination with chlorine, phosphoric, sulphuric, and carbonic acid. The 
 phosphates of lime, potash, and magnesia contribute largely to the 
 formation of bone, and are also essential for the growth of the nervous 
 system. Iron is required for the red blood corpuscles and coloring 
 matters, the chlorides are the source of hydrochloric acid in the gas- 
 tric juice and keep the globulins of the blood and other fluids of the 
 body in solution. Potassium for the blood cells and solid tisues and 
 sodium for the intercellular fluids are all essential for the growth and 
 repair of the tissues; of these certain quantities are daily eliminated 
 and must be replaced. Forster has shown that when the supply in 
 animals is suspended, serious digestive derangements, depressions of 
 the nervous system, muscular weakness, trembling, paralysis, stupor, 
 and death ensue. 
 
 Voit's experiments indicate that an insufficient supply of the salts of 
 lime produced rickets in growing animals, and children fed largely 
 upon farinaceous food are proverbially prone to this affection ; incom- 
 plete absorption of these salts produces the same effect, as shown by 
 the frequent development of rickets after prolonged diarrheal 
 affections. 
 
 An insufficient supply of iron or incomplete absorption may give 
 rise to chlorosis and anaemia, and a deficiency of the potassium salts 
 in consequence of an exclusive animal diet is believed to favor the 
 development of scurvy, but as this disease has developed among 
 prisoners who subsisted largely on a vegetable diet, I quite agree with 
 Fluegge that the absence of fresh vegetables, more especially the 
 organic acids contained therein, is the most important factor in the 
 development of scuryy. An excess of chloride of sodium, as during 
 a constant salt meat diet, doubtless predisposes to scurvy, probably 
 because the chloride of sodium exerts a decomposing effect on the 
 potassium combinations of the blood corpuscles. 
 
 The question as to the exact requirements of the inorganic salts in 
 the system has not yet been solved. According to Boussingault an 
 adult requires from 60 to 90 mgrs. of iron daily, and according to 
 Konig, persons upon a mixed diet require from 12 to 20 grams of 
 sodium chloride. 
 
 In reference to accessory foods, such as spices and condiments, 
 extractives of meat, bitter principles contained in vegetables, tonics, 
 and the alkaloidal beverages like coffee, tea, and cocoa, we can not 
 stop to point out their physiological effects, except to say that, since 
 .they act largely through the nervous system, every excess over and 
 above the amount required will produce mischiei; indeed we may 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 127 
 
 safely conclude that, while the use of accessory foods in moderation 
 increases temporarily the elasticity of mind and body and a desire and 
 capacity for work, their abuse is fraught with danger. 
 
 FOOD. 
 
 The two broad divisions of food are animal and vegetable, although 
 the mineral kingdom unites to furnish man with sustenance. Animal 
 food is characterized by a predominance of the proteids and mineral 
 salts, while vegetable food is rich in carbohydrates, which, however, 
 like the vegetable albumin, are inclosed in cells composed of a fibrous 
 frame-work known as cellulose, and therefore more difficult to be 
 acted upon by the digestive fluids. 
 
 An excess of this cellulose usually excites undue peristaltic action 
 and consequently a more rapid transit of the intestinal contents, and 
 thus interferes with the complete utilization of the nutritive material ; 
 a certain amount of cellulose is necessary, however, to promote the 
 action, because if the food was so nutritious as to be entirely absorbed, 
 there would be very little solid to transmit and the action of the bow- 
 els would become irregular and unsatisfactory. Hence the good 
 effect of graham bread, vegetables, and fruit in habitual constipation. 
 
 ANIMAL FOOD. 
 MEAT. 
 
 In a dietetic point of view we mean by meat the muscular substance 
 with its connective tissues, the fat and various juices deposited 
 therein. 
 
 The nutritive value of meat depends upon the large percentage of 
 protein. Dark meats, such as game and wild fowl and beef, contain 
 from 18 to 25 per cent of albumin. 
 
 The relative amount of nutritive matter is shown in the following 
 table based upon analyses by Konig, Voit, and others : 
 
 
 Proteids. 
 
 Gelatin. 
 
 Fat. 
 
 Salts. 
 
 Extract- 
 ives. 
 
 Beef 
 
 Per cent. 
 18.4 
 16.3 
 17.5 
 15.5 
 15.3 
 19.8 
 21.7 
 23.3 
 21.5 
 19.3 
 21.1 
 
 Per cent. 
 1.6 
 4.5 
 
 Per cent. 
 
 0.9 
 
 1.0 
 
 1.5 
 
 6.5 
 
 28.9 
 
 20.8 
 
 2.5 
 
 1.1 
 
 2.5 
 
 16.3 
 
 22.9 
 
 Per cent. 
 1.3 
 1.0 
 1.2 
 1.2 
 .8 
 5.5 
 1.0 
 1.1 
 
 Per cent. 
 1 9 
 
 Veal 
 
 .9 
 
 
 1 4 
 
 Pork fresh lean 
 
 1.5 
 
 1 3 
 
 
 
 Ham smoked lean 
 
 
 
 
 
 
 Game ( rabbit) 
 
 
 
 Broiler chicken .. 
 
 
 
 
 
 1.0 
 1.0 
 
 
 Turkey 
 
 
 
 
 
 
 According to the foregoing table, game and fowl are richest in pro- 
 teids, salts and extractives; veal and pork are poorest in proteids; 
 veal richest in gelatin ; ham and pork richest in fat ; horse and veal 
 poorest in fat ; beef richest in extractives ; veal poorest in extractives. 
 
 All of which explains the superior nutritive value of game and wild 
 fowl, in the so-called dark meats and also the superior flavor of beef 
 and fowl over veal and pork, and also explains the rich amount of 
 gelatin in veal broth and gravies. 
 
128 BEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 The particular part from which the meat is derived also influences 
 the percentage of proteids, as shown by Konig ; 
 
 Per cent of proteids in beef from — 
 
 A shoulder piece 14. 50 
 
 The loins 18. 80 
 
 The neck 19. 50 
 
 The hind quarter 20.81 
 
 The meat of young animals, on account of the excess of water, con- 
 tains less nutriment, but because of the more delicate connective tissue 
 is more readily digested. 
 
 FISH. 
 
 The meat of fish contains about the same foodstuffs, only in smaller 
 proportions, due to the excess of water. Most of the fish meat con- 
 tains from 15 to 20 per cent of proteids, but oysters, crabs, and 
 lobsters contain only from 5 to 10 per cent. There is little or no 
 difference in the digestibility of white and dark meats, as from 95 to 
 96 per cent are utilized. Fish meat, contrary to popular opinion, 
 contains less phosphates than that of other animals. 
 
 Carbo- 
 hydrates. 
 
 Oysters 
 
 Canned oysters.. 
 
 Clams 
 
 Mussels 
 
 Lobsters 
 
 Crab 
 
 Shrlmj)s, canned 
 
 Terrapin 
 
 Green turtle 
 
 Proteids. 
 
 Fats. 
 
 Salts. 
 
 Per cent. 
 
 Per cent. 
 
 Per cent. 
 
 9.78 
 
 2.05 
 
 1.98 
 
 7.41 
 
 2.07 
 
 2.15 
 
 14.55 
 
 1.79 
 
 2.76 
 
 12. 51 
 
 1.67 
 
 1.73 
 
 14.49 
 
 1.84 
 
 1.71 
 
 16.64 
 
 1.96 
 
 3.13 
 
 25.38 
 
 1.00 
 
 2.58 
 
 21.23 
 
 3.47 
 
 1.02 
 
 19.84 
 
 .53 
 
 1.20 
 
 Per cent. 
 5.89 
 3.95 
 2.94 
 5.42 
 
 According to J. Konig and the United States Commissioner of 
 Fisheries the composition of fish meat is as follows : 
 
 » 
 
 Haddock 
 
 Pike 
 
 Carp 
 
 Herring 
 
 Eel 
 
 Salmon 
 
 Shad 
 
 Spanish mackerel 
 
 Mackerel 
 
 Lake trout 
 
 Brook trout 
 
 Halibut 
 
 Black bass 
 
 Red bass 
 
 White perch 
 
 Yellow perch 
 
 Red snapper 
 
 Sturgeon 
 
 Smelt 
 
 Codfish meal 
 
 Smoked haddock 
 
 Smoked herring 
 
 Proteids. 
 
 Fats. 
 
 Percent. 
 
 Per cent. 
 
 16.71 
 
 0.20 
 
 18.34 
 
 .51 
 
 21.86 
 
 1.09 
 
 10.11 
 
 7.11 
 
 12.83 
 
 28.37 
 
 15.01 
 
 6.42 
 
 18.65 
 
 9.48 
 
 20.97 
 
 9.43 
 
 18.77 
 
 8.21 
 
 18.22 
 
 n.88 
 
 18.97 
 
 2.10 
 
 18.35 
 
 6.18 
 
 21.05 
 
 2.44 
 
 16.68 
 
 .53 
 
 19.03 
 
 4.07 
 
 18.49 
 
 .70 
 
 19.20 
 
 1.03 
 
 17.96 
 
 L90 
 
 17.36 
 
 1.80 
 
 74.46 
 
 LOO 
 
 33.68 
 
 .17 
 
 36.44 
 
 15.82 
 
 Salts. 
 
 Per cent. 
 L44 
 
 .93 
 1.33 
 2.07 
 
 .81 
 1.36 
 L36 
 1.60 
 L40 
 1.26 
 L21 
 1.06 
 1.24 
 1.23 
 1.19 
 1.29 
 L31 
 1.43 
 1.68 
 6.41 
 1.63 
 2.06 
 
 The consumption of raw meats should be discouraged on account 
 of the danger of transmission of animal parasites which are only 
 destroyed by a temperature of 1G0° F. 
 
 In roast iig meat, certain chemical changes take place which not 
 only improve the taste but its digestibility, largely because the ccn- 
 
EEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 129 
 
 nective tissue is converted into gelatin and the liberated muscular 
 fibers are more readily acted upon by the digestive fluids. 
 
 Broiling produces very much the same changes, except perhaps a 
 more complete retention of the juices, extractives, and salts. Fried 
 meats are usually objectionable, unless they have been dropped into 
 very hot fat, in which case coagulation of the albumin not only pre- 
 vents excessive absorption of fat, but also the exudations of flavor 
 and juices. 
 
 BOILED MEATS AND BEOTHS. 
 
 Boiling water coagulates the albumin, transforms the connective 
 tissue into gelatin, and dissipates the coloring matter, but as the 
 water penetrates, it abstracts some of the newly formed gelatin, ex- 
 tractives, and salts ; also some of the fats and proteids. The loss thus 
 sustained depends upon whether the meat has been placed in boiling 
 or cold water. If we wish to retain the juices and flavor in the meat, 
 it should be plunged in boiling water, as the rapid coagulation of 
 the albumin will prevent excessive exudation. If, on the other hand, 
 we desire a rich broth, the meat should be placed in cold water and 
 kept at a temperature below 160°. The loss sustained in extractives, 
 salts, and water renders boiled meat less palatable and also some- 
 what tougher unless cooked at a temperature below 180°, and it is 
 therefore not so easily digested; the nutritive value of boiled meat, 
 however, is not impaired and the objections referred to can be over- 
 come by chopping and the addition of spices. 
 
 In stewing, the meat should be cut into small pieces, placed in cold 
 water, and brought up gradually to a temperature of 180 degrees, and 
 kept there for several hours. 
 
 Gravies, on account of the large amount of fat and gelatin present, 
 are liable to cause indigestion in feeble stomachs and are not suitable 
 for the sick and invalids. 
 
 The meat peptones and meat juices, because of the presence of pro- 
 teids, are doubtless of value in the treatment of disease. 
 
 SPECIAL CONCENTRATED MEAT PBODUCTS. 
 
 Meat powder or meat flour is made of lean beef, cut into strips and 
 dipped into very hot fat. After draining, it is dried slowly in an 
 oven and ground into very fine powder, 1 pound representing about 
 4 pounds of flesh. The nutritive value of these products is very high. 
 Carne pura contains 68 per cent of protein, and codfish meal Y9 per 
 cent. Their digestibility is also very good, they keep well, and the 
 price is moderate, but on account of their taste and odor they have 
 not come into general use. Meat powder has been mixed with meal 
 from the legumes, wheat flour, and other farinaceous food in the form 
 of biscuits or compressed cakes for use as an army emergency ration. 
 The nutritive value of ham, bacon, sausage, and other meat products 
 is also very high. 
 
 Meat may be preserved by cold storage, by heat as in the canning 
 process, by drying as in the case of jerked beef or venison, by smoking 
 and pickling either in brine or vinegar. Chemical preservatives 
 other than salt or vinegar should not be tolerated, as we possess in 
 cold storage and heat far more efficient and certainly less harmful 
 preservatives. 
 
 S. Doc. 644, 60-2 10 
 
130 EEPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 MEAT INSPECTION. 
 
 In judging the quality and wholesomeness of meat, the color, con- 
 sistency, and odor are valuable points to be observed. Good beef has 
 a bright red color and marbled appearance due to the presence of 
 fat; it is firm yet elastic to the touch, moderately moist, and has a 
 characteristic beefy odor. Bull beef is usually of a darker color; 
 mutton has more of a brownish red color; meat of immature animals 
 is pale, watery, and friable. Meat which has gone beyond the first 
 stage of decomposition is soft and liable to pit or crackle upon pres- 
 sure, and emits an offensive tainted odor, especially when hot water 
 is poured upon it. In pushing a knife to the hilt, the resistance in 
 good meat is uniform, while in putrefying meat some parts are softer 
 than others and the tainted odor clings to the knife. In temperate 
 climates the marrow remains solid for twenty-four hours and is of a 
 light pink color; when it is soft, looks brownish, and contains black 
 points the animal has either been sick or putrefactive changes have 
 begun. 
 
 In connection with meat products the possibility of ptomaine 
 poisoning, with symptoms of nauseau, vomiting, diarrhea, cramps, 
 and depression should not be overlooked. Similar symptoms have 
 been observed after the eating of oysters, mussels, crabs, lobsters, and 
 milk. Oysters raised in sewage-polluted beds have been known to 
 transmit the germs of typhoid fever. Diseases like anthrax, bovine 
 tuberculosis, hydrophobia, foot-and-mouth disease, infectious en- 
 teritis, actinomyces, trichina, and cystererci are transmissible to man 
 through the meat supply. For all these reasons hygiene demands 
 not only a proper control of the meat market, but also proper cook- 
 ing, since nothing short of a temperature of 160° wdll destroy these 
 organisms. 
 
 MILK. 
 
 Milk is an ideal food. The average composition of cow's milk is 
 protein, 4.5 ; fat, 3 ; sugar, 4.5 ; salts, 0.75 ; water, 8T.25. 
 
 In keeping milk at ordinary temperature it rapidly undergoes 
 changes which are brought about by the agency of micro-organisms. 
 One of the greatest dangers in milk is caused by impurities seen in 
 the so-called milk sediments, which consist largely of excrementi- 
 tious matter clinging to the teats and udder of the animal, and which, 
 owing to the presence of fecal bacteria, bring about rapid souring 
 of the milk, with the production of toxins such as tyrotoxicon, and 
 these in turn give rise to cholera infantum and other gastro-enteric 
 diseases. 
 
 The reaction of milk should be neutral or amphoteric, the amount 
 of cream should not be less than 10 per cent per volume, and the 
 amount of total solids not less than 12 per cent, of which at least 3 
 per cent should be butter fat. Milk is not quite as digestible as meat; 
 nevertheless, from 89 to 92 per cent is utilized. Boiled milk is not as 
 digestible as raw or pasteurized milk. (See also milk as a cause of 
 disease, p. 193. 
 
 Skimmed milk is the residue after the cream has been removed. 
 As it contains the other solids and is quite cheap, it should become a 
 more popular article of food. The same may be said of cott^ige cheese. 
 
 There are a number of brands of condensed milk in the market, all 
 made by the evaporation of the water of the milk by moderate heat or 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 131 
 
 in vacuum pans with or without the addition of sugar. In the plain 
 variety the milk is condensed to about one-third or one-fourth of its 
 volume. As at present prepared, condensed milk is unsuitable for 
 infant feeding, because it contains an excess of the proteids and sugar 
 and is deficient in fats. These objections can be removed by modify- 
 ing the milk previous to condensation, so that the composition is as 
 nearly as possible that of human milk. It then can be condensed to 
 about one-third of its original volume and the proportions restored 
 by proper dilution just before using it for infant feeding. 
 
 Whey is the serum or watery part of the milk which remains after 
 the curds have been pressed out from the milk to make cheese. It is 
 used in certain diseases and also as a food in very difficult cases of 
 indigestion in infant feeding. 
 
 Milk wines, like koumis and kefyr, are made from mares' or cows' 
 milk, respectively, and are the products of a peculiar fermentation, 
 combining alcoholic with lactic acid fermentations. These beverages, 
 in addition to the normal constituents of milk, contain alcohol, car- 
 bonic acid, and lactic acid, and are of value in the feeding of invalids. 
 
 Buttermilk contains all of the constituents of milk except that the 
 amount of fat and sugar is less. The presence of lactic acid imparts 
 a pleasant taste, and as it contains most of the desirable nutrients and 
 is, moreover, quite cheap, its use should be encouraged. 
 
 CHEESE. 
 
 Cheese varies in richness according to the amount of cream used in 
 its manufacture. Cheeses contain from 26 to 40 per cent of fat and 17 
 to 29 per cent of protein, and possess, therefore, remarkable nutritive 
 qualities. If taken in reasonable quantities, 96 per cent of the protein 
 and 97 per cent of the fat is digested. Cheese should never be taken in 
 the form of toasted cheese. The richer cheeses, unless eaten quite 
 sparingly, are very apt to produce dyspepsia. 
 
 BUTTEE AND BUTTEB SUBSTITUTES. 
 
 Butter is formed by churning the cream of milk. The amount of 
 butter in coavs' milk is about 3.75 or 4 per cent (i. e., about 4 pounds 
 to the 100 pounds of milk). Butter contains about 84 per cent of fat, 
 of which nearly 97 per cent is digested if taken in moderate quanti- 
 ties. Eancid butter is very liable to cause indigestion. 
 
 Process or renovated butter is the product of rancid or tainted but- 
 ter which has been purified by melting and washing, and, since it is 
 sold far below the market value of butter and possesses the same nutri- 
 tive properties as fresh butter, its use should not be scorned. 
 
 Oleomargarine is a mixture of oleo oil derived from the richest 
 and choicest fat of the beef, neutral lard, butter, cream, or milk and 
 salt, and in the cheaper grades cotton- seed oil is also used. Oleo and 
 neutral lard are the chief ingredients. These, after melting, are 
 churned with cream or milk, salted, and run through cold water, 
 worked in a butter worker, and placed in suitable packages and 
 labeled, according to the United States laws, " Oleomargarine." If 
 colored to resemble June butter it is subject to a special tax of 10 cents 
 per pound. If sold uncolored the revenue tax is only one-fourth cent 
 per pound. There is practically no difference in the nutritive value 
 
132 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 and the digestibility between butter and oleomargarine or butterine, 
 and, as it is sold for half the cost of butter, the writer, as a teacher 
 of hygiene, has urged upon his students for years to bring the nutri- 
 tive value of this foodstuff to the attention of the public and, in the 
 interest of the wage-earners, to correct, as far as possible, the preju- 
 dice which has been created against its use, provided, of course, it is 
 sold under its true name and at its real value. 
 
 EGGS. 
 
 Egg albumin has the following composition : Albumin 13 per cent, 
 fat 0.2 per cent, salts 0.6 per cent, water 86 per cent ; yolk, vitellin 15.8 
 per cent, lecithin 8.7 per cent, nuclein 1.5 per cent, fat 20.3 per cent, 
 salts 1 per cent, water 51.8 per cent. Eggs, raw or soft boiled or when 
 stirred into hot soups, are readily digested ; about 97 per cent of the 
 proteids and 95 per cent of the fats are utilized. Hard-boiled eggs 
 are not readily digested, and for people with feeble digestion the yolk 
 of the egg stirred in soup should be preferred. The nutritive value 
 of a single egg is equal to 37 grams of fat beef or 165 c. cm. of rich 
 milk. Fish eggs contain, on the whole, the same nutritive principles 
 as chicken eggs, only in different proportions. 
 
 VEGETABLE FOOD. 
 
 CEEEALS. 
 
 Of all the vegetables the cereals stand at the head of the list. While 
 the legumes contain more vegetable albumin, they can not be prepared 
 in so many suitable ways, and are more difficult of digestion. 
 
 H. W. Wiley's analysis, based upon American grains, is as follows : 
 
 Wheat 
 
 Rye 
 
 Barley 
 
 Oata 
 
 Indian corn... 
 Buckwheat . . . 
 Rice, polished 
 
 Mois- 
 ture. 
 
 Per cent. 
 10.60 
 10.50 
 10. 85 
 10.00 
 10.75 
 12.00 
 12.40 
 
 Pro- 
 teids. 
 
 Per cent. 
 12.25 
 12.26 
 11.00 
 12.00 
 10.00 
 10.75 
 7.50 
 
 Fat and 
 
 ether 
 extracts. 
 
 Per cent. 
 1.75 
 1.50 
 2.25 
 4.50 
 4.25 
 2.00 
 .40 
 
 Starch. 
 
 Per cent. 
 71.25 
 71.75 
 69.55 
 58.00 
 71.75 
 62. 75 
 78.80 
 
 Cellu- 
 lose. 
 
 Per cent. 
 2.40 
 2.10 
 3.85 
 12.00 
 1.75 
 10.75 
 .40 
 
 Salts. 
 
 Per cent. 
 1.75 
 1.90 
 2.50 
 3.50 
 1.50 
 1.75 
 .50 
 
 The following table (ITffelmann's) shows the average composition 
 of different flours and cereals: 
 
 
 Pro- 
 tein. 
 
 Cnrbo- | Cellu- 
 hydratcs. lose. 
 
 Fine wheat flour 
 
 Per cent. 
 11.00 
 10.20 
 10.43 
 10.89 
 11. 25 
 14.29 
 10.00 
 10.71 
 7.80 
 
 Per cent. 
 74.90 
 7.'i.l0 
 75.95 
 71.85 
 70.64 
 65.73 
 71.00 
 70.12 
 79.40 
 
 Per cent. 
 
 Pine rye flour 
 
 
 Fine cracked wheat 
 
 22 
 
 Fine cracked barlev 
 
 47 
 
 Pealed barley 
 
 54 
 
 Oatmeal 
 
 2 24 
 
 Commeal 
 
 2 50 
 
 Buckwheat meul _ 
 
 1 04 
 
 Rice 
 
 
 
 
EEPORTS OF THE PKESIDENT S HOMES COMMISSION. 
 
 133 
 
 The cereals are eaten only after a series of careful manipulations 
 producing different grades of flour, varieties of breakfast cereals, etc. 
 In the finest grades of flour nearly all the outer membranes of the 
 wheat grain (bran) is separated; while this removes much indigesti- 
 ble matter it also removes some of the proteids and fats. On the other 
 hand the nutritive material in bran is in a form quite difficult of 
 digestion, and the experiments conducted by Professor Snyder in 1901 
 indicated that the available proteids in graham bread are not utilized 
 to the same extent as in high-grade white bread. 
 
 Wlieat and rye flour, on account of the gluten present, are especially 
 suited for the preparation of bread; preference should be given to 
 properly baked yeast bread, and next to the patent aerated bread, 
 while the use of baking powders should be discouraged. Apart from 
 the fact that yeast predigests in a degree the starchy matter, baking 
 powders are often subject to shameful adulterations. Bread possesses 
 decided nutritive qualities, the proportion of nitrogenous to non- 
 nitrogenous matter being 1 in 7. Experience has shown that a male 
 adult can not digest over 750 grams, and a female over 600 grams a 
 day. This amount would supply about two-fifths of the protein and 
 two-thirds of the carbohydrates required in twenty-four hours. 
 When taken in proper quantities 95 to 96 per cent of a light, spongy 
 bread are digested. Toasted bread contains less water and hence more 
 nutriment pound for pound. Crackers can not take the place of 
 bread. Gluten crackers are suitable for diabetic subjects, because they 
 contain from 55 to 75 per cent of protein and only from 10 to 30 per 
 cent of starch. 
 
 The nutritive value of vermicelli, macaroni, and the various grits 
 used in soups and in the preparation of mushes may be materially 
 enhanced by the addition of milk and cream. 
 
 Legumes are a most valuable class of foodstuff, on account of the 
 great amount of vegetable albumin present, and have very aptly been 
 called the poor man's meat.- The difference in nutritive value be- 
 tween the immature peas and beans, which are used as green vegeta- 
 bles, and the matured seeds is shown by the analysis of Konig, 
 Atwater, and Bryant : 
 
 
 Pro- 
 teids. 
 
 Fat. 
 
 Starch 
 
 and 
 dextrin. 
 
 Carbohy- 
 drates. 
 
 Cellu- 
 lose. 
 
 Salts. 
 
 Soja beans 
 
 Per cent. 
 33.41 
 24. 27 
 23.21 
 22.85 
 26.70 
 7.00 
 3.60 
 
 2.30 
 1.10 
 
 Per cent. 
 17.19 
 1.61 
 2.14 
 1.79 
 1.89 
 • .50 
 .20 
 
 .30 
 .10 
 
 Per cent. 
 29.99 
 49.01 
 53.67 
 52.46 
 53.46 
 
 Per cent. 
 
 Per cent. 
 4.71 
 7.09 
 3.69 
 5.43 
 3.57 
 
 Per cent. 
 5.19 
 3.26 
 3.56 
 2.58 
 3.04 
 1 00 
 
 
 
 Kidney beans 
 
 
 Peas 
 
 
 Lentils 
 
 
 Green peas (Atwater and Brvant) 
 
 16.90 
 9.80 
 
 7.40 
 3.80 
 
 Canned peas (Atwater and Bryant) 
 
 
 
 1 10 
 
 String beans: 
 
 Fresh 
 
 
 
 80 
 
 Canned 
 
 
 
 1 30 
 
 
 
 
 
 The digestibility of these vegetables depends largely upon the 
 rnode of cooking; they should not be cooked in hard water, as the 
 lime salts form insoluble compounds with the legumin, and after 
 cooking the outer membrane should be removed by straining, in 
 which case about 88 per cent of the nutritives are utilized. If they 
 are old they should first be soaked for twenty-four hours in cold 
 water. 
 
134 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 SUCCULENT VEGETABLES. 
 
 Almost all of the fresh vegetables, except potatoes and green peas, 
 contain a great amount of water, cellulose, and salts, and therefore 
 very little nutriment. They are rich in amido-compounds, and their 
 chief value consists in the fact that they supply the mineral salts in 
 a very palatable and assimilable form. 
 
 Potatoes contain proteids 2 per cent, fat 0.10 per cent, starch 20 
 per cent. The juice is a valuable antiscorbutic. If over 600 grams of 
 potatoes are taken daily some of the starch is liable to undergo fer- 
 mentation. In sprouting solanin, a toxic agent, is produced ; this is 
 liable to cause nausea, vomiting, and diarrhea. The nutritive value 
 of potatoes can be improved by cooking them in their jackets and the 
 addition of butter and milk; fried potatoes, except in the form of 
 Saratoga chips, can not be recommended. 
 
 String beans and green peas possess greater nutritive value than 
 potatoes, carrots, beets, oyster plant, parsnips, radishes, turnips, 
 pumpkins, celery, lettuce, squash, asparagus, tomatoes, and cucum- 
 bers on account of the greater amount of vegetable albumin present. 
 With the exception of beans and peas most of the vegetables are 
 deficient in proteids but fairly rich in carbohydrates and are chiefly 
 valuable for their salts and for the variety which they give to our 
 food. 
 
 The different varieties of cabbage and spinach are antiscorbutic 
 agents, while lettuce and endive owe their refreshing taste to the 
 presence of organic acids in the form of citrates, malates, and oxa- 
 lates. The efficacy of onions, wild artichoke, sorrel, scurvy grass, 
 mustard, cress, and lambs' quarters as antiscorbutics should not be 
 forgotten. The nutritive value of edible mushrooms is not greater 
 than that of other fresh vegetables; they are not easily digested and 
 have been greatly overrated as an article of diet. 
 
 FRUITS. 
 
 Fruits, apart from vegetable fiber and juice, contain some soluble 
 proteids, sugar, dextrose, lavulose, pectins, free organic acids (citric, 
 malic, and tartaric), and compounds of these with potassium, sodium, 
 and lime. The quantitative composition of some of the fresh fruits, 
 according to Konig, is as follows : 
 
 Qrapes 
 
 Cherries 
 
 Peaches 
 
 Pears 
 
 Apples 
 
 Apricots 
 
 Plums 
 
 Currants 
 
 Strawberries. . 
 
 Oranges 
 
 Blackberries. . 
 RaspbcrricH... 
 Cranberries... 
 Huckleberries 
 Dried grapes . 
 Dried apples.. 
 Dried pears... 
 " plozoB. . 
 
 Proteids. 
 
 Per cent. 
 
 0.59 
 
 .67 
 
 .65 
 
 .36 
 
 .78 
 
 .61 
 
 .54 
 
 .73 
 
 .51 
 
 .40 
 
 .12 
 
 .78 
 
 2.42 
 
 1.28 
 
 2.07 
 
 2.25 
 
 Free 
 acids. 
 
 Per 
 
 cent. 
 
 0.79 
 
 .91 
 
 .92 
 
 .20 
 
 .82 
 
 1.16 
 
 .85 
 
 2.16 
 
 .93 
 
 2.44 
 
 1.19 
 
 1.42 
 
 2.34 
 
 L66 
 
 3.60 
 
 .84 
 
 2.75 
 
 Sugar 
 
 and 
 
 pectin. 
 
 Per cent. 
 
 26. 32 
 
 12.00 
 
 11.65 
 
 11.90 
 
 13.03 
 
 11.04 
 
 11.07 
 
 7.28 
 
 7.74 
 
 5.54 
 
 4.44 
 
 3.86 
 
 1.53 
 
 5.02 
 
 62.00 
 
 59. 77 
 
 58.80 
 
 62.32 
 
 Cellu- 
 lose. 
 
 Per cent. 
 3.60 
 6.07 
 6.06 
 4.30 
 1.51 
 6.27 
 5.41 
 4.67 
 2.32 
 1.79 
 6.97 
 8.10 
 6.27 
 13.16 
 
 4.99 
 6.86 
 1.62 
 
 Salts. 
 
 Per cent. 
 
 0.53 
 
 .73 
 
 .69 
 
 .31 
 
 49 
 
 82 
 
 .71 
 
 .72 
 
 .81 
 
 .49 
 
 .48 
 
 .48 
 
 .16 
 
 1.02 
 
 1.21 
 
 1.57 
 
 1.67 
 
 1.87 
 
REPORTS OP THE PRESIDENT S HOMES COMMISSION. 
 
 135 
 
 Watermelons contain 92 per cent of water, 0.4 per cent of protein, 
 0.2 per cent fat, 6.7 per cent of carbohydrates and fiber, and 0.3 per 
 cent of salts. There is nothing in their nutritive qualities to justify 
 their popularity. Ripe bananas contain 20 per cent of sugar, 2 per 
 cent of protein, 0.5 per cent of starch, and a little more of fat. Fresh 
 figs are about equal in nutritive value to the banana. The dried fig 
 contains 50 per cent of sugar, 4 per cent of protein, 3 per cent of salts, 
 and about 13 per cent of seeds and indigestible fiber. 
 
 Fruit contains very little protein, but the percentage of carbohy- 
 drates is considerable, and on account of the organic salts and aro- 
 matics they are very refreshing and promote the action of the bowels 
 and kidneys. Hard and very acid fruits are liable to produce diar- 
 rhea. Lemon and lime juice contain free organic acids, about 30 
 grains of citric acid to 1 ounce of the juice, and are excellent anti- 
 scorbutic agents. 
 
 Shell fruits contain a great amount of nutritive material in the 
 form of protein, fat, and carbohydrates, as shown by the following 
 table prepared by Uffelmann : 
 
 
 Protein. 
 
 Fat. 
 
 Carbo- 
 hydrate. 
 
 Cellu- 
 lose. 
 
 Salts. 
 
 Almonds 
 
 Per cent. 
 24.18 
 16.37 
 5.48 
 3.99 
 
 Per cent. 
 
 53.68 
 
 62. 86 
 
 1.37 
 
 1.69 
 
 Per cent. 
 
 7.23 
 
 7.89 
 
 38.34 
 
 67.67 
 
 Per cent. 
 6.56 
 6.17 
 1.61 
 5.10 
 
 Per cent. 
 2 96 
 
 Walnuts 
 
 2 03 
 
 Chestnuts 
 
 1.72 
 
 Bread fruit 
 
 1 69 
 
 
 
 Hazelnuts have about the same composition as walnuts. The meat 
 of cocoanuts contains about TO per cent of fat and the milk contains 
 nearly 7 per cent of sugar. Peanuts contain about 30 per cent of pro- 
 tein and 45 per cent of fat, and hence enjoy a very deserved reputa- 
 tion. Chestnuts are quite indigestible in the raw state, and should 
 be either roasted or cooked. Roasting also aids in the digestion of 
 peanuts and almonds. 
 
 Honey, sugar, and sirups are foodstuffs, as they supply heat and 
 energy in the system and also improve the palatability of the food. 
 The same is true of jams and jellies; the latter delicacies should 
 always be homemade, as it is frequently the case that they are made 
 from glucose, sirups, and gelatin artificially colored and flavored. 
 Indeed it has been shown that the refuse of fruit-canning establish- 
 ments and such tasteless articles as summer squash, boiled white tur- 
 nips, and clover seed are transformed into commercial jams. 
 
 COMBINATION OF FOOD. 
 
 A question of considerable importance is whether the needs of the 
 economy shall be supplied with an animal, vegetable, or mixed diet, 
 and the answer is plainly in favor of a mixed course. In the first 
 place, the structures of our teeth and digestive tract plainly indicate 
 that we occupy an intermediate position between the carnivora and 
 herbivora. In the second place, if we were to supply the needs of 
 protein in the system exclusively from the vegetable kingdom, we 
 would have to introduce an excess of carbohydrates, i. e., about 1,800 
 grams of bread or rice or 6,000 grams of potatoes. On the other 
 hand, in order to supply the requirements of carbon from the animal 
 kingdom, we woul^ have to eat about 7,000 grams of meat containing 
 
136 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 5 per cent of fat or drink 6,000 grams of milk. Such quantities can 
 not be taken for any length of time without creating intense disgust 
 for food and causing serious systemic disorders. For these reasons 
 alone a mixed diet should be preferred. Moreover, Uffelmann has 
 shown that the recruits of a Prussian infantry company, between the 
 ages of 21 and 22 years, made their best gains while subsisting on 
 39 grams of animal and 71 grams of vegetable proteids, and con- 
 cludes that this proportion is, physiologically speaking, the proper 
 one. Indeed an exclusive animal diet is liable to produce gout and 
 diseases of the arteries, kidneys, and liver, and health suffers when- 
 ever 75 per cent or more of the proteids are supplied in the form of 
 meat or eggs, probably on account of the crystalline waste products 
 in the blood. 
 
 Food should be combined so as not to tax the digestive organs. 
 Thus, for example, milk is not well borne with acid fruits, and the 
 digestibility of eggs is impaired by large quantities of fluids. The 
 condiments and relishes should not be wanting, and monotony in diet 
 should be avoided. The foundation of a suitable diet will, however, 
 be found in meat, milk, butter or fat, bread, rice, or potatoes. 
 
 The amount of cooked meat should not be less than 160 grams and 
 should not exceed 190 grams a day, or from 180 to 210 grams of fish. 
 If the minimum amounts are taken, the deficiency should be supplied 
 by 250 c. cm. of milk. 
 
 The daily requirements of fat are at least 25 grams of butter, oleo- 
 margarine or lard, or 30 grams of bacon, according to the taste and 
 circumstances of the individual. 
 
 Bread is an indispensable article of diet, and has long been called 
 the staff of life; it furnishes a well-balanced ration of protein and 
 hydrocarbons, but experience has shown that more than 750 grams 
 
 Eer day can not be tolerated, nor can more than 600 grams of potatoes 
 e profitably consumed per day. It is very desirable that legumes 
 and rice should take the place of some of the potatoes. 
 
 From our knowledge of the proximate constituents contained in 
 the various foodstuffs, diet tables can be constructed which will meet 
 the requirements of the body as well as the purse of the consumer. 
 So, for example, a ration of bread, codfish, lard, bacon, potatoes, 
 beans, milk, sugar, and tea may be purchased for 15 to 20 cents which 
 in actual food value is equal to the best hotel fare. 
 
 STOREROOMS AND PANTRIES. 
 
 The different methods employed in food preservation — such as cold 
 storage, drying, salting, pickling, and canning — have been briefly re- 
 ferred to, and it remains to point out what may be done for the preser- 
 vation of food of a perishable nature. When we realize that all fer- 
 mentative and putrefactive processes are initiated by micro-organ- 
 isms, we will appreciate the importance of absolute cleanliness and 
 the creation of such environments as will preclude at least their rapid 
 proliferation. For this purpose the food should be kept in dry, well- 
 ventilated, and cool storerooms or pantries, located preferably in the 
 basement, and away from contaminating influences, such as impure 
 air, dust, and other sources of infection. In summer the use of ice 
 boxes or cold storage is quite essential to inhibit bacteria 1 develop- 
 ment, and food should be purchased in such quantities ns to insure 
 speedy consumption. It is perhaps unnecessary to say that food 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 137 
 
 should never be kept in, or in close proximity to, living and sleeping 
 rooms or soiled linen closets, and yet this is not infrequently the case. 
 In order to prevent infection of the food by means of flies, the store- 
 room should be properly screened, and it is also a good plan to use 
 either filtered or boiled water for washing fruits and vegetables which 
 are eaten raw. Persons suffering or recovering from communicable 
 diseases should not be permitted to handle food for others. Food 
 should never be placed in dirty pans or dishes, and great care should 
 be exercised to prevent metallic contamination. For example, old 
 milk pans may impart zinc, utensils made of tin, lead, or copper may 
 contaminate fruit, lead or tinfoil may contaminate cheese; arsenical 
 pigments have been knowm to contaminate the bread in green-painted 
 bread boxes, or confectionery wrapped in colored papers. 
 
 PREPARATION OF FOOD FOR COOKING, ETC. 
 
 Prior to coolring, all raw materials should be thoroughly cleaned by 
 soaking, rubbing, rinsing, and wiping. This will render the food not 
 only more appetizing, but also more wholesome, by the removal of 
 adherent particles of dirt and micro-organisms. The same may be 
 said of the removal of decayed or indigestible portions — such as the 
 husks of legumes, the peelings of fruits, potatoes, and other vege- 
 tables — and the removal of tendons and fasciae from meat. Chopping, 
 grinding, and pounding render meat and other articles more tender 
 and accessible to the action of the digestive fluids. The addition of 
 condiments improves the taste and digestibility, provided the food is 
 not too highly seasoned. A high temperature secured by boiling, 
 steaming, roasting, or baking not only influences the consistency, 
 taste, flavor, chemical constitution, digestibility, and keeping qualities 
 of food, but also destroys all parasites and micro-organisms which 
 may be present. 
 
 COOKING AND EATING UTENSILS. 
 
 Hygiene demands that all such utensils must be kept scrupulously 
 clean; apart from the hygienic and esthetic aspect, food served in 
 clean and attractive dishes tastes better and stimulates the appetite 
 and digestion. 
 
 We have learned that, long before we knew of the existence of 
 saprophytic germs and ptomaine intoxications, the Hebrews paid 
 special attention to the subject of clean cooking, eating, and drinking 
 utensils. We know from daily observation that unclean methods are 
 a fruitful cause of disease. (Industrial Hygiene, p. 111.) 
 
 The shape of cooking utensils is. of importance in the question of 
 cleanliness ; for this reason a flat bottom, with a quarter-round termi- 
 nation of the sides, should be chosen. Earthenware pots and pans 
 glazed with lead, or iron pots enameled with lead or zinc containing 
 lead, should not be used. Britannia ware occasionally contains lead 
 and should be tested. Utensils made of nickel impart a peculiar bit- 
 ter taste to the food and drink, but are not otherwise objectionable. 
 Copper and brass utensils must be kept polished to prevent the forma- 
 tion of copper salts. Food containing fat, chloride of sodium, and 
 ammonia compounds should not be permitted to cool in copper uten- 
 sils, as the copper oxidizes at the level of the food and becomes solu- 
 ble. Iron utensils impart a peculiar inky taste and grayish appear- 
 
138 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 ance to food, and should therefore be tinned or enameled. For all 
 these reasons porcelain lined or granite ware and the various steam- 
 cooking utensils should be preferred. 
 
 The temperature of food and drink is not a matter of indifference ; 
 this is especially seen in the artificial feeding of infants. Iced drinks 
 hastily swallowed are liable to cause neuralgia of the stomach, dys- 
 pepsia, and even acute gastric catarrh ; cold grapes and fruit are apt 
 to produce colic and diarrhea. The bad effects of cold victuals have 
 been frequently observed in persons obliged to eat cold lunches, and 
 may be regarded as a frequent cause of intemperance. 
 
 Apart from the bad effects of high and low temperature upon the 
 teeth,'* we know that cold injesta also impair the action of pepsin 
 and ptyalin, which are most efficient at about the body temperature. 
 Hot food or drinks, apart from injuring the mucous membranes of 
 the mouth and stomach, also interfere with the action of pepsin and 
 ptyalin, which is completely arrested at a temperature of 140° F. 
 On the whole, we may conclude that the temperature of food and 
 drink should be as nearly as possible that of the body heat, and this 
 should be the rule for infants. A temperature of 45° may be re- 
 garded an extreme low and one of 120° an extreme high temperature 
 for the introduction of food. 
 
 The consistency of food exerts considerable influence upon our di- 
 gestive organs; coarse and tough substances are less susceptible to the 
 action of the digestive fluids, and consequently more difficult of diges- 
 tion ; this is especially true of many fibrous vegetables, of hard-boiled 
 eggs, and heavy, sodden bread. For infants, liquid food is the best 
 form, but adults require a certain stimulus, not to be had in liquid 
 food, and if taken for any length of time this is certain to disagree 
 and create disgust. A semisolid food has also been objected to be- 
 cause of the excess of water, which is believed to lower the tone of the 
 digestive organs. These objections have been urged by physicians on 
 behalf of prisoners, who, on account of insufficient exercise, can not 
 very well get rid of the excess of water. This same objection does not 
 apply to persons actively employed, and for whom a semisolid food 
 has indeed been found by experience the best suited to their wants. 
 
 VOLUME OF FOOD. 
 
 It is not sufficient to supply the required quantity of food, but it 
 should also be introduced in such a volume as to satisfy the feeling of 
 the individual and the capacity of the stomach. 
 
 From the results of experience and observation we may conclude 
 that an adult of average weight and performing ordinary labor, in 
 order to satisfy a feeling of contentment, requires from 1,600 to 2,000 
 grams (4 to 5 pounds of food) daily. Of this amount from 800 to 
 1,000 grams (2 to 2^ pounds) should be taken at dinner. These fig- 
 ures are simply suggestive, and as individual habits play an impor- 
 tant role it will be well to guard against a sudden increase or diminu- 
 tion in the volume of food. 
 
 MEAL HOURS. 
 
 The daily allowance of food should be taken in divided meals. On 
 account of the different habits and occupations it is difficult to formu- 
 late a rule for all classes. In a general way we may say that a 
 
 • Kober's Industrial Hy^ene, p. 119. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 139 
 
 healthy adult should eat at least three times and not oftener than five 
 times a day. The most rational dinner hour for a man who begins his 
 labors at 6 or 7 o'clock in the morning is between 12 and 1 o'clock, for 
 he will then be in need of food, and if he defers his principal meal till 
 evening he will be so tired that he can neither enjoy nor fully digest 
 it. Such persons should eat a good breakfast, a full dinner about 
 noon, and a supper between 5 and 6 o'clock. If their appetite for an 
 early breakfast is poor, they should eat a light lunch about 9 o'clock 
 a. m. and a similar lunch between 8 and 9 p. m. For persons not 
 engaged in active muscular work it is desirable that they should eat a 
 light breakfast, a hot lunch at noon, dinner at 5 o'clock, and some 
 light lunch between 8 and 9 p. m. 
 
 Unfortunately, we possess as yet no reliable data, as regards the re- 
 quirements of food for men who, while leading a sedentary life, per- 
 form a great amount of brain woi'k. Some authorities claim that 
 mental, like physical, labor increases the amount of carbon consump- 
 tion, but not of nitrogen. Others insist that since the brain and 
 nerve tissues contain the elements of nitrogen and phosphorus which 
 occur in the protein compounds, they should be especially concerned 
 in building up brain and nerves and keeping them in repair. The 
 general impression, however, is that people whose work is mental 
 rather than physical eat too much, especially fat and carbohydrates, 
 and that the ordinary subsistence diet composed of 100 grams of 
 protein, 56 grams of fat, and 450 grams of carbohydrates is best 
 suited for their wants. The food for all persons of leisure should 
 be selected with a view of preventing overtaxing the digestive tract, 
 and the production of constipation with its attending evils, such as 
 pelvic congestion, enlargement of the liver, hemorrhoids, and chronic 
 dyspepsia. The legumes, coarse vegetables, and clarets should be 
 avoided, but the use of light dry wines, fruits, and coffee instead of 
 tea may be encouraged. 
 
 The importance of a good set of teeth for complete mastication 
 and avoidance of bolting the food, in order to secure thorough in- 
 salivation, has already been pointed out; nor should we underrate 
 the influence of our frame of mind upon this important physiological 
 function. Every meal should be a feast; the food should be tempt- 
 ingly served and monotony avoided; relishes and flavors should not 
 be wanting. Pawlow, in 1902, has shown that the primary secretion 
 of true gastric juice is the result of a reflex starting in the mouth 
 and that the relish of the food originates the reflex. In other words, 
 he has experimentally demonstrated why certain tempting dishes, 
 however inexpensive, "make our mouths water," and Hornborg, in 
 1904, has shown that distasteful food fails to cause gastric secretion. 
 
 GOOD FOOD AT REASONABLE COST. 
 
 [By C. F. Lang WORTHY, Ph. D., expert in nutrition. Office of Experiment Stations, United 
 States Department of Agriculture.] 
 
 The human body needs food, air, and water for its growth and 
 maintenance just as do all living things. An engine can not run a 
 machine or draw a train unless it has fuel, which is converted into 
 energy or, as we say, which is used to generate power. In the same 
 way the body must have fuel for the work of all sorts which it per- 
 forms, for instance, for the work expended by a mason in laying 
 stone, or by a carpenter in sawing or driving nails, by a woman who 
 
140 BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 sweeps or does her housework, or by a child who runs or plays, and 
 the body must also have fuel for the work which goes on inside it, 
 such as the beating of the heart, or the movement of the chest when 
 we breathe, a sort of work which is less often thought about and so 
 less familiar to most of us. 
 
 Everyone knows that a large engine requires more fuel than a small 
 one, and that if the work is severe more fuel is needed than is the 
 case when the engine is simply running and little or no work is done. 
 It is the same way with the human body. A large, vigorous man 
 needs more food than a small 'child or a woman who is not more than 
 two-thirds his size, and if a man or woman is engaged in severe work 
 each needs more food than when idle, the need being manifested by 
 " a better appetite." Age also has a decided effect on the kind and 
 amount of food needed, an aged man or woman naturally requiring 
 less food than a man in youth or middle life, since the daily tasks 
 and the amount of work done gradually decrease until in extreme old 
 age most of the time is passed in quiet. Soft foods and simple dishes 
 are more suited to old age, w^hen teeth are few and body vigor is much 
 less than in the prime of life, than are the hearty foods which strong 
 men and women need. The infant needs the mother's milk and later 
 the simple foods — eggs, milk, bread, vegetables, cereals, fruits, etc., 
 which are the best foods for childhood and are most certain to build 
 up a vigorous body. As childhood passes, the mixed diet with which 
 most of us are familiar is commonly followed and, all things con- 
 sidered, is doubtless the most satisfactory for ordinary persons in 
 health. Such a diet is made up of vegetables, fruits, flour and other 
 products from cereal grains, meat, fish, dairy products, eggs, and so on. 
 
 Many persons have an idea that there is some special food, some 
 ideal diet suited to each kind of work and to every condition of life, 
 and that if we possessed full knowledge of the subject it would be 
 desirable to prescribe the daily fare with the same care and accuracy 
 with which a physician prescribes his medicines, but this does not 
 seem to be the case. We do not regulate with such exactness the work 
 we do, the leisure we take, the amount of clothing we wear, and all 
 other conditions of our daily lives, and so it is for our best interest 
 simply to regulate our diet along general lines in accordance with 
 good sense, economy, and the knowledge which has been gained from a 
 scientific study of the subject, taking care that the different foods are 
 so combined that all the needs of the body are provided for, that 
 excessive waste is prevented, and that both undernourishment and 
 excess or overeating are avoided. 
 
 It is essential that foods should be of good quality, clean, and 
 wholesome, and that they should be well cooked. The dishes that are 
 most relished and the methods of preparing them will vary in different 
 countries and in different regions of the same country, for each race, 
 and, indeed, each region, has its favorite foods and its special methods 
 of cookery. However, when the question of food is carefully studied, 
 we find that value of the diet expressed in scientific terms is practi- 
 cally the same the world over when we consider persons of like size 
 and weight performing equal aCmounts of work. This means that 
 just as an engine of a given size would require in China the same 
 amount of fuel for a given work which would.be needed in the United 
 Stales, so the human machine in anj part of the world requires the 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 141 
 
 same amount of fuel, that is, food, for a given task which would be 
 required in any other region. 
 
 With the engine it is immaterial whether the fuel be wood, coal, or 
 anything else which is convenient, provided the quality is satisfactory 
 and the engineer knows how to use it. With the human machine it is 
 something the same. All ordinary foods are useful when rightly 
 combined, and each country will naturally make use of the food 
 supply which may be most easily and economically produced. 
 
 A study of the various materials which are used as food shows that 
 they are composed of comparatively few constituents, namely, water, 
 mineral matter, starch, sugar, and other bodies which are called car- 
 bohydrates, fat, and nitrogenous material commonly called protein, 
 such as the white of egg and the lean of meat. The human body is 
 made up of the same constituents. All of the body tissues contain 
 the nitrogenous material, protein, which is similar to that found in 
 the lean of meat, the white of egg, in gluten of wheat, etc., and so it is 
 understandable that the body must be supplied with food containing 
 nitrogenous material enough for forming this tissue and for replacing 
 any which, like the skin, finger nails, etc., may be worn away by the 
 various conditions of our daily life and also for other purposes for 
 which the body requires protein. In the case of the infant the nitrog- 
 enous material needed for body growth is supplied by the milk — a 
 food comparatively rich in this constituent as well as in the other 
 nutrients. Later in life the nitrogenous material is supplied largely 
 by milk, cheese, eggs, meat, cereals, beans, and similar foods. 
 
 As has been said, men, the world over, of like size and performing 
 like amounts of work apparently eat practically the same amounts of 
 food when considered from the standpoint of its composition, and 
 students of nutrition questions are very generally of the opinion that 
 this fact is more than a coincidence and that these average quantities 
 eaten actually represent average needs. Values deduced from such 
 observations are commonly referred to as dietary standards — that is, 
 guides for food management. 
 
 Expressed in its simplest terms, the dietary standard for a man of 
 medium size, say 150 pounds in weight, in good health and perform- 
 ing a moderate amount of work, calls for 100 grams (or 3.5 ounces) 
 of nitrogenous material (protein), and fat and carbohydrates enough 
 to supply with the protein 3,500 calories of energy in the amount of 
 food provided per day. There is always some waste in cooking and 
 serving food, and if we consider the food purchased the values are 
 115 grams protein (4 ounces) and 3,800 calories. These terms are un- 
 familiar to most persons, and it is unfortunate that some terms which 
 are more familiar can not be found, but it is true here as everywhere 
 else that each subject requires its own terms. We can measure cloth 
 by the yard or milk by the quart, but we must measure work by 
 horsepower or electricity by terms which are even less familiar. For- 
 tunately, in the case of food and diet the matter can be explained in 
 other ways so that the results can be applied in home management 
 without undue difficulty. 
 
 The housekeeper who wishes to estimate the nutritive value of the 
 food she prepares, in order that she may conform with the suggested 
 dietary standards, can readily do so by the use of such a table as the 
 one here given, which shows the protein and energy value of the por- 
 
142 
 
 REPOBTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 tions ordinarily served of the more common food materials, the 
 values given being approximately only, as it would be hardly desir- 
 able to state absolute figures for such a purpose as that for which the 
 table is designed. 
 
 The weights of the food portions included in the table are given in 
 both grams, the unit of weight commonly used in scientific work, and 
 in ounces, the more common household unit. To avoid unusual frac- 
 tions of an ounce the nearest half ounce or quarter ounce or some 
 similar common fraction is used instead of more accurate equivalents. 
 
 In such a table the protein content of the food gives an idea of its 
 relative value for building body tissue. The value of the food as a 
 source of power for carrying on work is expressed by the energy it 
 supplies when utilized in the body as fuel is burned under a boiler, 
 and is measured as calories. A calorie is equal very nearly to 1.54 
 foot-tons — that is, it represents force which would be sufficient to lift 
 1 ton 1.54 feet — and is a more convenient unit for such purposes 
 than horsepower or other similar unit. 
 
 Approximate weight and nutritive value of an average portion of some common 
 
 foods. 
 
 Kind of food. 
 
 1 slice of roast meat 
 
 1 portion of meat stew 
 
 1 Frankfurt sausage 
 
 1 pork chop 
 
 1 slice of boiled bacon 
 
 1 portion of fried bacon 
 
 1 portion of steak 
 
 1 portion of meat soup 
 
 1 portion of pea or bean soup 
 
 1 cup or glass of milk 
 
 1 cup or glass of skim milk or buttermilk 
 
 1 portion of cream .* 
 
 legg 
 
 1 portion of butter 
 
 1 portion of cheese 
 
 1 baked or boiled potato 
 
 1 portion of turnip, beet.carrot, or similar 
 
 vegetable. 
 1 ear of green corn or 1 portion of stewed 
 
 corn. 
 1 tomato or 1 portion of stewed tomato. . 
 1 serving of cooked spinach, cabbage, or 
 
 other green vegetable. 
 1 portion of baked beans or black-eyed 
 
 peas. 
 
 1 slice of bread 
 
 1 portion of com bread 
 
 1 slice of cake 
 
 1 slice of apple or other fruit pie 
 
 1 cup of flour 
 
 1 teaspoonful of sugar 
 
 1 cup of sugar 
 
 1 portion of sirup or molasses 
 
 1 portion of cooked cereal 
 
 1 portion of dry ready to eat cereal 
 
 M i Ik f or cereal 
 
 1 portion of boiled rice 
 
 1 portion of rice pudding, bread pudding, 
 
 or similar cuitard pudding. 
 1 portion of cherry roll or similar pudding 
 
 1 apple or pear 
 
 1 banana 
 
 1 orange 
 
 1 peach or 2 plums 
 
 1 portion of stewed prunes 
 
 1 portion of preserves 
 
 1 portion of fresh berries 
 
 Average weight 
 of portion. 
 
 Grams. Ounces 
 
 325 
 
 60 
 
 190 
 
 100 
 
 50 
 
 100 
 
 190 
 
 190 
 
 225 
 
 225 
 
 65 
 
 50 
 
 10 
 
 20 
 
 140 
 
 130 
 
 75 
 
 95 
 126 
 
 200 
 
 60 
 
 50 
 
 60 
 
 150 
 
 225 
 
 10 
 
 226 
 
 76 
 
 200 
 
 50 
 
 25 
 
 140 
 
 176 
 
 176 
 100 
 100 
 126 
 
 75 
 100 
 
 65 
 100 
 
 3 
 11 
 2 
 7 
 3i 
 2 
 3J 
 7 
 7 
 8 
 8 
 2 
 2 
 
 4J 
 
 Average bulk of por- 
 tion. 
 
 Saucerful . 
 
 Cupful 
 
 do 
 
 One-half pint. 
 do 
 
 One-half gill.. 
 
 Protein, 
 grams. 
 
 1-inch cube. 
 
 Medium size, 3 inches 
 
 long. 
 Saucerful 
 
 .do 
 
 .do. 
 .do. 
 
 .do. 
 
 4 by 4 by 1 Inches. 
 
 3 by 3 by 1 inches. 
 
 4 by 2 by 1 inches. 
 One-sixth of a pie. 
 One-half pint 
 
 One-half pint 
 
 About one-half gill. 
 
 Saucerful 
 
 do 
 
 One-half gill 
 
 Saucerful 
 
 do 
 
 Slice. 
 
 Saucerful . 
 
 do.... 
 
 do.... 
 
 Energy, 
 calories. 
 
 197 
 461 
 170 
 765 
 432 
 252 
 411 
 60 
 70 
 170 
 86 
 130 
 96 
 95 
 94 
 145 
 
 25 
 40 
 
 300 
 
 175 
 142 
 190 
 440 
 960 
 
 40 
 890 
 200 
 170 
 200 
 
 40 
 155 
 
 50 
 70 
 50 
 36 
 116 
 160 
 35 
 
EEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 143 
 
 The table may be conveniently used by supposing that the food 
 eaten by one member of the family will represent in character and 
 amount the food for the entire family. To estimate by means of 
 the table the food value of the diet, the portions of each article used 
 at each meal should be set down in order, together Avith the protein 
 and energy which each supplies, and the total sum of the protein and 
 of the energy will represent the amount eaten in the whole day. 
 
 Suppose, for instance, that breakfast for the man of the family, a 
 mechanic, whose work calls for a medium expenditure of physical 
 strength, consists of 2 slices of bread, 1 portion of butter, a potato, 
 2 cups of coffee, and 2 eggs. Each slice of bread, as the table shows, 
 supplies 4 grams protein and 175 calories. Two slices would there- 
 fore supply 8 grams protein and 350 calories. A portion of butter 
 supplies 95 calories of energy. Butter, as will be noted, contains no 
 protein. One potato would supply 4 grams of protein and 145 
 calories; 2 eggs 14 grams protein and 192 calories. Tea and coffee 
 in themselves supply so little nutritive material that they may be 
 neglected. The sugar and cream, however, which would be used 
 should be taken into account. If in each cup of coffee a teaspoonful 
 of sugar is used, the amount for two cups would of course be two 
 teaspoonfuls, and the energy value 80 calories. As the table shows, 
 sugar contains no protein. When one-quarter gill of cream is used 
 for each cup of coffee one-half gill will be used for two cups, and 
 according to the figures in the table would supply 2 grams protein 
 and 130 calories. If these foods eaten at breakfast and the protein 
 and energy which they supply are set down in order and the quan- 
 tities added together, the total shows the amount eaten for breakfast, 
 as follows: 
 
 Food value of hreakfast. 
 
 Protein. 
 
 Energy. 
 
 2 slices bread 
 
 1 portion butter 
 
 1 potato 
 
 2eggs 
 
 2 cups coffee 
 
 2 teaspoonfuls sugar for coffee 
 One-half gill cream for coffee. 
 
 Total 
 
 Grams. 
 
 Calories. 
 
 8 
 
 350 
 
 
 
 95 
 
 4 
 
 145 
 
 14 
 
 192 
 
 
 
 
 
 
 
 80 
 
 2 
 
 130 
 
 28 
 
 992 
 
 In the day's ration which has been selected we will suppose that the 
 man carries his lunch and that it consists of two sandwiches (made 
 from four slices of bread, one portion of butter, and two portions of 
 cheese) a slice of cake, and a banana, and that for dinner he has one 
 portion of beefsteak, one potato, one serving of turnips, an ear of 
 corn, one slice of bread, one portion of butter, a dish of rice pudding, 
 and one cup of tea withl sugar and milk. Following the same method 
 as was used in computing the value of breakfast, the lunch would 
 supply the following. 
 
144 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Food value of lunch. 
 
 Protein. 
 
 Energy. 
 
 4 slices of bread for sandwiches. . 
 2 portions cheese for sandwiches 
 1 portion butter for sandwiches. . 
 
 1 slice cake 
 
 1 banana 
 
 Total 
 
 Grams. 
 
 Calories. 
 
 16 
 
 700 
 
 10 
 
 198 
 
 
 
 95 
 
 8 
 
 19C 
 
 
 
 70 
 
 29 
 
 1,253 
 
 The protein and energy value of dinner computed in the same way 
 would be as follows: 
 
 Food value of dinner. 
 
 Protein. 
 
 Energy. 
 
 1 portion beefsteak 
 
 1 potato 
 
 1 portion turnips 
 
 1 ear corn 
 
 1 slice bread 
 
 1 portion butter 
 
 1 dish rice pudding 
 
 1 cup tea 
 
 1 teaspoonful sugar for 1 cup tea. . 
 One-quarter gill milk for 1 cup tea 
 
 Total 
 
 Grams. 
 
 Calories. 
 
 26 
 
 411 
 
 4 
 
 145 
 
 1 
 
 80 
 
 2 
 
 82 
 
 4 
 
 176 
 
 
 
 95 
 
 7 
 
 300 
 
 
 
 
 
 
 
 40 
 
 1 
 
 20 
 
 45 
 
 1,348 
 
 The total protein and energy of the food eaten by the man during 
 the day would of course be the sums of the amounts for breakfast, 
 lunch, and dinner, as follows: 
 
 Food value of day's ration. 
 
 
 Protein. 
 
 Energy. 
 
 Breakfast 
 
 Orams. 
 
 28 
 29 
 45 
 
 Calories. 
 992 
 
 Lunch .... .... 
 
 1,253 
 1,348 
 
 Dinner 
 
 
 
 Total . 
 
 102 
 
 3 593 
 
 
 
 As will be seen from the figures given above, the total protein for 
 the day's ration is 102 grams, or 3f ounces, and the total energy value 
 3,593 calories — values which correspond very closely with those called 
 for by the suggested dietary standard. If a little more or a little less 
 food were eaten these figures would vary somewhat, though the agree- 
 ment might still be reasonably close. Suppose, for instance, that 
 another portion of cheese had been used in making the sandwiches. 
 This would have added 5 grams of protein and 94 calories, making 
 the total amount 107 grams protein and 3,687 calories. Such varia- 
 tions are, of course, what might be expected and are of no particular 
 moment. It is by no means necessary that the food eacli (\\\y should 
 agree exactly with the suggested dietary standard, for any deficiency 
 in protein or energy one day will very probably be offset by an excess 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 145 
 
 on some other day. It is believed, however, that the daily food will 
 be most satisfactory when the average for long periods agrees with 
 the suggested values. The calculated values obtained by the methods 
 outlined above are designed simply to show in a general way whether 
 the food corresponds to the dietary standard and to afford the house- 
 wife some knowledge as to whether the meals which she provides are 
 sufficient as to the kind and amount of nutritive material which they 
 furnish. 
 
 In the table on page 142 only the more common foods and staple 
 dishes have been included. It will very often happen that other 
 foods and dishes will be served. When this is done, and it is desired 
 to calculate the relative value of the ration, no great error will ordi- 
 narily be involved if the values of the food most like the article in 
 question are used. For instance, griddlecakes or waffles, which are 
 often served at breakfast, are not given in the table. A griddlecake 
 or a waffle so closely resembles a slice of bread in food value that the 
 protein and energy for a slice of bread may be used to represent the 
 food value of each griddlecake or waffle served. In the same way an 
 ordinary portion of boiled lamb may be assumed to have the same 
 food value as a slice of roast beef, and a portion of pork sausage the 
 same food value as a Frankfurt sausage. If a housekeeper desires to 
 study the subject in greater detail she will find an abundance of data 
 regarding the composition of foods, etc., in bulletins of the United 
 States Department of Agriculture and elsewhere. 
 
 In the calculations which have been described nothing has been said 
 of the fact that women and children usually eat smaller amounts than 
 men. Taking such factors into account would complicate the calcu- 
 lations, and it is therefore easiest to take into account simply the 
 amounts which the man of the family eats, and to assume that, as the 
 same sort of food is provided for the family, each member will re- 
 ceive the proper amount, and that if a diet for the man corresponds 
 reasonably to the dietary standard the same may be supposed to be 
 the case with that for the other members of the family. Young 
 children, of course, would have milk or special foods, and so would be 
 considered separately. 
 
 The ways in which meat, fish, vegetables, and other common foods 
 can be prepared for the table are endless, ranging all the way from 
 the simple boiled potato or fried egg to the most elaborate dish of the 
 highly trained cook. The ideal for family living is enough variety in 
 food and method of preparation to make the daily fare attractive 
 without excessive cost or undue labor, and it is possible to attain this 
 ideal. It is just as possible to make a dinner pleasing and satisfactory 
 in every way from simple materials simply cooked as it is to make ap- 
 propriate and attractive clothing for a child or grown person from in- 
 expensive yet suitable and well-chosen materials. It is the way in 
 which it is done as much as the materials used. Anyone who works 
 in a mill or factory with a complicated machine knows that many 
 things must be learned before the machine can be intelligently man- 
 aged and that much practice is required before he can become a skilled 
 operator. The same is true of selection and preparation of food and 
 other household tasks, but it is equally true that the skill and ability 
 which comes from good training is just as valuable in the home as it 
 is in the factory or workshop, and that the well-trained worker can 
 S. Doc. 644, 60-2 11 
 
146 REPORTS OF THE PRESIDENT'S HOMES COMMISSCON. 
 
 accomplish better results with less trouble in a given time than the 
 unskilled or poorly trained worker. 
 
 If we look over the long list of foods which we use and the dishes 
 we make from them, it becomes evident that they are of two general 
 sorts — those which, like bread, rice, potatoes, and many other foods, 
 have little distinctive taste, and those like cabbage, onions, cheese, 
 sweet foods, and many other dishes, which possess a pronounced and 
 characteristic flavor. It also becomes evident, when the subject is 
 studied, that the foods which are used in greatest quantity belong to 
 the. former class. 
 
 A little butter and jam make a slice of bread something which a 
 child will eat with relish. It is equally true that it is the foods and 
 dishes of distinctive flavor which very largely at least make the daily 
 fare appetizing and satisfactory and which insure the consumption of 
 enough of the staple foods, many of them lacking in flavor, to make 
 the diet well balanced and adequate. This distinctive flavor or pala- 
 tability which is so desirable may, in general, be attained in two 
 ways — namely, by the use of foods which are in themselves of dis- 
 tinctive flavor, and by appetizing methods of cookery with proper 
 seasoning. 
 
 The art of housekeeping in its highest form consists in planning the 
 meals so that the two classes of foods are well balanced and the cost 
 kept within bounds, as related to the income, with the labor involved 
 not excessive. 
 
 Many housekeepers, since they have been well trained in youth by 
 their mothers or in other ways have learned how to be good home- 
 makers, instinctively provide tasty dishes in about the right propor- 
 tion to the bread, potatoes, and other staple foods, and those who do 
 not know how to do so should make the effort to learn. Such prob- 
 lems can often be solved by care and attention, and by means of 
 schools and classes for home economics and the like ways of good 
 housekeeping are readily taught. For instance, if we assume that 
 bread of some sort and coffee and some of the ordinary cereals are the 
 usual breakfast dishes, and they doubtless are with the majority of 
 families in this country, the needed variety is readily secured by bacon 
 or creamed fish, fish balls, eggs, honey, sirup, or other foods. If work 
 is light and a hearty breakfast is not needed, fried potatoes (perhaps 
 seasoned with onions) , fried apples, or some similar dish is a palatable 
 addition to creamed toast, cereal, or the bread and butter which 
 makes up the principal part of the meal if that is not thought to be 
 enough. 
 
 Tea and coffee as a part of breakfast or other meal owe their food 
 value mainly to the sugar and milk or cream commonly taken with 
 them. Cocoa in itself contains rather more nutritive material than 
 either tea or coffee, but also owes its food value for breakfast or any 
 other meal largely to the milk and sugar which are used in making it. 
 It is usually considered more satisfactory for children than either tea 
 or coffee. The value of milk as a beverage, particularly for children, 
 must never be overlooked. Skim milk is not usually fully appreciated 
 for this purpose. It is, of course, " thinner " or " less hearty " than 
 whole milk, as it has less fat (cream) — but is still a nutritious food — 
 and though rather dilute, like all liquid foods, is well worth using in 
 quantity. 
 
BEPORTS OF THE PEESIDENt's HOMES COMMISSION. 147 
 
 When the man of a family takes his lunch away to his work some- 
 thing should be provided which is palatable as well as capable of 
 satisfying hunger. Cold meat, a little smoked fish, or a chopped 
 boiled egg will make a sandwich which is more palatable and more 
 nutritious than plain bread and butter, and cheese of different kinds, 
 cold bacon, and many other things may be used in the same way, while 
 an apple, a banana, or a piece of cake or something similar will un- 
 doubtedly be relished as much as the hearty food. If the children 
 come home from school they and their mother should have something 
 which is suited to their needs and yet which does not involve too much 
 trouble. Bread and milk, or cereal and milk, with fruit, fresh or 
 cooked, are all simple and easily prepared dishes which are suitable 
 for the purpose, while bread and butter with a little cold meat, fruit, 
 tomatoes, or any left-over foods which are relished will also answer 
 the purpose. 
 
 The evening meal under such circumstances would naturally be the 
 heaviest meal of the day. If dinner is eaten in the middle of the day 
 and supper at night, the suggestions made for lunch may be applied 
 to supper, but some hot dish is an addition which most persons relish 
 for supper. Creamed chipped beef, hash, meat croquettes, oysters in 
 season, and similar dishes suggest themselves, but if so hearty foods 
 are not wanted creamed potatoes, corn chowder, fried tomatoes, and 
 others may be readily prepared. 
 
 When roast beef, which is usually an expensive dish, is the princi- 
 pal item of a dinner, the cost of the meal may be kept within reason- 
 able limits by serving inexpensive vegetables and dessert. Any meat 
 left over from the roast should be used for some other meal, either 
 cold or made into a meat pie, meat croquettes, hash, or some other 
 made dish, while any bones and scraps made into a well-seasoned 
 thick soup may form the principal dish at still another meal. 
 
 Hamburg steak, round steak, ham, and sausages are meats which 
 may be readily cooked and which are appetizing, while pork chops 
 have always been a favorite and are usually considerably less expen- 
 sive than similar cuts of beef or lamb. 
 
 Herring, mackerel, and other sorts of fish, when in season, make a 
 pleasant variety and are as nutritious as meat. Perhaps fish is most 
 commonly fried, but boiled fish with a well-made sauce, or fish stuffed 
 and baked, is as easily prepared and adds variety. 
 
 Custom has made it almost compulsory in this country to have 
 some sweet dish at dinner, and the custom is reasonable, as such foods 
 are palatable, and although badly made pastry and other desserts are 
 frequent causes of digestive disturbances such dishes when well made 
 and eaten at suitable times in reasonable quantity are generally con- 
 ceded to be wholesome and are reasonably nutritious. 
 
 A housekeeper who plans her meals rationally will serve a light 
 dessert like stewed fruit with or without simple cakes or cookies, a 
 simple rice pudding, or some similar dish with a hearty meat, and the 
 heavy puddings, such as apple dumplings, suet pudding, etc., when 
 the rest of the dinner is not so hearty. 
 
 Beets, cabbage, onions, carrots, spinach, green com, tomatoes — in- 
 deed, all the ordinary vegetables — are wholesome, valuable fcDds and 
 should be used liberally. They contain a good deal of water and are 
 bulky in proportion to their nutritive value, but this is in their favor. 
 
148 
 
 By care and thought in selecting and by different methods of cooking 
 vegetables and other foods it is easy to vary the dinner from day to 
 day without too much labor. 
 
 When most fresh vegetables are out of season or high in price, 
 hominy, rice, fried corn-meal mush, and similar dishes are pleasant 
 changes from canned corn, canned tomatoes, and other canned goods 
 which are so much used to supplement potatoes, the standard vegeta- 
 ble in most American homes, and which, when of good quality, are 
 useful foods. 
 
 Fresh fruits are always attractive additions to the diet and may be 
 made to furnish a considerable amount of nutritive material. Canned 
 fruits, jams, jellies, and the like are all valuable additions to the diet, 
 useful for their nutritive value and for their palatable flavor. 
 
 In earlier times in New England creamed salt codfish with baked 
 potatoes, boiled salt salmon with drawn butter, boiled salt codfish 
 with beets and boiled potatoes, and pork and beans were simple, 
 inexpensive, and appetizing dinner dishes which were very commonly 
 used. These foods are wholesome, nourishing, and have always been 
 favorites in large numbers of families. Fried salt pork or bacon, 
 well cooked, with cream gravy, and served with fried eggs and baked 
 potatoes, is another old-fashioned dinner which retains its popular- 
 ity, particularly in rural regions. Some such dish as this with hot 
 corn bread, some vegetable which is in season, and a rice pudding or 
 some other simple dessert makes a meal which is appetizing, ade- 
 quate, easily prepared, and not expensive. 
 
 In the Southern States hominy and rice, like corn breads of differ- 
 ent sorts, have always been favorite dishes of reasonable cost. Corn 
 bread and buttermilk is an old-fashioned combination which is well 
 worth more extended use, for it is nutritious, wholesome, and to most 
 people palatable. 
 
 The dishes and food combinations which have been mentioned are 
 only suggestions, for each housewife must of necessity suit her meals 
 to the tastes of her family, and food customs differ decidedly with 
 regions and with other circumstances. The southerner will relish 
 bacon and greens, fried chicken, com bread, and many other dishes 
 for which southern cooks are famous, while the northerner will per- 
 haps prefer fish-balls, baked beans and brown bread, or " a boiled 
 dinner " of corn beef with vegetables, or some similar dish with 
 which he has always been familiar. Families of Italian origin or. 
 descent naturally use macaroni, which they cook in such appetizing 
 ways with tomatoes, cheese, or other seasoning, salads with an abun- 
 dance of olive oil, and other dishes whi ;h are typical of Italy, while 
 the Germans will more commonly select noodle soup, pork cutlet 
 with cabbage or sauerkraut, apple cake, and many of the other char- 
 acteristic and appetizing German dishes. 
 
 Readiness to adopt new ideas is characteristic of American life 
 and, as might be expected, many of the typical dishes of other coun- 
 tries have become well known on most tables, and this may well be 
 the case for, after all, the staple foods which are always in market 
 and reasonable in price are not too numerous and new methods of 
 cooking mean a pleasant variety. 
 
 In general, it is true that to be reasonable in cost usually means 
 that more time is required for the preparation of a monl or a dish 
 than is the case when cost is not taken into account. A steak or chop 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 149 
 
 which can be quickly cooked is more costly than a stew, than beef 
 or veal loaf, beef a la mode, pot roast, beef with horse radish, boiled 
 mutton with white sauce, or any of the other appetizing dishes 
 which can be made from the cheaper cuts of meat. The stew owes 
 its palatabiltiy very largely to the onions or other seasoning, or to 
 the fact that the meat was browned in a pan before it was stewed, 
 and its pleasing texture to the long, slow cooking which makes tough 
 meat tender. The steak or chop is in itself more tender and full 
 of flavor than cheaper cuts, so it is reasonable that a simpler method 
 of cooking is required for it. That such dishes as stews, etc., are 
 very generally relished by people in all circumstances is shown by 
 the fact that they so often appear on menus in expensive hotels and 
 restaurants, as well as those where prices are cheaper, though more 
 often as luncheon than dinner dishes, and find their way to most 
 tables — no matter how large or how small the income. 
 
 Granting that the foods are w^holesome and suitable, the final test 
 with foods, after all, is skill in preparation. The simplest dish 
 well cooked is always superior to an elaborate dish indifferently 
 made and simple meals in the long run are more relished than those 
 which are very elaborate. 
 
 The housekeeper who manages her home with little or no help 
 except that which other members of her family give has no time to 
 waste on the entrees, elaborate cakes, and other sorts of " food fancy 
 work " for which recipes are so frequently published and which 
 many people seem to consider a mark of good living. It should be 
 said that well-informed housekeepers long ago recognized that the 
 majority of such dishes can not be satisfactorily prepared except by 
 an unusually skillful cook and that, though entirely appropriate for 
 special occasions and under many circumstances, they have little 
 place in the everyday bill of fare. Furthermore, most persons tire 
 of such dishes much more quickly than they do of foods prepared by 
 simpler methods. 
 
 As time has progressed very many household industries have 
 become the subject of careful study with the result that they now rest 
 on a sound scientific basis. 
 
 The perfection which has been reached in spinning and weaving 
 and other manufacturing enterprises, which have grown out of 
 home industries, is a proof of what may be accomplished by a scien- 
 tific study of domestic problems and an indication of what may be 
 expected when careful consideration is given to food and nutrition 
 as a part of home work by all housekeepers. 
 
 In the development of labor-saving devices household work has not 
 kept pace with farm work or with general manufacturing. How- 
 ever, at the present time new interest seems to have been aroused in 
 this question, and dishwashers, bread and cake mixers, and similar 
 devices which are on the market, and hay boxes or fireless cookers 
 are becoming fairly well known. When such devices are found to 
 be fairly satisfactory they should find a place in the home with the 
 washing machine and the carpet sweeper as a means of lessening the 
 labors of the housekeeper. 
 
 No carpenter can build a house or carry out even a simple enter- 
 prise without a plan, and the better the plan the easier and more 
 satisfactory will be the 'work, other things being equal. With the 
 housbkeeper the same is true. Thought and system are important 
 
150 REPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 time and strength savers. We do not need to live by rote, but simply 
 to carry on the household tasks according to some definite plan which 
 is flexible enough to permit of the variations made necessary by cir- 
 cumstances. 
 
 The housekeeper who will take advantage of opportunities to learn 
 something regarding the relative nutritive value of different foods 
 and their real worth as distinguished from their market value, and 
 who understands good, sensible methods of cooking and serving food, 
 and who will plan her meals and other household work so that un- 
 necessary labor may be avoided, will be able to provide her family 
 with a reasonable and palatable diet without undue labor or excessive 
 cost. Thanks to its varied climate and soil, the United States pro- 
 duces all staple foods in great variety, as well as the majority of those 
 which are usually termed " luxuries," and for this and other reasons 
 tlie food problem is a simpler one than is the case in many other 
 countries where food materials are less plentifully grown and prices 
 are higher. Good, substantial food, pleasing to the eye as well as 
 satisfying the body, is within the reach of all, and w^ien wholesome, 
 well-prepared meals are the rule in our homes and women's work in 
 the household is carried on generally with the system and precision 
 which were long ago introduced into the trades and manufacturing 
 industries, then household work will be less a burden and the family 
 will be healthier and better in every way. 
 
 FOOD AND HOME BETTERMENT. 
 
 [Introduction by Geo. M. Kober, M. D.] 
 
 In our sociological study of families in this city we found that 476 
 families, with an income of $500 or less, expended 43.68 per cent of 
 their annual income for food; 159 families, with an income of $500 
 to $600, 43.59 per cent ; 153 families, with an income of $600 to $700, 
 41.40 per cent; and 153 families, with an income of $700 to $800, 
 40.21 per cent for food. The question of food, while of importance 
 to all classes in its relation to health and efficiency, is of special 
 significance from an economic standpoint in families with limited 
 means. It has been well said that " half the struggle for life is the 
 struggle for food." Many of the problems tonnected with the nutri- 
 tive value of farm products and other foods, the preparation of food 
 for the table, the digestibility, palatability, and utilization of differ- 
 ent foodstuffs, the hygienic and economic aspect of the question have 
 received careful attention in the nutrition investigations conducted by 
 the Office of Experiment Stations, United States Department of 
 Agriculture. It may be truly said that these investigations have been 
 a constant source of information and inspiration to teachers of 
 domestic science in public schools and colleges, to settlement workers, 
 persons in charge of charitable institutions, and others interested in 
 the social betterment of their less resourceful neighbors. The work 
 is of the utmost value, and, while much has been accomplished, it 
 should be continued in the interest of home economics and home 
 betterment. 
 
 It has been found, over and over again, that persons of limited 
 means purchase food containing little or no nutriment, or select 
 needlessly expensive kinds of food, or prepare a diet altogether too 
 one-sided, and last, but not least, know little or nothing about the art 
 of cooking, and thus impair not only the nutritive value of the food. 
 
REPOKTS OF THE PRESIDENT S HOMES COMMISSIOTST. 
 
 151 
 
 but also the digestive functions and general health as well. In order 
 to give housekeepers whose income is $1.50 a day an opportunity to 
 prepare suitable dishes for a family of 6 — 2 adults and 4 children — 
 Miss E. M. Cross, of the McKinley Manual Training School, has 
 prepared suitable menus for winter and summer use which it is 
 hoped will stimulate interest in the subject. Miss Cross assures me 
 that she has verified the market prices personally and that the food 
 can be purchased at the figures given. For reasons already stated 
 butterine may very properly replace butter in families with small 
 means, and for hygienic reasons bread twenty-four hours old is 
 really superior to fresh bread. The writer desires to emphasize the 
 fact that beans, peas, and lintels, containing, as they do, much protein, 
 can replace from time to time the more expensive meat and egg ration. 
 The nutritive value of skim milk, buttermilk, and cottage cheese, 
 and the cheaper fish meats should also be more fully appreciated. 
 To limit the expenditure for food, with an income of $1.50 to an 
 average of 75 cents a day for a whole family, is no small under- 
 taking and requires experience and judgment which are best obtained 
 in our cooking schools. It is sincerely hoped that every girl will 
 take a deep interest in matters of cooking and domestic economy. 
 Every housewife should supply herself with scales and follow the 
 general directions given in the cooking recipes with precision. All 
 the quantities given are for a family of six, and reductions are made 
 accordingly, rememboring always that hard-working men and nurs- 
 ing or pregnant women, and convalescents from acute diseases, re- 
 quire a more liberal diet. If, in spite of good cooking, there should 
 be evidence in any member of the family of malnutrition and im- 
 paired health it will be well to consult a physician. Miss Cross is 
 entirely responsible for the following menus and cooking recipes, 
 and is entitled to the credit for whatever merit they possess: 
 
 MENUS FOR WINTER MONTHS." 
 
 
 Protein. 
 
 Energy. 
 
 Cost. 
 
 Monday: 
 
 Breakfast— Hominv, skim milk, creamed hake, toast, butter, coffee.. 
 Dinner— Irish stew' with dumplings, boiled rice, cold slaw, apple pie. . 
 
 Grams. 
 28 
 54 
 13 
 
 Calories. 
 
 1,053 
 
 1,711 
 
 819 
 
 Cents. 
 18 
 31 
 23 
 
 
 
 Total 
 
 96 
 
 3,583 
 
 72 
 
 
 
 Tuesday: 
 
 Breakfast— Rice cakes (left-over rice), kidney stew, entire wheat 
 
 44 
 
 28 
 29 
 
 1,176 
 
 842 
 1,196 
 
 16 
 
 Dinner— Corned beef, boiled potatoes, spinach, tapioca with milk 
 
 71 
 
 
 10 
 
 
 
 Total 
 
 101 
 
 8,214 
 
 97 
 
 
 
 Wednesday: 
 
 Breakfast— Stewed prunes, meat cakes, com bread, butter, coffee — 
 
 Dinner— Split pea soup, braised beef's heart, boiled cabbage (corn 
 
 beef liquor), boiled onions, potatoes, apricot roll, vanilla sauce 
 
 23 
 
 56 
 29 
 
 771 
 
 1,572 
 1,002 
 
 27 
 
 44 
 18 
 
 
 
 Total ... 
 
 108 
 
 3,345 
 
 89 
 
 
 
 Thursday; 
 
 Breakfast— Rolled wheat, skim milk, Potomac herring, corn bread, 
 butter coffee . .................. . . .. . . 
 
 26 
 
 61 
 23 
 
 866 
 
 1,530 
 840 
 
 19 
 
 Dinner— Salt pork, potatoes, turnips, escarolle, apple butter, short 
 cake . 
 
 29 
 
 Supper — Pigs' feet potato cakes bread, butter, coffee 
 
 26 
 
 
 
 Total 
 
 110 
 
 3,236 
 
 74 
 
 
 
 a For quantities of material to be used when not given in cooking recipes, see p. 156. 
 
152 EEPORTS OF THE PRESIDENT'S HOMES COMMISSIOIT. 
 
 MENUS FOR SUMMER MONTHS. 
 
 Friday: 
 
 Breakfastr— Oom flakes, skim milk, salt-water trout corn dodgers, 
 
 coffee 
 
 Dinner— Stewed tripe, boiled potatoes, stewed onions, raw tomatoes, 
 
 bread, rice pudding 
 
 Supper — Beef stew, corn cakes, butter, stewed apples, tea 
 
 Total 
 
 Saturday: 
 
 Breakfast— Fried tomatoes, bacon, bread, butter, coffee 
 
 Dinner—Boiled leg of mutton, boiled rice, green corn, summer squash, 
 
 bread, gingerbread 
 
 Supper— Cottage cheese, baked potatoes, raw onions, bread, butter, 
 
 gingerbread, tea 
 
 Total 
 
 Sunday: 
 
 Breakfast — Boiled eggs. Potomac herring, corn bread, butter, coffee. 
 Dinner — Chartreuse of mutton, tomato sauce, boiled potatoes, string 
 
 beans, blackberries, milk 
 
 Supper— Rice muffins, baked tomatoes, apple butter, coffee 
 
 Total 
 
 Protein. Energy. 
 
 Grama. 
 28 
 
 Calories. 
 
 1,175 
 
 1,035 
 
 35 
 
 120 
 
 3,106 
 
 1,054 
 1,014 
 1.048 
 
 Cost. 
 
 Cents. 
 .26 
 
 .35 
 
 .28 
 
 3,116 
 
 818 
 
 1,187 
 1,066 
 
 3,071 
 
 .13 
 .97 
 
 .23 
 
 1.33 
 
 23 
 
 56 
 
 COOKING KECIPES FOR WINTEB MENUS. 
 
 Creamed hake. — ^After freeing 2 pounds of the fisli from bones and skin, flake 
 it, then cover it with boiling water, put a cover on the pan and keep it on the 
 back of the stove for ten minutes. Drain the water from it, then pour cream 
 sauce over it and serve. 
 
 Cream sauce. — Two tablespoonfuls butter, 2 tablespoonfuls flour, 1 cupful 
 milk, one-half teaspoonful salt, one-eighth tea spoonful pepper. After melting 
 the butter over steam, or on a cool part of the stove, add the flour and stir 
 over the fire for one minute. Add the milk and the mixed salt and pepper, then 
 stir the mixture until it thickens, after which cook over steam for ten minutes. 
 Serve while hot. 
 
 Irish stew with dumplings. — One pound beef (brisket), 1 slice salt pork, 1 
 onion, 4 potatoes. Cut the meat into 2-inch pieces, then dredge them with 
 flour and brown them all over in the pork fat with the sliced onion. Cover the 
 meat and onion with boiling water and let the mixture cook slowly on the back 
 of the stove. In the meantime pare and dice the potatoes and boil them for ten 
 minutes, then drain the water from them and add them to the stew when the 
 meat is tender. When the potatoes are nearly done, put in the dumplings, 
 pouring off the liquid, if necessary, so they will rest on the potatoes. Keep the 
 pan closely covered and let the stew cook for ten minutes. Take out the 
 dumplings, season the stew with salt and pepper, and put it in the center of a 
 platter, then place the dumplings around the edge. 
 
 Dumplings. — One pint flour, one-half teaspoonful salt, 1 cupful milk (scant), 
 S teaspoonfuls baking powder. Make a soft dough and flatten it out half an 
 inch thick, then cut into small rounds or mix softer and drop by the spoonful 
 into the hot stew. 
 
 Cold slaw. — One-fourth pound salt pork, 4 tablespoonfuls vinegar, 1 onion, 1 
 teaspoonful salt, one-third medium-sized head of cabbage. Put the pork into a 
 pan with half a cup of water; let it boil until the water evaporates, then cook 
 until the pork is brown and crisp. When the fat is cool, add it to the rest of 
 the ingredients and pour the mixture over the thinly sliced cabbage. 
 
 Apple pie. — One and one-half cupfuls flour, 1 teaspoonful salt, 8 tablespoon- 
 fuls drippings, about three-fourths cupful ice water. After sifting the flour and 
 salt together add the shortening and mix by cutting together with a knife, add 
 the water slowly, still mixing with a knife, until a dry, crumbly paste is formed, 
 but all of the flour is moistened. Turn this out on a board without flour, and 
 after rolling it into a thin sheet turn the paste around and roll again. Con- 
 tinue this process until the materials are well blended and the paste is smooth. 
 Keep in a cool place until it is quite firm. It is better kept over night. Roll 
 out one-half of the paste to fit the pie pan, cover this with a layer of apples, 
 
BEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 153 
 
 which have been cored, pared, and cut into thin slices across the core. Sprinkle 
 with sugar and a little cinnamon. Continue to put in these layers until the pan 
 is full, having it higher in the center than on the sides. Put on a cover of 
 pastry, fasten the edges down, then trim the pie, holding the knife well under 
 the plate. Make several openings on the top for the escape of steam, then bake 
 it in a moderately hot oven until it is brown, about thirty minutes. Remove it 
 at once from the plate and serve either hot or cold. 
 
 Corn Bread. — One pint meal, 1 teaspoonful salt, 1 tablespoonful fat from 
 bacon, 1 teaspoonful soda, 1 pint sour buttermilk. Pour over the meal enough 
 boiling water to scald it. The meal must be moist, not wet. Add the shorten- 
 ing, salt, and the soda, which has been mixed with a little cold water. Stir 
 this until it is thoroughly mixed, then put in the milk. Bake it in a quick oven 
 in shallow pans for about forty-five minutes. Serve at once. 
 
 Kidney stew. — Split the kidneys lengthwise in halves and trim off every bit 
 of sinew and fat from the inside, then cut the kidneys into small pieces. Put 
 them into a saucepan and cover them with cold water; then heat the water until 
 it is nearly boiling. Drain this water off and cover the kidneys again with cold 
 water; then heat the water as before. Repeat this, thus making three treat- 
 ments. Be careful each time that the water does not boil at all, or the kidneys 
 will be hard and tough. Discard all the water. Reheat the kidney in a brown 
 sauce, season it with salt and pepper, and serve it. 
 
 Brovm sauce. — Two tablespoonfuls butter, 2 tablespoonfuls flour, 1 cupful 
 stock or w^ater, one-half teaspoonful salt, one-eighth teaspoonful pepper. After 
 browning the butter add to it the flour and brown this mixture, then add the 
 stock or water and stir until it is thick. Season and add the prepared kidney. 
 Serve at once. 
 
 To boil corn beef. — Wash the meat well and put it on in cold water. Bring 
 slowly to simmering point and let it simmer thirty minutes for every pound of 
 meat. If the meat is to be served cold allow it to cool in the liquor in which it 
 was boiled. 
 
 Tapioca with milk and sugar. — Cover 1 cup of flake tapioca with cold water 
 and let stand over night. In the morning drain the water from it and add 1 
 quart of hot water. Cook over a slow fire until it is quite transparent, then 
 add a pinch of salt and the rind and juice of 1 lemon. Pour this into molds 
 which have been wet with water and keep in a cool place. When firm turn 
 them out on a platter and serve with milk and sugar. 
 
 Fried mush. — One pint water, 1 teaspoonful salt, one-half cupful yellow 
 meal, 1 egg. Scatter the meal slowly into the boiling salted water, stirring 
 constantly, then let the mixture bubble once or twice. Place the pan over hot 
 water and let it cook for two hours, after which turn the mush into a square 
 pan and keep in a cool place until it is firm. Cut it into slices half an inch 
 thick and cover them with the beaten egg, which has been mixed with 1 table- 
 spoonful of cold water. Cook these in smoking hot fat (enough to cover the 
 pieces) until they are a golden brown. Serve at once. 
 
 (Note. — Two saucepans may be used for cooking the mush, the smaller one 
 resting on a piece of wire gauze in the bottom of the larger one, which contains 
 water. The fat used is made from the small pieces of fat meat which may be 
 purchased from the butcher at 2 cents per pound. The fat is strained and kept 
 in a cool place for future use.) 
 
 Stewed primes. — After v^ashing 1 pound of prunes, cover them with cold 
 water and let them stand for several hours. Put them on the stove in the same 
 water and let them cook slowly until a straw will go through them easily. Put 
 the prunes in a dish, sweeten the liquid, let it boil for two minutes, then pour 
 it over the prunes. 
 
 (Note. — ^AU dried fruits should be soaked in the water before they are 
 cooked.) 
 
 Meat cakes. — One pound beef, 1 teaspoonful salt, one-eighth teaspoonful 
 pepper. Use the lower part of the round, which may be purchased in some 
 markets for 6 cents per pound. Grind the meat or have the butcher chop it 
 with a cleaver until it is quite fine, then mix the seasoning with it, and shape 
 it into small cakes, having the edge as thick as the center. Put enough fat in 
 a hot spider to keep the meat from sticking to the pan, put in the cakes, and 
 shake the pan over the fire until they are brown all over. Now let them cook 
 more slowly, allowing seven minutes if they are an inch thick, turning them 
 occasionally. After taking out the cakes, put into the pan 1 tablespoonful of 
 drippings and the same amount of flour, stir well, then add half a cup of cold 
 
164 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 water and cook until it thickens. Season with salt and p.epper and serve with 
 meat cakes. 
 
 Split pea soup. — One cupful split peas, 6 pints cold water, 1 onion, 2-inch cube 
 salt pork, 2 tablespoonfuls drippings, 2 tablespoonfuls flour, 1^ teaspoonfuls 
 salt, one-eighth tea spoonful pepper. After picking over the peas, wash them 
 and let them soak in the cold water for five or six hours. Add the pork and 
 onions, which have been cut into small pieces and cooked until they are a light 
 brown. Let this mixture cook slowly for about four hours, after which strain 
 it, mix the fat with the flour and add to the soup, stirring constantly until the 
 mixture thickens, then let it cook for ten minutes. Season and serve at once. 
 
 Braised beefs heart. — After soaking the heart in cold water for three hours, 
 remove the muscles from the inside and the blood. Make a forcemeat of 1 cup 
 of bread crumbs, 2 tablespoonfuls of drippings, 1 teaspoonful of thyme, 1 table- 
 spoonful of chopped celery tops, 1 teaspoonful of onion juice, half a teaspoonful 
 of salt, one-eighth of a teaspoonful of pepper. Mix and stuff the heart. Tie it 
 together with twine, and put it into a pan which has a close-fitting cover. Add 
 enough boiling water to half cover the heart, put on the lid, and cook in a mod- 
 erately heated oven for three hours. Brown 2 tablespoonfuls of fat, add 2 
 tablespoonfuls of flour, and when well mixed, add the water in which the heart 
 was cooked. Stir until it thickens, season with salt and pepper. Dish the 
 heart and pour the sauce over it, then serve. 
 
 Apricot roll. — Two cupfuls flour, one-half teaspoonful salt, one-third pound 
 suet, 1 pint apricots. Free the suet from the fiber and skin, then chop it fine or 
 press it through a wire basket. Mix this with the flour and salt and add gradu- 
 ally enough cold water to make a soft dough. Roll it out on a floured board into 
 a sheet about an inch thick, spread the apricots thickly over the dough, roll it 
 up and tie it in a well-flouted cloth, leaving plenty of room for it to swell. 
 Put it into a pot of boiling water and boil for two hours, or it may be steamed 
 two hours and a half. Serve hot with vanilla sauce. 
 
 Vanilla Sauce. — Two tablespoonfuls butter, 2 tablespoonfuls cornstarch, one- 
 half cupful sugar, 1^ cupfuls water, 1 teaspoonful vanilla. After heating the 
 butter and water to boiling point, stir in the mixed cornstarch and sugar. Cook 
 the mixture for ten minutes, then flavor and serve. 
 
 Comed-heef hash. — One pint finely chopped beef, 1 pint boiled potatoes, one- 
 half teaspoonful salt, one-eighth teaspoonful pepper, 2 tablespoonfuls fat. 
 Cut the potatoes into small pieces and mix them with the rest of the ingredi- 
 ents. Put this into a heated spider, add enough hot water to moisten and stir 
 until the mixture is well heated, then pack it closely in the pan, cover it, and 
 let it cook until it is well browned on the bottom. Turn it out on a platter and 
 serve. 
 
 Apple butter short cake. — One pint flour, 1 teaspoonful salt, 3 tablespoonfuls 
 drippings, 2 teaspoonfuls baking powder, milk or water (about three-fourths 
 cup. Sift the flour with the salt and baking powder, then add the fat, and mix 
 well. Pour in the water slowly, mixing with a knife until a soft dough is formed. 
 Turn it out on a floured board and, after surrounding it with flour, roll it into 
 a thin sheet about half an inch thick. Cut it into four-inch squares and bake 
 them in a quick oven until they are a light brown, about twenty minutes. Split 
 each square and put the apple butter between. Serve while hot. 
 
 Pigs' feet. — After scraping a set of four of the feet soak them in cold water 
 for several hours, then wash and scrub them. Split the feet and put them on in 
 cold water and let them simmer until tender. Put them in an earthen jar, sea- 
 son with salt and pepper, and pour over them hot spiced vinegar. They will be 
 ready for use the next day. 
 
 Spiced vinegar. — Boil for one minute a half-pint of cider vinegar, 12 whole 
 cloves, 3 inches of cinnamon bark, and 2 bay leaves. 
 
 Potato cakes. — Mash 1 pint boiled potatoes, then season them with salt and 
 pepper, and moisten with hot milk. Make into cakes and brown in a pan with a 
 small quantity of fat Serve hot. 
 
 BECIPES FOB SUMMEB MENUS. 
 
 Com dodgers.— Two cupfuls white meal, 6 tablespoonfuls skim milk, 2 table- 
 spoonfuls shortening, 1 teaspoonful salt. After scalding the meal with boiling 
 water, using just enough to moisten the meal, add the shortening and stir until 
 it is well mixed, then put in the salt and milk. Put the mixture by spoonfuls 
 in a large baking pan, flatten into small cakes, and keep them separate. Bake 
 In a moderately heated oven until brown on both sides, then serve. 
 
REPOETS OF THE PRESIDENT'S HOMES COMMISSION. 155 
 
 Stewed tripe. — Two pounds boiled tripe, 2 ounces salt pork (ham may be used) 
 one-balf medium sized onion, 1 tablespoonful chopped parsley, 1 bay leaf, 2 
 tablespoonfuls flour, 1 pint milk, 1 teaspoonful salt, one-eighth tea spoonful 
 pepper. Cut the tripe into pieces about li inches long and a half inch wide. 
 Dice the pork and put in a pan with the sliced onion and the bay leaf. Stir 
 over the fire until quite brown, then add the flour, and when well mixed add the 
 milk. Stir this until it is as thick as ordinary cream, after which put in the 
 salt, pepper, and the tripe, and keep over a very moderate fire for five minutes. 
 Add the parsley and serve at once. 
 
 Rice pudding. — One-half cupful rice, one-half cupful sugar, 1 pinch of salt, 1 
 quart of milk. After washing the rice thoroughly, let it soak in the milk for half 
 an hour, after which add the salt and sugar. Pour the mixture into a deep pan, 
 cover it and let it bake about two hours, slowly at first, until the rice has 
 softened and thickened the milk, then let it brown slightly. This may be served 
 hot or cold. 
 
 Beef stew. — One pound plate or brisket, 4 potatoes, 1 teaspoonful salt, 1 
 carrot, 1 tablespoonful fat, 1 tablespoonful flour, one eighth teaspoonful pepper. 
 Cleanse the meat by wiping it with a damp cloth or by scraping it with the back 
 of the knife. Cut it into pieces about 2 inches square, and put it into a saucepan 
 with the bones and sliced carrot. Pour over this enough boiling water to cover 
 well, about a pint and a half, and let it simmer until the meat is tender, then add 
 the diced and parboiled potatoes. When the potatoes are done, thin the mixed fat 
 and flour with a little of the hot liquor from the stew, and after pouring it 
 into the stew stir it until it thickens slightly. Cook a few minutes longer, 
 then remove the bones, season and serve. 
 
 Corn eakes. — One pint meal, one-half cupful flour, 1 pint sour buttermilk, 1^ 
 teaspoonful soda, 1 tablespoonful fat, 1 egg, 1 tablespoonful salt. Scald the 
 meal with suflicient boiling water to moisten, then put in the fat and stir until 
 well mixed. When this is cool add the salt, flour, and the buttermilk. Stir in 
 the beaten egg and the soda, which is mixed with a little cold water. Bake in 
 small cakes on a lightly greased hot griddle. 
 
 Gingerbread. — One cupful molasses, one-third cupful drippings, 1 teaspoonful 
 soda, one-half teaspoonful salt, 1 cupful sour buttermilk, 1 tablespoonful ginger, 
 3 cupfuls flour, 1 teaspoonful cinnamon, one-half teaspoonful allspice. After 
 mixing the salt and spices with the molasses add the fat, after which add flour 
 and buttermilk alternately, then beat until perfectly smooth. Stir in the soda, 
 which is mixed with a little cold watef, and partly fill greased gem pans with 
 the batter. Bake in a moderately hot oven about thirty minutes or until the 
 cakes are a light brown. 
 
 Chartreuse of mutton. — One cupful cooked chopped mutton, 1 teaspoonful 
 chopped parsley, one-half teaspoonful onion juice, 1 teaspoonful lemon juice, 
 one-fourth teaspoonful salt, 2 tablespoonfuls butter, 1 cupful stock or water, 
 2 tablespoonfuls flour, little cayenne. Make sauce as directed for cream sauce, 
 then add the rest of the ingredients and mix thoroughly. Line a greased mold 
 with hot boiled or steamed rice, having the layer about half an inch thick, 
 then fill the center with the mutton mixture and cover the top evenly with 
 rice. Steam forty-five minutes, then turn from the mold and serve with tomato 
 sauce. The greased mold may be coated with bread crumbs, then lined with 
 mashed potatoes and, after filling with the mutton, covered with potato. Bake. 
 
 Tomato sauce. — Two tablespoonfuls drippings, 1 cupful strained tomatoes, 
 2 tablespoonfuls flour, one-half teaspoonful salt, one-eighth teaspoonful pepper. 
 After melting the fat add the flour and cook for one minute, then add the 
 strained tomatoes, the salt, and the pepper. Stir until it thickens, then serve. 
 
 Scrapple. — Four pints water in which the lamb was cooked, 1 pound scrap 
 meat, 3 teaspoonfuls salt, 1 teaspoonful thyme, 1 teaspoonful sweet marjoram, 
 1 pint meal, one-fourth teaspoonful pepper. After cleansing the meat, by 
 wiping it with a damp cloth, cut it into small pieces and cook it slowly ih 
 the mutton broth until it will easily separate. See that there is one quart of 
 the liquid and that the meat is in very small pieces. Season the mixture of 
 water and meat, put it on the stove and, when it reaches boiling point, stir in 
 the meal. Cook over hot water for two hours, then add the thyme and mar- 
 joram and, when well mixed, turn it into square pans and stand away to cool. 
 When this is flrm cut it into slices and brown in a little fat. 
 
 Rice muffins. — Two and one-fourth cupfuls flour, 1 cupful milk, three-fourths 
 cupful hot rice, 1 egg, 5 teaspoonfuls baking powder, 2 tablespoonfuls butter 
 or drippings, 1^ teaspoonfuls salt. After mixing the flour with the salt add 
 the rice, which has been pressed through a strainer, and the milk which is 
 
156 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 mixed with the beaten yolli of the egg. Beat until the batter is quite smooth, 
 then add the melted fat, stir in carefully the baking powder and then fold in the 
 stiffly beaten w^hite. Partly fill greased gem pans with the batter and bake in 
 a moderately hot oven until a light brow^n, about thirty minutes. Serve hot. 
 
 Market price of goods. 
 
 Article. 
 
 WINTER. 
 
 Apples 
 
 Apple butter 
 
 Bacon (country) 
 
 Beef: 
 
 Part of the round. 
 
 Brisket and plate . 
 
 Corned 
 
 Beef's heart 
 
 Beans 
 
 Broken rice 
 
 Bread (stale) 
 
 Butter 
 
 Buttermilk 
 
 Cabbage 
 
 Coffee 
 
 Com flakes 
 
 Cottage clieese 
 
 Escarolle 
 
 Evaporated apricots. . . 
 
 Flake tapioca 
 
 Flour 
 
 Hake 
 
 Hominy 
 
 Kidney 
 
 Meal 
 
 Mutton: 
 Breast... 
 Fore leg. 
 Neck — 
 
 Unit. 
 
 Quarter peck 
 
 Jar 
 
 Pound 
 
 do... 
 
 do... 
 
 do... 
 
 do... 
 
 Quart 
 
 Pound... 
 
 Loaf 
 
 Pouixd.. . 
 Que -t. . . . 
 He^ i.... 
 Pound... 
 Package. 
 
 Pint 
 
 Head-... 
 Pound... 
 
 do... 
 
 6 pounds 
 Pound... 
 
 Quart 
 
 Each 
 
 Pound 
 
 Quart 
 
 Pound. 
 ....do. 
 ....do. 
 
 Cost. 
 
 Cents. 
 10 
 
 10 
 
 Article. 
 
 Pigs' feet 
 
 Potomac herring 
 
 Potatoes 
 
 Prunes 
 
 Rolled wheat 
 
 Salt pork 
 
 Saltwater trout.. 
 
 Sausage 
 
 Skim milk 
 
 Spinach. 
 
 Split peas 
 
 Sugar 
 
 Tea 
 
 Tripe 
 
 Turnips 
 
 Apples 
 
 Beets 
 
 Blackberries 
 
 Butter 
 
 Cabbage 
 
 Corn 
 
 Eggs 
 
 Onions 
 
 Potatoes 
 
 Spinach 
 
 String beans 
 
 Summer squash . 
 Tomatoes 
 
 Unit. 
 
 Set 
 
 Dozen 
 
 Feck 
 
 Pound 
 
 Package 
 
 Pound 
 
 do 
 
 3 pounds 
 
 Quart 
 
 Quarter peck . 
 
 Pound 
 
 do 
 
 do 
 
 2 pounds 
 
 Quarter peck . 
 
 Quarter peck . 
 
 3 bunches 
 
 Quart 
 
 Pound 
 
 Head 
 
 Dozen 
 
 -...do 
 
 3 bunches 
 
 Bushel 
 
 Quarter peck . 
 
 do 
 
 Dozen 
 
 Quarter peck . 
 
 Cost. 
 
 Cents. 
 
 Quantities of materials to he used for a family of six ichen not given in cooking 
 
 recipes. 
 
 BREAKFAST. 
 
 Uncooked hominy cupful^_ 1 
 
 Skim milk gills__ 3 
 
 Toast loaf__ai 
 
 Butter oimces__°3 
 
 Coffee tablespoonfuls— 4 
 
 Kidney 1 
 
 Stewed prunes pound__ 1 
 
 Rolled wheat , cupful__ 1 
 
 Potomac herring 3 
 
 Com flakes , cupfuls-_ 2 
 
 Fried tomatoes. . 8 
 
 Boiled eggs 12 
 
 DINNER. 
 
 Uncooked rice . cupfuls__ 1^ 
 
 Corned beef, for 3 meals pounds_- 8 
 
 Potatoes, 3 in. long 12 
 
 Spinach peck__ i 
 
 Milk for tapioca gills__ 3 
 
 Sugar for tapioca tablespoonfuls.— 2 
 
 Beef's heart 1 
 
 Boiled cabbage head— \ 
 
 Boiled onions 6 
 
 Potatoes 6 
 
 «Same quantity each time used. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 157 
 
 Salt pork _-POimd__ * 
 
 Turnips (mashed) 8 
 
 Potatoes 6 
 
 Escarolle head— 1 
 
 Raw tomatoes 6 
 
 Leg of lamb, for 3 meals pounds__ 7 
 
 Rice cupful— 1 
 
 Corn ears— 12 
 
 Squash i-_ 4 
 
 String beans peck— i 
 
 Blackberries quart— 1 
 
 Milk gills— 3 
 
 SUPPER. 
 
 Cottage cheese pint— 1 
 
 Molasses gills__ 3 
 
 Pig's feet set— 1 
 
 Potatoes 8 
 
 Apples peck__ i 
 
 Cottage cheese pint— 1 
 
 Potatoes 9 
 
 Onions (raw) 6 
 
 Tomatoes__— peck__ i 
 
 Apple butter pint— i 
 
 Chapter III. 
 THE CAUSATION AND PREVENTION OF DISEASE. 
 
 DANGER PERIODS IN LIFE.** 
 
 According to a French medical journal the annual mortality of the 
 entire human race is 33,000,000 persons. A fourth of the race die 
 before completing their eighth year, and one-half before the end of the 
 seventeenth year, but the average duration of life is about 38 to 40 
 years. Not more than one person in 100,000 lives to be 100 years old. 
 ("Medical Eecord," February 27, 1892.) 
 
 During life the fluids and tissues of the body are constantly under- 
 going changes; new matter is formed and the old is removed with 
 ceaseless activity. The body is indeed a complex machine in which 
 the law that force is generated by decomposition is fully carried out. 
 Every motion of the body, every pulsation of the heart, nay, even 
 every thought, is accompanied by the destruction of a certain amount 
 of tissue. As long as food is supplied in sufficient amount and the 
 assimilative functions are not disordered, reparation proceeds as 
 rapidly as decay, and so long as these two actions exactly counter- 
 balance each other life and health, unless, of course, in case of acci- 
 dent, continues. 
 
 The human body has been aptly likened to a machine, and it is said 
 that every machine has a natural life, capable of doing just so much 
 work, but after all our machine differs from an inorganic machine in 
 the fact that it possesses the power of self-repair, and also that for a 
 given time, say between birth and the twenty-fifth year, our machine 
 increases in growth and efficiency ; there is then another period, limited 
 
 o Carpenter, "Cyclopedia of Anatomy and Physiology," Vol. I, article "Age," 
 ** Hammond's Treatise on Hygiene." 
 
158 BEPOBTS OF THE PRESIDENT'S HOMES COMMISSION". 
 
 usually between the twenty-fifth and thirty-fifth year, during which 
 the living machine maintains its fullest development and resistance, 
 probably because regeneration and waste are exactly counterbalanced, 
 and then comes the period of decline, reaching from the thirty-fifth 
 year to the extreme limit of Imman life, when this natural resistance 
 begins to fail and the tissues are not regenerated as fast as they are 
 broken down. (Hammond.) 
 
 The various periods in the life of man are marked by certain pecul- 
 iarities, and exhibit susceptibility to some diseases and immunity to 
 others. 
 
 Statistics show that out of every 1,000 children born alive, 188, or 
 over one-sixth, perish before the completion of the first year. Of the 
 twelve months during the first year of life the first month furnishes 
 the highest mortality. This is due to the fact that a great many 
 children, imperfectly developed at birth, die within a few days; the 
 first month is followed by the second, third, and fourth month, prob- 
 ably, also, because of diminished vital resistance ; next by the twelfth 
 month. This jump from the fourth to the twelfth month is quite 
 suggestive, as it is the usual period of weaning, with its attending 
 danger from digestive diseases incident to artificial feeding. 
 
 During the second and subsequent years the mortality gradually 
 decreases, and of children between the ages of 1 and 5 years there die 
 annually about 37 out of 1,000, making a total loss during the first five 
 years of 336 out of every 1,000 children bom. If we stop to inquire 
 into the immediate cause of the excessive mortality during the first 
 twelve months, we find that about 40 per cent perish from diseases of 
 the digestive system ; about 21 per cent from affections of the respira- 
 tory organs; next in frequency are the infectious diseases like diph- 
 theria, scarlet fever, measles, whooping cough, mumps, tubercular 
 affections. Rickets, diseases of the nervous systems, convulsions, and 
 inflammation of the brain and its membranes are also of common 
 occurrence. 
 
 As the age of the child advances the body becomes more fully de- 
 veloped and better fitted to resist disease. The diseases to which the 
 race is especially liable during the period extending from puberty to 
 maturity, or about the twentj^-fifth year, are those of the respiratory 
 organs, tuberculosis, appendicitis, and typhoid fever. Thus of 500 
 cases of typhoid fever analyzed by me, 327 cases were between the ages 
 of 10 and 25 years. It has been suggested that the undue prevalence of 
 these diseases, as well as of mental and nervous affections during this 
 period, may possibly be connected with a diminished power of resist- 
 ance, the result of morbid sexual habits. 
 
 The diseases which are most frequently met with during the period 
 of maturity, which ordinarily extends from the twenty-fifth to the 
 thirty-fifth year of life, are consumption, gastric affections, and 
 rheumatism. 
 
 The period of decline has been stated to embrace the thirty-fifth 
 year to the extreme limit of human life. This is scarcely exact, as 
 in the majority of instances we observe a period varying from five 
 to ten years, during which the body remains at a nearly fixed point 
 of development, before a disposition to degeneration is manifested. 
 Indeed, during the first few years of actual decay the organism is so 
 slowly affected that very little inconvenience results, and occasionally 
 
BEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 159 
 
 Individuals may withstand the tendency to degeneration to a very 
 advanced period of existence. 
 
 The diseases to which the period of decline is especially liable are 
 apoplexy and organic diseases of the heart and blood vessels, liver, 
 and urinary organs. Gout and chronic rheumatism, pneumonia, 
 bronchitis, and a variety of nervous affections are also very common ; 
 while malignant diseases, especially in the female after the cessation 
 of the menstrual functions, are not infrequent. 
 
 We have not attempted to answer the question, quite often asked, 
 why the body, after reaching a certain point of development, ceases 
 to grow. A question equally interesting and difficult is, Why does 
 the body, after reaching maturity, begin to degenerate ? It has been 
 said by Hammond: 
 
 If it were possible to so adjust the repair to the waste that neither would 
 be in excess, there is no physiological reason why life, if protected against 
 accidents, should not continue indefinitely. 
 
 But as this, with our present knowledge, is impossible, we should 
 at least direct our attention to the removal of the factors which here- 
 tofore have interfered with the average span of life allotted to us. 
 We know that with the advance of hygiene the average human life 
 has been lengthened from eighteen to twenty years in the sixteenth 
 century to thirty-eight to forty years and over at the present time, 
 and there is reason to hope that we may still further prolong our 
 existence. While much has been accomplished in the past, more 
 remains to be done, and one of the pressing needs is an enlightened 
 system of dietetics. 
 
 A long series of investigations on tissue metamorphosis have been 
 conducted by the Department of Agriculture — but are now inter- 
 rupted for lack of funds — with a view of determining what substances 
 are necessary to repair a certain amount of waste. We are extremely 
 careful in other machines to use only those substances for the genera- 
 tion of force Avhich are proper and no more than is absolutely neces- 
 sary. In the human system little attention is paid to this question, 
 and we eat without regard to the exact wants, and sooner or later 
 disorganization results. Next, we want to be able to exercise all the 
 organs of the body to that extent only which will insure their activity 
 and the deposit of sufficient new material to keep them in a state of 
 preservation, without leading to excess of the process of either re- 
 gressive or progressive metamorphosis. 
 
 THE CAUSES OF DISEASE. 
 
 The direct and exciting causes of disease have been a source of much 
 study. Thanks to the progress of medical science, the field is now 
 limited to certain chemical, physical, mechanical, and vital agencies 
 capable of producing definite alterations of the tissues and fluids of 
 the body and manifestations of disease. Among the chemical causes 
 we recognize: First. Those originating without the body of an or- 
 ganic an dinorganic character, commonly known as irritants or 
 poisons, many of which have been referred to in connection with in- 
 dustrial pursuits. Second. Those originating within the body as a 
 result of overeating, malnutrition, malfermentation, and other defects 
 in the physiological functions of the body. Some of these, according 
 
160 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 to Abbott,'* include the ordinary end products, or waste matter of 
 tissue activity, that have accumulated within the system as a result 
 of defective accretory and excretory organs; while still others are 
 the toxic products of malfermentations, often in operation within the 
 alimentary tract. There is much reason for believing that the pro- 
 tein, when taken in excess in the food, undergoes putrefaction, and 
 the absorption of these products gives rise to auto-intoxication by 
 rendering the blood current impure. Herter, Comb, and others have 
 shown that such a condition produces various maladies and milder 
 forms of indisposition, and MetchnikofF considers auto-infection the 
 chief cause of premature old age. Among the most frequent physical 
 causes of disease are excessive heat, cold, and moisture.^ while the 
 mechanical causes include, of course, accidents and injuries of every 
 description. 
 
 VITAL CAUSES. 
 
 By the term " vital causes " we understand certain living animal 
 and vegetable parasites capable of reproduction in the body, and under 
 favorable conditions of producing manifestations of disease. " It 
 matters little whether the living organism is large or small, or belongs 
 to the vegetable or animal kingdom, or whether it produces its effect 
 in the skin, muscle, lympathics, internal organs, intestines, or in the 
 blood, its introduction and reproduction constitute infection." 
 (Sternberg.) 
 
 The writer does not pretend to differentiate between infectious and 
 contagious diseases except to indicate that all contagious diseases are 
 infectious, but not all the infectious diseases are contagious. Small- 
 pox, measles, scarlet fever, German measles, mumps, and chicken pox 
 are notable contagious diseases. Erysipelas, pneumonia, tuberculosis, 
 glanders, and diphtheria, while not usually contagious, may become 
 so under favorable conditions. Typhoid fever, cholera, yellow fever, 
 and common suppuration are given by Abbott as examples of non- 
 contagious infectious diseases. 
 
 THE PREVENTION OF INFECTIOUS DISEASES. 
 
 One great peculiarity of most of the infectious diseases is that they 
 usually occur in groups, for it rarely happens that isolated cases of 
 diphtheria, scarlet fever, measles, etc., develop unless special precau- 
 tions have been taken to stamp out the first cases. Very generally a 
 number of cases occur which can be traced to a common source of in- 
 fection, and the disease may assume epidemic proportions. The ques- 
 tion naturally arises. What constitutes an epidemic? In other wcft-ds, 
 how many cases are necessary before an infectious disease in a com- 
 munity with a given population can be said to be epidemic. Various 
 answers have been given. The writer believes that a sudden and un- 
 due prevMlcnce of any infectious disease may very properly be char- 
 acterized as an epidemic. A disease is spoken of as pandemic when it 
 spreads, like influenza for example, over a great extent of country — 
 affects groups of several countries of the world generally. The term 
 
 « " Hygiene of Transmissible Diseases," 1899, p. 52. 
 » Kober's " Industrial Hygiene," p. 65. 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 161 
 
 " endemic " is applied to diseases that prevail in particular localities 
 and are influenced by local conditions. 
 
 It is in the field of infectious diseases that hygiene has achieved, 
 and doubtless will continue to achieve, its greatest triumphs, and there 
 is ample room when we contemplate the frightful mortality from 
 these diseases. Think of the fact that consumption, during the census 
 year 1900, claimed 111,059 victims in the United States alone. Pneu- 
 monia caused 105,971 deaths, diarrheal diseases 46,907, typhoid fever 
 35,379, cholera infantum 25,576, influenza 16,645, diphtheria 16,475, 
 croup 12,249, malarial fever 14,874, measles 12,866, whooping cough 
 9,958, septicemia 6,776, scarlet fever 6,333, cerebro-spinal meningitis 
 4,174. In order to appreciate the full significance of these figures we 
 must consider not only the mortality, but also the number of cases 
 treated. So, for example, the 35,379 deaths from typhoid fever in 
 one year represent an annual prevalence of not less than 353,790 cases. 
 The duration of a case of typhoid fever is not less than thirty days. 
 If we calculate the average cost for care, treatment, and loss of work 
 to be $300, and the average value of a human life at $5,000, we have a 
 total loss of $283,032,000 per annum from one of the so-called pre- 
 ventable diseases. 
 
 We know that many of these diseases are preventable, and can at 
 least, be checked, if not entirely stamped out. The decrease in the 
 death rate from consumption in the United States since 1890 amounts 
 to 54.9 per 100,000 of population. Diphtheria and croup, 52.5; 
 cholera infantum, 31.9; diarrheal diseases, 19; typhoid fever, 12.5; 
 malarial fever, 10.4; whooping cough, 3.1; scarlet fever, 2.7. Indeed, 
 the average age at death in 1890 in the United States was 31.1; in 
 1900 it was 35.2 years. 
 
 " IF CERTAIN DISEASES ARE PREVENTABLE, WHY ARE THEY NOT 
 
 PREVENTED? " 
 
 This very pertinent question was asked some years ago by the 
 Prince of Wales, now King Edward, of England. Our answer is, 
 while every scientific physician knows full well that if the methods 
 of prevention recommended by sanitarians — including the prompt 
 disinfection of the dejecta of typhoid fever patients, the expectora- 
 tion and excretions of diphtheria, tuberculosis, and pneumonia pa- 
 tients — were adopted, these diseases would be reduced to a minimum, 
 and probably eradicated in the course of a few years. The facts are, 
 these recommendations have not been generally adopted because the 
 knowledge gained by experimental medicine is not sufficiently 
 diffused. Nor is the medical profession responsible for the fact that 
 so many States still permit every charlatan to practice one of the 
 most difficult and responsible of all professions, without a rigid sys- 
 tem of examination. So long as we recognize and employ irregular 
 and incompetent practitioners, so long will infectious diseases be 
 spread as the result of ignorance and neglect. 
 
 The public should be made familiar with the nature and causes of 
 infectious diseases, and be taught that many are a source of danger 
 against which it is entitled to be warned. The health department 
 should have competent medical inspectors and a clinical laboratory 
 for the verification of the diagnosis. It should have the power, in 
 
 S. Doc. 644, 60-2 12 
 
162 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 certain of these diseases, to display warning signs, to enforce isola- 
 tion and disinfection, and to take such other steps in the way of pre- 
 vention as may be deemed necessary to limit their spread. 
 
 Isolation to be effective should extend to all persons who have come 
 in intimate contact with the patient. This is rarely enforced, except 
 in smallpox, in the case of the wage-earners of the family, but it is 
 clearly their duty to take special precautions in the way of clothing 
 and personal disinfection. 
 
 Since our knowledge of the nature of infectious diseases has been 
 more and more defined, scientific methods for their prevention have 
 been applied. We have learned, too, that in addition to the germ 
 there must be a suitable soil for its proliferation and that sanita- 
 tion should not only destroy the environment for its development 
 without the body, but also place the system in the best possible con- 
 dition to resist its poisonous action. In the way of individual efforts, 
 all measures which will improve the tone, nutrition, and vital powers 
 of the system, many of which have been alluded to in the preceding 
 pages, can not fail to render us less susceptible to infection. Nor 
 should we underrate the importance of preventive inoculations, for 
 it must be remembered that smallpox, for example, would continue 
 to carry off one-tenth of the population and disfigure another tenth 
 if it were not for the protective influence of vaccination. 
 
 The diseases which deserve special preventive efforts on account of 
 their undue prevalence are consumption, pneumonia, scarlet fever, 
 diphtheria, typhoid fever, diarrhea, and dysentery. . During the prev- 
 alence of the last three diseases, and especially when the water is 
 regarded with suspicion, the safest plan is to boil the drinking water 
 and bring the milk to the boiling point. While the general rules of 
 hygiene are necessary at all times, they are especially indicated 
 during the prevalence of epidemics. A simple life, hope and courage, 
 avoidance of excesses, of overwork, fear, and anxiety will serve to 
 maintain a natural power of resistance to infection. 
 
 If in spite of all precautions, including, of course, avoidance of 
 sources of infection, contagious diseases should gain a foothold in the 
 family, the advisability of hospital treatment ought to be seriously 
 considered. The advantages from every point of view are in favor 
 of such a course, especially when we consider the danger of infection 
 to other members of the family. 
 
 SICK ROOM, CARE AND DISINFECTION. 
 
 If the patient is treated at home, a bright, quiet, and cheerful room 
 should be chosen, and promptly stripped of carpets and unnecessary 
 furniture. It is in just such instances, when the importance of simple 
 furniture, oiled or waxed floors, avoidance of draperies, dust and 
 germ traps gain special significance. It is needless to insist that the 
 room must be kept properly ventilated. 
 
 In the light of our knowledge it is certainly our duty to tell the 
 family, in typhoid cases, that the infectious matter is contained in the 
 excreta, and must be destroyed for the protection of others. In like 
 manner we should not hesitate to inform a consumptive and his 
 friends that the germs of the disease are contained in the expectora- 
 tions; how they may be conveyed to others in coughing, kissing, and 
 
REPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 163 
 
 dried sputum, and how they should be destroyed. And so we might 
 go through the list of infectious diseases. 
 
 Scientific disinfection had its inception with the labors of Koch 
 and Sternberg in 1880. Although certain physical and chemical 
 agents were used empirically for ages, now we know, from laboratory 
 experiments, that they are effective, because they destroy the vitality 
 of the germs. We also know that in most of the contagious diseases 
 the infective matter is given off by the patient chiefly through the 
 secretions and excretions, and it is evident that disinfection to be of 
 value must be directed to these and all the media with which the 
 patient has come in contact. 
 
 A small gas stove near the sick room, and a 4-gallon wash boiler 
 in which napkins, soiled linen, or clothing can be boiled, and thus 
 disinfected before being laundered, will protect other inmates. The 
 use of separate eating and drinking utensils, which can be boiled 
 in a weak soda solution, is also a necessary precaution. 
 
 The refuse of meals should be placed in a covered vessel containing 
 a disinfectant solution (IJ tablespoonfuls of lysol to 1 quart of 
 water). A similar solution may be used to wipe the floor, furniture, 
 and door knobs. Clinical thermometers, tongue depressors, and other 
 instruments should be kept in a disinfectant solution and rinsed off in 
 warm water before using. 
 
 The stools, vomited matter, expectorations, urine, blood and pus of 
 infectious patients, especially those suffering from typhoid fever, 
 dysentery, cholera, tuberculosis, pneumonia, influenza, diphtheria, 
 and scarlet fever, should be placed in a covered vessel containing the 
 germicidal solution to be hereafter described, the whole to be thor- 
 oughly mixed and allowed to stand for one hour before throwing the 
 contents into water closets or privy vaults. Disinfection is also indi- 
 cated in diseases like typhus fever, cerebro-spinal meningitis, small- 
 pox, anthrax, glanders, and j^ellow fever ; in the latter disease chiefly 
 for the destruction of mosquitoes. It would also be well to resort to 
 disinfection in all the early cases of measles, whooping cough, doubt- 
 ful cases of fever, and diarrheal affections. 
 
 In diseases like smallpox and scarlet fever, in which the infectious 
 agent is given off most likely from the surface of the body, occasional 
 sponging with dilute chlorinated soda solution, 1 part to 9 of water, 
 has been recommended, or the body may be anointed with some harm- 
 less antiseptic ointment ; while during convalescence, i. e., just before 
 the patient mingles with others, a corrosive sublimate bath, 3 drachms 
 to 30 gallons of water, is indicated. Infectious corpses should not 
 be washed, but enveloped at once in a sheet saturated with a 5 per 
 cent solutioa of carbolic acid or bichloride solution, 2 drachms to a 
 gallon of water. 
 
 All worthless articles should be burned. Metallic bodies may be 
 sterilized b}^ exposure to red heat or boiling. A good solution for 
 soiled body and bed clothing is made of carbolic acid 3 parts, com- 
 mon soft soap 2 parts, and cold water 100 parts; they should soak 
 for two hours, when they may be rinsed and sent to the laundry. 
 Valuable clothing, mattresses, carpets, and draperies should be sub- 
 jected to disinfection in a special apparatus furnished by the health 
 department, and in the absence of such facilities they should be hung 
 up loosely in the room and subjected to the influence of formaldehyde 
 
164 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 gas, which has also been found the most effective agent for room 
 and house disinfection after the recovery, death, or removal of pa- 
 tients, and is usually conducted by agents of the health office. A 
 cheerful compliance with the rules and regulations of this service 
 can not fail to be a benefit to the family and public at large. If such 
 a department does not exist, if becomes the duty of the attending 
 physician to see that the premises are properly disinfected. For this 
 purpose it is necessary to make the apartments as nearly air-tight 
 as possible, and to generate either formaldehyde by the combustion 
 of wood alcohol or liberate it from formalin. The room must be kept 
 closed for six hours after fumigation and it should then be thor- 
 oughly aired and exposed, when practicable, to sunlight, which is in 
 itself a very efficient germicide. 
 
 The report of the committee on public health of the Medical 
 Society, District of Columbia (" Washington Medical Annals," 
 January, 1908), shows that there has been a marked reduction in 
 the mortality of diphtheria, measles, and scarlet fever during the past 
 ten years in the American cities, coincident with the establishment 
 of municipal quarantine and disinfection. The average reduction 
 in the mortality from diphtheria in 10 cities amounted to 24.4 per 
 cent. While in this disease the use of antitoxin has served to accom- 
 plish the result, the reduction of 44 per cent in the mortality from 
 measles and a reduction of 70.8 per cent in the mortality of scarlet 
 fever must be largely attributed to preventive efforts, including, of 
 course, higher standards of living. 
 
 In this connection the early use of diphtheria anitoxin should be 
 emphasized. The average diphtheria mortality, where antitoxin was 
 used, in Chicago in 1902 was 6.48 per cent, and where not used it 
 was 32.5 per cent ; the mortality in children when used upon the first 
 day was only 1.45 per cent, but when used later than the fourth day 
 it rose to 14.49 per cent. 
 
 Space will not permit a detailed statement of other triumphs in 
 preventive medicine, but the fact that, according to Surgeon-General 
 Wyman of the Public Health and Marine-Hospital Service, there were 
 during the last eight years 242,847 cases of smallpox with 6,067 deaths 
 in the United States prompts the suggestion that every death from 
 smallpox is a disgraceful reflection upon the intelligence of the age. 
 This disease is entirely preventable by vaccination and proper re- 
 vaccination. The statistics of England show that in the last half 
 of the eighteenth century out of every 1,000 deaths from all causes 96, 
 or nearly one-tenth, perished from smallpox. On the 14th of May, 
 1796, Edward Jenner introduced vaccination. During the period of 
 optional vaccination the death rate fell from 200 to 41.-^ per 100,000 
 of population, and from 1850 to 1898, during a period of compulsory 
 vaccination, it fell to 5.3. In August, 1898, the " conscientiously 
 believes " clause was inserted in deference to the anti- vaccinationists ; 
 230,147 persons were exempted by the operation of the law, and in 
 1902 the rate rose in Scotland to 7.5, and in the United Kingdom 
 to 6.1 per 100,000. The statistics of Prussia show that with the en- 
 actment of the revaccination law in 1874 the mortality has fallen 
 to less than one-tenth per 100,000 of population, while the rate in 
 the registration area in the United States is just 34 times greater. 
 Indeed, it is claimed that Prussia would be entirely free from the 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 165 
 
 disease were it not for the importations from Eussia and Austria. 
 President Thomas Jeiferson was instrumental in introducing vacci- 
 nation in 1801 in the South, and in 1806, according to Harrington, 
 wrote the following letter to Doctor Jenner : 
 
 You have erased from the calendar of human afflictions one of its greatest. 
 Yours is the comfortable reflection that mankind can never forget that you 
 have lived. Future nations will know by history alone that the loathsome 
 smallpox has existed and by you has been extirpated. 
 
 It is to be regretted that these prophetic words should not have been 
 fulfilled in this country of progress and enlightenment. With the 
 introduction of glycerinated animal lymph every vestige of prejudice 
 against vaccination should cease, and compulsory laws should be 
 enacted in every State, so that smallpox here, as in the German army, 
 may become practically unknown. While quite a number of States 
 have enacted laws requiring that un vaccinated children shall not be 
 admitted to the public schools, the undue prevalence of the disease 
 indicates that these laws are not rigidly enforced. 
 
 TUBERCULOSIS OR CONSUMPTION. 
 
 The total number of deaths reported as due to consumption in the 
 United States during the census year of 1900 was 109,750, of which 
 53,626 were males and 56,124 were females. Statistics also show that 
 the death rate from this disease in 1900 was highest in the District of 
 Columbia. As a matter of fact, according. to the records of the health 
 office during the past thirty years, 14.5 per cent of all the deaths 
 occurring in the District of Columbia have been caused by pulmonary 
 tuberculosis. The death rate, however, has gradually and constantly 
 improved and has fallen from 4.5 per 1,000 inhabitants in 1878 to 2.3 
 in 1907. This decline, we believe, is almost entirely due to improved 
 methods in general sanitation and higher standards of living, which 
 have increased the natural power of resistance to the disease. The 
 decline in the death rate of the white race during this period has been 
 from 3.3 in 1878 to 1.3 in 1907, and for the colored race from 6.9 to 
 4.5 during the same period. An emphasis is given to the comparison 
 of the death rates of the two races when we realize that the average 
 colored population of the District during the past thirty years was 
 about 31.8 per cent of the entire population. In other words, 31.8 per 
 cent of the population has furnished over 54 per cent of deaths from 
 pulmonary consumption since 1878. There were 9,534 deaths from 
 this disease during the past twelve years in this city — 4,266 white and 
 6,268 colored. 
 
 Consumption not only leads the list of diseases in order of frequency 
 and mortality, but the pecuniary losses entailed by the long duration 
 of the disease and the danger to others from infection renders the 
 subject of importance from an economic as well as medical point of 
 view. If we assume the average duration of the disease to be two 
 hundred days, and that $2 per day is expended for treatment, care, 
 and loss of work, the 9,534 deaths in twelve years involved a total 
 financial loss to the community of $3,813,600, or an average of 
 $317,800 per annum. 
 
 The classical researches of Koch have established beyond a doubt 
 that the disease is caused by the growth and multiplication in the 
 
166 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 body of man or animal of a living microscopic organism or vegetable 
 cell called the tubercle bacillus. 
 
 The mere introduction does not necessarily cause disease, as the 
 system possesses certain defensive forces, and if the tissue cell hap- 
 pens to be stronger than the microbial invader no liarm results. If, 
 on the other hand, the conditions of the system favor the growth and 
 development of the germ, little tumor-like knots are formed, known 
 as tubercles or tubercular deposits. These, if formed in the lungs, 
 may soften and break down and are coughed up. Heller calculates 
 that 7,200,000,000 of bacilli may be expectorated in twenty- four 
 hours by a single patient. 
 
 The disease most commonly affects the lungs, but may also affect 
 the glands, intestinal and other internal organs ; also the skin, mucous 
 membranes, bones, joints, and the membranes of the brain. 
 
 The bacillus has been found in all tubercular deposits in man and 
 animals, and the most frequent source of infection is conveyance from 
 man to man, while the possibility of transmission from animals to 
 man can not be ignored. 
 
 The germs may enter the system by the respiratory and alimentary 
 passages, and by the skin and mucous membranes if there is an 
 abrasion. The tubercle bacilli have not yet been demonstrated in the 
 soil, water, or atmosphere, except in the immediate vicinity of a con- 
 sumptive. Cornet demonstrated their presence in the dust of rooms 
 and hospitals inhabited by consumptives in 40 of the 147 samples 
 examined. Since the brea.th of tuberculous patients does not con- 
 tain the germs, we may assume that, when found in rooms, they 
 originate from the material coughed up by persons and carelessly 
 expectorated upon the floor, walls, or carpet, which material, after 
 drying, becomes a constituent of the household dust. 
 
 It has also been shown by the classical investigations conducted 
 under Professor Fluegge that about 80 per cent of consumptives may 
 in coughing, sneezing, and talking project into the air little droplets 
 infected with tubercle bacilli, withm a distance of 2 to 3 feet from 
 the patient ; and that these droplets constitute a source of danger, as 
 they may be inhaled in a fresh and virulent state, especially if pa- 
 tients fail to guard against this mode of spreading by the use of 
 handkerchiefs held before their mouths. It is believed that this 
 mode of spreading infection also operates to a great extent in in- 
 fluenza and infectious catarrh of the respiratory passages, sore 
 throats, diphtheria, etc. Fluegge, without wishing to exaggerate the 
 danger from droplet infection, believes it to be greater than from the 
 inhalation of infected dust. He very properly emphasizes the sources 
 of infection from fresh dried sputum on floors, handkerchiefs, cloth- 
 ing, towels, etc., and it is perfectly conceivable that the germs may 
 likewise be conveyed by small particles of sputum in kissing, in in- 
 strumental manipulations, or by adhering to eating and drinking 
 utensils in common use. There is much reason to believe that the 
 germs may be conveyed in clothing from carelessly expectorated 
 sputum. Perlen tells us that of 4,177 tuberculosis subjects treated in 
 the Munich Poliklinik, 709 were engaged in tailoring, cleaning, and 
 shoe shops. 
 
 Tubercle bacilli have been found in the milk of tuberculous mothers 
 and cows, especially when the lacteal glands were the seat of the 
 disease or the system was infected with general tuberculosis; they 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 167 
 
 have also been found, under certain conditions, in the flesh of animals, 
 and in the blood, feces, and urine of affected persons. Milk, cream, 
 butter, ice cream, and dairy products may contain tubercle bacilli if 
 the product is derived from an infected cow. 
 
 Professor Koch's views on this subject are in substance as follows: 
 
 1. The tubercle bacilli of bovine tuberculosis are different from 
 those of human tuberculosis. 
 
 2. Human beings may be infected by bovine tubercle bacilli, but 
 serious diseases from this cause occur very rarely. 
 
 3. Preventive measures against tuberculosis should, therefore, be 
 directed primarily against the propagation of human tubercle bacilli. 
 
 His opponents, on the other hand, believe that the danger from the 
 transmission of bovine tuberculosis is considerable, and infection by 
 the intestinal route may not only produce tuberculosis of the bowels, 
 peritoneum, and lymphatic glands, but also of the lungs. Much re- 
 mains to be done, however, to determine the real degree of danger 
 from bovine tuberculosis. 
 
 According to Doctor Salmon, during the year 1900, of 4,186,166 in- 
 spected cattle in the United States, 5,279, or 1 in 921, were tubercu- 
 lous, and of 23,336,884 hogs, 5,444 were sufficiently affected to cause 
 contamination of some part of the carcass. The writer has tabulated 
 86 cases of milk-borne tuberculosis, 3 accidental inoculations in man 
 by the topical application of cream and milk, and 12 tuberculosis 
 wound infections in veterinarians and butchers. 
 
 The possibility that the germs of tuberculosis may be carried by 
 means of flies and dust suggests that greater precaution be exercised 
 in the exposure of foodstuff's in show windows and markets. Other 
 modes of infection, such as by the mucous membranes of the eye, geni- 
 tals, wounds, and even through the unbroken skin, have been reported. 
 There is little or no evidence to show that the disease is ever inherited, 
 but we may assume that in children of consumptive parents we are 
 dealing with the transmission of vulnerable anatomical elements, and 
 this, together with the fact that they are constantly exposed to the 
 germs, renders them peculiarly liable to the disease. 
 
 From what has been said it is evident that the tubercle bacilli are 
 widely scattered; the modes of invasion are also numerous; and yet 
 there is a certain proportion of those exposed who do not contract the 
 disease. This shows that in addition to the germ there must also be 
 a suitable soil for its growth and development. Such a soil is usually 
 found in persons of feeble physique, victims of malnutrition, whose 
 bodies have been weakened from any one or more of numerous causes, 
 whether it be a previous attack of sickness, loss of sleep, dissipation, 
 morbid habits, insanitary houses, lack of pure air, cleanliness, sunlight 
 and outdoor exercise or of proper food. 
 
 Clinical experience indicates that faulty nutrition, debility, loss of 
 blood, anemia, mental anxiety, diabetes, whooping cough, measles, 
 and other diseases favor the development of tuberculosis. We also 
 know that a predisposition may be mherited, as evidenced by a deli- 
 cate physique, narrow chest, and general vulnerability of the tissues. 
 A vulnerability of the tissues to the disease may also be acquired by 
 dust- producing occupations, and here the amount of dust seems less 
 important than the character of the particles which compose it. For 
 this reason, no doubt, the hard, sharp, and angular particles of iron 
 
168 REPORTS OF THE PRESIDENT'S HOMES COMMISSION, 
 
 and slone dust are more liable to produce injuries of the respiratory 
 passages, thus favoring the invasion of the bacilli. 
 
 Uffelmann believes that what we call inherited or acquired predis- 
 position to tuberculosis may amount, in many instances, only to a 
 local susceptibility of the respiratory passages, a weakness of the 
 membranes, and greater vulnerability, and refers to the fact that 
 some individuals, otherwise healthy, show a greater liability to laryn- 
 geal and bronchial catarrhs, and later to tuberculosis, whilst in others 
 repeated attacks of tonsilitis predisposes to diphtheria. 
 
 The observations of Doctor Bowditch, of Boston, and Doctor 
 Buchanan, of England, indicate that damp soils and habitations are 
 important predisposing causes to tuberculosis, and we know posi- 
 tively that a decided reduction has been observed everywhere coinci- 
 dent with the introduction of sewers. The only reasonable explanation 
 is that sewers have helped to purify the air, and rendered otherwise 
 damp soil and houses dry and more healthful. It is well known that 
 a damp soil is liable to make a house damp by a capillary attraction, 
 and the injurious effects of damp air have already been pointed out 
 on page 104.* 
 
 As in other infectious diseases, the question as to whether the germs 
 are introduced directly, and in sufficient numbers, is of importance. 
 The observations of Humphrey, Pollock, and Leudet conclusively 
 show that in well-ventilated wards of chest and consumption hos- 
 pitals the disease is not usually found to spread. In private practice 
 the results are different. A French committee of investigation pre- 
 sents 213 cases of tuberculosis in which the communicability of the 
 disease was clearly established. In 64 of these cases the disease was 
 conveyed from husband to wife ; in 43 from the wife to the husband ; 
 in 38 it was transmitted to brothers or sisters ; in 19 from parents to 
 the children; in 16 to distant relatives; and in 32 to outsiders. The 
 communicability was most marked among the poorer classes. Another 
 collective investigation, by a German medical society, revealed the 
 fact that of 938 married persons who died of acquired tuberculosis, 
 in 101 instances either the husband or the wife also contracted the 
 disease. In 8.1 per cent of these cases the husband contracted the 
 disease from his wife, and in 13.2 per cent the wife was infected 
 from the husband. Other statistics might be adduced in favor of the 
 communicability of the disease, but Zasetzlcy's observation is of spe- 
 cial interest. He reports the case of a tuberculous woman who mar- 
 ried, between 1872 and 1883, 3 husbands, all previously healthy; 
 the first husband died in 1879 of tuberculosis ; the second in 1881, and 
 the third husband, at the time of the report in 1884, was also a 
 victim of the disease, the wife in the meantime having died of 
 consumption. 
 
 We can only explain the greater contagiousness in such cases by a 
 more intimate contact, the occupation of the same room and bed, 
 common use of eating and drinking utensils, mouth to mouth contact, 
 and the vitiated and infected air of private rooms. 
 
 KABLT SYMPTOMS OF CONSUMPTION. 
 
 The early symptoms are by no means clearly defined; we have, 
 however, a steady loss in weight, with a slight amount of fever, 
 
 • Kober's Industrial Hygiene. 
 
BEPORTS OP THE PRESIDENT'S HOMES COMMISSION. 169 
 
 especially in the afternoon or evening ; the heart's action is quickened 
 upon the slightest exertion, there is a general feeling of progressive 
 weakness, with loss of appetite or disturbed digestion. There may- 
 or may not be a cough in the early stage of the disease. The 
 symptoms referred to are sufficiently serious to call for the advice 
 of a physician, and should never be neglected. Every child should 
 learn to know that prompt treatment in the incipient stage offers 
 the best chances for recovery, and that by proper care 80 per cent 
 may be permanently cured. 
 
 Consumption is a curable disease, and the chief remedies, such as 
 fresh air, wholesome food and living quarters, suitable clothing, 
 systematic bathing and hardening of the skin, are also the best pre- 
 ventive measures. Patients should not waste money on patent medi- 
 cines or advertised cures for consumption. No reputable physician 
 ever advertises his skill, and persons unable to pay for medical 
 services will always find competent men at the dispensaries. 
 
 PREVENTION OF TUBERCULOSIS. 
 
 The facts presented in the foregoing pages justify the following 
 conclusions : 
 
 1. Tuberculosis is an infectious disease caused by a microbe, trans- 
 missible to healthy persons under certain favorable conditions. 
 
 2. Inherited and acquired predisposition play an important role 
 in the invasion and multiplication oi the bacilli. 
 
 3. The germs may enter the system by the respiratory and alimen- 
 tary passages, and by the skin and mucous membranes, if there be 
 an abrasion. 
 
 4. 'V^^iile the bacillus may be transmitted through the milk, flesh, 
 and blood of animals and man, the most common and effective way of 
 distributing the disease is by the sputum and droplets of tuberculous 
 patients. 
 
 5. The habitations of consumptives as well as their personal effects, 
 clothing, etc., are infected and liable to convey the disease to others. 
 
 Space will not permit me to consider in detail the measures for 
 the prevention of this disease, but I desire to emphasize a few which 
 may be resorted to in the control of the sources of infection and the 
 diminution of the predisposing causes : 
 
 1. Compulsory notification of cases to the health authorities as 
 soon as the disease is recognized. This is of vital importance for 
 the location and control of the sources of infection, and for the 
 protection of the family and others. It has been urged that the 
 depressing effect of such information would be too great for the 
 patient, but this will surely be counterbalanced when we inform him 
 that it is a curable and preventable disease, and that his chances 
 for recovery are especially favorable if he does not reinfect himself. 
 
 The health authorities, apart from distributing proper printed 
 directions for the use of the family and the patient, as regard the 
 care, disinfection of sputum and avoidance of droplet infection, 
 should also resort to disinfection of the home and personal effects, 
 especially upon the death of the patient or vacation of the premises. 
 It is a good plan to receive the expectoration into paper spitting 
 cups, paper napkins, or moist saw dust, which should be burned. 
 Cuspidors should contain a carbolic acid solution (6 ounces to a 
 
170 BEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 gallon of water). The patient, when outdoors, should use pocket 
 spitting flasks, and during coughing or sneezing hold a handkerchief 
 over mouth or nose. Under no circumstances should patients spit 
 into spaces where the expectoration may be dried, and as pulverized 
 dust, gain access to the air. The same directions about disinfection 
 apply to cases suffering from pneumonia, influenza, and diphtheria. 
 The public should not cultivate an exaggerated fear of such cases, 
 but has a right to insist upon clean and decent precautions. 
 
 2. The enactment and enforcement of laws against promiscuous 
 expectoration and coughing into the faces of persons where the 
 sputum is liable to infect, and provisions for suitable spittoons and 
 their proper disinfection in all public places are called for. The 
 streets should be sprinkled and swept at night so as to reduce the 
 inhalation of germ-laden dust to a minimum. 
 
 3. The supervision of the sanitary condition of hotels, theaters, 
 churches, schools, ambulance service, sleeping cars, etc., should like- 
 wise be under the control of the health department, and house- 
 cleaning should be accomplished as far as practicable by the vacuum 
 system. 
 
 4. Marriage with a tuberculous person should not only be dis- 
 couraged, but absolutely prohibited by law. A tuberculous mother 
 should not nurse her infant, and in the selection of a wet nurse a 
 certificate of health should be demanded. 
 
 5. Isolation of tuberculous patients should be insisted upon in hos- 
 pitals, asylums, and public institutions. In private life the patient 
 should occupy at least a separate bed, use separate eating and drink- 
 ing utensils, and neither receive nor give kisses. 
 
 6. Government inspection of dairies and of dairy and meat prod- 
 ucts, and the extermination of bovine tuberculosis, are called for. 
 Until this is accomplished or as an additional precaution, milk should 
 be heated to 150° for ten minutes, cooled quickly and kept cold, and 
 all meats should be well cooked. 
 
 Having considered the sources of infection and the indications for 
 their control, it is well to refer to what may be done towards dimin- 
 ishing the predisposing causes to consumption. Many of these ques- 
 tions have been considered under personal hygiene, habitations, ven- 
 tilation, food, alcohol, tobacco, clothing, bathing, etc., and it remains 
 to sum up the duties of the state in this direction. 
 
 Reference has already been made to the good effects of sewers in 
 preventing air pollution, and in the removal of dampness by drain- 
 age. When we recall the influence of sewers upon the prevalence 
 of the disease, and remember that only about 30 per cent of the popu- 
 lation in the United States live in sewered towns, and about 41 per 
 cent live in towns having public water supplies, we see at once the 
 necessity that a system of public sewerage should go hand in hand 
 with the public water supply. The neglect on the part of the State 
 not only mcreases the dampness of the soil, but compels recourse to 
 the various makeshifts for the collection and removal of excreta, 
 and leads to pollution of the air, soil, and water. 
 
 INSANITARY DWELLINGS. 
 
 The influence of insanitary dwellings on the prevalence of tuber- 
 culosis has already been emphasized. In addition to what has been 
 
KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 171 
 
 said on page 104,** it should be remembered that the tubercle bacillus 
 clinging to floors and walls in carelessly expectorated sputum or 
 droplets would be destroyed by a few hours of sunlight, but finds in 
 damp and gloomy rooms a suitable environment for its vitality and 
 growth; and the other insanitary factors, alluded to vastly increase 
 the susceptibility to the disease. For all these reasons I consider the 
 condemnation of houses unfit for human habitation and substitution 
 of sanitary homes only second in importance to the destruction of the 
 germs. 
 
 The State may not be in position to provide sanitary houses, but it 
 can at least regulate and supervise the construction of all new houses 
 with reference to the exclusion of dampness, sanitary plumbing, 
 amount of air space, light, heating, and ventilation of dwellings, 
 and clearly define what constitutes an insanitary tenement, offered 
 for rent, and provide a suitable penalty. The State should also 
 interdict the erection of tall buildings, and of all buildings covering 
 over 66 per cent of the lot, since they shut out light and air, thus 
 destroying the very object for which broad streets and avenues were 
 created, and bringing us back to the insanitary era of the medieval 
 towns with their narrow and winding streets. 
 
 PHYSICAL CULTURE, PUBLIC PLAYGROUNDS, AND BATHS. 
 
 The State should pay attention to the physical development of our 
 youth, and this is best accomplished by proper training, preferably in 
 the open air, in connection with the public schools and playgrounds. 
 The children of consumptives require special attention because of the 
 transmission of vulnerable anatomical elements which render them 
 peculiarly liable to the disease ; this predisposition may certainly be 
 overcome, in addition to proper food, by pure air, methodical gym- 
 nastics, and systematic hardening of the skin secured by bathing, and 
 no school should be without these hygienic advantages. If it be 
 found that school children are starving for want of food it is clearly 
 our duty to make suitable provisions to prevent permanent depend- 
 ency. No effort should be spared to increase the resisting power of 
 the individual. Indeed, we are altogether too apt to underrate the 
 question of soil or predisposing factors in our crusade against the 
 disease. 
 
 There is abundant statistical material to indicate the influence of 
 dust-producing occupations as a predisposing factor to tuberculosis 
 and other pulmonary diseases, and it is clearly the duty of the State 
 to formulate efficient laws in regard to factory sanitation and the 
 occupations in general which are injurious to health. 
 
 It is certainly the duty of the State to see that every patient who 
 has no home, or whose environment offers less favorable conditions 
 for his recovery, is provided with proper care and shelter. It may be 
 truly said that hospital treatment of consumptives offers the best 
 chances for recovery and the ultimate extermination of the disease, 
 and the State, until a comprehensive system of industrial insurance 
 has been adopted, must shoulder the responsibility in the case of 
 patients unable to bear the financial burdens. Every city of any size 
 should provide facilities for the isolation and proper treatment of 
 
 •Kober's Industrial Hygiene. 
 
172 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 the patients, supplemented by general state sanatoria. Since the 
 identification of the disease is the first and most important step in its 
 treatment and prevention, the establishment of dispensaries for the 
 recognition of incipient cases among the dependent classes seems ur- 
 gently called for. Such dispensaries should become the feeders for 
 municipal and state sanatoria, and when properly conducted, with 
 special reference to social service, will be a most important factor in 
 the combat against tuberculosis. In all such cases it is desirable to 
 sift charity from abuse ; and it devolves upon the State to determine 
 the financial condition of the applicant and also prevent destitution 
 of the family while the breadwinner is incapacitated for work. It 
 is also the duty of the State to suppress quackery, for no class 
 falls more readily a prey to unscrupulous mountebanks than our 
 consumptives. 
 
 The Federal Government is already performing an important duty 
 by exercising a watchful care over the subject of tuberculosis among 
 animals. The preventive measures urged by the Bureau of Animal 
 Industry are of far-reaching significance, although primarily in- 
 tended to protect the pocketbooks of our farmers and stock raisers. 
 Large sums are annually, and very properly, expended to quarantine 
 our seaports against cholera, yellow fever, and smallpox, because 
 these diseases, if permitted to gain a foothold, occur in epidemics, are 
 rapidly fatal, and hence strike terror into a community. It is to be 
 hoped that similar opportunities will be afforded the public-health 
 service to cope with tuberculosis, which claims more victims than all 
 these diseases combined. 
 
 In the actual care and treatment we also have a right to expect a 
 more active participation on the part of the Federal Government. It 
 is a notorious fact that thousands of helpless cases of consumption 
 are annually dumped upon our States and Territories which have 
 become famed as health resorts; and the hospitals, sanatoria, and 
 almshouses of the Carolinas, California, Colorado, Arizona, and New 
 Mexico are filled with indigent dying consumptives. 
 
 It is claimed by Mr. Frank D. Witherbee, in " Charities," Novem- 
 ber 6, 1904, that in Phoenix, Ariz., public and private charity is 
 taxed to the uttermost, and that three-quarters of the money ex- 
 pended on the inmates of the almshouses goes to alien consumptives. 
 It is cruel and worse than useless to send a consumptive away from 
 home without sufficient means to secure the ordinary comforts and 
 advantages of climatic treatment, and the Federal Government should 
 not tolerate it. But until this is prevented, the Public Health and 
 Marine-Hospital Service should be authorized to study the problem, 
 which studies may form the basis for a more permanent and en- 
 lightened amelioration of the sufferings of this unfortunate class 
 of victims. 
 
 It is ver}^ evident that the great problem which confronts most of 
 our sanatoria to-day is. What shall be done with the class of indigent 
 patients whose disease has been arrested, but who need suitable em- 
 ployment and surroundings for their permanent recovery? While it 
 IS hoped that the opportunities of a cooperative system will broaden 
 out in time in connection with the State sanatoria, it can not be 
 denied that certain sections in the Far West offer suitable advantages 
 for a permanent cure, and the question arises whether the Federal 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 173 
 
 Government would not be justified in engaging in extensive live- 
 stock raising and employ young men of this class to do the work? 
 The Government needs horses and mules, beef and mutton, butter 
 and dairy products for the public service. It has many valuable 
 reservations, susceptible of cultivation with or without reclamation, 
 and there is no good reason why such government farms should not 
 prove self-supporting. 
 
 The results of the government sanatoria for consumptives at Fort 
 Bayard, Fort Stanton, and Fort Lyons have been so gratifying that 
 substantial and permanent results may be hoped for by an expansion 
 of the system to at least the civilian employees of the Government, 
 along the lines indicated, or by the establishment of colonies for 
 arrested cases. 
 
 PNEUMONIA. 
 
 Pneumonia ranks next in frequency to consumption as a cause of 
 death. During the census years of 1900 there were 105,971 deaths 
 from pneumonia in the United States. 
 
 The records of the health department show that during the past 
 twelve years there were 5,947 deaths from this disease in the District 
 of Columbia, 2,632 white and 3,315 colored. 
 
 The undue prevalence of pneumonia and tuberculous diseases of 
 the respiratory system is general. The colored population shows a 
 peculiar susceptibility, which is, in all probability, caused by environ- 
 ment and sociological factors rather than by racial differences. At 
 all events, an attempt will be made, on page 210, to account for the 
 undue mortality among our colored population. 
 
 Pneumonia, like tuberculosis, is an infectious disease, and is caused 
 by a microbe, first discovered by Gen. George M. Sternberg in 1880, 
 and subsequently demonstrated to be the essential factor in the 
 causation of the disease. This germ, known as a micrococcus, is 
 found in a considerable number in the mouth and saliva of perfectly 
 healthy subjects, and in very great numbers in the phlegm which 
 fills the air cells of the affected part of the lung, and is coughed up 
 during the disease in the form of rusty sputum. The rusty appear- 
 ance is due to the presence of blood corpuscles issuing from highly 
 inflamed lung tissue. The danger in pneumonia depends upon the 
 extent of lung tissue involved, the amount of toxins generated and 
 absorbed, the condition of the heart and kidneys, and the general 
 power of resistance of the patient. 
 
 In the causation of the disease we are evidently dealing with 
 several factors, viz, the presence of the micrococcus, individual pre- 
 disposition, and an exciting cause. Since the germ has been found in 
 the mouths of perfectl}^ healthy persons, and was, in fact, discovered 
 by General Sternberg in his own saliva, we may conclude that the 
 invasion of the microbe alone is not sufficient to produce the disease. 
 If, therefore, an attack of pneumonia results, the patient must have 
 furnished a suitable soil for the rapid multiplication of the germs, 
 and the structural changes which are brought about by their agency. 
 As in tuberculosis, so in this disease debilitating factors and depress- 
 ing influences, such- as malnutrition, alcoholism, and insanitary sur- 
 roundings, are important predisposing causes. But, in addition to 
 all this, there must be an exciting cause. A caref id study of the soa- 
 
174 BBPORTS OF THE PBESIDENT's HOMES COMMISSION. 
 
 sonal prevalence shows that pneumonia, like tuberculosis, bronchitis, 
 and congestion of the lungs, is very much influenced by temperature, 
 humidity, and prevailing winds. The following chart of the health 
 department shows deaths from pneumonia during 1906, arranged by 
 months, compared with the average monthly deaths for the past ten 
 years. This chart shows that the disease is especially prevalent dur- 
 ing the colder months of the year, and reaches a minimum in June, 
 July, August, and Septen.ber. It is well known that cold, and espe- 
 cially damp cold, winds, are often the cause of catching cold, prob- 
 ably because they abstract bodily heat in proportion to their velocity, 
 and if this takes place to an unusual degree, or with great abruptness, 
 the capillaries of the skin contract, the blood is driven into the in- 
 ternal organs, and congestion results, usually in the weakest spot. 
 As an additional effect of sudden changes in temperature, we have 
 the suppression of the cutaneous function and consequent retention 
 of effete matter in the blood. We can readily appreciate how all 
 this may be aggravated by the habitual presence of alcohol in the 
 blood current, which diminishes oxidation of the waste products, and 
 also by overcrowding, because the effect of deficient air supply is not 
 only to reduce the quantity of carbonic acid by expiration, but also 
 to diminish the normal oxidation of effete matter. In any event, the 
 conditions referred to favor the accumulation of effete matter, render 
 the blood current sufficiently impure to lose its germicidal properties, 
 and thus constitute a suitable fluid for the rapid multiplication of 
 the pneumococcus invader. It is also evident that other depressing 
 influences, such as previous illness, especially an attack of measles or 
 of influenza, vastly increase the vulnerability of the tissues and 
 chances of infection. 
 
 This disease is doubtless communicable from sick to well persons, as 
 shown by the occurrence of epidemics in prisons, institutions, etc.; 
 indeed, its infectiveness is no longer a matter of doubt, and calls for 
 prompt disinfection of the sputum and avoidance of close contact, in 
 the manner already described in the care of tuberculous patients. 
 
 While precautionary measures for the destruction of the germs are 
 of great importance in stamping out the sources of infection, our aim 
 must also be directed toward the correction of predisposing and ex- 
 citing causes. This we can do by clothing adapted to climate and sea- 
 sons, proper housing conditions as regards heating and ventilation. 
 proper food, and temperate habits. The disease, unfortunately, is 
 mcreasing in this country, and the increase is doubtless influenced 
 by the increased consumption of alcohol. We have already empha- 
 sized the fact that pneumonia is vastly more fatal among the topers. 
 
 We may also lessen the harmful effects of abrupt changes in tem- 
 perature by systematic hardening of the skin, remembering always 
 that a normal function of the skin depends largely upon .cleanliness, 
 and a proper tone of the cutaneous vessels and nerves, secured by 
 bathing. 
 
 INFI.UENZA (la GRIPPE ) . 
 
 Influenza or epidemic catarrh is also an infectious disease, caused by 
 a very small bacillus, discovered by Pfeiffer in 1892. This organism 
 is constantly found in the bronchial and nasal secretions of the af- 
 fected persons, and, as in tuberculosis and diphtheria, is largely dis- 
 
MONTHLY DEATHS FROM PNEUMONIA DURING 1906, COMPARED WITH AVERAGE MONTHLY 
 DEATHS FOR PAST TEN YEARS. 
 
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 Reproduced from the Report of the Health Officer, District of Columbia, 1907 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 175 
 
 seminated by close contact with the sick. The disease often assumes 
 pandemic proportions, because all ages are susceptible to infection, 
 and no precautions are taken to guard against its contagious nature. 
 As early as 1173 the disease is reported to have appeared in different 
 parts of Germany, Italy, and England, and since then over 60 epi- 
 demics have been recorded, of which 15 were very extensive. The 
 disease in the United States was first recognized in New England in 
 1627, and a number of epidemics, notably those of 1807, 1815, 1824, 
 1847-^8, 1851, 1857-58, 1874-75 have been recorded. The most ex- 
 tensive epidemic occurred in 1892 to 1897, and during the census year 
 1900 there were no less than 16,645 deaths from the disease in this 
 country. During the past twelve years 808 deaths were reported in 
 the District of Columbia. It is by no means a trivial affection, as it 
 carries off a number of persons, chiefly from pneumonic complica- 
 tions, and wrecks the health of many more by affections of the nerv- 
 ous system, heart, kidneys, eyes, and ears. In the prevention of the 
 disease the same general rules which have been urged in tuberculosis 
 and pneumonia are clearly indicated. 
 
 TYPHOID FEVER. 
 
 Typhoid fever carries off annually over 35,000 victims in the United 
 States. According to the records of the health department, there 
 were during the ten years ended December 31, 1906, 1,693 deaths (968 
 white and 725 colored) from this disease in the city of Washington. 
 Based upon an estimated mortality of 10 per cent, it is within reason 
 to assume that there were not less than 16,930 cases during the same 
 period. If we calculate the average cost for care, treatment, and loss 
 of work to be $300, and the average value of a human life $5,000, we 
 have a total loss in the vital assets of this community of $13,544,000 
 from one of the so-called preventable diseases. 
 
 Typhoid fever is essentially a filth disease, caused by a specific 
 bacillus, which is constantly found in the intestinal discharges, and 
 almost always in the blood and urine of typhoid fever patients. The 
 invasion of the microbe most likely takes place through the ali- 
 mentary tract, as evidenced by the location of the disease in the intes- 
 tines, and the frequent dissemination of the germs through the water 
 and milk supply. The possibility of transmission through the air 
 should not be excluded, for, as in tuberculosis, so in this disease the 
 infectious material may have become dried and pulverized, and with 
 particles of dust may gain access to the food or the mouth, there to 
 be swallowed or inhaled. 
 
 The principal source of transmission, however, is through the water 
 supply, infected milk, food, and infected hands. In all such in- 
 stances the virus proceeds primarily from the stools and urine of 
 typhoid patients, and gains access through sewers, or otherwise, to 
 the water supply, or contaminates vegetables and fruit which are 
 eaten raw, through the medium of night soil or washing them with 
 infected water. Milk and food may be contaminated by washing the 
 utensils with infected water or by handling it with unclean or in- 
 fected fingers. The writer, in his investigation of the typhoid-fever 
 situation in 1895, also pointed out how flies may carry the germs on 
 their feet, from typhoid stools and infected sources, to the food and 
 
176 RKPOBTS OP THE PBBSIDENt's HOMES COMMISSION. 
 
 milk supply. There is special danger from infection of the fingers in 
 handling or washing soiled patients, or their clothing, bedding, and 
 utensils, as the germs from the soiled parts may cling to the fingers 
 and be conveyed to the mouth during eating, or infect the food and 
 milk of others in handling it, unless the hands have been thoroughly 
 washed after every unclean act. Moreover, it has been shown within 
 the last ten years that some persons after recovering from typhoid 
 fever may continue to carry the germs and spread them through the 
 urine and feces, although the persons themselves apparently enjoy 
 good health. From the statistics of Lentz, Klinger, and V. Drigal- 
 ski, Goldberger estimates that about 3 per cent of typhoid- fever 
 patients become " chronic bacillus carriers," and thus constitute an 
 important source of infection, chiefly in handling milk and food. 
 Those who are familiar with the average dairy employee or cooks will 
 have no difficulty in surmising how the fingers may become infected 
 by careless toilet habits. Indeed, it is very evident that the Mosaic 
 law of ablution of the hands after every unclean act can not be too 
 strongly urged in the light of our knowledge concerning the trans- 
 mission of disease germs. 
 
 Notwithstanding the different modes of dissemination of the germs, 
 it should be remembered that typhoid fever is a typical water-borne 
 disease. The infection of a water supply is either direct or indirect; 
 the former includes all instances where the water is contaminated by 
 specifically infected sewage emptied directly into the river or lake, 
 or by excreta deposited along the banks, which sooner or later are 
 washed into the water supply. By indirect infection we understand 
 those instances in which the excreta, or wash waters, have been de- 
 posited in or upon the soil, and by percolation finally reach wells, 
 springs, or other bodies of water. 
 
 That the excreta from a single typhoid patient have infected the 
 water supply of a whole community has been shown in connection 
 with the epidemic at Cumberland in 1889, the history of which shows 
 that there were no cases of typhoid fever in that town until the dis- 
 charges from a young man, who returned from Ohio in December, 
 quite sick, found their way into the public water supply. This case 
 died December 20. The next case appeared January 10, 1890, and 
 within a short time 485 cases developed in a population of 1,200. 
 Every case but one was traced to polluted river water. The accom- 
 panying chart shows that the epidemic resulted in the highest typhoid 
 mortality rate ever reached in this city, viz, 104 deaths in every 
 100,000 of the population. 
 
 The typhoid fever epidemic at Plymouth, Pa., which affected over 
 1,100 persons, and began April 9, 1885, was traced to a case who con- 
 tracted the disease elsewhere, returned to his home in January, 1885, 
 and was for many weeks quite ill. The dejecta from this case was 
 thrown along the sloping banks of a mountain stream, where they 
 remained innocuous upon the snow and frozen ground until some 
 time between March 25 and April 1, when thaws set in. Under the 
 influence of this thaw they were washed into the mountain stream 
 and carried into the reservoir which supplied the town with water. 
 There is every reason to believe that the typhoid fever germs were 
 distributed in the water between March 28 and April 4 or 5. The 
 first case was reported April 9, During the week beginning April 12 
 
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 MEAN DEATH RATES FROM TYPHOID FEVER. T902 TO 1906, IN 66 AMERICAN CITIES AND 7 FOREIGN CITIES. GROUPED, 
 
 AFTER FUERTES. ACCORDING TO THE QUALITY OF THEIR DRINKING WATER. THE 
 
 RATES FOR FOREIGN CITIES ARE TAKEN FROM JAMES H. FUERTES. 
 
BEPOBTS OF THE PBESIDENT's HOMES COMMISSION. 177 
 
 from 50 to 100 cases appeared daily, and on one day it is said that 
 200 new cases were reported. 
 
 Such instances might be multiplied by the hundreds ; we have sim- 
 ply to recall the epidemic at. Ithaca, N. Y., during the months of 
 January, February, and March, 1903, affecting 1,350 persons in a 
 population of 13,000, with 78 deaths, among them 128 students at 
 Cornell University, with 26 deaths. The epidemic at Butler, Pa., in 
 the same year, affecting 1,348 persons with 111 deaths in a popula- 
 tion of 18,000; the epidemic at Columbus, Ohio, in 1904, with 1,640 
 cases and 166 deaths in a population of 140,000 ; and the more recent 
 epidemic of Scranton, in 1906-T, with 970 cases and 77 deaths, are 
 other shocking examples of water-borne typhoid. 
 
 INFLUENCE OF WATER SUPPLIES UPON TYPHOID FEVEB. 
 
 Sanitarians are so convinced that a pure water supply is incom- 
 patible with a high typhoid fever rate that they unhesitatingly 
 declare, " Show me a city's statistics of the disease and I will tell 
 you the character of its water supply." The writer, in a paper on 
 "Conservation of life and health by improved water supply," pre- 
 sented a number of diagrams showing the typhoid fever rate in a 
 number of cities, classified according to their water supply, of which 
 plate 7 is here reproduced. 
 
 This diagram also conclusively shows that the European cities 
 which do not only prevent pollution of rivers, but also filter their 
 water, enjoy the lowest typhoid fever rates. In the same paper the 
 writer has shown that in seven American cities the reduction in ty- 
 phoid fever, after the introduction of pure water, amounted to 70.5 
 per cent, and that during the past twenty-five years the death rate 
 from typhoid fever in 14 countries and cities, tabulated by him, has 
 been reduced 54.3 per cent. The Bulletin for the month of April, 
 1908, of the New York State department of health shows that the 
 death rate from typhoid fever in 10 cities of that State has been 
 reduced 53.4 per cent by an improved water supply. 
 
 CAUSES OF TYPHOID FEVEB. 
 
 The writer has heretofore held that about 50 per cent of the cases 
 are water borne (well, river, commercial, and ice), and has taught 
 for years that wells in this city, on account of soil pollution, should 
 not be tolerated, and that the only way to render a suspicious supply 
 safe for drinking purposes was to boil the water. The danger from 
 Potomac water since filtration, has been practically eliminated, but 
 ice should not be mixed with it as it may be as impure as the water 
 from which it is derived. Moreover, iced drinks and foods are also 
 objectionable on account of the injury to the digestive functions, 
 especially in the summer months, unless sipped very slowly, and, 
 upon general principles, ice cream should be made with sterilized 
 cream. 
 
 In the writer's report on typhoid fever for 1895, he urged as a 
 preventive measure the boiling of milk, and the systematic inspection 
 of dairies. This, together with the fact that he has tabulated 195 
 of so-called milk-borne typhoid epidemics, clearly indicates that in 
 his judgment milk is to a certain extent responsible for the dissemi- 
 S. Doc. 644, 60-2 13 
 
178 BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 nation of the disease, probably in about 15 per cent of the cases. In 
 148 of the 195 epidemics analyzed by him there is evidence of the 
 disease having prevailed at the farm or dairy. In 67 instances it is 
 probable that the infection reached the milk by soakage of the germs 
 into the well water with which the utensils were washed, and in 16 
 instances the intentional dilution with polluted water is a matter of 
 evidence. In 7 instances the infection is attributed to the cows wad- 
 ing in sew age- polluted water and meadows, and it is quite conceiv- 
 able that the germs clinging to the udder and teats found their w^ay 
 into the milk. In 4 instances the infection was spread through 
 cream prepared in infected premises. In 7 instances through cream- 
 eries. In 1 instance the milk tins were washed with the same cloth 
 used among the fever patients. In other instances the germs were 
 probably carried into the milk by flies passing from the infected 
 excreta. In 24 instances the people handling the milk also acted as 
 nurses. In 10 instances patients while suffering from mild attacks, 
 or during the first ten days of their illness, continued at work. From 
 what has been said of the danger of soiled hands, we may assume 
 that the germs in all such instances may be conveyed in the manner 
 already explained. 
 
 In like manner a " chronic bacillus carrier " may convey the germs 
 by soiled fingers into the milk. This mode of infection was strongly 
 suspected ever since Doctor Soper, of New York, traced a number 
 of household epidemics to an infected cook,*^ and also by a very in- 
 teresting instance reported by Dr. Henry Albert, occurring in the 
 fall of 1907, at Cedar Falls, Iowa. The possibility of spreading the 
 disease by such a carrier has been materially strengthened by a study 
 of a milk-borne typhoid epidemic in this city in October, 1908. 
 Surgeon-General Wyman's report says: 
 
 Twenty-six cases of typhoid in Georgetown, occurring between October 8 and 
 15, were traced througli tlie milk to ttie dairy farm. On close inspection of 
 this dairy farm no case of typhoid fever for years could be found to have 
 occurred among any of the employees, nor was any other source of infection 
 discovered until after a systematic examination of dejecta of all the em- 
 ployees had been made in the hygienic laboratory. 
 
 This examination developed large numbers of typhoid bacilli In the dejecta 
 of one woman who had had typhoid fever eighteen years before, and was one 
 of the milkers of the dairy. Persons thus affected are known to the medical 
 profepfeion as typhoid bacilli carriers, but this is the first considerable outbreak 
 of typhoid in the United States traced through milk to such a carrier, excepting 
 the case reported by Dr. Henry Albert, of Iowa, in the " Hygienic Laboratory 
 Bulletin," on "Milk and Its Relation to the Public Health," published last 
 January. 
 
 The case just discovered is deemed of special interest to health officers in 
 their endeavors to trace the source of typhoid outbreaks when that source 
 seems to be obscure. At least 2 per cent of all recovered cases of typhoid 
 fever become bacilli carriers for a longer or shorter period, even while enjoying 
 good health. Ten per cent of the cases of typhoid fever in Washington during 
 the past three years have been definitely traced to infected milk. 
 
 This instance is of extreme interest and certainly suggestive of dan- 
 ger, but scientific critics may be tempted to ask: (1) If this woman 
 was the only possible source of infection, why did she not infect the 
 consumers of the milk before? unless, indeed, it can be shown that she 
 had a recent reinfection; (2) were the typhoid fever germs actually 
 found in the milk? (3) if not, why was there no effort made to 
 
 <»" Journal American Medical Association," Vol. XLVIII, No. 24, p. 2019. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 179 
 
 demonstrate experimentally that this woman with the careless toilet 
 habits could infect her hands and through it the milk? and (4) have 
 all other local sources of infection in Georgetown been effectually 
 eliminated ? 
 
 The evidence on milk infections shows how important it is for us to 
 bring our milk to the boiling point (scalding), which will kill the 
 germs. In this connection it is interesting to note that, of the 330 
 milk epidemics (typhoid, scarlet fever, and diphtheria) collected by 
 the writer, 243 have been recorded by English authors, 52 by Ameri- 
 can, 14 by German, 11 by Scandinavian, and 5 each by French and 
 Australian writers. This is probably due to the fact that the Eng- 
 lish and Americans usually consume raw milk, while on the Conti- 
 nent milk is rarely used without being first boiled. 
 
 About 15 per cent of all typhoid cases are brought to the city from 
 summer resorts and rural districts, and about 20 per cent may be 
 spread through the agency of flies, personal contact, the consumption 
 of raw oysters and shell fish raised in sewage-polluted waters, or the 
 eating of strawberries, radishes, celery, lettuce, and other vegetables 
 and fruits which have been contaminated with infected night soil. 
 Hence the importance of carefully washing all uncooked articles 
 of food. 
 
 TYPHOID FEVEB IN THE EURAL DISTRICTS. 
 
 There is much reason for assuming that the undue prevalence of 
 typhoid in rural districts is a fruitful source of infection to the urban 
 population, chiefly through the milk supply and summer boarders. 
 
 When we consider the fact that over 70 per cent of our population 
 resides in rural districts, that the " bone and sinew " of these are 
 engaged in agricultural pursuits, and that they do not enjoy the 
 benefits of enforced sanitation by local health boards, we see at once 
 the desirability of the family physician extending useful suggestions 
 on healthful building sites and homes, disposal of house wastes, the 
 importance of a pure water supply, wholesome and properly cooked 
 food, etc. As it is now, the diet is faulty, especially the hot biscuits 
 and greasy fried dishes, while wells and privies are often dangerous 
 neighbors, favoring the spread of filth diseases. The undue prev- 
 alence of typhoid fever could be materially checked by chemical dis- 
 infectants, or by adding to the discharges four or five times the 
 quantity of boiling water kept in contact for at least ten minutes. 
 While prompt disinfection of the excreta is of vital importance, we 
 should also make an effort to get rid of the flies by prompt disposal 
 of the horse manure in which they breed, the abandonment of open 
 privies and surface pollution, substitution of the dry earth closet, or 
 other rational methods for the collection and disposal of excreta, 
 removal of garbage, etc 
 
 PREDISPOSING CAUSES TO TYPHOID FEVEB. 
 
 The writer, in his investigation of 500 cases in 1895, found that in 
 a large number of cases, especially in the southwest and along the 
 eastern branch of the Potomac, the system was very much debilitated 
 by the malarial cachexia prior to the attack. What effect the James 
 Creek Canal, the backing up of sewage and consequent flooding of 
 
180 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 uncemented basements and cellars, or the emanations from the filth- 
 reeking shores may have had, as a contributory factor, it is difficult 
 to say. We know, however, that marshes breed mosquitoes, which 
 are the carriers of malaria, and that, apart from the unwholesome 
 emanations, the evaporation of water also increases the humidity of 
 the air and thus intensifies the effects of both heat and cold, all of 
 which can not fail to lower the power of resistance to disease. For 
 these reasons his fifth recommendation, submitted in 1895, referred 
 to sanitary measures looking to the reclamation of the stagnant and 
 polluted marshes and the prompt disposal of sewage. 
 
 In this connection let us remember, however, that while the Ana- 
 costia flats are productive of disease, directly and indirectly, similar 
 effects, differing only in degree, may be produced by filthy homes, 
 back yards, and stagnant pools of water within the city limits. 
 
 The same report, on page 261, says: 
 
 In addition to the germ, there must also be a suitable soil for its proliferation 
 in the system, and this individual predisposition or vulnerability, which renders 
 the body more liable to be acted upon by the germs, may be the result of 
 debility, faulty nutrition, fatigue^ excesses of all kinds, abrupt changes in 
 temperature, impure air, mental depression, unwholesome food, and many other 
 factors calculated to diminish the power of resistance of the individual. 
 
 The factors of environment and other predisposing causes jye 
 plainly revealed by the imdue fatality in the colored population. The 
 average typhoid death rate among the colored during the past ten 
 years was 76.4, as compared with 47.4 for the whites. 
 
 Many of the factors concerned will be alluded to on page 210, and 
 much may be done by uplifting influences and higher standards of 
 living toward the removal of the predisposing causes of typhoid fever. 
 
 WHY IS THEBE MORE TYPHOID FEVEB IN WASHINGTON THAN IN NORTHERN CITIES? 
 
 Now that we have a pure-water supply this very pertinent question 
 has been asked, and among the answers so far given may be mentioned 
 the following: 
 
 1. Washington, like very many other southern cities, has a very 
 large colored population, with their greater susceptibility to disease. 
 This, however, accounts for only a certain percentage of the excess, 
 as the rate for the white population is also abnormally high. 
 
 2. It is a well-known fact that all intestinal diseases are especially 
 prevalent in hot climates and seasons. This is probably due to the 
 fact that the blood is kept too long at the periphery on account of 
 excessive perspiration, and the stomach and other internal organs 
 suffer in tone and nutrition for want of adequate blood supply, and 
 can not exert their normal defensive forces.** So, for example, 
 typhoid-fever germs would be digested, like many other vegetable 
 cells, as long as the digestive functions are normal, but if for any 
 reason this function is impaired or arrested, this defensive force 
 ceases, and the way for infection is open. Functional derangements 
 of the stomach, together with the debilitating influences of heat, 
 doubtless play an important role in increasing the general suscepti- 
 bility to typhoid fever in all southern climes. 
 
 3. Doctor Woodward, our health officer, suggests that the greater 
 intensity of heat in the South leads to the ingestion of larger quan- 
 
 « See page 80, Kober's Industrial Hygiene, 
 
REPORTS OF THE PRESIDEKT^S UOMES COMMISSION. 181 
 
 titles of water than are consumed farther north, and, therefore, so far 
 as water-borne typhoid fever is concerned, to increased chances of 
 infection. He also suggests that " intensity of heat and the long dura- 
 tion of the heated season probably lead to a more rapid and more 
 extensive lowering of the water in the streams and wells than occurs 
 in cooler regions, and thus lead to a greater concentration of infec- 
 tivity, if the water in such streams and wells are infected. The 
 temperature of the water in such streams and wells may be better suited 
 to the lief of the typhoid-fever bacillus than is the temperature of 
 northern waters. Moreover, owing to the greater duration of the 
 summer season, the fly season is longer, and the period during which 
 the diet of the people consists largely of uncooked articles is corre- 
 spondingly extended. The chances of infection are therefore cor- 
 respondingly increased in so far as relates to infection through foods. 
 Still it would be but poor comfort to know that because Washington 
 is a southern city it must continue forever to pay its death toll to the 
 typhoid-fever Juggernaut; the problem must not be solved in that 
 way. But the problem is not yet solved, nor is it likely ever to be 
 solved until the investigation is taken up along broader lines than 
 any that have yet been adopted; that is, until the investigation into 
 the causes of the undue prevalence of typhoid fever in this District 
 is made to include an investigation into the causes of the prevalence 
 of typhoid fever elsewhere, so that by a process of comparison and 
 exclusion the cause for the excessive typhoid fever rates in the District 
 of Columbia can be ascertained." 
 
 PBEVENTION OF TYPHOID FEVEE. 
 
 The writer, in his report on typhoid fever in 1895, referred in his 
 concluding recommendation to thorough disinfection of the excreta 
 from all typhoid-fever patients, and greater care on the part of those 
 connected with the sick. We have known for over twenty-five years 
 that the typhoid germs are conveyed chiefly through the feces and 
 urine of infected persons, that they are capable of reproduction 
 within and without the body, unless killed by certain physical or 
 chemical agents. We have already mentioned that even the addi- 
 tion of four or five times the volume of boiling water to feces or 
 urine will effectually destroy the vitality of the germs. If chemical 
 agents are used the method must be thorough and exact. The at- 
 tendant must prepare and use germicidal solutions of standard 
 strength, and unless this is done the whole process is a snare and 
 delusion. So, for example, all vessels containing stools should be 
 filled with a double volume of a solution of chloride of lime (6 
 ounces to the gallon), or a 5 per cent solution of carbolic acid, 6 
 ounces to 1 gallon of boiling water, or a corrosive sublimate solu- 
 tion, 60 grains of corrosive sublimate, 2 teaspoonfuls of table salt 
 to 1 gallon of water, or any of the standard disinfectants ; and kept 
 in a covered vessel for at least one hour before emptying. Disin- 
 fection must also extend to the patient's soiled body, clothing, and 
 bedding, and to the hands of the nurse. If this is not done there 
 is danger from so-called contact infection. Infected fingers may 
 contaminate the food, while a fly alighting upon a soiled part may 
 carry the germs on its feet to the food and drink of the other inmates 
 or even to some neighboring houses. Prompt and efficient disinfec- 
 tion will destroy the principal sources of infection, and if carried 
 
182 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 out universally, would go far toward removing typhoid fever from 
 the face of the globe. That this is possible is shown by the fact 
 that the typhoid rate in Berlin has been reduced from 142 per 
 100,000 of population in 1872 to 5 in 1906. 
 
 The causes of typhoid fever in this city are perhaps more complex 
 and varied than elsewhere ; no one factor can alone be held responsible 
 for its undue prevalence, and in the prevention of the disease due 
 attention must be paid to the removal of all the causes likely to influ- 
 ence its spread. 
 
 Among the sanitary measures which should be invoked are the 
 following: The expenditure of $100,000 asked for by Major Cosby 
 for the perfection of the quality of the filtered water. While the 
 installation of the filtration plant has resulted in an improved water 
 supply, it is found that during periods of great turbidity, especially 
 during the months of December and January, the number of bacteria 
 remaining in the effluent exceeds permissible limits. It has also 
 been shown that the efficiency of the filters, as regards removal of 
 bacteria, can not be increased without previous chemical treatment 
 of the water at such periods. In view of the fact that the degree 
 of danger varies with the number of bacteria left in the water, no 
 effort should be spared to eliminate these high counts by the methods 
 proposed by the engineer in charge. 
 
 The prevention of river pollution involves problems which should 
 be solved in the interest of this and other communities using a public 
 water supply from interstate rivers, under which circumstances the 
 inhabitants of one Commonwealth are powerless to protect themselves 
 against the misdeeds of their neighbors. 
 
 The abandonment of public and private wells and box privies, 
 wherever found, the removal of slums, insistence upon clean homes, 
 back yards, basements, cellars, alleys, streets, and vacant lots, and 
 more stringent laws for the production and sale of milk and cream, 
 together with the reclamation of the Anacostia Flats can not fail to 
 diminish some of the contributory factors in the prevalence of the 
 disease. 
 
 Many of these measures have been urged by the commissioners and 
 the health officer for years, and it is the duty of every good citizen 
 to strengthen their hands in their well-directed efforts. In addition 
 to all this, there is special need for more visiting nurses and social 
 workers to instruct our neglected neighbors in higher standards of 
 living, and finally, more attention should be paid in our schools to 
 hygienic and sociological questions, so that the average child may 
 learn the essentials for the preservation and promotion of health. 
 
 DIARRHEA AND DYSENTERY. 
 
 While diarrhea is a symptom of very many diseases, there is reason 
 for believing that certain forms, occurring in infants as well as adults, 
 toward the middle or close of a hot, dry summer, are caused by the 
 consumption of tainted food, milk, impure water, etc., superinduced 
 by putrefactive bacteria, and that the serious forms of summer com- 
 plaints are due to specific germs. 
 
 From what we know of the nature and cause of dysentery we are 
 led to consider it an infectious disease, which is spread very much like 
 typhoid fever. The tropical form of dysentery is caused by an 
 ameboid organism, while the type most prevalent in this country is 
 due to a bacillus. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION . 183 
 
 In our present state of knowledge we may conclude that the virus 
 of dysentery, whether of the bacillary or amebic type, proceeds from 
 the intestinal discharges of a previous case, and the most usual mode 
 of transmission of the germs is through the water supply. This is 
 the opinion of Virchow, based upon personal experience in Egypt, 
 and Uffelmann has frequently observed that persons using boiled 
 watet during a dysentery epidemic remained exempt, and that the 
 simple closing of a suspicious well often checked the spread of the 
 disease. It is also perfectly conceivable that the germs may be spread 
 through soils strongly polluted and infected with excrementitious 
 matter, and with particles of dust gain access to milk, fruit, fresh 
 vegetables, etc., which are eaten raw. The agency of flies in carrying 
 the germs from infected sources to the food supply can not be 
 ignored. 
 
 Temperature also plays an important role in the development of 
 the disease. At all events, statistics show that in temperate climates 
 the disease assumes epidemic proportions in July, August, and Sep- 
 tember, and declines with the approach of cold weather ; it goes hand 
 in hand, therefore, with a maximum temperature of the air and soil. 
 It is also a clinical fact that badly nourished individuals, and those 
 suffering from indigestion or intestinal catarrhs, are especially liable 
 to be attacked. 
 
 Prophylaxis: In the attempt to prevent epidemic extensions . of 
 these diseases the water supply should be looked after, and every 
 source of contamination of wells, springs, and public reservoirs must 
 be avoided, and suspicious supplies closed. 
 
 The public should be enlightened as to the nature of these diseases, 
 and especially of the necessity for prompt disinfection of stools. It 
 should also be informed that indigestion, the result of indiscretion in 
 eating and drinking, and chilling of the body increase the suscep- 
 tibility ; that it is desirable during the prevalence of these diseases to 
 use only boiled water and milk, and to avoid the consumption of 
 raw vegetables and fruit, unless they have been thoroughly washed 
 with water previously boiled. 
 
 Chapter IV. - ' 
 
 INFANTILE MORTALITY. 
 
 According to Oesterlein's statistics it is safe to assert that the 
 average death rate during the first year of life is 188 out of 1,000 
 infants born. 
 
 According to the census of 1900 the infantile mortality per 1,000 
 births in the so-called registration States was as follows : 
 
 District of (Columbia 274. 5 
 
 Rhode Island 197. 9 
 
 Massachusetts 177. 8 
 
 New Hampshire 172. 6 
 
 New Jersey 167. 4 
 
 New York 159. 8 
 
 Connecticut 156.8 
 
 Maine 144. 1 
 
 Vermont 122.1 
 
 Michigan 121. 8 
 
184 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 It will be seen that the rate of Vermont and Michigan is less than 
 one half that of the District of Columbia. 
 
 The rates in foreign countries likewise vary considerably. In 
 France the average rate from 1874 to 1893 was 167 ; in 1903 it had 
 fallen to 137, practically the same as that of New Jersey. 
 
 According to Harrington* our highest rate about equals Russia, 
 and it is not much greater than that of Austria. Ehode Island makes 
 a better showing than Germany and Italy. The German rates for the 
 five years 1901-1905 were 216, 184, 202, 204, 204. The Italian rates 
 are 170. Maine stands with England and Wales, and better than 
 Belgium and the Netherlands. The rates for England and Wales 
 are 150; Belgium, 156; the Netherlands, 147. The rate of Vermont 
 is lower than Scotland (126), Denmark (127), Finland (134), or 
 Switzerland (144). Michigan is also lower than Scotland (126). 
 The following countries have lower rates: New South Wales, 108; 
 Victoria, 105; Ireland, 105; South Australia, 102; Queensland, 101; 
 Sweden, 98 ; Norway, 90 ; New Zealand, 79. 
 
 These are mean rates for rural and urban districts. In towns and 
 cities the mortality is always higher, amounting to 33.6 per cent, as 
 compared with the rural mortality of 27.8 per cent. 
 
 The District of Columbia in 1900 had the unenviable reputation o:^ 
 leading the list of the registration States in infant mortality, but 
 the rate of Washington as a city compares favorably with other 
 cities. 
 
 The census of 1900 gives a list of 106 cities and towns with infantile 
 death rates in excess of 175. In 9 cases the rate exceeded 300; in 38 
 it was between 200 and 280, and in 49 it was between 175 and 200. 
 
 The following is a partial list of these cities : 
 
 Charleston, S. C 419. 5 
 
 Savannah, Ga 387.5 
 
 Mobile, Ala 344. 5 
 
 Key West, Fla 311.8 
 
 Biddeford, Me. 811.6 
 
 Atlanta, Ga 306.0 
 
 Fall River, Mass 304.7 
 
 Lynchburg, Va 301. 7 
 
 Richmond, Vji 300.7 
 
 Laconia, N. H 294. 6 
 
 Shreveport, La 293. 5 
 
 Jacksonville, Fla 287.6 
 
 Norfolk, Va 284.6 
 
 Lowell, Mass 275. 5 
 
 Washington, D. C 274. 5 
 
 Baltimore, Md 235.1 
 
 New Orleans, La 1229.2 
 
 Detroit, Mich 201.2 
 
 Philadelphia, Pa 201.9 
 
 Newport, Ky 189.8 
 
 Indianapolis, Ind 173.5 
 
 Kansas City, Mo 168.8 
 
 Springfield, 111 167,4 
 
 New York, N. Y 189.4 
 
 •Harrington, Infantile Mortality, "Am. Jour. Med. Sc," December, 1906. 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 185 
 
 The following is a list of 24 German cities with excessive infantile 
 death rates: 
 
 Chemnitz .. 
 
 Stettin 
 
 Posen 
 
 Nuremberg. 
 
 Breslau 
 
 Dantzig 
 
 Halle 
 
 Magdeburg. 
 Konigsberg 
 
 Leipzig 
 
 Rixdorf 
 
 Munich 
 
 Cologne 
 
 Plauen 
 
 Stuttgart . . . 
 Mannheim . 
 
 Berlin 
 
 Brunswick . 
 
 Aachen 
 
 Dresden .... 
 Strassburg.. 
 Diisseldorf . 
 Karlsruhe . . 
 Dortmund.. 
 
 Infantile 
 death rate. 
 
 Diarrheal 
 
 infantile 
 
 death rate. 
 
 270.99 
 
 135.67 
 
 260.54 
 
 112.28 
 
 i 248.29 
 
 92.62 
 
 247. 63 
 
 113.80 
 
 244.39 
 
 98.62 
 
 243. 19 
 
 109. 87 
 
 235. 71 
 
 124. 77 
 
 233.52 
 
 100.73 
 
 233. 25 
 
 113.47 
 
 222. 14 
 
 121.49 
 
 218. 49 
 
 103.66 
 
 217. 39 
 
 95.33 
 
 212.45 
 
 93.60 
 
 208.01 
 
 36.25 
 
 205.63 
 
 74.80 
 
 203.67 
 
 86.46 
 
 199.83 
 
 87.99 
 
 196.64 
 
 81.22 
 
 195. 12 
 
 78.60 
 
 191.29 
 
 83.23 
 
 190.45 
 
 92.82 
 
 187. 97 
 
 82.43 
 
 185.12 
 
 86.17 
 
 184.96 
 
 61.76 
 
 Percentage 
 of infan- 
 tile deaths 
 due to diar- 
 rheal dis- 
 
 60.07 
 43.09 
 37.27 
 45.97 
 40.36 
 45.18 
 52.94 
 43.14 
 48.65 
 54.69 
 47.44 
 44.14 
 44.06 
 16.05 
 
 44.03 
 41.32 
 40.28 
 43.61 
 48.74 
 43.85 
 46.55 
 33.38 
 
 In 1904, in the 323 German cities and towns having populations ex- 
 ceeding 15,000 the rate was 202. In the twelve months ended June 
 30, 1906, in 32 German cities with a population of over 100,000, 
 the rate was 198. (Harrington.) 
 
 From the foregoing figures it appears that in many cities, out of 
 every 1,000 children born alive, over one-third perish before the com- 
 pletion of the first year ; but fortunately for the perpetuation of the 
 human race the average infant mortality all over the world is only 
 about one-sixth of those born. 
 
 Of the twelve months during the first year of life the first month 
 furnishes the highest mortality. Of the 1,233 infantile deaths re- 
 ported in this city in 1906, 222 were due to premature birth; 40 to 
 congenital debility; 28 to malformations, and 9 to difficult labor. 
 The first month is followed by the second, third, and fourth months, 
 probably also because of diminished vital resistance. The tenth, 
 eleventh, and twelfth months are also dangerous months, as this is 
 at the usual period of weaning with its attending danger from digest- 
 ive diseases incident to artificial feeding. We have already referred 
 to diarrheal diseases as the principal cause of infantile mortality. 
 A mortality of 40 per cent from diarrheal diseases and 2.5 per 1,000 
 from tubercular diseases of the abdominal lympathics and glands 
 can not fail to claim our attention, and certainly points, with more 
 than mere suspicion, to the fact that the morbific agent in these cases 
 is introduced into the body with the food, especially unwholesome 
 and infectious cow's milk. Nor is it improbable that the 21 per cent 
 who die from affections of the respiratory organs are largely the 
 victims of ignorance as regards temperature and clothing and other 
 environments of the child. The infant mortality is everywhere 
 influenced by extremes of heat and cold, but tie hot months, like 
 
186 REPORTS OF THE PRESIDENT'S HOMES COMMISSION". 
 
 July, August, and September, are the most dangerous on account of 
 the disastrous attacks of diarrheal diseases. The fatal influence 
 of heat is graphically shown in the accompanying chart. (See 
 next page.) The deaths from diarrheal diseases ranged according to 
 months, from 5 in January to 108 in July and 58 in August, after 
 which there is a rapid decline. The same abrupt changes are noted 
 in the large statistical material of German cities in 1905, dealing 
 with 128,035 deaths under one year, the deaths from diarrheal 
 diseases ranging from 1,192 in January to 15,863 in August. 
 
 High infantile mortality rates have always been considered the 
 opprobrium of the healing art. Dickson asked over fifty years ago, 
 " How shall we prevent the early extinction of half the newborn 
 children of men ? " While powerless to solve all the mysteries con- 
 nected with this subject, an attempt will be made to answer the prac- 
 tical question. Can they be reduced? Space will not permit to 
 enter into detail of infant hygiene, but we must at least point out the 
 fact that the mortality can be greatly reduced by improving the 
 original stock, i. e., the physique and habits of the parents, and plac- 
 ing them, as well as their offspring, under more suitable environ- 
 ments, especially with reference to fresh air, sunlight, exercise, 
 suitable clothing, and habitations, and last but not least, proper food. 
 
 The influence of favorable hygienic conditions was demonstrated 
 by Casper's statistics, published as early as 1825, showing that the 
 infant mortality rate among royal children was only 57, as compared 
 with 345 per 1,000 among the infants of the poor. Of 170 deaths 
 from infantile diarrhea, investigated by Helle in Graz in 1903 and 
 1904, not one belonged to a rich family, and but 9 to the well-to-do 
 class, while 161 belonged to the poor and the very poor. Clay cal- 
 culates that of every 100 children born in England, 90 will be alive 
 at the end of the first year of those born in aristocratic families, 79 
 in the mercantile class, and 68 among the laboring classes. The rela- 
 tion of infantile mortality to the occupation of the women has 
 already been discussed in a previous report. 
 
 Dr. George Reid, at the National Conference on Infantile Mor- 
 tality, held in London in June, 1906, contrasted the infantile mor- 
 tality in two districts, identical in health conditions, but with the 
 important difference that in one women are largely employed in 
 industrial pursuits, and in the other there is practically no employ- 
 ment for them, with the result that the infantile mortality varied 
 from 149 to 198 per 1,000. 
 
 The infantile mortality returns in the United States also indi- 
 cate that we are dealing with a class mortality, which is highest in 
 communities where women are employed in mills and other gainful 
 occupations, and in consequence the children fall victims to igno- 
 rance and neglect. Contrast, for example, the census rates for 1900 
 of Fall River, Mass. (304.7) ; Lowell, Mass. (275.5) ; Nashua, N. H. 
 (261.2); Lawrence, Mass. (246.5); Manchester, N. H. (238.4), all 
 typical mill towns, with the rate at Cambridge, Mass., which was 
 186.5. The seasonal and climatic influences arc of course the same 
 and, presumably, also, the general quality of the milk supply, hence 
 we must look largely to sociological factors for an explanation, such 
 as has been offered on pages 78-80,° and may be summed up in igno- 
 
 <» Kober's Industrial Hygiene. 
 
MONTHLY DEATHS FROM INFANTILE DIARRHEAL DISEASES DURING 1906 COMPARED WITH 
 AVERAGE MONTHLY DEATHS FOR PAST TEN YEARS. 
 
 Deaths 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 110 
 105 
 100 
 95 
 90 
 85 
 80 
 75 
 70 
 65 
 60 
 55 
 50 
 45 
 40 
 35 
 30 
 25 
 12 
 11 
 10 
 5 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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 H Deaths from Diarrheal Diseases during 1906. 
 Average annual deaths from Diarrheal Diseases for 7 years. 
 Reproduced from the Report of the Health Officer, District of Columbia, 1907. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 187 
 
 ranee and poverty. The same explanation applies to tlie excessive 
 rates among colored infants in many of our States and in our own 
 city. During the year 1906 the number of children under two years 
 of age who died in Washington from diarrheal diseases and inflam- 
 mation of the bowels was 318, 146 white and 172 colored. The cor- 
 responding death rate per 100,000, calculated on the basis of the 
 entire population, was for the white population 63.1 and for the 
 colored population 181. If any further ar^ment is necessary to 
 show the influence of sociological factors, it will be found in the fact 
 that 1,792 of the 2,711 infantile deaths investigated by Neuman in 
 Berlin in 1903 occurred in 1-room dwellings, 754 in 2-room, and 165 
 in 3-room and larger dwellings. ^ 
 
 The difference in the mortality of legitimate and illegitimate chil- 
 dren is very great and varies, according to Uffelmann, as follows; 
 
 
 Legitimate 
 children. 
 
 nieRitimate 
 children. 
 
 
 Per cent. 
 15.0 
 22.9 
 13.0 
 14.0 
 
 Per cent. 
 
 •60.0 
 
 Austria. .. 
 
 36.1 
 
 Sweden 
 
 24.8 
 
 
 85.0 
 
 
 
 But the most frightful mortality rates are everywhere furnished 
 by the hand or bottle fed children. 
 
 Doctor Newsholme,<» the medical officer for Brighton, England, 
 states that breast-fed infants contribute but one-tenth of the deaths 
 from infantile diarrhea. W. J. Tyson ^ asserts that three-fourths of 
 the 150,000 infantile deaths in Great Britain were those of bottle-fed 
 children. Indeed, we have evidence that of the 54,027 infantile deaths 
 which have been investigated at home and abroad with reference to 
 feeding, 86.6 per cent had been artificially fed, all of which points to 
 the fact that the quality of the food, chiefly cow's milk, in hand-fed 
 children, plays the most important role. This assumtion finds, 
 moreover, support by the fact that the infantile death rate and diar- 
 rheal diseases in children under five years of age have materially 
 decreased in a number of American cities since the enactment of pure- 
 milk laws, notably in Buffalo, Rochester, Chicago, New York, and 
 Washington. The report of the health officer of the District of Co- 
 lumbia for 1906, page 11, says: 
 
 High as is the infantile mortality rate even now from diarrhea and Inflam- 
 mation of the bowels, it is far below the figures that formerly prevailed. Dur- 
 ing the five-year period 1880-1884 the death rate from diarrhea and inflam- 
 mation of the bowels among children under 2 years of age was 162 per 100,000 
 per annum. During the five-year period 1885-1889 the average annual rate 
 was 168. During the next period, 1890-1894, the death rate rose to 175, but 
 in the year 1895 a diminution began. During the period 1895-1899 the death 
 rate from the diseases named was only 135; in the period 1900-1904 it was only 
 109 ; in 1905 it was 104, and in 1906 it was only 97. 
 
 The only explanation for the fall in the death rate from infantile diarrhea 
 that I have been able to discover is the enactment, on March 2, 1895, of the law 
 regulating the sale of milk in the District of Columbia and the establishment 
 of dairy and dairy-farm inspection under the provisions of that law. ♦ ♦ ♦ 
 
 "Journal of Hygiene, April, 1906. 
 
 * Journal of State Medicine, September, 1904. 
 
188 BEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 MATERNAL NURSING. 
 
 The mortality statistics in hand-fed children are the most eloquent 
 arguments which can be offered in favor of breast feeding. 
 
 Recent statistics collected by Von Bunge in different parts of 
 Europe indicate that probably 75 per cent of the women could nurse 
 their children. Budin asserts that 448 out of 557 women who at- 
 tended one of the Paris clinics ,were able to nurse their children. 
 Madame Dluski, in an able thesis, maintains that of every 100 healthy 
 women, when the necessary conditions of alimentation and repose are 
 present, 99 are actually able to nurse their offspring. The importance 
 of maternal .nursing is emphasized in different parts of Europe by 
 popular education, and by the enactment of laws requiring, in indus- 
 trial establishments where 50 or more women are employed, special 
 rooms for maternal nursing. On the other hand, statistics collected 
 by Hegar in large obstetrical institutions in Germany indicate that 
 only about 50 per cent of women are capable of nursing their offspring 
 for merely a few weeks, and the question naturally arises : What are 
 the causes of this inability to discharge their sacred maternal duties ? 
 Among them may be mentioned physicial inability as a result of in- 
 sufficient or improper food, hard work, care, hereditary debility and 
 disease, tuberculosis, alcoholism of the woman's own father, modified 
 syphilis, or nervous diseases in the family. Von Bunge believes that, 
 apart from actual disease in the mother, alcoholism is one of the chief 
 causes, as the daughters of the third generation of alcoholics are 
 usually unable to nurse their offspring. The effects of hard work 
 and gainful occupations have been pointed out,** but there is absolutely 
 no excuse for mothers who, although physically able-bodied, are dis- 
 inclined to nurse their children, chiefly as a matter of ease, comfort, 
 and social pleasures, and who, instead of employing a healthy wet- 
 nurse, prefer artificial feeding, and often resort to patent baby foods. 
 
 Dr. Henry D. Fry,^ professor of obstetrics, Georgetown University, 
 in his excellent monograph on maternity, states that such foods are 
 more often the cause of scurvy than other nourishment. On page 149 
 he says: 
 
 Pictures of fat babies smile at us from the pages of newspapers and maga- 
 zines, and the advertisements say they were raised on this or that food product. 
 Unfortunately, many babies have been raised to " worlds unl^nown," but we do 
 not see their pictures. The evidence of this must be sought in graveyards, where 
 tombstones bear silent witness to the high rate of mortality in early life. 
 
 These remarks are equally applicable to the pernicious use of 
 ** soothing " and " teething " sirups, " babies' friend," etc. 
 Professor Jacobi '' offers some excellent advice when he says : 
 
 Infants are the future citizens of the Republic. Let the Republic see that 
 no harm accrue from the incompetence or unwillingness to nurse. * ♦ ♦ 
 From a physical, moral, and socio-political point of view, there is only one 
 calamity still graver, that is to refuse to have children at all. ♦ ♦ * The 
 human society of the future will have to see to it that no poverty, no cruel 
 labor laws, no accident, no luxurious indolence must interfere with the nursing 
 of infants. 
 
 • Kober's Industrial Hygiene, p. 78. 
 » Fry, Henry D., " Maternity," 1907. 
 
 • The History of Pediatrics, etc., " Jour. Am. Med. Asso.," November 5, 1904. 
 
BEPORTS OP THE PRESIDENT S HOMES COMMISSION. 189 
 
 We are building hospitals for the sick of all classes ; asylums for the insane, 
 neuropathies, and drunliards; nurseries and schools for epileptics, cretins, 
 and idiots; refuges for the dying consumptives, and sanatoria for incipient 
 tuberculosis. We are bent upon curing and upon preventing. Do we not 
 begin at the wrong end? We allow consumptives and epileptics to marry and 
 to propagate their own curse. We have no punishment for the syphilitic and 
 gonorrheic who ruins a woman's life and impairs the human race. Man, 
 however, should see that his kind must not suffer. One-half of us should not 
 be destined to watch and nurse and support the other half. Human society 
 and the state have to protect themselves by looking out for a healthy, uncon- 
 taminated progeny. Laws are required to accomplish this. * * * 
 
 As a matter of fact, Indiana, Wisconsin, Michigan, and Connecti- 
 cut have laws prohibiting the marriage of epileptics. Indiana also 
 prohibits marriages of persons suffering from transmissible diseases, 
 and, by an act of 1907, "confirmed criminals, imbeciles, idiots, and 
 rapists, procreation by whom is deemed inadvisable by experts, shall 
 be unsexed by surgical operation." 
 
 Until there is greater perfection in the physical, moral, and eco- 
 nomical conditions of the human race, there will always be a large 
 percentage of infants deprived of their natural food. In order to 
 appreciate the dangers of artificial feeding it may be well to point 
 out briefly some of 
 
 THE ANATOMICAL AND PHYSIOLOGICAL CHARACTERISTICS OF INFANTS. 
 
 The average weight of a healthy newborn male child is 3,500 
 grams, and of a female 3,000 grams; at the expiration of the first 
 month the child should weigh about one-third more than at birth; 
 during the middle of the fifth month it should have doubled its 
 weight, and at the completion of the first year it should weigh three 
 times its original weight. 
 
 At the end of the second year the normal child should weight about 
 12,000 grams, or a little over 26 pounds. Any decided variation 
 should cause the mother to seek proper advice. It should also be re- 
 membered that the anatomical elements of the digestive tract of in- 
 fants are very delicate and vulnerable and especially susceptible to 
 injurious influences, such as cold or improper food, atmospheric 
 temperature, etc. The saliva, up to the tenth month, is scant and in- 
 capable to any considerable extent of converting starchy food into 
 sugar, a property only fully developed about the expiration of the 
 ninth month. 
 
 The muscular coats of the stomach are delicate, and vomiting is 
 easily provoked ; the gastric glands secrete a juice which is less acid 
 than in after years, and the contents are passed from the stomach into 
 the upper intestinal canal at intervals of one and three-fourths hours. 
 The pancreatic juices for the first few months in life are scant, and up 
 to the fourth or sixth week incapable of converting starch into sugar, 
 but fully prepared to digest the proteids and fats of the milk. The 
 stools of a normal infant scarcely exceed two or three during the 
 twenty-four hours ; they are of a semiunctuous consistency and orange 
 or egg-yellow in color. 
 
 There can be no question that the natural food is breast milk from 
 a healthy mother — no other food insures to the same extent the 
 physiological development of the child. A normal infant requires a 
 daily supply of milk to the amount of about one-seventh of its weight. 
 
190 BEPOBTS OP THE PBESIDENT's HOMES COMMISSION. 
 
 The average composition of human milk, after the regularity of 
 lactation has been established, is about as follows: Water, 87.30 per 
 cent; proteids, 1.5 per cent; fats, 4 per cent; sugar, 7 per cent; and 
 mineral salts, 0.2 per cent. The composition of the milk is by no 
 means constant, and is influenced by a number of factors, such as the 
 age of the mother, food, habits, emotions, race, physical peculiarities, 
 etx3. The digestibility of human milk is nearl}^ perfect, as 97 per cent 
 is generally utilized; all of the constituents are absolutely essential 
 to health and a proper growth of the body. 
 
 CARE OF TPIE BREASTS. 
 
 The mother should take special care of the nipples and breasts and 
 can prevent much physical suffering, from local inflammatory affec- 
 tions, by washing the parts after each nursing with plain water and 
 careful drying. 
 
 It is very doubtful whether the practice of washing the nipples 
 during the last three months of pregnancy with alcohol and astringent 
 lotions is productive of good ; indeed. Professor Fry * believes they 
 are harmful by drying up the secretions of the sebaceous glands and 
 making them more liable to crack, and he recommends instead the 
 application of cocoa butter, lanolin, albolene, vaseline, or castor oil. 
 
 Much can be done at the outset in preventing sunken or depressed 
 nipples by avoidance of tight clothing, but when they do occur they 
 should be treated by the attending physician. 
 
 FREQUENCY OF NURSING. 
 
 There is nothing to justify the frequent practice of administering 
 to newborn infants different teas and sweetened water during the 
 first few days after birth. Plain boiled water, at a temperature of 
 99, may be given ; but above all we should endeavor to establish regu- 
 lar habits at the outset and avoid overfeeding. Professor Heubner 
 believes that the number of feedings heretofore advocated is too 
 ^eat, and a less number is productive of better results. In this he 
 IS supported by other competent observers, and Doctor Schereschew- 
 sky,^ in his excellent article on " Infant Feeding," gives the following 
 schedule, which seems to fulfill the best practice in this direction : 
 
 Age. in 24 during Night 
 
 Nursings 
 
 Interval 
 
 in 24 
 
 during 
 
 hours. 
 
 day.'' 
 
 4 
 
 6 
 
 6 
 
 4 
 
 8 
 
 2i 
 
 7 
 
 3 
 
 6 
 
 3 
 
 5 
 
 4 
 
 Firstday 4 6 1 
 
 Secondday 6 4 1 
 
 Third to twenty-eighth dav 8 2i 1 
 
 Fourth to thirteenth week 7 3 1 
 
 Third to fifth month 6 8 
 
 Jifth to twelfth month 5 4 
 
 The infant during the first four or five days after birth usually 
 loses about 8 per cent of its weight. It should then regain lost 
 weight and continue to gain at the rate of 120 to 150 grams (4 or 5 
 
 «Fry, Henry D., "Maternity," 1907. 
 
 •Bulletin 41, Public Health and Marine-Hospital Service, 190S. 
 
EEPOKTS OF THE PEESIDENT's HOMES COMMISSION. 191 
 
 ounces) every week during the first three months, and from the third 
 to the sixth month it should gain about 100 to 120 grams or from 
 3^ to 5 ounces each week. 
 
 By weighing the baby regularly we can judge with precision of its 
 general progress. Professor Fry ^ says : 
 
 A baby that is at a standstill or losing weight is not getting enough food. 
 Crying under these circumstances means more food or a better quality of the 
 food. In order to differentiate between the cries of hunger, colic, or earache, he 
 points out that a hungry baby cries after it has been nursed and cries before 
 the next feeding. He suggests placing the finger in its mouth, when it 
 will stop crying and suck it for a moment and then cry again at its disappoint- 
 ment. Nursing babies may be starving in spite of an abundant secretion of 
 breast milk. The fluid may be abundant in quantity but poor in quality. The 
 nutritive value of breast milk can be ascertained by a simple method. Draw 
 off some and let it stand in a test tube over night. If normal a good layer of 
 cream will form on top — from 3 to 4 per cent. If poor the color is pale blue at 
 first, the next morning watery, and the cream will be only 1 per cent or a little 
 more. Very bad milk will show less than 1 per cent of cream. Again, a 
 starving baby is not nourished properly. To find this out examine the skin 
 over the tibia (shank). If the baby is not getting enough nourishment the 
 skin can be pinched up with the fingers ; if properly nourished the skin is firmly 
 attached to the underlying tissue and the grasp of the fingers slips over it. 
 This point is demonstrated by examining the skin on the back of anyone's 
 hand. Extend the fingers and the skin is easily picked up, like that over the 
 tibia of a starving baby. Close the fist 'and the skin is tight, as one will find 
 it over the shank of a properly nourished baby. 
 
 WEANING OF INFANTS. 
 
 It is believed that a normal woman who enjoys a good appetite and 
 a supply of good wholesome food, obeying the ordinary rules of 
 health, will have no difficulty in discharging her maternal duties. 
 Nature probably intended that the infant should subsist upon breast 
 milk until the eruption of the first molars, and many mothers actually 
 nurse their offspring until the twelfth or fifteenth month. 
 
 If we can appoint our OAvn time, the weaning should be gradual and 
 not considered before the tenth or twelfth month, especially not dur- 
 ing the hot months, provided the health of the mother is good and 
 the child is doing well. It would be very unwise to wean a sick 
 child unless the sickness is caused by the mother's milk. 
 
 An inadequate supply of breast milk can be made up by mixed feed- 
 ing, and surely even a half supply of normal mother's milk for sick 
 children is better than a full supply of prepared milk. 
 
 CONDITIONS WHICH MAY COMPEL RECOURSE TO ARTIFICIAL FEEDING. 
 
 Unfortunately, there are a number of reasons which may render the 
 employment of a wet nurse or recourse to artificial feeding imperative 
 at any period of lactation : 
 
 1. A motherless child, or when the mother is suffering from an 
 infectious or communicable disease, such as tvphoid fever, pneumonia,' 
 etc. A tuberculous mother would not only aggravate her disease but 
 also expose the child to infection. 
 
 2. Childbed fever and other severe complications of the parturient 
 state, such as hemorrhages, convulsions, inflammation of the kidneys; 
 
 • Maternity. 
 
192 
 
 BEPOETS OF THE PfiESIDENT S HOMES COMMISSION. 
 
 also in anemic and in cachectic and serious nervous conditions, such 
 as chorea and epilepsy. 
 
 3. Inflammatory conditions of the nipples and breast, because of 
 the admixture of pus and disease germs. 
 
 4. AVhen no milk is secreted, and deformities and anomalies of the 
 nipple and breast exist which can not be corrected. 
 
 5. Return of menstrual period or early pregnancy, if resulting in 
 digestive derangements or malnutrition in the child. 
 
 If under such circumstances the employment of a wet nurse is im- 
 practicable, artificial feeding must be considered and the question con- 
 fronts us, AVhat is the best possible substitute for human milk, the 
 requirements of which are: 
 
 1. That it must offer the same character and amount of nutritive 
 elements and in the same proportion as human milk. 
 
 2. The nutritive elements must be present in the same digestible 
 form and of the same consistency, and should be introduced into the 
 stomach at a temperature not less than 98° F. by means of slow suction 
 at proper intervals. 
 
 3. This substitute must not contain any morbific or infective agent, 
 whether originally present or introduced during the preparation or 
 keeping of the same. 
 
 A moment's reflection upon the physiology of infantile digestion 
 will at once suggest the propriety of rejecting all starchy foods before 
 the expiration of the tenth month, except in very limited quantities 
 and previously converted into maltose by boiling, as in barley water. 
 Since milk is the natural food of all mammalia few will be disposed 
 to doubt that some modification of cow's milk offers the best possible 
 substitute. 
 
 COMPARISON or cow's MILK AND HUMAN MILK. 
 
 The difference in the composition is shown in the following table: 
 
 Woman's 
 mUk. 
 
 Cow's 
 milk. 
 
 Fat 
 
 Proteids 
 
 Sugar 
 
 Baits 
 
 Water 
 
 Calories per kilo 
 
 Percent 
 
 4.00 
 
 1.50 
 
 7.00 
 
 .20 
 
 87.30 
 
 Per cerU. 
 
 3.00 
 
 4.50 
 
 4.50 
 
 .80 
 
 87.20 
 
 100.00 
 
 710.50 
 
 100.00 
 
 700.00 
 
 Human milk contains, therefore, less proteids and salts and more 
 fat and sugar. There appears to be also a difference in the quality 
 •of the casein of the two secretions. 
 
 The addition of dilute*acid in a test tube to cow's milk precipitates 
 the casein in hard coagula or lumps, while in human milk it separates 
 into a fine powder giving the appearance of light flocculent curds, 
 which readily dissolve in an excess of acid. Since the coagulum in 
 the same quantity of human milk is but one-fifth as large as that of 
 cow's milk, this difference, which is solely one of compactness and 
 solubility, is believed to influence the digestibility of the two secre- 
 
KEPORTS OF THE PEESIDENt's HOMES COMMISSION. 193 
 
 tions. This statement has been questioned, however, by Heubner, 
 whose studies indicate that when the test-tube experiments are carried 
 on to imitate the movements of the stomach the resulting curd is quite 
 as fine as the curd of human milk. He also verified his conclusions 
 by withdrawing cow's milk shortly after ingestion by infants with a 
 stomach tube. Admitting that Heubner is correct in assuming that 
 cow's milk contains the same constituents, but in different proportions, 
 which can be corrected by modifying it, there still remain differences 
 which are important, especially the fact that human milk is always 
 fresh and, from a healthy mother, rarely contains micro-organisms, 
 while cow's milk is never free from bacteria, and may, moreover, be 
 the vehicle of infectious germs and other morbific agents. 
 
 1. It has been shown that certain diseases in the cow are commu- 
 nicable to man through the medium of the milk. This is especially 
 true of tuberculosis, foot-and-mouth disease, anthrax, and cowpox. 
 The writer, in 1903, published 86 cases of milk-borne tuberculosis, 
 and Doctor Salmon has shown, from the vital statistics of Massachu- 
 setts and Michigan, that while there has been a marked reduction in 
 the mortality of phthisis at all other ages, there has been a tremendous 
 increase in the class under 5 years of age. There is also evidence to 
 show that diseases like garget, inflammation of the udder and teats, 
 digestive derangements, and septic fevers in the cow will render the 
 milk morbific to man. 
 
 2. It has been shown that cows which have been fed on poisonous 
 forage plants, or have been treated with strong medicaments for any 
 or all causes, are disqualified from producing a pure or sound milk. 
 
 3. The writer has collected and taubulatea the history of 195 epi- 
 demics of typhoid fever, 99 of scarlet fever, and 36 of diphtheria, all 
 traceable to the milk supply. In a recent investigation into the 
 causes of typhoid fever in Washington, the bureau of public health 
 definitely traced 85 out of 866 (about 10 per cent) to infected milk. 
 
 Last but not least the writer desires to emphasize two important 
 milk faults which may be considered sources of constant danger in 
 infant feeding, and perhaps the most important factors in swelling 
 the mortality rates of our helpless babes, viz, milk sediments (dirty 
 milk) and their effects on premature acidity. 
 
 MILK SEDIMENTS OR DIRTY MILK. 
 
 Every consumer of milk has doubtless observed the presence of 
 more or less foreign matter at the bottom of the bottle in which it is 
 kept ; indeed, it is a matter of such common occurrence that it hardly 
 excites our attention, and many are disposed to look upon it as a matr 
 ter of course. Professor Soxhlet, of Munich, was perhaps the first to 
 point out that these deposits are largely made up of excrementitious 
 matter from the cow, which, adhering to the udder of the animal, 
 gained access to the bucket during the act of milking. If these sedi- 
 ments are subjected to microscopical examination we will find that 
 they are composed of epithelial debris, hairs of the cow, organic and 
 inorganic dust particles, excrementitious matter, vegetable fibers, 
 S. Doc. 644, 60-2 14 
 
194 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 bacteria, fungi, and spores of every description ; fully 90 per cent of 
 the germs are fecal bacilli — all of which is not only disgusting but 
 extremely suggestive of danger. The number of micro-organisms is 
 largely increased, and we know that under a suitable temperature bac- 
 terial development and consequent decomposition are materially has- 
 tened in such a medium. 
 
 The greatest danger from milk of this class is the possible presence 
 of ptomains or toxins produced b}^ certain saprophytic germs acting 
 on the albuminoids of the milk. Professor Vaughan, of Ann Arbor, 
 Mich., in 1885, isolated a poison called tyrotoxicon, which is one of 
 the causes of the toxic symptoms in some cases of milk poisoning, 
 cheese and ice-cream poisoning. The presence of the very filth re- 
 ferred to, a summer temperature, and the pernicious habit of placing 
 the milk before cooling in cans and bottles perhaps dirty besides, con- 
 stitute favorable environments for the development of this and analo- 
 gous poisons. 
 
 Germ development and acidity of the milk are influenced by tem- 
 perature. Milk when it leaves the udder of the cow contains very 
 few germs; the majority gain access during unclean handling, espe- 
 cially when the milking is done in a dirty stable, or from excrementi- 
 tious matter adhering to the udder and teats of the animal. These 
 germs multiply with astonishing rapidity whenever the temperature 
 of the milk is above 50° F., and if disease germs are present their 
 proliferation augments the chances of infection. A temperature of 
 58° or 60° F. will not subserve the interest of public health. So, for 
 example, Petruschky has shown that at the room temperature a 
 streptococcal content of 300 per cubic centimeter may increase in 
 twenty-four hours to one of 10,000,000, but the same milk kept at 50° 
 F. yielded but 30,000, or but three one-thousandths as many. 
 
 Von Freudenreich ("Dairy Bacteriology," London, 1895) exposed 
 a sample of milk containing 153,000 bacteria per cubic inch to a 
 temperature of 59° F.; one hour after it contained 539,750 bacteria 
 per cubic inch; two hours after, 616,250; four hours after, 680,000; 
 seven hours after, 1,020,000; nine hours after 2,040,000; twenty-five 
 hours after, 85,000,000. 
 
 Bryce, of Toronto, has made similar investigations. All of which 
 indicates the extent of germ development which must go on in milk 
 transported over long distances during the summer months, when the 
 mercury ranges from 85° to 95° and the cans are allowed to stand in 
 the sun without ice; and we can appreciate why even 100,000,000 of 
 bacteria per cubic centimeter have been found in samples of Wash- 
 ington milk, far exceeding the number usually found in the sewage 
 of cities. Other cities are, however, similarly afflicted, and nothing 
 short of clean, decent habits in handling the milk and keeping it at 
 a temperature of 50° F. will prevent the mischief. Dr. H. C. Plant, 
 of Leipzig, found, as a rule, that in warm weather the so-called fresh 
 milk delivered in the morning is unfit for young children, and of 47 
 infants whose milk supply was carefully investigated by him 18 de- 
 veloped serious digestive and intestinal diseases, and 6 died. One of 
 the chief reasons why there are less deaths from infantile diarrhea 
 in the country than in towns and cities, in proportion to the popula- 
 tion, is that the milk used is comparatively fresh, contains fewer 
 germs and less toxins. Without doubt dirty and sour milk, or milk 
 which is on the point of turning, are the chief causes of diarrheal 
 
KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 195 
 
 diseases in bottle-fed children, and in the more acute cases we have 
 the phenomena of cholera infantum, due most likely to a toxic char- 
 acter of the milk. These views have steadily gained ground and 
 have resulted in great sanitary reforms in our milk establishments, 
 the fruits of which are already apparent in the decrease of deaths 
 from infantile diarrhea in this city. (See page 187.) 
 
 PRODUCTION or PURE MILK. 
 
 The Washington market milk compares favorably with the supply 
 in other cities ; there is no evidence to shoAv that it is worse, but there 
 is abundant evidence to indicate that stale, dirty, and infected mar- 
 ket milk is everywhere responsible for a needless sacrifice of human 
 life, and it is clearly the duty of the State to take what precautions 
 it can to prevent sickness and distress. 
 
 Those who are familiar with the surroundings of our milk farms 
 and the habits of the average dairy employee need no arguments for 
 the necessity for sanitary reforms, and the principles which ought to 
 be carried out should be embodied in effective laws and accepted and 
 enforced in a practical sense. Honorable men will not object to regu- 
 lations calculated to promote the purity of their product and the 
 health of their customers, and as many of the most serious faults in 
 the milk business are the result of ignorance rather than of inten- 
 tional neglect, the difficulties will be materially lessened by proper 
 education and trade competition. 
 
 Pure natural milk can only be secured at dairies with sanitary 
 buildings, a. pure water supply, healthy, well-fed, and well cared for 
 cows, a well -equipped and well-kept milk room, provisions for 
 thorough cleanliness, intelligent and conscientious people in charge, 
 and clean methods throughout. 
 
 CERTIFIED MILK.* 
 
 It was in consequence of a just appreciation of these principles 
 that the so-called " certified milk " came into existence about ten 
 years ago. Responsible bodies of citizens interested in an improved 
 milk supply organized in different cities milk commissions. Such 
 commissions usually select and secure the advice and assistance of 
 four experts — a veterinarian, a physician, a bacteriologist, and a 
 chemist — all more or less familiar wdth the conditions and possibili- 
 ties on dairy farms. The commission sends to each dairyman who 
 supplies milk to the city a circular naming all the particular condi- 
 tions which should be found on every farm where milk is produced 
 for city use, and announcing that where any dairyman notifies the 
 commission that he is fully conforming to the conditions specified, 
 or endeavoring to do so, his dairy will be inspected, and, if it is found 
 to comply in letter and spirit to all the requirements, his name will 
 be placed upon an approved list and he will receive official indorse- 
 ment to the effect that his dairy farm and the herd thereon have 
 
 « Extract from a Report of the Committee on Sanitary Relations to a con- 
 ference appointed by the Commissioners of the District of Colmnbia to consider 
 and report upon the local milk supply. The writer was chairman of the sub- 
 committee which submitted the report. 
 
196 EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 been thoroughly examined and found to comply with the conditions 
 recommended by the commission. These conditions include a healthy 
 herd, the use of pure feeds, appropriate stabling and care, pure 
 water, and clean and prompt handling of the milk, which is of good 
 composition and quality and so free from pathogenic and unneces- 
 sary bacteria as reasonable safeguards can provide. The attendants 
 are cleanly and free from communicable diseases, and all milk is 
 promptly cooled, immediately after milking, to a temperature of 50° 
 F. Every intelligent dairy farmer insists upon cooling his milk as 
 soon as the bucket is full. 
 
 The inspections are made unannounced and at irregular intervals, 
 so as to insure maintenance of the prescribed standard. Any neg- 
 lected condition is immediately reported to the commission, which 
 decides whether or not the cause is sufficient to withdraw and cancel 
 the last certificate issued. 
 
 PASTEURIZED MILK. 
 
 It must be apparent that it will require time and education to 
 secure compliance with even reasonable safeguards, and it is equally 
 evident that the number of dairy farms now in a position to live up 
 to sanitary requirements will supply but a small percentage of the 
 population, although it is hoped that such dairy farms will be stimu- 
 lated into existence by trade competition and the refusal of the public 
 to buy dirty milk at any price. Until this is accomplished, the com- 
 mittee, in the interest of public health, strongly advocates clarification 
 and pasteurization of all milk. This, to be sure, will not make bad 
 milk good, but it will at least destroy its power to transmit disease 
 germs. 
 
 PASTEURIZING PLANTS OR MILK DEPOTS. 
 
 Your committee also believes that this object can be most efficiently 
 Aiid economically secured by the establishment of a pasteurizing plant 
 provided by the District government or, preferably, by private enter- 
 prise, which plant should be under the supervision of the health 
 department. 
 
 There is every argument from a commercial and sanitary stand- 
 point in favor of a central plant, erected within reasonable distance 
 from the Union Depot, where all the milk for the city should be re- 
 ceived and prepared for distribution. Such a step would result in 
 the creation of suitable conditions for the proper handling and stor- 
 age of milk, sterilization of milk cans and utensils, and the efforts of 
 the local milk dealers to provide decent facilities for their 150 or 
 more dairies scattered over the city, all more or less liable to infection, 
 could be concentrated in one plant with a decided saving of expense. 
 
 Milk should never be sold by grocery stores or milk shops unless it 
 has been delivered to such establishment in original sealed bottles, and 
 then only when there is provision for maintaining the milk at a tem- 
 perature of 50° F. 
 
 ADVANTAGES AND DISADVANTAGES OF PASTEURIZED MILK. 
 
 Your committee is aware that there is a difference of opinion among 
 medical men as to the wholesomeness of pasteurized milk. The ad- 
 vantages and disadvantages have been exhaustively studied by Dr. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 197 
 
 M. J. Rosenau, director of the Hygienic laboratory of the United 
 States Bureau of Public Health and Marine-Hospital Service, and 
 in his opinion the advantages so far outweigh the disadvantages that 
 he " unhesitatingly recommends compulsory pasteurization of all milk 
 not certified under class 1 or class 2 of Doctor Melvin's classification." «* 
 Your committee is so strongly impressed with the manifold dangers 
 connected with the milk supply that until the needful reforms in 
 dairy methods are accomplished it recommends to the public the fol- 
 lowing as immediate safeguards : 
 
 1. Do not patronize a milk dealer, at any price, whose milk after 
 standing for two hours reveals a visible sediment at the bottom of the 
 bottle. It is evidence of dirty habits, extremely suggestive of danger, 
 and entirely preventable by clean, decent methods without greatly 
 increasing the cost. 
 
 2. Subject all your milk to home pasteurization by simply bringing 
 it to the boiling point, and, after cooling, keep the milk on ice. This 
 will destroy germ life and reduce the chances of milk-borne diseases 
 to a minimum. 
 
 Dr. H. W. Wiley's committee submitted the following recommenda- 
 tions : 
 
 1. That the milk which is supplied to infants under the age of 3 years in 
 the District of Columbia should be certified by the health office. Milk should 
 contain not more than 5,000 bacteria per centimeter, should be not more than 12 
 hours old, and should be delivered in artificially cooled packages. 
 
 2. That the health oflEicer of the District be authorized to advertise for dairies 
 which will be willing to so modify their barns, stables, etc., if necessary, as to 
 secure a license from him for the production of certified milk under the most 
 improved sanitary conditions. 
 
 3. That each cow furnishing the milk in the dairy be tested, under the 
 supervision of the health officer, for tuberculosis or other contagious or infec- 
 tious diseases; and that any animal so suffering be excluded from the herd. 
 
 4. That a daily sample or samples drawn from the supply of each certified 
 milk furnished to the city be secured for the purpose of making the bacterial 
 count and determining the chemical composition, etc. 
 
 5. That parents and guardians be urged to use only certified milk, at least 
 for infants' food, in the District of Columbia for all infants under the age of 
 3 years. 
 
 6. That if private dairies can not be induced to furnish certified milk, the 
 Commissioners of the District of Columbia, as a health measure affecting in 
 the highest degree the welfare of the District of Columbia, be asked, if it can 
 be legally done, to establish a municipal dairy for the purpose of furnishing 
 certified milk for the use of infants under 3 years of age. 
 
 7. That pending the time which must necessarily elapse for the inauguration 
 of a service of certified milk for infants' use, the health officer be authorized, 
 as a result of inspection, to publish a list of dairies from which the milk 
 supply is drawn, giving the average rating of each dairy, the chemical com- 
 position, and bacterial count of the samples. 
 
 8. That for the purpose of securing modified milk for infants in ill health, 
 according to the prescription of physicians, the milk commission of the Dis- 
 
 oThe classification referred to is as follows: Class 1, certified milk for infants, 
 as hereinbefore described. Class 2, clean, raw milk from healthy cows, as 
 determined by the tuberculin test and veterinary physical examination; the 
 cows to be housed, fed, and milked under good conditions, but not necessarily 
 equal to the conditions provided for in class 1; pure water, as determined by 
 chemical and bacteriological examination, to be provided; the bacteriological 
 count of the milk not to exceed 100,000 bacteria per cubic centimeter, at the 
 time the milk reaches the city, at any season of the year, as determined by the 
 health department at frequent intervals; milk to be delivered to the customer 
 in sterilized containers, to be filled upon the dairy farm, and the temperature of 
 the milk not to exceed 50° F. until delivered to the customer. 
 
198 KEPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 trict Medical Society be requested to secure the establishment of a laboratory, 
 under its supervision, in which only certified milk shall be used, and in which, 
 by the use of a separator or otherwise, milk of a definite chemical composition 
 may be prepared from certified milk, in harmony with the physicians' pre- 
 scriptions relating thereto. 
 
 9. That a complete chemical and bacteriological laboratory be established 
 in connection with the health office, of a capacity to examine all the samples 
 necessary to secure the certified and modified milks above described. 
 
 10. That the term "certified milk," as used herein, is to be applied to mill- 
 secured at dairies subject to a periodic inspection, and the products of which 
 are subjected to constant analysis. The cows providing the milk are properly 
 fed, free from tuberculosis or other contagious diseases, and housed in clean 
 stables, properly ventilated, and they are supplied with wholesome water and 
 food, and kept clean. The milk is drawn under precautions to avoid infection, 
 is immediately strained and cooled and packed in sterilized bottles, which are 
 kept at a temperature not to exceed 50° F. until delivered to the consumer. 
 
 It is fully realized that milk of this character will cost more to 
 produce and should bring a higher price in the market than ordinary 
 uncertified milk. At the same time it is hoped that the producers 
 of milk will endeavor to keep the prices within the means of the 
 ordinary citizen while making a fair profit on their invested capital. 
 
 In the language of Professor Harrington, " the public needs proper 
 education that clean milk is a necessity, and that infant sickness and 
 funerals can be reduced at least 40 per cent. * * * j^ model farm 
 properly manned certainly can not compete on equal terms with a 
 filthy farm, where no attempt is made to conduct the business in a 
 decent manner, especially if customers are indifferent. The dirty 
 producer can e^fe'n afford to cut prices and take customers away from 
 the other, if customers care to save a cent and make it up in pus and 
 cow dung." 
 
 HOME TREATMENT OF NURSERY MILK.« 
 
 The milk, as soon as delivered, should be placed in a refrigerator 
 upon ice, so that the temperature may not exceed 50° F. If desired 
 for infant feeding, it should stand for one hour, when the upper 
 third (10 per cent top milk) can be taken off. This top milk is then 
 modified, so that the proportion of the constituents may be those of 
 human milk. This is done by mixing 7 ounces of the top milk with 
 1 ounce or 2 tablespoonfuls of milk sugar, the same quantity of lime- 
 water, and 12 ounces of boiled water. If only 10 ounces be required 
 for twenty-four hours' feeding, the proportion of each ingredient is 
 reduced one-half; if 30 ounces be necessary, add one-half. In case 
 the child presents evidence of feeble digestion, the amount of fats and 
 proteids must be reduced by cutting down the top milk to 6, 5, 4, 3, 
 or even 2 ounces, and sufficient boiled water added to make 20 ounces. 
 After modifying the milk in the manner directed, the correct amount 
 of each feeding is put in a nursing bottle. The necks of the bottles 
 are stopped up with plugs of clean nonabsorbent cotton. 
 
 The milk should then be pasteurized. For this purpose different 
 pasteurizers have been placed on the market. A very simple and 
 inexpensive method is to place the bottles in a tin kettle, pour warm 
 water around them, and bring the water to a temperature of 180°. 
 The kettle is then covered and removed from the stove, wrapped in 
 
 «This infomation is obtained largely from Prof. Plenry D. Fry's monograph 
 on " Maternity," Washington, 1907, a work which can be confidently recom- 
 mended. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 199 
 
 a piece of flannel blanket, and set upon folded newspapers. At the 
 expiration of half an hour the bottles should be taken out, cooled, 
 and kept on ice until used. When it is time to feed the baby, one of 
 the bottles is removed and set in hot water until the temperature 
 of the milk is 98°. A higher or lower temperature is absolutely in- 
 jurious to the infant. 
 
 QUANTITY OF FOOD FOR EACH FEEDING. 
 
 The number of feedings in twenty-four hours has been given on 
 page 190. Doctor Fry believes that a frequent cause of failure to 
 jraise babies on modified milk is that they are overfed. He considers 
 1 to 2 tablespoonfuls sufficient for each feeding during the first few 
 weeks of life. At 1 month of age give 2 to 3 tablespoonfuls ; at G 
 weeks 3 to 4 tablespoonfuls; at 2 months 4 to 5 tablespoonfuls. In- 
 crease the quantity at the rate of 1 ounce each month up to 6 months 
 of age. Two tablespoonfuls make an ounce. Another trouble is the 
 baby gets the food into its stomach too fast. When nursing at the 
 breast the baby requires from fifteen to twenty minutes to suck the 
 nourishment. When fed with the bottle it often obtains its food in 
 five minutes. 
 
 In this connection it should be remembered that no substitute for 
 human milk as yet prepared can take the place of a sound mother's 
 milk, and that as long as we are compelled to resort to infant feeding 
 we should feel our way gradually, bearing in mind Biedert's conclu- 
 sions, that a bottle-fed infant thrives best when the minimum amount 
 of food necessary for development is given. If in the course of feed- 
 ing symptoms of diarrhea with green stools appear, it is best to stop 
 the milk altogether and feed the baby with albumen water, barley 
 water, or rice water, and consult a physician at once. 
 
 Barley water is made as follows: Take 2 tablespoonfuls of pearl 
 barley, add 1 quart of water, boil for three hours, add enough water 
 to keep the quantity to 1 quart, strain through course muslin. Keep 
 well covered in refrigerator, warm to 98° before using it. Rice 
 water is made in the same manner. 
 
 CARE OF THE NURSERY REFRIGERATOR, NURSING BOTTLES, NIPPLES, 
 
 UTENSILS, ETC. 
 
 " It is absolutely essential that intelligent and careful attention 
 should be paid at home to the cleanliness of bottles, nipples, dippers, 
 cooking utensils, etc. The nursery refrigerator must be metal lined 
 and kept clean, aired free from odors, and well supplied with ice 
 (unless the place in which it is kept has a temperature less than 50°). 
 
 The bottles can be cleaned as follows: Einse with the brush in 
 cold water in which a little washing soda is dissolved, then wash and 
 brush thoroughly with soap and hot water and rinse again in sterile 
 water. Or the bottles as soon as emptied can be filled with cold 
 water to which a little bicarbonate of soda is added. Before being 
 refilled they should be thoroughly washed with a brush and hot soap 
 suds and then boiled for twenty minutes. * * * Never let a 
 nursery bottle stay dirty after use until the milk dries in it. The 
 neck of the bottle should be large enough to permit easy cleaning 
 and it should have no corners or angles on the inside. The nipples 
 
200 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 should be of rubber and made so that they can be easily turned inside 
 out for cleaning. New nipples should always be boiled before use. 
 Immediately after use the nipples should be washed in soda water 
 and kept in a solution of boric acid, and when wanted again they 
 should be rinsed in water. Attention to these details should not be 
 neglected, as the life of the infant depends upon absolute cleanliness 
 of the food at all times, and especially during the warm months." 
 From what has been said on this subject it is evident — 
 
 1. That no effort should be spared to secure the enactment of more 
 stringent laws regulating the production and sale of pure milk and 
 cream. 
 
 2. The establishment of day nurseries, where the infants of thosa 
 who are obliged to go out to their work may be properly cared for, is 
 urgently called for. 
 
 3. The establishment of dispensaries, where intelligent instructions 
 are given in infant feeding and modified milk sold at reasonable 
 rates, would be in the interest of public health and humanity. 
 
 It is gratifying to note that such a dispensary was started April 13, 
 1908, in connection with the Neighborhood House in southwest Wash- 
 ington. According to Dr. William J. French, up to October 1, 1908, 
 261 infants and children have been treated. There were but 3 deaths. 
 The records of the health office show that during 1907 there were 50 
 deaths in southwest Washington in children under 10 years of age, 
 while during the year 1908 there were but 29 deaths in children of 
 the same age period, in spite of the very hot summer. Doctor French 
 very justly considers the clean, pure milk and the instruction fur- 
 nished by the dispensary factors in this marked reduction of mor- 
 tality rates. 
 
 Chapter V. 
 
 THE PREVENTION OF PERMANENT DISABILITIES IN CHILDHOOD. 
 
 The writer, in his sociological studies of physically defective per- 
 sons who contribute such a large contingent to our charitable institu- 
 tions, has felt convinced that many of these partial and complete dis- 
 abilities could have been prevented by proper care and treatment in 
 childhood. It is now well known that many of the joint deformities 
 in children are amenable to treatment, and that a ruptured child or 
 person may be radically cured. As a member of the Board of Chari- 
 ties he recommended that the physicians to the poor and agents of 
 the Associated Charities be requested to encourage the parents of such 
 children to authorize operative procedures or hospital treatment, for 
 the prevention of permanent disabilities. The result within the past 
 year more than justifies a general acceptance of these principles. The 
 records of the Children's Hospital reveal the gratifying fact that the 
 operations for the radical cure of hernia, for example, have increased 
 from 9 in 1907 to 25 in 1908, and that every child was discharged as 
 cured. The increase in the number of joint cases and deformities 
 treated is also very marked. 
 
 In order to determine the number of physically defective children 
 in our graded public schools the health officer and the board of educa- 
 tion authorized a general medical survey of the pupils. The exami- 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 201 
 
 nation was conducted by the medical inspectors of the schools, under 
 the general direction of Dr. Henry C. Macatee, assistant secretary of 
 the President's Homes Commission. The results have been tabulated 
 by him and will be found in Table A. 
 
 From this table we learn that out of 43,005 pupils in the graded 
 schools 13,407 were colored and 29,598 were white. Among the 
 colored children 3,784 instances of the defects listed in the table were 
 encountered, or a relation of 28.2 per cent; among the white pupils 
 11,520 notations of defects, a relation of 38.9 per cent to the whole, 
 were encountered. The difference in percentage of defects between 
 white and colored children is solely due to better condition of the 
 teeth in the colored children. Total defects noted, 15,304, or 35.5 
 per cent of the pupils examined. These percentages, high as they 
 may appear, are very much lower than the rates reported from New 
 York. 
 
 Omitting from this consideration the 6,698 pupils who probably 
 needed only dental care — a matter of importance, however, to the 
 general health — we still have to deal with 8,606 pupils, or 20 per cent 
 of the total, whose physical condition should be a matter of grave 
 concern to the parents. Of this number 149 were crippled, 272 de- 
 formed, 461 had strabismus (squint), 312 had discharging ears, 
 835 defective hearing, 2,176 defective vision, 2,062 were "mouth 
 breathers," 703 were undersized, 727 ill nourished, and 934 were 
 anaemic. 
 
 It was not deemed best to conduct physical examinations involving 
 the removal of clothing, and hence the number of ruptured children 
 ,could not be determined, but, judging from the reports of the agents 
 of the Associated Charities, the number is sufficiently great for serious 
 consideration. 
 
 It will be readily conceded that every crippled or deformed child 
 should, if possible, be spared from permanent disability, and no 
 thoughtful parent should hesitate to act when attention is directed to 
 the serious consequences of neglect. Poverty is no excuse for the 
 " do-nothing system," as the medical charities offer adequate facilities 
 for treatment of persons unable to pay for the same. 
 
 Nor is there an excuse for not attempting to cure discharging ears, 
 defective hearing or vision, since every observer is familiar with the 
 sad consequences of such defects in the ultimate struggle for existence. 
 Parents may not know that a child afflicted with a squint, harelip, or 
 cleft palate may be transformed into a vicious character, because it is 
 the object of constant ridicule within and without school, and that 
 all of this could be avoided by a timely operation. Parents are prob- 
 ably not aware that many of the nervous affections and even mental 
 defects in boys are due to some slight malformation of the genital 
 organs, for which the Hebrews instituted circumcision. Nor is it 
 generally known that anaemic and ill-nourished children and those 
 suffering from enlarged tonsils, cervical glands, or post-nasal growths, 
 and the majorit}^ of " mouth breathers " are peculiarly susceptible to 
 disease in general and to tuberculosis in particular. 
 
 Lastly, there is no good reason why special attention should not be 
 given to the physical development of undersized children or those 
 affected with slight muscular deformities, which, if left uncorrected, 
 will be a source of regret and even reproach to the teacher and parent. 
 
 The remedy lies chiefly in education, and for this purpose the study 
 
202 
 
 EEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 of hygiene should be made an important part of the school curric- 
 ulum. In this way the parents may be reached through the child. 
 Instructive visiting nurses should be appointed for the schools, so that 
 they may follow the child to the home and point out to the parents the 
 desirability of securing prompt professional advice in all cases where 
 it is indicated, and especially in instances where neglect is likely to 
 result in permanent disability. In this general educational campaign 
 the medical inspectors of schools, teachers, social-settlement workers, 
 agents, and friendly visitors of the Associated Charities can render a 
 distinct service to the child and the State. 
 
 Table A. — Inquiry for the PresidenVs Homes Commission — Medical inspection 
 of puUic school children, Washington, D. C. 
 
 School 
 
 d 
 
 a 
 
 i 
 
 5 
 
 
 
 1 
 5 
 
 t 
 
 1 
 
 •d 
 
 1 
 
 
 
 3 
 '> 
 
 a> 
 > 
 
 u 
 <u 
 "S 
 
 
 bo 
 
 a 
 
 xi - 
 Q 
 
 B 
 
 Xi 
 
 5 
 
 B ^ 
 
 Si 
 
 1 
 
 1 
 
 1 
 g 
 
 1 
 
 WHITE. 
 
 Corcoran . . 
 
 39 
 29 
 
 11 
 13 
 
 2 
 28 
 24 
 11 
 
 9 
 14 
 
 I 
 
 3 
 
 8 
 
 9 
 
 7 
 
 11 
 
 13 
 
 2 
 
 16 
 
 4 
 
 7 
 
 
 2 
 
 17 
 8 
 
 1 
 
 31 
 12 
 
 6 
 6 
 
 • 9 
 1 
 
 3 
 2 
 
 10 
 5 
 
 1 
 1 
 
 39 
 22 
 
 13 
 6 
 
 3 
 
 6 
 
 2 
 
 2 
 
 1 
 
 86 
 53 
 
 27 
 
 23 
 
 12 
 
 73 
 
 76 
 
 56 
 
 20 
 
 72 
 
 104 
 
 5 
 
 5 
 
 78 
 
 105 
 
 19 
 
 65 
 
 3 
 
 18 
 
 9 
 
 109 
 
 83 
 
 13 
 
 62 
 
 36 
 
 71 
 
 41 
 
 95 
 
 69 
 
 25 
 
 40 
 
 14 
 
 42 
 
 42 
 
 62 
 
 52 
 
 18 
 
 72 
 
 80 
 
 41 
 
 87 
 
 143 
 
 47 
 
 104 
 
 98 
 
 166 
 
 102 
 
 103 
 
 104 
 
 110 
 
 68 
 
 91 
 
 226 
 139 
 
 68 
 
 63 
 
 14 
 159 
 187 
 116 
 
 67 
 117 
 155 
 
 27 
 
 23 
 154 
 202 
 
 70 
 113 
 
 45 
 
 69 
 
 68 
 156 
 121 
 
 31 
 122 
 
 91 
 120 
 
 82 
 191 
 173 
 101 
 124 
 
 73 
 114 
 139 
 166 
 108 
 
 37 
 135 
 169 
 
 85 
 156 
 251 
 
 93 
 192 
 191 
 345 
 246 
 207 
 198 
 276 
 137 
 182 
 
 412 
 
 ■Wpi or Vi t.m fl n 
 
 375 
 
 Industrial Home 
 School 
 
 .... 
 
 3 
 
 134 
 
 
 127 
 
 Conduit .... 
 
 
 
 
 24 
 
 
 3 
 1 
 
 2 
 
 "2 
 
 1 
 5 
 1 
 1 
 
 1 
 2 
 
 6 
 6 
 4 
 
 1 
 1 
 1 
 7 
 2 
 1 
 
 15 
 
 19 
 
 18 
 
 14 
 
 19 
 
 20 
 
 1 
 
 3 
 
 17 
 
 6 
 
 5 
 
 5 
 
 4 
 
 7 
 
 7 
 
 6 
 
 4 
 
 2 
 
 4 
 
 14 
 
 18 
 
 16 
 
 43 
 
 23 
 
 15 
 
 43 
 
 37 
 
 20 
 
 21 
 
 27 
 
 21 
 
 15 
 
 33 
 
 45 
 
 16 
 
 32 
 
 48 
 
 25 
 
 31 
 
 81 
 
 56 
 
 40 
 
 36 
 
 38 
 
 89 
 
 13 
 
 22 
 
 5 
 
 5 
 5 
 1 
 3 
 3 
 1 
 ...... 
 
 2 
 
 '.'J. 
 
 2 
 
 I 
 
 1 
 
 2 
 
 3 
 
 
 
 '""i* 
 
 2 
 
 ....„ 
 
 2 
 
 8 
 7 
 3 
 
 6 
 4 
 4 
 1 
 1 
 2 
 4 
 8 
 1 
 2 
 4 
 2 
 1 
 4 
 ...... 
 
 9 
 13 
 
 il 
 
 12 
 16 
 13 
 
 16 
 28 
 10 
 13 
 2 
 7 
 6 
 9 
 25 
 46 
 20 
 21 
 8 
 15 
 13 
 14 
 14 
 10 
 15 
 17 
 12 
 10 
 27 
 41 
 18 
 20 
 13 
 36 
 83 
 26 
 14 
 2 
 12 
 24 
 23 
 20 
 25 
 8 
 27 
 30 
 56 
 47 
 25 
 37 
 37 
 17 
 12 
 
 4 
 13 
 5 
 
 1 
 1 
 3 
 
 1 
 
 ""2 
 
 1 
 5 
 
 278 
 
 Curtis 
 
 369 
 
 Addison 
 
 319 
 
 Hyde 
 
 341 
 
 Fillmore 
 
 272 
 
 
 313 
 
 
 114 
 
 Beiinintr 
 
 
 
 127 
 
 Edmonds 
 
 2 
 
 1 
 2 
 
 .... 
 
 13 
 19 
 7 
 7 
 9 
 9 
 8 
 5 
 2 
 5 
 10 
 6 
 2 
 4 
 4 
 12 
 16 
 3 
 3 
 11 
 8 
 17 
 4 
 1 
 6 
 9 
 1 
 
 12 
 16 
 6 
 7 
 
 19 
 
 22 
 
 26 
 
 7 
 
 9 
 
 10 
 
 8 
 
 12 
 
 6 
 10 
 
 1 
 3 
 1 
 3 
 2 
 
 'I 
 
 "'il' 
 ...... 
 
 :::::: 
 
 I 
 
 3 
 ...... 
 
 6 
 
 1 
 
 2 
 
 6 
 
 4 
 
 3 
 
 7 
 
 16 
 
 11 
 
 5 
 
 6 
 
 8 
 
 7 
 
 14 
 
 377 
 
 Tavlor 
 
 323 
 
 Maury 
 
 1 
 
 
 369 
 
 
 312 
 
 Blair 
 
 
 
 2 
 10 
 5 
 2 
 2 
 
 329 
 
 Blow 
 
 1 
 4 
 
 1 
 
 .... 
 
 206 
 
 Webb 
 
 383 
 
 
 305 
 
 Pierce 
 
 367 
 
 Kenil worth 
 
 101 
 
 Wheatley 
 
 10 
 3 
 
 "2 
 1 
 
 1 
 3 
 3 
 2 
 
 1 
 "3' 
 
 "i' 
 
 2 
 
 1 
 
 2 
 
 1 
 
 ...... 
 
 2 
 4 
 2 
 
 359 
 
 Eckington 
 
 340 
 
 
 414 
 
 Langdon 
 
 
 275 
 
 
 1 
 3 
 3 
 3 
 
 1 
 
 621 
 
 Abbot 
 
 399 
 
 Twining 
 
 312 
 
 
 468 
 
 
 2 
 
 
 3 
 
 1 
 
 ""e 
 
 1 
 
 501 
 
 Polk 
 
 ....„ 
 
 2 
 
 2 
 
 1 
 16 
 20 
 11 
 
 413 
 
 Morse 
 
 i 
 
 2 
 2 
 
 1 
 
 1 
 
 334 
 
 Seaton 1 
 
 407 
 
 Haves 
 
 .... 
 3 
 
 1 
 
 299 
 
 Stanton 
 
 142 
 
 Van Ness, J. P 
 
 
 .... 
 
 1 
 
 5 
 4 
 1 
 
 ;;:;:; 
 
 318 
 
 Ketehem 
 
 1 
 2 
 
 301 
 
 Van Buren 
 
 
 
 
 76 
 
 Van Buren Annex 
 
 3 
 4 
 
 
 
 326 
 
 Bradley 
 
 4 
 1 
 8 
 3 
 
 23 
 5 
 
 19 
 
 il 
 
 11 
 8 
 
 
 
 6 
 2 
 5 
 
 
 
 376 
 
 Potomac 
 
 
 
 138 
 
 Small wood 
 
 2 
 
 "2 
 3 
 
 1 
 
 1 
 2 
 1 
 
 1 
 2 
 
 4 
 
 1 
 
 ...... 
 
 3 
 
 400 
 
 Amidon 
 
 405 
 
 
 3 
 7 
 6 
 3 
 19 
 5 
 7 
 
 1 
 1 
 
 j- 
 
 3 
 2 
 
 810 
 
 Bowen.S.J 
 
 Greenleaf 
 
 352 
 391 
 
 Congress Heights 
 
 847 
 
 Cranch 
 
 Tvler 
 
 Buchanan 
 
 7 
 3 
 
 4 
 
 4 
 
 1 
 1 
 
 8 
 1 
 9 
 
 602 
 386 
 414 
 
KEPOKTS OF THE PKESIDENT S HOMES COMMISSION. 
 
 203 
 
 Table A. — Inquiry for the PresidenVs Homes Commission — Medical inspection 
 of public school children, Washington, D. C. — Continued. 
 
 School. 
 
 < 
 
 ft 
 
 o 
 
 
 
 1 
 
 
 1 
 
 
 i 
 1 
 
 +3 
 
 03 
 
 1 
 
 s 
 
 It 
 
 
 
 WHITE— con. 
 Orr 
 
 8 
 14 
 16 
 19 
 
 18 
 19 
 26 
 18 
 17 
 
 1 
 
 3 
 2 
 2 
 1 
 2 
 2 
 1 
 - 
 
 2 
 
 ■"--- 
 
 4 
 6 
 
 8 
 
 I 
 
 4 
 5 
 5 
 10 
 
 18 
 29 
 39 
 21 
 54 
 35 
 40 
 18 
 56 
 
 3 
 21 
 25 
 40 
 31 
 35 
 24 
 18 
 30 
 30 
 14 
 18 
 
 3 
 13 
 
 6 
 11 
 
 3 
 18 
 14 
 37 
 39 
 44 
 12 
 12 
 19 
 18 
 
 1 
 
 1 
 5 
 6 
 6 
 
 11 
 9 
 
 10 
 7 
 2 
 
 5 
 4 
 3 
 6 
 10 
 11 
 13 
 13 
 10 
 
 8 
 29 
 30 
 40 
 44 
 31 
 37 
 25 
 14 
 
 5 
 
 18 
 9 
 28 
 19 
 16 
 20 
 8 
 4 
 5 
 15 
 12 
 4 
 13 
 5 
 4 
 1 
 2 
 4 
 1 
 2 
 2 
 2 
 5 
 2 
 3 
 2 
 3 
 5 
 6 
 5 
 14 
 
 "2 
 
 4 
 
 2 
 6 
 5 
 8 
 1 
 
 27 
 6 
 1 
 
 10 
 
 2 
 
 ...... 
 
 1 
 
 3 
 
 ...... 
 
 ...... 
 
 3 
 
 '""i" 
 
 ....„ 
 ....„ 
 ....„ 
 
 ...... 
 
 1 
 
 33 
 130 
 154 
 30 
 72 
 190 
 144 
 81 
 96 
 6 
 3 
 10 
 53 
 57 
 64 
 60 
 52 
 66 
 88 
 19 
 49 
 107 
 78 
 72 
 67 
 18 
 90 
 42 
 97 
 135 
 112 
 25 
 
 ■■■33" 
 52 
 
 85 
 
 245 
 273 
 156 
 236 
 364 
 304 
 178 
 220 
 17 
 70 
 91 
 93 
 138 
 130 
 105 
 88 
 111 
 144 
 43 
 77 
 120 
 105 
 99 
 88 
 29 
 135 
 74 
 167 
 193 
 189 
 103 
 21 
 69 
 
 202 
 
 
 376 
 
 Dent 
 
 380 
 
 Brent 
 
 319 
 
 Wallach 
 
 591 
 
 Towers 
 
 424 
 
 Peabody 
 
 588 
 
 Hilton 
 
 376 
 
 Carbery 
 
 335 
 
 
 306 
 
 Force 
 
 4 
 3 
 
 2 
 1 
 5 
 3 
 2 
 4 
 8 
 
 .'.'.. 
 
 1 
 2 
 
 I 
 
 5 
 
 6 
 
 
 
 4 
 2 
 4 
 1 
 4 
 6 
 3 
 1 
 ....„ 
 
 1 
 1 
 2 
 2 
 
 
 
 3 
 4 
 6 
 1 
 6 
 3 
 7 
 1 
 2 
 1 
 1 
 
 ""2 
 
 1 
 1 
 
 17 
 28 
 7 
 18 
 5 
 3 
 4 
 6 
 8 
 4 
 2 
 5 
 2 
 8 
 2 
 3 
 6 
 3 
 7 
 4 
 14 
 28 
 3 
 1 
 4 
 
 1 
 
 603 
 
 Webster 
 
 554 
 
 Grant 
 
 456 
 
 Gales 
 
 425 
 
 Arthur 
 
 345 
 
 Toner 
 
 296 
 
 Blake 
 
 294 
 
 Hubbard 
 
 363 
 
 Petworth 
 
 
 3 
 
 347 
 
 
 
 
 107 
 
 Takoma « 
 
 4 
 
 1 
 
 2 
 
 3 
 
 2 
 
 1 
 
 7 
 
 8 
 
 13 
 
 4 
 
 10 
 
 12 
 
 
 
 
 273 
 
 Morgan, T. P 
 
 
 1 
 
 ...... 
 
 """i' 
 1 
 
 3 
 3 
 1 
 
 469 
 
 Harrison 
 
 304 
 
 
 424 
 
 
 330 
 
 Woodburn 
 
 
 
 108 
 
 Phelps, 1 
 
 4 
 
 3 
 2 
 4 
 
 .'.1 
 
 
 
 3 
 
 1 
 2 
 2 
 2 
 6 
 2 
 1 
 5 
 
 1 
 
 349 
 
 Brentwood 
 
 
 
 194 
 
 Monroe 
 
 
 
 359 
 
 Johnson 
 
 525 
 
 Ross 
 
 
 
 
 478 
 
 Franklin 
 
 
 
 1 
 1 
 
 357 
 
 625 Q street, Atypical-. 
 Chevy Chase 
 
 1 
 2 
 2 
 
 1 
 
 
 36 
 
 244 
 
 Berret 
 
 2 
 
 1 
 
 
 
 249 
 
 Twelfth Street Kinder- 
 garten 
 
 
 
 1 
 
 31 
 
 
 
 
 
 
 Total (miscella- 
 neous, 2) 
 
 555 
 
 99 
 
 59 
 
 217 
 
 1,898 
 
 251 
 
 375 
 
 1,492 
 
 656 
 
 261 
 
 5,574 
 
 11,520 
 
 29,598 
 
 COLORED. 
 
 Magruder.. 
 
 5 
 29 
 10 
 10 
 13 
 
 10 
 1 
 1 
 
 1 
 
 1 
 
 14 
 2 
 13 
 7 
 8 
 29 
 12 
 10 
 3 
 1 
 16 
 5 
 
 3 
 
 4 
 
 14 
 
 24 
 
 33 
 
 12 
 
 29 
 
 13 
 
 9 
 
 5 
 
 1 
 
 26 
 
 9 
 
 1 
 
 4 
 3 
 7 
 5 
 5 
 1 
 9 
 2 
 6 
 
 2 
 
 7 
 
 8 
 32 
 41 
 
 4 
 14 
 
 7 
 17 
 
 2 
 
 5 
 17 
 19 
 
 8 
 22 
 
 4 
 12 
 
 8 
 19 
 
 4 
 
 1 
 26 
 
 1 
 
 19 
 26 
 16 
 20 
 27 
 6 
 15 
 18 
 27 
 8 
 1 
 14 
 10 
 4 
 9 
 
 10 
 11 
 17 
 22 
 50 
 17 
 9 
 48 
 39 
 14 
 26 
 
 7 
 6 
 5 
 7 
 5 
 1 
 3 
 
 1 
 4 
 
 ""2 
 1 
 3 
 
 18 
 
 24 
 18 
 50 
 57 
 43 
 78 
 
 2 
 20 
 15 
 
 7 
 41 
 
 8 
 
 75 
 137 
 100 
 172 
 ■ 211 
 
 82 
 190 
 
 66 
 111 
 
 37 
 
 12 
 141 
 
 41 
 
 286 
 
 Slater 
 
 360 
 
 Langston 
 
 252 
 
 Douglass 
 
 374 
 
 
 458 
 
 Ivy Citv 
 
 123 
 
 Ab. Simmons 
 
 I 
 
 1 
 
 - - 
 
 317 
 
 Jones 
 
 276 
 
 Logan 
 
 2 
 
 
 365 
 
 Deanwood 
 
 230 
 
 BenningRoad 
 
 
 1 
 3 
 2 
 
 
 
 106 
 
 Payne 
 
 
 3 
 2 
 2 
 5 
 3 
 5 
 3 
 
 14 
 5 
 6 
 2 
 6 
 8 
 2 
 1 
 
 10 
 
 2 
 
 
 322 
 
 WUson, Hy 
 
 
 
 358 
 
 Chain Bridge 
 
 
 
 
 31 
 
 Reno 
 
 
 1 
 1 
 3 
 
 "'i' 
 
 3 
 
 "2 
 2 
 
 
 3 
 3 
 4 
 1 
 6 
 4 
 6 
 2 
 16 
 12 
 4 
 1 
 
 ...... 
 
 2 
 
 "ii" 
 1 
 
 2 
 
 29 
 12 
 5 
 6 
 17 
 43 
 11 
 12 
 76 
 73 
 56 
 64 
 
 47 
 33 
 33 
 
 72 
 85 
 158 
 74 
 52 
 190 
 181 
 117 
 128 
 
 145 
 
 Sumner 
 
 
 
 
 2 
 1 
 4 
 9 
 12 
 6 
 4 
 
 '"'i' 
 
 2 
 3 
 5 
 
 I 
 
 7 
 6 
 12 
 14 
 20 
 14 
 
 192 
 
 Miner 
 
 .. 
 
 "2 
 
 2 
 9 
 7 
 3 
 5 
 7 
 1 
 8 
 
 1 
 29 
 
 5 
 17 
 13 
 11 
 15 
 
 6 
 
 7 
 11 
 
 368 
 
 Montgomery 
 
 5 
 
 6 
 
 8 
 
 1 
 
 3 
 
 12 
 
 10 
 
 10 
 
 9 
 
 334 
 
 Briggs 
 
 394 
 
 Stevens 
 
 800 
 
 Phillips 
 
 337 
 
 Wormley 
 
 358 
 
 A. Lincoln 
 
 360 
 
 BeU 
 
 367 
 
 Giddings 
 
 347 
 
 Randall 
 
 463 
 
 • Takoma first grade not included. 
 
204 
 
 EEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 Table A. — Inquiry for the President's Homes Commission — Medical inspection 
 of puhlic school children, Washington, D. C. — Continued. 
 
 School. 
 
 d 
 •< 
 
 1 
 5 
 
 s 
 
 t5 
 
 1 
 
 1 
 
 5 
 
 1 
 
 a 
 
 .£2 
 
 t 
 
 1 
 
 
 
 g 
 1 
 
 1 
 
 1 
 1 
 
 be 
 
 1 
 
 i 
 
 ii 
 
 5 
 
 5 
 
 ii 
 
 B 
 
 
 4i 
 
 1 
 g 
 
 1 
 
 COLORED— cont'd. 
 A. Bowen 
 
 9 
 
 7 
 12 
 
 8 
 21 
 13 
 10 
 12 
 
 9 
 
 5 
 10 
 19 
 
 2 
 
 1 
 1 
 2 
 
 1 
 
 3 
 
 ? 
 
 3 
 
 8 
 10 
 14 
 15 
 14 
 25 
 19 
 23 
 17 
 
 9 
 34 
 
 6 
 
 4 
 9 
 3 
 3 
 9 
 7 
 4 
 6 
 2 
 2 
 2 
 1 
 
 2 
 
 1 
 
 ....„ 
 
 2 
 4 
 3 
 
 10 
 13 
 21 
 10 
 15 
 5 
 
 3 
 
 18 
 
 49 
 
 33 
 
 29 
 
 8 
 
 13 
 
 8 
 
 8 
 
 9 
 
 1 
 
 5 
 
 12 
 
 3 
 
 1 
 
 3 
 
 5 
 
 16 
 
 14 
 
 11 
 
 12 
 
 4 
 
 2 
 
 4 
 
 3 
 
 1 
 
 2 
 
 6 
 
 2 
 6 
 2 
 2 
 2 
 1 
 1 
 
 
 
 
 
 ....„ 
 
 55 
 
 61 
 
 75 
 
 60 
 
 67 
 
 3 
 
 6 
 
 9 
 
 2 
 
 2 
 
 I 
 
 1 
 
 118 
 
 176 
 
 174 
 
 145 
 
 158 
 
 70 
 
 67 
 
 61 
 
 58 
 
 34 
 
 38 
 
 83 
 
 14 
 
 5 
 
 18 
 
 6 
 
 6 
 
 297 
 
 Bimey 
 
 470 
 
 Ambush . . 
 
 320 
 
 Cardoza 
 
 "2" 
 2 
 
 "3" 
 1 
 
 ! 
 
 1 
 .... 
 
 1 
 
 5 
 7 
 3 
 3 
 2 
 4 
 2 
 1 
 2 
 1 
 1 
 1 
 2 
 1 
 
 404 
 
 Syphax 
 
 343 
 
 Garnet 
 
 694 
 
 Mott. . . 
 
 523 
 
 Banneker 
 
 385 
 
 Cook 
 
 1 
 
 1 
 
 ....„ 
 
 2 
 2 
 2 
 6 
 
 369 
 
 Bruce 
 
 222 
 
 Garrison 
 
 423 
 
 Patterson 
 
 497 
 
 Military Road 
 
 96 
 
 Fort Slocum 
 
 
 
 1 
 2 
 
 1 
 4 
 
 
 51 
 
 Orphans' Home 
 
 Garnet Atypical 
 
 3 
 
 1 
 1 
 
 1 
 1 
 
 1 
 
 1 
 
 1 
 
 
 
 73 
 13 
 
 St. Luke Atypical 
 
 
 
 1 
 
 
 
 
 14 
 
 
 
 
 
 
 
 Total 
 
 279 
 
 50 
 
 213 
 
 510 
 
 164 
 
 210 
 
 328 
 
 684 
 
 179 
 
 51 
 
 1,124 
 
 3,784 
 
 13, 407 
 
 
 
 Grand total 
 
 934 
 
 149 
 
 272 
 
 727 
 
 2,062 
 
 461 
 
 703 
 
 2,176 
 
 835 
 
 312 
 
 6,698 
 
 15,304 
 
 43,005 
 
 Per cent relation to 
 total examined: 
 White 
 
 2.21 
 2.08 
 2.17 
 
 0.33 
 .37 
 
 0.19 
 1.58 
 .63 
 
 0.73 
 3.80 
 1.69 
 
 6.41 
 1.22 
 4.79 
 
 0.84 
 1.56 
 1.07 
 
 1.26 
 2.44 
 1.63 
 
 5.04 
 5.10 
 5.05 
 
 2.21 
 ,1.33 
 •1.94 
 
 0.88 
 
 18.83 
 8.38 
 15.57 
 
 
 
 Colored 
 
 
 
 All 
 
 
 
 
 
 
 Defects, exclusive of toothache, occurred In— Per cent. 
 
 White 20.08 
 
 Colored 19.84 
 
 All 20.01 
 
 All defects occurred in- 
 White 38.92 
 
 Colored 28.22 
 
 All 35.58 
 
 , Chapter VI. 
 
 THE HEALTH OF THE CITY OF WASHINGTON. 
 
 In speaking of the health of a given locality it has always been 
 deemed necessary that the climatic and telluric conditions should be 
 considered. For the purpose of a comparative study I requested 
 Prof. Willis L. Moore and Prof. A. J. Henry, of the United States 
 Weather Bureau, to furnish me with meteorological data covering a 
 period of thirty years for the city of Washington and six other cities 
 where the climatic conditions are quite similar to those which obtain 
 in this city. A careful analysis of these data and a study of the com- 
 parative mortality statistics justify the conclusion that there is ab- 
 solutely nothing inimical to health in the climate of Washington. It 
 was found, however, that although the city enjoys practically the same 
 climate as Cincinnati, Indianapolis, Detroit, Philadelphia, Spring- 
 
REPOKTS OP THE PRESIDENT'S HOMES COMMISSIOF. 205 
 
 field, and Kansas City, it has the highest death rate'' — 22.8 per 1,000 — 
 Philadelphia coming next with a rate of 21.2 per 1,000, while Detroit, 
 Kansas City, Indianapolis, and Springfield have an average of 17.5 
 per 1,000.^' 
 
 As a matter of record, Doctor Busey, in one of his addresses, quotes 
 the Washington Gazette of 1791, that " during that year, in a 
 population of 2,000, but 7 deaths occurred in this city." If , then, 
 during succeeding decades, " fatal epidemics of bilious fever, inter- 
 mittent bilious fever, and bilious dysentery," and typhoid fever 
 occurred, and the reputation of the National Capital as regards health 
 conditions has suffered, it can not be the effect of climate, but of some- 
 thing added to the climate, and students of the subject have long since 
 recognized that, apart from temperature, humidity, atmospheric pres- 
 sure, winds, sunshine, and other meteorological conditions, there are 
 many factors — such as soil, water, impure air, the presence of insects, 
 social" and racial problems — which play an important role in the 
 healthfulness of a given locality. 
 
 It can be safely asserted that a number of causes have operated in 
 the production of insanitary factors in the National Capital. 
 
 The topography of the basin in which the city is located was undu- 
 lating, interspersed with small valleys, ravines, morasses, and lowlands 
 subject to periodical overflows. The lowlands, according to Doctor 
 Busey, " spread south of the F street ridge to the river shore, includ- 
 ing a greater part of the ^Vhite Lot and the Mall, and in the section 
 known as ' the slashes,' lying along the northern boundary from the 
 Tiber to Rock Creek, and dipping in many places far into the interior 
 of the basin. When the city was first platted there were no Potomac 
 and Anacostia River flats; the formation of the Potomac marshes is 
 attributed to the construction of the Anacostia causeway in 1805 and 
 the building of the Long Bridge in 1808, and the Anacostia River 
 flats to the construction of the Kentucky Avenue Bridge in 1795 and 
 the Bennings Bridge in 1797." Whatever their cause may have been, 
 they increased from year to year by continuous depositions and soon 
 became notorious breeding grounds for mosquitoes and the chief 
 source for the propagation of malaria. The Potomac flats have been 
 reclaimed since 1882, adding about 621 acres to our parking system, 
 but the Anacostia River flats, which cover an area of over 1,000 acres, 
 the title to which is vested in the United States, still continue to be a 
 menace to the health of our inhabitants. The reclamation of the 
 Potomac flats has greatly reduced the prevalence of malaria, as shown 
 by the statistics of the health department, and it is reasonably and 
 scientifically correct to maintain that similar results would follow the 
 reclamation of the Anacostia flats. Take away the mosquito-breeding 
 places of every description and there will ne no extra corporal habitat 
 for the germs of malaria. It is a deplorable fact that, although this 
 measure has been urged by the Commissioners since 1894, no legis- 
 lative action has yet been taken. 
 
 o Of these seven cities Washington had the highest death rates from malarial 
 and diarrheal diseases, typhoid, and consumption (Philadelphia exceeding in 
 pneumonia ) . 
 
 * Considerably less than the general death rate in the registration area in the 
 United States, representing 10,000,000 inhabitants. For the census year 1900 
 this was 18.6 per 1,000. 
 
206 KEPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 RELATIONS OF WATER SUPPLY AND SEWERS TO HEALTH, 
 
 Prior to the introduction of Potomac water in 1859 the inhabitants 
 had to depend upon springs, pumps, wells, and cisterns subject to pol- 
 lution from sewage of cesspools, vaults, and box privies. It was 
 the old story of wells and privies being dangerous neighbors and 
 failure to recognize the necessity that a system of public sewerage 
 must go hand in hand with the public water supply, the neglect of 
 which compels recourse to various makeshifts, and must inevitably 
 lead to pollution of soil, water, and air. There can be no question 
 that these factors have played an important role in the causation and 
 spread of typhoid fever, dysentery, diarrhea, and other intestinal 
 infections, and have served to swell the general mortality rates. 
 Many of these conditions have been improved, a comprehensive sys- 
 tem of sewerage disposal has been adopted within the city limits, 
 and the number of public pumps has been reduced from 171 iii 1895 
 to 42 in 1908. The number of private wells, however, is a matter of 
 conjecture. 
 
 It may be urged that with the introduction of a purer water supply 
 in 1859, health conditions, especially as regards the so-called " water- 
 borne diseases," should have improved, but it is a long and tedious 
 matter to convince the average man that a clear, sparkling and very 
 palatable pump water in cities may be, and very frequently is, liable to 
 the grossest forms of pollution. He knows from observation that 
 hydrant water is at times absolutely j&lthy from suspended matter, 
 and that it reaches in summer a temperature which is far from palata- 
 ble. But he does not know that the well water in its passage may 
 have simply been deprived of the suspended matter, without losing 
 some of the most dangerous forms of disease germs. It involves, 
 therefore, many years of education to impress the public with the 
 dangers of pumps, and, by the time this was fairly well accomplished 
 (although many even now are still in doubt) the Potomac River, by 
 reason of an ever-increasing population in the towns, villages, and 
 settlements located along the banks and within its watershed, had be- 
 come itself a dangerous source of infection. 
 
 My suspicions that typhoid- fever germs might travel all the way 
 from Cumberland, a distance of 134 miles, and infect the consumers 
 of Potomac water in Washington, were confirmed as early as the 
 winter of 1889-90 by studying the effects of the typhoid-fever epi- 
 demic at Cumberland upon the prevalence of the disease in Washing- 
 ton. The records of the health office show that during this epidemic, 
 from December, 1889, to April, 1890, the deaths from typhoid fever 
 amounted to 74, as compared with 42 for the corresponding months 
 of the previous year. Indeed, we had almost double the number of 
 typhoid deaths during these months than for any correspond i no- 
 months either before or since this epidemic. Cumberland had about 
 45 deaths and 485 cases. Washington had 74 deaths and about 800 
 cases, and yet the starting point of all was the excreta of one patient 
 washed into a little run which empties into the Potomac River 300 
 feet above the pumping station of the water supply for Cumberland. 
 In the face of this fact and the almost constant presence of intesti- 
 nal bacteria in Potomac water, the writer had no hesitation in de- 
 claring that the excessive typhoid-fever rate of the National Capital 
 
BEPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 207 
 
 was largely due to contaminated Potomac water, and urged, with 
 other members of the profession, the speedy purification by means of 
 sand filtration, as well as the prevention of river pollution. 
 
 FILTRATION OF THE POTOMAC WATER. 
 
 In 1901 and subsequent thereto Congress appropriated sufficient 
 money for a complete system of slow or natural sand filters. This 
 filtration plant was completed under the supervision of United States 
 engineer officers, with Allen Hazen as consulting engineer, in the fall 
 of 1905. It covers 29 acres and is the largest in America, and in many 
 respects the most modern and scientific in the world. It handles 
 about 75,000,000 gallons a day and eliminates 98 to 99 per cent of all 
 the bacteria; and we have at least the comforting assurance that a 
 corresponding percentage of disease-producing germs will also be 
 removed. The effects of filtration upon the typhoid fever rates are 
 shown by the fact that the rate reached as high as 104 in 1890, and 
 was still 60.3 during the five-vear period 1896-1900, but has fallen in 
 1907 to 34.6 per 100,000. As^a result of the installation of filtration 
 plants elsewhere, not only a reduction of 81 per cent in the deaths 
 from typhoid fever has been noted, but also a marked reduction in 
 the general death rate. Computations by Hazen clearly indicate that 
 where one death from typhoid fever has been avoided by the use of a 
 better water, a certain number of deaths, probably two or three, from 
 other causes, have been avoided. 
 
 It is a difficult matter to explain how water is connected with the 
 deaths other than those from water-borne diseases, yet when we con- 
 sider that water enters into the composition of the body to the extent 
 of about 60 per cent, we are in a position to appreciate the sanitary 
 acumen of Aristotle when he wrote in his Politica : 
 
 The greatest influence upon health is exerted upon those things which we most 
 freely and frequently require for our existence, and this is especially true of 
 water and air. 
 
 INFLUENCE OF SEWERS UPON THE HEALTH OF THE COMMUNITY. 
 
 According to D. C. McComb, superintendent of sewers, " the first 
 action materially affecting the drainage of the city was the con- 
 struction of the Washington Canal, from the Potomac River at the 
 foot of Seventeenth street west to the Anacostia River at the foot of 
 Second street east. The sewers constructed by the city prior to 1871 
 emptied into the canal. * * * After the introduction of the 
 Potomac water supply in the year 1859 the demand for and the con- 
 struction of sewers increased, and it was not long before complaints 
 were made of the nuisance caused by the foul materials brought by 
 these sewers to the canal. * * * j^ ^j^^ ^^^ until the act of the 
 legislative assembly of August 21, 1871, that the discharge of solids 
 into sewers was permitted, although in point of fact water-closets 
 with direct sewer connections were in use for many years prior to the 
 passage of this act." 
 
 As a result of these conditions, the board of health, in 1871, found 
 not only over 30,000 privy boxes, " many in bad condition and over- 
 flowing," the contents of which were emptied, according to Doctor 
 
208 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Tindall, upon the commons of south Washington, within less than 1 
 mile from the best residence and business section of the city, but also 
 that the Washington Canal, which L'Enfant had hoped to preserve 
 as a natural waterway, had become, in the language of Professor 
 Henry, of the Smithsonian Institution, " an open cesspool, a fruitful 
 source of discomfort and disease, receiving the sewage direct in its 
 midst, and inconsistent with the intelligence of the age." This great 
 nuisance, passing within a few hundred yards of the White House, the 
 War, Navy, and State Departments, through the Agricultural, Smith- 
 sonian, and Botanical gardens, almost to the very gates of the Capitol, 
 was abated in 1871-1880, upon the demands of the board of health. 
 
 It is safe to say that the District prior to 1871 spent less than 
 $100,000 for sewers. We now have 103.2 miles of main sewers and 
 365.2 miles of pipe sewers, constructed at a total cost of $13,613,932.38. 
 Provisions have never been adequate, however, and the records of the 
 health department show that even now in about 4,100 houses sewer 
 connections can not be made because of the absence of branch sewers. 
 
 A summary of the evidence reveals the significant fact that the 
 cities, both at home and abroad, in which there has been the most 
 marked decrease in typhoid fever are those in which a pure water 
 supply has been substituted for a preexisting contaminated one, and 
 the effects are still more marked when combined with a good sewerage 
 system. 
 
 The history of every sewered town shows a lessening of the typhoid 
 death rate subsequent to the construction of the sewers, and that the 
 typhoid rate is always higher in sections supplied with makeshifts. 
 In 1895 the writer pointed out that typhoid prevailed in the city of 
 Washington in 1 of 81 houses with privies and in only 1 in 149 
 of those connected with sewers. The health officer of Nottingham, 
 England, has since then presented similar evidence. The only reason- 
 able explanation for this is that sewers carry away the filth that other- 
 wise would contaminate the soil and ground water, but even if there 
 were no wells these makeshifts are still a source of danger in so far as 
 they favor the transmission of the infection by means of flies, nor 
 can the possibility be ignored that the germs in leaky or overflowing 
 boxes may reach the upper layer of the soil and, with pulverized dust, 
 gain access to the system. 
 
 HAS HUMAN LIFE BEEN PROLONGED BY EFFORTS IN SANITATION? 
 
 Professor Finkelnburg, of Bonn, estimates that the average length 
 of human life in the sixteenth century was only between eighteen and 
 twenty years, and at the close of the eighteenth century it w^as a little 
 over thirty years, while to-day it is between thirty-eight and forty 
 years ; indeed, the span of life since 1880 has been lengthened about 
 six years. No two factors have contributed so much to the general 
 result as the improvement of the air we breathe and the water we 
 drink. Indeed, we have ample evidence that, with the introduction 
 of public water supplies and sewers, the general mortality in numer- 
 ous cities during the past fifty years has been reduced fully one-half, 
 the good effects being especially shown by a marked decrease in the 
 number of cases of typhoid fever, diarrheal diseases, and consump- 
 
KEPOBTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 209 
 
 tion. The vital statistics of Great Britain furnish the proof," and 
 our experience with American cities confirms this conclusion. 
 
 The death rate in London has been decreased from 40 per 1,000 in 
 1780 to 15.1 per 1,000 in 1905 ; in Berlin, from 32.9 in 1875 to 16.4 
 in 1904; in Munich, from 41.6 in 1871 to 18 in 1906; in Washington, 
 from 28.08 in 1875 to 19.25 in 1907 ; and in New York, from 38 per 
 1,000 in 1854 to 18.9 in 1906. The general mortality in the United 
 States has been reduced from 19.6 in 1890 to 16.2 per 1,000 in 1905, 
 which means a saving of over 290,000 lives in one year alone. 
 
 To demonstrate the beneficent effects of sanitary reforms, the fol- 
 lowing comparative illustration, which I gathered from one of the 
 public addresses of my deceased friend, Doctor Busey, and have 
 brought up to date, may be cited : 
 
 In 1872 the cities of Berlin and Wasliington were alike in primitive municipal 
 methods of sanitation. Without adequate distribution of the water supply, 
 the larger part of their population was dependent upon public and private 
 wells. Without systems of sewerage, both were alike supplied with makeshifts 
 for the disposal of human excreta and waste waters. The unpaved streets 
 were the common receptacle of garbage, ashes, and house sweepings, and along 
 the gutters the surface and house drainage were conducted to the neighboring 
 water courses. Since the city of Berlin began the system of sanitary improve- 
 ments, completed in 1890, at a cost of 59,000,000 marks for a pure and ample 
 water supply and 42,500,000 marks for construction of sewers, the typhoid 
 fever death rate has fallen from 143 in 1872 to 5 in 1896 per 100,000 of its 
 inhabitants, and the general death rate from 32.9 in 1875 per 1,000 to 16.4 per 
 1,000 in 1904; while our death rate from typhoid fever is still seven times 
 greater than that of Berlin, our general death rate has been reduced from 28.08 
 in 1875 to 19.25 in 1907 — results not so much due to climatic differences, but 
 largely due to the fact that the German capital enjoyed superior advantages in 
 sanitation and the housing problem, while we are still in the process of evolu- 
 tion, and are making slower progress on account of the mixed character of 
 our population. 
 
 The writer, however, is not a pessimist as regards the health of this 
 city, since a retrospect conclusively shows that the efforts of Senator 
 Gallinger and other Members of Congress, the Commissioners, and 
 the health department in the sanitation of the national capital have 
 been most fruitful and beneficent. 
 
 DECREASE IN DEATH RATES SINCE 1876. 
 
 When we recall the fact that in 1875 the death rate for the white 
 population was still 21.04 per 1,000, while in 1907 it was only 15.54, 
 
 oThe following table shows the death rate from certain diseases per 10,000 
 of population in English cities before and after the introduction of sanitary 
 works (see Cameron, "A Manual of Hygiene," 1874, p. 129) : 
 
 
 Before sanitary works. 
 
 After sanitary works. 
 
 City. 
 
 Typhoid 
 fever. 
 
 Diarrhea. 
 
 Consump- 
 tion. 
 
 Typhoid 
 fever. 
 
 Diarrhea. 
 
 Consump- 
 tion. 
 
 Bristol 
 
 10.0 
 14.7 
 17.5 
 14.2 
 19.0 
 12.5 
 13.3 
 
 10.5 
 16.0 
 17.2 
 11.0 
 5.7 
 11.2 
 4.0 
 9.5 
 10.0 
 
 31.0 
 43.3 
 34.7 
 51.5 
 40.0 
 26.6 
 25.5 
 26.5 
 
 6.5 
 7.7 
 10.5 
 8.5 
 9.0 
 4.0 
 5.7 
 9.0 
 5.5 
 
 9.1 
 
 19.3 
 4.5 
 9.0 
 8.0 
 5.7 
 8.3 
 7.0 
 7.0 
 
 25.5 
 29.3 
 28.6 
 35.3 
 32.3 
 26.5 
 31.3 
 21.2 
 
 Leicester 
 
 Cardiff 
 
 Macclesfield 
 
 Warwick 
 
 Stratford 
 
 Ashby 
 
 Dover 
 
 14.0 
 15.0 
 
 Croydon 
 
 
 
 
 S. Doc. 644, 60-2- 
 
 -15 
 
210 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 and that likewise a steady and most gratifying decrease from 42.86 
 to 28.21 per 1,000 of the colored population has taken place, we have 
 reason to look hopefully to the future. 
 
 In discussing the healthfulness of the national capital, it would 
 not be just to the fair name of our city did we fail to emphasize the 
 fact that the colored element is a potent factor in maintaining a high 
 general death rate. For example, the mortality rate during the 
 census year of 1900 in the larger cities of the registration area in 
 the United States, representing 10.000,000 of inhabitants, surrounded 
 by modern influences of civilization, was 18.6 per 1,000; our own 
 rate for the white population was 17.81, and for the colored 30.43, 
 making a general high average of 21.74. Our population is com- 
 posed of 231,417 whites and 95,018 colored, which means that Wash- 
 ington includes the largest colored population in the world. 
 
 CAUSES OF LARGE DEATH KATES AMONG THE COLORED RACE. 
 
 An analysis of the relative incidence of the most fatal diseases on 
 the white and colored race shows that the excessive mortality is 
 especially marked in pneumonia (ratio, 1 to 3.30), tuberculosis of the 
 lungs (1 to 3), abdominal tuberculosis (1 to 4.10), pulmonary hem- 
 orrhage (1 to 6.13), diarrhea and enteritis under 2 years of age 
 (1 to 2.96), and typhoid fever (1 to 1.79), and is higher in all other 
 diseases, even in malarial affections (1 to 4.32), from which they were 
 supposed to enjoy comparative immunity, the only exceptions'^ being 
 alcoholism, delirium tremens, and cirrhosis of the liver, in which the 
 ratio is less than among the whites. 
 
 It is not an easy matter to account for this excessive mortality. 
 In the first place, we can not say that transferring the African race 
 to a temperate climate has improved its physical condition. Negroes 
 in this and other temperate climates are extremely liable to tubercu- 
 losis and kindred affections. This must be attributed not onl}^ to 
 climatic conditions, but also to the radical changes of living, both as 
 regards habitation and food. The changes from the native shelter, 
 with its natural ventilation, to the schoolroom and house, the abrupt 
 change from native and simple food to the more refined flours and 
 sugars, doubtless produce in the negro, as in the Indian, a vulner- 
 ability of the respiratory and gastric tract to the invasion of the 
 tubercle bacillus and lessens his general power of resistance. All of 
 the bad effects are accentuated when one race mingles with another, 
 and, as a result, a tendency to degeneration manifests itself. Racial 
 degeneracy has been defined as nonresistance to the influences inim- 
 ical to the existence of the race. The individual, therefore, who can 
 not resist the disease-producing causes which are about him, whether 
 they be germs, climate, or whatever their nature, is physically degen- 
 erate. We see this especially manifested in the half-breed Indian and 
 in the mulatto, neither of whom is scarcely ever as robust as either of 
 the races from whence he came. The transplantation of the negro 
 from his native soil, both in Africa and in the South, to less favorable 
 environments as regards food and housing conditions, was not con- 
 ducive to his physical welfare. The housin^: of the colored popula- 
 tion has always been a disgrace to the national capital, and even 
 now our alley houses and slums constitute the main shelter for nearly 
 20,000 of this class of population. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 211 
 
 The rapid influx of a negro population during the civil war, esti- 
 mated to have been between 30,000 and 40,000, imperatively demanded 
 immediate accommodation. In consequence of this necessity hovels of 
 every description arose, much of the material having been obtained 
 from the abandoned army camps and hospitals. 
 In the report of the board of health for 1877, page 46, we read: 
 No meaner cabins for temporary or permanent shelter can be found than 
 some our wretched poor are born and exist and die in here at the capital 
 of the United States. And, strange as it may seem, none so mean that they 
 have not an owner mean enough to charge rent for them. Down in the alleys 
 below grade, with combination roof of tar, felt, shingles, rags, tin, gravel, 
 boards, and holes, floors damp and broken, walls begrimed by suKjke and age. 
 so domiciled are families with all the dignity of tenants having rent to pay. 
 
 This description, given thirty-one years ago, fits many of the habi- 
 tations in this city to-day, and the influence of such homes upon death 
 rates is shown by the fact that in 1906 the death rate among alley 
 residents was 26.96 as compared with 18.75 among the residents of 
 streets. 
 
 It is known that 90.54 per cent of our alley population are colored. 
 It is not surprising, therefore, that during the past twelve years they 
 have contributed 5,268 out of the 9,534 deaths from consumption. 
 
 Infantile diarrhea, for reasons given,** is also more prevalent in in- 
 sanitary dwellings. 
 
 Here, again, the colored population, obliged as they are to find 
 shelter in houses unfit for human habitation, contributed in the last 
 six years 1,202 out of the 2,003 deaths from diarrhea and enteritis 
 under 2 years of age. The mortality of children under 1 year of age 
 is 115.5 per 1,000 among the white, and 334.86 among the colored. 
 The white infantile death rate of 115.5 per 1,000 is lower than that 
 of any of the 106 American cities, and also lower than that of 42 
 German cities tabulated by Professor Harrington, while the rate for 
 colored infants is appalling. 
 
 It is likewise a noteworthy fact that, out of the 1,672 deaths from 
 typhoid fever during the last ten years, 698 were colored and 974 
 white. The rate per 100,000 of population was 47.4 for the whites and 
 76.4 for the colored. Both rates are excessive, to be sure, but the 
 factor of environment and other predisposing causes is plainly re- 
 vealed by the undue fatality in the colored population. 
 
 Sufficient reference has been made to the influence of insanitary 
 homes, but the mortality rate is especial^ excessive when combined 
 with overcrowding. Hand in hand, and not infrequently as a result 
 of such conditions, we also observe a greater amount of abject want, 
 of filth, of crime, licentiousness, and other excesses which predispose 
 to disease and even affect the imborn offspring. 
 
 I am not disposed to attribute all this and the general excessive 
 mortality rate in the colored race to racial degeneracy, because many 
 of the factors are sociological and to be found among the poor and 
 ignorant everywhere. The colored element in Washington represents 
 to a large extent those engaged in laborious work, probably the most 
 exposed to hardships and inclement weather. Some allowance must 
 be made for this in computation of the comparative death rates. The 
 broad fact remains, however, that the average mortality rate in the 
 seven cities which I selected, on account of similarity of climate, is 
 
 « Kober's Industrial Hygiene, p. 105. 
 
212 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 18.01 in the white population and 27.12 for the colored element, and 
 we may conclude that, while uplifting influences and higher standards 
 of living are necessary among the least resourceful classes, regardless 
 of race, they are especially imperative for the Afro- American. That 
 his physical welfare responds promptly to improved environment is 
 strikingly illustrated by a decrease in his general death rate from 
 42.86 in 1875 to 28.21 per 1,000- in 1907, and in the rate from con- 
 sumption from 6.9 in 1878 to 4.5 in 1907. 
 
 REGENERATION OF HOUSING CX)NDITI0NS. 
 
 The regeneration of the housing conditions and removal of slums 
 does not concern a few well-meaning citizens alone, for the germs of 
 typhoid fever may be carried by flies from a patient inhabiting one 
 of the alley houses, often situated in the interior of a fine residence 
 block, and contaminate the food and drink of neighboring homes. 
 The contagion of diphtheria, scarlet fever, and tuberculosis may be 
 spread by servants from these plague spots to the very best families. 
 
 The question involves both money and education; those who can 
 not invest in sanitary homes can at least contribute their mite to the 
 employment of trained agents engaged in the prevention of sickness 
 and distress, or render, what is far better, some personal service in 
 this uplifting work. Who can deny the influence of a friendly visitor 
 in teaching his fellow -man the value of a clean home, proper food and 
 cooking, and sober habits in the preservation of health and morals ? 
 
 It is a lamentable fact that only about 1,500 of our residents are 
 engaged in charitable and uplifting influences. The same men and 
 women who subscribe to the Associated Charities, social settlements, 
 playgrounds, summer outings, prevention of tuberculosis, day nur- 
 series, visiting nurses to the poor, and other philanthropic agencies, 
 have so far furnished the means for the erection of 240 buildings, 
 which provide clean, healthful homes for 480 families. The wealthy 
 men are not adequately represented, nor are the rank and file of 
 our citizens. 
 
 THE PRESENT SITUATION. 
 
 It is not difficult to conceive that health officials appointed for a 
 brief period and clothed with limited authority are decidedly handi- 
 caj)ped in the conduct of their office, and as a result two such officers 
 were found wanting in the control of the sanitary affairs of this city. 
 
 In 1895 our present health officer came into onice, and it is due to 
 his intelligent aj^preciation of the needs of the city that a number of 
 sanitary laws and regulations have been framed and enacted. In 
 fact, his efforts for the control of scarlet fever and diphtheria and 
 for a more rigid system of food inspection, with special reference to 
 the milk supply, with corresponding reduction in death rates, will 
 stand out preeminently in the sanitary history of the city. 
 
 If it is deemed desirable that such important duties and repson- 
 sibilities should devolve upon one man, he should be sustained by the 
 strong arm of the law. This, however, in the very nature of our 
 government, can not be, and the result is that the health office is not 
 m a position to render the most efficient service. A health officer or 
 board should be invested with full power from Congress to declare 
 what shall be deemed nuisances injurious to health and to provide 
 for the removal thereof, to make and enforce health ordinances, etc., 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 213 
 
 subject to the approval of the District Commissioners, and the ap- 
 pointments should be made, as in the case of the assessor or chief of 
 police, during good behavior. 
 
 A health officer with an advisory board of health, with the super- 
 vising general of the Public Health Service as a member ex officio, 
 would offer many advantages. The personal element would be en- 
 tirely eliminated in the exercise of discretionary power and the health 
 officer relieved from grave responsibilities in passing upon important 
 problems and in the settlement of vexatious questions relating to the 
 employment and discharge of subordinates and in the rigid enforce- 
 ment of existing laws and ordinances. 
 
 Moreover, municipal hygiene is a progressive science, and the Com- 
 missioners and congressional committees would be relieved from the 
 consideration of details in the formulation of sanitary legislation if 
 these were acted upon by a board of experts. We do need more 
 deliberative bodies, like the board of education and the Board of 
 Charities, competent and willing to give to the commissioners and 
 the public the benefits of expert knowledge without regard to com- 
 pensation. 
 
 CONGRESS AND THE HEALTH OF THE DISTRICT. 
 
 The advocates of sanitary reforms and the improvement of housing 
 conditions gratefully acknowledge the important services rendered 
 by Senator Gallinger and other distinguished members of both 
 Houses in the cause of sanitation of the national capital. Much has 
 been accomplished, but more remains to be done before we can hope 
 to place the healthfulness of this city on a par with some of the 
 European capitals. 
 
 Congress, in the administration of the affairs of the District, has a 
 sacred duty to perform. The General Government owns more than 
 one-half of the property in the city, contributes more than one-fourth 
 of the population in the way of officials and employees, not to men- 
 tion the immense number of American citizens who annually visit 
 the seat of government. In addition. Congress has permitted, during 
 and after the war, 40,000 negro refugees to find shelter as best they 
 could in our midst. For all this the United States simply pays one- 
 half the taxes, no more ; and no infrequently has paid less. 
 
 As sanitarians, we contend that in building a city, the capital of 
 a gigantic nation, the first care should be the protection of the health 
 of its people. Its beautifying is essential, but of secondary im- 
 portance. Economy, however laudable its general purpose, should 
 never be exercised at the expense of public health. 
 
 Chapter VII. 
 
 SEXUAL AND MORAL PROPHYLAXIS. 
 
 In this connection it may not be out of place to refer to diseases 
 arising from impure sexual intercourse, whether it be a simple ex- 
 coriation, which has been inoculated with some one of the septic 
 germs, or whether it be an inflammation of the urethra produced by 
 a specific discharge, or whether it be one of the forms of syphilis 
 as now recognized. 
 
 The absence of reliable statistics in venereal diseases is very much 
 to be deplored, for if we wish to approach the subject intelligently 
 
214 
 
 REPOKTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 we should know something more definite as to their prevalence in 
 civil life. 
 
 An appropriate idea may be gotten by a study of army statistics. 
 Doctor Munson (in his Military Hygiene, p. 823) gives the latent / 
 admission rate per 1,000 strength, as follows: 
 
 Germany 27. 9 
 
 Russia 36. 
 
 Japan 36.0 
 
 France 40. 9 
 
 Holland 4S. 1 
 
 Austria-Hungary. 61. 
 
 United States 73.7 
 
 Great Britain: 
 
 Home statistics 173.8 
 
 Indian statistics ^___ 522. 3 
 
 Annual admission rate per 1,000 strength for the three years, 1890->1S92 
 
 (Munson), 
 
 Primaryand 
 secondary 
 syphilis. 
 
 All other 
 venereal 
 
 Germany 
 
 France 
 
 Russia 
 
 Italy 
 
 United States 
 
 Dutch troops (home statistics 
 
 East Indies 
 
 British troops: 
 
 Home statistics 
 
 Indian statistics 
 
 5.50 
 9.00 
 13.10 
 13.90 
 
 16.83 
 14. 80 
 47.00 
 
 101.70 
 175. 40 
 
 21.50 
 34,90 
 29.90 
 57.40 
 57.96 
 55.00 
 408.60 
 
 101.90 
 262. 60 
 
 It is a lamentable fact that the very countries in which the senti- 
 ment, both in and out of the profession, is strongly against recogniz- 
 ing the evil, furnish the highest army rates, while in countries where 
 some special regulations are in force preventing the spread of 
 venereal diseases, such as weekly inspections of the men and periodi- 
 cal examination of the women engaged in prostitution, with compul- 
 sory isolation if such are found diseased, the army rates are lowest. 
 
 The comparative amount of army and civil venereal diseases is 
 not known, because we have no statistics of the amount in civil life. 
 
 According to Fournier one-seventh of the population of Paris is 
 syphilitic, and the mortality of infants born of syphilitic parents in 
 many hospitals of that city reaches 84 to 86 per cent. 
 
 According to Doctor Weiss, there are 150,000 syphilitics in Berlin, 
 or 12 per cent of the inhabitants. 
 
 In 1901 a committee of seven, under the auspices of the Medical 
 Society of the County of New York, made an investigation into the 
 prevalence of venereal diseases, and from the information received 
 from private physicians, reports of the hospitals and dispensaries 
 concluded that there were not less than 243,000 cases of venereal dis- 
 eases treated in one year in that city. During the same year there 
 were only 41,585 other cases of infectious of communicable diseases 
 reported to the health department, viz, measles, 12,570; diphtheria, 
 11,001; tuberculosis, 8,877; scarlet fever, 7,787; chicken pox, 99. In 
 other words, the morbidity from venereal diseases was nearly six 
 times greater than that from all the above-named infectious diseases 
 combined. 
 
 Parkes of England says : 
 
 It Is a question whether a large number of the young men of the upper and 
 middle classes do not suffer in youth from some form of venereal disease. In 
 the lower classes it is perhaps equally common. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 215 
 
 Neisser, of Germany, holds that gonorrhea is, with the exception 
 of perhaps measles, the most widespread of all diseases. Other Ger- 
 man authorities have computed that fully three-quarters of the adult 
 male population, and one-sixth or more of the adult females have 
 contracted gonorrhea, and that 15 per cent of the population is 
 syphilitic. 
 
 Dr. Prince A. Morrow, based upon a large personal experience and 
 the results of the New York and Baltimore investigations by com- 
 mittees on sanitary and moral prophylaxis, says : 
 
 Assuming from experience and tlie statistics collected in New York and in 
 Baltimore that our population is more virtuous than that of Europe, it must 
 be a conservative estimate that in this country the morbidity from gonorrhea 
 would represent 60 per cent of the adult male population, and that of syphilis 
 from 10 to 15 per cent, which would mean that between 3,000,000 to 4,000,000 cases 
 are annually treated in this country. According to Morrow, 20 per cent of 
 the cases occur before the twenty-first year, 60 per cent before the twenty-sixth 
 year, and 10 per cent of the men who marry infect their wives. The report of 
 the New York committee "would indicate that nearly 30 per cent of all vene- 
 real infections occurring in women in private practice in that city are commu- 
 nicated by their husbands ; " and from his personal observation at the New 
 York Hospital, extending over a period of several years, he concludes that 
 " fully 70 per cent of all women who come therein for treatment were respect- 
 able married women who had been infected by their husbands." 
 
 VICE DISEASES IN THE DISTRICT OF COLUINIBIA. 
 
 Dr. Henry C. Macatee, of the President's Homes Commission, has 
 made a special study of the prevalence of so-called " vice diseases " in 
 the District of Columbia. The results have been tabulated and will 
 be found in Table B. The period covers nine years, except in the case 
 of Providence Hospital, Columbia Hospital, and the Children's Hos- 
 pital, for which institutions the data cover only two years. From 
 this table it appears that out of a total of 274,611 patients treated 
 38,183 cases were vice diseases, viz, 9,869 syphilitic affections, 3,643 
 cases of chancroids, and 14,435 cases of gonorrheal affections. In 
 addition to the 27,947 cases of sexual diseases there Avere treated 9,510 
 patients for alcoholism, 409 for delirium tremens, 256 for the opium 
 habit, and 61 for the cocaine habit; an average of 4,243 cases per 
 annum of vke diseases, or nearly one-seventh of all the cases treated 
 in the city hospitals. As a matter of fact, 23.6 per cent of all the 
 cases treated in the Washington Asylum Hospital and 31.6 per cent 
 of those treated in the workhouse were vice diseases. The majority 
 of the patients treated in the hospitals belonged to the dependent 
 classes. We have no statistics as to the prevalence of vice diseases 
 among the middle and upper classes. 
 
216 
 
 EEPORTS OF THE PRESIDENT S HOMES COMMISSION". 
 
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220 REPOKTS OF THE PEESIDENt's HOMES COMMISSION. 
 
 SYPHILIS. 
 
 This disease first attracted attention in Europe in the latter decade 
 of the fifteenth century. During the siege of Naples by the French 
 troops under the command of Charles VIII in 1495, a disease char- 
 acterized by ulcers on the genitals, general eruptions of the skin, 
 violent pains in the head and limbs broke out among the French sol- 
 diers and the civil population, and after the return of the French 
 soldiers the disease appears to have spread rapidly throughout France 
 and Europe. Quite early in the history it was recognized that the 
 disease was principally contracted during sexual intercourse and 
 hence was named lues venerea, while the populace commonly spoke of 
 it as the Frenchman's disease. The real nature of syphilis remained a 
 mystery until two years ago, when an organism was isolated called the 
 " spirocheta pallida," which is believed to be the causative factor. 
 This micro-organism evidently clings to the secretions of syphilitic 
 ulcers, to the tissues of diseased organs, and possibly also invades the 
 blood and the mammary glands after it has ceased to be a purely local 
 affection. The virus may be conveyed m an extragenital way by 
 kisses, use of infected pipes, cigars, and cigarettes ; by glass blowers 
 and the mouthpieces of wind instruments; by dental and surgical 
 instruments; by the act of suckling, from infants to nurse and con- 
 versely; in tattooing, and during digital examination by physicians, 
 in case of abraded surfaces, hangnails, etc. There is every reason for 
 assuming that the virus may be transmitted to the offspring, either 
 through the sperma or the blood of a syphilitic mother. 
 
 Syphilis is indeed a disease of the blood and affects every tissue of 
 the body. Apart from the long duration of the disease, and the 
 pecuniary losses involved by care and treatment and arrest of the 
 earning capacity, its effect upon longevity and procreation are most 
 destructive. 
 
 Syphilis is responsible for 42 per cent of abortions and miscar- 
 riages, from 60 to 86 per cent of the offsprings of syphilitics die before 
 or shortly after birth, and those who survive are subjects of degen- 
 erative and organic defects, transmitted to future generations. Four- 
 nier's personal statistics show that 90 women infected by their hus- 
 bands became pregnant in the first year of married life ; 50 of these 
 aborted, 40 carried the offspring to full term, but of these only 2 sur- 
 vived. He also gives statistics, based upon authentic sources, where 
 syphilis has practically extinguished the posterity of certain families. 
 One table gives out of 216 births 183 deaths; another out of 157 
 births 157 deaths, or a mortality of 100 per cent. 
 
 The disease swells the number of inmates of almshouses, asylunis 
 for the insane, and homes for incurables, wrecks the health and happi- 
 ness of many families, and leads to premature decay. Morrow states 
 that " every case of hemiplegia occurring in a man less than 40 
 years of age, not addicted to alcohol or affected with lesions of the 
 circulatory system, is eight — or, more correctly, nine — times out of 
 ten of syphilitic origin. 
 
 " The proportion of ocular paralysis resulting from syphilis is about 
 75 per cent on the average. * * * In statistics embracing 743 
 cases of cerebral syphilis^ 354 of which were followed up to a known 
 termination, 77 were cured, 68 died, while the remaining 209 sur- 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 221 
 
 vived, but with various infirmities of a grave character and in every 
 case irremediable." 
 
 According to the statistics of Erb, Althaus, Fournier, and others, 
 from 80 to 90 per cent of the cases of locomotor ataxia are of syphi- 
 litic origin. In 3,429 cases of tertiary syphilis Fournier found dis- 
 eases of the nervous system in 1,085 instances, cerebral syphilis in 
 461, spinal affections in 40, general paralysis in 32 cases. 
 
 GONORRHEA. 
 
 This disease, so often regarded as a trivial affection by frivolous 
 young men, is also specific in character, caused by a micro-organism 
 discovered by Neisser in 1879. The organism clings to the discharges 
 in acute and chronic cases and may persist long after the disease is 
 apparently arrested. While at first a purely local affection, it may 
 produce destructive inflammation, resulting in stricture of the 
 urethra; it may also extend to the testicle, prostate gland, bladder, 
 and kidneys, and ultimately affect the heart, joints, and other vital 
 organs. Indeed, the disease is believed to be responsible for more 
 misery, ill health, and race suicide than any other sociological factor. 
 
 The average duration of acute cases is from four to six weeks, but 
 there are a large number of chronic cases requiring at least six 
 months' careful treatment, and, according to the investigations of a 
 committee of the American Medical Association, 3 per cent of the 
 cases are practically incurable. One of the most baneful effects is 
 the latency of the disease and the great danger of communicating the 
 virus to wives by husbands who considered themselves as having 
 been cured before marriage. It is certainly startling to be told by 
 competent specialists that fully 80 per cent of all the operations for 
 inflammatory diseases peculiar to women, practically all the pus 
 tubes, 75 per cent of the suppurative inflammations of the pelvic 
 organs, 70 per cent of all the work done by specialists for diseases 
 peculiar to women are of gonorrheal origin. It is equally appalling 
 to realize that the same germs are the cause of blenorrhea neonatu- 
 rum, a purulent affection of the eyes of new-born children, which 
 contributes a contingent to our asylums for the blind of from 10 to 
 20 per cent — from 40 to 60 per cent before the Crede method of pre- 
 vention was instituted. Dr. Swan M. Burnett, professor of oph- 
 thalmology, Georgetown University, expressed the conviction that 
 at least 15,000 of the 50,000 blind persons in the United States 
 lost their sight from this cause, involving a financial loss to the com- 
 monwealth of seven and one-half millions annually. 
 
 The destructive effects of gonorrhea on the procreative functions 
 have been very properly emphasized in connection with the "race- 
 suicide problem." Neisser maintains that gonorrhea is even a more 
 potent factor than syphilis in sterility, and that more than 45 per 
 cent of all involuntary childless marriages are due to this cause. 
 
 The remedial measures which have been proposed for the pre- 
 vention of these diseases and which affect not only the offender, but 
 the wives, the offspring and not infrequently also perfectly innocent 
 persons are numerous enough, but not so easy of application. Since 
 the chief source of infection is prostitution, the sanitarian suggests 
 that a person afflicted with a venereal disease is quite as much a 
 
222 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 menace to public health as would be a case of smallpox or any other 
 communicable disease and points with emphasis to what has been 
 accomplished in Europe in the way of official control of prostitution, 
 as a lesser evil, by registration of brothels and their inmates, periodi- 
 cal inspections, and the detection and cure of diseased men and 
 women. He will tell us, and the statistics will support him, that 
 the prevalence of venereal diseases is least where sanitary measures 
 are most vigorously enforced. 
 
 The medical profession is by no means agreed as to the propriety 
 of this method, mainly because such a system seems too much like a 
 recognition of the inevitableness of the social evil and practically an 
 official sanction of it. Others, moreover, with good reason assert 
 that licensing and sanitary inspection t^nd to produce clandestine 
 prostitution, which has heretofore furnished the largest number of 
 syphilitic cases. On the whole, we may conclude that health officers 
 in this country are not prepared to advocate the European plan of 
 inspection and license. 
 
 CRUSADE AGAINST THE SOCIAL EVIL.<» 
 
 The subject of prostitution has always been considered of great 
 sociological and economic importance by persons who have witnessed 
 the sad effects among the inmates of hospitals, prisons, almshouses, 
 asylums for the blind, etc. It is gratifying to note that in 1858, just 
 fifty years ago, a most intelligent and painstaking study was made 
 by Dr. Wm. W. Sanger, resident physician of Blackwells Island, 
 under the auspices of the governors of the almshouse of the city and 
 county of New York. A few passages from the introduction are re- 
 produced, for they are as applicable now as when first indited by his 
 graceful pen : 
 
 Hitherto reticence has been the policy. This position has been held too long, 
 for it is false in principle and injurious in tendency. The day has arrived 
 when the shroud must be removed, when the public safety imperiously demands 
 an investigation into the matter; when those who regard it as a small wrong 
 may have their attention directed to its real proportions. * * * ^ small 
 matter it decidedly is not. * * * Nor is it unmanageable except when con- 
 cealed. Stripped of the veil of secrecy which has enveloped it, there appears 
 vice arising from an inextinguishable natural impulse on the part of one sex, 
 fostered by confiding weakness in the other ; from social disabilities on one side 
 and social oppression on the other ; from the wiles of the deceiver working upon 
 unsuspecting credulity, and, finally, from the stern necessity to live. 
 
 The book covers 676 pages, and is the first effort on the Western 
 Continent in sexual and moral prophylaxis, but unfortunately has so 
 far been fruitless on account of the general apathy on the part of the 
 general public. 
 
 Some of the facts brought out in the detailed investigation of 2,000 
 prostitutes in New York City are of sufficient interest to be adduced. 
 Of the entire number 750 were between 15 and 20 years, 1,154 be- 
 tween 21 and 39, and 96 over 40 years of age; 1,238 were foreign 
 born and 762 natives of the United States. Of the latter the majority 
 hailed from New York, New Jersey. Connecticut, Massachusetts, 
 Maine, New Hampshire, and Vermont. Doctor Sanger is inclined 
 
 o I am indebted to my friend Dr. Edward L. Morgan for a number of valuable 
 references to the literature of the subject. 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 223 
 
 to attribute this to the employment of a much larger proportion of 
 females in manufacturing and sedentary occupations, and says : 
 
 A young woman of ardent temperament can not but feel the hardship of 
 this position in life ; * * * thus, when already predisposed in favor of any 
 change, she falls into the hands of the tempter a pliant victim. * * * Be- 
 yond the hardships attendant on her daily labor the associations which are 
 formed in factories or workshops, where both sexes are employed, very fre- 
 quently result disastrously for the female. * * * 
 
 In speaking of the foreign class the author says : 
 
 Many of the females become mothers almost as soon as they land on these 
 shores; in fact, the probability of such an event sometimes hastens their de- 
 parture. They exist here in the most squalid misery in some tenement house 
 or hovel. Their children receive none of the advantages of education, for as 
 soon as they can beg they are compelled to aid in the struggle for bread and the 
 most frequent result is that the boys are arrested for some petty theft and the 
 girls become prostitutes, thus contributing to meet the demand caused by the 
 classes already mentioned. 
 
 In this connection attention is called to Judge De Lacy's letter, 
 page 380. 
 
 Of the 2,000 persons investigated 490 were married, 71 of whom 
 still lived with their husbands; 103 left their husbands on account 
 of ill usage, 60 were deserted by their husbands, 43 were deserted 
 by husbands to live with other women ; others left their homes on ac- 
 count of nonsupport, drunkenness, infidelity, and in 75 no specific 
 cause was assigned. There were also 294 widows in the general list. 
 The author believes the principal conclusion to be drawn from the 
 table which he presents " is that the majority of this class (widows) 
 are driven to a course of vice from the destitution ensuing on 
 her husband's death. It has been shown that a large number of 
 them are very young and it can be scarcely necessary to repeat that 
 any young woman in a state of poverty will be surrounded with temp- 
 tations she can with difficulty resist. Much as this state of society 
 may be deplored, its existence can not be denied." 
 
 The section dealing with the hidden springs of the evil is of ex- 
 treme interest. The causes assigned by the women themselves are 
 as follows : 
 
 Inclination, 513; destitution, 525; seduced and abandoned, 258; 
 drink and a desire to drink, 181 ; ill treatment of parents, relations, 
 or husbands, 164; as an easy life, 124; bad company, 84; persuaded 
 by prostitutes, 71 ; too idle to work, 29 ; violated, 27 ; seduced on board 
 of emigrant ships or in emigrant boarding houses, 24. 
 
 Doctor Sanger, in discussing the subject of inclination, adduces 
 considerable evidence to show " that if a positive inclination to vice 
 was the proximate cause of the fall, it was but the result of other 
 and controlling influenced." Most pathetic instances of how destitu- 
 tion, seduction, and other predisposing causes led to the degradation 
 will be found on pages 489-522. 
 
 Of the 2,000 cases examined witli reference to previous occupation, 
 933 belonged to the servant class, 499 lived with parents or friends, 
 285 were dressmakers, tailoresses, and seamstresses, and the remain- 
 der were engaged in miscellaneous occupations; 534 claim to have 
 earned only $1 per week; 336, $2 a week; 230, $3; 127, $4; 68, $5; 27, 
 $6; 8, $7; 5, $8; two had earned over $20 a week, and in 663 the 
 question of earnings was not ascertained. 
 
224 REPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 The investigation revealed the fact that 947 of the 2,000 women 
 became mothers. Of these, 357 single women had 490 children, 357 
 married women had 791 children, and 233 widows had 636 children. 
 Of the 1,917 children born, 1,185 had died before the inquiry, and 
 732 were alive. The ratio of mortality was as follows ; 
 
 Children of — Per cent. 
 
 Single women • 73 
 
 Married women 58 
 
 Widows 59 
 
 An average of 62 per cent, or more than six deaths for every 10 
 children born. On page 487 of the book it is shown that 821 of the 
 2,000 investigated had contracted specific diseases incident to prosti- 
 tution, viz: Gonorrhea in 250 instances, gonorrhea and syphilis in 
 36, and syphilis in 535 cases. The difficulty of securing such informa- 
 tion is very great and the probability is that the real number far 
 exceeds this average, but the confessed facts are quite sufficient to 
 estimate the amount of public mischief resulting daily from a mass of 
 prostitutes. 
 
 The appendix to the edition of Doctor Sanger's book, published in 
 1906, states that Doctor Sanger in 1858 placed the number of public 
 prostitutes in New York at 6,000, or one in every 117 inhabitants, 
 while a conservative estimate would now place their number at 30,000, 
 or one in about 55 of the resident population. 
 
 In 1902 the committee of fifteen, composed of prominent citizens, 
 presented a report on the social evil with special reference to condi- 
 tions existing in the city of New York, but found it impossible to 
 approximate the number of prostitutes or houses of prostitution; 
 evidence was secured, however, of over 300 separate disorderly apart- 
 ments in tenement houses. In many of these tenement houses as 
 many as 50 children resided. An acquaintance by the children with 
 adult vices was inevitable. Almost any child on the East Side in 
 New York will tell you what a " nafke bias " is. * * * The 
 statistics of venereal diseases among children and the many revolt- 
 ing stories from the red-light district tell how completely they learned 
 the lessons taught them. 
 
 Mr. George Kibbe Turner, in a recent magazine article, presents a 
 study of the great immoralities in the city of Chicago, and estimates 
 " the gross revenues from prostitution in Chicago in 1906 at 
 $20,000,000, and probably more. There are at least 10,000 profes- 
 sional prostitutes. Annual average receipts of $2,000 each are 
 brought in by these women. They do not themselves, however, have 
 the benefit of this revenue. Much of it is never received by them. 
 They are, in fact, exploited by large business interests. There are 
 four large interests which are concerned in the exploitation of pros- 
 titution. The first of these is the criminal hotels, the second is the 
 houses of ill-fame; the third, the cheap dance halls and saloons, and 
 the fourth, the men — largely Russian Jews — Avho deal in women for 
 the trade." * * * Major Sylvester, the chief of police of Wash- 
 ington, estimates that there are about 400 prostitutes m this city, con- 
 fined almost wholly to a certain district, and that special pains have 
 been taken by the police to prevent minors from frequenting these 
 places. 
 
 A recent investigation by the Department of Commerce and Labor 
 shows that there are 62 houses of prostitution, with 365 white inmates, 
 
EEPOETS OP THE PEESIDENT's HOMES COMMISSION. 225 
 
 of whom 68 were of foreign birth, and 16 houses with 105 colored 
 females, all natives of this country. It is gratifjdng to know, from 
 an official source, that the number of prostitutes in Washington is 
 placed at 470. 
 
 In the crusade against the social evil every effort heretofore made, 
 spasmodically to be sure, has been to apprehend the female offender, 
 and all such attempts have simply resulted in secret prostitution, 
 which is far more dangerous in its social and sanitary aspects. Indeed 
 every attempt to make laws upon the subject which apply to women 
 and not to men is most unjust and establishes a different standard 
 of morality for the two sexes. 
 
 As expressed by Morrow, "the prostitute is but the purveyor of 
 the infection. She simply returns to her male partner, the pros- 
 tituant, as he is termed, the infection she has received from another 
 prostituant. In the ultimate analysis it will be found * * * that 
 the most essential cause, the causa causans, of prostitution is mascu- 
 line unchastity — the polygamous proclivities and practice of the male, 
 which lead him to seek the gratification of his sexual instinct 
 wherever and whenever he can find a receptive partner. * * * 
 The woman owes her fall to the aggressive solicitations or seductions 
 of the man. She may even be a quasi willing victim, but she yields 
 rather from sentimental feeling than from sexual inclination. 
 * * * Women are the most pitiless and unrelenting in the ostra- 
 cism of those of their sex who have crossed the Rubicon of virtue. 
 The virtuous matron who would shield her daughter from all contact 
 with a fallen sister as contaminating, with most indulgent charity 
 smiles upon the very man who may have been the author of her ruin ; 
 she may, indeed, receive him as a suitor for her daughter if he is 
 otherwise eligible. * * * As a result of this double standard of 
 morality, society practically separates its women into two classes — 
 from the one it demands chastity ; the other is set apart for the grat- 
 ification of the sexual caprices of its men. It thus proclaims the 
 doctrine, immoral as it is unhygienic, that debauchery is a necessity 
 for its men." 
 
 EDUCATIONAL METHODS. 
 
 On the whole, the present writer believes the remedy lies in public 
 education. The great majority of the people have no knowledge of 
 the subject, simply because of the erroneous assumption that it is 
 not one which lends itself to general discussion. 
 
 It is indeed gratifying that such a respectable magazine as the 
 Ladies Home Journal has given attention to topics of this character 
 and insisted for several years upon a greater parental frankness with 
 children about their physical selves. In the editor's personal page, 
 in the issue of September, 1908, we find the following courageous 
 statement : 
 
 Because of tlie secrecy with which the whole question is enshrouded it Is 
 practically impossible to obtain absolute figures. But so far as the highest 
 authorities have been able, through the most careful inquiries, to secure ac- 
 curate figures, it is a conservative statement to make that at least 60 out of 
 every 100 young men are to-day " sowing their wild oats." Of these 60 young 
 men a startling number are either already making or will make a tragedy of 
 marriage. They produce either childless homes, dead-born or blind babies; 
 children with lifelong diseases with them, or they will send thousands of 
 
 S. Doc. 644, 60-2 16 
 
226 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 women to the operating table. ♦ * * This frightful condition has been 
 brought about largely by two contributing factors: (1) The parental policy of 
 mock modesty and silence with their sons and daughters about their physical 
 selves, and (2) the condoning in men what is condemned in women. Fathers 
 and mothers, and in consequence girls, have condoned in a young man this 
 sowing of his " wild oats," because it was considered a physical necessity ; 
 that it " would do him good ;" that it " would make a man of him ;" that " it 
 would show him the world" — all arguments absolutely baseless. The reme- 
 dies proposed are along the principles already indicated, viz, knowledge of 
 the subject, and that " we fathers of daughters must rid ourselves of the 
 notion that has worked such diabolical havoc of a double moral standard. 
 There can be but one standard — that of moral equality. Instead of being so 
 painfully anxious about the " financial prospects " of a young man, * * * 
 it is time that we put health first and money second. * * * Let a father 
 ask the young man, as the leading question, whether he is physically clean ; 
 insist that he shall go to his family physician, and if he gives him a clean bill 
 of health, then his financial prospects can be gone into. But his physical self 
 first. That much every father would do in the case of a horse or a dog that 
 he bought with a view to mating. Yet he does less for his daughter, his own 
 flesh and blood. Once let young men realize that such a question would be 
 asked them by the father of the young women whom they would marry; that 
 a physical standard would be demanded, and that knowledge would be more 
 effective for morality among young men than all the preaching and moraliz- 
 ing and exhortations of the past thousand years. Thus, and thus only, can 
 we save our daughters and their unborn children. But in no other way. 
 
 It should be stated in justice to my friend and teacher that the late 
 Dr. J. Harry Thompson, then in charge of the Columbia Hospital 
 for Women in Washington, as early as 1873 advocated the plan of 
 insisting upon a clean bill of health, and related to the class an in- 
 stance in which the young man, after complying with what he con- 
 sidered a reasonable parental request, told the father : 
 
 Now, that I have furnished you with evidence of my own physical cleanness, 
 I shall insist upon a similar evidence in your case, as I am equally anxious 
 to perpetuate the purity of my blood. 
 
 To which request the father unhesitatingly acceded. 
 
 As a teacher of hygiene I can not find words strong enough in com- 
 mendation of the brave editorial and the excellent article, " The 
 tragedy of the marriage altar" (by Dr. Abraham L. Wolbarst), in 
 the Ladies Home Journal for September and October, 1908. The 
 writer has realized for years the necessity of proper education, for if 
 we expect the parents to impart information on sexual purity, they 
 must acquire it primarily from some competent and reliable source. 
 Few of our magazine writers have heretofore been brave enough to 
 present this question as the Ladies Home Journal has done. For 
 all these reasons I have advocated for years that hygiene should form 
 part of the curriculum in our public schools and the question discussed 
 from the standpoint of sexual hygiene pure and simple. Public lec- 
 turers on the purity of man commit a serious mistake, generally, when 
 they picture the consequences of the social evil without offering a 
 suitable remedy. Many a young man thinks it essential to his health 
 to give vent to his penned up secretions by sexual intercourse and to 
 demonstrate his manhood. If deterred by fear of contracting venereal 
 diseases, in the absence of other remedies he will most likely resort to 
 unnatural methods. 
 
 We should make a strong plea in favor of continence, and tell our 
 young men that, while the sexual passion is very strong, it can be 
 accelerated or delayed, excited or lowered, by the influence of the will. 
 We should assure them that sexual indulgence is not a physiological 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 227 
 
 necessity, and that nature will relieve herself by an occasional noc- 
 turnal emission. By the cultivation of pure thoughts, removal of 
 temptation, normal mental conditions, and especially by cold baths 
 and vigorous physical exercise, and avoidance of an excessive meat 
 diet, continence may not only become possible, but easy. Those who 
 witness the good enects of athletic sports can not fail to appreciate 
 that here is a good field in which to expend exuberant animal spirits, 
 and in this sense " public playgrounds " are a strong factor in the 
 promotion of sexual purity. We can hardly go astray if we follow 
 Doctor Parkes in advising a pure young man to make his home after 
 the age of 22 or 23, and thus secure himself both from the temptations 
 and expenses of bachelorhood. Dr. Howard A. Kelly believes that 
 the Christian standard is the solution of the whole problem of chas- 
 tity. I quite agree with him, provided the church makes an endeavor 
 to combine religious and social work, and until this is accomplished 
 we should not hide the evil because it is not a pleasant subject to talk 
 about. 
 
 Suggestions as to what the church may do have been offered in a 
 former report, see page 106, Industrial Hygiene, and the desirability 
 of social settlements in connection with schools and churches will be 
 emphasized in connection with the drink evil, see page 248. 
 
 Among the sensible recommendations submitted by the " commit- 
 tee of fifteen " in the city of New York were, first, " strenuous efforts 
 to prevent, in the tenement houses, the overcrowding which is the 
 prolific source of sexual immorality. * * * Secondly, the fur- 
 nishing, by public or private munificence, of purer and more elevat- 
 ing forms of amusements to supplant the attractions of the low dance 
 halls, theaters, and other similar places of entertainment that only 
 serve to stimulate sensuality and to debase the taste. The pleasures 
 of the people need to be looked after far more earnestly than has been 
 the case hitherto. * * * Thirdly, whatever can be done to im- 
 prove the material conditions of the wage-earning class, and espe- 
 cially of young wage-earning women, will be directly in line with the 
 purpose which is here kept in view. It is a sad and humiliating 
 admission to make, at the opening of the twentieth century, in one 
 of the greatest centers of civilization in the world, that in numerous 
 instances it is not passion or corrupt inclination, but the force of 
 actual physical want that impels young women along the road to 
 ruin." Referring to the question of intimate contact in tenement 
 houses as a predisposing cause to prostitution, it is a matter of 
 satisfaction to record that both General Sternberg and the writer 
 realized this danger when they urged, in 1898, the adoption of model 
 two-story apartment houses with separate entrances and exits for 
 each family so that the sanctity of the home might be preserved. 
 
 STATE METHODS. 
 
 The question naturally arises. What can and should the State do to 
 prevent the moral, social, and physical ravages of these diseases ? It 
 must be confessed that the measures looking to the inspection and 
 control of prostitutes are sadly inadequate. It has been suggested by 
 German authors that the evil might be materially lessened by holding 
 the persons who knowingly spread venereal diseases responsible for 
 the damages. Indeed, a German jurist goes so far as to advocate the 
 punishment of persons who neglect to seek treatment when afflicted 
 
228 REPOBTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 with sexual diseases. Apart from this the State should certainly 
 insist upon — 
 
 First. The enforcement of laws or police regulations relating 
 to houses of ill-fame and to the sale of alcohol, particularly to 
 minors. A closer supervision of soliciting in streets and enticing 
 females under a fixed age. There is certainly no good reason Avhy the 
 terrible temptations which greet our young men and women on every 
 street and in many public places should not be removed. A well- 
 trained police force will have no difficulty in recognizing and ban- 
 ishing the solicitors, both male and female, from the streets, and in 
 cautioning young men, especially minors, of the dangers in the red 
 light districts. 
 
 Second. Health boards can also recommend the enactment of laws 
 for the prevention of syphilis, acquired in an extra genital way, by 
 regulating the profession of barbers, chiropodists, and manicurists, 
 and requiring a special examination of wet nurses, cigar makers, and 
 glass blowers. Apart from the real dangers from these sources, the 
 educational effects of such ordinances will be beneficial. 
 
 Third. Health boards should also exert their influence toward 
 securing adequate facilities for the treatment of indigent patients. 
 
 In northern Europe, where venereal diseases are reportable and 
 treatment is within the reach of all classes, these diseases, according 
 to Weiss, have greatly diminished, but here, as Bulkley puts it, 
 " ignored through ignorance, neglected through negligence of our 
 duty, so ostracised and outclassed, venereal diseases, through false 
 shame, concealment, prejudice, carry on their slaughter unhampered, 
 unchecked, and undisturbed, devastating coming generations and 
 ruining the present one." 
 
 Fourth. Health boards may cooperate with the profession and 
 dispensaries by printing, for distribution, leaflets stating the nature 
 of the diseases, the manner in which they are contracted, and the 
 ways in which they can be transmitted to other persons, and by the 
 encouragement of a general educational campaign in which sexual 
 purity, respect for women, and the possibility of physiological conti- 
 nence should be inculcated. The evil and far-reaching consequences 
 of impure and unlawful gratification should be clearly pointed out. 
 
 In conclusion, a word of caution is necessary to impress upon the 
 victims of sexual diseases the utter uselessness of securing treatment 
 with various advertised cures. As very properly said by Mr. Samuel 
 Adams Hopkins in Collier's Weekly, September 22, 1906 : 
 
 All this class of practitioners are frauds and swindlers. Many of them 
 are ex-criminals in other fields. " The old doctors," the " physicians' insti- 
 tutes," the "medical councils," and the "quick cures" are all equally to be 
 shunned. Blackmail is the underlying principle of this business. These treat- 
 ments can not cure; ten to one they only aggravate the disease and render 
 it dangerous or even deadly. But once they have a man in their clutches they 
 need not help him in order to get his money. If he demurs at their charges, 
 a threat to expose the nature of his ailment to his family or employers is 
 enough. * ♦ * Every advertisement of private diseases or " men's special- 
 ists" ought to be a danger signal pointing not only to wasted money, shame, 
 and misery, but often to invalidism and a dreadful form of death, where in 90 
 per cent of cases reputable treatment would have brought the patient through. 
 
 In some localities it is against the law to publish advertisements of this 
 class. Pennsylvania has such a law, but it is a dead letter. St. Louis is 
 attempting to enforce its Illegal advertising ordinance, and the St. Louis news- 
 papers are fighting to save themselves the dollars tainted with unspeakable 
 filth. 
 
EEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 229 
 
 Chapter VIIL 
 
 THE TOBACCO HABIT. 
 
 In view of the fact that our sociological study of 1,217 families in 
 this city shows an average annual expenditure of $12.19 for each 
 family, which at a conservative estimate would amount to $239,655,- 
 000 for the annual tobacco bill in the United States, it is important 
 to consider the effects of tobacco on the system. 
 
 Tobacco owes its general effects to the presence of toxic alkaloids 
 known as nicotine, nicotianin, and the " pyridin bases " which are 
 formed during smoking. Syrian and Havana tobacco contain little 
 or no nicotine, while the common grades contain from 3 to 4 per cent. 
 Nicotine is a poison which produces a local irritation of the digestive 
 tract, nausea, and diarrhea. In some instances there may be dizzi- 
 ness, weakness, restlessness, depressed action of the heart, and convul- 
 sions. Strangely enough, man becomes accustomed to these effects and 
 may even experience an agreeable excitation of the nervous system, 
 characterized by increased mental and physical elasticity. There is 
 nothing to justify the assumption, however, that the use of tobacco is 
 free from danger. Professor Seaver's observations on Yale students 
 appear to show that nonsmokers made the best physical gains in 
 weight, chest measure, and lung capacity, and that out of every 100 of 
 the best students only 5 were smokers, while 95 were not smokers. His 
 data were apparently so convincing that Japan, ever ready to profit 
 by the experience of other nations, enacted in 1900 a law prohibiting 
 the smoking of tobacco by persons under the age of twenty — an 
 example well worthy of emulation. Dr. A. A. WoodhuU, U. S. 
 Army, holds that cigarette smoking by the young is harmful, as it 
 arrests the natural elimination of waste and hinders the utilization 
 of fresh material. This explains the fact that the stature of youths 
 who use it is less than those who do not use it. 
 
 The bad effects of tobacco may be summarized as follows : Tobacco 
 smoke contaminates the air of rooms with coal gas and other prod- 
 ucts of combustion. According to the London Lancet,* 1 ounce of 
 tobacco yields from 1 to 5 pints of carbon monoxide or coal gas, 
 which, when inhaled, is a blood poison. In many instances tobacco 
 in any form produces a chronic inflammation of the throat and stom- 
 ach, which disappears after the removal of the cause. The excessive 
 use of tobacco produces a chronic form of nicotine poisoning, with 
 impairment of vision, nervous irritability or exhaustion, a predispo- 
 sition to neuralgia, and a peculiar affection of the heart, described by 
 Professor Da Costa as the tobacco heart, characterized by irregu- 
 larity of the heart sounds, accelerated action and weakness of the 
 cardiac muscles. Chewing of tobacco is even more to be deprecated 
 than smoking, as the injurious elements are dissolved by the saliva 
 and not infrequently swallowed. Doctor Woodhull points out that 
 cigarette smoking by the young develops a greater tendency to acquire 
 an appetite for alcoholic liquors, premature puberty is induced, in- 
 creasing the sexual propensity and leading to improper sexual prac- 
 tices. There is a consensus of opinion among educators that the use 
 
 « The Lancet, London, 1908, CLXV. 
 
230 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 of tobacco dulls the memory and intellect. When a promising pupil 
 in a public school begins to decline in his work it is almost certainly 
 found that he has begun the use of cigarettes. 
 
 On the whole we may conclude that the use of tobacco is not a 
 physiological necessity, and its abuse, like that of other nerve stimu- 
 lants, is doubtless a fruitful cause of a breakdown. It is especially 
 harmful in nervous subjects and those of insufficient will power 
 properly to restrict its use. A German authority maintains, and no 
 doubt correctly, that the danger is greater from smoking cigarettes, 
 because of the ease with which the smoke is inhaled. In any event, 
 the practice of inhaling the smoke into the lungs, or smoking before 
 breakfast, is a bad one. Pipes, cigar or cigarette holders, and the 
 mouth should be kept clean. Symptoms of shortness of breath, 
 obscure pains around the heart and nervous irritability are indica- 
 tions to reduce or stop the habit altogether. 
 
 Chapter IX. 
 
 THE ALCOHOL QUESTION. 
 
 In our sociological survey of 1,217 families in this city we found 
 the average expenditure for alcoholic beverages to be $16.14 per an- 
 num. In view of the importance of the subject from an economic, 
 social, and sanitary point of view, a- study of the alcohol question 
 seems very desirable. Before doing so it will be well to refer briefly 
 to different alcoholic beverages in most common use. 
 
 FERMENTED LIQUORS (wINe). 
 
 Among the oldest and best known of alcoholic beverages is wine, 
 which is obtained from the fermented juice of grapes. The juice con- 
 tains water, proteids, grape sugar, levulose, inosite, pectins, tartaric 
 and malic acids and their salts; also small quantities of mineral 
 salts (sulphates and chlorides), coloring matter, and tannic acid. 
 In off years malic acid predominates and there is a deficiency of 
 sugar. The quality of the juice and the resulting wines depend 
 upon the character of the grape (soil, climate, ripening process) and 
 many other factors in the preparation of the must. 
 
 If a white wine is desired the skins and stems of the grape are re- 
 moved, while for colored wines they are permitted to remain; the 
 blue and yellow pigments during fermentation and under the influ- 
 ence of free acids turn red. 
 
 Fermentation of the grape juice is usually carried on at a tempera- 
 ture between 60° and 75° F. and is the result of a natural ferment 
 or yeast plant found on the skin of the grape. During fermentation 
 the proteids in the must are to a great extent used up in the forma- 
 tion of yeast cells and the grape sugar and part of the levulose are 
 split up into alcohol and carbonic acid. The inosite remains un- 
 changed, the pectous matter is changed, and a portion of the salts 
 are percipitated in the form of cream of tartar. In addition, gly- 
 cerin and various aromatic ethers, which impart to the wine its flavor, 
 and small quantities of the higher alcohols and free organic acids 
 are formed. The resulting wine may be said to contain, apart from 
 
EEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 231 
 
 water, alcohol and carbonic acid, also small quantities of proteids, 
 inbsite, free malic, tartaric and succinic acid, salts, glycerin, and 
 aromatic ethers, and in the case of grapes fermented with their skins 
 also tannic acid and coloring matter. 
 
 The lighter wines of this and other countries, viz, the Bordeaux, 
 Burgundies, Rhine, and Moselle wines, hock, sauternes, clarets, and 
 champagnes usually contain from 9 to 15 per cent of alcohol by vol- 
 ume. The fortified or stronger wines like port, sherry, tokay, etc., 
 contain from 16 to 27 per cent of alcohol. The amount of sugar 
 varies from in dry wines to 26 per cent in the sweet wines. The 
 natural wines contain little or no carbonic acid as most of it escapes 
 during fermentation. The effervescent wines like champagne are the 
 product of a second fermentation in the bottle, sugar and flavoring 
 extracts having been added for the purpose. 
 
 The dietetic effects of wine depend entirely upon the amount of al- 
 cohol present. Dry wines usually promote peristaltic action and act 
 upon the kidneys, the red wines commonly retard the movements of 
 the bowels which is due to the astringent effects of tannin. 
 
 Cheap wines are frequently made from other fruits and even the 
 natural wines have been subject to various forms of adulteration, 
 such as the addition of sugar, glycerin, various ethers, logwood and 
 other coloring agents, like malvey leaves, red beets, carmine, fuchsin, 
 and other analin colors. 
 
 Unfortunately the manufacture of artificial wines appears to be 
 everywhere extending. Some years ago Petiot considered it perfectly 
 legitimate to extract repeatedly the skin and seeds of grapes with a 
 solution of sugar, which was then permitted to undergo the usual 
 fermentation, the percentage of alcohol varying with the amount of 
 sugar present. Harrington informs us that an artificial wine known 
 as "piquette," and of which over 50,000,000 gallons were made in 
 France in 1898, is made as follows : " To each gallon of water used 
 are added 1 pound of raisins and 1 of dried apples; the mixture is 
 placed in an open vessel and allowed to stand three days. It is then 
 bottled with one-half teaspoonful of sugar and a small piece of cinna- 
 mon in each bottle. It is said to be 'a pleasant and harmless 
 beverage.' " Indeed, so serious and widespread has become the manu- 
 facture of artificial wine in France that the wine growers in 1907 
 revolted and demanded adequate legislative protection. Harrington 
 and Wiley furnish other examples of the methods followed by those 
 engaged in this nefarious trade: 
 
 Port. — Cider, 30 gallons; alcohol, 5 gallons; sirup, 4 gallons; kino, one-half 
 pound; tartaric acid, one-quarter pound; port-wine flavor, 6 ounces. 
 
 White wine. — Dissolve 25 pounds of grape sugar and 1 of tartaric acid in 
 25 quarts of hot water; add 75 quarts of cold water and 50 pounds of grape 
 pulp, stir, cover, let ferment for four or five days and strain. 
 
 Claret. — California hock, 40 gallons; extract of kino, 8 ounces; essence of 
 malvey flower, 8 ounces. 
 
 These samples are given to show how easy it is to deceive the 
 average customer, who often pays a high price for beverages assumed 
 to possess food values or medicinal properties. 
 
 FRUrr WINES. 
 
 Homemade wines are often made from the fermented juice of 
 apples, pears, currants, gooseberries, and oranges ; they contain pretty 
 
232 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 much the same ingredients, except inosite, as grape wine. The per- 
 centage of alcohol is, however, less, on account of the deficiency of 
 sugar, unless sugar has been added, which is often done. 
 
 Apple or pear cider usually contains from 4J to 6 per cent of alco- 
 hol. According to Parkes such wines are sometimes manufactured 
 or stored in earthenware vessels, coated inside with litharge glaze, 
 which readily gives up larg;e quantities of lead to acid liquids and is 
 thus productive of lead poisoning. If the air is not absolutely ex- 
 cluded from all kinds of wine, acetous fermentation ensues, and the 
 liquid is transformed into vinegar. The effects of home-made wines 
 are moderately stimulating, and slightly laxative and diuretic on 
 account of the free organic acids contained therein. It is also held 
 that their habitual use favors the formation of gravel and stone in 
 the bladder and chronic inflammation of the urinary passages. 
 
 BEERS. 
 
 Beer is a very ancient beverage, having been used by the Egyptians 
 over two thousand years ago. It was introduced into Germany 
 during the twelfth century and for a long time the art of brewing 
 was largely confined to the cloistered monks. Pure beer is manu- 
 factured from malt, hops, and water. In the first place, clean 
 barley is steeped in hard water and is then allowed to sprout 
 in heaps, which are spread out when the germination has reached 
 the requisite stage. During this process diastase develops which 
 converts the starch into dextrin and maltose, and the insoluble albu- 
 minous matter is rendered soluble. Further germination is prevented 
 by first drying and then parching the malt at a temperature of 125° 
 to 180°; this also develops color and flavor. The malt is then 
 screened for the removal of the sprouts and, after being crushed, 
 is steeped in water at a temperature of 160° F., which has the effect 
 of converting the balance of starch in the wort into maltose. The 
 resulting infusion, after the addition of hops, is now boiled for a 
 couple of hours, during which about one-third of the bitter princi- 
 ples of the hops are taken up, the coagulable proteids are separated 
 and all existing micro-organisms are destroyed. The decoction is 
 then rapidly cooled in tanks and transferred into vats, where, after 
 the addition of yeast, it is allowed to ferment at a temperature of 
 G0° to 66° F. ; during this process the maltose is split up into alcohol 
 and carbonic acid. When fermentation has gone far enough the 
 yeast is removed and the beer is run into casks. Good beer, apart 
 from alcohol, carbonic acid, glycerin, succinic acid, also contains 
 some proteids, sugar, malt extracts, salts, and bitter principles. The 
 percentage of alcohol varies from 3 per cent in the lighter kinds to 
 6 or 7 per cent in ale and porter. In the 28 specimens exan ined 
 by Mr. C. A. Crampton, of the Internal Revenue Office^ the amount 
 of alcohol averaged 4.63 per cent by weight or 5.79 per cent by 
 volume. 
 
 The so-called " Weiss beer " is made from a mixture of barley and 
 wheat malt and usually contains more carbonic acid and yeast par- 
 ticles and less alcohol than ordinary beer. Porter, ale, and bock beer 
 are made from a stronger wort and*^ hence contain more alcohol. The 
 chemical analysis shows that beer is not only a beverage, but also a 
 foodstuff, because 2 liters of beer contain about 10 grams of proteids 
 
EEPORTS OP THE PBESIDENt's HOMES COMMISSION. 283 
 
 and 100 grams of carbohydrates, or nearly one-tenth of the protein 
 ration, and one-fifth of the daily requirements of carbohydrates. 
 
 In recent years beer has been known to be adulterated by the em- 
 ployment of glucose and invert sugars obtained by the action of dilute 
 sulphuric acid upon rice and com. 
 
 This sophistication affects not only the nutritive value of the beer 
 by a deficiency of the proteids, but may also be a source of arsenical 
 poisoning, if the sulphuric acid happens to be derived from arseix.cal 
 pyrites. Such an instance occurred in 1900 at Manchester and Sal- 
 ford in the northwest of England, where over 3,000 consumers of beer 
 developed symptoms of arsenical poisoning, such as paralysis and 
 wasting of certain muscles, functional disturbances of certain sensory 
 nerves, with 36 fatal cases from peripheral neuritis. Specimens of the 
 glucose showed from 0.02 to 0.05 per cent of arsenious oxide and the 
 beers made from it contained from 0.10 to 1.60 grains of arsenic per 
 gallon. It is gratifying to note that adulterated beer is quite uncom- 
 mon in this countTj, as none of the 476 samples examined in the State 
 of New York contained hop substitutes. The effects of beer and wine 
 depend upon their purity, the quantity consumed, and the suscep- 
 tibility of the individual. Quite a number of authors believe that 
 these beverages, consumed in moderation, say from one-quarter to 
 one-half liter of wine or from one-half to 1 liter of beer during 
 twenty-four hours, in otherwise normal persons, will have no inju- 
 rious effects, and may even possess certain advantages, such as aiding 
 digestion by promoting the flow of digestive juices, while the bitter 
 principles of hops possess certain tonic properties. On the other 
 hand Buchner, Ogata, and others claim that beer retards digestion, 
 and all agree that if taken habitually in excess, both beer and wine, 
 in the language of Parkes, " lead to the storage up of superfluous fat 
 in the tissues, and they interfere with the proper elimination of effete 
 matter; imperfect oxidation leads to an excessive formation of uric 
 acid, and the plethoric and gouty habit are produced, eventually tend- 
 ing to palpable disease." 
 
 BRANDY. 
 
 Brandy, the strongest alcoholic drink, is derived from the distilla- 
 tion of wine, but as commonly sold it is for the most part a mixture 
 " of varying amounts of spirits from the distillation of com grain 
 spirits, etc." Apart from water it contains 55 to 65 per cent of alcohol 
 by volume, or 39 to 47 per cent by weight, in which are held aromatic 
 ethers, also traces of tannin, coloring matter, and various secondary 
 products, including aldehydes, furfural and higher alcohols. Har- 
 rington gives a number of examples showing how fictitious brandy is 
 made, of which the following is reproduced : 
 
 Boil 5 ounces of raisins and 6 of St. John's bread in water, filter and make up 
 to 10 quarts; mix this with 20 quarts of alcohol, one-half ounce of essence of 
 violet flowers, and 10 ounces of brandy essence. 
 
 RUM AND ARRACK. 
 
 Rum is distilled from fermented molasses, and arrack from fer- 
 mented rice or cocoanuts; they contain from 55 to 65 per cent of 
 alcohol by volume and more or less of the objectionable fusel oil and, 
 like other strong drink, are frequently adulterated. 
 
234 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 WHISKY. 
 
 Whisky is made by distillation of malted grain, especially rye, corn, 
 and wheat, although barley, oats, and potatoes are sometimes used. 
 The mash for Scotch whisky consists of 2 parts of malt, 7 of barley, 
 and 1 each of oats and rye; the mash for Irish whisky is the same 
 with the exception of the rye; the peculiar smoky taste of these 
 whiskies is due to the cresote products evolved in peat and turf fires 
 over which the malt is dried. Good Bourbon whisl^ has an agree- 
 able flavor, the mash being a mixture of corn and rye. All new 
 whiskies, in addition to about 45 per cent of ethylic alcohol, contain 
 amylic alcohol or fusel oil and other impure alcohols. These im- 
 purities are very irritating to the mucous membranes of the throat 
 and stomach and produce rapid intoxication; the fusel oil is also 
 responsible for the headache, nausea, and general depression so often 
 observed after the consumption of impure liquors. The amount of 
 toxicity of the fusel oil depends upon the character of the raw mate- 
 rial, it being greatest when derived from potatoes and least when 
 obtained from grapes. The aldehydes can be removed by redistilla- 
 tion and the fusel oil by charcoal or a fractionating patent still. 
 The fine spirit secured by rectification contains from 72 to 90 per 
 cent of absolute alcohol and only traces of the impurities referred 
 to, while ordinary whisky contains from 35 to 50 per cent by volume 
 of alcohol and almost always some of the toxic principles. It is a 
 familiar but true saying that whisky improves with age in taste 
 and flavor. This is due to the fact that the constituents of fusel oil 
 are converted into nontoxic aromatic ethers which impart the agree- 
 able flavor to aged whiskies and brandies and also constitute, with 
 other compounds, the bouquet in different wines. The new and cheap 
 grades of whisky are decidedly injurious to health and when fusel 
 oil is present to the extent of 1 part per 1,000 it is unfit for use. 
 
 There is abundant evidence to show that whisky is frequently 
 manufactured from alcohol, water, and various flavoring compounds, 
 of which the following example is given by Harrington : 
 
 Scotch whisky. — Alcohol, 46 gallons; genuine Scotch, 8 gallons; water, 18 
 gallons; ale, 1 gallon; cresote, 5 drops in 2 ounces of acetic acid; pelargonic 
 ether, 1 ounce; honey, 3 pounds. 
 
 The writer fears that in the manufacture of fictitious whiskies 
 methyl or wood alcohol is also used on account of its cheapness ; this, 
 when employed as an intoxicant, has been known to produce total 
 blindness. 
 
 THE nation's drink BILL.<» 
 
 As the nation grows in population and wealth, so does its expendi- 
 tures for stimulating beverages. This is the more surprising in view 
 of the warfare waged against the saloon and the milder beverages. 
 The per capita consumption of spirituous liquors for the year ending 
 June 30, 1907, is the highest on record, reaching 23.63 gallons per 
 capita, an increase over 1906 of 1.27 gallons. 
 
 oThls article appeared in the American Grocer, May 27, 1908, and is repro- 
 duced by permission of the editor. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 235 
 
 The advance in the consumption of distilled spirits from 1.52 
 gallons per capita in 1906 to 1.63 gallons in 1907 is more notable than 
 an increase of 0.12 gallon in the use of wine and a rise of 1.04 gallons 
 in beer. 
 
 The year was one of phenomenal prosperity, and this may account 
 for the increase in expenditure for stimulants, which was quite as 
 marked for coifee and cocoa as for alcoholic drinks. The use of tea 
 seems to have declined considerably, as it falls below the yearly 
 average for five years. 
 
 A gain of 1,600,806 in population will not account for the increased 
 use of stimulating beverages. Possibly extensive advertising is re- 
 sponsible for no small share of the increase, which seemingly goes 
 forward in spite of all efforts to check the sale of intoxicating bev- 
 erages and to kill the demand for coffee. " There's a reason," but it 
 baffles solution. There are many theories or opinions, but the finding 
 of a reasonable check to the use of spirituous beverages seems as far 
 away as ever. Legislation does not seem to curb the curse of drink. 
 
 RETAIL COST OF ALL BEVEEAGES. 
 
 The various estimates of cost, presented by the American Grocer, 
 compiled, so far as quantity is concerned, from the report of the 
 United States Bureau of Statistics, shows that the average annual 
 cost of alcoholic and nonalcoholic stimulants in the United States, 
 1905-1907, was as follows : 
 
 Alcoholic drinks. $1, 466, 584, 327 
 
 Nonalcoholic stimulants : 
 
 Coffee $161, 598, 437 
 
 Tea 41, 902, 680 
 
 Cocoa 10, 000, 000 
 
 213, 501, 117 
 
 Total, 1907. 1, 698, 085, 444 
 
 1906 1, 660, 489, 520 
 
 1905 1, 548, 708, 307 
 
 1904. 1, 498, 622, 715 
 
 , 1903- 1, 451, 633, 379 
 
 Total drink bill, five years, 1903-1907 7, 857, 548, 365 
 
 Average annual drink bill, 1903-1907 1, 571, 509, 673 
 
 The above represents a per capita expenditure for beverages in 1907 
 of $19.74 for the 85,817,239 inhabitants of the United States, or 
 $98.70 for each family of five. Yearly average for five years, $19, or 
 $95 per family. 
 
 The quantities of the four leading beverages consumed annually for 
 three years, 1905-1907, as estimated by the American Grocer, were 
 as follows : 
 
 Gallons. 
 
 Beer 1, 686, 667, 659 
 
 Coffee 1, 615, 984, 370 
 
 Tea 558,500,000 
 
 Spirits and wines 156,029,818 
 
236 REPOETS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 PEB CAPITA CONSUMPTION ALCOHOLIC DKINKS. 
 
 The following table shows the annual per capita consumption of 
 liquors in the United States for ten years : 
 
 Year ending June 30— 
 
 Spirits. 
 
 Wines. 
 
 Beer. 
 
 Total. 
 
 1898 
 
 Gallons. 
 1.12 
 1.18 
 1.28 
 1.33 
 1.36 
 1.46 
 1.48 
 1.45 
 1.52 
 1.63 
 
 Gallons. 
 0.28 
 .35 
 .39 
 .37 
 .63 
 .48 
 .53 
 .42 
 .55 
 .67 
 
 Gallons. 
 15.96 
 15.28 
 16.01 
 16.20 
 17.49 
 18.04 
 18.28 
 18.50 
 20.19 
 21.23 
 
 Gallons. 
 17 36 
 
 1899 
 
 16 81 
 
 1900 
 
 17.68 
 
 1901 
 
 17 90 
 
 1902. 
 
 19 48 
 
 1903 
 
 19 98 
 
 1904 
 
 20 35 
 
 1905 
 
 20 38 
 
 1906 
 
 22 26 
 
 1907 
 
 23 53 
 
 
 
 TOTAL ALCOHOLIC DRINK BILL. 
 
 Bringing together the quantities of liquors consumed, estimated at 
 the retail cost on the basis of previous reports, it is shown that the 
 American people spent for alcoholic stimulants for the year ending 
 June 30, 1907: 
 
 Beer $843, 333, 829 
 
 Whisky (exclusive of quantity used in arts) 118,456,091 
 
 Grand total, 1907 1,466,544,327 
 
 1906 1, 450, 855, 448 
 
 1905 1, 325, 439, 074 
 
 1904 1, 277, 727, 190 
 
 1903 1, 242, 943, 118 
 
 1902 1, 172, 565, 235 
 
 1901 1, 094, 644, 155 
 
 1900 1, 059, 563, 787 
 
 1899 973, 589, 080 
 
 LIQUOB AND TOBACCO TAX. 
 
 The total revenue of the United States Government in 1907 from 
 spirituous and malt liquors, and from tobacco, the ally of liquor, was 
 $247,458,911, or $2.88 per capita, equal to $14.40 tax on every family. 
 
 CONCLUSION. 
 
 We must leave to students of social economy the question of a great 
 nation spending an average of over one and one-half billions annually 
 for stimulating beverages ; a sum about as great as the appropriations 
 of the Congress for a session. Nearly double as much per capita is 
 spent for drink as is spent for the maintenance of public schools. It 
 nearly equals the value of exports of merchandise per capita. It is 
 double the amount of the public debt. It is more than the farm value 
 of the corn crop, which exceeds 2,500,000,000 bushels ; three times the 
 value of the wheat grown ; more than double the worth of the cotton 
 crop. The indirect cost is beyond estimate, and so great is the waste 
 and misery created that States are fighting the evil and endeavoring 
 to banish the saloon as a distributing factor. It is easily the fore- 
 most question of the day, and places the support of a big navy or an 
 army in the shade. 
 
KEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 237 
 
 ALCOHOL AS A POODSTHBT. 
 
 Professor Liebig was perhaps the first to declare that alcohol stands 
 only second to fat as a respiratory material, but wisely added that the 
 s xme effect could be produced in the body by means of saccharine and 
 farinaceous articles of food at one-fourth or one-fifth the cost. 
 
 Professor Atwater, in order to determine the food value of alcohol, 
 substituted for a portion of the nonnitrogenous food a quantity of 
 ethyl alcohol equivalent in energy to the food which it replaced — 2^ 
 ounces of absolute alcohol per day in six doses — and found what had 
 been taught in fact by Liebig (1) extremely little of the alcohol was 
 given off from the body unconsumed in the breath or otherwise — ^the 
 alcohol was oxidized, i. e., burned as completely as bread, meat, and 
 other ordinary foods in the body and in the same way; (2) in the 
 oxidation all of the potential energy of the alcohol was transformed 
 into heat or muscular energy. In other words, the body transformed 
 the energy of the alcohol just as it did that of sugar, starch, and fat. 
 That is, whether the body was at rest or at work, it held its own just 
 as well when alcohol formed a part of the diet as it did with a diet 
 without alcohol. 
 
 These experiments clearly demonstrate the food value of alcohol, 
 but Atwater wisely adds that it should be remembered that the physi- 
 ological action of alcohol involves much besides its nutritive effect. 
 Its "influence on the circulatory and nervous functions is especially 
 important. He also said : 
 
 Whether alcohol is to be called a food or not depends upon the definition of 
 the food. 
 
 The writer does not question, the scientific deductions made from 
 these experiments, but objects that alcohol should be considered any- 
 thing else than an accessory, to be used with extreme precautions.- 
 Professor Atwater has told us, in one of his excellent bulletins, that 
 " the most healthful food is that which is best fitted to the wants of 
 the user ; the cheapest food is that which furnishes the largest amount 
 of nutriment at the least cost, and the best food is that which is both 
 healthful and cheapest." 
 
 PHYSIOLOGICAL EFFECTS OF ALCOHOL. 
 
 Absolute alcohol, on account of its affinity for water, exerts a caustic 
 effect on the mucous membranes. When properly diluted, it is rap- 
 idly absorbed and speedily oxidized. It is a stimulant to the central 
 nervous system and the sympatheticus of the heart and produces a 
 feeling of exhilaration, vivacity of the mind, accelerated pulse, and 
 increased muscular activity. Bunge denies these properties, and 
 claims that its primary action is that of a depressant, and that its 
 apparent good effects are simply due to the obtusing influence upon 
 physical and mental suffering. But this is scarcely a correct assump- 
 tion, as there are individuals in whom the smallest doses produce 
 palpitation of the heart, throbbing of the carotids, and great mental 
 activity. He also claims that alcohol does not produce renewed vigor 
 in tired individuals, but simply obtuses the feeling of exhaustion. 
 Dr. Henry Smith Williams, discussing the relation of alcohol to 
 muscular work, states that alcohol does not increase the capacity to 
 
238 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 do muscular work, but distinctly decreases it. (McClure's Magazine, 
 October, 1908.) Atwater's experiments conclusively show that in the 
 oxidation of alcohol in the system all the potential energy is trans- 
 formed into heat or muscular energy; and there is certainly reason 
 for believing that it is also a stimulant. How else can we explain 
 the action o? brandy in cases of heart failure? It would be absurd 
 to talk here of an obtusing or stupefying effect. It is a stimulant 
 which, like other agents of this class, is followed by a stage of de- 
 pression. 
 
 Alcohol, in moderate and diluted doses, evidently stimulates diges- 
 tion, as shown by its beneficial effects after a hearty meal; but large 
 quantities interfere with or arrest the peptonizing process, and fre- 
 quently produce acute gastric catarrh. These effects are liable to be 
 observed, when present, to the extent of 10 per cent of the gastric 
 contents. Alcohol also exerts a marked diuretic effect, which is be- 
 lieved to be due to a direct irritation of the renal epithelium. 
 
 PATHOLOGICAL EFFECTS OF ALCOHOL. 
 
 The habitual use of immoderate doses of alcohol can not fail to pro- 
 duce serious injury to mind and body. One of the most constant 
 effects is chronic inflammation of the stomach, with consequent im- 
 paired digestion and nutrition. It produces fatty degeneration of the- 
 heart, liver, and arterial coats, a most common cause of apoplexy, 
 probably because it promotes the conversion of albuminoid tissues into 
 fats. The connective tissues of the body increase in amount and their 
 subsequent contraction gives rise to cirrhosis (hardening of the 
 liver), Bright's disease, and chronic meningitis. It is one of the 
 most fruitful causes of insanity and affections of the nervous system — 
 like inflammation of the nerves, palsies, epilepsy, etc. Doctor Maca- 
 tee's investigation shows that during the past nine years 9,510 patients 
 were treated for alcoholism and 409 for delirium tremens in the city 
 hospitals of Washington, the majority of the patients at public 
 expense. 
 
 It is a lamentable fact that while the mortality from the so-called 
 preventable diseases in the United States has markedly declined in 
 the last two decades, the death rate from Bright's disease, heart dis- 
 ease, dropsy, apoplexy, and pneumonia are apparently greater than 
 in 1890. For reasons just stated we may well pause to inquire 
 whether our ever-increasing " national drink bill " may not be a factor 
 in the undue prevalence of these diseases, as also in the increase of 
 insanity and nervous disorders. 
 
 ALCOHOL INCREASES THE SUSCEPTIBILITY TO DISEASE. 
 
 Professor Hodge, of Clark University, in 1895 demonstrated the 
 injurious effects of alcohol upon dogs. The more recent experiments 
 of Taavlaitmen, cited by Babcock," apparently show that in dogs, 
 rabbits, guinea pigs, fowls, and pigeons alcohol distinctly increases 
 the susceptibility to experimental infection; and that the abnormal 
 temperature of experimental diseases persists longer than in infected 
 animals that do not receive the drug. Dr. Reid Hunt, of the Public 
 
 •Preventive Medicine, p. 83. 
 
BEPOETS OF THE PRESIDENT S HOMES COMMISSION. 
 
 239 
 
 Health and Marine-Hospital Service, in 1906 conducted a similar 
 line of experiments and arrived at the same conclusion. Metchnikoff « 
 attributes this to the fact that alcohol lowers the resistance of the 
 white corpuscles of the blood, which are the natural defenders of the 
 body. 
 
 Lanceraux has shown that in 2,192 cases of tuberculosis studied by 
 him over one-half were confirmed drunkards, and Guttstadt's Sta- 
 tistics ^ also indicate that consumption is especially common among 
 bartenders and brewers. Indeed, every physician knows that alcohol 
 not only predisposes to tuberculosis, pneumonia, typhoid fever, and 
 other infectious diseases, but also that these diseases are more fatal 
 or run a more severe course in alcoholic subjects — probably because 
 of the impaired digestive functions and a general depraved nutrition 
 of the system, with consequent diminished power of resistance. Apart 
 from the diseases already referred to, alcohol also increases the ten- 
 dency to rheumatism and gout, and according to Babcock " there is a 
 distinct relationship between the incidence of alcoholism, insanity, 
 venery, and crime." 
 
 EFFECTS OF ALCOHOL UPON LONGEVITY. 
 
 The following figures, taken from Doctor Ogle's report (Forty- 
 fifth annual report of the registrar-general of England), show the 
 effect of intemperate habits in shortening life: 
 
 Comparative mortality of males 25 to 65 years of age. 
 
 All causes complete. 
 
 Mortality figures 
 
 Diseases of the nervous system 
 
 Respiratory system 
 
 Urinary system 
 
 Liver 
 
 Alcoholism 
 
 Gout 
 
 
 
 Innkeepers- 
 
 All males, 
 
 
 publicans 
 
 England 
 and 
 
 Brewers. 
 
 spirit, 
 wine, 
 
 Wales. 
 
 
 or beer 
 dealers. 
 
 1,000 
 
 1,361 
 
 1,521 
 
 119 
 
 144 
 
 200 
 
 182 
 
 236 
 
 217 
 
 41 
 
 55 
 
 83 
 
 39 
 
 96 
 
 240 
 
 10 
 
 25 
 
 55 
 
 3 
 
 9 
 
 13 
 
 Life-insurance tables based upon English statistics cited by Jewett 
 (Town and City, p. 87) : 
 
 
 Average 
 expecta- 
 tion of 
 Ufe. 
 
 Moderate 
 drinkers. 
 
 Total 
 abstainers. 
 
 At 20 expect to live to be 
 
 62 
 65 
 68 
 
 35 
 
 m 
 
 5U 
 
 64 
 
 At 30 expect to live to be 
 
 661 
 R8 
 
 At 40 expect to live to be 
 
 
 
 EFFECTS OF ALCOHOL UPON MENTAL AND MORAL FACULTIES. 
 
 Perhaps one of the most deplorable effects of alcohol is that it pro- 
 duces structural changes of the cells of the brain and spinal cord — a 
 
 oThe New Hygiene, p. 25. 
 
 ^ Klin. Jahrbuch f. 1904. 
 
240 REPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 fruitful cause of insanity — ^and leads to a mental and moral deteriora- 
 tion, characterized by the loss of will power, blunted moral sensi- 
 bilities, and the ruin of character; and, saddest of all, these effects are 
 often transmitted through vulnerable anatomical elements to the 
 offspring. 
 
 A curious record has been complied by Professor Pellman of the 
 University of Bonn. It relates to the career of a notorious drunkard 
 who was bom in 1740 and died in 1800. In investigating her history 
 her descendants were found to have numbered 834, of whom 709 have 
 been traced from their youth. Of these, 7 were convicted of murder, 
 76 of other crimes, 142 were professional beggars, 64 lived on charity, 
 and 181 women of the family led disreputable lives. Further inquiry, 
 moreover, showed that the family cost the German Government for 
 maintenance and costs in the courts, almshouses, and prisons no less 
 than $1,250,000 — in other words, just a fraction under $1,500 each. 
 It would probably be difficult to find a more remarkable example than 
 this of the evil effects of the drink habit and the transmission of 
 hereditary defects. 
 
 The statistics of the Elmira Reformatory for 1900 show that 3,363 
 of the 9,344 convicts had drunken ancestors and the records of every 
 police court reveal the startling fact that about 60 per cent of all 
 sentences are imposed for drink. Ninety-one of the 175 prisoners 
 examined by Dr. Paul B. Johnson in the Washington Workhouse were 
 sentenced for drunkenness and disorderly conduct, and 171 admitted 
 the use of alcohol, most of them to excess. Mr. Boies estimates that 
 the share of alcohol in the expense of crime in the United States is 
 $4.34 per capita, or over $420,000,000 per annum (Jewett, p. 24-25). 
 
 Professor Demme's statistics of 10 temperate and 10 intemperate 
 families, based upon ten years' study and observation, are also of 
 interest : 
 
 Children 
 
 Died before 6 weeks old 
 
 IdlotB 
 
 Stunted in growth 
 
 Epilepsy 
 
 Nervous in childhood, but cured 
 
 Ordinary good health in childhood, per cent 
 
 Temper- 
 
 Drunkards' 
 
 families. 
 
 families. 
 
 61 
 
 67 
 
 5 
 
 25 
 
 
 
 6 
 
 
 
 5 
 
 
 
 6 
 
 6 
 
 
 
 81.5 
 
 17.6 
 
 Moreover, Von Bunge has shown that the daughters of alcoholic 
 fathers in the third generation are usually unable to nurse their 
 offsprings. 
 
 ALCOHOL AS A CAUSE OF ACCmENTS. 
 
 Considerable evidence might be adduced to show the relationship of 
 alcohol to railroad and other accidents. Those who are familiar with 
 the effects of intoxicants need no argument in favor of sobriety. All 
 business men and railroad corporations realize the value of sober hab- 
 its among their employees, and quite a number insist upon total 
 abstinence at all times, whether on or off duty. 
 
 On the whole we may conclude that, for persons in health, alcohol 
 in any form presents no advantages not found in other foodstuffs or 
 stimulants, and which are, moreover, comparatively free from the 
 dangers attending its use. Indeed, the subsequent depressing effects 
 
BEPOKTS OF THE PEESIDENt's HOMES COMMISSION. 241 
 
 and the baneful influence of its misuse should make us careful in the 
 employment of alcohol, even for medicinal purposes, especially when 
 rest, proper food, and some of the beverages and stimulants like coffee, 
 tea, or beef tea may accomplish the same object. 
 
 CAUSES OF INTEMPERANCE. 
 
 The writer has watched with satisfaction the physical development 
 of the population of the United States, which has more than justified 
 the opinion, long since expressed by scientists, that a mixture of the 
 blood of different nations of the same race is better than either of the 
 parent stock. Our typical American is a very different type from 
 his English, French, Irish, or German ancestor. As a result of a 
 commingling of the blood, he has developed into an individual of 
 strikingly superior physical and intellectual qualities, destined to play 
 a very important role in the affairs of the world. And yet one of the 
 dangers which appears to threaten us is the growing evil of intem- 
 perance, which is intimately connected with our mode of life. In a 
 general way, there is no class of men more ambitious, more industri- 
 ous, and more fond of accumulating wealth than our people. The 
 very excellence of our progress and its accelerated speed have quick- 
 ened the pulse, stimulated the nerves and intellect, and fired the amjbi- 
 tion of men until they overleap the limits of their natural powers. 
 Under this high-pressure system the rich and poor alike strain their 
 physical and mental energies. Rest and recreation seem impossible to 
 many and the temporary stimulant derived from the tempting cup 
 offers, for the time being, relief to our physical and mental exhaus- 
 tion. It is, however, a dangerous remedy. It is like the whip ap- 
 plied to the tired horse and the result is generally bad. 
 
 Professor Kraeplin, one of the foremost experts on insanity in 
 Europe, in his monograph on "Alcohol and Youth," in discussing the 
 causes which lead up to the drink habit, says : 
 
 The blacksmith offers as an excuse exposure to heat, the liveryman pleads 
 exposure to cold, the masons and bricklayers plead outdoor exposure, the 
 miller blames the dust, the sailor the fog, another his wife, and still others 
 business reverses. 
 
 From this he concludes that the very diversity of causes assigned 
 show that none of them will stand the test of scrutiny. Mr. Wurm, 
 in a very interesting address on the alcohol question, delivered at 
 Essen, September 20, 1907, takes issue with Kraeplin and proceeds 
 to present some of the causes which operate in the drink habit among 
 wage-earners. The writer quite agrees with him that the dust- 
 producing occupations are at least predisposing factors, especially 
 when the employer makes no attempt to furnish pure water or non- 
 alcoholic beverages to allay the thirst and when the rules and regu- 
 lations for the prevention and removal of dust are totally ignored. 
 In like manner he makes a strong plea for the operatives exposed to 
 extremes of high temperature, the inhalation of injurious and offen- 
 sive gases, and very properly insists that the causes of abnormal 
 thirst should primarily be prevented by efficient and copious venti- 
 lation. He attributes, and we believe correctly, the drink habit so 
 prevalent among painters to the fact that they resort most unwisely, 
 upon the appearance of the first symptoms of lead colic, to alcoholic 
 beverages to allay their suffering, when, as a matter of fact, the most 
 
 S. Doc. 644. 60-2 17 
 
242 REPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 rational preventive measure would be to abolish the use of lead pig- 
 ments altogether. He describes, graphically, the exposure of quarry- 
 men, stonecutters, masons, bricklayers, joiners, teamsters, motormen, 
 etc., to the elements, and points out that the men engaged in con- 
 struction work are rarely supplied with a shack and a cook stove 
 where they can warm up and take their noonday meal. In the 
 absence of suitable conveniences the workmen are compelled to fre- 
 quent the saloons, and here highly seasoned tidbits promote thirst, 
 while the social element is also conducive to excesses. All of these 
 evil conditions are very much aggravated in this country by the per- 
 nicious system of treating. This abominable custom can not be too 
 strongly condemned, as it is almost as vicious as the seduction of a 
 young man to take his first drink. Many a young man has fallen a 
 victim to the habit by the encouragement of his older companions 
 to " be a man and take a drink." 
 
 Among the causes stated by 171 of the prisoners in the Washing- 
 ton workhouse investigated by Dr. Paul B. Johnson, we find the 
 following: Bad companions, dusty employments, long hours of 
 work, especially at night, exposure to cold and wet, work in hotels 
 and bottling establishments; given toddy, beer, etc., as children 4 
 years old and upwards ; death of relatives and troubles. 
 
 Mr. Wurm considers the effects of mental and bodily fatigue as a 
 cause of intemperance and emphasizes the peculiar effects of mental 
 strain combined with monotonous machine work, in which, after all, 
 constant attention is demanded to prevent accidents and spoiled 
 products. Mr. Emmet L. Adams, master of the American Machin- 
 ists, also believes that the monotony of machine work, especially 
 when combined, as in the naval gun shops, with strict orders not to 
 converse during the work, is conducive to mental fatigue and empti- 
 ness, which the wage-earner seeks to counteract by the use of alco- 
 holic beverages. In his opinion long hours, dirty work, and low 
 wages are fruitful causes of discontent and intemperance. 
 
 POVERTY AND DRINK. 
 
 Keferring to the effect of low wages as a cause of intemperance, 
 Mr. Wurm quotes Prof. Justus von Liebig, who, in 1860, declared: 
 
 Alcoholism is not the cause, but the result of distress. It is the exception 
 to the rule for a well-nourished individual to become a drunliard. When, on' 
 the other hand, a man's earnings are insufficient to provide the quantity and 
 quality of food required for the restoration of his working capacity, sheer 
 necessity compels him to have recourse to alcohol. 
 
 It will be remembered that Liebig was the first to demonstrate the 
 food value of alcohol, and this view may have been justified at a time 
 when wages in Germany were extremely low, and the cost of whisky 
 so nominal as to be classified as one of the most inexpensive articles 
 of food. Wurm also quotes Friedrich Engel, who appears to have 
 been aware of the fact that the social conditions, as observed by him 
 in England in 1845, are not only a cause of alcoholism, but that the 
 drink habit is also very often the primary cause of the low standards 
 of living. 
 
 Engel says: 
 
 Seduction and every possible temptation combine to produce the drink habit. 
 Ardent spirits at present constitute the workiugman's only source of pleasure. 
 He returns weary and exhausted from his work to a damp, gloomy, and unat- 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 243 
 
 tractive home, devoid of all the ordinary comforts of life. He is sadly In need 
 of good cheer and encouragement; his body weakened by improper food and 
 exposure to bad air demands some form of stimulant. He wants to meet his 
 friends and resorts to the saloon as the only place to gratify his longings. 
 Under such circumstances drunkenness ceases to be a vice. 
 
 We have, on the other hand, the opinion of John Burns, the Eng- 
 lish statesman, himself a former wage-earner, who, in his lecture on 
 " Labor and drink " (p. 5), declares: 
 
 Drinking is bad enough in the prosperous, well-fed, and comfortable classes, 
 who can mitigate its heavy drain upon their health, strength, and resources by 
 rest, change, and counter-attractions. But on the poor it is an additional load, 
 piled upon their own backs, too often by their own hands, and nearly always 
 at the time they are least able to bear it. From their strength as a class, from 
 their powers of endurance as individuals, and from their capacity as craftsmen, 
 it is a never-ending drain. 
 
 On page 12, in speaking of " Poverty and drink," he says : 
 
 The theory, dogmatically asserted, that poverty causes drink is rudely shaken 
 by the fact that the drink expenditure per middle and upper class family who 
 have the means, is two and a half times greater than that of the working class 
 family, although the effect is less apparent. But the strongest answer is the 
 statistical fact that as wages rise general drunkenness follows, insanity in- 
 creases, and criminal disorder due to drink keeps pace with all three. The 
 converse generally holds good, for in rural districts, where wages are low, 
 drunkenness is lower, and insanity due to drink is scarcer. In support of these 
 views and tables, the prison commissioners' report (p. 16, Judicial Statistics, 
 1899) : "A year of great prosperity, 1899, was also a year of great drunken- 
 ness." Yet drunkenness in 1899, I am pleased to say, per 100,000, was much 
 lower than in previous periods of prosperity, as for instance in 1884; the year 
 1875, our busiest year, was the most drunken of any recorded. 
 
 It may be urged, in extenuation of these deplorable facts, that the determining 
 cause was the previously low wages; also that it is the sudden rise from rural 
 to urban wages that sweeps the appreciated wage-earner from his simple, sober 
 ways to exciting, heavy-drinking habits. If this be accepted, it diminishes 
 enormously the force of the theory that poverty causes drink. * * * 
 
 Industrial prosperity is always the measure of wages, generally the standard 
 of drunkenness, the gauge of insanity, and too often the stimulus of crime. 
 This is strikingly confirmed by that patient, devoted, and capable investigator 
 Mr. W. D. Morrison: "A glance at the criminal returns for a series of years 
 will at once show that crime is highest in summer and autumn — a time when 
 occupation of all kinds, and especially for the poorest members of the com- 
 munity, is most easily obtained — and lowest in winter and spring, when eco- 
 nomic conditions are adverse." All these facts, instead of pointing to poverty 
 as the main cause of drunkenness, point the other way. 
 
 Wurm stoutly maintains that in Germany higher wages have 
 created a greater demand for the less harmful but more expensive 
 beverages, like wine and beer, and quotes from the " Volkstimme," of 
 Frankfort, that in all trades where there has been a reduction in the 
 working hours alcoholism has diminished, because the men have an 
 opportunity to enjoy nobler pursuits than to sit around in common 
 saloons. 
 
 Justice De Lacy, of the juvenile court of Washington, informed the 
 writer that quite a large number of deserted wives, pleading for com- 
 pulsory support, declare that when their husbands earned from $2.50 
 to $3.50 a day they led exemplary lives, but now, when they are earn- 
 ing from $4 to $5 a day, a number of days are lost in idleness by the 
 drink habit. 
 
 The writer does not pretent to offer an authoritative view, and pre- 
 fers to adduce the evidence on both sides of the question. He is 
 strongly inclined to the belief, amounting to a conviction, that the 
 
244 REPORTS OF THE PRESIDENT'S HOMES COMMISSION." 
 
 subject is so broad and the evil effects so far reaching as to deserve a 
 systematic and exhaustive study by a special commission. 
 
 Reference has been made in a former report to the fact that mal- 
 nutrition, whether the result of insufficient or improperly prepared 
 food, or the consumption of cold ^actuals, is a very fruitful cause of 
 intemperance. In our sociological study of 1,217 families it was 
 found that 760 wage-earners carried dinner pails, and 205 were re- 
 ported as being accustomed to consume alcoholic beverages with their 
 meals. The number in each case was greater among the white than 
 the colored wage-earners. Everyone at all familiar with the subject 
 knows that badly cooked food, especially when consumed from the 
 " cold dinner pail," produces derangements of the stomach and a 
 craving for alcoholic stimulants, which in turn aggravate the original 
 gastric disturbance and readily lead to the drink habit. 
 
 In addition to the causes mentioned, the unnecessary number of 
 saloons, not infre(juently connected with employment agencies or 
 located in the vicinity of workshops, wharves, and the homes of wage- 
 earners, increase the temptation. Last, but not least, the character- 
 istic American bar — drinks being consumed in rapid succession, aided 
 by the pernicious system of treating — is a very fruitful cause of the 
 drink habit. 
 
 REMEDIAL. MEASURES. 
 
 The remedy is difficult to suggest. Prohibition does not prohibit, 
 and all such attempts are repugnant to the masses and lead to the sub- 
 stitution of even greater evils, such as the drug and other morbid 
 habits. In Doctor Johnson's investigation quite a number of the 
 prisoners admitted that when unable to secure liquor they have re- 
 sorted to alcohol diluted with water, hot water and sugar, soda water, 
 sarsaparilla, etc. Wood alcohol was stated to be used in the United 
 States Navy, obtained from shellac varnish stolen from the paint 
 room, the shellac being precipitated by water and the fluid poured 
 off and mixed with hot water and sugar. The following substitutes 
 for liquor were also alluded to : Duffy's malt whisky, Johann Hoff 's 
 malt extract, Jamaica ginger, Peruna, S. S. S., renewed prescriptions, 
 and forged prescriptions. During my army experience at posts situ- 
 ated within the heart of an Indian country and where it was imprac- 
 ticable to establish grog shops, within a reasonable distance, whisky 
 was brought into the garrison through the mail in various disguises, 
 or in express packages and peddled in 2-ounce vials by the soldiers 
 themselves. Others resorted to the purchase of essence of ginger, 
 lemon, vanilla, bay rum, alcohol, patent and proprietary remedies 
 containing alcohol in various percentages ; hence even the most favor- 
 able environment failed to prohibit. It was not until the establish- 
 ment of the canteen system that better conditions were offered. It 
 was the creation of the soliders' club, with the sale of light wines, 
 beers, and nonalcoholic beverages, which reduced drinking to a mini- 
 mum and promoted not only temperance and contentment, but also 
 lessened immorality and crime. 
 
 In spite of the fact that beer and wine drinking, viewed in the 
 abstract, is unproductive of good, quite a number of friends of tem- 
 perance believe that saloons dispensing light wines and beers should 
 pay a very much lower license tax than those selling stronger alcoholic 
 beverages. They also deprecate the tendency to suppress the sale of 
 beer by the quart, because it is found that the men, instead of " rush- 
 
REPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 245 
 
 ing the growler," will purchase whisky by the pint or quart with 
 infinitely more harmful effects. 
 
 So long as human nature is weak, and the masses are not properly 
 educated, the substitution of a lesser evil is not only justifiable but 
 will, in the future, as it has in the past, prevent excesses which are 
 fatal to soul and body. At present every effort toward total absti- 
 nence merely opposes theory to facts and sentiment to statistics. 
 
 While it is true that nearly one-half of the population of the United 
 States is now living under prohibition liquor laws and nine States 
 have prohibition outright, there is no marked diminution in the con- 
 sumption of alcoholic beverages. One of the immediate effects has 
 been an appalling increase in the number of drug stores in " dry 
 States." The subject was deemed of sufficient importance by Mr. 
 Harry B. Mason, editor of the " Bulletin of Pharmacy," to bring it 
 to the attention of the American Pharmaceutical Association at a 
 meeting held at Hot Springs, September 6, 1908. 
 
 Mr. Mason said in part: 
 
 We are facing a great world movement. It has been instituted by society 
 for the protection and maintenance of its own interests. It will continue its 
 onward development whether we like it or not, and as pharmacists we are af- 
 fected in so vital a manner that our future reputation and welfare are largely 
 at stake. Prompt and vigorous measures are necessary if we are to avoid 
 public calumny and disgrace. 
 
 Why? For the very simple and apparent reason that a small minority of 
 druggists are willing, nay, eager, to take advantage of the downfall of the sa- 
 loon and seize upon the business which it is no longer able to continue. In 
 some of the prohibition States, and in most of the " dry " towns and counties, 
 it is recognized that liquor is a medicinal necessity, and the druggist is conse- 
 quently given the legal right to dispense it for legitimate purposes. Some- 
 times a physician's prescription is demanded ; in other instances it is provided 
 that the sale must be only for " medicinal, chemical, and sacramental purposes," 
 and strict registration of every sale is required ; in still other sections, different 
 methods are prescribed, but the fundamental expectation everywhere is that 
 the pharmacist shall observe the spirit of the law and refrain from selling 
 liquor as a beverage. 
 
 Now, it is unquestionably wise and proper that, by some method or other, 
 people who need liquor for legitimate purposes should be left with the means 
 of procuring it, and the drug store is the natural and practically the only place 
 to look to in such an emergency. 
 
 No article in the materia melica is more useful and necessary than liquor, 
 and it would be unfortunate, indeed, if pharmacists were everywhere denied the 
 legal right of dispensing it. It would be nothing short of a professional dis- 
 grace of the most humiliating character if this privilege were to be taken from 
 us through inability on our part to respect it in letter and spirit, and yet this 
 very thing has been done in some States and sections and is threatened in 
 others. 
 
 Every county or city association in " dry " territory might well make the 
 matter a local issue, take control of the situation, outline a policy, eject mem- 
 bers who violate the law, cooperate with the legal authorities, and convince 
 the public, the newspapers, and the officers of the law that pharmacy is a dig- 
 nified and honorable occupation which will tolerate no liquor abuses. This, 
 as I see it, would prove the most effective method of remedying the evil and 
 averting the crisis. 
 
 As a result of Mr. Mason's address, the association adopted resolu- 
 tions declaring that any druggist who goes into the illegitimate sale 
 of liquor is a disgrace to the profession and should be ostracized by it, 
 and calling upon the local authorities to assist in exposing and 
 penalizing those druggists who abuse their privileges and who thus 
 drag the name of pharmacy into the mire of infamy and degradation. 
 
 Laudable as this effort is, it will prove of little avail until higher 
 moral standards reach all classes, including even the liberal profes- 
 
246 REPORTS OF THE PRESIDENT'S HOMES COMMISSIOK. 
 
 sions. The American Medical Association has preached for years 
 against the nefarious traffic in secret and proprietary medicines, but 
 in spite of solemn protests and ostracism, the frightful list of such 
 harmful compounds increases at the rate of about 200 a year. Mounte- 
 banks and hypocrites are not easily subdued and when compelled to 
 respect the liquor law may have recourse to a number of medicinal 
 preparations which are protected hj patents or trade-marks. The 
 following list of medicinal preparations have been analyzed in the 
 office of the Commissioner of Internal Kevenue and are classed as 
 compound liquors for the sale of which a special tax is required : 
 
 Patent and proprietary compounds containing sufficient alcohol to he intoxicants. 
 
 American Alimentary Elixir 
 
 Angostura Aromatic Tincture Bitters... 
 
 Aroma Stomach Bitters 
 
 Aromatic Bitters 
 
 Atwood's La Grippe Specific 
 
 Augauer Kidney Aid 
 
 Augauer Bitters 
 
 Belvedere Stomach Bitters 
 
 Bismarck Laxative Bitters 
 
 Biamarck's Royal Nerve Tonic 
 
 Blackberry (Karles Medicine Company) 
 Blackberry Cordial (LQtemational Co.). . . 
 Blackberry Cordial (Irondequoit WineCo. ) 
 Blackberry Cordial (Strother Drug Co) . . . 
 Blackberry & Ginger Cordial (Standard 
 
 Chemical Co.) 
 
 Black Tonic 
 
 Bonekamp Stomach Bitters 
 
 Bonekamp Bitters 
 
 Brown's Aromatic Cordial Bitters 
 
 Brown's Utryme Tonic 
 
 Brown's Vin Nerva Tonic 
 
 B otanic Bitters 
 
 Celery Pepsin Bitters 
 
 Cinchona Bitters 
 
 Clifford's Cherry Cure 
 
 Clifford's Peruvian Elixir 
 
 Cooper's Nerve Tonic 
 
 Crescent Star Jamaica Ginger 
 
 Coca Wine 
 
 Callsaya 
 
 Cuban Gingeric 
 
 Dandelion Bitters 
 
 De Witt's stomach Bitters 
 
 Dr. Brown's Blackberry Cordial 
 
 Dr. Brown's Tonic Bitters 
 
 Dr. Hopkin's Union Stomach Bitters 
 
 Dr. Hoffman's Golden Bitters 
 
 Dr. Sterki's Ohio Bitters 
 
 Dr. Dade's Blackberry Cordial 
 
 Dr. Bouvler's Buchu Gin 
 
 Dr. Fowler's Meat & Malt 
 
 Dr. Gray's Tonic Bitters 
 
 Dr. Hortenbach Stomach Bitters 
 
 Dr. Worme's Gesundheit Bitters 
 
 Dr. Ratthiger's Bitters 
 
 Dubonnet 
 
 Dubonnet Wine 
 
 Duffy's Malt Whiskey (Whiskey) 
 
 Ducro's Alimentary Elixir 
 
 Elixir of Bitter Wine (Pleasant Tonic 
 
 Bitters Co.) 
 
 Elixir Calisava 
 
 Eucalyptus Cordial 
 
 Ferro China Bascal 
 
 Ferro China Bissler 
 
 Ferro Quina Bitters 
 
 Fhie Old Bitter Wine 
 
 Gastrophan 
 
 Gentian Bitters 
 
 Genuine Bohemian Malted Bitter Wine 
 
 Tonic 
 
 Gilbert's Rctjuvenating Iron and Herb 
 
 Jnloe. 
 
 Alcohol 
 
 by 
 volume. 
 
 Per cent. 
 16.16 
 45.00 
 19.60 
 42.14 
 32.70 
 35.65 
 34.13 
 20.32 
 2L14 
 20.67 
 16.35 
 19.84 
 19.96 
 2L50 
 
 25.62 
 44.62 
 20.34 
 37.03 
 42.14 
 19.45 
 27.32 
 20.44 
 18.82 
 27.44 
 35.90 
 24.77 
 16.55 
 42.65 
 
 10.75 
 31.09 
 30.15 
 23.86 
 29.04 
 19.64 
 15.82 
 26.30 
 2L67 
 28.84 
 39.83 
 33.70 
 18.30 
 15.89 
 27.92 
 27.10 
 
 18.74 
 
 23.01 
 
 16.94 
 22.96 
 9.18 
 32.10 
 28.87 
 16.96 
 18.35 
 26.10 
 39.95 
 
 13.28 
 
 23.81 
 
 Ginger Tonic 
 
 Ginseng Cordis 
 
 Glycerine Tonic (Elixir Pepsin) 
 
 Green's Chill Tonic 
 
 Greiner's Blackberry Cordial 
 
 Harrison's Quinine Tonic 
 
 Health Bitters 
 
 Herbton 
 
 Herbs Bitters 
 
 Jack Pot Laxative Bitter Tonic 
 
 Jarvis Blackberry Brandy 
 
 Jerome's Dandelion Stomach Bitters. 
 
 Jones' stomach Bitters 
 
 Juni-Kola 
 
 Juniper Kadney Cure 
 
 Karlsbader Stomach Bitters 
 
 Katamo 
 
 K.K.K 
 
 Kola and Celery Bitters 
 
 Kola Wine 
 
 Kreuzberger's Stomach Bitters 
 
 Kudros 
 
 Lee's Celebrated Stomach Bitters 
 
 Lemon Ginger 
 
 LaxaBark Tonic 
 
 Magen Bitters 
 
 MetaMulta 
 
 Mikado Wine Tonic 
 
 Milbum's Kola & Celery Bitters 
 
 Miod Honey Wine 
 
 Neuropin 
 
 Newton's Nutdtive Elixir 
 
 O' Hare's Bitters 
 
 ObermueUer's Bitters 
 
 Old Dr. Jacques Stomach Bitters 
 
 Old Dr. Scroggin's Bitters 
 
 Our Ginger Brandy 
 
 Ozark Stomach Bitters 
 
 Panama Bitters 
 
 Pepsin Stomach Bitters 
 
 Peptonic Stomach Bitters. 
 
 Pioneer Ginger Bitters 
 
 Quinquina Dubonnet 
 
 Rimsovo Malto-Sove Vino Chino 
 
 Rockandy Cough Cure 
 
 Royal Pepsin Tonic 
 
 Scheetz Bitter Cordial 
 
 Severa's Stomach Bitters 
 
 Sirena Tonic 
 
 Smart Weed 
 
 Smith' s B itters , 
 
 Steinkonig's Stomach Bitters 
 
 St. Raphael Quinquina 
 
 Strauss Exhilarator 
 
 Tatra(Latra) 
 
 Tolu Rock and Rye 
 
 True's Magnetic Cordial , 
 
 U-Go 
 
 Uncle Josh's Dyspepsia Cure 
 
 Warner's Stomach Bitters , 
 
 WestphaUa Stomach Bitters 
 
 White's Dyspepsia Remedy 
 
 William's Kidney Relief 
 
 Zeman's Medicinal Bitter Wine 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 247 
 
 The percentage of alcohol was ascertained from the Commissioner 
 of Internal Kevenue in a communication dated November 28, 1908.<* 
 
 On the whole the problem must be solved by educational methods, 
 and hygiene offers many valuable suggestions. It teaches that intem- 
 perance is a vice the result of a violation of natural laws, and in order 
 to eradicate the evil and far-reaching consequences we must endeavor 
 to remove the primary causes. Reference has been made to mental 
 and physical fatigue as an important predisposing factor. The indi- 
 cations are to regulate our life so that we do not burn the candle at 
 both ends, take more rest, more recreation, and more interest in gen- 
 teel amusements calculated to counteract the influence of saloons. 
 The eight-hour labor law is indicated in the interest of health and 
 morals. Quite a number of clear-headed employers appreciate their 
 responsibility in this matter and have appointed social secretaries, 
 " whose duty it is to watch not only over the health, comfort, and 
 happiness of the force during working hours, but also to obtain 
 sufficient knowledge of their private life to be a real help in times of 
 trouble. The secretary establishes luncheon rooms, rest rooms, mutual 
 aid associations, thrift funds, and penny provident banks. Besides 
 the usual betterment features the secretary also arranges many forms 
 of amusements, such as dances, lectures, and musicales. If this func- 
 tionary did nothing more than to teach working people how to en- 
 joy themselves in a sane, healthy way the work would be justified. 
 * * * The cardinal principle of the social secretary's gospel are 
 sanitation, recreation, and equalization." (Review of Reviews, 
 August, 1906.) 
 
 Hygiene long ago recognized that dust-producing occupations, ex- 
 posure to extremes of heat and cold, and to the inhalation of offensive 
 gases, etc., are fruitful causes of disease in general and the drink habit 
 in particular, and has also pointed out how the injurous effects may 
 be prevented or at least mitigated. Until this is accomplished by 
 universal factory sanitation, pure drinking water and nonalcoholic 
 beverages should be furnished by the employer. Indeed, efforts are 
 being made in Germany to limit in every reasonable way the con- 
 sumption of alcoholic beverages by the establishment of canteens in 
 industrial plants for the sale of coffee, tea, cocoa, milk, hot soups, 
 and soft drinks of every description, all of which allay thirst, while 
 many are stimulating without the injurious effects of alcohol. 
 
 In 1905 the breweries of Munich and other Bavarian cities stopped 
 the issue of free beer to employees, but allowed an extra compensation 
 of 25 cents a day for beer money. The consumption has been reduced 
 from an average of 6 quarts to If quarts for each employee a day. 
 
 Money spent in temperance saloons, especially for warm, whole- 
 some food and drinks, will be a good health investment, provided, of 
 course, they are consumed within reasonable limits. It may be stated 
 in general terms that while coffee, tea, coca, spices, and condiments 
 in moderation stimulate the central nervous system, and increase tem- 
 
 « Compiled from Circular No. 713, December 3, 1907, and No. 727. Circular 
 No. 713 contains the following paragraph : " It must be clearly understood, 
 however, that the list here given is not exclusive and does not purport to give 
 the names of all the preparations for the sale of which special tax is or may- 
 be required, but embraces only those which have been analyzed by this oflSce, 
 and held to be insufficiently medicated to render them unsuitable for use as a 
 beverage. * ♦ ♦>» 
 
248 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 porarily the elasticity of mind and body, their abuse is fraught with 
 danger, and we may have "coffee and tea topers" who suffer from 
 diseases of the nervous system. 
 
 One of the most effective weapons against intemperance will be 
 found in the thorough training of our girls in domestic science, 
 preferably in the public schools. Apart from the fact that the aver- 
 age expenditures for food are larger than for any other single item, 
 the question of well selected and properly cooked food and of " home 
 making " generally is of the utmost importance to the health and 
 morals of the community. No woman can aspire to higher accom- 
 plishments than to be a good cook ; and a true " housewife " can do 
 more for the physical and moral development of her family, and the 
 cause of temperance, than all the moralists combined. A thoughtful 
 mother, apart from seeing that her family is supplied with good 
 food, will also make the home attractive, inculcate aesthetic home 
 tastes, and, above all, a spirit of thrift and economy. The habit of 
 saving money can not be too strongly urged upon children, and 
 when once strongly rooted offers one of the best safeguards against 
 expenditures for immoral purposes. The beneficent effects of the 
 provident savings system are fully recognized by charity workers 
 and quite a number of American cities have introduced the stamp- 
 saving system into the public schools. 
 
 Much may be done for the cause of temperance and general sani- 
 tation by introducing the subject of hygiene as a part of the curricu- 
 lum in our schools and colleges, so that the children, the future 
 parents and citizens, may acquire accurate knowledge upon this and 
 other subjects in relation to health and disease. 
 
 Apart from educational methods we should bear in mind that man 
 is essentially a social animal and if he asks for bread we have no 
 right to offer him a stone. He needs opportunities for recreation to 
 vary the monotony and turmoil of life, and many a young man, with 
 the best of intentions, has found his way to saloons and places of 
 evil resort for lack of better opportunities. When we supply clean and 
 decent amusements we can indeed hope for a higher cultivation and 
 moral training of the male youth of all classes. The writer notes 
 with gratification that such an effort was made in 1902 by the estab- 
 lishment of the " Everett Clark Club House," the gift of Mrs. Potter, 
 wife of the Bishop of New York, and her son. Lieutenant Clark, 
 U. S. Army, to the members of Grace Episcopal Church, Elizabeth, 
 N. J. The special interest of this gift lies in the fact " that it is a 
 signal example of intelligent contribution to the needs of the whole 
 man — religious, physical, social, and aesthetic. Under one roof there 
 is a chapel, kitchen, restaurant, dining, reading, card, committee, 
 smoking, shuffle board, and billiard room, a swimming tank and other 
 baths, gymnasium, running track, and bowling alleys." (Outlook.) 
 
 Similar efforts have been made in connection with our local 
 churches, and it is to be hoped that the time is not far distant when 
 every church and school in the land will also become a social center. 
 
 The writer is familiar with the excellent results obtained in one of 
 the Boston churches, in cooperation with the medical profession, in 
 the cure of consumptive and nervous invalids. While not deprecat- 
 ing such efforts, it must be conceded that the most substantial and 
 permanent results will be achieved by preventive rather than curative 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 249 
 
 measures, which primarily involves the removal of the cause. So, 
 for example, every effort to diminish intemperance, the drug habit, 
 and sexual excesses will reduce the number of nervous, mental, and 
 moral wrecks. Likewise every effort to improve the housing condi- 
 tions and standards of living will diminish the number of con- 
 sumptives. 
 
 It is sincereljr hoped that the wage-earners of this country, in addi- 
 tion to cultivating home life and higher ideals, will hold their meet- 
 ings in buildings wholly divorced from saloons, along strictly ethical 
 lines, and in every way in keeping with the dignity of labor. There 
 is certainly room for special buildings dedicated to the improvement 
 of artisans and their industrial and social conditions. 
 
 RECREATION AND INEXPENSIVE AMUSEMENTS. 
 [By Mabel T. Boardman.] 
 
 That all people, from the lowest savages to the most civilized 
 races, crave recreation and amusement is a fact that is recognized by 
 all, but the importance of providing sane and wholesome entertain- 
 ment to satisfy this craving is too much overlooked in the case of the 
 least resourceful people. The playground system, boys' and girls' 
 clubs, and social settlement entertainments are fortunate movements 
 along this line as far as children are concerned, but too little has been 
 done to meet this same desire in the older generation. The habits 
 of intemperance and kindred vices are formed not in a man's working 
 but in his recreation hours. The saloon has been frequently called 
 " The poor man's club," and it is quite natural that a man's social 
 inclination should take him where he may find congenial company. 
 He desires the recreation of a chat with his fellow-men. His home 
 is too small, or too much occupied by his family, for him to gather 
 with them there. The factories, or the other places where he may 
 work, are closed, and where save in the saloon can he find the com- 
 panionship he desires ? He can not frequent a saloon without becom- 
 ing its patron, and while at first he seeks it merely for the sake of 
 social companionship, he may become its habitue for the sake of 
 drink. 
 
 It is unfortunate that in this country there exist so few places like 
 the beer gardens and halls of Germany, where a man can take his 
 family and at a very small expense listen to good music, gossip with 
 his friends, and spend a sane and wholesome evening. If only the 
 philanthropists of a city would build and partially endow some large 
 amusement hall, so constructed that in summer it could be turned into 
 an almost ©pen-air garden, where every evening a good orchestra 
 would provide popular music, or some unobjectionable vaudeville 
 performance be given, while the men could sit talking and smoking 
 around the tables, their families gathered about them, a great deal 
 could be accomplished in the way of keeping them from the tempta- 
 tions the saloon affords. Young men and women of the families 
 could have a respectable place in which to meet, and, with some over- 
 sight, arrangements might be made for part of the large hall to be 
 devoted to dancing. Soft drinks and beer could be sold. Men and 
 
250 REPORTS OF THE PRESIDENT'S HOMES COMMISSION". 
 
 women whose daily labor may be of a nature that requires little 
 mental work would find the daily task much lightened, for while 
 their hands are occupied with routine work their minds would be 
 filled with the memories of a pleasant yestereven or the anticipation 
 of another one to come. 
 
 The dreary and monotonous home lives of.^many of the women 
 would not only be lightened by the opening of such great halls during 
 the afternoon hours, but the opportunity on cold and rainy days in 
 winter, or on the hot days in summer, of keeping their children about 
 them in a physically and morally healthful atmosphere would prove 
 of great benefit. The influence of the mother over her children is far 
 greater than can be that of the father, whose work keeps him so much 
 occupied during the day, and anything that can help to improve and 
 better her existence can not fail to directly affect that of her children. 
 For a time taken out of the drudgery of her daily life amused and 
 entertained, much of the dull and tired feeling that often makes her 
 cross, nagging, and irritable will depart, and the home will become 
 a far happier place for the husband and children. 
 
 Educational departments have in many cities wisely provided pub- 
 lic lectures on a great variety of subjects, mainly of an educational 
 character, but human nature does not wish to devote all its hours of 
 recreation to improving its mental conditions. It desires relaxation ; 
 it wants to be amused. The children of the larger growth need their 
 play time, too, and it is to the satisfying of this craving on the part 
 of the least resourceful people that too little consideration has been 
 given. Of themselves they can provide little or nothing, and the 
 natural desire for amusement makes them too often the prey of the 
 saloon, the cheap sensational theater, or the morbid shows of the 
 penny-in-the-slot character. Thousands of boys and girls leave school 
 every year at the most formative period of their lives, and the nature 
 of the recreations and amusements they indulge in will have a lasting 
 influence and may properly be considered as having still to do with 
 their education in a broad sense. The enormous growth of the 5 
 and 10 cent theaters and their popularity in all of our large cities is 
 sufficient proof of the need of cheap amusements. When the enter- 
 tainments provided by them are sane and wholesome, even though 
 not of the most elevated nature, they should be encouraged, but cer- 
 tain powers of supervision over these places should lie m the hands 
 of some civic authority, possibly the board of education. 
 
 Public lectures of a popular nature, travel monologues with ster- 
 eopticon views, etc., should be provided by the educational depart- 
 ment of the city and the public schools used for this purpose in the 
 evenings. Doubtless volunteers for many such lectures could be 
 secured, so that with lecturers and places provided free of cost, the 
 expense need not be great. The parish halls, chapels, and Sunday 
 school buildings of churches might also be utilized for this purpose. 
 
 If the importance of healthful and wholesome amusement to gratify 
 this demand of human nature is recognized and provided for, there 
 is no doubt there would result a marked reduction of intemperance 
 among the least resourceful people and a general uplift in their 
 social condition. 
 
EEPOBTS OP THE PRESIDEKT S HOMES COMMISSION. 
 
 251 
 
 Chapter X. 
 
 THE DRUG HABIT. 
 
 The writer, as a member of a committee of the Medical and Surgical 
 Society of the District of Columbia, appointed in 1896 to investigate 
 the extent of the opium habit, had occasion to witness the physical 
 and moral impoverishment which results from the use of drugs which 
 enslave. 
 
 The report of the committee was published as Senate Document 
 No. 74, Fifty-fourth Congress, second session, and shows that during 
 the ten years ending June 30, 1895, 7 persons died from the opium 
 habit, 36 persons died from accidental or negligent opium poisoning, 
 and 36 committed suicide with opium or its preparations. Of the 
 accidental deaths 12 were under 5 years of age, while the remainder 
 were over 20 years of age. 
 
 The statistics have been extended by Dr. H. C. Macatee, and are 
 as follows: 
 
 
 1 
 
 B 
 
 a 
 
 1 
 
 Suicides from poison- 
 ing by- 
 
 Accidoi 
 fatal 
 
 tal or negligent 
 poisoning by — 
 
 
 
 Year. 
 
 Nar- 
 cotic 
 poisons. 
 
 Corro- 
 sive 
 poisons. 
 
 Miscel- 
 laneous, 
 includ- 
 ing car- 
 bolic 
 acid 
 and gas. 
 
 Nar- 
 cotic 
 poisons. 
 
 Corro- 
 sive 
 poisons. 
 
 Miscel- 
 laneous, 
 includ- 
 ing car- 
 bolic 
 acid 
 and gas. 
 
 Deaths 
 from 
 
 alcohol- 
 ism. 
 
 
 
 5^' 
 
 
 H. 
 
 o 
 
 i 
 
 
 i 
 
 .0 
 
 lO 
 
 I2 
 
 
 
 
 lO 
 
 6 "■ 
 
 ,0 
 
 1886 . 
 
 1 
 
 
 2 
 1 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 1887 
 
 
 
 
 
 2 
 
 
 
 
 
 .... 
 
 
 1888 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1889 
 
 2 
 1 
 2 
 
 
 1 
 5 
 3 
 6 
 4 
 5 
 9 
 7 
 4 
 4 
 2 
 3 
 9 
 
 
 
 
 
 
 1 
 1 
 1 
 3 
 5 
 9 
 3 
 4 
 4 
 5 
 6 
 4 
 9 
 
 s 
 
 1 
 
 d3 
 4 
 
 
 
 
 
 
 
 1890 
 
 
 
 
 
 
 
 
 
 
 
 
 1891 
 
 
 
 
 
 2 
 
 
 
 
 
 
 
 1892 
 
 
 
 
 
 
 
 
 
 ' * 
 
 
 1893 
 
 
 
 
 
 
 
 3 
 2 
 3 
 
 1 
 
 "2 
 1 
 
 di 
 
 
 
 
 
 
 
 1894 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1895 
 
 1 
 
 
 
 
 
 
 
 
 
 
 .... 
 
 
 1896 
 
 
 3 
 9 
 
 7 
 
 6 
 1 
 
 1 
 1 
 3 
 3 
 
 .... 
 
 .... 
 
 2 
 
 10 
 
 2 
 
 1 
 
 6 
 
 10 
 
 12 
 
 4 
 
 14 
 
 20 
 
 19 
 
 20 
 
 /SI 
 
 ""3' 
 1 
 1 
 
 ""i" 
 
 1 
 2 
 
 8 
 
 1 
 
 
 
 
 1897 ... 
 
 
 
 12 
 
 a3 
 
 1 
 
 3 
 
 blO 
 
 :::. 
 
 
 1898 
 
 
 
 
 1899 
 
 2 
 
 
 1 
 2 
 
 "2 
 
 .... 
 
 17 
 
 1900 
 
 21 
 
 1901 
 
 2 
 
 1 
 
 
 34 
 
 1902 
 
 15 
 
 1902 (July 1 to Dec. 31 ) 
 
 
 1 
 
 d6 
 d7 
 d4 
 1 
 d3 
 
 
 
 1 
 18 
 all 
 9 
 3 
 5 
 
 :::: 
 
 9 
 
 1903.. 
 
 3 
 
 
 
 
 
 23 
 
 22 
 
 1904 
 
 
 
 6 
 4 
 1 
 3 
 
 1905 
 
 
 
 1 
 
 
 24 
 
 1906 
 
 
 
 
 1 
 2 
 
 
 .... e-S 
 
 03 
 
 1907 
 
 
 
 2 
 
 im 
 
 32 
 
 
 
 
 
 Total 
 
 15 
 
 
 87 
 
 .... 
 
 40 
 
 
 151 
 
 23 70 
 
 9 
 
 8 
 
 24 
 
 76 
 
 ..... 
 
 287 
 
 
 
 
 
 That part of the table for the years ending June 30, 1886 to 1805, inclusive, 
 piled by Doctor Kober, and refers to opium only. 
 
 " One from cocaine. 
 
 '' One from paraldehyde. 
 
 ''One from quick pain killer (opium). 
 
 " Eleven from opium. 
 
 « One froffn chloralhydrate. 
 
 f Nineteen from gas. 
 
252 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 In addition there were treated during the same period in the four 
 hospitals of this city 125 cases of opium poisoning and 70 patients 
 for the opium habit. Doctor Macatee has continued this investigation 
 up to date and finds that during the last nine years 256 patients have 
 been treated for the opium habit in seven of our hospitals, and 62 
 patients for the cocaine habit in three of our hospitals. The report 
 of the committee referred to says: 
 
 Witliout a most exhaustive collective investigation it is impossible to even 
 estimate the number of persons treated by physicians for acute or chronic 
 opium poisoning who may recover from the immediate effects of the drug, or 
 who have died victims of the opium habit and in which the cause of death 
 may have been assigned to some remote pathological effects of the drug. 
 
 The investigation of the committee revealed, however, the fact 
 that " there are quite a large number of persons in this city who have 
 become the victims of the opium habit, and that the different prepa- 
 rations of the drug are used in the following manner: 
 
 1. The hypodermic injection of morphia. 
 
 2. The use of morphia by the mouth and rectum. 
 
 3. The use of alcoholic preparations of opium by the mouth. 
 
 4. The use of gum opium by the mouth (opium eating). 
 
 5. The use of the extract of opium by inhalation (opium smoking). 
 In regard to the actual extent of the morphine habit and the 
 
 amount consumed, either by the hypodermic method, by the mouth 
 or rectum, it is difficult to present any definite data, but, judging 
 from the statements of our pharmacists, there is scarcely one who 
 does not recall one or more victims to the drug, and, while many 
 refuse to sell morphia in unusual quantities, it is evident from their 
 sales, general observations, and calls for the drug, that the habit is 
 widespread ; some of the victims use as high as 1 dram of morphia 
 a day, one store alone selling about $100 worth of morphia a month. 
 
 Quite a large number of pharmacists report sales in unusual quan- 
 tities of the alcoholic preparations of opium, such as McMunn's 
 Elixir, laudanum, papine, Squibb's Mixture, and proprietary or 
 secret medicines containing opium, the demand for McMunn's Elixir 
 being especially active, while paregoric and Squibb's Mixture supply 
 the wants of many victims to the use of narcotics. 
 
 The use of gum opium (opium eating or chewing) is not so very 
 common. Nevertheless, a sufficient number of sales in suspicious 
 quantities reveals the existence of habitues to this form of the drug. 
 In regard to the use of the extract of opium by inhalation (opium 
 smoking) the data are quite meager. Pharmacists have occasional 
 calls for the extract, but are of the opinion that the bulk is supplied 
 by Chinese merchants. Dr. Wade H. Atkinson recently reported to 
 this society a fatal case from opium smoking in the person of a white 
 man aged 28. Doctor Atkinson, in presenting the case, says : 
 
 I know of about 20 in this city, and I have asked a few others who could most 
 probably estimate the number correctly. A popular drug clerk estimates the 
 smokers at 150. A very noted clerk in a lunch room who is well acquainted 
 with several smokers consulted with them and estimated the number at 500. 
 A special detective in the police department says he thinks there are not more 
 than 20 smokers, and only one "joint" here. Chinese are not considered in 
 these estimates. I believe a fair average of 150 or 200 habitual smokers are 
 in Washington, and know of two "joints." 
 
 Investigation into the causes of the opium habit leads to the con- 
 clusion that one class of subjects have contracted the habit by the 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 253 
 
 dse of the milder preparations of opium, such as McMunn's Elixir, 
 paregoric, Squibb's Mixture, and some of the various proprietary or 
 secret remedies usually employed as domestic remedies. 
 
 Another class have evidently acquired the habit by the constant 
 use of prescriptions containing opium or its preparations for the 
 relief of pain, the individuals being at first quite unconscious of the 
 enslaving nature of the drug. Competent and experienced phar- 
 macists are of the opinion that prescriptions containing opiates are 
 more frequently refilled than other prescriptions; that copies of such 
 prescriptions are frequently multiplied for friends, and that sup- 
 positories containing opiates are commonly renewed. 
 
 The social condition of the foregoing classes appears to be of a 
 mixed character, and includes all grades of society, the rich and 
 intellectual predominating. Another class of persons belong to the 
 moral degenerates, or fast men and women, who have acquired the 
 habit by contact with opium habitues and through solicitation, invita- 
 tion, and persuasion of fallen victims to the vice. In the opinion 
 of many prominent pharmacists the habit, from whatever cause, is 
 readily established, because opium and its preparations are altogether 
 too easily obtained. Before considering the question as to the extent 
 to which the State should exercise control in the interest of public 
 health over the sale of poisons reference should be made to the obli- 
 gations of the physicians in the matter. 
 
 There can be no successful concealment of the fact that the pro- 
 longed and indiscriminate use of opium and its preparations, espe- 
 cially in neurotic subjects, has been a most fruitful cause of morphin- 
 ism, and while inquiry reveals a decrease in the amount of morphia 
 prescribed by the physicians, there are still a goodly number of 
 so-called " morphine doctors " who have received this appellation by 
 pharmacists because they are in the habit of making it one of the 
 ingredients in nearly all of their prescriptions. 
 
 In view of the fact that prescriptions containing opiates are fre- 
 quently refilled and taken in increased and unauthorized quantities, 
 and may thus establish a habit, in the absence of legal restrictions all 
 physicians should endeavor to reduce the danger from morphinism 
 to a minimum by a judicious employment of the drug and careful 
 supervision of the patient. 
 
 While some pharmacists believe that the request of the physician 
 on the prescription " not to be renewed " would be generally respected, 
 others believe that the prescription, having been declared the personal 
 property of the patients, is subject to their orders only. It would 
 possibly be wise not to incorporate opium and its preparations in any 
 prescription, and when its use is indicated it might be dispensed by 
 the physician without the knowledge of the patient as to the nature 
 of the remedy. But perhaps the easiest way to solve the question 
 would be to follow the lead of the New York legislature, which, in 
 June, 1887, enacted a law that no pharmacist, druggist, apothecary, 
 or other person shall refill more than once prescriptions containing 
 opium or morphine, or preparations of either, in which the dose of 
 opium shall exceed one- fourth grain or morphine one-twentieth grain, 
 except with the verbal or written order of a physician. 
 
 The committee submitted drafts of two bills for consideration 
 which it was believed would go far toward preventing the spread of 
 
254 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 the opium habit, and also expressed the opinion that with regard to 
 the sale of proprietary and secret medicines containing poisonous 
 drugs the contents should be clearly expressed on the label, and the 
 word " poison " added, as required in the sale of poisons under ex- 
 isting acts. No action was taken for several years upon these recom- 
 mendations, which were clearly in the interest of public health and 
 morals. In the meantime the cocaine habit also assumed alarming 
 proportions, so that Major Sylvester, chief of the police, in his an- 
 nual report for 1904 (p. 27) called attention to the fact that ex- 
 amination of the poison register of one dealer's place alone disclosed 
 40 sales in one day. The goods having been put in properly labeled 
 envelopes, there was no violation of the law. In his report for 1905 
 (p. 36) he pointed out that parties have been apprehended for 
 peddling the drug from door to door, and that some worthy and 
 capable people have wrecked their own lives and made that of others 
 miserable. In each of his reports he urged appropriate legislative 
 action. 
 
 A new pharmacy law was finally enacted and approved May 7, 
 1906, which placed greater restrictions upon the sale of poisons in 
 general and the habit-forming drugs, such as opium, morphine, 
 cocaine, chloral in particular, and also made the filling of pre- 
 scriptions containing such drugs in certain doses, except upon the 
 written order of the signer of the original prescription, unlawful. 
 
 The chief of police, in his report for 1906, on page 23, says : 
 
 The cocaine habit and sale is the most diflScult to cope with, and the law 
 should be so complete as to prohibit other than licensed druggists, physicians, 
 dentists, or veterinarians having it in his or her possession except on a 
 physician's prescription, and then the package to bear the name of the physi- 
 cian and the patient for whom prescribed. 
 
 In the report for 1907 he states " that the sale of cocaine has been 
 largely reduced, but there are many who dispense the dtug under 
 cover." 
 
 Dr. Paul B. Johnson, in his investigation of 175 prisoners in the 
 Washington workhouse, found that 15 had intimate knowledge of 
 the use of cocaine. " Cocaine was described always as used by 
 sniffing the powder into the nostrils, either from the package, or from 
 the palm of the hand, or from the fingers like snuff, or most often by 
 dipping a short quill into the powder and placing the other end to 
 the nostril. It was stated as easily purchased in drug stores or in 
 the rear of barrooms." Dr. Lyman F. Kebler, Chief of the Division 
 of Drugs of the Bureau of Chemistry, United States Department of 
 Agriculture, in a recent paper on the " dope question," refers 
 to the cocaine habitue as socially inclined, offering a friend a 
 "sniff." * * * In fact, whole circles assemble to enjoy a cocaine 
 spree, where the dope, commonly known as " coke," is passed from 
 one to another to take an allotted sniff. In speaking of the effects, 
 Doctor Kebler states that "cocaine in some cases transforms other- 
 wise safe and tractable citizens into dangerous characters, and in 
 most instances wrecks the individual and all depending on him, as 
 well as jeopardizes the lives of many." 
 
 Major Sylvester, in a letter dated December 6, 1908, writes as 
 follows : 
 
 Investigation shows that there were about a half dozen druggists making a 
 specialtv of the sale of cocaine and other drugs, and a dozen or more selling 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 255 
 
 such to a few customers; the other druggists in the District would not make 
 such sales except to persons whom they had reason to believe would use the 
 same for legitimate purposes, and some of them would not handle it at all. 
 
 Upon the passage of the present pharmacy law, such sales were stopped by 
 druggists, except a limited number who continue the sale to customers upon 
 whom they could rely not to betray them, and who were actuated by sympathy 
 rather than other motives; three or four others continued the sale, only to be 
 apprehended and fined. 
 
 The member of the force detailed as inspector of pharmacy has had occasion 
 to bring to court three physicians for writing prescriptions for morphine and 
 cocaine, all of which were aggravated cases, and he has given notice to others 
 not to indulge in the practice. 
 
 The department, in this work, has had the cordial cooperation of physicians 
 generally, and finds that in their opinion the drug habit, especially morphine, 
 is due largely to the injudicious prescribing of drugs, and it has evidenced an 
 inclination on the part of physicians to curtail the use of them. 
 
 In the course of his investigation the inspector found that morphine fiends, 
 with two exceptions, had become addicted to the use of the drug through sick- 
 ness or injury; one of those excepted stated he formed the habit through no 
 other cause than that of the lowest depravity, while the other stated he became 
 addicted to its use through having it prescribed by a physician after getting 
 over a long spree. 
 
 I am informed that there are one or two physicians who have a few patients 
 whom they feel in duty bound to supply with the drug. 
 
 It is believed that if the law could be made stringent enough to put the sale 
 of morphine beyond the reach of such persons, after they had been treated 
 under confinement, they would make useful citizens. 
 
 The morphine, laudanum, and kindred drug users, according to the observation 
 of the inspector of this department, have been greatly reduced in number 
 through the efforts of the medical profession. 
 
 The habit of opium smoking has never become serious in this city; it was 
 slightly increased with the passage of the pharmacy law, as the drug is easier 
 to get from Chinamen, who are hard to detect. It is confined principally to 
 degraded persons, both white and black, who are beyond reformation. Arrests 
 are made by the police and penalties imposed upon the Chinese engaged in the 
 traffic. I think if the penalties inflicted were a little more severe the effect 
 would be more ample. 
 
 The inspector states that in the course of his investigation he has learned 
 of no foreign white people who are addicted to the drug habit. He finds that 
 the cocaine habit is by far the greatest menace to society, because the victims 
 are generally vicious. The use of this drug superinduces jealousy and pre- 
 disposes to commit criminal acts. In districts where druggists formerly dis- 
 pensed cocaine disorder has decreased so noticeably that it is commented upon 
 by the neighbors and the police officers on the beats ; it has also had the effect 
 that a large percentage of persons using cocaine will not make an effort to get 
 it when it is accompanied by the risk of arrest. 
 
 The present source of supply is mainly through druggists who are not now 
 in the business, and clerks who are employed at drug stores, who, it is believed, 
 deliver it to persons to peddle when they can find anyone who will purchase. 
 Others procure it from the near-by suburban towns, localities without this 
 jurisdiction. 
 
 It is quite a difficult matter to convict these people, as possession of the drug 
 is not held to be sufficient evidence. In Virginia possession is held to be evi- 
 dence of intent to sell, and is punishable by not less than one nor more than 
 five years in jail. Under the present law there is no distinction between a clerk 
 and a proprietor ; if a person is registered he can purchase any amount. No 
 person other than a druggist should have the privilege of handling cocaine. 
 
 It is believed that there are about a dozen persons who peddle cocaine from 
 time to time, and those who use it are numbered approximately by the in- 
 spector's report at about 100. The number of persons who use morphine can 
 not be approximated, as they are distributed throughout all classes of society. 
 Many who use the drug are not known as such habitues outside of their own 
 homes. There have been a number of peddlers or writers of bogus prescrip- 
 tions arrested and fined from $50 to $200, or sent to jail. My information is 
 that the sale of cocaine is about one-tenth of what it was before the present 
 law went into effect. ♦ * * 
 
256 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 MEDICINAL PREPARATIONS WHICH CONTAIN HABIT-FORMING DRUGS. 
 
 Doctor Kebler says: 
 
 There are upon the market many medical preparations which contain as 
 ingredients habit-forming drugs. Such drugs are alcohol, opium and its deriva- 
 tives, notably morphine, codeine, and heroin; cocaine, chloral, Cannahis indica, 
 acetanilid, etc. 
 
 The presence of most of the habit-forming drugs, under the pro- 
 visions of the pure food and drugs act, must now be declared upon 
 the label of drug products, and the public is thus made aware to 
 some extent of the nature of preparations containing these agents. 
 The drug products which contain opium and it derivatives most fre- 
 quently are the painkillers, cough and consumption cures, and sooth- 
 ing sirups. 
 
 Below is given a list of some of the medicinal preparations which 
 contain habit-forming drugs other than alcohol: 
 
 Coco-Bola (cocaine). Dr. Seth Arnold's Cough Killer 
 
 Godfrey's Cordial (opium). (morphine). 
 
 Harrison's Opium Elixir (opium). Piso's Cure (CannaMs indica). 
 
 Wright's Instant Relief (opium). Boschee's German Syrup (morphine). 
 
 Grossman's Specific Mixture (opium). Shiloh's Cure (heroin). 
 
 Petit's Eye Salve (morphine). Tubercine (opium). 
 
 P>rou's Injection (morphine). Hooper's Anodyne; the Infant's 
 
 Carney Common Sense Cure (morph- Friend (morphine). 
 
 ine). Pierce's Smart Weed (opium). 
 
 Habitina (morphine). Colwell's Egyptian Oil (opium). 
 
 Anglo-American Catarrh Powder; Ag- Maguire's Compound Extract Benne 
 
 new's Powder (cocaine). (morphine). 
 
 Captol (chloral). Dr. Fahrney's Teething Syrup (morph- 
 
 Gowan's Pneumonia Cure (opium). ine). 
 
 Dr. James' Soothing Syrup (heroin). Jayne's Expectorant (opium). 
 
 Mrs. Winslow's Soothing Syrup Taylor's Sweet Gum and Mullein Com- 
 
 ( morphine). pound (morphine). 
 
 Children's Comfort (morphine). Victor Lung Syrup (opium). 
 
 D. D. D. Remedy (chloral). Dr. Moffett's Teethina; Teething 
 
 Mexican Oil (opium). Powders (opium). 
 
 One Day Cough Cure (morphine, Caji- Tucker's Asthma Cure (cocaine). 
 
 naMs indica). Rexal Cholera Cure (opium). 
 
 Tousley's Sneezel ess Snuff (morphine). Fruit-Lax (morphine). 
 Watkin's Anodyne (heroin). 
 Dr. Drake's German Croup Remedy 
 
 (opium). 
 
 DANGER OF SOFT DRINKS CONTAINING HABIT-FORMING DRUGS. 
 
 In this connection attention is directed to the danger of soft drinks 
 containing caffeine, extract of kola nut, and extract of coca leaf, the 
 active principle of the two latter being cocaine. According to Doctor 
 Kebler, see Appendix, there are now nearly one hundred different 
 medicated soft drinks on the market. 
 
 These beverages are extensively advertised, some, in fact, as head- 
 ache remedies and nerve tonics, and sold at nearly every soda-water 
 fountain or as carbonated goods in all parts of the country without 
 the slightest warning to the public of the harmful ingredients con- 
 tained therein. We restrict the use of coffee and tea in children 
 and delicate nervous individuals, and yet these same persons fre- 
 quent the soda fountains, regale themselves with soft drinks, quite 
 unconscious of their contents, experience the stimulating and re- 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 257 
 
 freshing effects and soon fall victims to the habit, so that even " Coca 
 Cola fiends " have come into prominence. We have seen how the 
 opium habit may be acquired by the use of the various proprietary 
 or secret preparations (pain killers), usually employed as domestic 
 remedies, and so the cocaine habit may be developed by the use of 
 these much-lauded soft drinks. 
 
 It is a significant fact that Mr. Vanzant, the special police officer 
 charged with the execution of the pharmacy law, with the exception 
 of the Chinese opium fiends, has never encountered other foreigners 
 who are addicted to the drug habit. This may be accounted for by 
 the fact that nowhere is the habit of self-medication with secret or 
 proprietary medicines for each and every ailment so widespread as 
 in this country. No wonder that insanity and diseases of the nervous 
 system are on the increase, and that the physical, moral, and mental 
 wrecks of the alcohol and drug habit continue to swell the number 
 of dependents in hospitals, insane asylums and other public insti- 
 tutions. 
 
 From a careful analysis of the evidence it is apparent that the sale 
 of habit-forming drugs is still carried on through the instrumentality 
 of (1) unscrupulous local dealers, (2) depraved and unscrupulous 
 local physicians, and (3) through dealers, physicians, agents, and 
 peddlers located in other jurisdictions. 
 
 The writer has reached the conclusion that Major Sylvester's pro- 
 posed amendment to the present law will not prove effective unless 
 a law is enacted permitting the revocation of a license to physicians, 
 dentists, and veterinarians whenever, in the judgment of the court, 
 such persons are abusing the privilege of prescribing these drugs. A 
 law should likewise be enacted regulating the transportation of habit- 
 forming and poisonous drugs in interstate and foreign commerce, as 
 contemplated by House Res. 21982, introduced by Mr. Mann, May 
 12, 1908. 
 
 REMEDIAL MEASURES FOR THE VICTIMS OF THE ALCOHOL AND DRUG HABIT. 
 
 The reports of the chief of police show that during the five years' 
 period ended June 30, 1908, there were 27,985 arrests for intoxication 
 in the District of Columbia, an average of 5,596 per annum. Of 
 these, 18,075 were arrests for simple intoxication, and 8,288 arrests 
 for intoxication and disorderly conduct. There being no law against 
 simple intoxication, those detained for this cause are released by the 
 police after they have sobered up. Such cases are taken up as ob- 
 structions and for their own security and welfare, and of these 18,075 
 cases no doubt " many were saved from injury, robbery, and sickness, 
 if not from death." In spite of precautions taken by the police, a 
 number of deaths from acute alcohol poisoning have occurred in 
 police cells, indicating the necessity of greater discrimination in the 
 care and treatment of such cases. 
 
 There were 1,622 arrests, an average of 324 per annum, on the 
 charge of habitual drunkenness, and these, together with those 
 charged with disorderly conduct, are held for the court, and many 
 find their way into the workhouse or jail. It is lamentable that 15 
 of the 675 arrests of persons under the age of 21 years were arrested 
 as " habitual drunkards." 
 
 S. Doc. 644, 60-2 ^18 
 
258 
 
 REPOKTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 Nwnl)er of arrests in the District of Columbia for intoxication, and intoxica- 
 tion coupled with disorderly conduct, for the five years ended June SO, 1908. 
 
 
 Under 21 years of age. 
 
 Over 21 years of age. 
 
 
 Male. 
 
 Female. 
 
 Wkite. 
 
 Colored. 
 
 Male. 
 
 Female. 
 
 White. 
 
 Colored. 
 
 1904. 
 
 
 
 
 
 
 
 
 
 
 2 
 
 60 
 60 
 
 
 2 
 
 45 
 17 
 
 
 214 
 2,978 
 1,531 
 
 12 
 150 
 201 
 
 188 
 
 2,457 
 
 945 
 
 38 
 
 Intoxication 
 
 4 
 20 
 
 19 
 63 
 
 671 
 
 Intoxication and disorderly 
 
 787 
 
 1906. 
 
 
 
 
 
 
 
 
 
 Habitual drunkard ...... 
 
 3 
 
 69 
 69 
 
 
 2 
 
 47 
 29 
 
 1 
 16 
 56 
 
 261 
 3,265 
 1,469 
 
 13 
 
 206 
 198 
 
 211 
 
 2,674 
 
 986 
 
 63 
 
 
 4 
 
 16 
 
 797 
 
 Intoxication and disorderly 
 
 681 
 
 1906. 
 
 
 
 
 
 
 
 
 
 Fahltnn.1 d"iTiVftTd , , ^ 
 
 1 
 
 65 
 
 44 
 
 
 1 
 
 37 
 20 
 
 
 272 
 3.529 
 1,518 
 
 18 
 241 
 236 
 
 227 
 
 2,883 
 
 976 
 
 63 
 
 Intoxication . ... 
 
 9 
 19 
 
 27 
 43 
 
 887 
 
 Intoxication and disorderly 
 
 778 
 
 1907. 
 
 
 
 
 
 
 
 
 
 Habitual drunkard 
 
 4 
 
 50 
 51 
 
 
 2 
 
 27 
 27 
 
 2 
 
 31 
 49 
 
 413 
 3,521 
 1,246 
 
 25 
 
 236 
 182 
 
 341 
 
 2,870 
 692 
 
 97 
 
 Intoxication 
 
 8 
 25 
 
 887 
 
 Intoxication and disorderly 
 
 736 
 
 1908. 
 
 
 
 
 
 
 
 
 
 Habitual drunkard 
 
 Intoxication 
 
 4 
 
 50 
 36 
 
 1 
 
 4 
 18 
 
 S 
 
 29 
 17 
 
 2 
 
 25 
 36 
 
 340 
 3,395 
 1,215 
 
 S9 
 
 251 
 135 
 
 278 
 
 2,775 
 684 
 
 106 
 
 871 
 
 Intoxication and disorderly 
 
 666 
 
 
 647 
 
 128 
 
 305 
 
 370 
 
 25,167 
 
 2,143 
 
 19, 182 
 
 8,128 
 
 Doctor Macatee's investigation shows that during the past nine 
 years 9,510 patients were treated in the hospitals of the city of 
 Washington for alcoholism; 409 for delirium tremens; 256 for the 
 opium habit, and 61 for the cocaine habit; the majority of these were 
 treated at public expense. 
 
 All investigation of the records of the Board of Charities reveals 
 the fact that the daily average number of insane chargeable to the 
 District of Columbia has increased from 1,035 in 1901 to 1,317 in 
 1908. The board, recognizing that the alcohol and drug habit are 
 two of the best known causes of insanity, in 1907 made provisions, in 
 connection with the old almshouse building, for the cure and treat- 
 ment of such habitues among the dependent classes. A bill intro- 
 duced by Senator Gallinger, April 6, 1908, is now pending before 
 Congress, making habitual drunkenness, the habitual use of opium 
 or other narcotic drugs a misdemeanor, punishable by a fine or incar- 
 ceration in the hospital for inebriates for not longer than two years. 
 The act contemplates a rational care and treatment for the cure of 
 the habit, which is best secured by a good dietetic and hygienic 
 regimen, followed by some useful occupation as soon as the patients 
 are able to work, so as to make them self-supporting during the 
 period of abstinence and restraint. The former system of confining 
 such persons in the workhouse and jail is cruel and wholly ineffective. 
 
 The crying need for compulsory restraint has been pointed out by 
 the chief of police over and over again, and the appeal for humane 
 and scientific treatment of husbands, fathers, brothers, and wives is 
 
"RBPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 259 
 
 not of recent date. As a matter of f act,<* Congress, in an act approved 
 March 30, 1876, known as "An act to incorporate the Washington 
 City Inebriate Asyhim in the District of Columbia," approved the 
 principle of compulsory restraint and treatment of inebriates. This 
 act provided for the organization of a private institution authorized 
 to receive both free and pay patients, and provided for commitment 
 by court to said institution. * * * Apparently the incorporators 
 never organized the institution as authorized in the act. 
 
 ADVERTISED HABIT CURES. 
 
 It is high time that some rational method for the permanent recla- 
 mation of these unfortunate victims be adopted in this and other 
 communities. As it is now, the rich and poor alike fall an easy prey 
 to advertising charlatans, who profess to cure the drug and alcohol 
 habit, when as a matter of fact these so-called drug cures merely ag- 
 gravate the habit and never cure it, and in the case of the alcohol 
 cures, the patients' stomach and digestion are often permanently in- 
 jured and no real good is accomplished. Mr. Samuel Hopkins Ad- 
 ams, in Collier's Weekly, September 22, 1906, published a list of 
 16 advertised cures for the opium habit when in each case the remedy 
 contained morphine, and says: 
 
 The whole purpose is to substitute for the slavery to the drug purchased at 
 the corner pharmacist, the slavery to the same drug disguised, purchased at 
 a much larger price from the " doctor " or " institute " or " society." It was 
 hoped that with the enactment of the pure-food law, which requires that the 
 amount of habit-forming drug in any medicine be stated on the label, such 
 nefarious practices would cease. Imagine my surprise at the audacity of a 
 firm, when shown . by Doctor Kebler a preparation known as " Habitina," 
 recommended as a cure for all drug addictions, etc., when the label disclosed 
 the fact that 1 ounce of the solution contains 24 grains of morphine. 
 
 Mr. Adams mentions a remedy procured from the Rev. W. N. 
 Richie, D. D., 156 Fifth avenue. New York, which contained 2.12 
 grains of crystallized morphine per dose; the ordinary dose for 
 medicinal purposes is from one-eighth to one- fourth of a grain. No 
 wonder this courageous writer speaks of the opium, morphine, and 
 cocaine cure quacks as the "wreckers who lure their victims to de- 
 struction by false signals." Nor are we surprised that one of these 
 victims wrote to Mr. Adams : 
 
 When I tried to stop the remedy I found I could not and It was worse than 
 the morphine itself. I then went back to plain morphine, but found that I re- 
 quired twice as much as before I took the cure. That is what the morphine 
 cure did for me. 
 
 In the appendix will be found Doctor Kebler's list of 52 alleged 
 cures for drug and liquor habits. As an analytical chemist, he con- 
 firms the belief, long since held by the profession, that the drug cures 
 in almost every instance contain a generous proportion of an opiate 
 and most of the nostrums for the cure of the liquor habit contain some 
 nauseating ingredients or slow emetics. The object of the latter 
 treatment is in most cases to make the victim's stomach so sensitive 
 that it will instantly reject anything of an irritating nature like 
 alcohol. It will be readily conceded that such treatment is of no 
 
 « Extract from letter of the Board of Charities to the CJommlflsionerB, February 
 4, 1908. 
 
260 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 real value and is likely to produce permanent injury of the stomach 
 and digestive functions. Mr. Adams's comments in Collier's Weekly 
 on this subject are very much to the point. "The Sunday news- 
 papers and small weeklies teem with advertisements of drink cures 
 which are supposed to exorcise the alcoholic craving when secretly 
 given in the tea or coffee. Few of these concoctions can be described 
 as immediately dangerous, though none of them is really safe. All are 
 swindles. They do not cure the drink habit. Once in a while some 
 drunkard will succeed in breaking his fetters synchronously with 
 the taking of the ' remedy,' and the wcmderful ' cure ' is heralded 
 to the world. But the percentage of these cures is so small as to be 
 practically negligible. * * * Speaking of the safe rule to follow 
 in the cure for the drug and alcohol habit, he says : 
 
 Reputable sanitariums there are in plenty for this purpose; most physicians 
 know of them. The addict who can not be cured in them can not be cured any- 
 where, and might better buy his poison at the regular rate than at a fancy 
 price from the vicious quacks of the advertising school. 
 
 THE HARMFUL EFFECTS OF SO-CALLED ETHICAL PROPRIETARY MEDICINES, 
 ACETANILID, ANTIPYRIN, AND PHENACETIN. 
 
 HEADACHE REMEDIES, ETC. 
 
 Before considering the nostrum evil in general, attention should be 
 invited to Doctor Kebler's excellent unpublished article on the harm- 
 ful effects of the above remedies when employed promiscuously and 
 without medical supervision. For the purpose of this paper it is 
 simply necessary to state that these preparations were used at one 
 time rather extensively by physicians for the reduction of tempera- 
 ture in fevers and for the relief of pain, especially in neuralgia and 
 headaches. The profession, however, soon learned that the adminis- 
 tration of these drugs was attended quite frequently with profound 
 symptoms of depression and other untoward effects, and this, together 
 with a number of fatalities incident to their use, resulted in a gradual 
 but not complete discontinuance of the drugs. In the meantime, how- 
 ever, the pain-relieving properties of these drugs became known to the 
 laity, and they are extensively used in their original form for the 
 relief of headache and other pains, or as ingredients of many adver- 
 tised cures for headaches, etc. 
 
 According to Doctor Kebler, there are approximately 365 headache 
 remedies now on the market, and the list is by no means complete; 
 about one-half of these have so far been examined by the Bureau of 
 Chemistry under the pure food and drugs act. (See Appendix.) 
 Among these is the remedy known as Harper^s " Curf orheadake Brain 
 Fude," which acquired recently notoriety in the local courts, and 
 which, according to the Bureau of Chemistry, contained, among other 
 ingredients, acetanilid and antipyrin. In regard to the ridiculous 
 claim that such preparations act as food for the nerves or brain, the 
 judge in the case just referred to, in his charge to the jury, said : 
 
 If that word " brain food," spelled in the two different ways that it is spelled, 
 would convey to the ordinary citizen the idea that it was a food for the brain 
 as contradistinguished from the idea of a food for the whole body, then it is — 
 and I so charge you in this first prayer — misleading and therefore a violation 
 of the law. 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 261 
 
 The Department of Agriculture has carried on a very exhaustive 
 investigation into the poisonous properties of these drugs for the very 
 laudable purpose of sounding a note of warning as to the injurious 
 and even fatal effects which may follow their ill-advised, prolonged, 
 or habitual use. The following table shows the number of instances 
 in which poisoning, death, or habitual use has been known to result: 
 
 Total numher of cases. 
 
 
 Poison- 
 ing. 
 
 Death. 
 
 Habitual 
 use. 
 
 Acetanilid 
 
 909 
 592 
 161 
 
 31 
 
 15 
 
 8 
 
 144 
 
 
 7 
 
 Acetphenetidin (phenacetin) 
 
 18 
 
 
 
 Total 
 
 1,665 
 
 64 
 
 169 
 
 
 
 Of this total number, 852 were found in medical literature and 813 
 were reported by 400 of the 925 physicians to whom letters of inquiry 
 had been directed by the department. Doctor Kebler says : 
 
 Granting that the 525 physicians who did not reply had no cases to report, 
 the question may be profitably asked — if 925 physicians have observed 813 cases 
 of poisoning by these drugs, 28 deaths which were attributed to their use, and 
 136 instances of habitual use, how many such cases have in all probability been 
 observed by the 125,000 physicians scattered throughout the United States? 
 
 THYROID EXTRACTS IN OBESITY OR ANTIFAT CUKES. 
 
 Doctor Kebler," and more recently Drs. Reid Hunt and A. Seidell,^ 
 of the Hygienic Laboratory of the Public Health and Marine- 
 Hospital Service, have called attention to the frequency with which 
 thyroid preparations are being used in the antifat nostrums. As in 
 the case of the remedies just discussed, so, with thyroid extracts, 
 have physicians become extremely cautious in their employment. 
 These preparations were primarily used for the cure of goitre, and, 
 while they produced a marked reduction in the size of the tumor, it 
 was also found that they caused a marked loss in bodily weight, 
 amounting in some instances from 2 to 11 pounds a week, all of 
 which naturally suggested their employment for the reduction of 
 obesity. But the careful observer soon found that these results were 
 not without serious risks to the general health, and practically 
 abandoned the remedy except in some well-selected cases. The manu- 
 facturer of proprietary remedies seized, however, very promptly 
 upon the opportunity to incorporate what must be considered dan- 
 gerous remedies with other ingredients, and offered them as " Obes- 
 ity Food," "Rengo Fruit," " Kellogg's Obesity Food," "Arbolum 
 Mixture," " Marmola," with the usual assurances of being scientific 
 and effective preparations for the reduction of fat. Since thyroid 
 extract is characterized by Dr. Reid Hunt as " the most powerful 
 tissue-destroying drug known," the effects upon the unfortunate vic- 
 tims of misplaced confidence can be imagined. The employment of 
 these agents for this purpose is, however, of such recent date that no 
 
 • " Journal A. M. A.,** November 10, 1906. 
 » ** Journal A. M. A.." October 24, 1908. 
 
262 
 
 fatalities have been reported. We know, however, that several fatal 
 cases were reported when employed under the supervision of com- 
 petent physicians, and, in November, 1906, in an editorial in the 
 "Journal of the American Medical Association," the danger of 
 " organotherapy " in producing arterial degeneration was pointed 
 out, as well as the necessity of being " careful in the application of 
 such remedies, and especially not to hand over the employment of 
 them too freely to the public under such circumstances that they will 
 be used over prolonged periods without proper safeguards and the 
 careful observation of a trained medical mind." 
 
 THE NOSTRUM EVIL IN GENERAL." 
 
 Our sociological study of 1,217 families in this city shows that 
 they expended $2,032.39 per annum for patent or proprietary medi- 
 cines. The annual expenditure in the United States has been esti- 
 mated to be not less than $62,000,000. The far-reaching consequences 
 of this traffic, which impoverishes the health and depletes the pocket- 
 book of a large class of persons, has been made, in a fearless and most 
 commendable manner, the subject of popular education, notably by 
 the Ladies Home Journal, Collier's Weekly, the Journal of the Amer- 
 ican Medical Association, Pharmaceutical Journal, and by Prof. 
 Harvey W. Wiley and his associate. Dr. Lyman F. Kebler, of the 
 Bureau of Chemistry, United States Department of Agriculture. 
 
 The writer has long since taken a keen interest in the subject be- 
 cause as a sanitarian he felt convinced that the harmful effects of 
 this nefarious business upon the health and general welfare of the 
 community have never been sufficiently emphasized, even by the 
 medical profession. The American Medical Association adopted 
 the following principles over fifty years ago : " It is equally deroga- 
 tory to professional character for physicians to hold patents for any 
 surgical instruments or medicines; to accept rebates on prescriptions 
 or surgical appliances; to assist unqualified persons to evade legal 
 restrictions governing the practice of medicine, or to dispense or pro- 
 mote the use of secret medicines, for if such nostrums are of real 
 efficacy, any concealment regarding them is inconsistent with benefi- 
 ■ cence and professional liberality ; and if mystery alone can give them 
 public notoriety, such craft implies either disgraceful ignorance or 
 fraudulent avarice. It is highly reprehensible for physicians to give 
 certificates attesting the efficacy of secret medicines or other sub- 
 stances used therapeutically." 
 
 No effective work in the propaganda for reform in proprietary 
 medicines was done, however, until the creation of the Council on 
 Pharmacy and Chemistry in the American Medical Association in 
 February, 1905. This council has rendered, and will continue to 
 render, most meritorious services to the cause of humanity. To show 
 the enormity of the traffic and corresponding dangers, the following 
 statement (the data to December 31, 1900, having been originally 
 collected for my " Oration on State Medicine," delivered before the 
 American Medical Association June 8, 1901), is herewith presented: 
 
 •The author is indebted to Dr. M. Q. Motter for valuable references to the 
 literature of the subject 
 
EEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 263 
 
 Patents issued hy the United States Patent Office, 
 
 
 To Dec. 
 31, 1900. 
 
 From Jan. 
 
 1, 1901, to 
 
 Oct. 31, 
 
 1908. 
 
 Disinfectants . . 
 
 321 
 250 
 
 48 
 180 
 376 
 
 56 
 371 
 
 78 
 
 
 9(V> 
 
 Extracts 
 
 65 
 
 Hair dyes and tonics 
 
 7 
 
 Insecticides. . 
 
 64 
 
 
 58 
 
 Plaster 
 
 19 
 
 Topical remedies 
 
 35 
 
 Veterinarv 
 
 10 
 
 
 
 Total 
 
 1,680 
 
 
 460 
 
 
 
 Trade-marks issued: 
 
 Drugs and chemicals 
 
 319 
 5,974 
 
 
 Medical compounds 
 
 
 
 
 Under date of November 17, 1908, the Commissioner of Patents in- 
 forms me that trade-marks have been reclassified, and since January 
 1, 1901, there have been issued in subclass No. 6, chemicals, medicines, 
 and pharmaceutical preparations, approximately 2,105 trade-marks. 
 This means that up to October 31, 1908, the office has issued 2,140 
 patents and 8,398 trade-marks on drugs, chemicals, and medical com- 
 pounds. 
 
 By the term patent medicine, as properly employed, it must be un- 
 derstood that the composition is known and can be seen at the Patent 
 Office. The proprietary medicine is a secret preparation protected 
 by a trade-mark and hence preferred by the owner, but both are 
 vaguely termed by the public patent medicines. 
 
 The proprietary medicines are subject to the control of the state 
 authorities and, if containing alcohol in sufficient quantity to be in- 
 toxicants, are subject to internal-revenue laws. But up- to the enact- 
 ment of the pure food and drugs law, June 30, 1906, nothing was done 
 to control the sale of secret remedies and medicinal preparations con- 
 taining habit- forming drugs, the composition of which need not even 
 be disclosed to the Patent Office. 
 
 Fortunately, section 8 of the act referred to provides that an article 
 shall be deemed to be misbranded * * * if the package fails to 
 bear a statement on the label of the quantity or proportion of any al- 
 cohol, morphine, opium, cocaine, heroin, alpha or beta eucaine, chloro- 
 form, cannabis indica, chloral hydrate or acetanilid or any derivative 
 or preparation of any such substances contained therein. In conse- 
 quence of this very wise provision of the law we are now enabled to 
 estimate the enormity of the harm which must inevitably result from 
 promiscuous use of such preparations. 
 
 A most excellent report on " secret drugs, cures and foods " was 
 presented by Special Commissioner Octavius C. Beale to the Parlia- 
 ment of the Commonwealth of Australia, August 8, 1907, in which he 
 discusses the subject under six headings, viz : Prevention of concep- 
 tion and feticide; (2) infanticide and infantile mortality; (3) injury 
 and death to the adolescent; (4) injury and death to adults; (5) ad- 
 vertisements; (6) legislation. In view of the importance of the sub- 
 ject, it is deemed desirable to present here a brief summary of the 
 
264 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 most important facts collected by this painstaking investigator, not 
 only in Australia, but also in the United States, Canada, Great Brit- 
 ain, Germany, and France. 
 
 PREVENTION OF CONCEPTION AND FETICIDE REGULATION OF FAMILIES. 
 
 In this section Commissioner Beale writes : 
 
 The practice of interference with the sexual function is so common and the 
 knowledge of it so universal that it would be thinnest hypocrisy upon the part 
 of any grown person to pretend that modesty may be shocked at considering 
 its causes and consequences. The disastrous effects upon men and women are 
 set forth in plain and decent language in the report of the New South Wales 
 royal commission upon the decline in birth rate and upon mortality of children, 
 which it would be well to reproduce by another inquiry over a wider sphere, 
 or indeed merely to reprint for broadest distribution. Just because deception 
 and falsehood are widespread there is occasion to confront them by candid 
 truth. * * * Before me is a co])y of the second volume. * * * There, 
 upon page after page, are photographs of the advertisements of obscene crea- 
 tures who corrupt society at its core and live like larvae upon their own poison 
 and the corruption it causes. The announcements appear to-day just as before, 
 only more of them. To debauch and degrade humanity is a profitable trade. 
 On those pages are also photographs of numbers of preparations to prevent 
 births, of contrivances toward obscene practices. * * * There is only one 
 remedy — morality by act of Parliament, enforced by severe penalties. * * ♦ 
 No attempt will be made to give a comprehensive statement of the means 
 adopted to induce miscarriage. The unnatural practice is assisted by the free 
 sale of drugs, often at exorbitant prices, under proprietary names. These are 
 openly advertised in Anglo-Saxon countries, which differ therein from one 
 another only in degree, the names and descriptions of the drugs being well 
 understood by dealers and users. 
 
 In order amply to elucidate the subject of criminal abortion by 
 drugs Mr. Beale quotes the following extract from Taylor's " Medi- 
 cal Jurisprudence " (Vol. II, p. 166, et seq.) : 
 
 The following generalization, which is strictly warranted by facts, conveys 
 a warning to would-be abortionists, whether professional or habitual, or lay 
 and occasional. There is no drug, and no combination of drugs, which will, 
 when taken by the mouth, cause a healthy uterus to empty itself, unless it be 
 given in doses sufficiently large to seriously endanger by poisoning the life of 
 the woman who takes it. 
 
 In this country, as explained by Doctor Kebler, the publication of 
 advertising matter inviting attention to means whereby conception 
 can be prevented or abortion produced is specifically prohibited by 
 law. In order to circumvent the law, however, the advertising litera- 
 ture is so framed as to clearly indicate the purpose for which the 
 preparation is intended, such as " French Female Pills, a safe, certain 
 relief for suppressed menstruation. Never known to fail. Safe, 
 sure, speedy," etc. 
 
 Vital statistics show that the birth rate in England has dropped 
 from 34.3 per 1,000 in 1878 to 28 per 1,000 in 1901 ; in South Aus- 
 tralia from 39 in 1885 to 24 in 1906 ; in Germany from 40.4 in 1881 
 to 35.3 in 1894. The great decline in the birth rate in France has 
 been a matter of much comment, and the latest statistcis show little 
 or no increase in the French population. The birth rate of Paris, 
 already low in 1881, has further declined from 23.3 to 16.6 in 1894. 
 We have no reliable birth rates for the United States as a whole. 
 The census statistics of 1900 show that the birth rate has increased 
 from 26.9 in 1890 to 27.2 per 1,000 of the mean population in 1900. 
 Harrington, in speaking of the decline in birth rates in foreign coun- 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 265 
 
 tries, says among the descendents of the original colonists and earlier 
 immigrants the same decline is most evident. * * * In Massa- 
 chusetts the statistics of 1898 show that the greatest proportion of 
 the number of births belongs to the foreign born, the children of 
 native parentage on both sides representing 32.36, those of mixed 
 parentage 19.42, and those of foreign-born parentage 48.22 per cent 
 of the total births. The crude birth rate was 27.37. 
 
 Mr. Roosevelt is quoted to have said that " there are fewer descend- 
 ants of the revolutionary forefathers living to-day than there were 
 fifty years ago. We must either alter our ways or we must make 
 way lor the other races — Asiatic or whatever they are — that will 
 certainly replace us." Every thoughtful physician and layman rea- 
 lizes that the declining birth rates are chiefly the effects of vice, un- 
 natural interference, and actual homicide. 
 
 Dr. H. S. Pomeroy, of Boston, over twenty years ago presented the 
 moral, social, and medical aspects of prevention in his book, " The 
 Ethics of Marriage," which evoked the unqualified approval of the 
 late Mr. W. E. Gladstone. The President of the United States has 
 uttered notes of warning on the " race suicide problem," and Profes- 
 sor Emmet, the eminent gynecologist, asks : 
 
 Can anyone accustomed to treating the diseases of women say in truth the 
 statement is exaggerated that we can see on any one day more sorrow and 
 misery resulting from the abuse of the married state than would be found in a 
 month from uncomplicated child-bearing? 
 
 Doctor Kebler has furnished me with a list of 51 so-called female 
 pills or regulators advertised in this country. ( See appendix. ) While 
 quite a number may act as abortifacients, the majority are worthless 
 and frauds pure and simple. Among a number of fraud orders issued 
 by the Postmaster-General during the past two years the following 
 transcript from the records of the Assistant Attorney-General's 
 office, submitted May 29, 1908, in the case of Mrs. A. Kirk and the 
 Reliable Remedy Company, 2317 Brooklyn avenue and Eighteenth 
 and Grove streets, Kansas City, Mo., will be of interest: 
 
 It will be remembered that on October 29, 1907, a fraud order was issued 
 against the Doctor Price Remedy Company, its officers and agents as such, 
 and Mrs. J. Linson and Mrs. A. Miller, 2904 Woodland avenue, Kansas City, 
 Mo. The scheme against which the order was directed was conducted by a 
 man by the name of Arthur P. Miller, and involved the sale through the mails, 
 by means of advertisements in newspapers and circulars, of pills for women 
 to act as abortifacients, which pills in fact were worthless for the purpose, 
 as was well known to Miller. Miller was indicted November 5, 1907, in con- 
 nection with the above case, and on the following day he entered a plea of 
 guilty and was sentenced to a term of six months in the Bates County jail 
 at Butler, Mo., and to pay the costs of prosecution. 
 
 A report has now been received from the inspector at Kansas City, Mo., that 
 Miller, as soon as the fraud order was issued October 29, moved his desk into 
 the real estate office of a man by the name of William Abel, Eighteenth and 
 Grove streets, Kansas City, Mo., where the two continued the business until 
 Miller pleaded guilty, and that during the time he was serving the sentence his 
 wife conducted the business for him with Abel. * * * In order to receive 
 the mail, these parties advertised under the fictitious names of Mrs. A. Kirk, 
 2317 Brooklyn avenue, which is the residence of Abel and Miller, and to those 
 persons who replied to their advertisements they sent circulars under the name 
 of Reliable Remedy Company, Eighteenth and Grove streets, which was the 
 office of Abel, in which circulars the addressee was solicited to remit $2 for 
 pills, which were described in language calculated to cause the reader to believe 
 they would act as abortifacients. * * * The inspector says that about 25 
 letters are being received dailj hj those persons in connection with the scheme. 
 
266 RBPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 The inspector states that he presented the above facts to the United States 
 attorney, who caused the matter to be presented to the grand jury, which re- 
 turned an indictment against both Miller and Abel on May 5, to which indict- 
 ments these parties have entered a plea of not guilty and gave bond of $1,000 
 each to stand trial. * * * Fraud order issued May 29, 1908. Abel was 
 sentenced September, 1908, to pay $25 and costs. 
 
 INFANTICIDE BY SYSTEMATIC DRUGGING OP CHILDREN. 
 
 In discussing the subject of infant mortality in relation to the occu- 
 pation of women, the influence of ignorance and poverty has been 
 emphasized, and we quoted Sir John Simon, on page 78," to the effect 
 that " infants who should be at the breast are improperly fed or 
 starved, or have their cries of hunger and distress quieted by those 
 various fatal opiates which are in such request at the centers of our 
 manufacturing industry." We have also referred to the injury done 
 by abnormal cow's milk and the injurious quality of certain proprie- 
 tary and other artificial foods. But when' we contemplate the fright- 
 ful mortality in illegitimate children, and of the stillbirths, especially 
 in illegitimate offsprings, we may well apprehend that this extraor- 
 dinary destruction of life is induced not only by ignorance or poverty, 
 but also by crime. 
 
 Of the 66,808 births in Washington from 1879-95, 37,781 were 
 white and 29,127 colored, with 1,136 illegitimate births in the white 
 race and 6,706 in the colored element. Of the 7,249 stillbirths in this 
 city during the same period 2,750 were white and 4,449 were colored ; 
 of this number 2,053 were illegitimate, 307 or 15.1 per cent were white 
 and 1,746 or 84.9 per cent were colored. 
 
 In this connection it is desirable to point out the serious conse- 
 quences of the systematic drugging of children by " soothing 
 syrups," " teething syrups," " children's comfort," " The infant's 
 friend," etc. Doctor Kebler has furnished me with a list of six such 
 compounds, all containing opium or morphine, not to mention the 
 numerous cough and croup remedies in the market. Nearly every 
 one is familiar with " Mrs. Winslow's soothing syrup ;" it contains 
 morphine ; so does " Doctor Fahrney's teething syrup," for, according 
 to Doctor Kebler, the label declares each ounce contains alcohol, 9 per 
 cent ; morphine, one-seventh grain ; chloroform, two-thirds of a minim ; 
 combined with seven other articles. " For babes. A sure remedy 
 for all ailments incident to babes from 1 day old to 2 or 3 years; 
 * * * contains nothing injurious to the youngest babe and if 
 given in proper dose will always relieve." .Elsewhere upon the label 
 occurs the following statement : " Mothers need not fear giving this 
 medicine to the youngest babe, as no bad results come from the con- 
 tinued use of it. Many children have taken 2 and 3 dozen bottles 
 and to-day are hale and hearty boys and girls." This language shows 
 on the face of it that the manufacturer knows full well that the drug 
 is dangerous. It should be known that children are especially sus- 
 ceptible to the toxic effects of opium and its preparations. In De- 
 cember, 1905, a coroner's jury in Baltimore warned the public not to 
 use " Kopp's baby friend," on account of the death of a white in- 
 fant, aged 3 months and 14 days, who had been given this prepara- 
 tion by his mother while suffering from indigestion. The evidence at 
 
 • Kober's Industrial Hygiene. 
 
BEPOETS OF THE PRESIDENT S HOMES COMMISSION. 
 
 267 
 
 the inquest, according to the district attorney, showed that not only 
 this child, but probably three others in the neighborhood, had died 
 recently from the use of patent medicines administered to them. The 
 Journal of the American Medical Association, February 9, 1907, 
 reports the death of twin children 6 weeks old in New Castle, Pa., 
 caused, according to Doctors Cooper and Warner, by " Kopp's baby 
 friend." The parents gave it according to the directions accompany- 
 ing the bottle — 6 drops every two or three hours to keep the infant 
 from crying. The children were not sick ; they lived about one day 
 after beginning to take the medicine. When Doctor Warner, the 
 attending physician, saw them, they were in the last stage of opium 
 poisoning. They had not been given any other medicine. In the 
 same issue of the Journal are the reports of the death of a child 
 aged 10 months from " Mrs. Winslow's soothing syrup," another death 
 in a child from the effects of " Monell's teething syrup," and still 
 another from the effects of " Rex cough syrup." Space will not per- 
 mit the presentation of other cases or to point out the extreme danger 
 which lurks in many of the cough, colic, and diarrhea mixtures and 
 other proprietary remedies which have killed children and adults and 
 yet are unblushingly advertised as safe and harmless for babes. 
 
 Every one at all familiar with the subject knows how frequently 
 nurses have to be discharged for " doping " infants, and the fact that 
 44 children under 5 years of age have perished in this city during the 
 last 10 years from accidental poisoning is sufficient indication of the 
 dangers attending the promiscuous use of poisonous drugs. 
 
 DIPHTHERIA CURES. 
 
 Doctor Kebler has furnished a list of 10 advertised diphtheria 
 cures. In view of the fact that diphtheria antitoxin is the only 
 reliable remedy in this disease there can be no question that recourse 
 to advertised cures is fraught with danger to the child. The death 
 rate from diphtheria and croup in 1890 was 97.7 per 100,000; in 
 1900 it was only 45.2, a decrease of 52.5 per cent. This splendid gain 
 is almost entirely due to the use of antitoxin. The average diphthe- 
 ria mortality where antitoxin was used in 1902 was 6.48 per cent 
 and where not used it was 32.5 per cent. The earlier the antitoxin 
 is employed the lower are the death rates. The mortality in children 
 when used upon the first day was 1.45 per cent, but when used later 
 than the fourth day it rose to 14.49 per cent. 
 
 ADVERTISED DIPHTHERIA CUBES. 
 
 Hesperian Tonic, Dr. J. W. Roberts. 
 Cure for Diphtheria, etc. 
 
 Humbug Oil. Cures Diphtheria. 
 
 Colwell's Egyptian Oil. Dr. Colwell's 
 Magic Egyptian Oil, cures diph- 
 theria, etc. 
 
 Hamlin's Wizard Oil. Cures rheuma- 
 tism, diphtheria, etc. 
 
 Dr. Winchell's Teething Syrup. A cer- 
 tain preventive of diphtheria. 
 
 Wizard Oil. 
 
 Dr. Shoop's Diphtheria Remedy. For 
 the relief and cure of diphtheria. 
 
 Gar-Gol. An absolute specific * * ♦ 
 for all kinds of sore throat. Pre- 
 ventive of diphtheria. 
 
 Indian Rattle Snake Oil. We guaran- 
 tee a cure for ♦ * ♦ diphtheria 
 and catarrh. 
 
 Vapo - Cresoline. "Cures while you 
 sleep " whooping cough, * * * 
 diphtheria, catarrh. 
 
268 EEPOKTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 INJURY AND DEATH TO THE ADOLESCENT. 
 
 In this section Mr. Beale considers the exposure of the young to 
 demoralization and even to debauchery by (a) the sale of intoxicants 
 known as "bracers," which are disguised alcoholics; (&) by prepara- 
 tions of cocaine, of acetanilid, of sulfonal, and other synthetic de- 
 pressants, of opium (to a much less extent); (c) by compounded 
 drugs supposed to excite sexual desire; (d) by preparations intended 
 to prevent conception or to induce abortion; and, finally, (e) by the 
 sale of certain things manufactured in Europe which are designed 
 and sold for the sole purpose of nameless and unnatural vices. 
 
 The subject of " bracers " has already been discussed in connection 
 with the alcohol habit. Those desiring additional information as 
 to their general composition and effects, not infrequently seen in 
 innocent women and clergymen, can do so by consulting the pages 
 of " Collier's Weekly " for October, 1905, or Mr. Beale's report, 
 pages 90-94. Dr. J. D. Morgan informs me of a recent case of 
 alcoholic multiple neuritis in a most estimable lady who had taken 
 Peruna as a tonic 
 
 We have already discussed the cocaine and drug habit and the 
 shameful traffic in lost-manhood restorers. 
 
 It is impossible, in the scope of this article, to give an adequate 
 conception of the enormity of the nostrum evil. Some idea may be 
 formed by a perusal of the 431 pages of Mr. Beale's report and an 
 inspection of the storerooms of the Division of Drugs of the Bureau 
 of Chemistry, United States Department of Agriculture, where thou- 
 sands of preparations may be found, not one-tenth of which have been 
 analyzed for lack of laboratory force. And yet the end is not in sight, 
 but the supply is increased, as will be seen by reference to the sta- 
 tistics of the Patent Office, p. 263, at the rate of about 200 a year. "A 
 most able and veracious physician has truly asserted that quackery 
 has destroyed more in this country (Great Britain) than the sword, 
 famine, and pestilence united, and never was there a period in the 
 history of British medicine at which the force and truth of this 
 opinion was more obvious than at this day." (Cited by Beale from 
 the "Lancet," London, June, 1906, p. 1886.) The Standard Dic- 
 tionary defines a quack as a pretender and quotes the following : 
 
 South Sermons, Volume II, Sermon XXX, page 133: "Quacks and mounte- 
 banks are doubtless a very dangerous sort of men — they are both of them always 
 very large in pretense and promise, but short in performance and generally 
 fatal in their practice." 
 
 Dr. M. A. Clark, in a recent article on quacks," quotes Steele in his 
 " Spectator " of July, 1712, as saying : 
 
 Quack doctors who publish their great abilities in little green billets, distrib- 
 uted to all who pass by, are to a man impostors and murderers. I doubt not 
 but that the editors of our great newspapers of to-day would voice the same 
 sentiment, and yet we find these journals full of advertisements of quacks and 
 quack medicines. 
 
 OONSUMPnON CURES. 
 
 Doctor Kebler has furnished me with a list of 35 remedies adver- 
 tised for the prevention and cure of consumption. Many of these 
 preparations contain drugs which enslave, but the chief transgression 
 
 •Atlanta Joornal Record of Medicine, October, IOCS. 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 269 
 
 lies not as much in their composition " as in the fraudulent methods 
 used in their exploitation, such as symptom blanks and mystic and 
 misleading statements and false claims made in the advertising litera- 
 ture." The medical profession knows that there is no specific remedy 
 for the disease in any of its stages. It is also well known that no 
 germicide, whether taken internally or inhaled, which would kill the 
 tubercle bacilli, could be administered without serious danger to the 
 patient. It is also well known that good food, pure air, and a rational 
 hygienic regimen offer the best chances for recovery, and that patients 
 wlio resort to all sorts of quack remedies in the early stages of the 
 disease deprive themselves of the most favorable opportunity for a 
 permanent cure. It is true the excuse given by many is inability to 
 pay a doctor or druggist, but, as a matter of fact, no person belonging 
 to the dependent classes need ever go without the most skilled medical 
 care and treatment in connection with our dispensaries and hospitals. 
 I have never known a reputable physician to decline to lend a helping 
 hand in directing such patients into the proper channels. One of the 
 interesting features in connection with the alleged consumption cures 
 is that special attention is given to the dietetic and hygienic regimen, 
 which is, after all, the fundamental basis of success and can be had 
 free as a matter of public education. Among the remedies extensively 
 advertised is " Tuberculozyne," which is claimed as having killed the 
 consumption germs, and that all trace of the disease in blood and 
 tissue was destroyed." Doctor Kebler might have added " Liquozone," 
 which in addition to consumption is alleged to be a cure for 36 other 
 diseases from asthma down to tumors and ulcers. 
 
 Doctor Kebler's list of remedies advertised for the prevention or 
 cure of consumption is as follows: 
 
 Acker's English Remedy. (?) 
 
 Allen's Lung Balsam. (?) 
 
 Ayer's Cherry Pectoral. 
 
 Ballard's Horehound Syrup. 
 
 Birch Mountain Tea. 
 
 Dr. Bull's Cough Syrup. 
 
 Chamberlain's Cough Remedy. 
 
 H and N Consumption Cure. 
 
 Hickory Bark Cough Remedy. 
 
 Hoff' s Consumption Cure. 
 
 Dr. King's New Discovery. 
 
 Lung-Germine. 
 
 Mrs. Wesley Magg's Consumption Cure. 
 
 Mizpah Cure. 
 
 Peruna. 
 
 Phoric Electric Method. 
 
 Piso's Cure. 
 
 Richardson's B Z Lung Tonic. 
 
 Roger's Compound Syrup of Liverwort, 
 
 Tar and Canahalagua. 
 Severas Lung Balsam. (?) 
 
 Eckman's Alterative. 
 
 Elchert's Cold and Consumption Cure. 
 
 Father John's Medicine. 
 
 Foley's Honey and Tar. 
 
 Fourneir's Throat and Lung Remedy. 
 
 Germicidal Vapor Inhalation Treat- 
 ment. Dr. Anderson. 
 
 Shiloh's Consumption Cure. 
 
 Dr. Stevens' East India Consumption 
 Cure. 
 
 Tuberculoids. 
 
 Vanderpool's Consumption Cure, 
 
 Victor's Lung Syrup. (?) 
 
 Vinol. 
 
 Virgin Oil of Pine. Leach Chemical 
 Co. 
 
 Wilson's Preparation of Hypophos- 
 phites and Blodgetti. 
 
 Yonkerman Consumption Cure, " Tu- 
 berculozyne." 
 
 ASTHMA AND HAT FEVER CURES. 
 
 The following is Doctor Kebler's account of this class of secret 
 remedies : 
 
 These nostrums are usually sold over the counter. A few of them, however, 
 can only be obtained from the producer direct. As an example of the latter 
 class may be mentioned Tucker's Asthma Specific. This preparation, which is 
 widely advertised throughout the country and enjoys a large sale, consists of 
 
270 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 a small bottle of medicine and a spray atomizer. The price of tlie " treatment " 
 is $12.50. Analysis of a sample of the medicine disclosed the presence of 
 cocaine. The remedy should therefore be a good " repeater." Additional sup- 
 plies of the inhalant can be obtained from the producer upon payment of $1 
 per ounce. Some asthma cures are sold by the producer only after preliminary 
 correspondence and the use of " symptom blanks," as in case of cancer cures. 
 Hayes' Asthma Cure belongs to this class. 
 
 The remedies themselves may in general be divided into three classes: Medi- 
 cines intended to be taken internally, medicines intended to be taken by inhala- 
 tion, and medicines intended to be burned and inhaled. The preparation known as 
 Davis' Liquid Asthma Remedy is an interesting example of remedies belong- 
 ing to first of these classes. According to the statement which appears upon 
 the label, the product contains over five grains of chloral hydrate to the dose. 
 The directions state that it should be taken " one tablespoonful twenty minutes 
 after meals, at bedtime, and on arising in the morning." "Adults can repeat 
 dose every two hours." " Dose can be increased or diminished, or taken 
 oftener if needed." The statement also appears that it " keeps you from having 
 asthma." The danger of the formation of the chloral habit through the use 
 of such a preparation is apparent. 
 
 Following is a list of remedies belonging to the general class of asthma cure.s : 
 
 Himalaya Asthma Cure. 
 
 Hart's Swedish Asthma and Hay 
 
 Fever Cure. 
 Haylene Cure. 
 Dr. Olin's Asthma Cure. 
 Dr. R. Schififmann's German Asthma 
 
 Cure. 
 Green Mountain Asthma Cure. 
 Papham Asthma Specific. 
 Dr. Olin's Hay Fever Cure. 
 Dr. J. R. Stafford's Olive Tar. 
 Himrod's Asthma Cure. 
 Milk Emulsion. 
 Tucker's Asthma Specific. 
 Brater's Asthma Cure. 
 Dr. B. W. Hair's Asthma Cure. 
 Bryan's Imperial Asthma Cure. 
 
 Taft's Asthma Cure. 
 
 Ballard's Horehound Syrup. 
 
 Japanese Oil. 
 
 Severa's Lung Balsam. 
 
 Davis' Liquid Asthma Remedy. 
 
 Davis' Asthma Powder. 
 
 Warner's Safe Asthma Cure. 
 
 Asthma Cure. 
 
 Birch Mountain Tea. 
 
 Chilean Asthma Cure. 
 
 Frontier Asthma Cure. 
 
 Hayes' Asthma Cure. 
 
 Upham's Asthma Cure. 
 
 Ascaco. 
 
 Asthma Cure. Frank Wetzel, M. D. 
 
 William's Asthma Cure. 
 
 Renacol. 
 
 CATARRH CURES. 
 
 According to Doctor Kebler : 
 
 Nostrums belonging to this class are usually intended for local application 
 to the nose or throat and are generally prepared in the form of powder (or 
 "snuff"), ointment (or 'jelly'"), or in stick form for inhalation. In addition, 
 there are liquids intended for use as spray or douche. When the " cure " rises 
 to the dignity of a " treatment," a " constitutional " or " blood " medicine is 
 usually added, as in case of " Gauss' Combined Treatment," " Dr. T. F. Wil- 
 liam's Treatment," etc. The catarrh jellies, catarrh powders, and catarrh cures 
 generally are usually sold over the counter, but the " treatments" are furnished 
 upon application to the advertiser direct. The initial advertisement generally 
 contains an offer of free trial treatment or a free book upon the subject of 
 catarrh, in return for the reader's name and address. Accompanying the book 
 or the trial treatment are numerous testimonials and other advertising litera- 
 ture intended to interest the correspondent and secure a sale of the remedy. It 
 is possible that some of these preparations do good in chronic nasal catarrh 
 in a palliative way through a cleansing or antiseptic effort, but nont» of them 
 can possibly make good the extravagant claims made for them with regard to 
 the cure of the disease. 
 
REPOBTS OF THE PKESIDENT S HOMES COMMISSION. 
 
 271 
 
 A list of preparations belonging to tlie general class of 
 given below: 
 
 catarrh cures" is 
 
 Bunsen's Catarrh Cure. 
 Crown Catarrh Powder. 
 Catarrh Powder, Britt, Loeffler & Weil, 
 
 New York. 
 Tousley's Sneezeless Snuff. 
 Dr. A. W. Chase's Catarrh Powder. 
 Dr. Olin's Catarrh Cure. 
 Catarrh Balm. 
 
 Sanford's Radical Cure for Catarrh. 
 Century Catarrh Cure. 
 Pond's Extract Catarrh Cure. 
 I. C. R. Instant Catarrh Relief. 
 Ely's Liquid Cream Balm. 
 Dr. Agnew's Catarrh Powder. 
 Allan's Catarrh Cream. 
 Biel's Catarrh Jelly. 
 Dr. Slack's Mexican Ointment 
 Milk's Catarrh Cure. 
 Kondon's Catarrhal Jelly. 
 Cole's Catarrh Cure. 
 Dr. Birney's Catarrhal Powder. 
 Thymo Catarrh Balm. 
 Premuim Prescription. 
 Bear's Catarrh Remedy. 
 Dr. Bvory's Diamond Catarrh Remedy. 
 London Catarrh Cure. London Balm. 
 Bering's Vegetable Specific Catarrh 
 
 Cure. 
 
 Old Saul's Catarrh Cure. 
 
 Hall's Catarrh Cure. 
 
 Gauss' Combined Catarrh Cure. 
 
 Century Catarrh Cure. 
 
 Ozojell. 
 
 Nosena. 
 
 Pollantin Powder for Catarrh. 
 
 Paracamph. 
 
 Dr. Syke's Sure Cure for Catarrh. 
 
 Ka-ton-ka. 
 
 Branaman's Catarrh Cure. 
 
 McCode Catarrh Cure. 
 
 Sproule's Catarrh Cure. 
 
 Botonic Blood Balm. B.B.B. 
 
 Mederine. 
 
 Grove's New Discovery for Catarrh. 
 
 Dr. Shoop's Catarrh Remedy. 
 
 Mucu-Tone. 
 
 California Mineral Crystals. 
 
 Hyomei. 
 
 Davis' Oil. 
 
 Dr. Blosser's Catarrh Cure. 
 
 Catarrh Cure. Dr. W. O. Coffee. 
 
 Microcide. 
 
 Dr. W. H. Long's Great Mountain 
 
 Moss Catarrh Jelly. 
 Adlyne Catarrh Treatment. 
 Blackburn's Victory Catarrh Tablets. 
 
 SKIN CURES. 
 
 Doctor Kebler divides nostrums advertised for this purpose into 
 two classes: First, those which are claimed to cure skin diseases, like 
 eczema, parasitic skin affections, etc.; and, second, the products 
 which are claimed to be efficacious in the prevention and cure of less 
 serious skin affections, such as erythema, pimples, and blackheads. 
 They are advertised to prevent and remove wrinkles from the faces 
 of persons of any age; to impart youthful properties to the skin, 
 making it " clear, soft, and velvety ; " and to remove completely and 
 permanently all facial blemishes, pimples, blackheads, freckles, tan, 
 sunburn, sallowness, etc. It is claimed in most cases that they ac- 
 complish these results through a nourishing effect upon the skin, 
 " feeding the skin through and through." For this reason they are 
 often called " skin foods." They are analogous to " nerve foods," 
 " brain foods," etc. With regard to this use of the word " food " in 
 connection with the names of medicinal preparations, it may be w^ell 
 to recall the charge to the jury in the recent case of the United States 
 V. K N. Harper (see p. 260). 
 
272 
 
 REPORTS OP THE PRESIDENT S HOMES COMMISSION. 
 
 Following is a list of the remedies belonging to the general class 
 of skin cures: 
 
 Med-Aseptic Cold Cream Skin Food. 
 
 Riker's Violet Cerate Skin Food. 
 
 Hudnutine Toilet Cerate (Skin Food). 
 
 Marvelous Cold Cream Skin Food. 
 
 Excelsior Skin Food. 
 
 Kingsbury's Velvet Skin Food. 
 
 De Meridor Granulus Cold Cream Skin 
 
 Food. 
 Acme Tablets. Dermol. 
 Cuticura Soap. 
 Cuticura Ointment. 
 Cuticura Resolvent. 
 W. W. W. Wood's Ointment. 
 Pompeian Massage Cream and Skin 
 
 Food. 
 D. D. D. Remedy for eczema, etc. 
 Sartoin Skin Food. 
 Epp-O-Tone Skin Food. 
 Cre-Mo-Jel. 
 
 Wisdom's Rubertim (Skin Food). 
 Poslam. 
 Palmer's Vegetable Cosmetic Lotion. 
 
 Zema-Cura. 
 
 Dr. Agnew's Ointment. 
 
 Perfect C:k)ld Cream Skin Food. 
 
 Satin Skin Cream and Skin Food. 
 
 Red Cross Skin Food. 
 
 C. C. C. Eczema Cure. 
 
 Dr. Campbell's Arsenic Complexion 
 
 Wafers. 
 Crane's Eczema Cure. 
 Para-camph. 
 
 Rexall. Cream of Almonds. 
 Sempre Giovine. Skin Food. 
 Laird's Bloom of Youth. 
 Mme. Hayden's Skin Food. 
 Parisian Electro Skin Food. 
 Kintho Beauty Cream. 
 Aughinbaugh's Cold Cream. Skin 
 
 Food. 
 Eureka Complexion Tablets. 
 Nadinola. 
 
 Gourand's Oriental Cream. 
 Lait Antiphenique. 
 
 RHEUMATISM CURES. 
 
 The following is an extract from Doctor Kebler's article on nos- 
 trums and fraudulent methods of exploitation : <» 
 
 MAGIC FOOT DRAFTS. 
 
 The following are quotations from the literature: 
 
 " Magic Foot Drafts are known all over the world as the safest, surest, and 
 simplest cure for all kinds of rheumatism. They cure when everything else 
 fails. Best of all, they cure to stay cured. * * ♦ if 100,000 people from 
 every State and Kingdom of the earth have been cured of rheumatism, of every 
 kind and from whatever cause, by Magic Foot Drafts, can any prejudice exist 
 in your mind to prevent your giving the remedy a fair trial?" 
 
 No one reading these quotations can arrive at any other conclusion but that 
 "Magic Foot Drafts" are capable of curing all forms of rheumatism. "Magic 
 Foot Drafts " consist of pieces of oil cloth, covered on the unfinished side with 
 a border of adhesive mixture, and the central portion with a plaster composed 
 of the following; 
 
 Per cent. 
 
 Poke root 30 
 
 Pine tar 62 
 
 Corn meal 8 
 
 These drafts are to be applied to the hollow of the soles of the feet and are 
 claimed to effect cures in the following manner : 
 
 " By cutaneous absorption curative elements are taken from the draft. These 
 are carried to the blood by the lymphatics, and neutralize the poisons. ♦ ♦ * 
 It (Magic Foot Draft) stimulates the nerves to activity. The nerves in turn 
 act on the muscles, veins and arteries, increasing the circulation of the blood, 
 compelling it to hasten and deliver up its poisons from the whole system to 
 the sweat glands just beneath the skin, and from thence it Is drawn by the draft 
 through the pores and absorbed. Thus is effected a cure, no matter where the 
 pain Is located, because all the blood of the body passed through the capillarle«." 
 
 There Is nothing whatever in these drafts to warrant such claims and rep- 
 resentations. They possess no curative element whatever which when ab- 
 sorbed into the blood will neutralize the poisons which are supposed to be the 
 cause of the rheumatism and in this manner effect a cure. 
 
 •Jouraal Am. Med. Association, Novbr. 10 and 17, 1906. 
 
KEPORTS OF THE PRESIDENT S HOMES COMMISSION". 
 
 273 
 
 A particularly interesting feature connected with this scheme is that the 
 promoters when asked for reasons for their claims drew on the writings of the 
 best authors of the country, such as the late J. M. Da Costa, Dr. H. C. Wood, 
 Dr. J. V. Shoemaker, Dr. H. A. Hare, the medical author of the "American 
 Dispensary," and others. These authors, when informed relative to the use 
 made of their writings, vigorously protested, claiming that any interpretation 
 of their writings which would in any way bolster up the scheme of the " Magic 
 Foot Draft" was absolutely unjustifiable. 
 
 The following lists have been supplied by Doctor Kebler : 
 
 BHEUMATISM CURES. 
 
 Kennedy's East Indian Bitters. 
 
 Nature's Oil. 
 
 Kelly's Rheumatic Syrup. 
 
 Warner's Safe Rheumatism Cure. 
 
 T. Rheumatic Cure. The Great Blood 
 Purifier. 
 
 Athlophorus. 
 
 Griffith's Compound Mixture of Guaiac, 
 etc. 
 
 Dr. Olin's Rheumatic Cure. 
 
 Dr. MacDonald's Atlas Compound. 
 Specific No. 18. 
 
 Fulton's Renal Compound. 
 
 Silodyne. 
 
 R. R. R. Radway's Ready Relief. 
 
 Dr. Shoop's Rheumatic Remedy. 
 
 Wright's Instant Relief. 
 
 Japanese Oil. 
 
 St. Jacob's Oil. 
 
 Mysterious Pain Cure. 
 
 Hamlin's Wizard Oil. 
 
 Denver Mud. 
 
 Albert's Remedy. Cure for Rheuma- 
 tism, etc. 
 
 Anchor Pain Dispeller. Toxol. 
 
 Rexall Rheumatic Cure. 
 
 Dr. Slack's Mexican Ointment. 
 
 Dr. McConkey's Vigor of Life. 
 
 Bogle's Quaker Balm. 
 
 Celestial Oil. 
 
 Dr. Radcliffe's Great Remedy Seven 
 Seals. 
 
 Dr. Kilmer's W. O. Ointment. 
 
 Fenner's Kidney and Backache Cure. 
 
 Pnin Balm. 
 
 White's Wonder Worker Herbs. 
 
 A. D. S. Rheumatism Cure. 
 
 Griswold's X-ray Pain Killer. 
 
 Dr. Bell's Anti Pain. 
 
 Schrage's Rheumatic Cure. 
 
 Wood's Rheumatic Cure. 
 
 Ka-Ton-Ka. 
 
 Reagan's Positive Cure for Rheuma- 
 tism and Asthma. 
 
 The Wonderful Wintergreen. Great 
 Rheumatic Cure. 
 
 Rheumetts. Etts' warranted cure for 
 rheumatism. 
 
 Bi-Lo-Zone. 
 
 Yolta Powder. 
 
 Quinine Whisky. 
 
 Lane's Rheumatic Cure. 
 
 KIDNEY AND BLADDER CURES. 
 
 Dr. Gossom's Kidney and Bladder 
 Cure. A specific for Bright's Dis- 
 ease. 
 
 Bick's Laxative Kidney and Liver Tab- 
 lets. Cures Kidney and Liver trou- 
 bles in all its forms. 
 
 Bick's Kidney Pills. 
 
 Brown's Compound Concentrated Fluid 
 Extract of Buchu. 
 
 Zoeller's Kidney Remedy. (Formerly 
 Black Gin.) 
 
 National Kidney and Liver Cure. 
 
 Jay Neway's Kidney and Liver Rem- 
 edy. 
 
 McBurney's Kidney, Bladder and 
 Rheumatism Cure. 
 
 Welch's Aegopodium. 
 
 Mother Gray's Australian Leaf. 
 
 Dr. Olin's Kidney Cure. 
 
 O. K. Specific. 
 
 Dr. Maid's Celebrated Liver and Kid- 
 ney Tablets. 
 
 Dr. Kilmer's Swamp Root. 
 
 Dr. Swan's Celebrated Liver and Kid- 
 ney Cure. 
 
 Chewalla. 
 
 Dr. Hobb's Asparagus Kidney Pills. 
 
 S. Doc. 644, 60-2 iS 
 
 Dr. Bell's Kidney Pills. 
 
 Warner's Safe Kidney and Liv<] ire. 
 
 /Vlma-Bromo. 
 
 Warner's Safe Diabetes Cure. 
 
 Palmetto Berry Wine with Asparagus 
 Wine. 
 
 A Texas Wonder. Hall's Great Dis- 
 covery. Removes Gravel. 
 
 Marsh Root. Kidney and Liver Cure. 
 
 Rexall Kidney Cure. 
 
 Crane's Kidney and Bachache Cure. 
 
 Begg's Blood Purifier. 
 
 Allan's Kidney and Liver Cure. 
 
 Dodd's Kidney Pills. 
 
 Our Own Kidney and Liver Cure. Cer- 
 tain Cure of Bright's Disease. 
 
 Kidneyetts. Etts warranted cure for 
 kidneys and all urinary diseases. 
 
 Bouvier's Buchu Gin for the kidneys 
 and bladder. 
 
 Dr. Hubbard's Kidney and Bladder 
 Capsules. 
 
 Doan's Backache Kidney Pills. 
 
 Var's American Kidney Pills. 
 
 Fitch's Kidney and Liver Cooler. 
 
 Munyon's Kidney Cure. 
 
274 
 
 KEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 CANCER CURES. 
 
 The following is Doctor Kebler's account of the method employed 
 by the sure-cure school in incurable diseases. Additional informa- 
 tion on this subject will be found in " Collier's Weekly," July 14, 
 1906: 
 
 The initial step in the sale of these nostrums is usually the publication in 
 the newspapers of an advertisement inviting attention to a certain and speedy- 
 cure for cancer. Following is an illustration : " I have proven cancer can be 
 cured at home; no pain; no plaster; no knife. I have discovered a new and 
 seemingly unfailing remedy for the deadly cancer. I have made most aston- 
 ishing cures. I believe every person with cancer should know of this marvelous 
 medicine and its wonderful cures, and I will be glad to give full information 
 free to all who write me and tell me about their case." Those who seek further 
 information in response to such advertisements receive in reply a stock written 
 letter, shrewdly devised so as to give the impression that the communication 
 is a personal one. Accompanying this is a " symptom blank," which the pros- 
 pective purchaser is requested to fill out, and printed matter, including numer- 
 ous testimonials, all setting forth the claim that the remedy in question is a 
 certain, speedy, and painless cure for cancer. If there is delay in ordering the 
 remedy, the inquirer becomes the recipient of letter after letter in which the 
 attempt is made in every conceivable way to cajole him into purchasing the 
 " cure." The cost of the treatment is from $15 to $25 per month, some con- 
 cerns charging more than others. The sufferer is therefore obliged at the out- 
 set to part with a considerable sum of money before he receives the first supply 
 of " treatment." The result is invariably keen disappointment on the part of 
 the victim. The " treatment " consists of tonic and alterative remedies for 
 internal use and simple applications for use upon the skin. They are indeed 
 painless in most cases and are utterly worthless so far as the permanent eradi- 
 cation of cancer is concerned. Following is a list of concerns engaged in the 
 sale of remedies which are claimed to cure cancer : 
 
 Dr. Bye, Kansas City, Mo. 
 
 Dr. Curry Cancer Cure, Lebanon, Ohio. 
 
 C. Gee Wo Chinese Medicine Co., Port- 
 land, Oreg. 
 
 Indian Black Vegetable Salve & Reme- 
 dies Co., Brooklyn, N. Y. 
 
 Dr. Johnson Remedy Co., Kansas City, 
 Mo. 
 
 Dr. L. T. Leach, Indianapolis, Ind. 
 
 Mason Cancer Institute, 1700-8 Broad- 
 way, New York. 
 Dr. Mixer, Hastings, Mich. 
 
 D. Needham's Sons, Chicago, 111. 
 Radio-Sulpho Co., Denver, Colo. 
 
 E. E. Sonanstine, M. D., Colorado 
 Springs, Colo. 
 
 Dr. Rupert Wells, St. Louis, Mo. 
 
 C. Henry Wilson, M. D., Brooklyn, N. Y. 
 
 EPILEPSY CURES. 
 
 The methods employed by individuals, institutes, or firms who prey 
 upon this unfortunate class of patients are manifold and can best 
 be judged by an extract of a brief submitted by Assistant Attorney- 
 General Goodwin to the Postmaster-General, dated July 23, 1908, 
 and which is as follows : 
 
 In re The Epileptic Institute Company and the Epileptic Institute and their 
 officers and agents as such at Cincinnati, Ohio, and Dr. H. J. Luecke at P. O. 
 Box No. 99, Cincinnati, Ohio. 
 
 On June 6 last this concern was cited to show cause why a fraud order should 
 not be issued against it. ♦ ♦ * The facts of this matter as I find them to be 
 are substantially as follows: This business consists of a medical treatment by 
 mail of the disease of epilepsy. One Otto Kalmus, a resident of Cincinnati, 
 commenced the business in the spring of 1903 under the name of Epileptic 
 Institute, and so continued until July, 1907, when he incorporated it under the 
 name of "The Epileptic Institute Company," he continuing as president and 
 general manager and principal owner. As a private address for patients, who, 
 it was explained, might not care to have it known that they were corresponding 
 with an epileptic institute, use has been made of the name of Dr. II. J. Luecke, 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 275 
 
 a physician connected, until recently, with the institute. While not with the 
 institute since last November, Mr, Pyle and Doctor Schoenling explained at the 
 hearing that by agreement with Doctor Luecke his name has continued to be 
 used and that the institute receives that mail addressed to him, which is also 
 directed to box No. 99, in the Cincinnati post-office. 
 
 Until lately communciation with epileptics was obtained through advertise- 
 ments in newspapers, chiefly those circulated among Germans and other 
 foreigners. * ♦ * 
 
 More recently the practice has obtained of purchasing the names and 
 addresses of epileptics from, as the inspector says, " other concerns " that 
 have obtained all of the money possible from such unfortunates without effect- 
 ing a cure and then mailing circulars to such persons, urging them to take 
 treatment from the institute. * * * The samples of these circulars are 
 among the papers. They are filled with highly colored and extravagant rep- 
 resentations with reference to the unprecedented success of the institute 
 treatment, which it denominates the " Schonka " treatment as a cure for 
 epilepsy; and among other things, it is represented that this treatment is 
 original with the institute and by its means the institute can successfully treat 
 the heretofore considered incurable disease epilepsy, and in many cases effect a 
 cure ; that the treatment is something not known to medical science and is dif- 
 ferent from anything used by the profession in such cases ; that the physicians 
 of the institute are skilled and experienced specialists and include " one of the 
 foremost examining specialists in America, etc." 
 
 The time that this institute urges its patients to continue the treatment is 
 from a year to a year and a half, and longer, varying, of course, in different 
 cases. Its charge for medicine ranges from about $3 to $9 a month, the variance 
 depending, it seems, upon the amount which the patient can be induced to pay. 
 
 Here follow 10 pages of evidence. The report, on page 13, states: 
 
 The medical treatment so glowingly advertised by this institute as a " cure " 
 for epilepsy is based on the bromides. It is what in general is known as the 
 bromide treatment. Except, and this is where the institute tests its claims for 
 unusual and peculiar efiicacy, that the drug adonis vernalis is used in conjunc- 
 tion with the bromides. In connection with the medical treatment the usual 
 and ordinary rules regarding diet, hygiene, etc., are also given. Dr. L. F. 
 Kebler, Chief of Drug Laboratory Bureau of Chemistry, United States Depart- 
 ment of Agriculture, informed the Assistant Attorney-General " that what is in 
 general known as the bromide treatment is in common use by the profession in 
 treating epilepsy ; that its physiological action has been quite well defined ; that 
 It is not a ' cure ' for the disease, but acts simply as a sedative, and in this way 
 tends to suppress the attacks ; that medical science to-day has no drug treatment 
 that will cure this disease; that the disease is among the most diflScult and 
 intractable of all diseases to treat, and that a small per cent of the more favor- 
 able cases only have been successfully treated, and that the success in these 
 instances has been due most probably to the condition of the patient himelf 
 rather than to the medication." Doctor Kebler has also drawn my attention to 
 the following recognized medical authorities, who speak of the use of bromides 
 in treating this disease, and more especially of evil effects that may follow their 
 long continued use. 
 
 Here follow quotations from well-known medical authors, strongly 
 opposed to the promiscuous and indiscriminate use of the bromides 
 by epileptics. Of these the opinion of Dr. Wm. T. Sprattling, an 
 authority on this disease and medical superintendent of the Craig 
 Colony for Epileptics at Sonyea, N. Y., a state institution of recog- 
 nized merit, speaking of the evils that may attend the bromide treat- 
 ment, on page 364, says: 
 
 If pushed too far, death may supervene from acute bromide poisoning. This 
 happened in the case of a boy of 12 years whom I knew, whose parents gave 
 him too frequent doses of a patent nostrum, the essential ingredient of which, 
 as with the bulk of patent epileptic cures, was bromide of potassium. 
 
 All of the other citations from medical authorities are of similar 
 import. The testimony also shows that in the opinion of such emi- 
 nent physicians as Drs. J. H. Musser, Eichard C. Cabot, N. S. Davis, 
 
276 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 E. L. Hunt, Charles G. Stocton, Wm. P. Sprattling, and Chas. S. 
 Williamson, it is impossible to make a reliable diagnosis of epilepsy 
 in the absence of the patient by the use of what are known as 
 '' symptom blanks " sent through the mails. The evidence further 
 shows that, in the opinion of these physicians, the promiscuous and 
 indiscriminate use of the bromide by epileptics, without the guidance 
 of a physician other than advice sent by mail, is attended by danger 
 to the patient. As to the merits of adonis vernalis, the other drug 
 used by the concern, six of the physicians knew of no instance in 
 which the cure of epilepsy could be attributed to the use of this drug. 
 Dr. Wm. P. Sprattling's answer is qualified as follows : 
 
 No; not that drug alone. The proper treatment of all the epilepsies — there 
 are many kinds — can only be carried out under the following essential heads: 
 Medical, general, dietetic, and surgical. Epilepsy of any type can no more be 
 properly treated by the use of drugs alone than can tuberculosis be treated by 
 drugs alone. A combination of the essentials is called for in each case — and it 
 is the scientific application of these that alone can produce the best results. 
 
 The evidence discloses the fact that " there have been connected 
 with this institute since it commenced business in the spring of 1903, 
 three physicians, namely. Dr. E. H. Schoenling, Dr. H. J. Luecke, 
 and Dr. A. L. Guertin. Dr. Schoenling stated at the hearing that 
 for about the first six months, being half owner for the first three 
 months, he attended to the medical end of the business for Mr. Kal- 
 mus, examining the symptom blanks and diagnosing the cases, pre- 
 scribing the treatment, and compounding it as well ; that after he left 
 Doctor Luecke did this work until December, 1907; and that since 
 then he has again done the diagnosing and prescribing, and Doctor 
 Guertin has done the compounding. Doctor Schoenling graduated in 
 1900, when about 22 years of age, has made no special study of epi- 
 lepsy except in connection with this mail-order business, is not a mem- 
 ber of any medical society, is not regarded in the profession as a 
 specialist, and has most of the time since his graduation worked for 
 $25 a week for a Dr. Charles Shafer, of Cincinnati, who advertises in 
 the public prints, soliciting kidney and urinary and sexual cases. The 
 salary paid him for his work at the institute, he says, has been less 
 than $100 a month ; he stated that he spent but a few hours each day 
 at the institute and regarded it as a sort of side line to his regular 
 work with Doctor Shafer. 
 
 Doctor Luecke graduated in 1901, went to this institute in 1903, has 
 had no special preparation in epilepsy, does not consider himself a 
 specialist, and was paid by the institute, the inspector says, only $15 
 a month. He is not a member of any medical society, his professional 
 standing is doubtful, his regular practice is sexual and urinary dis- 
 eases, and in December last his advertisements were excluded from 
 the Cincinnati papers on the ground that they related to the sale of 
 abortifacients and the performing of criminal operations in violation 
 of the statutes of the United States. Doctor Guertin receives $35 a 
 month from the institute for his services, works there but a few hours 
 each day, is not a member of any medical society, his standing in the 
 profession is questionable, he has little or no practice in Cincinnati, 
 and was investigated by this department in 1905 for giving a concern 
 against which was pending a charge of fraud under these statutes, 
 and against which a fraud order was later issued, a testimonial as to 
 its medicine, which he later admitted to the department was done for 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 277 
 
 a valuable consideration and without reading the statement which he 
 was paid to sign, and which he repudiated as untrue. He admits he 
 is not a specialist. 
 
 Those are the self-styled specialists, and " foremost examining 
 specialists of America " of this institute. No comment is needed on 
 these facts to show the utter falsity and fraudulency of the represen- 
 tations in question." 
 
 The brief, which covers 32 pages, also discloses the fact that this 
 institute has treated in all about 6,000 persons, and concludes as 
 follows : 
 
 The physicians of the institute were not specialists as pretended, nor did the 
 staff of the institute include the foremost examining specialises of America, but 
 in truth the physicians of the institute were young graduates and men without 
 standing in their profession and following questionable lines of practice, and 
 were men employed at what would seem to be about as small salaries as any 
 at which the required service could be obtained; and the treatment intended 
 to be adniinistered was not entirely harmless, but was of a nature that might 
 wreck the health and even reason and life themselves of the patient. There- 
 fore, while, in what may be said to be a comparatively few instances — as the 
 institute has not disclosed its re(?ords in the great number of its cases — patients 
 have experienced from the treatment what is the ordinary effect of the bromides 
 and may feel satisfied with so much, yet I feel it is not true that the other and 
 the greater share of the patrons of the institute have not been deliberately 
 deluded with false hopes and representations, and defrauded of the money 
 which they probably would not have paid if aware of the facts, in addition to 
 having their health, reason, and life endangered. 
 
 The answer to the claim that certain of the patrons are satisfied with what 
 benefit they do get from the treatment, is that in that event, were the business 
 conducted with an honest purpose, there should be no occasion for promising 
 any more. 
 
 The satisfaction of the few is not justification for the defrauding of the many. 
 Furthermore, this scarcely is a case in which the patients are sufficiently 
 familiar with the facts to be able to determine whether they should be satisfied 
 or not, and this is especially so of the patient who has commenced the treatment 
 but comparatively recently, and particularly among the class of people among 
 whom it appears the most of the business of the institute is solicited. 
 
 I find that the business conducted by Otto Kalmus under the name of the 
 Epileptic Institute and the Epileptic Institute Company at Cincinnati, Ohio, 
 referred to above, is a scheme for obtaining money through the mails by means 
 of false and fraudulent pretenses, representations, and promises, and I therefore 
 recommend the issue of a fraud order. The United States attorney at Cincin- 
 nati has caused criminal proceedings to be instituted against Mr. Kalmus for 
 having devised and used the mails in the operation of a scheme to defraud in 
 violation of section 5084, Revised Statutes, in connection with this Epileptic 
 Institute business. 
 
 A fraud order was issued July 23, 1908. 
 
 THE MIRACLE WORKERS. 
 
 Mr. Samuel Hopkins Adams, in Collier's Weekly, August 4, 1906, 
 gives an excellent account of several magnetic quacks, radio-quackery, 
 etc. The following memorandum is copied from the records of the 
 Assistant Attorney- General's Office in the case of Prof. T. A. Mann, 
 Institute of Radiopathy and Central School of Psychology, and 
 their officers and agents as such at Rochester, N. Y. The Postmaster- 
 General, April 29, 1908, issued an order forbidding the delivery 
 of mail matter and money orders to this concern. * * * ''In 
 these advertisements he endeavors by the use of misleading and ex- 
 travagant assertions to lead the reader to believe that he is a doctor 
 of eminence in the United States, that he has discovered a wonderful 
 
278 EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 force of nature possessing marvelous curative properties, that by 
 means of this power he is able to and will cure diseases which are 
 generally considered hopeless. Among the representations calculated 
 to produce this belief are those to the effect that ' with his phenom- 
 enal poAver this man works wonders, the blind see, the paralyzed 
 walk * * * there is no illness which he can not cure ; ' he gives 
 back health in a most incomprehensible manner to sick people who 
 have been declared by physicians to be incurable; that he can and 
 will cure blindness, deafness, consumption, paralysis, cancer, etc.; 
 that he has found the most marvelous power man has so far invented. 
 * * * His advertisements extended to the foreign press and com- 
 plaints are in the case from the Italian consular agent at New York, 
 from a member of the Berlin Press Association, from Mr. Louis 
 Michel, a prominent American residing in Germany, and from sev- 
 eral other persons, to the effect that Mann is swindling thousands of 
 poor persons in Italy, Germany, France, Spain, South America, 
 Central America, Mexico, and Cuba. One of the pamphlets issued 
 by him states that ' we thoroughly explain to you how to renew youth 
 and how to keep it ; how to acquire force and how to use it to conquer 
 environment.' " ' 
 
 OTHER FORMS OF QUACKERY. 
 TOPICAL REMEDIES.^* 
 
 Among these may be mentioned the fraudulent and misleading 
 advertisements in connection with many of the hair restoratives, 
 tonics, hair dyes, and a number of cosmetic preparations especially 
 intended for colored people, like "Glossine," "Anti-Kinkine," " Kink- 
 ine," "Straightine," "Ozonized Ox Marrow," for which it is claimed 
 that they will make kinky, knotty, and curly hair straight. The hair 
 restorers are credited with the property of producing a luxuriant 
 growth of hair, " make the hair grow out on bald spots," " turn gray 
 hair dark," etc. 
 
 Medical literature contains a number of instances in which symp- 
 toms of lead poisoning and cases of paralysis were traced to the 
 habitual use of cosmetics, hair dyes, and hair restorers. In the 
 Pharmacal Journal (Vol. LXXIV, p. 223) will be found a list 
 of hair restorers. In 12 articles analyzed the percentage of lead 
 varied from 0.3 to 2.32. Other drugs in such preparations have been 
 known to produce violent inflammation of the scalp. 
 
 In this category also come some of the skin tonics, face lotions, and 
 toilet preparations. One of the 9 analyzed contained 47 grains of 
 corrosive sublimate and this same poison was contained in varying 
 proportions of 1 to 15 grains per ounce in all; and yet it is claimed 
 that they are " perfectly harmless for the removal of freckles," " to 
 make pretty faces, etc." In discussing the subject of skin bleaches 
 and beautifiers, Doctor Kebler says that one of the agents used for 
 improving the complexion was found on analysis to consist largely 
 of Rochelle salts. Another product sold under the designation of 
 " complexion tablets " contained, among other ingredients, strychnin, 
 and he relates an instance where a child 2| years old accidentally 
 consumed a number of these tablets and died from strychnin poison- 
 
 o See Doctor Kebler's interesting article on nostrums and fraudulent methods 
 of exploitation, Jour. Am. Med. Assoc, Nov. 10-17, 1906. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 279 
 
 ing. In this connection he also exposes the fraudulent claims of the 
 Mexican Remedy Company for its "Aquamiel," " a magical bust de- 
 veloper and the most marvelous bust producing, blood enriching, 
 tissue forming preparation — a product of the famous mague plant 
 of Mexico." Analysis showed that the medicine is absolutely worth- 
 less as a tissue developer, etc. In like manner he disposes of the 
 numerous plasters advertised as " positive cures for consumption and 
 other ailments," " the American Herb cure," and " Force of Life 
 remedies," " Nutriola," etc. 
 
 PRESCRIPTION NOSTRUMS." 
 
 Since the passage of the food and drugs act, which forbids the use 
 of any statement, design, or device which is false or misleading on 
 the label or package of any drug product, etc., the manufacturers of 
 nostrums found themselves seriously handicapped. But as in all 
 diabolical pursuits, a way appears to have been found to circumvent 
 the provisions of the law. Doctor Kebler informs us that as long 
 as the law does not forbid the publication of misrepresentations and 
 fraudulent statements in newspapers, this opening is taken advantage 
 of by many promoters of medicinal agents. A rather common 
 method is the jmblication in the newspapers of advertisements ex- 
 tolling the virtue of certain remedies in certain diseases. Often the 
 receipt is published in connection with the advertisement or fur- 
 nished upon application free of charge. The prescription, however, 
 always contains at least one product bearing a unique coined name, 
 the nature and composition of which is known only by the advertiser, 
 or the parties interested in furnishing the sale of the remedy. As a 
 result the local druggist is either unable to compound the prescrip- 
 tion, or in doing so he is compelled to obtain it from the parties in 
 question, or the patient is compelled to have the prescription filled 
 by the advertiser at an exhorbitant price. Doctor Kebler states that 
 this is really an old scheme, which was exposed in the " Druggists' 
 Circular," page 3, 1859, in connection with the consumption cure of 
 a fictitious Rev. Edward A. Wilson, and a questionable " Extract 
 Blodgetti." The individual behind this scheme during recent years 
 was a Mr. C. A. Abbott, who himself has no medical knowledge 
 whatever, and it appeared in the recent investigation by the Post- 
 Office Department that wdth regard to the Wilson Remedy, no such 
 ingredient as extract blodgetti was used. This name was used in the 
 prescription solely for the purpose of making it impossible for the 
 average druggist to iill, thereby compelling the patient to send the 
 advertiser $3 for the treatment, although he has no intention of in- 
 cluding extract of blodgetti in the compound furnished by him on 
 such orders. The Postmaster- General promptly issued a fraud order 
 March 20, 1908. 
 
 Doctor Kebler calls attention to the "Arabian Sea Grass " prescrip- 
 tion in connection with " Le Grande Arabian Recipe," exploited by 
 a Dr. J. A. Lawrence, of Brooklyn, N. Y., " for the cure of catarrh, 
 
 «» Condensation of the subject-matter contained in a special paper prepared for 
 the Commission by Dr. Lyman F. Kebler, Division of Drugs, U. S. Dept. of 
 Agriculture. 
 
280 BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 bronchitis, hay fever, and all diseases of the mucous membrane," and 
 of which the " Druggists' Circular " in 1885 said : 
 
 It thus appears that 9 out of the 16 substances either do not exist or are not 
 articles of commerce. The trap is so evident that no druggist need fail to 
 see it, but we have no doubt that many persons are influenced to send the 
 " Doctor " $3 for the medicines. 
 
 Doctor Kebler writes of a similar scheme under the designation of 
 " Dr. Stevens' East India Consumption Cure," and gives the follow- 
 ing sample of the advertisement used in newspapers : 
 
 Consumption. An old physician, retired from business, had placed in his 
 hands by an East India missionary the formula of a simple vegetable remedy for 
 the speedy and permanent relief of consumption, bronchitis, catarrh, asthma, 
 and all throat and lung affections; also a positive and radical cure for nervous 
 debility and all nervous complaints. Having tested its wonderful curative 
 powers in thousands of cases, and desiring to relieve human suffering, I will 
 send free of charge to all who wish it this recipe, with full directions for pre- 
 paring and using. Sent by mail, by addressing, with stamp, naming this paper, 
 W. A. Noyes, 847 Powers Block, Rochester, N. Y. 
 
 As in the case of the Wilson remedy, the patient, upon replying to 
 the advertisement, received printed matter setting forth a prescrip- 
 tion, testimonials, and a story telling how " Dr. Stevens," who in 
 1886, was afflicted with consumption, was cured through the agency 
 of the " Sativa remedy," which he received from the hands of an aged 
 missionary who had spent many years in India and other countries 
 of the East, and who had given the recipe to his successor, W. A. 
 Noyes, the present owner of the business, with the admonition to 
 carry on the work of making the remedy known to the afflicted as 
 long as was possible. 
 
 The prescription contained 10 ingredients, among them 2 unknown 
 substances. Investigation by the Post-Office Department developed 
 the fact that there was not, at the time of the investigation nor had 
 there ever been a Doctor Stevens or a missionary connected with the 
 scheme, and a fraud order was promptly issued. 
 
 It will be readily understood that such schemes can not be carried 
 on for any length of time without attracting the attention of the 
 officials of the Post-Office Department or of the Bureau of Chemistry. 
 The scheme finally evolved, according to Dr. Kebler, is " that the 
 false and misleading representations, statements, and promises should 
 appear in newspapers in the form of ' reading advertisements.' " 
 The advertisement usually contained a prescription, the filling of 
 which required several well-known efficacious agents, together with 
 a " fancy name " product. The prospective patient was advised that 
 the prescription could be filled by any druggist. The druggist, 
 therefore, is made a party to the scheme. In order to render the 
 scheme more effective, it w;is found desirable to place the advertise- 
 ment in papers in such a manner as to make them appear either as 
 editorials or general reading matter. As can readily be seen, this 
 required the acquiescence and cooperation of those interested in the 
 management of newspapers. On inquiry it was found that news- 
 paper managers require an increased rate in placing these advertise- 
 ments, double the regular price being the customary charge. From 
 the large amount of advertising and the number of these remedies, 
 this scheme has apparently been very attractive, not only to the news- 
 papers, but to the promoters of these remedies as well. The earlier 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 281 
 
 mail-order remedies were intended for the ignorant classes, but the 
 modernized scheme is for the benefit of the better educated, and that 
 it does appeal to this class is shown by the fact that requests for in- 
 formation concerning the same come from lawyers. Congressmen, 
 doctors, etc. 
 The following is a copy of one of the advertisements: 
 
 AN editor's advice TO KHEUMATICS. 
 
 It is truly said that the " Lord tempers the wind to the shorn lamb," and 
 He also seems to send for every ill a remedy. Modern science has done much 
 to develop these remedies, yet sufferers from rheumatism occasionally find it 
 hard to believe that there exists any positive relief for their distress. Never- 
 theless, we are in a position to recommend to our readers who suffer from 
 rheumatism or kidney or bladder trouble or any derangement of the urinary 
 or^^ans an unfailing relief for their pains. This, we know, will be all the more 
 welcome news because the remedy is easily produced. 
 
 Go ask your druggist for one-half ounce fluid extract cascara aromatic, 1 
 
 ounce of concentrated compound, and 4 ounces of aromatic elixir. The 
 
 compound is put up only in 1-ounce bottles, so be sure you get the right 
 
 article. Take these three things home, put them in a bottle, mix them, and 
 take 1 teaspoonful after each meal and at bed time. For children, from one- 
 third to one-fourth of this dose will be enough. In order to make a permanent 
 cure doubly certain it is best to continue taking the remedy for several days 
 after all pain and swelling have disappeared. You will then be as free from 
 pain as if you had never known what rheumatism was. 
 
 Investigation by Doctor Kebler shows that " since the passage of 
 the federal law about 40 of these prescription nostrums have been 
 launched. * * * The price charged is exorbitant to a degree. 
 * * * This is admitted even by the promoters, but the contention 
 is that it is necessary to charge a high price because of the extensive 
 and expensive advertising necessary to bring the remedies to the atten- 
 tion of the public. The men back of these schemes are usually nt)w, 
 or have been, connected with some advertising agency or have acted 
 in the capacity of advertising agent of some newspaper. They have 
 no knowledge of medicines and claim none is needed, because the 
 large pharmaceutical manufacturers are prepared not only to supply 
 the medicine but the medical data as well. The afflictions usually 
 aimed at for treatment by these remedies are those affecting the lungs, 
 stomach, liver, kidneys, and heart." 
 
 ErnCIENT WORK OF THE POST-OFFICE DEPARTMENT AND OF THE DEPART- 
 MENT OF AGRICULTURE IN ENFORCING THE LAW AROUSES OPPOSITION. 
 
 Sufficient evidence has been presented to indicate that the executive 
 departments of the Government are determined to administer the law 
 upon the principle that " Righteousness exalteth a nation." It was 
 to be expected that the promoters of fraudulent transactions would 
 leave no stone unturned to accomplish their purpose. In the lan- 
 guage of " Collier's Weekly," June 23, 1906 : 
 
 There was an ominous presumption of foreknowledge in what Attorney Lan- 
 nen, representing the National Food Manufacturers' Association in its fight for 
 adulterated foods, said at the pure food hearing : " I say that it will be but a 
 short time (sic) before the Post-Office Department will be made to conform to 
 better rules in promoting justice." 
 
 On March 12, 1906, a bill was introduced by Mr. Crumpacker in 
 the House of Representatives to provide for a judicial review of 
 
282 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 orders excluding persons from the use of United States mail facili- 
 ties." The effect of this legislation, in the judgment of the Post- 
 Office Department, would be to paralyze the good work by the Gov- 
 ernment in suppressing " fake get-rich schemes," " quack medicinal 
 cure-alls," and an inconceivable variety of confidence games per- 
 petuated through false and misleading advertisements, such as have 
 in the past cost the public millions of dollars. 
 
 According to the report of the Postmaster-General " over 2.400 
 fraud orders have been issued by the Post- Office Department under 
 authority of the act of 1890 and the supplemental act of 1895. In 
 less than 30 of these cases has the propriety of the order been chal- 
 lenged in court, and in none of them has it been held erroneous or 
 unwarranted. This record is of exceeding significance, and shows 
 clearly that the administration of these statutes by the Post-OfRce 
 Department has been marked by the utmost care and conservatism. 
 The period of time extends over the administration of many different 
 Postmasters-General of varying political parties, and the same thor- 
 oughness and judicial caution have characterized the administration 
 of the statutes by all of these officers. This record is strong assur- 
 ance that their future enforcement will be marked by full regard for 
 the rights and privileges of all citizens." 
 
 The following are extracts from the statement of the case by the 
 People's Lobby: 
 
 FRAUD ORDERS NOW REVIEWED BY THE COURTS. 
 
 From this excerpt it is clear that the courts do now review the action of the 
 Postmaster-General in issuing orders. In order to relieve the department of 
 unjust criticism, however, the Postmaster-General is not opposed to an express 
 provision of the law for a review in the manner provided by the bill prepared 
 by Representative Foster, a member of the Judiciary Committee, which meas- 
 ure was passed over in favor of the Crumpacker bill. 
 
 Although the measure is of such vital importance, it was never submitted to 
 the Postmaster-General for his opinion, nor was he asked to appear before the 
 Judiciary Committee of the House. The Assistant Attorney- General for the 
 Post-Office Department appeared of his own volition and argued against the 
 bill. * * * 
 
 It is positively asserted by the Post-Office Department that the influences 
 behind the Crumpacker bill are B. G. Lewis, of St. Louis, Mo., " Prof." Thomas 
 F. Adkin, of Rochester, N. Y., and the "Hon." E. F. Hanson, of Chicago, 111. 
 Lewis was the promoter of the People's United States Bank, which was organ- 
 ized to transact all its business through the mails. A fraud order was issued 
 against the People's Bank, July 6, 1905, because of the alleged false and 
 fraudulent representations which the Postmaster-General declared Lewis made 
 in the promotion of his scheme. Of these one of the most important was the 
 promise that no loan of funds should be made to the president or to any of the 
 directors of the bank. Up to the time of the issuance of the fraud order loans 
 had been made to Lewis and to certain of his business enterprises aggregating 
 $907,538.83 upon insufficient security or no security at all. 
 
 The action of the Postmaster-General in issuing a fraud order against the 
 People's Bank was reviewed by the United States circuit court of appeals, and 
 the Postmaster-General was fully sustained. 
 
 Adkin was the head of the so-called " New York Institute of Physicians and 
 Surgeons," of Rochester, N. Y., which, in advertising a treatment for disease 
 denominated " vitaopathy," made such extravagant claims as in the following 
 advertisement : 
 
 " Dead man talked back to life. Miraculous rescue from grave. Medical 
 science completely upset by Rochester wonder-worker, who restores life and 
 heals the sick without the use of drastic drugs or the surgeon's knife; hope- 
 less invalids restored to health. 
 
KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 283 
 
 " I feel that it is my duty as a Christian to use this wonderful power that 
 has been given to me for the benefit of all mankind to cast out from their 
 body the evils of disease. I have cured them that quiclily that I have been 
 credited with working miracles." 
 
 Adkin and the " New York Institute of Physicians and Surgeons " were de- 
 nied the use of the mails, and the action of the Post-Office Department was 
 sustained by the supreme court of the District of Columbia. 
 
 Hanson organized the " Nutriola Company " at Belfast, Me., and subsequently 
 moved his patent medicine business to Chicago, 111. A fraud order was issued 
 against this concern. Furthermore, Hanson was indicted and convicted on the 
 charge of misusing the mails because some of his literature was improper and 
 obscene. * * * 
 
 The Congressional Record bears out the charge that the Crumpacker Bill 
 was railroaded through the House. Three days before the holiday recess 
 the sponsor oi this measure secured the passage of a resolution placing it on 
 the calendar as a privileged bill. It is of particular importance to note that 
 Mr. Crumpacker put through his resolution largely on this statement : 
 
 " I submitted the bill to Mr. Overstreet, the chairman of the Committee on 
 the Post-Office and Post-Roads * * * and he said the bill ought to be 
 passed. He has had experience enough to believe the bill ought to pass, and 
 all I am asking now is to give the bill a status on the calendar so as it can 
 be taken up on its merits." 
 
 Mr. Overstreet was absent when this statement was made. As a matter 
 of fact, the chairman of the Committee on the Post-Office and Post-Roads made 
 the strongest speech in opposition to the bill when it came up for final action 
 January 7, 1907, and objected privately to Mr. Crumpacker that morning on 
 the inadequate time to be allowed for the consideration and discussion of so 
 vital a measure. Representative Mann, of Illinois, also opposed the bill in a 
 vigorous manner. 
 
 The Crumpacker Bill is now in the Judiciary Committee of the Senate, 
 where it is hoped more consideration will be given to the protection of the 
 public and less weight attached to the interests of borrower Lewis, the " Hon." 
 E. F. Hanson, and " Professor " Adkin. 
 
 It is gratifying to note that the bill was held up by the Senate Judiciary 
 Committee for a careful consideration. 
 
 CONCLUSIONS AND RECOMMENDATIONS. 
 
 A review of the evidence in the foregoing pages reveals the fact that 
 existing laws are insufficient to cope with the evil. The enactment 
 of Mr. Mann's bill, House resolution, and other amendments to the 
 poison law. while steps in the right direction, will not prevent im- 
 proper traffic in the habit-forming drugs so long as we have to deal 
 with unscrupulous persons even in the ranks of the medical, dental, 
 or veterinary profession — and for whom adequate punishment should 
 be provided whenever, in the judgment of the court, they have 
 abused their professional rights and privileges. As far as the sup- 
 pression of quackery is concerned, nothing short of a total exclusion 
 from the mails of letters, newspapers, circulars, pamphlets, or publi- 
 cations of any kind containing any advertisement of secret remedies 
 for the cure and treatment of disease, will reach the evil. As a 
 matter of fact, no physician should be permitted to prescribe by mail. 
 
 In view of the importance of the subject, it is recommended that 
 a special commission, composed of representatives of the Post-Office 
 Department, Prof. H. W. Wiley, of the Bureau of Chemistry, and 
 medical officers of the Public Health and Marine- Hospital Service, 
 be appointed for the purpose of investigation and the formulation 
 of such legislation as may be deemed necessary in the interest of 
 public health and morals. 
 
284 REPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Ill the meantime, it is earnestly recommended that the Postmaster- 
 General be requested to publish with the monthly supplements to the 
 Official Postal Guide a bulletin setting forth the essential facts in 
 connection with the fraud orders issued during the preceding months, 
 such bulletins to be posted in post-offices and to be distributed in 
 sufficient numbers along the rural-delivery routes. It is also recom- 
 mended that all information concerning the harmful ingredients in 
 foods, medicines, soft and alcoholic drinks which may come to light 
 during the execution of the pure food and drugs law, be published 
 by the Department of Agriculture in the same manner as farmers' 
 bulletins are now being published. The public is entitled to be 
 warned, and for this purpose it is essential that the indisputable facts 
 should emanate from some official source. 
 
 The Journal of the American Medical Association has done good 
 work in educating the medical profession, and many of our lead- 
 ing magazines have disseminated knowledge of this kind among 
 their readers ; but, after all, the masses must be reached in the manner 
 indicated, as the majority of newspapers will not publish the facts. 
 
 Chapter XL 
 
 SOCIOLOGICAL STUDY OP 1,251 FAMILIES. 
 
 [By G. H. Weber, Statistician of the Commission.] 
 
 SCOPE. 
 
 The investigation, which was conducted during the months of 
 February to June, inclusive, covered a total of 1,251 families, occupy- 
 ing 1,054 houses, and comprising 5,157 persons. The plan of the 
 commission was to investigate only those families whose incomes 
 were below $1,000 per annum. In some cases, where family incomes 
 were greater, but where the families lived under the same general 
 conditions and on the same streets and alleys, they were also in- 
 cluded. In selecting the streets, courts, and alleys the aim has been 
 to take a number of alleys where the living conditions were worst, a 
 fairly equal number where they were medium, and a corresponding 
 number where the conditions were the best. This was done in order 
 to give, as nearly as possible, a true picture of the housing, social, 
 and economic conditions of these people as a whole. 
 
 It has also been the aim of the commission to have the investiga- 
 tion cover a proportion of white and of colored families equal to that 
 of the total white and colored families of that class in Washington. 
 
 The following table shows, by streets and sections, the number of 
 houses, families, and persons included in the investigation: 
 
EEPORTS OP THE PRESIDENT S HOMES COMMISSION. 
 
 285 
 
 WHITE. 
 
 Northwest: 
 
 Twenty-seventh street 
 
 Cissel alley 
 
 Temperance avenue 
 
 Lingers court 
 
 Potomac street 
 
 Jackson Hall alley 
 
 Valley street 
 
 Bank street 
 
 Snow aUey 
 
 JefEerson street 
 
 Thirtieth street 
 
 Purdys court 
 
 Total. 
 
 Northeast: 
 
 Gales street 
 
 Twentieth street. 
 Brewers court . . . 
 Pleasant alley... 
 Kjamer street... 
 
 Total. 
 
 Southeast: 
 
 L street 
 
 K street 
 
 Fourteenth street. 
 
 Twelfth street 
 
 Fifth street 
 
 Thirteenth street. 
 Greorgia avenue... 
 Mechanics place . . 
 
 Total. 
 
 Southwest: 
 
 Rileys court , 
 
 Twelfth street 
 
 Maryland avenue. 
 
 Huntoon place 
 
 Armory place 
 
 Union street 
 
 McLean street 
 
 Willow Tree alley. 
 
 Nolans court 
 
 F street 
 
 Total 
 
 Total, all sections. 
 
 COLORED. 
 
 Northwest: 
 
 Twenty-seventh street 
 
 Cissel alley 
 
 Temperance avenue 
 
 Lingers court 
 
 Brainard street 
 
 Potomac street 
 
 Jackson Hall alley 
 
 Kings court 
 
 Philips court 
 
 Cleveland street 
 
 Shepherd alley 
 
 Valley street 
 
 O street alley 
 
 Bank street 
 
 Snow alley 
 
 Number 
 of houses, 
 
 23 
 10 
 
 al 
 
 65 
 
 a 12 
 
 21 
 
 1 
 
 2 
 
 o38 
 
 2 
 
 12 
 
 C127 
 
 Number 
 
 of 
 families. 
 
 109 
 
 144 
 
 («) 
 
 ol86 
 
 d566 
 
 13 
 
 5 
 
 e33 
 
 e27 
 
 7 
 
 /5 
 
 el6 
 
 9 
 
 16 
 
 44 
 
 13 
 
 29 
 
 36 
 
 6 
 
 42 
 
 143 
 
 29 
 
 148 
 
 33 
 
 191 
 
 Number of persons. 
 
 Adults. 
 
 64 
 
 29 
 
 2 
 
 4 
 
 25 
 
 53 
 
 66 
 
 3 
 
 5 
 
 134 
 
 436 
 
 104 
 27 
 33 
 12 
 
 116 
 
 292 
 
 372 
 
 558 
 
 594 
 
 Children 
 
 under 
 16 years. 
 
 a Not including 1 house occupied by both colored and white persons. 
 bNot including 2 houses occupied by both colored and white persons. 
 eNot including 6 houses occupied by both colored and white persons. 
 «lNot including 7 houses occupied by both colored and white persons, 
 « Including 1 house occupied by both colored and white i)ersons. 
 /Including 2 houses occupied by both colored and white iwrsong. 
 
 227 
 
 220 
 
 301 
 
 1,000 
 
286 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 
 Number 
 ofhouses. 
 
 Number 
 
 of 
 families. 
 
 Number of persons. 
 
 
 Adults. 
 
 Children 
 
 under 
 16 years. 
 
 Total. 
 
 COLORED— ccntinued. 
 
 Northwest— Continued. 
 
 Goat alley. . . . . 
 
 39 
 
 a 10 
 
 3 
 
 A7 
 16 
 4 
 
 113 
 45 
 17 
 
 57 
 22 
 2 
 
 170 
 
 Jefferson street 
 
 67 
 
 Johnson avenue 
 
 19 
 
 
 
 Total 
 
 6 353 
 
 m 
 
 1,261 
 
 535 
 
 1,796 
 
 
 Northeast: 
 
 Gales street 
 
 6 
 12 
 11 
 
 6 
 
 15 
 11 
 
 16 
 46 
 22 
 
 6 
 34 
 17 
 
 22 
 
 Levis street 
 
 80 
 
 
 39 
 
 
 
 Total 
 
 29 
 
 32 
 
 84 
 
 57 
 
 141 
 
 
 
 Southwest: 
 
 Armory place 
 
 3 
 
 38 
 
 31 
 
 o34 
 
 6 
 
 »8 
 41 
 49 
 46 
 10 
 
 »-25 
 100 
 118 
 109 
 34 
 
 4 
 47 
 43 
 73 
 
 9 
 
 29 
 
 Van street 
 
 147 
 
 Willow Tree aUey 
 
 161 
 
 Nolans court 
 
 182 
 
 F street 
 
 43 
 
 
 
 Total 
 
 a 112 
 
 ■ M 
 
 386 
 
 176 
 
 562 
 
 
 
 Tot^l, all sentions 
 
 C494 
 
 d657 
 
 d 1, 731 
 
 768 
 
 2,499 
 
 
 Total, white and colored 
 
 cl,060 
 
 d 1,251 
 
 d3,389 
 
 1,768 
 
 5,157 
 
 
 o Including 1 house occupied by both colored and white persons. 
 
 b Including 6 houses occupied by both colored and white persons. 
 
 c Including 7 houses occupied by both colored and white persons. 
 
 d Includes 2 mixed families, 7 white and 5 colored adults living together, all counted as colored. 
 
 Of the 1,251 families investigated 594, or 47^ per cent, were white 
 and 52J per cent were colored, and of the total persons constituting 
 these families 2,658, or 51J per cent, were white, and 2,499, or 48^ 
 per cent, were colored. 
 
 LIVING CONDITIONS. 
 
 The poorer people of Washington, unlike those of most other cities, 
 live mainly in small one- family houses. This is shown by the fact 
 that 2,151 families visited occupied 1,054 separate houses. These 
 houses are nearly all old two-story brick or frame buildings without 
 such modem conveniences as hot and cold water, bathrooms, or inside 
 water-closets. Cases of overcrowding were common, especially among 
 the colored people, in some instances as many as eight or ten people 
 occupying one bedroom at night. Cases were also common where 
 families crowded in one or two rooms at night when sitting or dining 
 rooms could have been utilized for sleeping purposes. In general, 
 however, where apartments were small and families large, all avail- 
 able space, even the kitchens, were used as bedrooms. While the num- 
 ber of families keeping boarders or lodgers was comparatively small, 
 not a few cases were found where members of families of both sexes, 
 old and young, slept in the same rooms with lodgers. The moral and 
 sanitary effects of such conditions are obvious. 
 
KEPORTS OP THE PRESIDENT S HOMES COMMISSION, 
 
 287 
 
 INCOME AND EXPENDITURES. 
 
 In the case of 1,217 families, for which fairly accurate returns 
 were made concerning income and expenditures, 476, or 39 per cent, 
 had a family income of $500 or less per annum; 159, or 13 per cent, 
 had an income of from $500 to $600 ; 153, or 12^ per cent, from $600 
 to $700 ; 153, or 12i per cent, from $700 to $800 ; 89, or 7 per cent, from 
 $800 to $900 ; 93, or 8 per cent, from $900 to $1,000 ; 82, or 7 per cent, 
 from $1,000 to $1,500; and 12, or 1 per cent, had an annual income of 
 over $1,500. 
 
 The average income and expenditures for each of these groups are 
 shown in absolute and relative figures in the following tables : 
 
 Average annual expenditures of one family. 
 
 Income. 
 
 Num- 
 ber 
 fami- 
 lies in 
 class. 
 
 Aver- 
 age size 
 of fami- 
 lies. 
 
 Average 
 income 
 
 per 
 family. 
 
 Rent. 
 
 Food. 
 
 Fuel 
 and 
 light 
 
 Cloth- 
 ing. 
 
 Insur- 
 ance. 
 
 Sick- 
 
 and 
 death. 
 
 Class A, $500 or under 
 
 Class B, SoOO to S no 
 
 Class C, $000 to $700 
 
 Class D, $700 to SSOO 
 
 Class E, $800 to S9:)0 
 
 Class F, $900 to $1,000 
 
 Class G, $1,000 to $1,500... 
 Class H, $1,500 and upward 
 
 476 
 159 
 153 
 153 
 89 
 93 
 82 
 12 
 
 3.11 
 3.94 
 4.18 
 4.40 
 4.79 
 4.77 
 5.48 
 4.50 
 
 $351. 35 
 546. 31 
 638.57 
 749. 91 
 846. 93 
 921. 41 
 
 , 182. 93 
 
 1,899.58 
 
 $72. 69 
 97.44 
 106.16 
 119. 04 
 115. 12 
 127. 36 
 135. 52 
 100.58 
 
 $146.85 
 220. 55 
 265.55 
 296.54 
 341.65 
 340.73 
 378. 74 
 401.00 
 
 $26. 25 
 33.88 
 32.18 
 38.01 
 37.03 
 38.91 
 41.81 
 49.83 
 
 $32. 54 
 53.62 
 69. 67 
 82.75 
 97.68 
 104. 13 
 148. 48 
 193. 16 
 
 $12.25 
 20.24 
 19.05 
 16.08 
 23.79 
 24.22 
 31.08 
 32.83 
 
 $5.43 
 5.05 
 6.77 
 9.90 
 
 10.51 
 8.80 
 
 15.46 
 
 47.83 
 
 Income. 
 
 Class A, $500 or under 
 
 Class B, $.500 to $000 
 
 Class C, $600 to $700 
 
 Class D, $700 to $800 
 
 Class E, $800 to $900 
 
 Class F, $900 to $1,000 
 
 Class G, $1,000 to $1,500... 
 Class H, $1,500 and upward 
 
 Num- 
 ber 
 
 fami- 
 lies in 
 class. 
 
 476 
 159 
 153 
 153 
 89 
 93 
 82 
 12 
 
 Aver- 
 age size 
 of fami- 
 lies. 
 
 3.11 
 3.94 
 4.18 
 4.40 
 4.79 
 4.77 
 5.48 
 4.50 
 
 Patent 
 medi- 
 cines. 
 
 $0.97 
 1.18 
 1.69 
 1.35 
 1.40 
 .97 
 3.71 
 2.08 
 
 Liquor, 
 
 $8.82 
 16.44 
 21.08 
 18.67 
 12.77 
 15.31 
 14.78 
 21.25 
 
 To- 
 bacco. 
 
 $4.72 
 
 7.64 
 11.10 
 13.12 
 13.52 
 16.25 
 12.53 
 19.50 
 
 Amuse- 
 ment. 
 
 $5.02 
 11.27 
 14.52 
 28.91 
 30.95 
 41.41 
 38.40 
 73.00 
 
 Miscel 
 laneous 
 
 or 
 other 
 
 $34.34 
 69.36 
 74.23 
 82.35 
 102. 64 
 109.90 
 210. 02 
 241.16 
 
 Total. 
 
 $349.88 
 636.67 
 622.00 
 706.72 
 787. 06 
 827. 99 
 1,030.53 
 1,182.22 
 
 Sur- 
 plus. 
 
 $9.64 
 16.57 
 43.19 
 59.87 
 93.42 
 152. 40 
 717.36 
 
288 EEPOBTS OF THE PKESIDENt's HOMES COMMISSION. 
 
 Showing same averages hy percentage. 
 
 Income. 
 
 Num- 
 ber 
 fami- 
 lies in 
 class. 
 
 lies, ^^^ 
 
 Rent. 
 
 Food. 
 
 Fuel 
 and 
 light. 
 
 Cloth- 
 ing. 
 
 Insur- 
 ance. 
 
 Sick- 
 
 and 
 death. 
 
 Class A, 1500 or under 
 
 Class B, $500 to $600 
 
 Class C, S600 to $700 
 
 Class D, $700 to $800 
 
 Class E, $800 to $900 
 
 Class F, $900 to $1,000 
 
 Class G, $1,000 to $1,500. . . . 
 Class H, $1,500 and upward. 
 
 476 
 159 
 153 
 153 
 89 
 93 
 82 
 12 
 
 3.11 
 3.94 
 4.18 
 4.40 
 4.79 
 4.77 
 5.48 
 4.50 
 
 100.00 
 100.00 
 100.00 
 100.00 
 100.00 
 100.00 
 100.00 
 100.00 
 
 21.37 
 
 17.56 
 17.17 
 15.64 
 13.31 
 13.60 
 10.96 
 5.37 
 
 43.68 
 43.59 
 41.40 
 40.21 
 41.92 
 38.43 
 33.38 
 21.03 
 
 6.74 
 5.41 
 4.88 
 4.89 
 4.33 
 4.05 
 3.34 
 2.77 
 
 8.99 
 9.90 
 10.53 
 11.14 
 11.59 
 11.70 
 11.55 
 10.23 
 
 2.80 
 3.04 
 2.67 
 2.27 
 2.77 
 2.90 
 2.39 
 1.90 
 
 2.12 
 .81 
 1.00 
 1.40 
 1.30 
 1.10 
 1.34 
 3.22 
 
 Income. 
 
 Num- 
 ber 
 fami- 
 lies in 
 class. 
 
 Aver- 
 age size 
 of fami- 
 lies. 
 
 Patent 
 medi- 
 cines. 
 
 Liquor. 
 
 To- 
 bacco. 
 
 Amuse- 
 ments. 
 
 Miscel- 
 laneous 
 
 or 
 other. 
 
 Total. 
 
 Sur- 
 plus. 
 
 Class A, $500 or under 
 
 Class B, $500 to $600 
 
 Class C, $600 to $700 
 
 Class D, $700 to $800 
 
 Class E, $800 to $900 
 
 Class F, $900 to $1,000 
 
 Class G, $1,000 to $1,500.... 
 Class H, $1,500 and upward. 
 
 476 
 159 
 153 
 153 
 89 
 93 
 82 
 12 
 
 3.11 
 3.94 
 
 4.18 
 4.40 
 4.79 
 4.77 
 5.48 
 4.50 
 
 0.29 
 .16 
 .18 
 .18 
 .13 
 .11 
 .23 
 .14 
 
 1.97 
 2.33 
 3.27 
 2.32 
 1.39 
 1.89 
 1.41 
 .90 
 
 1.21 
 1.45 
 1.82 
 1.71 
 1.52 
 1.76 
 1.19 
 1.02 
 
 1.47 
 2.76 
 2.68 
 3.52 
 3.43 
 3.95 
 3.97 
 4.00 
 
 7.76 
 10.78 
 11.20 
 10.78 
 12.04 
 11.89 
 14.01 
 14.08 
 
 98.39 
 97.73 
 96.82 
 94.10 
 93.76 
 91.42 
 86.29 
 64.58 
 
 3.18 
 2.42 
 3.18 
 5.90 
 6.28 
 8.58 
 13.71 
 35.42 
 
 Average weekly expenses {per cent). 
 
 Income. 
 
 Meats. 
 
 Fats. 
 
 Sugar. 
 
 Bread. 
 
 Vege- 
 tables. 
 
 Fruit. 
 
 Coffee. 
 
 Tea or 
 cocoa. 
 
 Class A, $.500 or under 
 
 1.13 
 
 1.67 
 1.84 
 2.16 
 2.38 
 2.27 
 2.76 
 3.31 
 
 0.24 
 .38 
 .38 
 .42 
 .51 
 .51 
 .85 
 .95 
 
 0.13 
 .19 
 .18 
 .21 
 .23 
 .22 
 .28 
 .30 
 
 0.48 
 .62 
 .65 
 .64 
 .82 
 .74 
 1.00 
 1.75 
 
 0.53 
 .80 
 1.06 
 1.42 
 1.50 
 1.65 
 1.34 
 1.02 
 
 0.16 
 .13 
 .18 
 .22 
 .23 
 .33 
 .35 
 .38 
 
 0.13 
 
 .17 
 .23 
 .27 
 .28 
 .33 
 .35 
 .32 
 
 0.07 
 
 Class B, $500 to $600 
 
 .13 
 
 Class C, $(J00 to $700 
 
 .15 
 
 Class D, $700 to $800 
 
 .15 
 
 Class E, $800 to $900 
 
 .18 
 
 Class F, $900 to $1,000 
 
 .20 
 
 Class G; $1,000 to $1,500 
 
 .17 
 
 Class H, $1,500 and upward 
 
 .11 
 
 
 
 These fibres show actual money received and expended. In the 
 expenditures no items appear unless they represent money actually 
 paid out. Where items of rent, food, clothing, etc., were unpaid at 
 the close of the year they do not figure in the expenditures. 
 
 The average family, with an income of $500 or less per annum, 
 expended about $6 per month for rent, this item constituting about 21 
 per cent of the total family income. The average monthly rents for 
 the other six groups were about $8, $9, $10, $9.50, $10.50, and $11, 
 respectively. It will be observed, by consulting the second table, that 
 the proportion of income paid for rent diminishes steadily with the 
 increase in the family income. Thus, an average family with an 
 income of $500 or less expended 21 per cent for rent; an average 
 family with an income of $500 to $600 expends 17^ per cent; $600 
 to $700, I7i per cent; $700 to $800, 15f per cent; $800 to $900, 13i 
 per cent; $900 to $1,000 13§ per cent, an average family with an income 
 of $1,000 to $1,500, and living in the territory investigated, expends 
 only about 11 per cent of its income for rent. 
 
BEPOETS OF THE PBESIDENt's HOMES COMMISSION. 289 
 
 In the matter of food the average family earning $500 or less 
 expended about $147 per year, or about 44 per cent of the total in- 
 come. This proportion also decreases almost steadily with the increase 
 in income, the average family in the highest class paying propor- 
 tionately onlj^ about 21 per cent of its income for food. 
 
 The same is true with regard to fuel and light, for which the 
 average family of the lowest income group pays $26, or 6f per cent, 
 for fuel and light, while the average family of the highest income 
 group pays about $42, or 2| per cent. 
 
 While for these necessities of life, i. e., shelter, food, heat, and light, 
 the proportion of expenditure increases with the decrease of income, 
 it is not so with other items. In the matter of clothing, the propor- 
 tion increases steadily from 9 to about 11 J per cent in the first six 
 income groups, namely, those of $1,000 and under, and then decreases 
 to lOJ per cent in the highest income group. The proportion of the 
 income paid for insurance varies irregularly in the different income 
 groups, being distinctly higher, however, in the case of families with 
 incomes of less than $1,000 than in the case of families whose incomes 
 are higher. The items of amusements, like that of clothing, increases 
 proportionately with the increase in family income. The other items 
 of expenditure show no marked tendency to increase or decrease in 
 family income. 
 
 The expenditures for liquor and tobacco, as shown in the table, are 
 probably less than those actually incurred, as all the investigators 
 report a tendency on the part of the families visited to minify this 
 item of expense. As it is, however, it shows that by eliminating this 
 useless expense an average family earning $500 or less per annum 
 could save over $12 per year, which, if added to the rent, would 
 materially improve the home conditions of the family. In the case 
 of the other families with incomes of $1,000 or less per annum, the 
 average annual expenditures for liquor and tobacco range, in the 
 different income groups, from about $24 to $32. Taken as a whole, 
 the families investigated could add on an average of at least one room 
 each to their overcrowded homes if the money expended for intoxi- 
 cants and tobacco were devoted to the payment of rent. 
 
 Sickness and death (including expenditures for patent medicines) 
 caused an annual expenditure ranging, in the different income groups, 
 from about $6.50 to $50 per annum. 
 
 The surplus remaining after deducting the annual family expend- 
 itures from the annual family incomes, as shown by the income 
 groups, increased steadily with the family income, ranging in amount 
 from $6.40 in the lowest group ($500 per annum and under) to 
 $718.92 in the highest group. It must be remembered that this last 
 group consists largely of families who live in the environments where 
 they were found on account of business interests, such as families of 
 grocers, saloon keepers, etc., or of foreign males who maintain 
 cooperative households and send a large part of their earnings to 
 their dependents abroad. 
 
 The 1,123 families whose incomes were less than $1,000 per annum 
 
 had an average income per family of $559 per year. Of this average 
 
 income, $435, or 78 per cent, were expended for actual necessities, 
 
 namely, for rent, food, fuel, clothing, insurance, sickness, medicines, 
 
 S. Doc. 644, 60-2 ^20 
 
290 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 and death. This leaves but $124, or 22 per cent, for all other expendi- 
 tures and for savings. Of this balance $23, or 4 per cent of the entire 
 income, were expended for intoxicating liquors and tobacco ; $15, or 3 
 per cent, for amusements; $63, or 11 per cent, for miscellaneous; 
 leaving $23, or 4 per cent of the average income, to be laid aside as 
 savings. 
 
 OCCUPATIONS. 
 
 Of the total occupants of the houses visited, the occupations of 
 2,413 wage-earners were ascertained. Of these 821 were white males, 
 708 were colored males, 153 were white females, and 731 were colored 
 females. It will be noticed that of the white people visited and whose 
 occupations were reported, only about 17J per cent were females, 
 while of the colored people over one-half of the wage-earners were 
 females. 
 
 Of the white males, about 42J per cent were skilled workers, such as 
 carpenters, painters, machinists, etc.; 27^ per cent were unskilled 
 laborers; 9i per cent were clerks, salesmen," etc. ; 8 per cent were 
 peddlers and hucksters ; 6 J per cent were drivers and teamsters. The 
 remaining 7J per cent were shopkeepers, persons engaged in personal 
 or domestic service, and various other occupations. 
 
 Of the colored male wage-earners, 56J per cent were unskilled 
 laborers; 19^ per cent were drivers and teamsters; 7^ per cent were 
 engaged in personal or domestic service; 5f per cent were skilled 
 workers ; 2 per cent were clerks, salesmen, etc., and the remaining 8| 
 per cent were in other occupations. 
 
 Of white female wage-earners, 38J per cent were clerks, saleswomen, 
 etc.; 15| per cent were dressmakers and seamstresses; 7| per cent 
 were laundresses; 7 J per cent were engaged as cooks and domestic 
 servants; 6J per cent were charwomen; 5 J per cent were shop- 
 keepers, and 4 per cent were waitresses and dish washers ; the remain- 
 ing 15 per cent being employed as nurses, hucksters, and in other 
 occupations. 
 
 Of the colored female wage-earners, 57j per cent were laundresses ; 
 34J per cent were cooks and domestic servants ; 3 per cent were dress- 
 makers and seamstresses; 2i per cent were charwomen, and the re- 
 maining 2J per cent were waitresses, dish washers, nurses, school- 
 teachers, shopkeepers, etc. 
 
 These occupation statistics show that the colored population was 
 engaged mainly in the unskilled manual occupations and in personal 
 or domestic service, while the white population were mostly engaged 
 in somewhat higher-class work. 
 
 The two following tables show the number of persons engaged in 
 each of the leading occupations in each section of the city and in the 
 entire district covered by the investigation: 
 
KEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 Occupation of males. 
 
 291 
 
 
 White. 
 
 Colored. 
 
 
 Occupation. 
 
 
 o gJ 
 
 5^ 
 
 it 
 
 
 
 1® 
 
 CO !* 
 
 3 S3 
 
 i 
 
 i 
 
 
 5 
 3 
 
 6 
 
 1 
 1 
 7 
 
 2 
 
 18 
 
 1 
 
 io 
 
 16 
 4 
 
 37 
 
 35 
 7 
 
 10 
 
 ■■4' 
 4 
 
 ""'5' 
 
 2 
 14 
 
 4 
 
 5 
 10 
 
 2 
 ...... 
 
 39 
 109 
 
 16 
 
 28 
 1 
 5 
 1 
 1 
 
 21 
 
 3 
 11 
 3 
 
 17 
 2 
 
 15 
 2 
 
 ■■■42' 
 
 41 
 
 6 
 
 17 
 
 '"'h' 
 
 1 
 
 12 
 
 J5 
 
 25 
 13 
 34 
 
 18 
 
 12 
 
 168 
 
 226 
 
 46 
 
 76 
 
 5 
 
 65 
 
 17 
 
 5 
 
 39 
 
 
 
 
 
 
 
 12 
 
 Carpenters 
 
 2 
 2 
 
 
 
 
 2 
 2 
 
 48 
 
 
 
 
 
 16 
 
 Machinists . 
 
 
 
 
 25 
 
 
 
 
 
 
 
 13 
 
 Painters 
 
 2 
 
 
 
 
 2 
 
 36 
 
 
 
 
 
 18 
 
 Tinners 
 
 7 
 50 
 41 
 17 
 21 
 
 4 
 48 
 11 
 
 4 
 13 
 
 
 
 
 
 
 12 
 
 Other skilled laborers 
 
 23. 
 
 276 
 
 107 
 
 10 
 
 42 
 
 8 
 
 3 
 
 1 
 
 46 
 
 3 
 14 
 8 
 2 
 3 
 
 8 
 
 110 
 
 23 
 
 3 
 
 8 
 
 
 34 
 
 400 
 
 138 
 
 15 
 
 53 
 
 8 
 
 5 
 
 1 
 
 48 
 
 202 
 
 Unskilled laborers 
 
 626 
 
 Drivers and t^arnstprs . . 
 
 184 
 
 Clerks, salesmen, etc 
 
 91 
 
 Personal service 
 
 58 
 
 Peddlers and hucksters 
 
 73 
 
 Shop keepers 
 
 
 2 
 
 
 22 
 
 Other independent workers 
 
 6 
 
 2 
 
 
 
 87 
 
 
 
 
 
 Total 
 
 239 
 
 155 
 
 259 
 
 168 
 
 821 
 
 522 
 
 32 
 
 154 
 
 
 
 708 
 
 1,529 
 
 
 
 Occupation of females. 
 
 
 White. 
 
 Colored. 
 
 
 Occupation. 
 
 ^ 
 
 6^ 
 
 II 
 
 !^+i 
 
 
 
 
 
 5^ 
 
 ^ 
 
 
 
 4 
 
 15 
 
 ""9 
 
 1 
 
 ....„ 
 
 5 
 
 3 
 
 18 
 
 1 
 8 
 
 ""3" 
 1 
 
 3 
 
 ....„ 
 
 1 
 1 
 
 10 
 59 
 2 
 
 24 
 3 
 
 12 
 3 
 
 10 
 
 1 
 
 9 
 
 
 20 
 
 30 
 
 Clerks, saleswomen, etc 
 
 59 
 
 Cooks 
 
 61 
 13 
 
 ...... 
 
 19 
 3 
 
 
 80 
 21 
 
 82 
 
 Dressmakers and seamstresses 
 
 Hucksters 
 
 10 
 
 45 
 3 
 
 
 3 
 2 
 
 324 
 4 
 
 13 
 1 
 2 
 4 
 
 81 
 
 1 
 
 
 418 
 6 
 2 
 
 170 
 2 
 6 
 6 
 
 430 
 
 Nurses 
 
 9 
 
 School teachers 
 
 2 
 
 Servants, domestic 
 
 Shop keepers 
 
 2 
 2 
 2 
 4 
 
 3 
 3 
 2 
 
 1 
 
 4 
 3 
 2 
 10 
 
 ""2 
 
 9 
 8 
 6 
 17 
 
 143 
 
 23 
 2 
 
 1 
 1 
 
 
 179 
 10 
 
 Waitresses and dish washers 
 
 Miscellaneous 
 
 5 
 5 
 
 
 
 12 
 23 
 
 
 
 Total 
 
 44 
 
 26 
 
 53 
 
 30 
 
 153 
 
 565 
 
 26 
 
 140 
 
 
 
 731 
 
 884 
 
 
 
 Of the total number of white wage-earners enumerated, 101, or 
 lOJ per cent, were reported as being members of labor organizations ; 
 and of the colored wage-earners only IJ per cent belonged to labor 
 unions. 
 
 HOUKS OF LABOR. 
 
 The hours of labor of these wage-earners varied from two to eight- 
 een per day, the number working more than ten and less than eight 
 being comparatively small. Of the total number reporting hours of 
 labor, 25f per cent worked eight hours per day ; 11^ per cent worked 
 nine hours, and 22 per cent worked ten hours per day. These, to- 
 gether with a small number working eight and one-half and nine 
 and one-half hours per day, make the total number working from 
 eight to ten hours per day equal to about 61 per cent of the persons 
 whose hours of labor were reported. Of the rest about 3J per cent 
 of the entire number worked less than eight hours; 22 per cent 
 worked over ten hours, and 13J per cent worked at irregular hours. 
 
292 
 
 BEPOKTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 Those working over ten hours per day were mainly colored laun- 
 dresses and female domestic servants. 
 
 The following table shows the number of white and colored wage- 
 earners classified according to the number of working hours per day : 
 
 Time employed per day. 
 
 
 White. 
 
 Colored. 
 
 
 
 i 
 
 
 1 
 
 i 
 
 1 
 
 *5 
 
 5 
 
 •3 
 
 1 
 
 % 
 
 1 
 55 
 
 1 
 
 
 1 
 
 1 
 
 |1 
 
 r 
 
 
 
 
 
 
 
 
 
 
 
 
 
 li hours 
 
 
 
 
 
 
 
 
 
 
 
 
 2 hours 
 
 2 
 
 
 
 
 2 
 
 3 
 
 
 
 
 3 
 
 5 
 
 2i hours 
 
 
 
 
 
 
 
 
 S hours 
 
 
 
 
 
 
 4 
 1 
 6 
 
 
 
 
 4 
 1 
 7 
 
 4 
 
 8i hours 
 
 
 
 1 
 
 1 
 
 
 
 1 
 1 
 1 
 4 
 2 
 
 
 
 
 2 
 
 4 hours . . 
 
 
 
 
 1 
 
 
 8 
 
 44 hours 
 
 1 
 
 1 
 1 
 
 
 1 
 
 5 hours 
 
 2 
 
 1 
 
 . .... 
 
 1 
 
 5 
 
 
 2 
 
 
 7 
 
 11 
 
 bi hours 
 
 2 
 
 
 
 
 11 
 
 2 
 
 3 
 
 
 16 
 
 If. 
 
 6i hours 
 
 1 
 2 
 1 
 
 71 
 
 1 
 5 
 
 
 
 
 1 
 
 5 
 
 5 
 
 303 
 
 15 
 
 155 
 
 8 
 
 226 
 
 11 
 
 23 
 
 1 
 
 7 hours 
 
 '"'82' 
 9 
 
 36 
 2 
 
 S3 
 
 3 
 
 4 
 86 
 
 4 
 30 
 
 6 
 
 115 
 
 11 
 
 6 
 
 1 
 
 84 
 
 '""29' 
 ....„ 
 
 8 
 
 
 2 
 
 
 10 
 
 15 
 
 7i hours 
 
 6 
 
 8 hours 
 
 131 
 
 4 
 
 60 
 
 2 
 
 165 
 
 1 
 
 41 
 
 8 
 ...... 
 
 ....„ 
 
 ...... 
 
 91 
 12 
 
 
 230 
 
 5 
 
 83 
 
 3 
 
 227 
 
 2 
 
 54 
 
 633 
 
 8i hours . 
 
 20 
 
 9 hours 
 
 238 
 
 9? hours 
 
 11 
 
 10 hours 
 
 49 
 
 453 
 
 IO5 hours . . 
 
 13 
 
 11 hours . 
 
 15 
 
 1 
 
 77 
 
 
 
 12 hours . . 
 
 13 
 
 1 
 2 
 
 7 
 2 
 3 
 
 9 
 
 
 29 
 3 
 8 
 
 172 
 
 13 
 
 37 
 
 3 
 
 1 
 
 6 
 
 3 
 
 ....„ 
 
 73 
 3 
 
 \ 
 
 1 
 
 
 251 
 
 19 
 
 40 
 
 7 
 
 2 
 
 280 
 
 13 hours 
 
 22 
 
 14 hours 
 
 2 
 
 1 
 
 48 
 
 15 hours 
 
 7 
 
 
 ' 
 
 1 
 
 
 
 2 
 
 4 
 
 17 hours . 
 
 
 
 
 
 
 1 
 26 
 
 
 
 1 
 154 
 
 2 
 89 
 
 1 
 15 
 
 
 
 3 
 
 127 
 
 4 
 
 Irregular 
 
 57 
 
 71 
 
 
 23 
 
 
 281 
 
 
 
 Total 
 
 224 
 
 186 
 
 349 
 
 201 
 
 960 
 
 759 
 
 46 
 
 2% 
 
 
 
 1,101 
 
 2,061 
 
 
 EMPLOYMENT. 
 
 In the case of 2,439 wage-earners returns were maiXe concerning 
 the continuance of employment during the year covered by the in- 
 vestigation. Of these, 993 were white and 1,446 were colored wage- 
 earners. 
 
 Of the white wage-earners, 581, or 58 J per cent, were employed the 
 entire year; 42, or 4J per cent, were idle an average of 11 weeks on 
 account of illness, and 370, or 37J per cent, were idle an average of 
 16J weeks for other reasons. Of the whole number of white wage- 
 earners (including those working full time) the average time lost 
 during the year was about 6J weeks out of the 52. 
 
 The colored wage-earners show a larger proportion of unemploy- 
 ment, if the latter is measured by the number of persons idle, but the 
 average time lost of all colored wage-earners is almost the same as 
 that of the white. Thus, of 1,446 colored wage-earners, 634, or 43} 
 per cent, worked the full 52 weeks; 161, or llj per cent, were idle an 
 average of 5.4 weeks on account of sickness, and 651, or 45 per cent, 
 were idle an average of 13.4 weeks for other reasons. The average 
 period of idleness of aU colored wage- earners was a little less than 
 
EEPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 293 
 
 6J weeks. It appears, therefore, that while the white wage-earners 
 are more steady in their employment, their periods of unemploy- 
 ment, both on account of illness and for other rea^ns, are longer 
 than those of the colored wage-earners. 
 
 The figures of unemployment are shown by color and geographical 
 section in the following table : 
 
 WeeJcs employed. 
 
 
 
 05 S ^ 
 
 Wage-earners idle on 
 aceouut of illness. 
 
 Wage-earners Idle for 
 other reasons. 
 
 
 Num- 
 ber. 
 
 Total 
 weeks 
 idle. 
 
 Weeks 
 idle per 
 person. 
 
 Num- 
 ber. 
 
 Total 
 weeks 
 idle. 
 
 Weeks 
 idle per 
 person. 
 
 WHITE. 
 
 Northwest 
 
 268 
 177 
 342 
 206 
 
 158 
 
 80 
 
 204 
 
 139 
 
 12 
 13 
 15 
 2 
 
 Ill 
 
 190 
 
 148 
 
 16 
 
 9.3 
 
 14.7 
 9.8 
 8.0 
 
 98 
 
 84 
 
 123 
 
 65 
 
 1,627 
 1,569 
 1.834 
 1,039 
 
 16.6 
 
 Northeast 
 
 18.7 
 
 Southwest 
 
 15.0 
 
 Southeast . . . 
 
 16.0 
 
 
 
 Total 
 
 993 
 
 581 
 
 42 
 
 465 
 
 11.1 
 
 370 
 
 6,069 
 
 16.4 
 
 
 
 COLORED. 
 
 Northwest 
 
 1,088 
 
 57 
 
 301 
 
 611 
 43 
 80 
 
 122 
 
 1 
 38 
 
 673 
 5 
 
 199 
 
 5.5 
 5.0 
 5.2 
 
 455 
 13 
 183 
 
 6,869 
 
 150 
 
 1,694 
 
 15.1 
 
 Northeast 
 
 11.5 
 
 Southwest 
 
 9.3 
 
 Southeast 
 
 
 
 
 
 
 
 
 
 
 
 Total 
 
 1,446 
 
 635 
 
 161 
 
 877 
 
 5.4 
 
 651 
 
 8,713 
 
 13.4 
 
 
 
 Total white and colored 
 
 2,439 
 
 1,215 
 
 203 
 
 1,342 1 6.6 
 
 1,021 
 
 14,782 
 
 14.5 
 
 Average weeks idle per wage-earner : 
 
 White 6.5 
 
 Colored 6. 6 
 
 The reasons given for unemployment are very meager, the persons 
 visited being generally averse to answering this inquiry. In the case 
 of white wage-earners, the reasons given were inability to secure 
 work in 43 cases ; illness in 42 cases ; old age in 4 cases ; drunkenness 
 in 3 cases; bad weather in 3 cases, and laziness in 1 case. Among 
 the colored people the causes assigned were illness in 161 cases; in- 
 ability to secure work in 62 cases; laziness in 11 cases; bad weather 
 in 11 cases; old age in 8 cases; drunkenness in 5 cases; incapacity in 
 2 cases, and lack of skill in 1 case. 
 
 wage-earners' lunches. 
 
 Inquiries concerning the meals of wage-earners brought out the in- 
 formation that in 678 cases they were compelled to eat cold victuals, 
 750 carried dinner pails, and 205 were reported as being accustomed 
 to consume alcoholic beverages with their meals. The number in 
 each case was greater among the white than among the colored wage- 
 earners. 
 
 SICKNESS. 
 
 The returns concegrning illness show that of a total population of 
 5,157 persons enumerated, there had been 613, or 12 per cent, sick 
 during the past year. It is very likely, however, that in this enumer- 
 ation many cases of slight illness had been forgotten by the families 
 when visited, as the actual sickness rate must have been much higher. 
 This rate was considerably higher among the colored than among 
 
294 
 
 REPORTS OF THE PRESIDENT S HOMES COMMISSION, 
 
 the white population. The average duration of sickness per case was 
 reported to be 29J days for a total of 607 cases. The average dura- 
 tion of illness was reported to be much longer in the case of colored 
 than of white persons, namely, 22.4 days and 35.6 days, respectively. 
 
 The deaths reported during the past year were likewise surpris- 
 ingly few, although the investigators made a special effort to obtain 
 complete returns. Thus, there were reported but 23 deaths among 
 the white, and 34 deaths among the colored population, making a 
 death rate of 9 and 13 per 1,000 respectively, figures which are ob- 
 viously too low. The most frequent causes of death reported were 
 tuburculosis, 11 cases; pneumonia, 7 cases; heart disease and indi- 
 gestion, each 4 cases. 
 
 The cases of permanent disability as shown by the returns are com- 
 paratively few, namely, 42. The age was reported in 39 cases, of 
 which 3 were persons 19 years of age or under; 14 persons 20 to 49 
 years; 19 persons 50 to 79 years, and 3 persons 80 years of age or 
 over. The most frequent causes of permanent disability were rheuma- 
 tism, 8 cases ; senility, 7 cases, and tuberculosis, 5 cases. 
 
 INSURANCE. 
 
 A surprisingly large number of persons were found to carry life or 
 sick insurance. Iii tabulating insurance returns only members of 
 families, exclusive of boarders and lodgers, were considered, because 
 such returns concerning the latter would necessarily be incomplete. 
 It was found that of a population of 4,889, 2,202, or 45 per cent, car- 
 ried life insurance of some sort, and 855, or 17J per cent, carried in- 
 surance against sickness. The insurance was almost entirely carried 
 in either industrial insurance companies or in fraternal or other 
 mutual benefit associations, and the premium payments were usually 
 made in weekly installments. About the same proportion of white 
 and colored persons carry this insurance, although there were pro- 
 portionately more white carrying life insurance and proportionately 
 more colored people carrying sick insurance. The next table gives 
 the details by color and geographical sections : 
 
 
 1 
 1 
 
 Members of fami- 
 lies, exclusive 
 of boarders and 
 lodgers. 
 
 Members of 
 families carrying— 
 
 Entire city. 
 
 ^1 
 
 Sick 
 insurance. 
 
 WHITE. 
 
 Northwest 
 
 143 
 112 
 148 
 191 
 
 611 
 501 
 620 
 861 
 
 863 
 831 
 160 
 851 
 
 27 
 
 Northeast... . 
 
 25 
 
 Southeast 
 
 7 
 
 Southwest 
 
 81 
 
 
 
 Total . . . 
 
 694 
 
 2,693 
 
 1,195 
 
 90 
 
 
 
 COLOEED. 
 
 Northwest 
 
 471 
 82 
 
 1,664 
 127 
 
 720 
 41 
 
 691 
 
 Northeast 
 
 84 
 
 Southeast 
 
 
 Southwest 
 
 166 
 
 605 
 
 246 
 
 140 
 
 
 
 Total 
 
 657 
 
 2,296 
 
 1,007 
 
 765 
 
 
 
 Grand total 
 
 1,251 
 
 4,889 
 
 2,202 
 
 855 
 
 
 
EEPORTS OP THE PRESIDENT S HOMES COMMISSION. 
 
 295 
 
 INSTALLMENT PAYMENTS. 
 
 The investigators found it exceedingly difficult to obtain informa- 
 tion concerning installment payments on furniture, clothing, and 
 money borrowed, and in many cases the families refused to answer 
 this inquiry. The returns, therefore, are necessarily somewhat 
 meager. 
 
 Transactions of this kind were found to be much more frequent 
 among the colored than among the white population. Of 136 fami- 
 lies who answered affirmatively the inquiry concerning furniture 
 purchases on the installment plan, 35 were white and 66 were colored. 
 The total cost of the furniture so purchased was greater, however, 
 in the case of the white than of the colored people, namely, $3,235 
 and $2,871, respectively. Under furniture were also included one 
 watch, one graphophone, and four pianos. Clothing was reported 
 purchased on the installment plan in 5 cases of white and 8 cases of 
 colored families, the total cost of the clothing being $121 and $162, 
 respectively. The furniture and clothing installment payments were 
 usually made weekly. 
 
 LOAN COMPANIES. 
 
 The practice of borrowing money for repayment on the installment 
 plan appears to have been confined mostly to the colored people, only 
 3 white families having reported such transactions as against 26 
 colored families. The total amount borrowed in this way was $130 
 by the white, and $420 by the colored families. It was not possible 
 in all these cases to ascertain the terms of repayment upon which 
 these loans were made, but a sufficient number of cases is given below 
 to show the exorbitant rates paid for the same: 
 
 Amount 
 
 Monthly 
 
 Number 
 
 Amount 
 
 Charges. 
 
 borrowed. 
 
 payments. 
 
 of months. 
 
 repaid. 
 
 m 
 
 $3.50 
 
 6 
 
 $21.00 
 
 $6.00 
 
 14 
 
 3.40 
 
 6 
 
 20.40 
 
 6.40 
 
 20 
 
 3.00 
 
 8 
 
 24.00 
 
 4.00 
 
 15 
 
 O.70 
 
 a46 
 
 32.20 
 
 17.20 
 
 10 
 
 2.60 
 
 6 
 
 15.60 
 
 5.60 
 
 10 
 
 2.95 
 
 6 
 
 17.50 
 
 7.50 
 
 10 
 
 2.20 
 
 8 
 
 17.60 
 
 7.60 
 
 15 
 
 2.65 
 
 10 
 
 26.50 
 
 11.50 
 
 20 
 
 8.50 
 
 10 
 
 35.00 
 
 15.00 
 
 25 
 
 3.80 
 
 10 
 
 38.00 
 
 13.00 
 
 10 
 
 2.25 
 
 8 
 
 18.00 
 
 8.00 
 
 15 
 
 3.00 
 
 6 
 
 18.00 
 
 8.00 
 
 15 
 
 3.70 
 
 6 
 
 22.20 
 
 7.20 
 
 25 
 
 4.50 
 
 9 
 
 40.50 
 
 15.50 
 
 15 
 
 2.75 
 
 9 
 
 24.75 
 
 9.75 
 
 10 
 
 3.00 
 
 6 
 
 18.00 
 
 8.00 
 
 10 
 
 O.70 
 
 o28 
 
 19.60 
 
 9.60 
 
 15 
 
 2.70 
 
 9 
 
 24.30 
 
 9.30 
 
 25 
 
 6.10 
 
 6 
 
 36.60 
 
 11.60 
 
 6 
 
 2.60 
 
 2* 
 
 6.50 
 
 1.60 
 
 a Weekly. 
 ILLITERACY. 
 
 In tabulating the statistics of illiteracy only those persons were con- 
 sidered who had passed the school age, namely, 14 years and over. 
 Of 4,161 such persons, 502, or 12.1 per cent, were unable to read or 
 
296 
 
 EEPORTS OF THE PRESIDENT S HOMES COMMISSlOlT. 
 
 write. The percentage of illiteracy was more than three times as 
 great among the colored than among the white population, namely, 
 17.5 and 5.4 per cent, respectively. In the case of both white and 
 colored the percentage of illiteracy was greater among the males than 
 among the females. The following table shows the data concerning 
 illiteracy by sex and color for each section : 
 
 
 Total persons 14 years of age 
 and over. 
 
 Illiterates 14 years of age and 
 over. 
 
 
 Male. 
 
 Female. 
 
 Both 
 sexes. 
 
 Male. 
 
 Female. 
 
 Both 
 sexes. 
 
 ■WHITE. 
 
 Northwest . 
 
 310 
 154 
 189 
 323 
 
 264 
 155 
 195 
 280 
 
 574 
 309 
 384 
 603 
 
 30 
 3 
 
 1 
 38 
 
 20 
 5 
 
 50 
 
 Northeast 
 
 8 
 
 Southeast 
 
 I 
 
 Southwest 
 
 4 
 
 42 
 
 
 
 Total 
 
 976 
 
 894 
 
 1,870 
 
 72 
 7.37 
 
 29 
 3.24 
 
 101 
 
 Per cent 
 
 5 40 
 
 
 
 
 
 
 COLORED. 
 
 Northwest 
 
 523 
 42 
 
 689 
 48 
 
 1,212 
 90 
 
 102 
 3 
 
 169 
 8 
 
 271 
 
 Northeast 
 
 10 
 
 Southeast 
 
 
 Southwest 
 
 176 
 
 490 
 
 989 
 
 62 
 
 58 
 
 120 
 
 
 
 Total 
 
 741 
 
 1,227 
 
 2,291 
 
 167 
 22.5 
 
 235 
 19.1 
 
 401 
 
 Per cent 
 
 17 5 
 
 
 
 
 
 
 Grand total 
 
 1,717 
 
 2.121 
 
 4,161 
 
 239 
 13.9 
 
 264 
 12.4 
 
 502 
 
 Percent 
 
 12 1 
 
 
 
 
 
 
 SCHOOL ATTENDANCE. 
 
 Figures showing school attendance are given in the next table 
 
 
 Children 7 to 14 years of age. 
 
 P bo 
 
 a 
 
 SI'S 
 
 4!> 
 
 c3 
 
 
 Total. 
 
 Attending school. 
 
 Not at- 
 tend- 
 ing 
 school. 
 
 •^8 
 
 s| 
 
 
 II 
 
 ill 
 
 i "■ 
 
 
 Si 
 
 3 
 
 O60 
 
 a 
 
 WHITE. 
 
 Northwest 
 
 no 
 
 102 
 162 
 123 
 
 
 2 
 
 4 
 3 
 
 39 
 
 8 
 
 9 
 3 
 
 54 
 
 92 
 
 79 
 
 110 
 
 64 
 
 101 
 91 
 153 
 118 
 
 8 
 11 
 10 
 
 5 
 
 6 
 
 12 
 
 7 
 
 5 
 
 10 
 
 Northeast 
 
 13 
 
 
 1 
 
 
 13 
 
 Southeast 
 
 10 
 
 
 
 
 
 
 Total 
 
 497 
 
 1 
 
 2 
 
 46 
 
 69 
 
 345 
 
 463 
 
 34 
 
 30 
 
 4< 
 
 
 
 GOLOBED. 
 
 Northwest 
 
 249 
 
 32 
 110 
 
 1 
 
 
 80 
 
 7 
 
 1 
 2 
 
 167 
 28 
 82 
 
 205 
 
 29 
 
 100 
 
 44 
 3 
 10 
 
 10 
 
 i 
 
 26 
 
 Northeast 
 
 5 
 
 
 2 
 
 
 
 14 
 
 12 
 
 Southeast 
 
 
 
 
 
 
 
 
 
 
 
 
 Total 
 
 391 
 
 3 
 
 
 44 
 
 10 
 
 277 
 
 834 
 
 57 
 
 18 
 
 43 
 
 Grand total . . 
 
 888 
 
 4 
 
 2 
 
 90 
 
 79 
 
 622 
 
 797 
 
 91 
 
 48 
 
 89 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 297 
 
 It will be observed that a considerable number of children of com- 
 pulsory school age were found who had either not attended school at 
 all during the past year or who attended less than one-half of the 
 school term. Thus, 91 children from 7 to 14 years of age had been 
 kept out of school the entire year, and 96 were in school less than 
 twenty weeks during the year. Those not attending at all were 
 mostly colored children. On the other hand 48 children under 7 
 years and 89 children over 14 years of age were found attending 
 school. In 40 cases children were kept out of school some time during 
 the year on account of a lack of the necessary clothing. Of these 7 
 were white and 33 were colored children. 
 
 Chapter XII. 
 
 THE BUSINESS RELATIONS OF WAGE-EARNERS. 
 
 [By James Bbonson Reynolds.] 
 
 In proportion as wealth increases devices for its protection increase 
 in number, quality, and efficiency. As wealth diminishes its safe- 
 guards diminish. When extreme poverty is reached the supposed 
 agencies of protection are frequently not only nonprotective, but 
 actually predatory. Among such are employment agencies where 
 the wage-earner seeks work; pawn shops and loan companies for 
 the wage-earner's borrowing; industrial insurance companies and 
 mutual benefit societies for his saving, and installment-payment con- 
 cerns where he purchases on credit. 
 
 Believing that the regulation, protection, and promotion by the 
 government of these instrumentalities are quite as important to the 
 industrial class as the protection of the home and the workshop 
 through sanitary and factory legislation, this commission has in- 
 dorsed the recommendations made to the President by the writer 
 that a new department of housing and labor be created to have direct 
 and complete supervision of these business enterprises. This pro- 
 posed department would not merely exercise the powers of restraint 
 at present intrusted chiefly to the police, but in addition would pro- 
 mote efficiency of service. 
 
 In view of the recommendation above mentioned^ it is appropriate 
 to indicate the present condition of these enterprises and to state the 
 character and extent of the improvements advocated. 
 
 EMPLOYMENT AGENCIES. 
 
 There were formerly about 25 employment agencies in the District. 
 They were nominally under the control of the police, but a careful 
 investigation showed that the police gave them very slight attention 
 unless specific complaints were presented. Most of these agencies 
 were indifferent to the character and occupation of the employers to 
 whom they sent employees. This was especially true in regard to 
 domestic agencies. The agencies which placed laborers took advan- 
 tage of the applicants through fraud and misrepresentation and 
 were careless in the fulfillment of their obligations to employers and 
 employees. 
 
298 EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 The present employment agency law, passed in 1907, while inade- 
 quate in some respects, has produced a decided improvement in the 
 service and paved the way for further progress. At present there 
 are only eleven licensed employment agencies. Before taking out a 
 license an agent must give a bond and furnish evidence of ability to 
 carry on the business in proper manner. The character of the appli- 
 cant is investigated by the police department. These agencies have 
 been inspected at frequent intervals in the past, and with the begin- 
 ning of the new license year the inspection will be made monthly. 
 Complaints against agencies under the present law are investigated 
 by the District Commissioners. During the past year nine hearings 
 were granted to persons bringing charges against employment agen- 
 cies. 
 
 This service is probably as good as could be obtained under the 
 existing law, but there are two serious defects in the law. 
 
 1. Supervision by the police is inadequate. The work of the police 
 must inevitably be confined to penal offenses. The regulation and 
 supervision of the efficiency of employment agencies is necessary and 
 should be performed by some properlj constituted public authority. 
 
 The effective distribution of labor is of such supreme importance 
 to the entire community that either employment agencies must receive 
 competent public supervision, or the European method of government 
 employment agencies, such as those of France and Germany, should 
 be adopted. This commission has preferred to adopt the more con- 
 servative alternative. 
 
 2. Complaints should be tried not by the head of the Distirct gov- 
 ernment, as at present, but by the official having direct oversight of 
 the agencies. If the proposed department of housing and labor 
 were established, the chief of the appropriate bureau or the head 
 of the department, both of whom would be closely in touch with the 
 service, should be the proper parties to conduct investigations and 
 trials. 
 
 PAWN SHOPS. 
 
 There are at present eight pawn shops in the District of Columbia. 
 The legal rate of interest charged is 3 per cent a month. The present 
 law has some excellent features. A report on articles pawned is 
 made daily to the police, and pawn shops are directly connected with 
 police headquarters by an electric call bell. The records are open at 
 all times to police inspection, and a proper bond must be filed to 
 secure the observance of the law and the recovery on judgments 
 against pawnbrokers. 
 
 The pawn shop is the only public agency for lending money to 
 which the poor can resort, and since it is likely that recourse thereto 
 will occur m times of extreme need, the terms of lending should be as 
 moderate as circumstances will permit. It is commonly supposed 
 that the pawnbroker lends as little as possible on articles pawned. 
 Careful inquiry and investigation reveal the fact that the high rate 
 of interest disposes the pawnbroker to lend as much as possible. 
 As the pawnbroker takes advantage of the improvidence of the bor- 
 rower and derives his profit from the interest charge, he determines 
 the amount to be advanced by his estimate of the likelihood of the 
 redemption of the article pawned. If a lower rate of interest were 
 charged, a smaller sum would be loaned, but a lighter burden would 
 
KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 299 
 
 be imposed on the borrower. The experience of the Provident Loan 
 Society of New York City, which has rendered most important 
 service to the community, is suggestive. Regular New York pawn 
 shops charging 3 per cent a month for the first six months, and 2 per 
 cent thereafter, report that from 70 to 80 per cent of the articles 
 pawned are redeemed. The Provident Loan Society, charging but 
 1 per cent a month, reports that from 98 to 99 per cent of articles 
 pawned are redeemed. It is probable that the loans made by the 
 Provident Loan Society on given articles are frequently less than 
 corresponding loans made by the pawn shops. The policy of the 
 Provident Loan Society, however, encourages redemption of valuable 
 articles, while that of the average pawn shop encourages improvir 
 dence with ultimate heavy loss. Such features in the conduct of 
 pawn shops merit the careful attention of public authorities quite as 
 much as do the discovery and return of stolen articles, now the main 
 concern of the police. 
 
 LOAN COMPANIES. 
 
 There are no official statistics regarding loan companies in the 
 District. Their number is variously estimated to be from 50 to 
 80. They are wholly without public supervision, though Commis- 
 sioner West states that '' the question of licensing, regulating, and 
 inspecting these loan companies is, in my judgment, one of the 
 most important matters to be accomplished." During the last ses- 
 sion of the Congress a measure was drafted at the request of Com- 
 missioner West by the corporation counsel of the District and 
 introduced in both Houses. Investigations made by Commissioner 
 West showed that these companies sent out circulars to school teach- 
 ers, department clerks, and others, urging them to borrow money. 
 The natural result of this solicitation was to stimulate the borrowing 
 habit. It was also reported to this commission by various chiefs of 
 the National Government that their subordinates were frequently 
 led, through the plausible representations of the companies, to reck- 
 less borrowing, leading to subsequent embarrassment. It is beyond 
 question that such companies render a necessary service, but they 
 should be so supervised and controlled by public authority that their 
 transactions would be beneficial instead of debauching. 
 
 The borrowing of money for repayment on the installment plan, 
 found in the investigation of this commission to be confined mostly 
 to colored people, is a device of certain loan companies which merits 
 the most careful scrutiny. It was not possible in all the cases investi- 
 gated to ascertain the terms of repayment upon which loans were 
 made, but a sufficient number were secured to show that exorbitant 
 rates were charged. 
 
 INSURANCE. 
 
 When the department of insurance was created January 1, 1902, 
 the superintendent found eleven companies undertaking industrial 
 or sickness, accident, and death insurance. Seven of these were 
 District of Columbia corporations. They had 19,661 policies in force, 
 representing $656,917 worth of insurance. The four foreign cor- 
 porations had 4,978 policies in force, representing $179,587 worth 
 of insurance. 
 
300 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 The superintendent at first refused to relicense them, but subse- 
 quently, recognizing that it would be a hardship to thousands of in- 
 nocent policyholders to deprive them of their insurance, consented 
 to grunt licenses. At the present time nearly all of the companies 
 refuse to pay the tax on their premium receipts, and consequently 
 they are not licensed or examined pending the final decision by the 
 court of their obligation to be taxed. 
 
 There is, however, supervision over the Metropolitan, Prudential, 
 and other large insurance corporations which obey the law as con- 
 strued by the department. The lack of law governing the industrial 
 assessment companies is fully appreciated by the Commissioners, and 
 various bills to remedy existing deficiencies have been introduced at 
 the request of the Commissioners and of the insurance department. 
 As insurance is one of the most notable agencies for the encourage- 
 ment and practice of saving and thrift, its thorough supervision is 
 highly in the public interest. 
 
 We also believe that the friendly or mutual benefit societies which 
 are under public supervision in most European countries should be 
 under government inspection in the District. Such inspection would 
 undoubtedly be in the interest and to the advantage of the members 
 of such societies, but as many organizations prefer their independ- 
 ence without interference, rather than the protection aiforded by gov- 
 ernment supervision, it might be sufficient to provide that the super- 
 intendent of insurance should have power to inspect and report the 
 condition and solvency of such organizations upon the request of the 
 officers or of a certain number of members paying dues and eligible 
 to benefits. 
 
 INSTALLMENT PAYMENTS. 
 
 The purchase of articles on the installment plan offers undeniable 
 advantages to people with limited means, and especially to those 
 beginning housekeeping with small capital and no reserve. It must, 
 therefore, be regarded as an established and valuable feature of the 
 business relations of the wage-earning class. Abuses under the sys- 
 tem are, however, not infrequent and impositions are often practiced. 
 Some measure of public supervision should be exercised over such 
 transactions, at least to the extent of requiring that concerns doing 
 business on this plan should be registered and their transactions sub- 
 ject to the scrutiny of the department of housing and labor. 
 
 Chapter XIII. 
 
 THE SCALE OF WAGES AND THE COST OF LIVING. 
 
 [By Geo. M. Kobeb, M. D.] 
 
 The Bureau of Labor has conducted an investigation on the subject 
 of wages based on a large number of establishments in the chief manu- 
 facturing and mechanical industries in the United States. The re^ 
 suits are set forth in Bulletin 77, July, 1908. 
 
 The retail prices of food are shown in a succeeding article of the 
 bulletin. From these investigations we learn that, with the single 
 exception of the year 1907, the scale of wages per hour has increased 
 with the increased cost of living. In brief, wages in 1907 were 28.8 
 
EEP 
 
 ORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 301 
 
 per cent higher than the average for the entire period from 1890- 
 1899, or 31.6 higher than in 1894, the year of lowest wages. The 
 variation in the purchasing power of wages may be measured by using 
 the retail prices of food, the expenditures for which constitute nearly 
 half of the expenditures for all purposes in a workingman's family. 
 From this study we learn that the retail price of the principal article 
 of food weighted, according to family consumption of the various 
 articles, was 20.6 per cent higher in 1907 than the average price paid 
 for the ten years' period 1890-1899, or 26.3 per cent higher than in 
 1896, the year of the lowest prices during the same period. Com- 
 pared with the average for the same year period the purchasing 
 power of an hour's wages in 1907, as measured in the purchase of 
 food, was 6.8 per cent greater than in the decade 1890-1899. 
 
 The differences between 1906 and 1907 are set forth as follows : In 
 the year 1907 the average wages per hour in the principal manufac- 
 turing and mechanical industries of the country were 3.7 per cent 
 higher than in 1906, and the retail prices of food were 4.2 per cent 
 higher in 1907 than in 1906, indicating that the purchasing power .of 
 an hour's wages, as measured by cost of food, was one-half of 1 per 
 cent less in 1907 than in 1906. 
 
 Unfortunately all of these valuable data are based upon a study of 
 industries in which skilled, and presumably organized, wage-earners 
 are employed, who, it may be presumed, have insisted upon an equit- 
 able basis of wages. The writer fears that the great army of the 
 working classes earning $10 or less a week have not participated to 
 the same extent in the general advance of wages, and yet have had to 
 carry the burden of increased cost of living. 
 
 The following table shows the articles for which the price in 1907 
 was higher than the average price for the decade of 1890-1899, and 
 also the articles for which the price in 1907 was lower during the 
 same period : 
 
 Article. 
 
 Bread, wheat 
 
 Vinegar 
 
 Tea 
 
 Molasses 
 
 Rice 
 
 Beef, salt 
 
 Milk, fresh, unskimmed 
 
 Flour, wheat 
 
 Beans, dry 
 
 Beef, fresh: 
 
 Roasts 
 
 Steaks 
 
 Fish, fresh 
 
 Potatoes, Irish 
 
 Fish, salt 
 
 Cheese 
 
 Relative 
 price, 
 1907. 
 
 104,5 
 104.5 
 105.3 
 
 107. 
 108. 
 114. 
 116. 
 117. 
 
 118.8 
 
 119.1 
 120.6 
 120.6 
 120.6 
 121.6 
 123.2 
 
 Article. 
 
 Apples, evaporated 
 
 Veal 
 
 Butter 
 
 Mutton 
 
 Pork, salt (ham) 
 
 Chicken (year or more old) , dressed 
 
 Corn meal 
 
 Lard 
 
 Eggs 
 
 Pork: 
 
 Salt, dried, or pickled 
 
 Fresh 
 
 Pork, salt (bacon) 
 
 Sugar 
 
 Coffee 
 
 Prunes 
 
 Relative 
 price, 
 1907. 
 
 124.6 
 125.0 
 127.6 
 130.1 
 130.7 
 131.4 
 131.6 
 134.2 
 137.7 
 
 142.2 
 142.5 
 157.3 
 99.6 
 95.0 
 88.4 
 
 It is especially deplorable that there should have been such a 
 marked advance in the necessaries of life, such as meats, beans, pota- 
 toes, corn meal, and pork or bacon, which with bread constitute the 
 foundations of a substantial diet for wage-earners. 
 
 The bulletin does not take into consideration the items of clothing 
 and dry goods. The cost of clothing, according to a recent report of 
 
302 
 
 BEPOBTS OF THE PKESIDENT's HOMES COMMISSION. 
 
 the chamber of commerce, since 1900 has advanced 30 per cent, ging- 
 ham 30 per cent, bleached cotton goods 60 per cent. 
 
 The tables on pages 197-200 are also of extreme interest; for in- 
 stance, the table on page 197, based on the average food cost of 2,567 
 families, distributed over five geographical divisions in the United 
 States, shows that the average cost of food for each family in 1890 
 was $318.20. In 1896, the year of lowest prices, it fell to $296.76, 
 since which time it has gradually risen to $374.75 in 1907. 
 
 The tables on pages 199 and 200 show the purchasing power of a 
 dollar from 1890 to 1907 of various articles of food of the grade used 
 by the 2,567 workingmen's families. Some of the principal items are 
 here reproduced in a condensed form : 
 
 
 1890. 
 
 1907. 
 
 Fresh beef 
 
 
 7.81 
 10.06 
 
 9.89 
 10.09 
 
 6.33 
 16.74 
 
 4.23 
 
 6.39 
 10.86 
 46.57 
 
 1.22 
 
 6.47 
 8 59 
 
 Salt beef 
 
 . do 
 
 Fresh pork 
 
 do.... 
 
 6 73 
 
 Fish.. 
 
 do 
 
 8 63 
 
 Egrg'g 
 
 dozen 
 
 8.89 
 14 40 
 
 i^ ::::::::::::::::::::::::::::::::::::::: 
 
 
 Butter . . . . . 
 
 . . . . . . . pounds 
 
 3 29 
 
 Cheese 
 
 do 
 
 6 12 
 
 Lard 
 
 do 
 
 7 95 
 
 Com meal 
 
 do 
 
 35 39 
 
 
 
 LID 
 
 
 The following table shows the average expenditures of 2,567 work- 
 ingmen's families for each of the principal items entering into the 
 cost oi living, and per cent of average total expenditure in 1901 
 (expenditure based on all families) : 
 
 Item of expenditure. 
 
 Average. 
 
 Per cent 
 of total 
 expendi- 
 ture. 
 
 Food 
 
 $326.90 
 99.49 
 
 8.16 
 
 6 3.98 
 
 32.23 
 
 8.15 
 
 83.73 
 
 26.03 
 
 48.08 
 
 6.79 
 
 1.53 
 19.44 
 
 8.87 
 
 5.18 
 
 7.62 
 
 2.39 
 
 26.31 
 
 8.36 
 
 12.28 
 
 12.44 
 
 10.93 
 
 20.64 
 
 46.13 
 
 42 54 
 
 Rent 
 
 12.96 
 
 Mortgage: 
 
 1.06 
 
 
 .52 
 
 Fuel 
 
 4.19 
 
 Lighting 
 
 1.06 
 
 Clothing: 
 
 Husband 
 
 4.39 
 
 Wife - - . 
 
 8.39 
 
 Children 
 
 6.26 
 
 
 .75 
 
 Insurance: 
 
 Pronerty 
 
 .20 
 
 Life ^ . 
 
 2.53 
 
 Organizations: 
 
 Labor 
 
 .50 
 
 Other 
 
 .67 
 
 
 .99 
 
 Charity 
 
 .81 
 
 Ti'iimitnrp and iitpnsila 
 
 3.42 
 
 
 1.09 
 
 A.musement8 and vacation 
 
 1.60 
 
 Intoxicating liauors 
 
 L62 
 
 
 L42 
 
 
 2.67 
 
 OthfiT nurooses 
 
 5.87 
 
 
 
 
 768.64 
 
 100.00 
 
 • Including interest paid by 18 families. 
 
 »Not including interest paid by 13 families, included in principal. 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 303 
 
 In Bulletin 93 of the Census of Manufactures, 1905, published in 
 May, 1908, we find some interesting data of earnings of wage-workers. 
 The investigation covers 3,297,819 wage-earners, of which 79.4 per 
 cent were men; 17.9 per cent were women, and 2.7 per cent were 
 children. The average weekly earnings of all classes was $10.06. For 
 men 16 years and over it was $11.16 ; for women $6.17, and for chil- 
 dren under 16 years $3.46. 
 
 The greatest number of men is reported in the $12 to $15 per week 
 group, and of women in the $6 to $7 group, while the greatest num- 
 ber of children is reported in the group receiving less than $3 a week. 
 
 The important fact revealed by these tables is that out of the total 
 number of men included in the statistics 1,215,798, or 46.5 per cent, 
 earned $10 or less a week. It would be extremely interesting to learn 
 how many of this group were married men. At all events the writer 
 believes that an explanation for the large army of women and chil- 
 dren engaged in wage-earning occupations may be found in these 
 figures. It is simply impossible for a family of five to maintain a 
 decent standard of living on an income of $10 a week, and hence the 
 wives and children are compelled to participate in the fierce struggle 
 for existence. 
 
 COMPENSATION OF GOVERNMENT EMPLOYEES. 
 
 Bulletin 94 of the Bureau of the Census, issued April 13, 1908, deals 
 with statistics of 185,874 employees, of which 172,053 were males and 
 13,821 females. The largest class, viz, 43,790 persons, or 23.6 per 
 cent of the total number, receive from $900 to $1,000 per annum ; next 
 in numerical importance is the class earning less than $720 per 
 annum, represented by 35,331 persons or 19 per cent of the total; 
 11.7 per cent of the total earn $720, but less than $840 a year; 5.7 per 
 cent earn between $840 and $900, and 18.4 per cent earn $1,000 but 
 less than $1,200 a year. 
 
 The approximate average compensation is $948. Of the employees 
 under 20 years of age, 71.2 per cent are paid at a rate of less than 
 $720 and 13.6 per cent at a rate of $900, but less than $1,000, making 
 a total in these two classes of 84.8 per cent. 
 
 Of the 25,351 Government employees residing in the District of Co- 
 lumbia, 12,901, or about one-half of the total, are married. The fol- 
 lowing shows the number of married employees in different salary 
 groups : 
 
 Compensation, 
 
 Total 
 employees. 
 
 Married 
 employees. 
 
 Less than $720 
 
 $720, but less than $840 
 
 $840. but less than $900 
 
 $900, but less than $1,000. . 
 $1,000, but less than $1,200 
 $1,200, but less than $1,400 
 $1,400, but less than $1,600 
 $1,600, but less than $1,800. 
 $1,800, but less than $2,000. 
 $2,000, but less than $2,500. 
 
 $2,500, and over 
 
 By piecework 
 
 6,501 
 
 2,236 
 
 602 
 
 1,516 
 
 2,453 
 
 4,537 
 
 2,469 
 
 1,361 
 
 1,163 
 
 841 
 
 617 
 
 1.046 
 
 2,028 
 
 1,267 
 
 827 
 
 533 
 
 1,113 
 
 2,514 
 
 1,552 
 
 949 
 
 906 
 
 681 
 
 504 
 
304 EEPOBTS OF THE PBESIDENT's HOMES COMMISSION, 
 
 Since the bulletin contained no specific data on the question of the 
 exact earnings of married men earning less than $720 a year, inquiries 
 on this point were addressed to the departments, and the following 
 table shows the number of married men employed in the respective 
 departments and the wage groups : « 
 
 Department of Agriculture 
 
 Treasury Department 
 
 Department of the Interior 
 
 Department of Commerce and Labor. 
 
 War Department 
 
 Navy Department 
 
 Postmaster-General , 
 
 Department of the Interior 
 
 Department of State 
 
 Interstate Commerce Commission 
 
 Salary 
 «600 to 8700. 
 
 90 
 188 
 205 
 
 42 
 122 
 
 54 
 
 51 
 
 13 
 
 771 
 
 Salary 
 $500 to $600. 
 
 47 
 
 115 
 
 19 
 
 3 
 
 195 
 
 Salary 
 below 
 «500. 
 
 67 
 
 From this table it appears that there are 1,033 married men in the 
 Government employ in this city earning less than $660 a year, 262 of 
 whom receive $600 a year or less. 
 
 In addition to the foregoing, according to information kindly fur- 
 nished by Commisisoner West, and the disbursing officer, Mr. Wilson, 
 there are 515 married employees in the District government earning 
 less than $500 a year; 450 married employees earning between $500 
 and $600, and 251 married employees earning between $600 and $720 
 a year. 
 
 A general survey of the situation justifies the conclusion that the 
 cost of living has lar outstripped the present rates of wages of men 
 earning less than $720 a year and of salaried employees m general. 
 This can only be remedied by an increase in wages or a decided de- 
 crease in the cost of the necessities of life. Since the latter is beyond 
 the general control of wage-earners, except in so far as increased 
 wages affect the cost of the products of labor, an increase in earnings 
 amounting to at least 25 per cent appears urgently called for. 
 
 No effort should be spared to improve the standards of living of 
 poorly paid wage-workers, especially of married men earning less 
 than $2 a day. Justice likewise demands an increase of 25 per cent 
 in the pay of salaried employees, especially where no such increase 
 has been made during the past ten years, in order to compensate for 
 the increased cost of living. 
 
 It has come to the knowledge of the committee that a large number 
 of employees in the navy-yard who have purchased homes and own 
 an equity in the property, are likely to suffer financial losses should 
 the intentions of the department to have the work done elsewhere and 
 reduce the number of employees here be carried out. This should be 
 avoided, if possible, on account of the evident hardships involved. 
 It is believed that the best interests of the service and of wage- 
 v7orkers would be subserved if a reasonable assurance of permanent 
 employment could be given. 
 
 •This does not include employees in the Government Printing Office and 
 Navy-Yard. 
 
KEPORTS OF THE PRESIDENT 's HOMES COMMISSION. 305 
 
 In the sociological study of our least resourceful neighbors we find 
 ample food for reflection. We encounter families who, although the 
 husband earns $2.50 a day when he works, are on the borderland of 
 dependency, because he takes three drinks of whisky a day at 5 cents 
 each and consumes 25 cents' worth over Sunday, which means not 
 only an expenditure of $59.80 a year for drink, but also considerable 
 loss of work on account of preventable illness. 
 
 While the conditions as a whole in our family groups whose income 
 is less than $700 a year indicate a fierce struggle for existence, some 
 splendid examples of neat and healthful homes, of thrift and happi- 
 ness, could be cited for the emulation of less competent neighbors. 
 The explanation is to be found in the fact that the parents lead a 
 strictly temperate life, the mother is a good home maker and anxious 
 to better the future of her children, and her spirit of economy, thrift, 
 and ambition animates every member of the household. These prin- 
 ciples should be inculcated into the minds of ever}^ child. An at- 
 tempt has been made in several cities to introduce the Provident 
 Stamp Saving System into the public schools. There can be no ques- 
 tion that all such efforts, and the establishment of postal savings 
 banks, would stimulate provident habits. If it is possible for the 
 agents and friendly visitors of the Associated Charities to collect over 
 $12,000 a year in this city from the least resourceful people as stamp 
 savings deposits for emergency purposes, there is no good reason why 
 the great army of better paid wage-earners, including salaried em- 
 ployees, should not cultivate similar habits of thrift and economy. 
 While it is true that a goodly number have established their homes 
 and are gradually paying for them, it is equally true that in these 
 days of inordinate desire for pleasure, dress and social rivalry, a very 
 discreditable number live wholly beyond their income and sooner or 
 later fall into the hands of the " loan and salary sharks." 
 
 Chapter XIV. 
 
 SUPPRESSION OF USURY IN THE DISTRICT OF COLUMBIA. 
 
 [By Geo. M. Kobeb, M. D.] 
 
 INTRODUCTION. 
 
 In view of the great number of cases of exorbitant rates of interest 
 charged by salary and loan sharks which have come under the notice 
 of the writer in connection with the Associated Charities, and also 
 in our sociological study of families, it was deemed desirable to se- 
 cure additional information on the subject with a view of formulat- 
 ing suitable recommendations for the suppression of the evil. Mr. 
 Charles F. Weller, of the Associated Charities, and Mr. George S. 
 Wilson, of the Board of Charities, referred in their discussion of the 
 subject to the efforts of the " Society for Savings " to bring about a 
 more tolerable state of affairs. In a number of interviews with offi- 
 cers of that society it was learned that they had entered the field, for 
 which there was an urgent need, with the hope of ameliorating the 
 condition of a large number of government employees by offering a 
 S. Doc. 644, 60-2 ^21 
 
306 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 better service at a reasonable price. The society found itself handi- 
 capped, however, by engaging in a business which can not be carried 
 on at the present legal rate of interest (6 per cent), and also because 
 good citizens do not care to invest funds which are loaned in violation 
 of the law. The officers, anxious to extend the usefulness of the 
 society, and at the same time to conduct a strictly legitimate business, 
 have made a careful study of the remedial legislation in other States, 
 with a view of promoting similar legislation in the District of 
 Columbia. 
 
 The principles embodied in modern legislation of this class are 
 based upon the theory that money-lending concerns are a necessity; 
 that small loans of this character can not be made at a less rate of 
 interest than 2 to 3 per cent a month during the first year of the 
 loan ; that legalization of such rates will attract the capital of reputa- 
 ble citizens and stimulate wholesome competition, which will ulti- 
 mately result in the reduction of the interest rate to about 1 per cent 
 per month. From the experience of the Provident Loan Society, of 
 New York, conceived and managed as a true business philanthropy, 
 it is apparent that a business in small loans can not be now conducted, 
 except as a purely charitable proposition, at less than 1 per cent 
 per month. 
 
 This subject is one of great importance to a very large number of 
 officials and employees of the government and of wage-earners in 
 general. The writer therefore requested Mr. J. T. Exnicios, the 
 manager and treasurer of the Society for Savings, to present the 
 result of his study of existing conditions in this city, and of the most 
 enlightened legislation which has been enacted in Massachusetts, New 
 York, and elsewhere to safeguard this unfortunate class of borrow- 
 ers against the vicious practices employed by unscrupulous concerns. 
 This he has done in a very satisfactory and comprehensive manner. 
 From a careful study of existing evils the writer feels convinced 
 that the bill framed by the commissioners, and known as H. R. 11772 
 and S. 2296 will, if enacted with a few minor amendments, have a 
 most salutary effect. The amendments suggested by Mr. Exnicios 
 are in line with legislation in other States. One of these is the reduc- 
 tion of a license tax from $1,000 to $100 per annum. The tax in 
 Massachusetts is only $50 a year, but the law requires that all exami- 
 nations of the affairs of such concerns made by the bank commis- 
 sioners of the State shall be at their expense. New York, Rhode 
 Island, and Maryland require no license tax. 
 
 It is very evident that all such charges are placed by indirection on 
 the borrower. For this reason, no doubt, the recorders' fee on chattle 
 mortgages in Massachusetts is only 75 cents, and no notarial certificate 
 is required on this class of mortgages, while the charges in this juris- 
 diction amount to $2.85, which greatly increases the cost of small 
 loans. 
 
 The provisions of the bill, on the whole, are excellent. Sections 4 
 and 5 are especially commendable, as tjiey require a register to be 
 kept of all loans and transactions, subject to official inspection. The 
 execution of such a law, in order to safeguard against abuses, re- 
 quires careful official supervision, such as contemplated by the recom- 
 mendations to the President, April 29, 1907, of Mr. James B. Reyn- 
 olds, in the creation of a bureau of labor. 
 
BEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 307 
 
 THE USURY EVIL IN THE CITY OF WASHINGTON. 
 [By J. T. ExNicios.] 
 
 I. THE MONEY BOBBOWEE. 
 
 In the city of Washington there is a very large number of per- 
 sons who are unable to secure loans from banks, trust companies, 
 or real- estate brokers, because having nothing in the form of assets 
 except their labor or earning capacity to offer as security, or possibly 
 household effects, and perhaps jewelry. These people might be di- 
 vided into three classes or groups : 
 
 First, the government clerks and employees, who can offer nothing 
 as security for money but their individual notes secured by the in- 
 dorsement of their fellow-clerks. 
 
 Second, that class of persons who, for various reasons, do not care 
 to have their needs made known to their friends on account of their 
 standing in the community, and offer as security for money obtained 
 their jewelry or other personal effects, and who, while possessing 
 homes and furniture, hesitate to give a chattel mortgage on their 
 household furniture because of the publicity attendant upon the re- 
 cording of such mortgages. 
 
 Third, that very large class of people who, not having steady em- 
 ployment or regular sources of income, and who, usually on account 
 of the small wages earned, and having large families depending upon 
 them, are unable to lay aside any savings to meet emergencies, are 
 compelled to mortgage their household effects; and as such people 
 nearly always need money, and emergencies arise when they must 
 have it quickly, they instinctively turn to the only source open to 
 them, the loan shark. 
 
 The money lender exists here because he is needed and renders 
 an indispensable service to those whose living depends on the work- 
 shop, the office, the city, or the National Government, where men 
 and women are earning salaries and wages. Salary earners are a 
 never-failing source of income and support to him. He is par- 
 ticularly active among clerks in every department and bureau of our 
 Government; among school teachers, firemen, policemen, and other 
 city employees, the newspaj)er office and the railroad office, but more 
 especially among the laboring class, where he not only trades and 
 fattens on their necessities but on their ignorance. 
 
 The cruel part of the whole system is the pettiness of the loans 
 made to the laboring class. The loan seldom exceeds $25, and the 
 need arises from sickness or trouble in the workman's family. His 
 pay is small, just enough to live on ; he may be going through that 
 period in the life of a family when children are born, or when they 
 are being educated, the expenses come closer to the danger line. Wife 
 or child may fall ill and an extra outlay has to be met; other ex- 
 penses, such as rent or grocery accounts, get behind, creditors begin 
 to press, the man is worried and miserable, and seeks relief from the 
 only source at his command, the loan shark, whose advertisement 
 offers money an easy payments and long time. He calls on the ad- 
 vertiser, anxious, flustered, disheartened; is received cordially, and 
 assured suavely that such difficulties are common and of daily occur- 
 rence ; told to call again ; his record is investigated meanwhile and 
 
308 BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 his household furniture appraised. On his return he secures the 
 small sum needed, signs some papers " as a matter of form," and is 
 tied hand and foot for perhaps years. Very few attempt to evade 
 these obligations, and as a consequence the loan sharks have very few 
 occasions for bringing suit to enforce payment of these loans to the 
 last penny. He indulges in threats, but rarely executes them, for his 
 great dread is publicity. 
 
 n. THE MONEY LENDERS AND THEIE METHODS. 
 
 There are many money lenders and money-lending concerns in 
 Washington (about 72), with an invested capital of approximately 
 a million dollars, loaning money at exorbitant rates of interest upon 
 mortgages of furniture and household effects, other personal prop- 
 erty, and indorsed notes. The rate of interest charged varies very 
 much ; often the rate is as low as 10 per cent per month ; sometimes 
 as high as 25 per cent, and occasionally even a higher rate of interest 
 is exacted. The following are a few of the many advertisements 
 which can be found in our daily papers : 
 
 Potomac Guarantee Loan Gompa/ny, 925 F street N. W, 
 
 $10 for one month costs $0.60 (or 72 per cent per annum). 
 $20 for one month costs $1.05 (or 63 per cent per annum). 
 $30 for one month costs $1.45 (or 58 per cent per annum). 
 We also make a small charge for appraising property, etc. 
 
 Union Loan and Trust Company, 810 F street NW. 
 
 $10 for one month costs $1.50 (or 180 per cent per annum). 
 $20 for one month costs $2.25 (or 135 per cent per annum). 
 $25 for one month costs $2.50 (or 120 per cent per annum). 
 
 Mutual Loan and Trust Company, 913 G street NW. 
 
 35 cents a week pays interest and principal on a $10 loan. 
 50 cents a week pays interest and principal on a $15 loan. 
 75 cents a week pays interest and principal on a $20 loan. 
 90 cents a week pays interest and principal on a $25 loan. 
 $1.50 a week pays interest and principal on a $50 loan. 
 $2.75 a week pays interest and principal on a $100 loan. 
 
 Now, these sums are paid by the borrower for a period of fifty-two 
 weeks, hence the cost of $10 is $8.20, or 161 per cent per annum ; $15 
 is $11, or 140 per cent per annum; $20 is $19, or 180 per cent per 
 annum; $25 is $21.80, or 171 per cent per annum; $50 is $28, or 109 
 per cent per annum ; $100 is $43, or 83 per cent per annum. 
 
 The Surety Loan Company, Ninth and F streets NW., whose 
 charges are on $10 for one month, $1 ; on $15 for one month, $1.50 ; 
 on $20 for one month, $2. That is 10 per cent per month, or 120 per 
 cent per annum. " No more, no less," to quote their advertisement. 
 Added to these various rates are the charges for notary fees, record- 
 ing mortgages, etc., running from $3 to $10. 
 
 Borrowers in many instances pay this heavy interest for months, 
 and even for years, without decreasing the amount of the original 
 debt, and often lose the property mortgaged by them, even when they 
 have paid the amount of the principal borrowed with lawful interest, 
 for under such rates a borrower can seldom pay up the principal of 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 309 
 
 his loan, but goes on, year after year, paying this heavy interest, 
 often in the end to have all he possessed taken from him when the 
 lender demands his principal. 
 
 Some of these concerns operate two or three companies, located 
 at different addresses and under different names, and incidentally 
 suggest to the borrower that, being unable to loan more than a part 
 of the sum desired, they might succeed in securing the additional 
 
 amount by applying to , furnishing the address of one of the 
 
 other offices, when, after paying over again the usual charges for 
 recording, notary fee, appraisement, etc., the borrower receives the 
 amount necessary to make up the original sum asked for. We have 
 in mind a particular case where the sum required was $30 on fur- 
 niture. After going to three of these (allied) concerns the borrower 
 secured the amount, $10 at each place and paid the regular fees at 
 each place. 
 
 At a hearing before the subcommittee on judiciary of the Com- 
 mittee on the District of Columbia, United States Senate, May 6, 
 1908, on various bills introduced for the suppression of usury in 
 the District of Columbia the testimony of Senator Gallinger, Com- 
 missioner Macfarland, and Mrs. Charlotte Everett Hopkins all point 
 to the grossest forms of abuses and exorbitant rates of interest which, 
 in the opinion of Senator Gallinger, " no community ought to permit 
 anyone to exact from poor people." 
 
 All the cases cited differ only in degree, not in kind, and how many 
 of them there are in any one year no one can ever tell, but there are 
 thousands of loans made annually, and as the profits must be enor- 
 mous the suffering entailed must be in due proportion. These con- 
 ditions have continued for a number of years and naturally have 
 grown worse, and though staggering and almost incredible they are 
 borne out by facts on record. 
 
 The foregoing statement also covers fully the abuses that were wont 
 to exist in the States of New York, Massachusetts, Rhode Island, and 
 Maryland until public opinion through the legislatures of these 
 States enacted laws which put a stop to the evil practice. 
 
 III. MEANS OF PBEVENTION TRIED IN WASHINGTON SINCE 1905. 
 
 In January, 1905, there was incorporated in this city the Society 
 for Savings of Washington, modeled after similar concerns in a num- 
 ber of the States, for the purpose, among others, of lending money 
 to deserving persons on indorsed notes. It was never for a moment 
 contemplated that the new venture should be in any sense a charity ; 
 in fact, it was realized that to lend money as a work of charity 
 would fail to reach the very class of persons whom it was desired 
 to afford a means of relieving a temporary embarrassment, namely, 
 persons who, while not able to obtain loans from banks, trust com- 
 panies, or real estate brokers, are able and willing to pay reasonably 
 for the accommodation. 
 
 The capital stock was fixed at $50,000, most of which is now paid 
 in. In the beginning, after considerable effort, a sum of about $7,500 
 was raised and operations were started. The loans made were neces- 
 sarily small, averaging $25, and never exceeding $50, to any one per- 
 son upon indorsed notes and confined almost exclusively to clerks in 
 the various Government departments, and at a rate of interest of 3 
 
310 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 per cent per month. After the first year, and upon increasing the 
 capital employed, the rate was reduced to 2J per cent per month, and 
 is now 2 per cent per month, with a small charge according to the 
 amount loaned, in some cases 25 cents, as upon a $25 loan, which costs 
 75 cents for one month, but never exceeding $3 in any one year, and 
 this latter sum is charged only when loans are made on household 
 goods (including charges of every character, among which is $2.35, 
 the actual fee for court recording, and 50 cents for notary fee, or 
 $2.85), which feature of the business was adopted about the beginning 
 of this year. In some very deserving cases a charge of IJ per cent 
 per month has been made, and only one-half per cent a month in one 
 case, that of a young man, a messenger in one of the departments, 
 who became deeply involved with a number of money lenders to the 
 extent of about $500. * * * 
 
 Much good, it is believed, has been done by this society, and a great 
 deal more could be done were it possible to secure the funds needed ; 
 but its business being what may be termed " outlawed," the directors 
 have labored under a handicap that is almost disheartening. 
 
 Small sums of money can not be loaned at the legal rate of interest 
 (6 per cent), pay operating expenses, no matter how economically 
 the business is conducted, stand the inevitable losses through uncol- 
 lectible notes, and pay a fair dividend on the capital invested. This 
 has been demonstrated time and again in every State of the Union 
 and in foreign countries as well. If there could be any doubt of the 
 correctness of this statement, legislation which has been enacted in 
 many of the States will prove its truth. This legislation will be more 
 particularly referred to further on. 
 
 IV. BEMEDY PROPOSED. 
 
 The most effective way to get rid of the loan and salary shark is to 
 meet him on his own ground. Legislation will not kill him. In try- 
 ing to exterminate him legislation is apt to abolish the service and 
 furnish nothing to replace it. ^ ^ 
 
 The logical way to get rid of him is to supply a better service at 
 reasonable rates. Along this line some very effective work is now 
 being done under protection of the law in other cities and could be 
 done here by the enactment of a suitable bill, which has been drafted 
 by the District Commissioners and is known as S. 2296 and H. R. 
 11772. Under its provisions the business will become legalized, the 
 stigma which now attaches to those carrying on a business not strictly 
 lawful would be wiped out, and a better class of our citizens would 
 engage therein, more capital would be attracted, and there would 
 be more competition, with the consequent lowering of the interest 
 charged and a resulting benefit to the borrower and the community. 
 
 A BILL To regulate the business of loaning money on security of any kind by persons,, 
 firms, and corporations other than national banks, savings banks, and trust companies 
 and real-estate brokers in the District of Columbia. 
 
 Be it enacted hy the Senate and House of Representatives of the United States 
 of America in Congress assemtled. That hereafter It shall be unlawful and 
 Illegal to engage in the business of loaning money on any security of any kind, 
 direct or collateral, tangible or intangible, without procuring license; and all 
 persons, firms, joint-stock companies, voluntary associations, and corporations 
 engaged In said business shall pay a license tax of one thousand dollars per 
 annum to the District of Columbia. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 311 
 
 Sec. 2. That applications for licenses to conduct such business must be made 
 In writing to the Commissioners of the District of Columbia, and shall contain 
 the full names of applicants, if natural persons, and the full names of the 
 officers and directors, by whatever name known, of corporations, companies, 
 and associations, the addresses of all persons named therein and the place 
 where such business is to be conducted, and such other information as the 
 said commissioners may require. Every license granted shall date from the 
 first of the month in which it is issued and expire on the thirty-first day of the 
 following October. Every application shall be filed not less than one week 
 prior to the granting of such license, and notice of the filing of such application 
 shall be posted in the office of the assessor of the said District. Protests may 
 be made by any person to the issuing of such license, and when such protests 
 are filed with the said commissioners the latter shall give public notice of and 
 hold a public hearing upon such protests before issuing such license. The said 
 commissioners shall have power to reject any application for license for failure 
 to observe this act, and for such failure to suspend or revoke any such license 
 for cause shown, after notice and hearing. 
 
 Sec. 3. That each application shall be accompanied by a bond to the District 
 of Columbia in the penal sum of five thousand dollars, with two or more suffi- 
 cient sureties, and conditioned that the obligor will not violate any law relating 
 to such business. The execution of any such bond by a fidelity or surety 
 company authorized by the laws of the United States to transact business 
 therein shall be equivalent to the execution thereof by two sureties, and such 
 company, if excepted to, shall justify in the manner required by law of fidelity 
 and surety companies. If any person shall be aggrieved by the misconduct of 
 any such licensed person, firm, corporation, company, or association, and shall 
 recover a judgment therefor, such person may, after a return unsatisfied either 
 in whole or in any part of any execution issued upon such judgment, maintain 
 an action in his own name upon such bond herein required in any court having 
 jurisdiction of the amount claimed. The Commissioners of the District of 
 Columbia shall furnish to anyone applying therefor a certified copy of any 
 such bond filed with them upon the payment of a fee of twenty-five cents, and 
 such certified copy shall be prima facie evidence in any court that such bond 
 was duly executed and delivered by the person* firm, corporation, company, or 
 . association whose names appear thereon. 
 
 Sec. 4. That every person, firm, corporation, company, or association conduct- 
 ing such business shall keep a register, approved by said commissioners, show- 
 ing, in English, the amount of money loaned, the date when loaned and when 
 due, the person to whom loaned, the property or thing named as security for 
 the loan, where the same is located and in whose possession, the amount of 
 interest, all fees, commissions, and renewals charged, under whatever name. 
 Such register shall be open for inspection to the said commissioners, their 
 officers and agents, on every day, except Sundays and legal holidays, between 
 the hours of nine o'clock in the forenoon and five o'clock in the afternoon. 
 
 Sec. 5. That no such person, firm, corporation, company, or association 
 shall charge or receive a greater rate of interest or discount upon any loan 
 made by him or it than two per centum per month and a sum not exceeding 
 three dollars for the first examination of the property to be mortgaged, or the in- 
 vestigation of the credit or responsibility of indorsers or sureties when an 
 indorsed note is taken as security, and for drawing the necessary papers, 
 which charge shall include all services of every character in connection with 
 the loan, except upon the foreclosure of the security, and no additional sums, 
 either in the way of bonus or otherwise, shall be required or exacted of bor- 
 rowers; nor shall it be lawful to divide or split up loans under any pretext 
 whatsoever for the purpose of requiring or exacting any other or greater 
 charge than herein prescribed. The foregoing interest and charge may be 
 deducted from the principal of the loan when the same is made. No such 
 loan greater than five hundred dollars shall be made to any one person. 
 
 Sec. 6. That the enforcement of this act shall be intrusted to the Commis- 
 sioners of the District of Columbia. Complaints against any licenses or appli- 
 cant shall be made in writing to the said commissioners, and reasonable notice 
 thereof, not less than one day, shall be given to said licensee or applicant by 
 serving upon him a concise statement of the facts constituting the complaint, 
 and a hearing shall be had before the said commissioners within one week 
 from the date of the filing of the complaint, and no adjournment shall be taken 
 for longer than one week. A daily calendar shall be kept of all hearings by 
 the said commissioners, which shall be posted in a conspicuous place in their 
 
312 EEPOBTS OP THE PEESIDENt's HOMES COMMISSION. 
 
 public office for at least one day before the date of such hearings. The said 
 commissioners shall render their decision within eight days from the time the 
 matter is finally submitted to them. Said commissioners shall keep a record 
 of all such complaints and hearings, and may refuse to issue and shall revoke 
 any license for any good cause shown, within the meaning and purpose of this 
 act; and when it is shown to their satisfaction that any license or applicant 
 under this act, either before or after conviction, is guilty of any conduct in 
 violation of this law, it shall be the duty of the said commissioners to revoke 
 or reject the license of such licensee or applicant, but notice of the charges 
 preferred shall be presented and reasonable opportunity shall be given said 
 licensee or applicant to be heard in his defense. Whenever for any cause such 
 license is revoked, said commissioners shall not issue another license to said 
 licensee until the expiration of at least six months from the date of revocation 
 of such license. 
 
 Sec. 7. That any violation of this act shall be punished by a fine of not less 
 than five dollars and not greater than two hundred dollars. The said commis- 
 sioners shall cause the corporation counsel to institute criminal proceedings 
 for the enforcement of this act before any court of competent jurisdiction. 
 
 Sec. 8. That nothing contained in this act shall be held to apply to the legiti- 
 mate business of institutions which are members of the Bankers' Association 
 of the District of CJolumbia, building and loan associations, or to the business 
 of pawnbrokers or real-estate brokers, as defined in the act of Congress of July 
 first, nineteen hundred and two. 
 
 Sec. 9. That the Commissioners of the District of Columbia are hereby author- 
 ized and empowered to make all rules and regulations necessary in their judg- 
 ment for the conduct of the said business and the enforcement of this act in 
 addition hereto and not inconsistent herewith. 
 
 Sec. 10. That all acts and parts of acts inconsistent herewith are hereby 
 repealed. 
 
 Sec. 11. That this act shall take effect from and after its passage. 
 
 V. amendments peoposed and approval of the bill. 
 
 Be it enacted ^y the Senate and House of Representatives of the United States 
 of America iti Congress assembled, That hereafter it shall be unlawful and 
 illegal to engage in the business of lending money on any security of any kind, 
 direct or collateral, tangible or intangible, without procuring license, and all 
 persons, firms, joint-stock companies, voluntary associations, and corporations 
 engaged in said business shall pay a license tax of one thousand dollars per 
 annum to the District of Columbia. 
 
 First, amend this section by inserting after the word " money," in 
 line 4, the words " upon which a rate of interest greater than 6 per 
 cent per annum is charged," so that it shall read : " The business of 
 loaning money, upon which a rate of interest greater than 6 per cent 
 per annum is charged," etc. 
 
 Second, substitute " one hundred " for " one thousand," in line 8, so 
 that it shall read : " Business shall pay a license tax of one hundred 
 dollars per," etc. 
 
 Reasons, — All States which now have laws governing the loaning 
 of money specifically state in the acts that all persons, firms, etc., 
 loaning money at more than the legal rate of interest, etc., which 
 shows that the provision has been carefully looked into and deemed 
 necessary. It might be said in this connection that Senator Johnston 
 and Hon. J. M. Thurston stated they " thought it might be a wise 
 provision," at the hearing before the subcommittee on judiciary of the 
 Committee on the District of Columbia, May 6, 1908, at which the 
 former was present as a member of said committee, and the latter 
 as attorney representing some money lenders. 
 
 As to the amount of license tax, the State of Massachusetts exacts 
 a tax of only $50 per year, but requires that all examinations of the 
 affairs of these concerns made by the bank commissioners of the State 
 
BEPOBTS OP THE PBESIDENt's HOMES COMMISSION. 313 
 
 shall be at their expense. The State of New York does not require a 
 license, nor does the State of Ehode Island, nor the State of Maryland. 
 
 That $1,000 per annum should not be exacted as a license charge 
 or tax seems to require no argument. It would be wringing from the 
 lenders a sum which is much too large, and would hold an inducement 
 for some of them to place this charge by indirection on the borrower. 
 Further, Commissioner West states: "Though this tax of $1,000 was 
 inserted, they were not insisting upon that amount, and it might well 
 be reduced." (Senate hearing. May 6, 1908, p. 21.) 
 
 Section 2: This section is in line with the practice and laws in 
 force in States hereinbefore mentioned. 
 
 Section 3 : Same reason as applied to section 2. 
 
 Section 6 : Same as section 2. 
 
 Sections 9, 10, and 11 : Same as section 2. 
 
 Sec. 4. That every person, firm, corporation, company, or association con- 
 ducting such business shall keep a register approved by said commissioners, 
 showing in English the amount of money loaned, the date when loaned, and 
 when due, the person to whom loaned, the property or thing named as security 
 for the loan, where the same is located, and in whose possession, the amount 
 of interest, all fees, commissions, and renewals charged, under whatever name. 
 Such register shall be open for inspection to the said commissioners, their 
 officers and agents, on every day, except Sunday and legal holidays, between 
 the hours of nine o'clock in the forenoon and five o'clock in the afternoon. 
 
 The only way to regulate this business is through publicity, for 
 laws, no matter how drastic their provisions, can and will be evaded ; 
 but when the people who carry on this business are compelled to lay 
 bare to the proper officials each and every transaction they have en- 
 gaged in, you then strike at the root of the evil, and are in a position 
 to apply the needed remedy. It has been stated that this section is' 
 impracticable, or, if practicable, it would involve considerable ex- 
 pense and labor. We denjr this for the reason that now, and for 
 many months past, the Society for Savings has in daily use such a 
 register, and after experience feels that it is the only method whereby 
 it can be seen at a glance that charges have been paid by the bor- 
 rower, and for what purposes. We think, though, this section would 
 be strengthened were it amended so as to require an annual state- 
 ment in the form of a trial balance of its books, on the 31st day of 
 December in each year, specifying the different kinds of its liabili- 
 ties and the different kinds of its assets, stating the amount of each, 
 together with such other information as may be called for. This 
 statement should be furnished to the District Commissioners on or 
 before the 20th day of January in each year by each individual or 
 company engaged in this business, and they should also print this 
 statement or trial balance in at least one newspaper of general circu- 
 lation in Washington, in such manner as may be directed by the 
 District Commissioners. 
 
 Inspection by state officials designated by law and annual reports 
 of the business are required in New York, Massachusetts, and Rhode 
 Island, likewise the publishing of annual reports. 
 
 Sec. 5. That no such person, firm, corporation, company, or association shall 
 charge or receive a greater rate of interest or discount upon any loan made by 
 him or it than two per centum per month, and a sum not exceeding three dol- 
 lars for the first examination of the property to be mortgaged, or the investi- 
 gation of the credit or responsibilty of indorsers or sureties when an indorsed 
 note is taken as security, and for drawing the necessary papers, which charge 
 shall include all services of every character in connection with the loan, except 
 
314 BEPOBTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 upon the foreclosure of the security, and no additional sums, either in the way 
 of bonus or otherwise, shall be required or exacted of borrowers; nor shall it be 
 lawful to divide or split up loans under any pretext whatsoever for the purpose 
 of requiring or exacting any other or greater charge than herein prescribed. 
 The foregoing interest and charge may be deducted from the principal of the 
 loan when the same is made. No such loan greater than five hundred dollars 
 shall be made to any one person. 
 
 The provisions of section 5 restricting the amount of such loans 
 and legalizing a rate of interest not higher than 2 per cent per month, 
 and a fixed charge not in excess of $3 for examining the property to 
 be mortgaged and drawing the necessary papers, are taken from the 
 acts of State legislatures, which will be now noticed at some length, 
 as also will be the business of some of the corporations operating 
 under them. 
 
 By the laws of the State of New York, chapter 326, Laws of 1895, 
 as amended by chapter 706, Laws of 1895, entitled "An act to provide 
 for the incorporation of associations lending money on personal 
 property, and to forbid certain loans of money, property, or credit," 
 it is provided : 
 
 Sec. 3. ♦ * * It [every such corporation] shall be entitled to charge and 
 receive upon such loan made by it without the actual delivery to it of the 
 property pledged or mortgaged, which charge shall include all services of every 
 character, in connection with said loan, except upon the foreclosure of the 
 security, interest or discount at a rate of not exceeding three per centum per 
 month for a period of two months or less, and not exceeding two per centum 
 per month for any period after said two months ; and also a sum not exceeding 
 three dollars for the first examination of the property to be pledged or mort- 
 gaged and for drawing and filing the necessary papers. 
 
 It will be observed that section 5 of the proposed bill is copied 
 •substantially from this law. 
 
 VI. METHODS IN FORCE IN NEW YOEK, MASSACHUSETTS, BHODE ISLAND, AND 
 
 MARYLAND. 
 
 The laws of the above-named States will now be noticed at some 
 length, as will be also the business of some of the corporations operat- 
 ing under them. 
 
 New York. — The Provident Loan Society of New York was organ- 
 ized under chapter 295 of the Laws of 1894. The New York legis- 
 lature granted a special charter to carry on this business to Otto T. 
 Bannard, Charles C. Beaumen, Henry R. Beekman, William L. Bull, 
 Frederic R. Coudert, Charles F. Cox, John D. Crimmins, R. Fulton 
 Cutting, Robert W. de Forest, William E. Dodge, Charles S. Fair- 
 child, David H. Greer, Abratn S. Hewitt, James J. Higginson, 
 Adrian Iselin, jr., D. Willis James, John S. Kennedy, Seth Low, 
 Solomon Loeb, Alfred B. Mason, Victor Morawetz, J. Pierpont 
 Morgan, Oswald Ottendorfer, Jacob H. Schiff, Gustave H. Schwab, 
 Charles S. Smith, James Speyer, Walter Stanton, J. Kennedy Tod, 
 Abraham Wolff, and Cornelius Vanderbilt, together with such per- 
 sons as they may associate with themselves. These gentlemen are 
 among the most prominent and substantial in the city of New York. 
 Section 3 of said act reads as follows : 
 
 Said society shall be entitled to act as pawnbroker, and shall be subject to 
 and entitled to all the benefits of all the provisions of the laws of this State 
 concerning pawnbrokers, except that it shall not be required to obtain a license 
 or file a bond. 
 
KEPORTS OF THE PEESIDENT's HOMES COMMISSION. 315 
 
 This society is allowed under the law to charge interest at the rate 
 of not exceeding 3 per cent per month, and, notwithstanding its stu- 
 pendous capital and the fact that it is classed as a benevolent society, 
 it actually charges as interest on all loans made 1 per cent per month. 
 From the thirteenth annual report of said society, for the year 1907, 
 it appears that the capital employed at the close of the year 1907 
 was $5,001,586.14, that the amount loaned during said year was 
 $10,601,000, and that the average single loan was $37.46. On page 11 
 of the report of 1905, in advocating making pawn offices accessible 
 to the working classes, this statement will be found : 
 
 The need of the workng classes, who form the great army of borrowers, can 
 best be met by making the pawn office accessible to them. Convenience of ac- 
 cess is even more important than a low rate of interest. This is evidenced by 
 the great growth of our own Eldridge street branch, on the East Side, where 
 the transactions already largely exceed those of the Fourth avenue office. It 
 is also evidenced by the fact that many prefer to patronize an adjacent pawn- 
 broker whose rate of interest is much higher than that charged by this society 
 rather than go a little out of their way to one of our offices. The benevolent 
 purpose of the society will be far better effectuated by an increase in the num- 
 ber of our branches than by any lowering of the rate of interest, even if such 
 a course were otherwise desirabre. Most loans are, or are intended to be, for 
 a short period when made. Car fares and loss of time count for more than a 
 higher interest charge. 
 
 Could there possibly be any stronger argument as to the necessity 
 for legalizing a reasonable rate of interest on such loans than the 
 operations of this society ? It has a vast capital, most of it made up 
 by gifts or bequests and contributions from the rich, and is operated 
 not primarily for profit, and yet it actually charges 1 per cent per 
 month on its loans and is allowed by law to charge 3 per cent per 
 month. 
 
 The report of the president for 1907 shows that — 
 
 In 1895, our first full year, we had one small loaning office, which made 20,804 
 loans, amounting to $377,845 ; in 1907, with six loaning offices in operation, 283,- 
 045 loans, amounting to $10,601,557, were made. In 1895, 18,214 loans, amount- 
 ing to $322,596, were repaid, whereas in 1907 the number was 254,663, amount- 
 ing to $9,840,379. Again, the interest earnings, amounting in 1895 to $23,847, 
 reached in 1907, the large sum of $564,534. The enormous attention to detail 
 involved in the successful conduct of this business becomes apparent when 
 one considers that the average of the loans made in 1907 was $37.46. 
 
 The same comparison holds good as to the personnel and organization of the 
 society. From a rented office with a staff of four or five people, employing 
 $100,000 capital, it has become a great fiscal institution of $5,000,000 capital, 
 a large, well-trained staff of about sixty employees, with six offices. * ♦ * 
 
 Of course, everyone will realize that the smaller the loan on personal prop- 
 erty the less the margin of profit, as the percentage of operating expenses is 
 proportionately larger when a small loan is made than when made in large 
 amounts. The executive committee decided that on November 1, 1907, in view 
 of the increased cost of capital and the greater cost of handling an increasing 
 volume of small loans (192,060 being for $25 and under, 91,754 being for $10 
 and under, and 44,450 being for sums of $25 to $50) all renewals, as well as all 
 new loans, should be at the interest rate of 1 per cent per month or fraction 
 thereof, except those repaid within two weeks from date of making, when one- 
 half per cent only would be charged. 
 
 Mr. Frank Tucker, the vice-president and executive officer, at a 
 conference held with a committee of our Society for Savings of 
 Washington, in July, 1908, stated that the handling of small loans 
 a't 1 per cent per month was purely a charitable propo'sition and so 
 
316 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 regarded by his society, but an absolute impossibility to any concern 
 with a smaller capital, and submitted the following figures as proof : 
 
 Number of loans made 1907, 283,045. 
 
 Operating expenses, excluding dividends, $127,052.62, or a cost per loan of 
 45 cents. 
 
 Cost of $10 loan to society, 45 cents. 
 
 Dividend of 6 per cent per annum on $10, 60 cents. 
 
 A loan of $10 cost the society for one year, $1.05. 
 
 Ten dollars at 1 per cent per month earns the society for one year $1.20, 
 or a loan of $10 for the first nine months merely earned its cost of handling, 
 but that 2 per cent per month was more reasonable and a fair business propo- 
 sition. 
 
 The Provident Loan Company, of Buffalo, was incorporated under 
 the aforementioned act, and a reading of the annual reports of said 
 company and of the other companies or societies hereinafter men- 
 tioned will be interesting to those who care to investigate further into 
 this matter. The rate of interest charged by the Provident Loan 
 Company, of Buffalo, is 3 per cent per month for the first month, 
 and 2 per cent for each month thereafter, and a charge of $3 for ex- 
 amination of property and recording of mortgages, etc., the rate 
 allowed by law. It is said in one of the annual reports of this com- 
 pany that "its purpose is the same as that of the Workingmen's 
 Loan Association, of Boston, founded by Robert Treat Paine in 1887, 
 and its methods of business are closely patterned after those in use 
 by that association." (See First Annual Report, September 9, 1895, 
 to September 30, 1896.) The Workingmen's Loan Association, of 
 Boston, was one of the pioneers in this line of business. The law 
 under which it was incorporated and its operations will be alluded to 
 further on. 
 
 Massachusetts. — By an act of the legislature of the State of Massa- 
 chusetts entitled " An act to incorporate the Pawner's Bank," ap- 
 proved April 5, 1859, it is provided by section 4 that — 
 
 The charge on all loans to cover expenses of every kind, including interest, 
 shall be uniform, and not to exceed one and one-half per cent per month. 
 
 This act was amended by an act entitled "An act to amend the 
 charter of the Pawner's Bank of Boston," approved June 21, 1869. 
 Section 2 thereof reads as follows: 
 
 The charge on loans, to cover expenses of every kind, including interest, 
 need not be uniform, but may be regulated by the bank, but it shall in no 
 case exceed two per cent per month. 
 
 This so-called bank is still in business, but it is now operated under 
 the name of the Collateral Loan Company of Boston. The total 
 amount of the loans made by it for the year 1905 amounted to 
 $2,092,566.08. The average single loan was $22.78. 
 
 The Workingmen's Loan Association of Boston was incorporated 
 by an act of the legislature of Massachusetts approved March 8, 
 1888, entitled "An act to incorporate the Workingmen's Loan Asso- 
 ciation." By this act a charter was granted to Robert Treat Paine, 
 Charles W. Dexter, John S. Blatchford, Francis C. Foster, John 
 D. W. French, I. Wells Clarke, George W. Pope, Charles H. Wash- 
 burn, Robert Treat Paine, second, Thomas T. Stokes, and Henry R. 
 Gardner, and their associates and successors. The association was 
 authorized to loan money upon pledge or mortgage of goods and 
 chattels, and on safe securities or every kind, or upon mortgage of 
 
BEPORTS OP THE PRESIDENT'S HOMES COMMISSION. 317 
 
 real estate. The capital stock of the association is $125,000. The 
 amount of outstanding loans on April 1, 1908, was $215,826.64, the 
 number of borrowers was 3,585, and the average single loan was 
 about $60. ( See the Twentieth Annual Report of the Workingmen's 
 Loan Association, dated April 16, 1908.) In a pamphlet published 
 by the Massachusetts board of managers. World's Fair, in 1893, 
 entitled " Origin and system of the Workingmen's Loan Associa- 
 tion," on page 5 appears the following statement : 
 
 The charge for interest is 1 per cent per month. An additional charge is 
 made on the making of each loan sufficient to cover all money expended in 
 investigation and recording the mortgage, and to give the company in ordinary 
 cases $1.65 for the time spent in appraisal and drawing papers. Nearly all 
 of the loans of the company are made on chattel mortgage of furniture and 
 household effects. 
 
 This has been amended, and at the present time, October, 1908, 
 the association, in addition to its regular rate of 1 per cent per 
 month, charges for investigation, recording of mortgages, etc., the 
 sum of $2.50 on loans under $50, $3 on loans of $50 to $250, and 
 $5 on loans over $250 ; $1 is the cost charged for renewals. No loan 
 is made for less than $25 on account of the cost of handling, which 
 amounts to $3.77, although the cost of recording chattel mortgages 
 in Massachusetts is but 75 cents, and no notarial certificate is required 
 on this class of mortgages. 
 
 The association also charges 25 cents on loans under $50, and 50 
 cents on loans from $50 to $100, to compensate the association for 
 the risk of loss of goods mortgaged, by fire, though no insurance 
 policy is taken out on the goods mortgaged as security for such small 
 loans. Thus it will be seen that the association receives interest on 
 its ordinary small loans for short periods of time of at least 2 per 
 cent per month, and sometimes more. Robert Treat Paine, of Bos- 
 ton, a gentleman of national reputation, was the first president of 
 this association, and he has been continuously reelected to the same 
 office to the present time. 
 
 In 1908 the legislature passed an act entitled " An act to regulate 
 further the business of making small loans " (chap. 605, 1908), which 
 act confers on the police commissioner of Boston, and upon the 
 mayor in other cities, the power to make the rate of interest to be 
 charged upon small loans of $200 or less, upon which a rate of in- 
 terest greater than 12 per cent per annum is charged, and for which 
 no security, other than a note or contract with or without indorsers 
 is taken, having due regard to the amount of the loan and the time 
 for which it is made. 
 
 It also fixed the charges or cost as follows : 
 
 Sec. 3. ♦ * * An amount not exceeding $2 if the loan does not exceed $25 ; 
 not exceeding $10 if the loan exceds $100 ; not exceeding $3 if the loan exceeds 
 $25 but does not exceed $50; and not exceeding $5 if the loan exceeds $50 but 
 does not exceed $100, may, if both parties to the loan so agree, be paid by the 
 borrower or added to the debt, and taken by the lender as the expense of mak- 
 ing the loan, and such amount shall not be counted as part of the interest on 
 the loan. A greater amount than that above specified shall not be taken for 
 such purpose, and any money paid, promised, or taken in excess of such amount 
 shall be deemed to be interest. 
 
 Under the power conferred on the police commissioner of Boston 
 to make the rate of interest that may be charged on said class of small 
 
318 EEPORTS OF THE PEESIDENt's HOMES COMMISSION. 
 
 loans, for which no security is taken other than a note or contract 
 with or without indorser, he has made the following rates : 
 
 Sec. 3. Interest may be charged by persons licensed under this rule as fol- 
 lows: 
 
 On loans not exceeding $50, at the rate of 36 per cent per annum ; on loans of 
 over $50, at the rate of 30 per cent per annum. 
 
 The license tax for this class of business is $50 per annum. 
 
 Rhode Island. — By an act of the general assembly of the State of 
 Rhode Island, passed February 28, 1895, entitled " An act to incorpo- 
 rate the Workingmen's Loan Association," it is provided that the 
 rate of interest on loans to be made by said association "shall not 
 exceed 1 per cent a month." (See sec. 4 of said act.) This act was 
 amended on May 27, 1897, and the rate of interest on such loans was 
 raised not to exceed 2 per cent per month, which rate is still in force. 
 Section 4 of said act as amended reads as follows : 
 
 All loans shall be for a time fixed, and for not more than one year, and the 
 mortgagor or pledgor shall have a right to redeem his property mortgaged or 
 pledged at any time before it is sold, pursuant to the contract between said 
 mortgagor or pledgor and said corporation, or before the right of redemption 
 is foreclosed, on the payment of the loan and interest at the time of the offer 
 to redeem. No loan of more than one thousand dollars shall be made to any 
 one person. The rate of interest upon any loan made by said corporation shall 
 not exceed two per cent a month. No dividend shall be paid in excess of six 
 per cent per annum. 
 
 'Maryland. — An act of the Maryland legislature of 1902, regulating 
 the loaning of money when, as security for such a loan, a lien is taken 
 upon household furniture and effects, musical instruments, typewrit- 
 ers, and sewing machines, authorizes a charge for the examination or 
 valuation of property offered as security for a loan and the prepara- 
 tion of the necessary papers, as follows: 
 
 On sums of $1 to $50, a charge of $5 ; on sums of $51 to $100, a charge of $6 ; 
 on sums of $101 to $1,000, a charge of $6 plus 5 per cent of increase over $100 ; 
 on sums of $1,001 and upvrard, a charge of $6 plus 5 per cent of increase 
 over $100 and plus 2\ per cent of increase over $1,000. 
 
 The said act also authorizes the collection of the amount actually 
 to be paid for recording papers, revenue stamps, and fire-insurance 
 premiums. While all of the loans under this act only bear interest 
 at the rate of 6 per cent per annum, it is plain that the fixed charges 
 by law more than raise the actual rate of interest to 2 per cent per 
 month on ordinary short-time loans. 
 
 Chapter XV. 
 
 HOW TO BENEFIT THE POOR IN THE SLUMS, 
 [By Wm. F. Downey.] 
 
 For many years the board of trade and other civic associations have 
 shown a deep interest in the material improvements in Washington. 
 Each year we have the reports of various committees on improve- 
 ments, embracing the departments of public buildings, parks, bridges, 
 harbors, streets, trees, sewers, manufactures and commerce, rail- 
 roads, etc., in which recommendations are made that millions of dol- 
 lars be appropriated for such improvements. 
 
REPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 319 
 
 While it is very commendable of our citizens to use every means 
 possible pertaining to the manufacturing and commercial progress 
 and material welfare of our city, we should not overlook that portion 
 where the poor dwell in slums, alleys, and courts, in unsanitary and 
 uninhabitable abodes. We can not truthfully boast of or take pride 
 in our capital city until we improve the conditions of our slum prop- 
 erty and remove the festering plague spots which are equally a men- 
 ace to the health and morals of the community. 
 
 Our attention must be directed to these slums and plague spots 
 where the poor are forced to live. As long as these sources of pov- 
 erty and crime are allowed to exist in our city, and are tolerated by 
 law, there is little use in attempting to reform them ; such evil haunts 
 are so many poison springs constantly throwing forth their putrid 
 waters over our city, and until they are purified all moral efforts will 
 avail but little. 
 
 The surgeon who is called to treat a patient does not devote his 
 services to the sound parts of the body, but immediately directs his 
 attention to the diseased spot. So it behooves us to apply our reme- 
 dies to the slums and plague spots of the community, where poverty 
 prevails, immorality is rampant, and crime originates and flourishes. 
 
 We notice that the health authorities in every town and city in 
 the land are endeavoring to prevent or check infectious diseases, and 
 if anyone becomes infected, that one is immediately quarantined. 
 Similar precautions are taken in the case of steamers arriving in port 
 with contagiously diseased patients on board. While this all-im- 
 portant attention is given to such cases, why should we permit greater 
 evils to exist which spread their blasting effects through the com- 
 munity, and transfer the contagion from generation to generation, 
 such as consumption and other diseases, emanating from immoral 
 lives due to dens of infamy, low saloons, etc. ? Insanitary and unin- 
 habitable dwellings, where people are crowded together, breed and 
 spread considerable disease. For instance, many people live in these 
 places at night, and work in homes all over the city during the day. 
 In this way the disease germs are carried into many homes, endanger- 
 ing the health of our little ones and blighting the happiness of our 
 people. 
 
 Much praise is due to Mr. Charles F. Weller, and those connected 
 with the Associated Charities for the light they have thrown on the 
 slum problem, and the aid they have rendered to those who dwell 
 there; also the Washington Sanitary Housing Company, which has 
 aided so many people of limited means to secure houses a moderate 
 rental. Squalid shacks have disappeared from certain quarters and 
 their sites are now occupied by habitable dwellings ; the purpose which 
 brought about this change is worthy of commendation. Every effort 
 which elevates and improves land and houses is entitled to its meed 
 of praise. But while the housing movements have benefited a class 
 of people who are able to pay moderate rents, what has become of 
 the unfortunates who dwell in shacks? 
 
 It is an easy matter to stigmatize the unfortunate with the names 
 their depraved habits deserve, but what of their reform; has there 
 been anything done to elevate them, to cleanse them, to withdraw 
 them from their evil associates? 
 
320 BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 This is the work under present contemplation. These poor crea- 
 tures should not be driven to desperation; we should see to it that 
 means are available to effect their temporal, physical, and moral 
 welfare. 
 
 It may be a work meriting all praise to beautify a portion of the 
 city in which we live, enhancing the value of property and of elevat- 
 ing human life. Indeed, it will be cheerfully conceded that such 
 work is deserving of the highest praise. But how incomparably 
 better is the merit of the effort and toil spent in uplifting frail mem- 
 bers of the human family. They are for eternity, and should they 
 not be impressed with the knowledge of the fact " Whatsoever you 
 do to the least of these, you do unto Me," said the Savior of men. 
 
 Shacks and shanties may be transformed into residences and man- 
 sions, but they will crumble away. The depraved citizen of the 
 slums is destined for eternity ; he is made in the image of God. His 
 being known, should it not be glorious work to restore the Image, 
 which has been well-nigh obliterated by dissipation and sin? The 
 merit of an undertaking is due to the object and the aim. Judged 
 by this canon how supremely meritorious is the work of redeeming 
 and uplifting those who have fallen away from their high inheritance 
 as children of God, and who are held in the thrall of base servitude. 
 To beautify a city and to make habitable homes is a work of com- 
 merce and art; to uplift and fortify frail humanity is to cooperate 
 with Christ in the work of redemption. 
 
 If the Government can build prisons for the criminals, almshouses 
 for the poor, asylums for the afflicted, and public schools, libraries, 
 etc., on which millions of dollars have been spent, it would seem that 
 in common sense and in logic there can be no condemnation for an 
 application of the same solicitude to the aid of those who are in a 
 condition of semiparalysis, owing to economic conditions. A little 
 government aid extended to these unfortunates in the form of a loan 
 to build them habitable dwellings would tend immensely toward their 
 uplifting and improvement. 
 
 The home is the very foundation and corner stone of society, and 
 should be particularly guarded against the contamination of all vice. 
 
 All unsightly and insanitary property should be condemned and 
 purchased by the Government, improved in a uniform manner, and 
 inexpensive an dhealthful habitations erected for the poor, who 
 could rent or purchase these homes on installment plans, at low rates 
 of interest. Should this be done, all would be benefited, for not like 
 money spent in the erection of prisons, poorhouses, libraries, schools, 
 etc., that never return to the public exchequer, the money expended 
 on such homes would return in the form of re^lar monthly pay- 
 ments, and this in turn could be used for the continuance and spread 
 of the good work of elevating the masses. 
 
 It is manifestly unfair to exact exhorbitant rents from the poorer 
 classes; the poorer a man is the more he is at the mercy of the 
 owner, and this is the very man the city should try to assist. Think 
 of it — these families paying rents for shacks, which give a gross 
 return to the owner of from 9 per cent all the way to 35 per cent; 
 renters pay from $6 per month to $12.50 which bring in these large 
 returns of interest. (See report of committee on building model 
 houses in Washington, D. C., 1908.) The fact that these renters 
 pay from $6 to $12.50 per month shows that they are among the 
 
BEPOETS OF THE PEESIDENt's HOMES COMMISSION. 321 
 
 poorer classes. It is the sick man who needs medicine ; likewise the 
 poor man needs assistance. In many instances there is little or no 
 chance of his coming to the front without this assistance. 
 
 How many poor helpless creatures born in the slums would, if 
 opportunity were given to them, develop in a pure atmosphere a 
 noble manhood and womanhood, which would make them the pride of 
 the country, instead of becoming or remaining a burden to the com- 
 munity? They might become some of the best citizens and bright- 
 est statesmen if their childhood days were rescued from unhallowed 
 surroundings. This is no dream, but the actual experience of the 
 writer, who has succeeded in helping numbers of individuals and 
 families to become self-helpful and rise to the highest grade of 
 citizens. 
 
 We read in the newspapers of the day of eminent men, well quali- 
 fied to speak on the subject, making an outcry against the wasteful 
 use of coal, iron, and timber and predicting a famine of the same in 
 future generations. While this subject is very commendable, I sin- 
 cerely hope the day is not far distant when the distinguished people 
 will also consider the temporal and moral welfare of the citizens, 
 which I think should be regarded as the most important of all 
 subjects, as it does not only pertain to the permanent and thorough 
 improvement and beautifying of our national capital city, but 
 pertains chiefly to the uplift of our citizens. 
 
 It is only the Federal Government which controls the affairs of the 
 city of Washington, which could undertake such a necessary and 
 meritorious work, by having an act passed by Congress giving power 
 to appoint three men — an engineer, an architect, and a sanitary engi- 
 neer — with power to condemn, purchase, and improve property m 
 squares having narrow minor streets, and alleys without proper open- 
 ings. Many of such squares are crowded with insanitary and unin- 
 habitable dwellings, which make them a menace to the health and 
 morals of the unfortunate people who are forced to dwell there. This 
 seems to be the only correct way to deal practically with this question, 
 and it readily appeals to the intelligence and desire of every good 
 citizen who has the welfare of our city and citizens at heart. 
 
 See the great advantage which would be derived from such an 
 undertaking. The commission suggested, of three gentlemen, would 
 first map out the improvements to be made in such squares, and after 
 the condemnation of certain lots and parts of lots, then to erase all 
 unsightly buildings from the land, so that the improvements could 
 be made in a uniform manner by grading and beautifying the land, 
 and erect houses on the most suitable plan. The streets in such 
 squares should not be less than 40 feet wide from building to build- 
 ing to be divided in the following manner : Take 10 feet in the center 
 for a parking, where trees could be planted, giving good shade in 
 summer to the occupants of the houses on each side of the street and 
 affording 15 feet roadway for each side of the street. This parking 
 and arrangement of the streets through squares would afford the 
 children ample playgrounds and save them from the many dangers 
 liable to happen on the public streets from trolley cars, teams, au- 
 tomobiles, etc. Of course there are other methods for street construc- 
 tion, but the one here suggested would no doubt be desirable, and 
 S. Doc. 644, 60-2 22 
 
322 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION". 
 
 give the houses air and sunshine, so essential to afford a bright, 
 healthful home. 
 
 The police department could carry on this work without additional 
 expense to the Government ; the police officers could not only be made 
 preservers of law and order, but also, as far as possible, suppress 
 and remove every source of evil, particularly those endangering the 
 morals of our youth. They could also be made the sanitary inspectors 
 and collect the monthly rents and installments from the people who 
 rent or purchase these houses. This money would go right back into 
 the funds of the Government, and be available for the improvement 
 of other such property, which in time would eliminate every unde- 
 sirable and uninhabitable house in the city. 
 
 If such an arrangement would be adopted it would bring about an 
 entire change in our city government, for instead of the police officers 
 being the prosecutors and persecutors of our unfortunate and crimi- 
 nal classes, who are ruined by the existing vices spread nearly every- 
 where, they would suppress and remove as far as possible the vices 
 and save the citizens. I predict if this plan was put in operation it 
 would reduce the criminal class more than 50 per cent. The police- 
 man should act as the good Samaritan, which would elevate him to 
 the highest rank in public service and make him beloved and re- 
 spected by every good citizen. In this way they could be made the 
 greatest power for good. 
 
 While this plan is perhaps new in our country, somewhat similar 
 plans have worked successfully in several foreign countries. I know 
 that foreign experiences do not apply fully to our country, and a plan 
 might work successfully there and not here on account of different 
 political and social conditions, but the problem is about the same and 
 its solution is of basic importance. We can profit by foreign ex- 
 perience and modify the plan so as to meet our social and political 
 conditions. I submit the plan herein outlined. Having the problem 
 to deal with in the United States, we should be the leaders and not 
 the followers. 
 
 Granting, then, that the problem exists and that the United States 
 should lead in its solution, I know of no city where it could be tried 
 to better advantage than in the city of Washington, and its success 
 here would mean in time its success in every city in our country. 
 There is no reason why our city should not be the finest in the world, 
 morally as well as materially and intellectually, and it soon would 
 be if we set about it in the right way. We have already secured pres- 
 tige as a center of art, letters, and legislation. Let us endeavor like- 
 wise to protect and influence our citizens to the highest moral stand- 
 ard by aiding them to secure better homes and to guard and protect 
 them from the contaminating influence which now confronts them 
 everywhere. 
 
Appendix A. 
 
 HEALTH OF EMPLOYEES IN THE GOVERNMENT PRINTING OFFICE, 
 
 WASHINGTON.^ 
 
 [By Wm. J. Manning, M. D., Medical and Sanitary Officer, Government Printing Office.] 
 
 Owing to improved hygienic conditions in modern printing offices, type foun- 
 dries, and stereotype and electrotype foundries, lead poisoning now exists to a 
 very limited extent in these trades. 
 
 In tlie Government Printing Office at Washington, where upward of 4,500 
 employees are gathered in one building, excellent hygienic conditions prevail. 
 Every ten minutes the air in each room is changed by a very simple device, 
 consisting of air shafts leading from the basement to the roof, and which are 
 pierced in each room near the ceiling with suitable openings. A revolving fan 
 placed just below the roof creates a suction, so that a constant supply of fresh 
 air is available at all times, owing to the vacuum thus formed. 
 
 The electrotype and stereotype foundries are placed on the topmost floor, the 
 modern, rapidly moving elevators making this practicable, so far as the em- 
 ployees are concerned. At that height from the ground currents of air are con- 
 stantly in motion, with a consequently greater diffusion of the gases than would 
 prevail on floors nearer the ground. In the large newspaper buildings of the 
 cities in the United States the same idea is being carried out, these rooms being 
 placed as high in the air as possible. 
 
 In the type-founding and stereotyping trades employees whose duties call them 
 to work over the fumes of the melting pots are most exposed to the injurious 
 influences of lead, although the large amount of alloy present tends to lessen the 
 danger. 
 
 " Finishers " of the plates, who handle only the smooth, hard, bright slabs 
 of the alloyed metal, which are free from all oxides, run the least risk of lead 
 poisoning. The fact that there is little or no dust, coupled with the fact that 
 the small particles which rub off the plates on the hands of the workman are 
 in the metallic state and perfectly dry renders it less liable to be absorbed. In 
 contradistinction to this is the case of the painter. Here the lead, being in the 
 form of a carbonate (white lead) and being mixed with such an excellent 
 absorbing material as oil, is much more rapidly absorbed. 
 
 EMERGENCY BOOM, GOVERNMENT PRINTING OFFICE, WASHINGTON, D. a 
 
 In type foundries practically the same conditions exist as in electrotype 
 foundries. Those who work in the vicinity of the melting pots are much more 
 liable to the toxic vapors which arise from the melting pot. This is particularly 
 the case where the lead is impure and contains volatile substances which, com- 
 bining with the lead fumes, might possibly add to the toxic influences of the 
 lead. Hence, in " fluxing " the metal, when wax is used as the agent, as little 
 as possible should be used. 
 
 Females are, as a rule, employed in this country to sort, finish, and pack 
 the type. Here, as with the " finishers " in the electrotype foundries, the metal 
 is bright and free from oxides, besides being largely alloyed ; hence, the chance 
 
 °' Doctor Manning's article on Plumbism, which is here reproduced, was sub- 
 mitted by him in competition for a prize offered by the Internationales Arbeit- 
 sant, Basel, Switzerland. The article was purchased for publication by that 
 office on account of merit. 
 
 828 
 
324 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 of absorption with toxic results is greatly lessened. Doctor Osier has pointed 
 out that the ratio of women susceptible to lead poisoning is small as com- 
 pared with men. Why they are thus immune is hard to say ; but, so far as type 
 founding is concerned, probably the above statement indicates the cause. 
 
 With the compositor the chances of absorption of lead from the type metal 
 by the skin is probably nil. Only a small portion of the epidermis of the 
 fingers (the apex of the thumb and forefinger) is brought in contact with the 
 metal both in " distributing " and in " setting," and the epidermis at these 
 parts is in a more or less thickened, dense condition. Thus, the compositor is 
 protected from absorbing the metal, even when the type is covered with the 
 hydrate which is formed by the long-continued action of air and water. It 
 is well known that substances are absorbed but slightly, if at all, through the 
 skin that is in a thickened condition. If one will stop to consider that the 
 small atoms which become separated from the metal type in one way and 
 another are in a metallic form the chances of absorption are even more remote. 
 
 The danger to the compositor, as with the melting-pot tender, would seem to 
 lie in inhalation. With the former the introduction into the system would be 
 by dust, and with the latter in the form of gas. 
 
 When foreign bodies are taken into the system in a state of fine subdivision, 
 the favorite seat will be found, as a rule, in the bronchi and the lungs. The 
 process, so far as compositors are concerned, might be termed plumbiosis. The 
 dust which is not carried directly into the alveoli of the lungs by the air 
 breathed finds lodgment on the membrane of the bronchi and the ramifications 
 thereof. That considerable dust is carried down the esophagus into the stom- 
 ach and from there swept out into the intestines is not to be doubted. Might 
 not these fine particles cause the " colic " or active peristalsis by the stimulation 
 of the circular and longitudinal muscular fibers in a mechanical way on the 
 muscles themselves or in a chemic way by a stimulation of the nerves con- 
 trolling these fibers? This "colic" is one of the first symptoms complained of 
 by the patient. 
 
 That the white blood corpuscles play an important part in carrying this 
 finely divided substance throughout the body is also probable, the mode of 
 action being to inclose the fine particles and try to dissolve them, and, failing 
 in that, to transport them to distant points in the body and to the various 
 organs. In that condition known as anthracosis, or coal-miner's consumption, 
 the lung is found to be covered with black dust. The same conditions are 
 found in those suffering from stonecutter's consumption, the lack of carbon 
 rendering the pigment somewhat lighter in color. The condition is known as 
 lithosis. In the knife and saw sharpener's trade the dust is in the form of 
 steel and the consequent disease is known as siderosis. In each case the 
 fine dust finds lodgment in the lungs. 
 
 The lungs become so pigmented after long exposure to these conditions, and 
 the alveoli so congested and choked, accompanied by a low form of inflamma- 
 tion that the substances set up, that this, with the unhygienic surroundings and 
 bad ventilation, might explain why so many compositors die each year from 
 tuberculosis. Certainly the tubercle bacilli find a congenial environment in 
 which to begin their fatal work. To the above conditions must be added, of 
 course, the toxic influence of the lead itself, together with the persistent astrin- 
 gent effect of the lead on the air cells. Lead is a very feeble antiseptic and does 
 not seem to inhibit the growth of the bacilli. 
 
 The lymph nodes very likely play an important part in carrying the lead 
 through the body to produce plumbism. When lymph nodes become loaded with 
 foreign material of any nature they are apt to break down and the circulation 
 carries the substances to various parts of the body. This would seem to explain 
 the peculiar color of those suffering from plumbism, and it might explain why 
 the kidneys become so irritated and why albumin is found in the urine. Certain 
 tissues seem to have an affinity for the lead thus carried and it is deposited 
 in them. The blue line on the gums which is pathognomic of lead poisoning 
 may be the result of this. It may be that sulphur, which has such a strong 
 affinity for lead and which might be taken into the mouth in articles of food 
 and drink causes this pigmentation. It is strange that the blue line does not 
 make its appearance on any other part of the body. Certain it is that the 
 potassium sulphite when added to a bath will bring out this pigment over the 
 entire body, which remains until the lead in the skin is either eliminated or 
 the affinity is satisfied. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 325 
 
 Lead poisoning in the chronic form, as already stated, is very rare among 
 type founders, electrotypers, stereotypers, and in the printing trades in this 
 country. It may present itself in the regular type or the symptoms may be 
 hidden. The characteristic symptoms are the blue line on the gums, and the 
 wrist drop, due to the paralysis of the extensors of the forearms. In some 
 cases it first makes its appearance in anaemia and in loss of strength. Anses- 
 thesia may appear in spots on different parts of the body, the spots varying 
 in size from half a dollar to tracts as large as the hand. They may appear on 
 the arms, legs, or on the back. In some cases, however, these symptoms are 
 entirely absent. Albumin may appear in the urine. Doctor Osier describes 
 cases that have come under his care where the symptoms resembled gout and 
 rheumatism. The joints would swell and become very red and tender, the 
 patient suffering all the while intense pain. Doctor Wood mentions cases 
 where the symptoms resembled actue poliomyelitis. In other cases there was 
 simply a failure of health, ansemia, nervous phenomena, etc., the patient having 
 ill-defined, sharp, shooting pains. The pain from the colic seems to merge from 
 the umbilicus in all instances. Arteriosclerosis has been noticed with atrophy 
 of the kidneys and hypertrophy of the heart, the enlargement of the latter 
 organ probably being due to the redoubled effort of the heart to force the 
 blood through the various contracted distal organs. This contraction may be 
 due in a measure to the astringent action of the lead which is noticed upon 
 all tissues when lead is applied in its various forms. 
 
 The treatment in these cases may be divided into the preventive and cura- 
 tive, the former relating, of course, only to the trades mentioned in this article. 
 Among the measures which might be taken in the prevention of plumb ism in 
 the printing, type founding, and electrotyping and stereotyping trades would 
 be, first of all, the location. The rooms devoted to the melting of type metal 
 should be situated as high as possible in the air, and on the topmost floor of 
 the building. The pots should be covered with iron hoods that will cover the 
 entire top of the melting pot proper. The hood should set as near the metal 
 as possible, in such a way that it will not interfere with the manipulation of 
 the ladles or dippers. Hoods with small pipes when used as fume chambers do 
 not answer. It has been found that to be of any service or benefit, the pipe 
 leading from the hood or fume chamber should be nearly as large as the cham- 
 ber itself, and should lead to a smoke chimney or into the outside air. The 
 heat generated should supply draft enough to carry the fumes off in this way. 
 It might be aided by placing a revolving circular ventilator in the pipe from 
 the outside and operated by the wind. The whole thing might be made very 
 cheaply of galvanized iron. Various face masks have been suggested, but none 
 seem to be practical, and after they are worn for some time really become a 
 greater danger than if they had not been used, owing to the lack of cleanli- 
 ness. Cotton and such substances in the nose are useless, because the workman 
 will then breathe through his mouth. The rooms should be at least 10 feet 
 high. Windows should be placed on both sides of the room, so that a current 
 of air may be in constant motion and a fresh supply always on hand. In 
 winter or bad weather a very simple way to obtain fresh air consists in placing 
 a board 3 or 4 inches high lengthwise under the lower window sash. This will 
 enable the fresh air to enter between the lower and upper windows without 
 causing a direct draft on the workmen. 
 
 The personal treatment on the part of the workman should be a change of 
 underclothing after work, a bath at least three times a week in hot water with 
 plenty of soap, and at the same time the vigorous application of a flesh brush 
 to the skin. The object here is twofold — to keep the pores free and to remove 
 any particles that may have lodged there, and hence lessen the danger of 
 absorption, while at the same time helping the pores to eliminate that which 
 has been absorbed. The bowels should be kept open by the use of such simple 
 laxatives as sweet oil, castor oil, calomel and soda, etc. An electrotyper who 
 has been in the business for some forty years, and who is now the chief of the 
 largest foundry in the world, informed me that it was his custom to take a 
 teaspoonful of sweet oil every other day, and that he had never suffered from 
 any ill effects of plumbism. 
 
 So far as compositors are concerned, the preventive treatment just described 
 would apply to them. The principal danger here is the bad ventilation, in- 
 sanitary surroundings, and the dust (principally graphite and minute particles 
 of type metal) which becomes detached by the abrasion of the pieces against 
 each other while being handled. To offset this, " cases " should be blown out 
 by a bellows at least once each week ; if possible, in the open air. The bottoms 
 
826 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 in the different boxes, instead of being fiat and square cornered, and covered 
 with paper, should be slightly concave at the bottom, with the corners rounded 
 somewhat like a cash till, the idea being to keep the dust from lodging in the 
 corners, where it is difficult to remove even with a bellows. In cases con- 
 structed in this manner the dust is, by its own weight, constantly working its 
 way toward the center of each box, where it can easily be removed. 
 
 A practical method of removing the caked dust is in vogue in the Govern- 
 ment Printing Office at Washington. The type forms after leaving the electro- 
 type foundry are placed on a raised rack which drains into a shallow tank 
 some 6 inches in depth, a pipe connecting this with a sewer. The forms are 
 placed in a horizontal position — that is to say, the side of the chase rests on 
 the rack. Steam under pressure is conducted by a rubber hose and the face of 
 the type is thoroughly " blown," as is the reverse of the form. Later, when the 
 This chamber consists of a zinc-lined box about 6 feet in length, 4 feet wide, 
 and 4 feet high, a trapdoor opening from the top being the only opening. In 
 the bottom is placed a coil of steam pipe which covers the entire floor of the 
 box, one end of the pipe being left open. The pages of type are placed on shallow 
 perforated trays somewhat like a " galley," each tray fitting in a copper rack, 
 consisting simply of two loops of copper, somewhat like an inverted U, with 
 pins attached on which the trays set. Each rack holds eight pages, or a " sig- 
 nature," on the eight trays. After the box is filled, steam is turned on and the 
 type is thoroughly boiled for an hour or more. The pages are lifted in and out 
 by means of hooks. This method not only removes the graphite but disinte- 
 grates the type and " loosens " it, permitting easy distribution. It also leaves 
 the type very clean and aseptic, lessening the chances of infection by the ab- 
 sence of germs. The method of letting cold water run on the forms and thus 
 cleansing them is not so thorough, because the graphite " cakes " and clings 
 to the type and the dust is thrown into the compositor's case with the type, 
 making the cases very dusty and dirty. Each compositor should supply himself 
 with a small brush, suitable for the hands, to be used each time he washes. 
 A private drinking cup is desirable. 
 
 In acute cases of lead poisoning the treatment consists in the administration 
 of alkaline carbonates, soap, soluble sulphates, sodium chloride, etc., washing 
 out the stomach with large drafts of water, etc. Alum has been given, and at 
 one time was considered almost a specific. Sweet oil and castor oil will be 
 found useful. Milk should be taken in large quantities. The idea is first to 
 combat the symptoms and then eliminate the lead. Opium can be given for 
 pain. Warm sulphureted baths are very beneficial. They can be made by 
 dissolving 4 ounces of potassium sulphide in 30 gallons of water in a wooden 
 tub. These baths discolor the skin, from the formation of lead sulphide, and 
 should be repeated every few days until this effect ceases. During each bath 
 the patient should be well washed with soap and water to remove discoloration. 
 
 The various kinds of typesetting machines all have a melting pot attached 
 to each machine, and where many are in use, unless there is plenty of pure 
 air constantly entering the room and perfect ventilation provided, the fumes 
 from each pot should be conducted by pipes to a chamber in which a vacuum is 
 present, so that the fumes may be instantly removed and carried out into the 
 atmosphere. The virtue of the machine lies in the fact, so far as health is 
 concerned, in the absence of dust, and with the additional advantage on the 
 part of the operator that he does not lay himself open to exposure in handling 
 the metal to so great a degree as in the case of the hand compositor. 
 
 There are other alloys that would take the place of lead in type metal, but 
 owing to the excessive cost and high fusing point their use is not practical. 
 
 DOCTOB manning's METHOD FOB THE COLLECTION, DISINFECTION, AND DISPOSAL OF 
 
 SPUTA. 
 
 From a sanitary point of view the collection, cleaning, and disinfection of 
 the spittoons in the Government Printing Office is a matter of considerable 
 importance. This will be readily understood when it is remembered that there 
 are over 4,300 persons oujrnirod during the twenty-four liours, all working in 
 eight-hour shifts, and ilmt no fewer than 1,200 cuspidors must be cleaned at 
 the end of each shift. 
 
 The method now Installed under Doctor Manning's direction effects this with- 
 out direct digital contact. It consists in a central sterilizing chamber situated 
 in the basement of the Printing Office, with a cement floor, graded toward the 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 327 
 
 center and made up of two inclines. All edges, angles, corners, and returns of 
 tho floor are well rounded and the base of each of the four walls have 6-inch 
 " sanitary bases " in order that all parts of the room may be self cleansing and 
 draining. The walls of the sterilizing chamber are composed of white, glazed, 
 vitrified brick. 
 
 The cuspidors are collected by means of a specially designed sanitary clutch 
 which picks up the cuspidors in an automatic manner, one above the other, in 
 " uests " of five, without the janitor or cleaner in any manner touching his 
 person or in any way coming in contact with the infected or soiled cuspidors, 
 avoiding entirely the irksome, repulsive features which characterize • the meth- 
 ods in vogue at the present time as concerns the washing of spittoons, and 
 greatly minimizes the danger of contraction of tuberculosis by all concerned, 
 and serves, in addition, to draw attention and illustrate a lesson in hygiene to 
 the unthinking and careless. 
 
 The vessels thus collected are carried by means of the clutch or 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 5 soiled cuspidors are taken to the truck they are replaced by 
 5 sterilized cuspidors picked up and distributed by the same mechanism, all 
 of which is accomplished by the use of one hand only of the operator. 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. 
 
 In the chamber is fitted up an iron rack similar in form to that shown in 
 photograph taken of Government Printing Office exhibit at the International 
 Congress on Tuberculosis, and is constructed of strips of 1-inch angle iron, 
 from which hang suspended at intervals of 10 inches steel- wire clutches, shaped 
 somewhat like an inverted letter U, into which are thrust the cuspidors after 
 they have been dipped and washed in boiling water (212° F.), and from whence 
 they are taken after they have been drained or dried, and replaced in trucks 
 for transmission back to the floors of building. 
 
 A galvanized-iron trough, connected directly with the sewer, is placed at 
 the base and in front of the iron rack. The hot, boiling water is piped directly 
 into this trough after it has been heated for this purpose by jets of steam 
 entering the pipe through which the cold water flows. 
 
 The contents of cuspidors are emptied directly into the trough by means of 
 short forceps which grasp the lip of the cuspidor, whence it escapes to the 
 sewer. After the vessel has been made thoroughly clean and sterilized by 
 immersion in the boiling water, the operator, still grasping the forceps, presses 
 the vessel into the steel spring clutch on rack, where it drains and dries, as 
 shown in photograph. 
 
 After the cuspidors have all been washed and sterilized in the manner 
 described, they are quickly removed from the spring clutch on iron rack by 
 the cleaner and replaced in truck. As each layer is laid down in the truck, 
 from 2 to 4 ounces of a solution made up of bichloride of mercury 7.3 grains; 
 citric acid, 7.7 grains to each gallon of water, which, in addition, is colored 
 with eosin to differentiate the solution and to warn persons that the liquid is 
 not water, is poured into each spittoon, where it remains until all the vessels are 
 washed again. This gives a strength solution suflicient to kill the most resistant 
 disease germs, yet when still further diluted with water in the trough during 
 the cleaning process, renders the solution harmless to plumbing work or the 
 piping of sewers. 
 
 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 expectorations, 
 and thus render the action of the bichloride of mercury more potent. It is one 
 of the most powerful antiseptics known to science. 
 
 The entire cost of the chemical disinfectants named amounts to less than 
 $12 per annum. Five gallons can be made for about 1 penny. 
 
 The cuspidors are specially designed to permit of easy cleaning and self- 
 draining, largely on account of the character of the curves employed. 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, 
 
328 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 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 cuspidor 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, white surface for sanitary 
 cleansing. 
 
 Approximately about 3,800 barrels of sawdust are used each year for cus- 
 pidors 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 of the foul and polluted sawdust, the main object has been 
 to reduce to a minimum the danger of infection through tuberculosis sputa 
 among the employees." 
 
 • * • * * 
 
 The report of Doctor Manning, in charge of the sanitary division of the 
 Government Printing Office, shows that of 4,556 employees in the building from 
 January 1, 1906, to February 29, 1908, 1,153 employees received treatment at 
 the emergency room, 595 were medical cases inclusive of 9 cases of lead colic. 
 Of these, 516 resumed work, 76 were sent home for treatment, and 3 died. Of 
 the 558 surgical cases, 517 resumed work and 41 were sent home for treat- 
 ment. The emergency department is well equipped, and the results have in 
 every way justified its establishment. 
 
 !Ajppendix B. 
 
 EEGTJLATION OF DANGEROUS TRADES IN ENGLAND. 
 
 In addition to the general provisions regarding ventilation, etc., which apply 
 to all manufacturing establishments, the English factory and workshop act 
 .(1901) contains a chapter of special provisions for dangerous and unhealthy 
 industries, which is reprinted below, together with the special rules and regu- 
 lations issued by the government officials in accordance with the grant of 
 authority therein made. 
 
 FACTORY AND WORKSHOP ACT, 1901. 
 
 Past IV. — Dangerous and Unhealthy Industries, 
 
 (i) SPECIAL PROVISIONS. 
 
 SECTioif 73. (1) Every medical practitioner attending on or called in to vl«it 
 a patient whom he believes to be suffering from lead, phosphorus, arsenical, 
 or mercurial poisoning, or anthrax, contracted in any factory or workshop, 
 shall (unless the notice required by this subsection has been previously sent) 
 send to the chief inspector of factories at the home office, London, a notice 
 stating the name and full postal address of the patient and the disease from 
 which, in the opinion of the medical practitioner, the patient is suffering, and 
 shall be entitled in respect of every notice sent in pursuance of this section to 
 a fee of 2 shillings and 6 pence, to be paid as part of the expenses incurred by 
 the secretary of state in the execution of this act. 
 
 (2) If any medical practitioner, when required by this section to send a 
 notice, fails forthwith to send the name, he shall be liable to a fine not ex- 
 ceeding 40 shillings. 
 
 « All of the mechanical devices used in the above method have been designed 
 by Doctor Manning, and were awarded a special gold medal by the Interna- 
 tional Congress on Tuberculosis, 1908. 
 
EEPORTS OF THE PEESIDENT 's HOMES COMMISSION. 329 
 
 (3) Written notice of every case of lead, phosphorus, arsenical, or mercurial 
 poisoning, or anthrax, occurring in a factory or workshop shall forthwith be 
 sent to the inspector and to the certifying surgeon for the district ; and the pro- 
 visions of this act with respect to accidents shall apply to any such case in like 
 manner as to any such accident as is mentioned in those provisions. 
 
 (4) The secretary of state may, by special order, apply the provisions of this 
 section to any other disease occurring in a factory or workshop, and thereupon 
 this section and the provisions referred to therein shall apply accordingly. 
 
 Sec. 74. If in a factory or workshop where grinding, glazing, or polishing on 
 a wheel, or any process is carried on by which dust, or any gas, vapor, or other 
 impurity, is generated and inhaled by the workers to an injurious extent, it 
 appears to an inspector that such inhalation could be to a great extent pre- 
 vented by the use of a fan or other mechanical means, the inspector may direct 
 that a fan or other mechanical means of a proper construction for preventing 
 such inhalation be provided within a reasonable time, and if the same is not 
 provided, maintained, and used, the factory or workshop shall be deemed not 
 to be kept in conformity with this act. 
 
 Sec. 75. (1) In every factory or workshop where lead, arsenic, or any other 
 poisonous substance is used, suitable washing conveniences must be provided for 
 the use of the persons employed in any department where such substances are 
 used. 
 
 (2) In any factory or workshop where lead, arsenic, or other poisonous sub- 
 stance is so used as to give rise to dust or fumes, a person shall not be allowed 
 to take a meal or to remain during the times allowed for him for meals in any 
 room in which any such substance is used, and suitable provision shall be made 
 for enabling the persons employed in such rooms to take their meals elsewhere 
 in the factory or workshop. 
 
 (3) A factory or workshop in which there is a contravention of this section 
 shall be deemed not to be kept in conformity with this act. 
 
 Sec. 76. (1) A woman, young person, or child must not be employed in any 
 part of a factory in which wet spinning is carried on unless sufficient means are 
 employed and continued for protecting the workers from being wetted, and 
 where hot water is used for preventing the escape of steam into the room occu- 
 pied by the workers. 
 
 (2) A factory in which there is a contravention of this section shall be 
 deemed not to be kept in conformity with this act. 
 
 Sec. 77. (1) In the part of a factory or workshop in which there is carried 
 on (a) the process of silvering of mirrors by the mercurial process, or (?)) the 
 process of making white lead, a young person or child must not be employed. 
 
 (2) In the part of a factory in which the process of melting or annealing 
 glass is carried on a female, young person, or a child must not be employed. 
 
 (3) In a factory or workshop in which there is carried on (a) the making 
 or finishing of bricks or tiles not being ornamental tiles, or (&) the making or 
 finishing of salt, a girl under the age of 16 years must not be employed. 
 
 (4) In the part of a factory or workshop in which there is carried on 
 (a) any dry grinding in the metal trade, or (6) the dipping of lucifer matches, 
 a child must not be employed. 
 
 (5) Notice of a prohibition contained in this section must be affixed in the 
 factory or workshop to which it applies. 
 
 Sec 78. (1) A woman, young person, or child must not be allowed to take a 
 meal or to remain during the time allowed for meals in the following factories 
 or workshops, or parts of factories or workshops; that is to say, (a) in the 
 case of glass works in any part in which the materials are mixed; and (6) in 
 the case of glass works where flint glass is made, in any part in which the work 
 of grinding, cutting, or polishing is carried on; and (c) in the case of lucifer- 
 match works, in any part of which any manufacturing process or handicraft 
 (except that of cutting the wood) is usually carried on; and (d) in the case 
 of earthenware works, in any part known or used as dippers' house, dippers' 
 drying room, or china scouring room. 
 
 (2) If a woman, young person, or child is allowed to take a meal or to remain 
 during the time allowed for meals in a factory or workshop or part thereof in 
 contravention of this section, the woman, young person, or child shall be deemed 
 to be employed contrary to the provisions of this act. 
 
 (3) Notice of the prohibition of this section shall be afl3xed in every factory 
 or workshop to which it applies. 
 
330 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 (4) Where it appears °^ to the secretary of state that by reason of the nature 
 of the process in any class of factories or workshops or parts thereof not named 
 in this section the taking of meals therein is specially injurious to health, he 
 may, if he thinks fit, by special order extend the prohibition in this section to 
 the class of factories or workshops or parts thereof. 
 
 (5) If the prohibition in this section is proved to the satisfaction of the sec- 
 retary of state to be no longer necessary for the protection of the health of 
 women, young persons, and children, in any class of factories or workshops or 
 parts thereof to w^hich it has been so extended, he may, by special order, rescind 
 the order of extension, without prejudice to the subsequent making of another 
 order. 
 
 (it) REGULATIONS FOR DANGEROUS TRADES. 
 
 Sec. 79. Where the secretary of state is satisfied that any manufacture, 
 machinery, plant, process, or description of manual labor, used in factories or 
 workshops, is dangerous or injurious to health or dangerous to life or limb, 
 either generally or in the case of women, children, or any other class of persons, 
 he may certify that manufacture, machinery, plant, process, or description of 
 manual labor to be dangerous : and thereupon the secretary of state may, sub- 
 ject to the provisions of this act, make such regulations as appear to him to be 
 reasonably practicable and to meet the necessity of the case. 
 
 Sec. 80. (1) Before the secretary of state makes any regulations under this 
 act, he shall publish, in such manner as he may think best adapted for inform- 
 ing persons affected, notice of the proposal to make the regulations, and of the 
 place where copies of the draft regulations may be obtained, and of the time 
 (which shall not be less than twenty-one days) within which any objection 
 made with respect to the draft regulations by or on behalf of persons affected 
 must be sent to the secretary of state. 
 
 (2) Every objection must be in writing and state — (a) the draft regulations 
 or portions of draft regulations objected to, (ft) the specific grounds of ob- 
 jection, and (c) the omissions, additions, or modifications asked for. 
 
 (3) The secretary of state shall consider any objection made by or on be- 
 half of any persons appearing to him to be aifected which is sent to him vrithin 
 the required time, and he may, if he thinks fit, amend the draft regulations, 
 and shall then cause the amended draft to be dealt with in like manner as an 
 original draft. 
 
 (4) Where the secretary of state does not amend or withdraw any draft 
 I'cgulations to which any objection has been made, then (unless the objection 
 eitlior is withdrawn or appears to him to be frivolous) he shall, before making 
 the regulations, direct an inquiry to be held in the manner hereinafter provided. 
 
 Sec. 81. (1) The secretary of state may appoint a competent person to hold 
 an inquiry with regard to any draft regulations, and to report to him thereon. 
 
 (2) The inquiry shall be held in public, and the chief inspector and any ob- 
 jector and any other person who, in the opinion of the person holding the in- 
 quiry, is affected by the draft regulations, may appear at the inquiry either in 
 person or by counsel, solicitor, or agent. 
 
 (3) The witnesses on the inquiry may, if the person holding it thinks fit, be 
 examined on oath. 
 
 (4) Subject as aforesaid, the inquiry and all proceedings preliminary and 
 incidental thereto shall be conducted in accordance with rules made by the 
 secretary of state. 
 
 (5) The fee to be paid to the person holding the inquiry shall be such as the 
 secretary of state may direct and shall be deemed to be part of the expenses of 
 the secretary of state in the execution of this act. 
 
 Sec. 82. (1) The regulations made under the foregoing provisions of this 
 act may apply to all the factories and workshops in which the manufacture, 
 machinery, plant, process, or description of manual labor certified to be dan- 
 gerous is used (whether existing at the time when the roirulations are made or 
 afterwards established), or to any specified class of such fnctorios or work- 
 shop. They may provide for the exemption of any specified class or factories 
 or workshops either absolutely or subject to conditions. 
 
 (2) The regulations may apply to tenement factories and tenement work- 
 shops, and in such case may impose duties on occupiers who do not employ 
 any person, and on owners. 
 
 <»For orders extending the prohibition in this section, see post. 
 
REPOETS OF THE PRESIDENT'S HOMES COMMISSION. 331 
 
 (3) No person shall be precluded by any agreement from doing, or be liable 
 under any agreement to any penalty or forfeiture for doing, such acts as may 
 be necessary in order to comply with the provisions of any regulation made 
 under this act. 
 
 Sec. S3. Regulations made under the foregoing provisions of this act may, 
 siniong other things — (a) prohibit the employment of, or modify or limit the 
 period of employment of, all persons or any class of persons in any manufacture, 
 machinery, plant, process, or description of manual labor certified to be danger- 
 ous, and (6) prohibit, limit, or control the use of any material or process, and 
 (c) modify or extend any special regulations for any class of factories or 
 workshops contained in this act. 
 
 Sec. 84. Regulations made under the foregoing provisions of this act shall 
 be laid as soon as possible before both houses of Parliament, and if either 
 house within the next forty days after the regulations have been laid before the 
 house, resolve that all or any of the regulations ought to be annulled, the regu- 
 lations shall, after the date of resolution, be of no effect, without prejudice to 
 the validity of anything done in the meantime thereunder or to the making of 
 any new regulations. If one or more of a set of regulations are annulled, the 
 secretary of state may, if he thinks fit, withdraw the whole set. 
 
 Sec. 85. (1) If any occupier, owner, or manager, who is bound to observe any 
 regulation under this act, acts in contravention of or fails to comply with the 
 regulation, he shall be liable for each offense to a fine not exceedhig £10 ($48.67) 
 and, in the case of a continuing offense, to a fine not exceeding £2 ($9.73) for 
 every day during which the offense continues after conviction therefor. 
 
 (2) If any person other than an occupier, owner, or manager, who is bound 
 to observe any regulation under jthis act, acts in contravention of or fails to 
 comply with the regulation, he shall be liable for each offense to a fine not 
 exceeding £2 ($9.73) and the occupier of the factory or workshop shall also be 
 liable to a fine not exceeding £10 ($48.67), unless he proves that he has taken 
 all reasonable means by publishing, and to the best of his power enforcing, the 
 regulations to prevent the contravention or noncompliance. 
 
 Sec. 86. (1) Notice of any regulations having been made under the foregoing 
 provisions of this act, and of the place where copies of them can be purchased, 
 shall be published in the London, Edinburgh, and Dublin Gazettes. 
 
 (2) Printed copies of all regulations for the time being in force under this 
 act in any factory or workshop shall be kept posted up in legible characters in 
 conspicuous places in the factory or workshop where they may be conveniently 
 rend by the persons employed. In a factory or workshop in Wales or Mon- 
 mouthshire the regulations shall be posted up in the Welsh language also. 
 
 (3) A printed copy of all such regulations shall be given by the occupier to 
 any person affected thereby on his or her application. 
 
 (4) If the occupier of any factory or workshop fails to comply with any pro- 
 vision of this section as to posting up or giving copies, he shall be liable to a 
 fine not exceeding £10 (49.67). 
 
 (5) Every person who pulls down, injures, or defaces any regulation posted 
 up in pursuance of this act, or any notice posted up in pursuance of the regula- 
 tions, shall be liable to a fine not exceeding £5 ($24. .So). 
 
 (6) Regulations for the time being in force under this act shall be judicially 
 noticed. 
 
 Special rules and regulations* 
 
 White lead factories. 
 
 Red and orange lead works. 
 
 Yellow lead works. 
 
 Lead smelting works. 
 
 Factories using yellow chromate of lead. 
 
 Earthenware and china works. 
 
 Electric accumulator factories (regulations). 
 
 Iron-plate enameling works (using lead, arsenic, or antimony), 
 
 Tinning and enameling works (using lead or arsenic). 
 
 Paint and color works (extractions of arsenic). 
 
 Brass and compound metal mixing or casting shops. 
 
 Chemical works. 
 
 Bichromate or chromate of potassium or sodium works. 
 
 Explosive works (using di-nitro-benzole) . 
 
332 EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Vulcanized india-rubber works (using bisulphide of carbon). 
 
 Lucifer match factories using white or yellow phosphorus. 
 
 Felt-hat factories (regulations). 
 
 Handling of dry and dry-salted hides and skins imported from Asia. 
 
 Wool and hair sorting (regulations). 
 
 Flax and tow spinning and weaving (regulations). 
 
 File cutting by hand (regulations). 
 
 Bottling of aerated water. 
 
 Spinning by self-acting mules (regulations).^ 
 
 Loading goods on docks and wharves (regulations). 
 
 Use of factory engines and cars (regulations). 
 
 White-Lead Factories. 
 [Form 247 — February, 1903.] 
 
 In these rules " persons employed in a lead process " means a person who is 
 employed in any work or process involving exposure to white lead, or to lead or 
 lead compounds used in its manufacture, or who is admitted to any room or 
 part of the factory where such process is carried on. 
 
 Any approval given by the chief inspector of factories in pursuance of rules 
 2, 4, 6, 9, or 12 shall be given in writing, and may at any time be revoked by 
 notice in writing signed by him. 
 
 DUTIES OF OCCUPIERS. 
 
 1. On and after July 1, 1899, no part of a white-lead factory shall be con- 
 structed, structurally altered, or newly used, for any process in which white 
 lead is manufactured or prepared for sale, unless the plans have previously 
 been submitted to and approved in writing by the chief inspector of factories. 
 
 2. (a) Every stack shall be provided with a standpipe and movable hose, and 
 an adequate supply of water distributed by a hose. 
 
 (&) Every white bed shall, on the removal of the covering boards, be effect- 
 ually damped by the means mentioned above. 
 
 Where it is shown to the satisfaction of the chief inspector of factories that 
 there is no available public water service in the district, it shall be a suflSicient 
 compliance with this rule if each white bed is, on the removal of the covering 
 boards, effectually damped by means of a watering can. 
 
 3. Where white lead is made by the chamber process, the chamber shall be 
 kept moist while the process is in operation, and the corrosions shall be effect- 
 ually moistened before the chamber is emptied. 
 
 4. (a) Corrosions shall not be carried except in trays of impervious material, 
 (6) No person shall be allowed to carry on his head or shoulder a tray of 
 
 corrosions which has been allowed to rest directly upon the corrosions, or upon 
 any surface where there is white lead. 
 
 (c) All corrosions before being put into the rollers or wash becks shall be 
 effectually damped, either by dipping the tray containing them in a trough of 
 water or by some other method approved by the chief inspector of factories. 
 
 6. The flooring around the rollers shall either be of smooth cement or be cov- 
 ered with sheet lead, and shall be kept constantly moist. 
 
 6. On and after January 1, 1901, except as hereinafter provided — 
 
 (o) Every stove shall have a window, or windows, with a total area of not 
 less than 8 square feet, made to open, and so placed as to admit of effectual 
 through ventilation. 
 
 (6) In no stove shall bowls be placed on a rack which is more than 10 feet 
 from the floor. 
 
 (c) Each bowl shall rest upon the rack and not upon another bowl. 
 
 (d) No stove shall be entered for the purpose of drawing until the temper- 
 ature at a height of 5 feet from the floor has fallen either to 70° F., or to a 
 point not more than 10* F. above the temperature of the air outside. 
 
 (e) In drawing any stove or part of a stove there shall not be more than one 
 stage or standing place above the level of the floor. 
 
 Provided that if the chief insi)ector approves of any other means of ventilat- 
 ing a stove, as allowing of effectual through ventilation, such means may be 
 adopted, notwithstanding paragraph (a) of this rule; and if he approves of any 
 other method of setting and drawing the stoves, as ellectually preventing white 
 
EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 333 
 
 lead from falling upon any worker, such method may be followed, notwith- 
 standing paragraphs (6) and (e) of this rule. 
 
 7. No person shall be employed in drawing Dutch stoves on more than two 
 days in any week. 
 
 8. No dry white lead shall be deposited in any place that is not provided 
 either with a cover or with a fan effectually removing the dust from the worker. 
 
 9. On and after January 1, 1900, the packing of dry white lead shall be done 
 only under conditions which secure the effectual removal of dust, either by 
 exhaust fans or by other efficient means approved in each case by the chief 
 inspector of factories. 
 
 This rule shall not apply where the packing is effected by mechanical means 
 entirely closed in. 
 
 10. The floor of any place where packing of dry white lead is carried on shall 
 be of cement, or of stone set in cement. 
 
 11. No woman shall be employed or allowed in the white beds, rollers wash 
 becks, or stoves, or in any place where dry white lead is packed, or in other 
 work exposing her to white lead dust. 
 
 12. (a) A duly qualified medical practitioner (in these rules referred to as 
 the "appointed surgeon") shall be appointed by the occupier for each factory, 
 such appointment to be subject to the approval of the chief inspector. 
 
 (6) No person shall be employed in a lead process for more than a week 
 without a certificate of fitness granted after examination by the appointed 
 surgeon. 
 
 (c) Every person employed in a lead process shall be examined once a week 
 by the appointed surgeon, who shall have power to order suspension from 
 employment in any place or process. 
 
 (d) No person after such suspension shall be employed in a lead process 
 without the written sanction of the appointed surgeon. 
 
 (e) A register in a form approved by the chief inspector of factories shall be 
 kept, and shall contain a list of all persons employed in lead processes. The 
 appointed surgeon will enter in the register the dates and results of his exam- 
 inations of the persons employed, and particulars of any directions given by 
 him. The register shall be produced at any time when required by His 
 Majesty's inspectors of factories or by the certifying surgeon or by the 
 appointed surgeon. 
 
 13. Upon any person employed in a lead process complaining of being unwell, 
 the occupier shall, with the least possible delay, give an order upon a duly 
 qualified medical practitioner. 
 
 14. The occupier shall provide and maintain sufficient and suitable respirators, 
 overalls, and head coverings, and shall cause them to be worn as directed in 
 rule 29. 
 
 At the end of every day's work they shall be collected and kept in proper 
 custody in a suitable place set apart for the purpose. 
 
 They shall be thoroughly washed or renewed every week, and those which 
 have been used in the stoves, and all respirators, shall be washed or renewed 
 daily. 
 
 15. The occupier shall provide and maintain a dining room and a cloakroom 
 in which workers can deposit clothing put off during working hours. 
 
 16. No person employed in a lead process shall be allowed to prepare or 
 partake of any food or drink except in the dining room or kitchen. 
 
 17. A supply of a suitable sanitary drink, to be approved by the appointed 
 surgeon, shall be kept for the use of the workers. 
 
 18. The occupier shall provide and maintain a lavatory for the use of the 
 workers, with soap, nailbrushes, and at least one lavatory basin for every five 
 persons employed. Each such basin shall be fitted with a waste pipe. There 
 shall be a constant supply of hot and cold water laid on, except where there 
 is no available public water service, in which case the provision of hot and 
 cold water shall be such as shall satisfy the inspector in charge of the district. 
 
 The lavatory shall be thoroughly cleaned and supplied with clean towels after 
 every meal. 
 
 There shall, in addition, be means of washing in close proximity to the 
 workers of each department, if required by notice in writing from the- inspector 
 in charge of the district. 
 
 There shall be facilities, to the satisfaction of the inspector in charge of the 
 district, for the workers to wash out their mouths. 
 
 19. Before each meal, and before the end of the day's work, at least 10 min- 
 uts in addition to the regular meal times shall be allowed to each work«* for 
 washing. 
 
334 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 A notice to this effect shall be affixed in each department. 
 
 20. The occupier shall provide and maintain sufficient baths and dressing 
 rooms for all persons employed in lead processes with hot and cold water, soap, 
 and towels, and shall cause each such person to take a bath once a week at the 
 factory. 
 
 A bath register shall be kept containing a list of all persons employed in lead 
 processes and an entry of the date when each person takes a bath. 
 
 This register shall be produced at any time when required by His Majesty's 
 inspectors of factories or by the certifying surgeon or by the appointed surgeon. 
 
 21. The dressing rooms, baths, and water-closets shall be cleaned daily. 
 
 22. The floor of each work room shall be cleaned daily, after being thoroughly 
 damped. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 23. No person shall strip a white bed or empty a chamber without previously 
 effectually damping, as directed in rules 2 and 3. 
 
 24. No person shall carry corrosions or put them into the rollers or wash 
 becks otherwise than as permitted by rule 4. 
 
 25. No person shall set or draw a stove otherwise than as permitted by rules 
 6 and 7. 
 
 26. No person shall deposit or pack dry white lead otherwise than as per- 
 mitted by rules 8 and 9. 
 
 27. Every person employed in a lead process shall present himself at the ap- 
 pointed times for examination by the appointed surgeon, as provided in rule 22. 
 
 28. No person, after suspension by the appointed surgeon, shall work in a lead 
 process without his written sanction. 
 
 29. Every person engaged in [stripping] white beds, emptying chambers, 
 rollers, wash becks, or grinding, setting, or dra-wing stoves, packing, paint mix- 
 ing, handling dry white lead, or in any work involving exposure to white-lead 
 dusts, shall, while so occupied, wear an overall suit and head covering. 
 
 Every person engaged in stripping white beds, or in emptying chambers, or in 
 drawing stoves, or in packing, shall in addition wear a respirator while so 
 occupied. 
 
 30. Every person engaged in any place or process named in rule 29 shall, be- 
 fore partaking of meals or leaving the premises, deposit the overalls, head 
 coverings, and respirators in the place appointed by the occupier for the pur- 
 pose, and shall thoroughly wash face and hands in the lavatory. 
 
 31. Every person employed in a lead process shall take a bath at the factory 
 at lenst once a week, and wash in the lavatory before bathing; having done so 
 he shall at once sign his name in the bath register, with the date. 
 
 32. No person employed in a lead process shall smoke or use tobacco in any 
 form or partake of food or drink elsewhere than in the dining room or kitchen. 
 
 33. No person shall in any way interfere, without the knowledge and concur- 
 rence of the occupier or manager, with the means and appliances provided for 
 the removal of dust. 
 
 34. The foreman shall report to the manager, and the manager shall report to 
 the occupier, any instance coming under his notice of a worker neglecting to 
 observe these rules. 
 
 35. No person shall obtain employment under an assumed name or under any 
 false pretense. 
 
 Arthxjb Whitelegge, 
 Chief Inspector of Factories. 
 M. W. Ridley, 
 One of His Majesty's Principal Secretaries of State. 
 1st June, 1899. 
 
 Note. — These rules must be kept posted up in conspicuous places in the fac- 
 tory to which they apply, where they may be conveniently read by the persons 
 employed. Any person who is bound to observe these rules and fails to do so, or 
 acts in contravention of them is liable to a penalty ; and in such cases the occu- 
 pier also is liable to a penalty unless he proves that he has taken all reasonable 
 means by publishing, and to the best of his power, enforcing the rules, to pre- 
 vent the contravention or noncompliance. (Factory and workshop act, 1901, 
 sees. 85 and 86.) 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 335 
 
 Red and Orange Lead Works. 
 
 [Form 261— February, 1904.] 
 
 DUTIES OF OCCUPIERS. 
 
 In drawing charges of massicot, or of red lead, or of orange lead, from the 
 furnace they shall not allow the charges of massicot, or of red lead, or of orange 
 leiid, to be discharged onto the floor of the factory or workshop, but shall ar- 
 range that it be shoveled, not raked, into wagons. 
 
 They shall arrange that no red or orange lead shall be packed in the room or 
 rooms where the manufacture is actually carried on. 
 
 They shall arrange that no red or orange lead shall be packed in casks or 
 other receptacles except in a place provided with a hood connected with a fan, 
 or shall provide other suitable means to create an effective draft. 
 
 They shall provide sufficient bath accommodation for all persons employed 
 in the manipulation of red and orange lead, and lavatories, with a good supply 
 of hot water, soap, nailbrushes, and towels for the use of such persons. 
 
 They shall arrange for a monthly visit by a medical man who shall examine 
 every worker individually, and who shall enter the result of each examination 
 in a register book to be provided by the said occupiers. 
 
 They shall provide a sufficient supply of approved sanitary drink for the 
 workers. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 In case where the cooperation of the workers is required for carrying out 
 the foregoing rules, and where such cooperation is not given, the workers shall 
 be held liable in accordance with the factory and workshop act, 1891, section 
 9, which runs as follows : 
 
 '* If any person who is bound to observe any special rules established for any 
 factory or workshop under this act, acts in contravention of, or fails to comply 
 with, any such special rule, he shall be liable on summary conviction to a fine 
 not exceeding £2 ($9.73)." 
 
 Yellow Lead. 
 
 [Form 263 — February, 1904.] 
 
 DUTIES OF occupiers. 
 
 They shall provide washing conveniences, with a sufficient supply of hot and 
 cold water, soap, nailbrushes, and towels. 
 
 They shall provide respirators and overall suits for the persons employed in 
 all dry processes. 
 
 They shall provide fans or other suitable means of ventilation wherever dust 
 is generated in the process of manufacture. 
 
 They shall provide a sufficient supply of epsom salts and of an approved san- 
 itary drink. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 In cases where the cooperation of the workers is required for carrying out 
 the foregoing rules and where such cooperation is not given, the workers shall 
 be held liable, in accordance with the factory and workshop act, 1891, section 9, 
 which runs as follows : 
 
 " If any person who is bound to observe any special rules established for any 
 factory or workshop under this act, acts in contravention of, or fails to comply 
 with, any such special rule, he shall be liable on summary conviction to a fine 
 not exceeding £2 ($9.73)." 
 
 Respirators.— A good respirator is a cambric bag with or without a thin 
 flexible wire made to fit over the nose. 
 
 Safiitary drink suggested. — Sulphate of magnesia, 2 ounces ; water, 1 gallon ; 
 essence of lemon, sufficient to flavor. 
 
336 BEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Lead Smelting Works. 
 
 [Form 264— January, 1906.] 
 
 DUTIES OF OCCUPIEBS. 
 
 They shall provide respirators and overall suits for the use of all persons 
 employed in cleaning the flues, and take means to see that the same are used. 
 
 They shall arrange that no person be allowed to remain at work more than 
 two hours at a time in a flue. (A rest of half an hour before reentering will 
 be deemed sufficient.) 
 
 They shall provide sufficient bath accommodation for all persons employed in 
 cleaning the flues, and every one so employed shall take a bath before leaving 
 the works. 
 
 They shall provide washing conveniences, with a sufficient supply of hot 
 and cold water, soap, nailbrushes, and towels. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 In cases where the cooperation of the workers is required for carrying out 
 the foregoing rules, and where such cooperation is not given, the workers shall 
 be held liable, in accordance with the factory and workshop act, 1891, section 
 9, which runs as follows : 
 
 " If any person who is bound to observe any special rules established for any 
 factory or workshop under this act, acts in contravention of, or fails to comply 
 with, 4ny such special rule, he shall be liable on summary conviction to a 
 fine not exceeding £2 ($9.73)." 
 
 Special Rules for Factories oe Workshops in which Yellow Chromate 
 OF Lead is Used, ob in which Goods Dyed with It Undergo the Proc- 
 esses OF Building ob Noddling, Winding, Reeling, W^eaving, ob any otheb 
 Tbeatment. 
 
 [Form 270 — February, 1904.] 
 DUTIES OF occupiers. 
 
 They shall provide washing conveniences, with a sufficient supply of hot and 
 cold water, soap, nailbrushes, and towels. 
 
 They shall provide respirators and overall suits for the persons employed in 
 all dry processes. 
 
 They shall provide fans and other suitable means of ventilation wherever 
 dust is generated in the process of manufacture. 
 
 They shall provide a sufficient supply of epsom salts, and of the sanitary 
 drink mentioned below, or some other approved by His Majesty's inspector of 
 factories. 
 
 Respirators. — ^A good respirator is a cambric bag with or without a thin 
 flexible wire made to fit over the nose. 
 
 Sanitary drink. — Sulphate of magnesia, 2 ounces ; water, 1 gallon ; essence of 
 lemon, sufficient to flavor. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 Every person to whom is supplied a respirator or overall suit shall wear the 
 same when at the special work for which such are provided. 
 
 Every person shall carefully clean and wash hands and face before meals 
 and before leaving the works. 
 
 No food shall be eaten in any part of the works in which yellow chromate 
 of lead is used in the manufacture. 
 
 Abthub Whitelegge, 
 E. M. Chief Inspector of Factories. 
 
 Under section 9, Factory Act, 1891, any person who Is bound to observe any 
 special rules is liable to penalties for noncompliance with such special rules. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 337 
 
 Amended Special Rules foe the Manufacture and Decoration of Earthen- 
 ware AND China. 
 
 [As established, after arbitration, by the awards of the umpire. Lord James of Hereford, 
 dated 30th of December, 1901, and 28th of November, 1903.] 
 
 [Form 923— October, 1905.] 
 DUTIES OF occupiers. 
 
 1. Deleted. 
 
 2. After tbe 1st day of February, 1904, no glaze shall be used which yields to 
 a dilute solution of hydrochloric acid more than 5 per cent of its dry weight 
 of a soluble lead compound calculated as lead monoxide when determined in 
 the manner described below. 
 
 A weighed' quantity of dried material is to be continuously shaken for one 
 hour, at the common temperature, with one thousand times its weight of an 
 aqueous solution of hydrochloric acid containing 0.25 per cent of HCl. This 
 solution is thereafter to be allowed to stand for one hour, and to be passed 
 through a filter. The lead salt contained In an aliquot portion of the clear 
 filtrate is then to be precipita.ted as lead sulphide and weighed as lead sulphate. 
 
 If any occupier shall give notice in writing to tlie inspector for the district 
 that he desires to use glaze which does not conform to the above-mentioned con- 
 ditions, and to adopt in his factory the scheme of compensation prescribed in 
 Schedule B, and shall affix and keep the same affixed in his factory, the above 
 provisions shall not apply to his factory, but instead thereof the following 
 provisions shall apply : 
 
 All persons employed in any process Included in Schedule A other than china 
 scouring shall be examined before the commencement of their employment, 
 or at the first subsequent visit of the certifying surgeon, and once in each 
 calendar month by the certifying surgeon of the district. 
 
 The certifying surgeon may at any time order by signed certificate the sus- 
 pension of any such person from employment in any process included in 
 Schedule A other than china scouring, if such certifying surgeon is of opinion 
 that such person by continuous work in lead will incur special danger from the 
 effects of plumbism, and no person after such suspension shall be allowed 
 to work in any process included in Schedule A other than china scouring 
 without a certificate of fitness from the certifying surgeon entered in the 
 register. 
 
 Any workman who, by reason of his employment being intermittent or 
 casual, or of his being in regular employment for more than one employer, is 
 unable to present himself regularly for examination by the certifying surgeon, 
 may procure himself at his own expense to be examined once a month by a 
 certifying surgeon, and such examination shall be a sufficient compliance with 
 this rule. The results of such examination shall be entered by the certifying 
 surgeon in a book to be kept in the possession of the workman. He shall 
 produce and show the said book to a factory inspector or to any employer on 
 demand, and he shall not make any entry or erasure therein. 
 
 If the occupier of any factory to which this rule applies fails to duly observe 
 the conditions of the said scheme, or if any such factory shall by reason of the 
 occurrence of cases of lead poisoning appear to the secretary of state to be in 
 an unsatisfactory condition, he may, after nn inquirj^, at which the occupier 
 shall have an opportunity of being heard, prohibit the use of lead for such time 
 and subject to such conditions as he may prescribe. 
 
 All persons employed in the processes included in Schedule A, other than 
 china scouring, shall present themselves at the appointed time for examination 
 by the certifying surgeon, as provided in this rule. 
 
 In addition to the examinations at the appointed times, any person so em- 
 ployed may at any time present himself to the certifying surgeon for examina- 
 tion, and shall be examined on paying the prescribed fee. 
 
 All persons shall obey any directions given by the certifying surgeon. 
 
 No person after suspension by the certifying surgeon shall work in any proc- 
 ess included in Schedule A, other than china scouring, without a certificate 
 of fitness from the certifying surgeon entered in the register. Any operative 
 who fails without reasonable cause to attend any monthly examination shall 
 procure himself, at his own expense, to be examined within fourteen days there- 
 after by the certifying surgeon, and shall himself pay the prescribed fee. 
 
 S. Doc. 644, 60-2 23 
 
338 REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 A register, in the form whicli has been prescribed by the secretary of state 
 for use in earthenware and chhia works, shall be kept, and in it the certifying 
 surgeon shall enter the dates and results of his visits, the number of persons 
 examined, and particulars of any directions given by him. This register shall 
 contain a list of all persons employed in the processes included in Schedule A, 
 or in emptying china biscuit ware, and shall be produced at any time when 
 required by His Majesty's inspectors of factories or by the certifying surgeon. 
 
 3. The occupier shall allow any of His Majesty's inspectors of factories to 
 take at any time sufficient samples for analysis of any material in use or mixed 
 for use. 
 
 Provided that the occupier may at the time when the sample is taken, and 
 on providing the necessary appliances, require the inspector to take, seal, and 
 deliver to him a duplicate sample. 
 
 But no analytical result shall be disclosed or published in any way except 
 such as shall be necessary to establish a breach of these rules. 
 
 4. No woman, young person, or child shall be employed in the mixing of 
 unfritted lead compounds in the preparation or manufacture of fritts, glazes, 
 or colors. 
 
 5. No person under 15 years of age shall be employed in any process included 
 in Schedule A, or in emptying china biscuit ware. 
 
 Thimble picking, or threading up, or looking over biscuit ware shall not be 
 carried on except in a place sufficiently separated from any process included in 
 Schedule A. 
 
 6. All women and young persons employed in any process included in Schedule 
 A shall be examined once in each calendar month by the certifying surgeon for 
 the district. 
 
 The certifying surgeon may order by signed certificate in the register the 
 suspension of any such women or young persons from employment in any 
 process included in Schedule A, and no person after such suspension shall be 
 allowed to work in any process included in Schedule A without a certificate of 
 fitness from the certifying surgeon entered in the register. 
 
 7. A register, in the form which has been prescribed by the secretary of 
 state for use in earthenware and china works, shall be kept, and in it the cer- 
 tifying surgeon shall enter the dates and results of his visits, the number of 
 persons examined in pursuance of rule 6 as amended, and particulars of any 
 directions given by him. This register shall contain a list of all persons em- 
 ployed in the processes included in Schedule A, or in emptying china biscuit 
 ware, and shall be produced at any time when required by His Majesty's in- 
 spector of factories or by the certifying surgeon. 
 
 8. The occupier shall provide and maintain suitable overalls and head cov- 
 erings for all women and young persons employed in the processes included in 
 the Schedule A, or in emptying china biscuit ware. 
 
 No person shall be allowed to work in any process included in the schedule, 
 or in emptying china biscuit ware, without wearing suitable overalls and head 
 coverings, provided that nothing in this rule shall render it obligatory on any 
 person engaged in drawing glost ovens to wear overalls and head coverings. 
 
 All overalls, head coverings, and respirators, when not in use or being washed 
 or repaired, shall be kept by the occupier in proper custody. They shall be 
 washed or renewed at least once a week, and suitable arrangements shall be 
 made by the occupier for carrying out these requirements. 
 
 A suitable place, other than that provided for the keeping of overalls, head 
 coverings, and respirators, in which all the above workers can deposit clothing 
 put off during working hours, shall be provided by the occupier. 
 
 Each respirator shall bear the distinguishing mark of the worker to whom it 
 is supplied. 
 
 9. No person shall be allowed to keep, or prepare, or partake of any food, or 
 drink, or tobacco, or remain during meal times in a place in which is carried on 
 any process included in Schedule A. 
 
 The occupier shall make suitable provision to the reasonable satisfaction of 
 the inspector in charge of the district for the accommodation during meal 
 times of persons employed in such places or processes, with a right of appeal 
 to the chief inspector of factories. Such accommodation shall not be provided 
 in any room or rooms in which any process included in Schedule A is carried on, 
 and no washing conveniences mentioned hereafter in rule 13 shall be main- 
 tained in any room or rooms provided for such accommodations. 
 
 SuitTible provision shall be made for the deposit of food brought by the 
 workers. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 339 
 
 10. The processes of the towing of earthenware, china scouring, ground lay- 
 ing, ware cleaning after the dipper, color dusting, whether on glaze or under- 
 glaze, color blowing, whether on glaze or under-glaze, glaze blowing, or transfer 
 nialiing, shall not be carried on without the use of exhaust fans, or other 
 efficient means for the effectual removal of dust, to be approved in each partic- 
 ular case by the secretary of state, and other such conditions as he may from 
 time to time prescribe. 
 
 In the process of ware cleaning after the dipper, sufficient arrangements shall 
 be made for any glaze scraped off which is not removed by the fan, or the 
 other efficient means, to fall into water. 
 
 In the process of ware cleaning of earthenware after the dipper, damp sponges 
 or other damp material shall be provided in addition to the knife or other 
 instrument, and shall be used wherever practicable. 
 
 Flat-knocking and fired-flint sifting shall be carried on only in inclosed re- 
 ceptacles, which shall be connected with an efficient fan or other efficient draft, 
 unless so contrived as to prevent effectually the escape of injurious dust. 
 
 In all processes the occupier shall, as far as practicable, adopt efficient 
 measures for the removal of dust and for the prevention of any injurious ef- 
 fects arising therefrom. 
 
 11. No person shall be employed in the mixing of unfritted lead compounds, 
 in the preparation or manufacture of fritts, glazes, or colors containing lead 
 without wearing a suitable and efficient respirator provided and* maintained by 
 the employer, unless the mixing is performed in a closed machine or the ma- 
 terials are in such a condition that no dust is produced. 
 
 Each respirator shall bear the distinguishing mark of the worker to whom it 
 is supplied. 
 
 12. All drying stoves as well as all workshops and all parts of factories shall 
 be effectually ventilated to the reasonable satisfaction of the inspector in charge 
 of the district. 
 
 13. The occupier shall provide and continually maintain sufficient and suit- 
 able washing conveniences for all persons employed in the processes included in 
 Schedule A, as near as practicable to the places in which such persons are em- 
 ployed. 
 
 The washing conveniences shall comprise soap, nailbrushes, and towels, and 
 at least one wash hand basin for every five persons employed as above, with a 
 constant supply of water laid on, with one tap at least for every two basins, 
 and conveniences for emptying the same and running off the waste water on 
 the spot down a waste pipe. 
 
 There shall be in front of each washing basin, or convenience, a space for 
 standing room which shall not be less in any direction than 21 inches. 
 
 14. The occupier shall see that the floors of workshops and of such stoves as 
 are entered by the work people are sprinkled and swept daily; that all rust, 
 scraps, ashes, and dirt are removed daily, and that the mangles, workbenches, 
 and stairs leading to workshops are cleaned weekly. 
 
 When so required by the inspector in charge of the district, by notice in 
 writing, any such floors, mangles, workbenches, and stairs shall be cleansed in 
 such manner and at such times as may directed in such notice. 
 
 As regards every potter's shop and stove, and every place in which any proc- 
 ess included in Schedule A is carried on, the occupier shall cause the sufficient 
 cleansing of floors to be done at a time when no other work is being carried on 
 in such room, and in the case of potters' shops, stoves, dipping houses, and 
 majolica painting rooms, by an adult male. 
 
 Provided that in the case of rooms in which ground laying or glost placing is 
 carried on, or in china dippers' drying room, the cleansing prescribed by this 
 rule may be done before work commences for the day, but in no case shall any 
 work be carried on in the room within one hour after any such cleansing as 
 aforesaid has ceased. 
 
 15. The occupier shall cause the boards used in the dipping house, dippers' 
 drying room, or glost placing shop to be cleansed every week, and shall not 
 allow them to be used in any other department, except after being cleansed. 
 
 When so required by the inspector in charge of the district, by notice in 
 writing, any such boards shall be washed at such times as may be direcLcJ in 
 such notice. 
 
340 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 Itj. All women and young persons employed in the processes included In 
 Schedule A shall present themselves at the appointed time for examination by 
 the certifying surgeon as provided in rule 6 as amended. 
 
 No person after suspension by the certifying surgeon shall work in any proc- 
 ess included in the schedule without a certificate of fitness from the certifymg 
 surgeon entered in the register. 
 
 17. Every person employed in any process included in Schedule A, or in 
 emptying china biscuit ware, shall, when at work, wear a suitable overall and 
 head covering, and also a respirator when so required by rule 11 as amended, 
 which shall not be worn outside the factory or workshop and which shall not be 
 removed therefrom, except for the purpose of being washed or repaired. Such 
 overall and head covering shall be in proper repair and duly washed. 
 
 The hair must be so arranged as to be fully protected from dust by the head 
 covering. 
 
 The overalls, head coverings, and respirators, when not being worn, and 
 clothing put off during working hours, shall be deposited in the respective 
 places provided by the occupier for such purposes under rule 8 as amended. 
 
 18. No person shall remain during meal times in any place in which is carried 
 on any process included in Schedule A, or introduce, keep, prepare, or partake 
 of any food or 'drink or tobacco therein at any time. 
 
 19. No person shall in any way interfere, without the knowledge and concur- 
 rence of the occupier or manager, with the means and appliances provided by 
 the employers for the ventilation of the workshops and stoves, and for the 
 removal of dust. 
 
 20. No person included in any process included in Schedule A shall leave the 
 works or partake of meals without previously and carefully cleaning and wash- 
 ing his or her hands. 
 
 No person employed shall remove or damage the washing basins or conveni- 
 ences provided under rule 13. 
 
 20a. The persons appointed by the occupiers shall cleanse the several parts of 
 the factory regularly, as prescribed in rule 14. 
 
 Every worker shall so conduct his or her work as to avoid, as far as practi- 
 cable, making or scattering dust, dirt, or refuse, or causing accumulation of 
 such. 
 
 21. The boards used In the dipping house, dippers' drying room, or glost 
 placing shop shall not be used in any other department, except after being 
 cleansed, as directed in rule 15. 
 
 EXEMPTION F#E PBOCESSES IN WHICH NO LEAD OB OTHEB POISONOUS MATERIAL 
 
 IS USED. 
 
 22. If the occupier of a factory to which these rules apply gives with reference 
 to any process included in Schedule A, other than china scouring, an undertak- 
 ing that no lead or lead compound or other poisonous material shall be used, 
 the chief inspector may approve in writing of the suspension of the operation of 
 rules 4, 5, 6, 7, 8, 15, 16, 17, and 21, or any of them in such process ; and there- 
 upon such rules shall be suspended as regards the process named in the chief 
 Inspector's approval, and in lieu thereof the following rule shall take effect, viz, 
 No lead or lead compound or other poisonous material shall be used in any 
 process so named. 
 
 For the purpose of this rule materials that contain no more than 1 per cent of 
 lead shall be regarded as free from lead. 
 
 Note. — ^These rules must be kept posted up in conspicuous places in the factory 
 to which they apply, where they may be conveniently read by persons employed. 
 Any i)erson who is bound to observe these rules and fails to do so, or acts in 
 contravention to them, is liable to a penalty, and in such cases the occupier 
 also is liable to a penalty unless he proves that he has taken all reasonable 
 means, by publishing and to the best of his power enforcing the rules, to prevent 
 the contravention or non-compliance. 
 
 Schedule A. 
 
 Dipping or other process carried on in the dipping house. 
 
 Glaze blowing. 
 
 Painting in majolica or other glaze. 
 
EEPOKTS OF THE PKESIDENT^S HOMES COMMISSION. 341 
 
 Drying after clipping. 
 
 Ware cleaning after the application of glaze by dipping or other process. 
 
 China scouring. 
 
 Glost placing. 
 
 Ground laying. 
 
 S!or blowtag } ^'•«*«^ «"-^'^^« "^ nnder-glaze. 
 
 Lithographic transfer malting. 
 
 Maliing or mixing of fruits, glazes, or colors containing lead. 
 
 Any other process in which materials containiiic; lead are used or handled In 
 the dry state, or in the form of spray, or in suspension in liquid other than oil 
 or similar medium. 
 
 Schedule A. — Notice to workmen employed in process named in Schedule A, 
 other than china scouring, 
 
 CONDITIONS or COMPENSATION. 
 
 1. Where a workman is suspended from working by a certifying surgeon of 
 the district on the ground that he is of opinion that such person by continued 
 work ill lead will incur special danger from the effects of plumbism, and the 
 certifying surgeon shall certify that in his opinion he is suffering from plumbism 
 arising out of his employment, he shall, subject as hereinafter mentioned, be 
 entitled to compensation from his employer as hereinafter provided. 
 
 (a) If any workman who has been suspended as aforesaid dies within nine 
 calendar months from the date of such certificate of suspension, by reason of 
 plumbism contracted before said date, there shall be paid to such of his de- 
 pendents as are wholly dependent upon his earnings at the time of his death 
 or upon the weekly compensation payable under this scheme, a sum equal to the 
 amount he has earned during a period of three years next preceding the date of 
 the said certificate, such sum not to be more than £300 ($1,459.95) nor less than 
 £150 ($729.98) for an adult male, £100 ($486.65) for an adult female, and £75 
 ($364.99) for a young person. 
 
 (&) If the workman does not leave any dependents wholly dependent as 
 aforesaid, but leaves any dependents in part dependent as aforesaid, a reason- 
 able part of that sum. 
 
 (c) If he leaves no dependents, the reasonable expenses of his medical at- 
 tendance and burial, not exceeding £10. 
 
 2. With respect to such payments the following provisions shall apply — 
 
 (a) All sums paid to the workmen as compensation since the date of the said 
 certificate shall be deducted from the sums payable to the dependents. 
 
 ( & ) The payment shall, in case of death, be made to the legal personal repre- 
 sentative of the workingman, or, if he has no legal personal representative, to 
 or for the benefit of his dependents, or, if he leaves no dependents, to the person 
 to wliom the expenses are due; and if made to the legal personal representative, 
 shall be paid by him to or for the benefit of the dependents or other person 
 entitled thereto. 
 
 (c) Any question as to who is a dependent, or as to the amount payable to 
 each dependent, shall, in default of agreement, be settled by arbitration as here- 
 inafter provided in clause 9. 
 
 {d) The sum allotted as compensation to a dependent may be invested or 
 otherwise applied for the benefit of the person entitled thereto, as agreed, or as 
 ordered by the arbitrator. 
 
 (e) Any sum which is agreed or is ordered by the arbitrator to be invested 
 may be invested in whole or in part in the post-office savings bank. 
 
 3. Where a workman has been suspended and certified as provided in condi- 
 tion 1, and while he is totally or partially prevented from earning a living by 
 reason of such suspension, he shall be entitled to a weekly payment not exceed- 
 ing 50 per cent of his average weekly earnings at the time of such suspension, 
 such payment not to exceed £1 ($4.87). The average may be- taken gver such 
 period, not exceeding twelve months, as appears fair or reasonable, having 
 regard to all the circumstances of the case. 
 
 4. In fixing these weekly payments regard shall be had to the difference 
 between the amount of the average weekly earnings of the workman at the time 
 of his suspension and the average amount, if any, which it is estimated that he 
 will be able to earn afterwards in any occupation or employment, and to any 
 paymaits (not being wages) which he may have received from the employer in 
 
342 BEPOKTS OF THE PKESTDENt's HOMES COMMISSION. 
 
 respect of the suspension, and to all the circumstances of the case, including his 
 age and expectation of life. 
 
 5. If it shall appear that any workman has persistently disobeyed the special 
 rules or the directions given for his protection by his employers, and that such 
 disobedience has conduced to his suspension, or has not presented himself for 
 examination by the certifying surgeon, or has failed to give full information 
 and assistance as provided in condition 6, his conduct may be taken into con- 
 sideration in assessing the amount of the weekly payments. 
 
 6. It shall be the duty of every workman at all times to submit to medical 
 examination when required and to give full information to the certifying sur- 
 geon and to assist to the best of his power in the obtaining of all facts necessary 
 to enable his physical condition to be ascertained. 
 
 7. Any weekly payment may be reviewed at the request either of the employer 
 or of the workman, and on such review may be ended, diminished, or increased, 
 subject to the maximum above provided, and the amount of payment shall, in 
 default of agreement, be settled by arbitration. 
 
 8. Any workman receiving weekly payments under this scheme shall submit 
 himself, if required, for examination by a duly qualified medical practitioner 
 provided and paid by the employer. 
 
 If the workman refuses to submit himself to such examination or in any way 
 obstructs the same, his right to such weekly payments shall be suspended until 
 such examination has taken place. 
 
 9. If any dispute shall arise as to any certificate of the certifying surgeon or 
 as to the amount of compensation payable as herein provided, or otherwise in 
 relation to these provisions, the same shall be decided by an arbitrator to be 
 appointed by the employer and workman, or in default of agreement by the 
 secretary of state. The said arbitrator shall have nU the powers of an arbitra- 
 tor under the arbitration act, and his decision shall be final. 
 
 The fee of the arbitrator shall be fixed by the secretary of state, and shall be 
 paid as the arbitrator shall direct. 
 
 10. No compensation shall be payable under these provisions unless notice 
 of claim in writing is made within six weeks of the date of the certificate of 
 suspension, or of the death, provided that the want of such notice shall not bar 
 the claim if in the opinion of the arbitrator there was reasonable excuse for the 
 want of it. 
 
 A claim for compensation by any workman whose employment is intermittent, 
 or casual, or who is regularly employed by more than one employer, shall only 
 arise against the employers for whom he has worked in a process included in 
 Schedule A within one month prior to his suspension. The said employers shall 
 bear the compensation among them in such proportion as in default of agreement 
 shall be determined by an arbitrator as herein provided. 
 
 11. " Employer " includes an occupier, a corporation, and the legal repre- 
 sentatives of a deceased employer. "Workman " includes every person, male or 
 female, whether his agreement be one of service or apprenticeship or otherwise, 
 and is expressed or implied, orally, or in writing, and shall include the personal 
 representatives of a deceased workman. " Dependents " has the same meaning 
 as in the workmen's compensation act, 1897. 
 
 The terms contained in this notice shall be deemed to be part of the contract 
 of employment of all workmen in the above-named process. 
 
 Electric Accumtjlatobs. 
 
 Whereas the manufacture of electric accumulators has been certified in pur- 
 suance of section 79 of the factory and wojdishop act, 1901, to be dangerous ; 
 
 I hereby, in pursuance of the powers conferred on me by that act, make the 
 following regulations, and direct that they shall apply to all factories and work- 
 shops or parts thereof in which electric accumulators are manufactured. 
 
 In these regulations " lead process " means pasting, casting, lead burning, or 
 any work involving contact with dry compounds of lead. 
 
 Any approval given by the chief inspector of factories in pursuance of these 
 regulations shall be given in writing, and may at any time be revoked by notice 
 in writing signed by him. 
 
KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 343 
 
 DUTIES OF OCCUPIER. 
 
 1. Every room in wbich casting, pasting, or lead burning is carried on sliall 
 contain at least 500 cubic feet of air space for each person employed therein, 
 and in computing this air space, no height above 14 feet shall be taken into 
 account. 
 
 These rooms and that in which the plates are formed shall be capable of 
 thorough ventilation. They shall be provided with windows made to open. 
 
 2. Each of the following processes shall be carried on in such manner and 
 under such conditions as to secure effectual separation from one another and 
 from any other process : 
 
 (a) Manipulation of dry compounds of lead. 
 
 (6) Pasting. 
 
 (c) Formation, and lead burning necessarily carried on therewith. 
 
 (d) Melting down of old plates. 
 
 Provided that manipulation of dry compounds of lead carried on as in regula- 
 tion 5 (&) need not be separated from pasting. 
 
 3. The floors of the rooms in which manipulation of dry compounds of lead or 
 pasting is carried on shall be of cement or similar impervious material, and 
 shall be kept constantly moist while work is being done. 
 
 The floors of these rooms shall be washed with a hose pipe daily. 
 
 4. Every melting pot shall be covered with a hood and shaft so arranged 
 as to remove the fumes and hot air from the workrooms. 
 
 Lead ashes and old plates shall be kept in receptacles specially provided for 
 the purpose. 
 
 5. Manipulation of dry compounds of lead in the mixing of the paste or other 
 processes shall not be done except (a) in any apparatus so closed, or so arranged 
 with an exhaust draft, as to prevent the escape of dust into the workroom ; or, 
 (&) at a bench provided with (1) efiicient exhaust draft and air guide so 
 arranged as to draw the dust away from the worker, and (2) a grating on which 
 each receptacle of the compound of lead in use at the time shall stand. 
 
 6. The benches at which pasting is done shall be covered with sheet lead or 
 other impervious material, and shall have raised edges. 
 
 7. No woman, young person, or child shall be employed in the manipulation of 
 dry compounds of lead or in pasting. 
 
 8. (a) A duly qualified medical practitioner (in these regulations referred to 
 as the " appointed surgeon " ) , who may be the certifying surgeon, shall be ap- 
 pointed by the occupier, such appointment unless held by the certifying surgeon 
 to be subject to the approval of the chief inspector of factories.- 
 
 (&) Every person employed in a lead process shall be examined once a month 
 by the appointed surgeon, who shall have power to suspend from employment in 
 any lead process. 
 
 (c) No person after such suspension shall be employed in a lead process 
 without written sanction entered in the health register by the appointed sur- 
 geon. It shall be sufficient compliance with this regulation for a written cer- 
 tificate to be given by the appointed surgeon and attached to the health register, 
 such certificate to be replaced by a proper entry in the health register at the 
 appointed surgeon's next visit. 
 
 (d) A health register in a form approved by the chief inspector of factories 
 shall be kept, and shall contain a list of all persons employed in lead processes. 
 The appointed surgeon will enter in the health register the dates and results 
 of his examinations of the persons employed and particulars of any directions 
 given by him. He shall on a prescribed form furnish to the chief inspector of 
 factories on the 1st day of January in each year a list of the persons suspended 
 by him during the previous year, the cause and duration of such suspension, 
 and the number of examinations made. 
 
 The health register shall be produced at any time when required by His 
 Majesty's inspectors of factories or by the certifying surgeon or by the ap- 
 pointed surgeon. 
 
 9. Overalls shall be provided for all persons employed in manipulating dry 
 compounds of lead or in pasting. 
 
 The overalls shall be washed or renewed once every week. 
 
 10. The occupier shall provide and maintain — 
 
 (a) A cloakroom in which workers can deposit clothing put off during work- 
 ing hours. Separate and suitable arrangements shall be made for the storage 
 of the overalls required in regulation 9. 
 
 (6) A dining room unless the factory is closed during meal hours. 
 
344 BEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 11. No person shall be allowed to introduce, keep, prepare, or partake of any 
 food, drink, or tobacco, in any room in which a lead process is carried on. 
 Suitable provision shall be made for the deposit of food brought by the workers. 
 
 This regulation shall not apply to any sanitary drink provided by the occupier 
 and approved by the appointed surgeon. 
 
 12. The occupier shall provide and maintain for the use of the persons em- 
 ployed in lead processes a lavatory, with soap, nailbrushes, towels, and at least 
 one lavatory basin for every five such persons. Each such basin shall be pro- 
 vided with a waste pipe, or the basins shall be placed on a trough fitted with a 
 waste pipe. There shall be a constant supply of hot and cold water laid onto 
 each basin. 
 
 Or, in the place of basins the occupier shall provide and maintain troughs of 
 enamel or similar smooth impervious material, in good repair, of a total length 
 of 2 feet for every five persons employed, fitted with waste pipes, and without 
 plugs, with a sufficient supply of warm water constantly available. 
 
 The lavatory shall be kept thoroughly cleansed and shall be supplied with a 
 sufficient quantity of clean towels once every day. 
 
 13. Before each meal and before the end of the day's work, at least ten min- 
 utes, in addition to the regular meal times, shall be allowed for washing to each 
 person who has been employed in the manipulation of dry compounds of lead 
 or in pasting. 
 
 Provided that if the lavatory accommodation specially reserved for such per- 
 sons exceeds that required by regulation 12, the time allowance may be pro- 
 portionately reduced, and that if there be one basin or 2 feet of trough for each 
 such person this regulation shall not apply. 
 
 14. Sufficient bath accommodation shall be provided for all persons engaged 
 in the manipulation of dry compounds of lead or in pasting, with hot and cold 
 water laid on, and.a sufficient supply of soap and towels. 
 
 This rule shall not apply if in consideration of the special circumstances of 
 any particular case, the chief inspector of factories approves the use of local 
 public baths when conveniently near, under the conditions (if any) named in 
 such approval. 
 
 15. The floors and benches of each workroom shall be thoroughly cleansed 
 daily at a time when no other work is being carried on in the room. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 16. All persons employed in lead processes shall present themselves at the 
 appointed times for examination by the appointed surgeon as provided in regu- 
 lation 8. 
 
 No person after suspension shall work in a lead process, in any factory or 
 workshop in which electric accumulators are manufactured, without written 
 sanction entered in the health register by the appointed surgeon. 
 
 17. Every person employed in the manipulation of dry comiX)unds of lead or 
 in pasting shall wear the overalls provided under regulation 9. The overalls, 
 when not being worn, and clothing put off during working hours, shall be de- 
 posited in the places provided under regulation 10. 
 
 18. No person shall introduce, keep, prepare, or partake of any food, drink 
 (other than any sanitary drink provided by the occupier and approved by the 
 appointed surgeon), or tobacco in any room in which a lead process is 
 carried on. 
 
 19. No person employed in a lead process shall leave the premises or partake 
 of meals without previously and carefully cleaning and washing the hands. 
 
 20. Every person employed in the manipulation of dry compounds of lead or 
 in pasting shall take a bath at least once a week. 
 
 21. No person shall in any way interfere, without the concurrence of the 
 occupier or manager, with the means and appliances provided for the removal 
 of the dust or fumes, and for the carrying out of these regulations. 
 
 These regulations shall come into force on the 1st day of January, 1904. 
 
 A. Akkrs-Douglas, 
 One of His Majesty's Principal Secretaries of State, 
 HoMX Office, Whitehall, 2Ut November, 1903, 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 345 
 
 WoEKs OB Pabts of Woeks, in Which Lead, Aesenic, oe Antimony is Used in 
 THK Enameling of Ieon Plates. 
 
 [Form 251— January, 1906.] 
 
 Duties of occupiers. 
 
 1. They shall provide washing conveniences with a suflacient supply of hot 
 and cold water, soap, nailbrushes, and towels, and take measures to secure 
 that every worker wash face and hands before meals and before leaving the 
 works. 
 
 2. They shall provide suitable respirators, overall suits, and head coverings 
 for all workers employed in the processes of grinding, dusting, and brushing. 
 
 3. They shall adopt measures on and after the 1st day of October, 1894, in 
 the dusting and brushing processes for the removal of all superfluous dust, by 
 the use of perforated benches or tables supplied with fans to carry the dust 
 down through the apertures of such benches or tables, the underpart of which 
 must be boxed in. 
 
 4. They shall provide a sufficient supply of approved sanitary drink, and shall 
 cause the work people to take it. 
 
 5. They shall arrange for a medical inspection of all persons employed, at 
 least once a month. 
 
 They shall see that no female is employed without previous examination and 
 a certificate of fitness from the medical attendant of the works. 
 
 They shall see that no person who has been absent from work through illness 
 shall be reemployed without a medical certificate to the effect that he or she 
 has recovered. 
 
 6. Upon any person employed in the works complaining of being unwell, the 
 occupier shall, with the least possible delay, and at his own expense, give an 
 order upon a doctor for professional attendance and medicine. It is to be 
 understood that this rule will not apply to persons suffering from complaints 
 which have not been contracted in the process of manufacture. 
 
 7. They shall provide a place or places free from dust and damp in which 
 the operatives can hang up the clothes in which they do not work. 
 
 (It is recommended that they shall provide for each female before the day's 
 work begins some light refreshment, such as a half pint of milk and a biscuit.) 
 
 DUTIES OF PEESONS EMPLOYED. 
 
 8. Every person to whom is supplied a respirator or overall and head cover- 
 ing shall wear the same when at the work for which such are provided. 
 
 9. Every person shall carefully clean and wash hands and face before meals, 
 and before leaving the works. 
 
 10. No food shall be eafen by any person in any part of the works except in 
 the apartment specially provided for the purpose. 
 
 11. No person may seek employment under an assumed name or under any 
 false pretense. 
 
 Respirators. — A good respirator is a cambric bag with or without a thin 
 flexible wire made to fit over the nose. 
 
 Sanitary drink suggested. — Sulphate of magnesia, 2 ounces ; water, 1 gallon ; 
 essence of lemon, sufficient to flavor. 
 
 Aethub Whitelegge, 
 His Majesty's Chief Inspector of Factories. 
 
 Note. — These rules must be kept posted up in conspicuous places in the fac- 
 tory to which they apply, where they may be conveniently read by the persons 
 employed. Any person who is bound to observe these rules and fails to do so 
 or acts in contravention of them, is liable to a penalty; and in such case the 
 occupier also is liable to a penalty unless he proves that he has taken all 
 reasonable means by publishing and, to the best of his power, enforcing the 
 rules to prevent the contravention or noncompliance. 
 
346 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 WoEKS IN Which Lead ob Arsenic is Used in the Tinning and Enameling of 
 Metal Hollow Waee and Cooking Utensils. 
 
 [Form 385 — March, 1906.] 
 DUTIES OF OCCUPIERS. 
 
 They shall provide washing conveniences with a sufficient supply of hot and 
 cold water, soap, nailbrushes, and towels, and take measures to secure that 
 every worker wash face and hands before meals and before leaving the works. 
 
 They shall see that no food is eaten in any room where the process of tinning 
 or enameling is carried on. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 Every worker shall wash face and hands before meals and before leaving 
 the works. 
 
 No worker shall eat food in any room where the process of tinning or en- 
 ameling is carried on. 
 
 Arthur Whitelegge, 
 His Majesty's Chief Inspector of Factories. 
 
 Note. — These rules must be kept posted up in conspicuous places in the fac- 
 tory to which they apply, where they may be conveniently read by the persons 
 employed. Any person who is bound to observe these rules and fails to do so 
 or acts in contravention of them, is liable to a penalty, and in such case the 
 occupier also is liable to a penalty unless he proves that he has taken all 
 reasonable means by publishing and, to the best of his power, enforcing the 
 rules to prevent the contravention or noncompliance. 
 
 Processes in the Manufacture of Paints and Colors and in the Extraction 
 
 OF Arsenic. 
 
 [Form 249 — June, 1904.] 
 
 duties of occupiers. 
 
 1. They shall provide washing conveniences, with a sufficient supply of hot 
 and cold water, soap, nailbrushes, and towels, and take measures to secure that 
 every worker wash face and hands before meals and before leaving the works; 
 and, in addition to the above, sufficient bath accommodation for the use of all 
 persons employed in the manufacture of Milan red, vermilionette, or Persian red, 
 
 2. They shall provide suitable respiratcis and overall suits, kept in a cleanly 
 state, for all workers engaged in any department w^here dry white lead or ar- 
 senic is used in either the manufacture or paint mixing, and overall suits for 
 .those engaged in grinding in water or oil, and for all workers in Milan red, 
 vermilionette, or Persian red, wherever dust is generated. 
 
 3. They shall provide a sufficient supply of approved sanitary drink, which 
 shall be accessible to the workers at all times, and shall cause such approved 
 sanitary drink to be taken daily by workers in any department where white 
 lead or arsenic is used in the manufacture, and shall provide a supply of 
 aperient medicine, which shall be given to the workers, when required, free 
 of charge. 
 
 4. No food shall be eaten in any part of the works where white lead or arsenic 
 is used in the manufacture. 
 
 DUTIES OF persons EMPLOYED. 
 
 5. Every person to whom is supplied a respirator or overall suit shall wear 
 the same when at the special work for which suctf are provided. 
 
 6. Every person shall carefully clean and wash hands and face before meals 
 and before leaving the works. 
 
 7. No food shall be eaten in any part of the works in which white lead or 
 arsenic is used in the niauufacLure. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 347 
 
 8. No person shall smoke or use tobacco in any part of the works in which 
 white lead or arsenic is used in the manufacture. 
 
 Aethur Whitelegge, 
 His Majesty's Chief Inspector of Factories, 
 
 Note. — These rules must be kept posted up in conspicuous places in the works 
 to which they apply, where they may be conveniently read by the persons em- 
 ployed. Any person who is bound to observe these rules and fails to do so or 
 acts in contravention of them, is liable to a penalty ; and in such case the occu- 
 pier also is liable to a penalty unless he proves that he has taken all reasonable 
 means by publishing and, to the best of his power, enforcing the rules to pre- 
 vent the contravention or noncompliance. 
 
 PfiOCESSES IN THE MIXING AND CASTING BrASS, GUN MeTAL, BeLL MeTAL, WHITB 
 
 Metal, Delta Metal, Phosphor Bronze, and Manila Mixture. 
 
 [Form 271 — February, 1904.] 
 
 DUTIES OF OCCtrPIERS. 
 
 1. They shall provide adequate means for facilitating, as far as possible, the 
 emission or escape from the shop of any noxious fumes or dust arising from 
 the above-named processes. Such means shall include the provision of traps or 
 of louver gratings in the roof or ceiling of any shop in which such processes, 
 or either of them, is or are carried on ; or in case of a mixing or casting shop 
 which is situated under any other shop, there shall be provided an adequate flue 
 or shaft (other than any flue or shaft in connection with a furnace or fireplace) 
 to carry any fumes from the mixing or casting shop, by or through any such 
 shop that may be situated above it. 
 
 2. They shall cause all such mixing or casting shops, whether defined as fac- 
 tories or workshops under the factory and workshop act, 1878, to be cleaned 
 down and limewashed once at least within every twelve months, or once within 
 every six months is so required by notice in writing from His Majesty's inspector 
 of factories and workshops, dating from the time when these were last thus 
 cleaned down and limewashed ; and they shall record the dates of such cleaning 
 down and limewashing in a prescribed form of register. 
 
 3. They shall provide a suflicient supply of metal basins, water, and soap for 
 the use of all persons employed in such mixing or casting shops. 
 
 4. They shall not employ or allow within their factory or workshop the em- 
 ployment of any woman or female young person, in any process whatever, in 
 any such mixing or casting shop, or in any portion thereof which is not entirely 
 separated by a partition extending from the floor to the ceiling. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 5. They shall not partake of or cook any food in any such mixing or casting 
 shop within a period of at least ten minutes after the completion of the last 
 pouring of metal in that shop. 
 
 Arthur Whitelegge, 
 His Majesty's Chief Inspector of Factories. 
 July 10, 1906. 
 
 Women and young persons under 18 years of age must not be allowed to take 
 a meal in any casting shop or to remain there during the time stated on the 
 notice aflixed in the works as being allowed for meals. 
 
 These rules must be kept posted up in conspicuous places in the works to 
 which they apply, where they may be conveniently read by the persons em- 
 ployed. 
 
 Any person who is bound to observe these rules and fails to do so or acts in 
 contravention of them, is liable to a penalty ; and in such case the occupier also 
 is liable to a penalty unless he proves that he has taken all reasonable means, 
 by publishing and to the best of his power enforcing the rules, to prevent the 
 contravention or noncompliance. 
 
348 EEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Chemical Works. 
 [Form 258 — Reprinted December, 1901.1 
 
 1. In future every uncovered pot, pan, or other structure containing liquid 
 of a dangerous character, shall be so constructed as to be at least 3 feet in 
 height above the ground or platform. Those already in existence which are less 
 than 3 feet in height, or in cases where it is proved to the satisfaction of an 
 inspector that a height of 3 feet is impracticable, shall be securely fenced. 
 
 2. There shall be a clear space around such pots, pans, or other structures, or 
 where any junction exists a barrier shall be so placed as to prevent passage. 
 
 3. Caustic pots shall be of such construction that there shall be no footing on 
 the top or sides of the brickwork, and dome-shaped lids shall be used where 
 possible. 
 
 4. No unfenced planks or gangways shall be placed across open pots, pans, or 
 other structures containing liquid of a dangerous character. This rule shall 
 not apply to black ash vats where the vats themselves are otherwise securely 
 fastened. 
 
 5. Suitable respirators shall be provided for the use of the workers in places 
 where poisonous gases or injurious dust may be inhaled. 
 
 6. The lighting of all dangerous places shall be made thoroughly efficient. 
 
 7. Every place where caustic soda or caustic potash is manufactured shall 
 be supplied with syringes or wash bottles, which shall be inclosed in covered 
 boxes fixed in convenient places, in the proportion of one to every four caustic 
 pots. They shall be of suitable form and size, and be kept full of clean water. 
 Similar appliances shall be provided wherever, in the opinion of an inspector, 
 they may be desirable. 
 
 8. Overalls, kept in a cleanly state, shall be provided for all workers in any 
 room where chlorate of potash or other chlorate is ground. In every such room 
 a bath shall be kept ready for immediate use. 
 
 In every chlorate mill, tallow or other suitable lubricant shall be used In- 
 stead of oil. 
 
 9. Respirators charged with moist oxide of iron or other suitable substance, 
 shall be kept in accessible places ready for use in cases of emergency arising 
 from the sulphuretted hydrogen or other poisonous gases. 
 
 10. In salt cake departments suitable measures shall be adopted by maintain- 
 ing a proper draft and by other means to obviate the escape of low-level gases. 
 
 11. Wei don bleaching powder chambers, after the free gas has, as far as may 
 be practicable, been drawn off or absorbed by fresh lime, shall, before being 
 opened, be tested by the standard recognized under the alkali act. Such tests 
 shall be duly entered in a register kept for the purpose. 
 
 All chambers shall be ventilated as far as possible, when packing is being 
 carried on, by means of open doors on opposite sides and openings in the roof 
 so as to allow of a free current of air. 
 
 12. In cases where the cooperation of the workers is required for carrying out 
 the foregoing rules, and where such cooperation is not given, the workers shall 
 be held liable in accordance with the factory and workshop act, 1S91, section 
 9, which runs as follows : "If any person who is bound to observe any special 
 rules, established for any factory or workshop under this act, acts in contra- 
 vention of, or fails to comply with, any such special rule, he shall be liable on 
 summary conviction to a fine not exceeding £2 ($0.73)." 
 
 Arthur Whitelegge, 
 His Majesty's Chief Inspector of Factories. 
 
 Amended Special Rules for Chemical Works in Which is Carried on the 
 Manufacture op Bichromate or Chromate of Potassium or Sodium. 
 
 [Form 260— January, 1906.] 
 
 In these rules " persons employed In a chromo process " means a person who 
 Is employed in any work involving contact with chromate or bichromate of 
 potassium or sodium, or involving exposure to dust or fumes arising from the 
 manufacture thereof. 
 
 Any approval given by the chief inspector in pursuance of rule 10 shall be 
 givra In writing, and may at any time be revoked by notice in writing signed 
 by him. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 349 
 
 DUTIES OF OCCTJPIEES. 
 
 1 No uncovered pot, pan, or other structure containing liquid of a dangerous 
 character shall be so constructed as to be less than 3 feet in height above the 
 adjoining ground or platform. ^ ^ ^ ^ 
 
 This rule shall not apply to any pot, pan, or other structure constructed before 
 January 1, 1899, or in which a height of 3 feet is impracticable by reason of the 
 nature of the work to be carried on, provided in either case that the structure 
 is securely fenced. 
 
 2. There shall be a clear space round all pots, pans, or other structures con- 
 taining liquid of a dangerous character, except where any junction exists, in 
 which case a barrier shall be so placed as to prevent passage. 
 
 3. No unfenced plank or gangway shall be placed across any pot, pan, or 
 other structure containing liquid of a dangerous character. 
 
 4. The lighting of all dangerous places shall be made thoroughly efficient. 
 
 5. The grinding, separating, and mixing of the raw materials (including 
 chrome ironstone, lime, and sodium and potassium carbonate) shall not be done 
 without such appliances as will prevent, as far as possible, the entrance of dust 
 into the workrooms. 
 
 6. ** Batches," when withdrawn from the furnaces, shall either be placed in 
 the keaves or vats while still warm, or be allowed to cool in barrows or other 
 receptacles. 
 
 7. Evaporating vessels shall be covered in, and shall be provided with ventilat- 
 ing shafts to carry the steam into the outside air. 
 
 8. Packing or crushing of bichromate of potassium or sodium shall not be 
 done except under conditions which secure either the entire absence of dust or 
 its effectual removal by means of a fan. 
 
 9. No child or young person shall be employed in a chrome process. 
 
 10. The occupier shall, subject to the approval of the chief inspector, appoint 
 a duly qualified medical practitioner (in these rules referred to as the appointed 
 surgeon), who shall examine all persons employed in chrome processes at least 
 once in every month, and shall undertake any necessary medical treatment of 
 disease contracted in consequence of such employment, and shall, after the 30th 
 day of April, 1900, have power to suspend any such person from work in any 
 place or process. 
 
 (&) No person after such suspension shall be employed in any chrome process 
 without the written sanction of the appointed surgeon. 
 
 (c) A register shall be kept in a form approved by the chief inspector, and 
 shall contain a list of all persons employed in any chrome process. The ap- 
 pointed surgeons shall enter in the register the dates and results of his exami- 
 nations of the persons employed and particulars of any treatment prescribed 
 by him. The register shall be produced at any time when required by His 
 Majesty's inspectors of factories or by the appointed surgeon. 
 
 11. Requisites (approved by the appointed surgeon) for treating slight 
 wounds and ulcers shall be kept at hand and be placed in charge of a re- 
 sponsible person. 
 
 12. The occupier shall provide sufficient and suitable overall suits for the 
 use of all persons engaged in the processes of grinding the raw materials, and 
 sufficient and suitable overall suits or other adequate means of protection 
 approved in writing by the appointed surgeon, for the use of all persons en- 
 gaged in the crystal department or in packing. 
 
 Respirators approved by the appointed surgeon shall be provided for the 
 use of all persons employed in packing or crushing bichromate of sodium or 
 potassium. 
 
 At the end of every day's work they shall be collected and kept in proper 
 custody in a suitable place set apart for the purpose. 
 
 The overalls and respirators shall be thoroughly washed or renewed every 
 week. 
 
 13. The occupier shall provide and maintain a cloakroom in which workers 
 can deposit clothing put off during working hours. 
 
 14. The occupier shall provide and maintain a lavatory for the use of the 
 persons employed in chrome processes; with soap, nailbrushes, and towels, and 
 a constant supply of hot and cold water laid onto each basin. There shall be 
 at least one lavatory basin for every five persons employed in the crystal de- 
 partment and in packing. Each srcli basin shall be fitted with a waste pipe, 
 or shall be placed in a trough fitted with waste pipe. 
 
350 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 15. The occupier shall provide and maintain sufficient baths and dressing 
 rooms for all persons employed in chrome processes, with hot and cold water 
 laid on, and a sufficient supply of soap and towels ; and shall cause each person 
 employed in the crystal department and in packing to take a bath once a 
 week at the factory. 
 
 A bath register shall be kept containing a list of all persons employed in the 
 crystal department and in packing, and an entry of the date when each person 
 takes a bath. 
 
 The bath register shall be produced at any time when required by His 
 Majesty's inspectors of factories. 
 
 16. The floors, stairs, and landings shall be cleaned daily. 
 
 DUTIES OF PERSONS EMPLOYED. 
 
 17. No person shall deposit a " batch " when withdrawn from the furnace 
 upon the floor nor transfer it to the keaves or vats otherwise than as prescribed 
 in rule 6. 
 
 18. No person shall pack or crush bichromate of potassium or sodium other- 
 wise than as prescribed in rule 8. 
 
 19. (a) Every person employed in a chrome process shall present himself at 
 the appointed times for examination by the appointed surgeon as provided in 
 rule 10. 
 
 ( 6 ) After the 30th day of April, 1900, no person suspended by the appointed 
 surgeon shall work in a chrome process without his written sanction. 
 
 20. Every person engaged in the processes of grinding the raw materials shall 
 wear an overall suit, and every person engaged in the crystal department or 
 in packing shall wear an overall suit or other adequate means of protection 
 approved by the appointed surgeon. 
 
 Every person employed in packing or crushing bichromate of sodium or 
 potassium shall in addition wear a respirator while so occupied. 
 
 21. Every person employed in the processes named in rule 20 shall before 
 leaving the premises deposit the overalls and respirators in the place appointed 
 by the occupier for the purpose, and shall thoroughly wash face and hands in 
 the lavatory. 
 
 22. Every person employed in the crystal department and in the packing shall 
 take a bath at the factory at least once a week ; and, having done so, shall at 
 once sign his name in the bath register, with the date. 
 
 23. The foreman shall report to the manager any instance coming under his 
 notice of a workman neglecting to observe these rules. 
 
 Arthur Whitelegge, 
 Chief Inspector of Factories, 
 M. W. Ridley, 
 One of Her Majesty's Principal Secretaries of State. 
 February, 1900. 
 
 Note. — These rules must be kept posted up in conspicuous places in the fac- 
 tory to which they apply, where they may be conveniently read by the persons 
 employed. Any person who is bound to observe these rules and fails to do so 
 or acts in contravention of them, is liable to penalty; and in such cases the 
 occupier also is liable to a penalty unless he proves that he has taken all rea- 
 sonable means by publishing and, to the best of his power, enforcing the rules, 
 to prevent the contravention or noncompliance. 
 
 Manutactuee of Explosives in which Di-Nitro-Benzole is Used. 
 [Form 257 — December, 1904.] 
 
 1. No person to be employed without a medical certificate, stating that he 
 or she is physically fit for such employment. 
 
 2. An examination of the workers at their work to be made at least once a 
 fortnight by a certifying surgeon, who shall have power to order temporary sus- 
 pension or total change of work for any person showing symptoms of suffering 
 from the poison, or if after a fair trial he is of opinion that any person is by 
 constitution unfit, he shall direct that such person shall cease to be employed. 
 
 3. A supply of fresh milk, and of any drug that the medical officer may con- 
 sider desirable, shall be kept where the workers in his opinion may require it. 
 
 4. No meals to be taken in the workrooms. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 351 
 
 5. There shall be provided separate lavatories for men and women, with a 
 good supply of hot water, soap, nailbrushes, and towels, and whenever the skin 
 has come in contact with di-nitro-benzole, the part shall be immediktely washed. 
 
 6. Overall suits and head coverings shall be supplied to all workers in shops 
 where di-nitro-benzole is used, these suits to be taken off or well brushed before 
 meals and before leaving the works, and to be washed at least once a week. 
 
 7. Suitable respirators (capable of being washed), folds of linen, or woolen 
 material of open texture, or other suitable material, shall be supplied to those 
 workers liable to inhale dust, and the wearing of such respirators shall be 
 urged where the workers derive benefit from their use. 
 
 8. Where di-nitro-benzole has to be handled, the hands shall always be pro- 
 tected from direct contact with it, either by the use of india-rubber gloves (kept 
 perfectly clean, especially in the inner side), or by means of rags which shall 
 be destroyed immediately after use. 
 
 9. Where di-nitro-benzole is broken by hand, the instrument used shall be a 
 wooden bar, spade, or tool with a handle long enough to prevent the worker's 
 face from coming into contact with the material. 
 
 10. In all rooms or sheds in which the process, either of purifying, grinding, or 
 mixing materials of which di-nitro-benzole forms a part, is carried on, efficient 
 " cowls," ventilating shafts, and mechanical ventilating fans shall be provided 
 to carry off the dust or fumes generated. 
 
 11. Drying stoves shall be efficiently ventilated, and, when possible, be 
 charged and drawn at fixed times, and a free current of air shall be admitted 
 for some time prior to the workers entering to draw either a part or the whole 
 of the contents. 
 
 12. In the process of filling cartridges, the material shall not be touched by 
 hand, but suitable scoops shall be used, and where patent ventilated cartridge- 
 filling machines are not used, there shall be efficient mechanical ventilation 
 arranged in such a manner that the suction shall draw the fumes or dust away 
 from and not across or over the faces of the workers. 
 
 13. A register, in a prescribed form, shall be kept, and it shall be the duty of 
 a responsible person named by the firm to enter, at least once a week, a state- 
 ment that he has personally satisfied himself that each and all of the special 
 rules have been observed, or if not, the reason for such nonobservance. The 
 surgeon to enter in this register the dates of his visits, the results of such visits, 
 and any requirements made by him. 
 
 14. The " dipping " rooms to be efficiently ventilated. 
 
 Arthur Whitelegge, 
 His Majesty's Chief Inspector of Factories. 
 
 Note. — These rules must be kept posted up in conspicuous places in the fac- 
 tory to which they apply, where they may be conveniently read by the persons 
 employed. Any person who is bound to observe these rules and fails to do so or 
 acts in contravention of them, is liable to a penalty; and in such case the occu- 
 pier also is liable to a penalty unless he proves that he has taken all reasonable 
 means by publishing and, to the best of his power, enforcing the rules, to pre- 
 vent the contravention or noncompliance. 
 
 Vulcanizing of India Rubber by Means of Bisulphide of Carbon. 
 [Form 274 — October, 1906.] 
 I. — DUTIES OF employers. 
 
 1. No child or young person shall be employed in any room in which bisul- 
 phide of carbon is used. 
 
 2. After May 1, 1898, no person shall be employed for more than five hours 
 in any day in a room in which bisulphide of carbon is used, nor for more than 
 two and a half hours at a time without an interval of at least an hour. 
 
 3. In vulcanizing waterproof cloth by means of bisulphide of carbon — (a) the 
 trough containing the bisulphide of carbon shall be self-feeding and covered over ; 
 
 (&) the cloth shall be conveyed to and from the drying chamber by means of an 
 automatic machine; (c) no person shall be allowed to enter the drying chamber 
 in the ordinary course of work; {d) the machine shall be covered over and the 
 fumes drawn away from the workers by means of a downward-suction fan 
 maintained in constant efficiency. 
 
 4. Dipping shall not be done except in boxes so arranged that a suction fan 
 shall draw the fumes away from the workers. 
 
352 EEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 5. No food shall be allowed to be eaten in any room in which bisulphide of 
 carbon is used. 
 
 6. A suitable place for meals shall be provided. 
 
 7. All persons employed in rooms in which bisulphide of carbon is used shall 
 be examined once a month by the certifying surgeon for the district, who shall, 
 after May 1, 1898, have power to order temporary or total suspension from work. 
 
 8. No person shall be employed in any room in which bisulphide of carbon is 
 used contrary to the direction of the certifying surgeon given as above. 
 
 9. A register in the form which has been prescribed by the secretary of state 
 for use in india-rubber works shall be kept, and in it the certifying surgeon will 
 enter the dates and result of his visits, with the number of persons examined, 
 and particulars of any directions given by him. This register shall contain a 
 list of all persons employed in rooms in which bisulphide of carbon is used, and 
 shall be produced at any time when required by His Majesty's inspector of fac- 
 tories or by the certifying surgeon. 
 
 II. — DUTIES OF PERSONS EMPLOYED. 
 
 10. No person shall enter the drying room in the ordinary course of work, or 
 perform dipping except in boxes provided with a suction fan carrying the fumes 
 away from the workers. 
 
 11. No person shall take any food in any room in which bisulphide of carbon 
 is used. 
 
 12. After May 1, 1898, no person shall, contrary to the direction of the certify- 
 ing surgeon, given in pursuance of rule 7, work in any room in which bisulphide 
 of carbon is used. 
 
 13. All persons employed in rooms in which bisulphide of carbon is used shall 
 present themselves for periodic examination by the certifying surgeon, as pro- 
 vided in rule 7. 
 
 14. It shall be the duty of all persons employed to report immediately to the 
 employer or foreman any defect which they may discover in the working of the 
 fan or in any appliance required by these rules. 
 
 Arthub Whitelegge, 
 His Majesty's Chief Inspector of Factories. 
 
 Note. — These rules are required to be posted up in conspicuous places in the 
 factory or workshop to which they apply, where they may be conveniently read 
 by the persons employed. Any person who willfully injures or defaces them is 
 liable to a penalty not exceeding £5 ($24.33). Occupiers of factories and work- 
 shops, and persons employed therein, who are bound to observe these rules, are 
 liable to penalties in case of noncompliance. ( Factory and workshop act, 1891, 
 sec. 9, and factory and workshop act, 1901, sees. 85 and 86. ) 
 
 Lucifer-Match Factories in Which White or Yellow Phosphorus is Used. 
 [Form 384 — January, 1904.] 
 
 In these rules " phosphorous process " means mixing, dipping, drying, boxing, 
 and any other work or process in which white or yellow phosphorus is used ; and 
 " person employed in a phosphorous process " means any person who is employed 
 in any room or part of the factory where such a process is carried on. 
 
 " Double-dipped matches " means wood splints, both ends of which have been 
 dipped in the igniting composition. 
 
 " Certifying surgeon " means a surgeon appointed under the factory and work- 
 shop acts. 
 
 Any approval or decision given by the chief inspector of factories in pursuance 
 of these rules shall be given in writing, and may at any time be revoked by notice 
 in writing signed by him. 
 
 Rules^5 (a), 5 (&), 6, 8, and 19, so far as they affect the employment of adult 
 workers, shall not come into force until the 1st day of October, 1900. 
 
 duties of employers. 
 
 1. No part of a luclfer-match factory shall be constructed, structurally altered, 
 or newly used, for the carrying on of any phosphorous process, unless the plans 
 have previously been submitted in duplicate to the chief inspector of factories, 
 and unless he shall have approved the plans in writing, or shall not within six 
 
EEPORTS OF THE PKESIDENT's HOMES COMMISSION. 353 
 
 weeks from the submission of the plans haye expressed his disapproval in writing 
 of the same. 
 
 2. Every room in which mixing, dipping, drying, or boxing is carried on shall 
 be efficiently ventilated by means of sufllcient openings to the outer air, and also 
 by means of fans, unless the use of fans is dispensed with by order in writing of 
 the chief inspector; shall contain at least 400 cubic feet of air space for each 
 person employed therein; and in computing this air space no height above 14 
 feet shall be taken into account; shall be efficiently lighted; shall have a 
 smooth and impervious floor. A floor laid with flagstone or hard bricks in good 
 repair shall be deemed to constitute a smooth and impervious floor. 
 
 3. (a) The processes of mixing, dipping, and drying shall each be done in a 
 separate and distinct room. The process of boxing double-dipped matches or 
 matches not thoroughly dry shall also be done in a separate and distinct room. 
 These rooms shall not communicate with any other part of the factory unless 
 there shall be a ventilated space intervening; nor shall they communicate with 
 one another, except by means of doorways with closely fitting doors, which 
 doors shall be kept shut except when some person is passing through. 
 
 (&) Mixing shall not be done except in an apparatus, or so arranged and 
 ventilated by means of a fan as to prevent the entrance of fumes into the air 
 of the mixing room. 
 
 (c) Dipping shall not be done except on a slab provided with an efficient 
 exhaust fan, and with an air inlet between the dipper and the slab, or with a 
 hood so arranged as to draw the fumes away from the dipper and to prevent 
 them from entering the air of the dipping room. 
 
 (d) Matches that have been dipped and can not at once be removed to the 
 drying room shall immediately be placed under a hood provided with an effi- 
 cient exhaust fan, so arranged as to prevent the fumes from entering the air 
 of the room. 
 
 (e) Matches shall not be taken to a boxing room not arranged in compliance 
 with subsection (/) of this rule until they are thoroughly dry, and matches shall 
 not be taken to a boxing room that is so arranged until they are dried so far 
 as they can be before cutting down and boxing. 
 
 (/) Cutting down of double-dipped matches and boxing of matches not thor- 
 oughly dry shall not be done except at benches or tables provided with an effi- 
 cient exhaust fan, so arranged as to draw the fumes away from the worker and 
 prevent them from entering the air of the boxing room. 
 
 Provided, that the foregoing rule shall not prevent the employment of any 
 mechanical arrangement for carrying on any of the above-mentioned processes 
 if the same be approved by the chief inspector as obviating the use of hand 
 labor, and if it be used subject to the conditions (if any) specified in such 
 approval. 
 
 Provided further, that If the chief inspector shall, on consideration of the 
 special circumstances of any particular case, so approve in writing, all or any 
 of the provisions of the foregoing rule may be suspended for the time named 
 in such approval in writing. 
 
 4. Vessels containing phosphorous paste shall, when not actually in use, be 
 kept constantly covered, and closely fitting covers or damp flannels shall be 
 provided for the purpose. 
 
 5. (a) For the purpose of these rules the occupier shall appoint, subject to 
 the approval of the chief inspector, a duly qualified and registered dentist, 
 herein termed the " appointed dentist." 
 
 It shall be the duty of the appointed dentist to suspend from employment in 
 any phosphorous process any person whom he finds to incur danger of phos- 
 phorous necrosis by reason of defective conditions of teeth or exposure of 
 the jaw. 
 
 (6) No person shall be newly employed in a dipping room for more than 
 twenty-eight days, whether such days are consecutive or not, without being 
 examined by the appointed dentist. 
 
 (c) Every person employed in phosphorous process, except persons employed 
 only as boxers of wax vestas or other thoroughly dry matches, shall be exam- 
 ined by the appointed dentist at least once in every three months. 
 
 (d) Any person employed in the factory complaining of tootache, or a pain 
 or swelling of the jaw, shall at once be examined by the appointed dentist. 
 
 (e) When the appointed dentist has reason to believe that any person em- 
 ployed in the factory is suffering from inflammation or necrosis of the jaw, or 
 is in such a state of health as to incur danger of phosphorous necrosis, he shall 
 
 S. Doc. 644, 60-2 ^24 
 
354 REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 
 
 at once direct the attention of the certifying surgeon and occupier to the case. 
 Thereupon such person shall at once be examined by the certifying surgeon. 
 
 6. No person shall be employed in a phosphorous process after suspension by 
 the appointment dentist, or after the extraction of a tooth, or after any opera- 
 tion involving exposure of the jawbone, or after inflammation or necrosis of 
 the jaw, or after examination by the appointed dentist in pursuance of rule 5 
 (d), or after reference to the certifying surgeon in pursuance of rule 5 (e), 
 unless a certificate of fitness has been given, after examination, by signed entry 
 in the health register, by the appointed dentist or by the certifying surgeon in 
 cases referred to him under rule 5 (e). 
 
 7. A health register, in a form approved by the chief inspector of factories, 
 shall be kept by the occupier, and shall contain a complete list of all persons 
 employed in each phosphorous process, specifying with regard to each such per- 
 son the full name, address, age when first employed, and date of first em- 
 ployment. 
 
 The certifying surgeon will enter in the health register the dates and results 
 of his examinations of persons employed in phosphorous processes, and particu- 
 lars of any directions given by him. 
 
 The appointed dentist will enter in the health register the dates and results 
 of his examinations of the teeth of persons employed in phosphorous processes, 
 and particulars of any directions given by him, and a note of any case referred 
 by him to the certifying surgeon. 
 
 The health register shall be produced at any time when required by His 
 Majesty's inspectors of factories, or by the certifying surgeon, or by the ap- 
 pointed dentist. 
 
 8. Except persons whose names are on the health register mentioned in rule 
 7, and in respect of whom certificates of fitness shall have been granted, no 
 person shall be newly employed in any phosphorous process for more than 
 twenty-eight days, whether such days are consecutive or not, without certificate 
 of fitness, granted after examination by the certifying surgeon, by signed entry 
 in the health register. 
 
 This rule shall not apply to persons employed only as boxers of wax vestas 
 «T other thoroughly dry matches. 
 
 9. The occupier shall provide and maintain sufficient and suitable overalls for 
 all persons employed in phosphorous processes, except for persons employed only 
 us boxes of wax vestas or other thoroughly dry matches, and shall cause them 
 to be worn as directed in rule 20. 
 
 At the end of every day's work they shall be collected and kept in proper 
 custody in a suitable place set apart for the purpose. 
 
 They shall be thoroughly washed every week, and suitable arrangements for 
 this purpose shall be made by the occupier. 
 
 10. The occupier shall provide and maintain (a) a dining room, and (6) a 
 cloakroom in which workers can deposit clothing put off during working hours. 
 
 11. No person shall be allowed to prepare or partake of any food or drink in 
 any room in which phosphorous process is carried on, nor to bring any food or 
 drink into such room. 
 
 12. The occupier shall provide and maintain for the use of the workers a 
 lavatory, with soap, nailbrushes, towels, and at least one lavatory basin for 
 every five persons employed in any phosphorous process. 
 
 Each such basin shall be fitted with waste pipe. There shall be a constant 
 supply of hot and cold water laid onto each basin. 
 
 Or, in the place of basins, the occupier shall provide and maintain enamel or 
 galvanlzed-iron troughs, in good repair, of a total length of 2 feet for every five 
 persons employed, fitted with waste pipes and without plugs, with a sufficient 
 supply of warm water constantly available. 
 
 The lavatory shall be kept thoroughly cleansed, and shall be supplied with a 
 sufficient quantity of clean towels twice in each day. 
 
 There shall, in addition, be means of washing in close proximity to the 
 workers In any department, if so required in writing by the inspector in charge 
 of the district. 
 
 13. The occupier shall provide for the use of every person employed in a 
 phosphorous process an antiseptic mouth wash approved by the appointed 
 dentist, and a sufficient supply of glasses or cups. 
 
 14. The floor of each room in which a phosphorous process is carried on shall 
 be cleared of waste at least once a day, and washed at least once a week. 
 
 15. A printed copy of these rules shall be given to eacli person on entering 
 iip<m employment in a phosphorous process. 
 
EEPOETS OP THE PRESIDENT'S HOMES COMMISSION. 355 
 
 DUTIES OF PEESONS EMPLOYED. 
 
 16. No person shall work in a mixing, dipping, drying, or boxing room under 
 other conditions than those prescribed in rule 3. 
 
 17. No person shall allow a vessel containing phosphorous paste to remain 
 uncovered except when actually in use. 
 
 18. All persons employed in a phosphorous process shall present themselves 
 at the appointed times for examination by the certifying surgeon and appointed 
 dentist, as provided in rules 5, 6, and 8. 
 
 19. Every person employed in a phosphorous process and suffering from 
 toothache or swelling of the jaw, or having had a tooth extracted or having 
 undergone any other operation involving exposure of the jaw, shall at once 
 inform the occupier, and shall not resume employment in a phosphorous process 
 without a certificate of fitness from the appointed dentist, as provided in rule 6. 
 
 No person after suspension by the appointed dentist, or after reference to the 
 certifying surgeon, shall resume empyolment in a phosphorous process with- 
 out a certificate of fitness, as provided in rule 6. 
 
 20. Every person employed in a phosphorous process for whom the occupier 
 is required by rule 9 to provide overalls shall wear while at work the overalls 
 so provided. 
 
 21. Every person employed in a phosphorous process shall, before partaking 
 of meals or leaving the premises, deposit the overalls in the place appointed by 
 the occupier for the purpose, and shall thoroughly wash in the lavatory. 
 
 22. No person shall prepare or partake of food or drink in any room in which 
 a phosphorous process is carried on, or bring any food or drink into such room. 
 
 23. No person shall in any way interfere, without the knowledge and concur- 
 rence of the occupier or manager, with the means and appliances provided for 
 the removal of dust and fumes. 
 
 24. Foremen and forewomen shall report to the manager any instance coming 
 under their notice of a worker neglecting to observe these rules. 
 
 Akthue Whitelegge, 
 Chief Inspector of Factories, 
 April, 1900. 
 
 Note. — These rules must be kept posted up in conspicuous places in the fac- 
 tory to which they apply, where they may be conveniently read by the person 
 employed. Any person who is bound to observe these rules and fails to do so 
 or acts in contravention of them is liable to a penalty; and in such cases the 
 occupier also is liable to a penalty unless he proves that he has taken all rea- 
 sonable means by publishing and, to the best of his power, enforcing the rules to 
 prevent the contravention or noncompliance. 
 
 Felt Hats. 
 
 Whereas the manufacturer of felt hats with the aid of Inflammable solvent 
 has been certified in pursuance of section 79 of the factory and workshop act, 
 1901, to be dangerous, I hereby, in pursuance of the power conferred on me by 
 that act, make the following regulations, and direct that they shall apply to all 
 factories and workshops in which any inflammable solvent is used in the manu- 
 facture of felt hats: 
 
 1. Every proofing room and every stove or drying room in which an inflam- 
 mable solvent is evaporated shall be thoroughly ventilated to the satisfaction of 
 the inspector for the district, so as to carry off as far as possible the inflamma- 
 ble vapor. 
 
 2. The number of wet spirit-proofed hat bodies allowed to be in a proofing 
 room at any one time shall not exceed the proportion of one hat for each 15 
 cubic feet of air space; and in no stove, while the first drying of any spirit- 
 proofed hats is being carried on, shall the number of hat bodies of any kind 
 exceed a proportion of one hat for each 12 cubic feet of air space. 
 
 A notice stating the dimensions of each such room or stove in cubic feet and 
 the number of spirit-proofed hats allowed to be therein at any one time shall be 
 kept constantly affixed in a conspicuous position. 
 
 3. Spirit-proofed hats shall be opened out singly and exposed for one hour 
 before being placed in the stove. This requirement shall not apply in the case 
 of a stove which contains no tire or artificial light capable of igniting inflamma- 
 ble vapor, and which is so constructed and arranged as, in the opinion of the 
 inspector for the district, to present no risk of such ignition from external fire 
 or light. 
 
356 KEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 4. The above rules, in so far as they affect drying stoves, shall not apply to 
 the process of drying hat bodies where the solvent is recovered in a closed oven 
 or chamber fitted with safe and suitable apparatus for the condensation of the 
 solvent. 
 
 5. No person shall smoke in any room or place in which inflammable solvent 
 is exposed to the air. 
 
 These regulations shall come into force on the 1st day of October, 1902. 
 
 A. Akers-Douqlas, 
 One of His Majesty's Principal Secretaries of State. 
 Whitehall, August 12, 1902, 
 
 Sfecial Rules foe the Handling of Dsy and Dbysalted Hides and Skins 
 Imported feom China ob feom the West Coast of India. 
 
 [Form 486 — February, 1906.] 
 
 DUTIES OF OCCUPIEBS. 
 
 1. Proper provision to the reasonable satisfaction of the inspector in charge of 
 the district shall be made for the keeping of the workmen's food and clothing 
 outside any room or shed in which any of the above-described hides or skins are 
 unpacked, sorted, packed, or stored. 
 
 2. Proper and sufficient appliances for washing, comprising soap, basins, with 
 water laid on nailbrushes, and towels shall be provided and maintained for the 
 use of the workmen, to the reasonable satisfaction of the inspector in charge of 
 the district. 
 
 3. Sticking plaster and other requisites for treating scratches and slight 
 wounds shall be kept at hand, available for the use of the persons employed. 
 
 4. A copy of the appended notes shall be kept affixed with the rules. 
 
 DUTIES OF PEESONS EMPLOYED. 
 
 6. No workman shall keep any food, or any article of clothing other than 
 those he is wearing, in any room or shed in which any of the above-described 
 hides or skins are handled. 
 
 He shall not take any food in any such room or shed. 
 
 6. Every workman having any open cut or scratch or raw surface, however 
 trifling, upon his face, head, neck, arm, or hand shall immediately report the 
 fact to the foreman, and shall not work on the premises until the wound Is 
 healed or is completely covered by a proper dressing after being thoroughly 
 washed. 
 
 Aethue Whitelegge, 
 Chief Inspector of Factories. 
 Chas. T. Ritchie, 
 One of His Majesty's Principal Secretaries of State, 
 August, 1901. 
 
 Note 1. — These rules must be kept posted up in conspicuous places in the fac- 
 tory to which they apply, where they may be conveniently read by the persons 
 employed. Any person who is bound to observe these rules and fails to do so, or 
 acts in contravention of them, is liable to a penalty ; and in such cases the occu- 
 pier also is liable to a penalty unless he proves that he has taken all reasonable 
 means by publishing and, to the best of his power, enforcing the rules to prevent 
 the contravention or noncompliance. 
 
 Note 2. — ^The danger against which these rules are directed is that of an- 
 thrax — a fatal disease affecting certain animals, which may be conveyed from 
 them to man by the handling of hides of animals which have died of the disease. 
 The germs of the disease (anthrax sores) are found in the dust and in the sub- 
 stance of the hide, and may remain active for years. In this country anthrax is 
 rare, and precautions are taken to prevent infected hides from coming into the 
 market, consequently there is little danger in handling the hides of animals 
 slaughtered in the United Kingdom; but in Russia, China, and the East Indies 
 and in many other parts of the world the disease is common, and infected hides 
 ^which do not differ from others In appearance) are often shipped to British 
 ports. IToiuo. in It.'nulliiic: fdipiLrii dry hides the above rules should be carefully 
 obsorvcd. wet s;ilU'(l hides are rrcc from dust and less risk is incurred in han- 
 dling them. 
 
EEPOETS OP THE PRESIDENT'S HOMES COMMISSION. 357 
 
 The disease Is communicated to man sometimes by breathing or swallowing 
 the dust from an infected hide, but much more usually by the poison lodging in 
 some point where the sh:in is broken — such as a fresh scratch or cut or a 
 scratched pimple, or even chapped hands. This happens most readily on the 
 uncovered parts of the body, the hand, arm, face, and most frequently of all on 
 the neck — owing either to an infected hide rubbing against the bare skin, or to 
 dust from such hide alighting on the raw surface. But a raw surface covered 
 by clothing is not free from risk, for dust lodging upon the clothes may sooner or 
 later work its way to the skin beneath. Infection may also be brought about by 
 rubbing or scratching a pimple with hand or nail carrying the anthrax poison. 
 
 The first symptoms of anthrax is usually a small inflamed swelling like a 
 pimple or boil, often quite painless, which extends and in a few days becomes 
 black at the center and surrounded by other " pimples." The poison is now 
 liable to be absorbed into the system and will cause risk of life, which can be 
 avoided only by prompt and, effective medical treatment in the early stage 
 while the poison is still confined to the pimple. Hence it is of the utmost im- 
 portance that a doctor should at once be consulted if there is any suspicion of 
 infection. 
 
 Note. — Suitable overalls, protecting the neck and arms, as well as ordinary 
 clothing, add materially to the safety of the workmen, and should be provided 
 and worn, where practicable, if dangerous hides are handled. They should be 
 discarded on cessation of work. Similarly, for the protection of the hands, 
 gloves should be provided and worn where the character of the work permits. 
 
 Wool and Haie Sorting. 
 
 Whereas, the processes of sorting, willying, washing, and combing and card- 
 ing wool, goat hair, and camel hair and processes incidental thereto have been 
 certified, in pursuance of section 79 of the factory and workshop act, 1901, to 
 be dangerous : 
 
 I hereby, in pursuance of the powers conferred on me by that act, make the 
 following regulations, and direct that they shall apply to all factories and work- 
 shops in which the said processes are carried on and in which the materials 
 named in the schedules are used. 
 
 It shall be the duty of the occupier to comply with regulations 1 to 16. It 
 shall be the duty of all persons employed to comply with regulations 17 to 23. 
 
 These regulations shall come into force on the 1st of January, 1906, except 
 that regulations 2 and 8 shall not come into force until the 1st of April, 1906. 
 
 DEFINITION. 
 
 For the purpose of regulations 2, 3, and 18, opening of wool or hair means 
 the opening of the fleece, including the untying or cutting of the knots, or, if 
 the material is not in fleece, the opening out for looking over or classing 
 purposes. 
 
 DUTIES OF OCCUPIEBS. 
 
 1. No bale of wool or hair of the kinds named in the schedules shall be opened 
 for the purpose of being sorted or manufactured, except by men skilled in judg- 
 ing the condition of the material. 
 
 No bale of wool or hair of the kinds named in Schedule A shall be opened 
 except after thorough steeping in water. 
 
 2. No wool or hair of the kinds named in Schedule B shall be opened except 
 (a) after steeping in water, or (6) over an efficient opening screen, with me- 
 chanical exhaust draft, in a room set apart for the purpose, in which no other 
 work than opening is carried on. 
 
 For the purpose of this regulation, no opening screen shall be deemed to be 
 efficient unless it complies with the following conditions : 
 
 (a) The area of the screen shall in the case of existing screens be not less 
 than 11 square feet, and in the case of screens hereafter erected be not less 
 than 12 square feet, nor shall its length or breadth be less than Si feet. 
 
 (6) At no point of the screen within 18 inches from the center shall the 
 velocity of the exhaust draft be less than 100 linear feet per minute. 
 
 3. All damaged wool or hair or fallen fleeces or skin wool or hair, if of the 
 kinds named in the schedules, shall when opened be damped with a disinfectant 
 and washed without being willowed. 
 
358 REPORTS OF THE PRESIDENT'S HOMES^ COMMISSION. 
 
 4. No wool or hair of the kinds named in schedules B or C shall be sorted 
 except over an efficient sorting board, with mechanical exhaust draft, and in a 
 room set ai)art for the purpose, in which no work is carried on other than sort- 
 ing and the packing of the wool or hair therein. 
 
 No wool or hair of the kinds numbered (1) and (2) in Schedule A shall be 
 sorted except in the damp state and after being washed. 
 
 No damaged wool or hair of the kinds named in schedules shall be sorted 
 except after being washed. 
 
 For the purix)se of this regulation, no sorting board shall be deemed to be 
 efficient unless it complies with the following conditions : 
 
 The sorting board shall comprise a screen of open wirework, and beneath it 
 at all parts a clear space not less than 3 inches in depth. Below the center of 
 the screen there shall be a funnel, measuring not less than 10 inches across the 
 top, leading to an extraction shaft, and the arrangements shall be such that all 
 dust falling through the screen and not carried away by the exhaust can be 
 swept directly into the funnel. The draft shall be maintained in constant effi- 
 ciency whilst the sorters are at work, and shall be such that not less than 75 
 cubic feet of air per minute are drawn by the fan from beneath each sorting 
 board. 
 
 5. No wool or hair of the kinds named in the schedules shall be willowed 
 except in an efficient willowing machine, in a room set apart for the purpose, 
 in which no work other than willowing is carried on. 
 
 For the purpose of this regulation no willowing machine shall be deemed to 
 be efficient unless it is provided with mechanical exhaust draft so arranged as 
 to draw the dust away from the workmen and prevent it from entering the air 
 of the room. 
 
 6. No bale of wool or hair shall be stored in a sorting room; nor any wool 
 or hair except in a space effectually screened off from the sorting room. 
 
 No wool or hair shall be stored in a willowing room. 
 
 7. In each sorting room, and exclusive of any portion screened off, there shall 
 be allowed an air space of at least 1,000 cubic feet for each person employed 
 therein. 
 
 8. In each room in which sorting, willowing, or combing is carried on suitable 
 inlets from the open air, or other suitable source, shall be provided and arranged 
 In such a way that no person employed shall be exposed to a direct draft from 
 any air inlet or to any draft at a temperature of less than 50° F. 
 
 The temperature of the room shall not during working hours fall below 
 50° F. 
 
 9. All bags in which wool or hair of the kinds named in the schedules has 
 been imported shall be picked clean and not brushed. 
 
 10. All pieces of skin, scab, and clippings or shearings shall be removed daily 
 from the sorting room, and shall be disinfected or destroyed. 
 
 11. The dust carried by the exhaust draft from opening screens, sorting 
 boards, willowing or other dust-extracting machines and shafts shall be dis- 
 charged into properly constructed receptacles and not into the open air. 
 
 Each extracting shaft and the space beneath the sorting boards and opening 
 screens shall be cleaned out at least once In every week. 
 
 The dust collected as above, together with the sweepings from the opening, 
 sorting, and willowing rooms, shall be removed at least twice a week and 
 burned. 
 
 The occupier shall provide and maintain suitable overalls and respirators 
 to be worn by the persons engaged in collecting and removing the dust. 
 
 Such overalls shall not be taken out of the works or warehouse, either for 
 washing, repairs, or any other purpose, unless they have been steeped overnight 
 In boiling water or a disinfectant. 
 
 12. The floor of every room in which opening, sorting, or willowing is carried 
 on shall be thoroughly sprinkled daily with a disinfectant solution after work 
 has ceased for the day, and shall be swept immediately after sprinkling. 
 
 13. The walls and ceilings of every room in which opening, sorting, or willow- 
 ing is carried on shall be limewashed at least once a year, and cleansed at least 
 once within every six months, to date from the time when they were last 
 cleaosed. 
 
 14. The following requirements shall apply to every room in which unwashed 
 wool or hair of the kinds named in the schedules, after being opened for sort- 
 ing, manufacturing, or washing purposes, is handled or stored. 
 
 (a) Sufficient and suitable washing accommodation shall be provided outside 
 tli« rooms and maintained for the use of aU persons employed in such room*. 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. S59 
 
 The washing conveniences shall comprise soap, nailbrushes, towels, and at 
 least one basin for every five persons employed as above, each basin being 
 fitted with a waste pipe and having a constant supply of water laid on. 
 
 (6) Suitable places shall be provided outside the rooms in which persons 
 employed in such rooms can deposit food and clothing put off during working 
 hours. 
 
 (c) No person shall be allowed to prepare or partake of food in any such 
 room. 
 
 Suitable and sufficient meal room accommodation shall be provided for 
 workers employed in such rooms. 
 
 (d) No person having any open cut or sore shall be employed in any such 
 room. 
 
 The requirements in paragraph (c) shall apply also to every room in which 
 any wool or hair of the kinds named in the schedules is carded or stored. 
 
 15. Requisites for treating scratches and slight wounds shall be kept at hand. 
 
 16. The occupier shall allow any H. M. inspectors of factories to take at any 
 time, for the purpose of examination, sufficient samples of any wool or hair 
 used on the premises. 
 
 DUTIES OF PEESONS EMPLOYED. 
 
 17. No bale of wool or hair of the kinds named In the schedules shall be 
 opened otherwise than as permitted by paragraph 1 or regulation 1, and no bale 
 of wool or hair of the kinds named in Schedule A shall be opened except after 
 thorough steeping in water. 
 
 If on opening a bale any damaged wool or hair of the kinds named in the 
 schedules is discovered, the person opening the bale shall immediately report 
 the discovery to the foreman. 
 
 18. No wool or hair of the kinds named in Schedule B shall be opened other- 
 wise than as permitted by regulation 2. 
 
 19. No wool or hair of the kinds named in the schedules shall be sorted other- 
 wise than as permitted by regulation 4. 
 
 20. No wool or hair of the kinds named in the schedules shall be willowed 
 except as permitted by regulation 5. 
 
 21. Every person employed in a room in which unwashed wool or hair of the 
 kinds named in the schedules is stored or handled shall observe the following 
 requirements : 
 
 (a) He shall wash his hands before partaking of food, or leaving the premises. 
 
 ( & ) He shall not deposit in any such room any article of clothing put off dur- 
 ing working hours. 
 
 He shall wear suitable overalls while at work, and shall remove them before 
 partaking of food or leaving the premises. 
 
 (c) If he has any open cut or sore, he shall report the fact at once to the 
 foreman, and shall not work in such a room. 
 
 No person employed in any such room or in any room in which wool or hair 
 of the kinds named in the schedule is either carded or stored shall prepare or 
 partake of any food therein, or bring any food therein. 
 
 22. Persons engaged in collecting or removing dust shall wear the overalls as 
 required by regulation 11. 
 
 Such overalls shall not be taken out of the works or warehouse either for 
 washing, repairs, or any other purpose, unless they have been steeped overnight 
 in boiling water or a disinfectant. 
 
 23. If any fan, or any other appliance for the carrying out of these regu- 
 lations, is out of order, any workman becoming aware of the defect shall imme- 
 diately report the fact to the foreman. 
 
 H. J. Gladstone, 
 One of Her Majesty's Principal Secretaries of State. 
 Home Office, Whitehall, 12th December, 1903. 
 
 Schedule A. 
 
 (Wool or hair required to be opened either after steeping or over an efficient 
 opening screen.) 
 
 1. Van mohair. 
 
 2. Persian locks. 
 
 3. Persian or so-called Persian (including Karadi and Bagdad) if not snb- 
 jected to the process of sorting or willowing. 
 
360 EEPOETS OF THE PRESIDENT'S HOMES COMMISSION, 
 
 Schedule B, 
 
 (Wool or hair required to be opened either after steeping or oyer an efficient 
 opening screen.) 
 
 Alpaca. 
 
 Pelitan. 
 
 East Indian cashmerew 
 
 Russian camel hair. , 
 
 Pekin camel hair. 
 
 Persian or so-called Persian (including Karadl and Bagdad) if subjected to 
 the process of sorting or willowing. 
 
 Schedule 0, 
 
 (Wool or hair not needing to be opened over an opening screen, but required 
 to be sorted over a board provided with downward draft.) 
 
 All mohair other than van mohair. 
 
 Note. — The danger against which these regulations are directed is that of 
 anthrax — a fatal disease affecting certain animals, which my be conveyed from 
 them to man by the handling of wools or hairs from animals which have died 
 of the disease. The germs of the disease (anthrax spores) are found in the dust 
 attaching to the wool, or in the excrement, and in the substance of the pieces 
 of skin, and may remain active for years. In this country and Australia anthrax 
 is rare, consequently there is little danger in handling wools from the sheep of 
 these two countries, but in China, Persia, Turkey, Russia, the East Indies, and 
 in many other parts of the world, the disease is common, and infected fleeces or 
 locks (which may not differ from others in appearance) are often shipped to 
 Great Britain. Hence, in handling foreign dry wools and hair, the above regu- 
 lations should be carefully observed. Greasy wools are comparatively free 
 from dust and therefore little risk is incurred in handling them. The disease is 
 communicated to man sometimes by breathing or swallowing the dust from these 
 wools or hair, and sometimes by the poison lodging in some point where the 
 skin is broken, such as a fresh scratch or cut, or a scratched pimple, or even 
 chapped hands. This happens more readily on the uncovered parts of the body, 
 the hand, arm, face, and most frequently of all, on the neck, owing either to 
 infected wool rubbing against the bare skin, or to dust from such wool alight- 
 ing on the raw surface. But a raw surface covered by clothing is not free 
 from risk, for the dust lodging upon the clothes may sooner or later work its 
 way to the skin beneath. Infection may also be brought about by rubbing or 
 scratching a pimple with hand or nail carrying the anthrax poison. Use of the 
 nailbrush, and frequent washing and bathing of the whole body, especially of 
 the arms, neck, and head, will lessen the chance of contracting anthrax. 
 
 The first symptom of anthrax is usually a small inflamed swelling like a 
 pimple or boil — often quite painless — which extends, and in a few days becomes 
 black at the center, and surrounded by other "pimples." The poison is now 
 liable to be absorbed into the system, and will cause risk of life, which can be 
 avoided only by prompt and effective medical treatment in the early stage, while 
 the poison is still confined to the pimple. Hence, it is of the utmost importance 
 that a doctor should be at once consulted if there is any suspicion of infection. 
 
 Flax and Tow SriNNiifQ and Weaving. 
 
 Whereas the processes of spinning and weaving flax and tow and the proc- 
 esses incidental thereto have been certified in pursuance of section 79 of the 
 factory and workshop act, 1901, to be dangerous : 
 
 I hereby,, in pursuance of the powers conferred on me by that act, make the 
 following regulations, and direct that they shall apply to all factories in which 
 the processes named above are carried on, and to all workshops in which the 
 processes of roughing, sorting, and hand-hackling of flax or tow are carried on. 
 
 These r^ulations shall come into force on the 1st day of February, 1907. 
 
 Provided that in case of all rooms in which roughing or hand-hackling is 
 now carried on, and in which there is respectively (a) no system of local 
 mechanical exhaust ventilation, or (&) no artificial means of regulating the 
 temperature, Regulations 2 and 3, respectively, shall not come into force until 
 the 1st day of February, 1908. 
 
REPORTS OP THE PRESIDENT'S HOMES COMMISSION. 361 
 
 DEPINmONS. 
 
 In these regulations — 
 
 " Degrees " means degrees on the Fahrenheit scale. 
 
 " Roughing, sorting, hand-hackling, machine-hacliling, carding, and preparing " 
 mean those processes in the manufacture of flax or tow. 
 
 It shall be the duty of the occupier to observe Part I of these regulations. 
 
 It shall be the duty of all persons employed to observe Part II of these 
 regulations. 
 
 PART I. — ^DUTIES OF OCCTJPIEBS. 
 
 1. In every room in which persons are employed the arrangements shall be 
 such that during working hours the proportion of carbonic acid in the air of the 
 room shall not exceed 20 volumes per 10,000 volumes of air at any time when 
 gas or oil is used for lighting (or within one hour thereafter) or 12 volumes 
 per 10,000 when electric light is used (or within one hour thereafter) or 9 
 volumes per 10,000 at any other time. 
 
 Provided that it shall be a sufficient compliance with this regulation if the 
 proportion of carbonic acid in the air of the room does not exceed that of the 
 open air outside by more than 5 volumes per 10,000 volumes of air. 
 
 2. In every room in which roughing, sorting, or hand-hackling is carried on, 
 and in every room in which machine-hackling, carding, or preparing is carried 
 on, and in which dust is generated and inhaled to an extent likely to cause 
 injury to the health of the workers, efficient exhaust and inlet ventilation shall 
 be provided to secure that the dust is drawn away from the workers at, or as 
 near as reasonably possible to, the point at which it is generated. 
 
 For the purposes of this regulation the exhaust ventilation in the case of 
 hand-hackling, roughing, or sorting shall not be deemed to be efficient if the 
 exhaust opening at the back of the hackling pins measures less than 4 inches 
 across in any direction, or has a sectional area of less than 50 square inches, 
 or if the linear velocity of the draft passing through it is less than 400 feet 
 per minute at any point within a sectional area of 50 square inches. 
 
 3. In every room in which hand-hackling, roughing, sorting, machine-hack- 
 ling, carding, or preparing is carried on, an accurate thermometer shall be kept 
 affixed; and the arrangements shall be such that the temperature of the room 
 shall not at any time during working hours where hand-hackling, roughing, or 
 machine-hackling is carried on fall below 50°, or where sorting, carding, or 
 preparing is carried on below 55° ; and that no person employed shall be ex- 
 posed to a direct draft from any air inlet, or to any draft at a temperament 
 of less than 50*. 
 
 Provided that it shall be a sufficient compliance with this regulation if the 
 heating apparatus be put into operation at the commencement of work, and if 
 the required temperature be maintained after the expiration of one hour from 
 the commencement of work. 
 
 4. In every room in which wet spinning is carried on, or in which artificial 
 humidity of air is produced in aid of manufacture, a set of standardized wet 
 and dry bulb thermometers shall be kept affixed in the center of the room or 
 in such other position as may be directed by the inspector of the district by 
 notice in writing, and shall be maintained in correct working order. 
 
 Each of the above thermometers shall be read between 10 and 11 a. m. on 
 every day that any person is employed in the room, and again between 3 and 
 4 p. m. on every day that any person is employed in the room after 1 p. m., 
 and each reading shall be at once entered on the prescribed form. 
 
 The form shall be hung up near the thermometers to which it relates, and 
 shall be forwarded, duly filled in, at the end of each calendar month to the 
 inspector of the district. Provided, that this part of this regulation shall not 
 apply to any room in which the difference of reading between the wet and dry 
 bulb thermometers is never less than 4°, if notice of intention to work on that 
 system has been given in the prescribed form to the inspectors for the district, 
 and a copy of the notice is kept affixed in the room to which it applies. 
 
 5. The humidity of the atmosphere of any room to which regulation 4 applies 
 shall not at any time be such that the difference between the readings of the 
 wet and dry bulb thermometers is less than 2°. 
 
 6. No water shall be used for producing humidity of the air, or in wet- 
 spinning troughs, which is liable to cause injury to the health of the persons 
 employed or to yield effluvia ; and for the purpose of this regulation any water 
 
362 EEPORTS OF THE PKESIDENT^S HOMES COMMISSION. 
 
 which absorbs from acid solution of permanganate of potash in four hours at 
 60° more than 0.5 grains of oxygen per gallon of water shall be deemed to be 
 liable to cause injury to the health of the persons employed. 
 
 7. Efficient means shall be adopted to prevent the escape of steam from wet- 
 spinning troughs. 
 
 8. The pipes used for the introduction of steam into any room in which the 
 temperature exceeds 70°, or for heating the water in any wet-spinning trough, 
 shall so far as they are within the room and not covered by water be as small 
 in diameter and as limited in length as is reasonably practicable, and shall be 
 effectively covered with nonconducting material. 
 
 9. Efficient splash guards shall be provided and maintained on all wet-spin- 
 ning frames of 2i-inch pitch and over, and on all other wet-spinning frames 
 unless waterproof skirts and bibs of suitable material are provided by the 
 occupier and worn by the workers. 
 
 Provided, that if the chief inspector is satisfied with regard to premises in 
 use prior to 30th June, 1905, that the structural conditions are such that splash 
 guards can not conveniently be used, he may suspend the requirements as to 
 splash guards. Such suspension shall only be allowed by certificate in writing, 
 signed by the chief inspector, and shall be subject to such conditions as may be 
 stated in the certificate. 
 
 10. The floor of every wet-spinning room shall be kept in sound condition, 
 and drained so as to prevent retention or accumulation of water. 
 
 11. There shall be provided for all persons employed in any room in which 
 wet spinning is carried on, or in which artificial humidity of air is produced 
 in air of manufacture, suitable and convenient accommodaton in which to keep 
 the clothing taken off before starting work, and in the case of building erected 
 after 30th June, 1905, in which the difference between the readings of the wet 
 and dry bulb thermometers is at any time less than 4°, such accommodation 
 shall be provided in cloak rooms, ventilated, and kept at a suitable temperature 
 and situated in or near the workrooms in question. 
 
 12. Suitable and efficient respirators shall be provided for the use of the 
 persons employed in machine-hackling, preparing, and carding. 
 
 PAET II. — ^DUTIES OF PERSONS EMPLOYED. 
 
 13. All persons employed on wet-spinning frames without efficient splash 
 guards shall wear the skirts and bibs provided by the occupier in pursuance of 
 regulation 9. 
 
 14. No person shall in any way interfere, without the concurrence of the 
 occupier or manager, with the means and appliances provided for ventilation, 
 or for the removal of dust, or for the other purposes of these regulations. 
 
 H. J. Gladstone, 
 One of His Majesty's Principal Secretaries of State. 
 Home Office, Whitehall, 80th February, 1906, 
 
 File Cutting by Hand. 
 
 Whereas the process of file cutting by hand has been certified in pursuance 
 of section 79 of the factory and workshop act, 1901, to be dangerous : 
 
 I hereby, in pursuance of the powers conferred on me by that act, make the 
 following regulations, and direct that 'they shall apply to all factories and 
 workshops (including tenement factories and tenement workshops) or parts 
 thereof in which the process of file cutting by hand is carried on; provided 
 that the chief inspector of factories may by certificate in writing exempt from 
 all or any of these regulations any factory or workshop in which he is satisfied 
 that the beds used are of such composition as not to entail danger to the health 
 of the persons employed. 
 
 1. The number of stocks in any room shall not be more than one stock for 
 every 350 cubic feet of air space in the room ; and in calculating air space for 
 the purpose of this regulation any space more than 10 feet above the floor of 
 the room slyill not be reckoned. 
 
 2. After the 1st day of January, 1904, the distance between the stocks meas- 
 ured from the center of one stock to the center of the next shall not be less 
 than 2 feet 6 inches, and after the 1st day of January, 1905, the said distance 
 Bhall not be less than 3 feet. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 363 
 
 3. Every room shall have a substantial floor, the whole of which shall be 
 covered with a washable material, save that it shall be optional to leave a 
 space not exceeding 6 inches in width round the base of each stock. 
 
 The floor of every room shall be kept in good repair. 
 
 4. Efficient inlet and outlet ventilators shall be provided hi every room. The 
 inlet ventilators shall be so arranged and placed as not to cause a direct draft 
 of incoming air to fall on the workmen employed at the stocks. 
 
 The ventilators shall be kept in good repair and in working order. 
 
 5. No person shall interfere with or impede the working of the ventilators. 
 
 6. Sufficient and suitable washing conveniences shall be provided and main- 
 tained for the use of the file cutters. The washing conveniences shall be under 
 cover and shall comprise at least one fixed basin for every ten or less stocks. 
 Every basin shall be fitted with a waste pipe discharging over a drain or into 
 some receptacle of a capacity at least equal to 1 gallon for every file cutter 
 using the basin. Water shall be laid onto every basin either from the main or 
 from a tank of a capacity of not less than 11 gallons to every worker supplied 
 from such tank. A supply of clean water shall be kept in the said tank while 
 work is going on at least sufficient to enable every worker supplied from such 
 tank to wash. 
 
 7. The walls and ceiling of every room, except such parts as are painted or 
 varnished or made of glazed brick, shall be limewashed once in every six 
 months ending the 30th of June and once in every six months ending the 31st of 
 December. 
 
 8. The floor and such parts of the walls and ceiling as are not limewashed 
 and the benches shall be cleansed once a week. 
 
 9. If the factory or workshop is situated in a dwelling house the work of file 
 cutting shall not be carried on in any room which is used as a sleeping place 
 or for cooking or eating meals. 
 
 10. Every file cutter shall when at work wear a long apron reaching from 
 the shoulders and neck to below the knees. The apron shall be kept in a 
 cleanly state. 
 
 11. A copy of these regulations and an abstract of the provisions of the fac- 
 tory and workshop act, 1901, shall be kept affixed in the factory or workshop 
 in a conspicuous place. 
 
 12. It shall be the duty of the occupier to carry out regulations 1, 2, 3, 4, 6, 
 7, and 11; except that, in any room in a tenement factory or tenement work- 
 shop which is let to more than one occupier, it shall be the duty of the owner to 
 carry out these regulations, except the last clause of regulation 6, which shall 
 be carried out by the occupiers. 
 
 It shall be the duty of the occupier or occupiers to carry out regulation 8. 
 It shall be the duty of the occupier or occupiers and of every workman to 
 observe regulations 5, 9, and 10. 
 
 These regulations shall come into force on the 1st day of September, 1903. 
 
 A. Akers-Douglas, 
 One of His Majesty's Principal Secretaries of State, 
 Home Office, Whitehall, 19th Jv/ne, 190S. 
 
 Special Rules for the Bottling of Aerated Wateb. 
 
 [Form 273— A 1-3-01.] 
 
 DUTIES OF OCCUPIERS. 
 
 1. They shall provide all bottlers with face guards, masks, or veils of wire 
 gauze. 
 
 They shall provide all wirers, sighters, and labelers with face guards, masks, 
 or veils of wire gauze, or goggles. 
 
 2. They shall provide all bottlers with full-length gauntlets for both arms. 
 They shall provide all wirers, sighters, and labelers with gauntlets for both 
 
 arms, protecting at least half of the palm and the space between the thumb 
 and forefinger. 
 
 3. They shall cause all machines for bottling to be constructed, so placed, or 
 so fenced, as to prevent as far as possible, during the operation of filling or 
 corking, a fragment of a bursting bottle from striking any bottler, wirer, 
 sighter, labeler, or washer. 
 
364 KEPORTS OF THE PRESIDENT 's HOMES COMMISSION. 
 
 DUTIES OF PEESONS EMPLOYED. 
 
 4. All bottlers shall, while at work, wear face guards, masks, or veils of wire 
 gauze. 
 
 All wirers, sighters, and label ers shall, while at work, wear on both arms 
 gauntlets protecting at least half of the palm and the space between the thumb 
 and forefinger; except labelers when labeling bottles standing in cases. 
 
 Abthue Whitelegge, 
 His Majesty's Inspector of Factories. 
 August, 1897. 
 
 These rules are required to be posted up in conspicuous places in the factory 
 or workshop to which they apply, where they may be conveniently read by the 
 persons employed therein, who are bound to observe any special rules, are liable 
 to a penalty of £5 ($24.33). Occupiers of factories and workshops and persons 
 employed therein who are bound to observe any special rules are liable to 
 penalties for noncompliance (factory and workshop act, 1891, sections 9 
 and 11). 
 
 The employer is required to provide the articles mentioned in the rules, and 
 to take all reasonable precautions to the best of his power to enforce their 
 use, but the responsibility for the actual wearing of them rests with the person 
 employed. 
 
 Spinning by Self-Acting Mules. 
 
 Whereas certain machinery used in the process of spinning in textile fac- 
 tories, and known as self-acting mules, has been certified in pursuance of sec- 
 tion 79 of the factory and workshop act, 1901, to be dangerous to life and 
 limb: 
 
 I hereby, in pursuance of the powers conferred on me by that act, make the 
 following regulations, and direct that they shall apply to all factories or parts 
 thereof in which the process of spinning by means of self-acting mules is 
 carried on: 
 
 1. In these regulations the term "minder" means the person in charge of a 
 self-acting mule for the time being. 
 
 2. Save as hereinafter provided, it shall be the duty of the occupier of a 
 factory to observe Part I of these regulations; provided that it shall be the 
 duty of the owner (whether or not he is one of the occupiers) of a tenement 
 factory to observe Part I of these regulations, except so far as relates to such 
 parts of the machinery as are supplied by the occupier. 
 
 It shall be the duty of the persons employed to observe Part II of these 
 regulations, but it shall be the duty of the occupier, for the purpose of en- 
 forcing their observance, to keep a copy of the regulations In legible characters 
 affixed in every mule room, in a conspicuous position, where they may be 
 conveniently read. 
 
 PAST I. — ^duties of occupiers. 
 
 8. After January 1, 1906, the following parts of every self-acting mule shall 
 be securely fenced as far as reasonably practicable, unless it can be shown that 
 by their position or construction they are equally safe to every person employed 
 as they would be if securely fenced : 
 
 (a) Back shaft scrolls and carrier pulleys and draw band pulleys. 
 
 (ft) Front and back carriage wheels. 
 
 (c) Faller-stops. 
 
 id) Quadrant pinions. 
 
 (e) Back of headstocks, including rim pulleys and taking-in scrolls. 
 
 (/) Rim band tightening pulleys, other than plate wheels, connected with a 
 self-acting mule erected after January 1, 1906. 
 
 PART n. — duties of persons employed. 
 
 4. It shall be the duty of the minder of every self-acting mule to take all 
 reasonable care to insure: 
 
 (o) That no child cleans any part or under any part thereof whilst the mule 
 is In motion by the aid of mechanical power. 
 
EEPORTS OF THE PKESIDENt's HOMES COMMISSION. 365 
 
 (6) That no woman, young person, or child work between the fixed and 
 traversing parts thereof whilst the mule is in motion by the aid of mechanical 
 power. 
 
 (c) That no person is in the space between the fixed and traversing parts 
 thereof unless the mule is stopped on the outward run. 
 
 5, No self-acting mule shall be started or restarted except by the minder or 
 at his express orders, nor until he has ascertained that no person is in the space 
 betweeen the fixed and traversing parts thereof. 
 
 A. Akeks-Douglas, 
 One of His Majesty's Principal Secretaries of State. 
 
 Home Office, Whitehall, 11th October, 1905. 
 
 Loading Goods on Docks and Whabves. 
 
 Whereas the processes of loading, unloading, moving, and handling goods in, 
 on, or at any dock, wharf, or quay, and the processes of loading, unloading, and 
 coaling any ship in any dock, harbor, or canal have been certified in pursuance 
 of section 79 of the factory and workshop act, 1901, to be dangerous : 
 
 I hereby, in pursuance of the powers conferred on me by that act make the 
 following regulations for the protection of persons employed in the processes or 
 In any of them, and direct that they shall apply to all docks, wharves, quays, 
 and ships as aforesaid. 
 
 These regulations shall come Into force on the 1st of January, 1905, except 
 that so much of regulations 6 and 8 as require structural alterations shall come 
 into force on the 1st of January, 1908. 
 
 Nothing in Parts II to VI, inclusive, of these regulations shall apply to the 
 unloading of fish from a vessel employed in the catching of fish. 
 
 The secretary of state may by order in writing exempt from all or any of the 
 regulations and for such time and subject to such conditions as he may prescribe 
 any docks, wharves, or quays in respect of which application for such exemption 
 shall have been made to him by the department of agriculture and technical 
 Instruction for Ireland or by the congested districts board for Ireland. 
 
 definitions. 
 
 "Processes'* means the processes above mentioned, or any of them. 
 
 " Persons employed " means a person employed in the above processes, or any 
 of them. 
 
 " Shallow canal " includes any of the following parts of a canal, canalized 
 river, nontidal river, or inland navigation : 
 
 (a) Any part having no means of access to tidal waters except through a 
 lock not exceeding 90 feet in length; (&) any part not in frequent use for the 
 processes; and (c) any part at which the depth of water within 15 feet of the 
 edge does not ordinarily exceed 5 feet. 
 
 DUTIES. 
 
 It shall be the duty of the person having the general management and control 
 of a dock, wharf, or quay to comply with Part I of these regulations ; provided 
 that if any other person has the exclusive right to occupation of any part of the 
 dock, wharf, or quay, and has the general management and control of such part 
 the duty in respect of that part shall devolve upon that other person; and 
 further provided that this part of these regulations shall not apply to any 
 shallow canal. 
 
 It shall be the duty of the owner or officer in charge of a ship to comply with 
 Part II of these regulations. 
 
 It shall be the duty of the owner of machinery or plant used in the processes, 
 ahd in the case of machinery or plant carried on board a ship not being a ship 
 registered in the United Kingdom it shall also be the duty of the master of 
 such ship, to comply with Part III of these regulations. 
 
 It shall be the duty of every person who by himself, his agents, or workmen 
 carries on the processes, and of all agents, workmen, and persons employed by 
 him in the processes, to comply with Part IV of these regulations. 
 
 It shall be the duty of all persons, whether owners, occupiers, or persons em- 
 ployed, to comply with Part V of these regulations. 
 
 Part VI of these regulations shall be complied with by the persons on whom 
 the duty is placed in that part. 
 
366 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 PAST I. 
 
 1. The following parts of every dock, wharf, or quay, as far as is practicable, 
 having regard to the traflBc and working, be securely fenced so that the height 
 of the fence shall be in no place less than 2 feet 6 inches, and the fencing shall 
 be maintained in good condition ready for use. 
 
 (a) All breaks, dangerous corners, and other dangerous parts of edges of a 
 dock, wharf, or quay. 
 
 (&) Both sides of such footways over bridges, caissons, and dock gates as are 
 in general use by persons employed, and each side of the entrance at each end 
 of such footway for a suflacient distance not exceeding 5 yards. 
 
 2. Provision for the rescue from drowning of persons employed shall be made 
 and maintained, and shall include: 
 
 (a) A supply of life-saving appliances, kept in readiness on the wharf or 
 quay, which shall be reasonably adequate, having regard to all the circum- 
 stances. 
 
 3. All places In which persons employed are employed at night, and any dan- 
 gerous parts of the regular road or way over a dock, wharf, or quay, forming 
 the approach to any such place from the nearest highway, shall be efficiently 
 lighted. 
 
 Provided that the towing path of a canal or canalized river shall not be 
 deemed to be " an approach " for the purpose of this regulation. 
 
 PAST n. 
 
 4. If a ship is lying at a wharf or quay for the purpose of loading or unload- 
 ing or coaling there shall be means of access for the use of persons employed 
 at such times as they have to pass from the ship to the shore or from the shore 
 to the ship, as follows: 
 
 (a) Where a gangway is reasonably practicable a gangway not less than 22 
 inches wide, properly secured, and fenced throughout on each side to a clear 
 height of 2 feet 9 inches by means of upper and lower rails, taut ropes, or chains, 
 or by other equally safe means. 
 
 (b) In other cases a secure ladder of adequate length. 
 
 Provided that nothing in this regulation shall be held to apply to cargo stages 
 or cargo gangways, if other proper means of access is provided in conformity 
 with these regulations. 
 
 Provided that as regards any sailing vessel not exceeding 250 tons net reg- 
 istered tonnage and any steam vessel not exceeding 150 tons gross registered 
 tonnage this regulation shall not apply if and while the conditions are such 
 that it is possible, without undue risk, to pass to and from the ship without the 
 aid of any special appliances. 
 
 5. If a ship is alongside any other ship, vessel, or boat, and persons employed 
 have to pass from one to the other, safe means of access shall be provided for 
 their use, unless the conditions are such that it is impossible to pass from one to 
 the other without undue risk without the aid of any special appliance. 
 
 If one of such ships, vessels, or boats is a sailing barge, flat, keel, lighter, or 
 other similar vessel of relatively low freeboard, the means of access shall be 
 provided by the ship which has the hiirher freeboard. 
 
 6. If the depth from the top of the coamings to the bottom of the hold exceeds 
 6 feet, there shall be maintained safe means of access by ladder or steps from 
 the deck to the hold in which work is being carried on, with secure handhold 
 and foothold continued to the top of the coamings. 
 
 In particular such access shall not be deemed to be safe : 
 
 (a) Unless the ladders between the lower decks are in the same line as the 
 ladder from the main deck, if the same is practicable having regard to the 
 position of the lower hatchway or hatchways. 
 
 (b) Unless the cargo is stowed sufficiently far from the ladder to leave at 
 each rung of the ladder sufficient room for a man's feet. 
 
 (c) If there is not room to pass between a winch and the coamings at the 
 place where the ladder leaves the deck. 
 
 (d) If the ladder is recessed under the deck more than is reasonably neces- 
 sary to keep the ladder clear of the hatchway. 
 
 7. When the processes are being carried on between one hour after sunset 
 and one hour before sunrise, (o) the places in the hold and on the decks where 
 w^>rk Is being carried on and (6) the means of access provided in pursuance of 
 regulatioM 4 and 6 shall be efflcientiy lighted, due regard being had to the 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 367 
 
 safety of the ship and cargo, of all persons employed, and of the navigation of 
 other vessels, and to the duly approved by-laws or regulations of any authority 
 having power by statute to make by-laws or regulations subject to approval by 
 some other authority. 
 
 8. All iron fore-and-aft beams and thwart-ship beams used for hatchway 
 covering shall have suitable gear for lifting them on and off without it being 
 necessary for any person to go upon them to adjust such gear. 
 
 PART in. 
 
 9. All machinery and chains and other gear used in hoisting or lowering in 
 connection with the processes shall have been tested, and shall be periodically 
 examined. All such chains shall be effectually softened by annealing or firing 
 when necessary, and all half-inch or smaller clu.ins in general use shall be so 
 annealed or fired once in every six months. 
 
 If the chains are part of the outfit carried by a seagoing ship, it shall be a 
 suflicient compliance with this regulation as regards softening by annealing or 
 firing of half-inch or smaller chains that no such chains shall be used unless 
 they have been so annealed or fired within six months preceding. 
 
 As regards chains, the safe loads indicated by the test, the date of last anneal- 
 ing, and any other particulars prescribed by the secretary of state, shall be 
 entered in a register which shall be kept on the premises, unless some other 
 place has been approved in writing by the chief inspector. 
 
 10. All motors, cogwheels, chains and friction gearing, shafting, and live elec- 
 tric conductors used in the processes shall (unless it can be shown that by their 
 position and construction they are equally aafe to every person employed as 
 they would be if securely fenced) be securely fenced so far as is practicable 
 without impeding the safe working of the ship without infringing any require- 
 ment of the board of trade. 
 
 11. The lever controlling the link motion reversing gear of a crane or winch 
 used in the processes shall be provided with a suitable spring or other locking 
 arrangement. 
 
 12. Every shore crane used in the processes shall have the safe load plainly 
 marked upon it, and if so constructed that the jib may be raised or lowered 
 either shall have attached to it an automatic indicator of safe loads or shall 
 have marked upon it a table showing the safe loads at the corresponding inclina- 
 tions of the jib. 
 
 13. The driver's platform on every crane or tip driven by mechanical power 
 and used in the processes shall be securely fenced, and shall be provided with 
 safe means of access. 
 
 14. Adequate measures shall be taken to prevent exhaust steam from any 
 crane or winch obscuring any part of the decks, gangways, wharf, or quay, 
 where any person is employed. 
 
 PAET IV. 
 
 15. No machinery or gear used in the processes, other than a crane, shall be 
 loaded beyond the safe load; nor a crane, unless secured with the written 
 permission of the owner by plates or chains or otherwise. 
 
 No load shall be left suspended from a crane, windli, or other machine unless 
 there is a competent person actually in charge of the machine while the load is 
 so left. 
 
 16. A boy under 16 shall not be employed as driver of a crane or winch, or 
 to give signals to a driver, or to attend to cargo falls on winch ends or winch 
 bodies. 
 
 17. Where in connection with the processes goods are placed on a wharf or 
 quay other than a wharf or quay on a shallow canal: (a) A clear passage lead- 
 ing to the means of access to the ship required by regulation 4 shall be main- 
 tained on the wharf or quay; and (&) if any space is left along the edge of the 
 wharf or quay, it shall be at least 3 feet wide and clear of all obstructions other 
 than fixed structures, plant, and appliances in use. 
 
 18. No deck stage or cargo stage shall be used in the processes unless it is 
 substantially and firmly constructed and adequately supported, and, where 
 necessary, securely fastened. 
 
 No truck shall be used for carrying cargo between ship and shore on a stage 
 so steep as to be unsafe. 
 Any stage which is slippery shall be made safe by the use of sand or otherwise. 
 
338 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 19. Where there is more than one hatchway, if the hatchway of a hold exceed- 
 ing 7 feet 6 inches in depth, measured from the top of the coamings to the 
 bottom of the hold, is not in use and the coamings are less than 2 feet 6 inches 
 in height, it shall either be fenced to a height of 3 feet or be securely covered. 
 
 Provided, That this regulation shall not apply during meal times or other 
 temporary interruptions of work during the period of employment 
 
 And provided, That until the 1st of January, 1908, the fending may be the best 
 the circumstances will allow without making structural alteration. 
 
 Hatch coverings shall not be used in connection with the processes in the 
 construction of deck or cargo stages, or for any other purpose which may 
 expose them to damage. 
 
 20. No cargo shall be loaded by a fall or sling at any intermediate deck unless 
 a secure landing platform has been placed across the hatchway at that deck. 
 
 PABT V. 
 
 21. No person shall, unless duly authorized, or In case of necessity, remove or 
 interfere with any fencing, gangway, gear, ladder, life-saving means or appli- 
 ances, lights, marks, stages, or other things whatsoever, required by these 
 regulations to be provided. 
 
 22. The fencing required by regulation 1 shall not be removed except to the 
 extent and for the period reasonably necessary for carrying on the work of the 
 dock or ship, or for repairing any fencing. If removed it shall be restored 
 forthwith at the end of that period by the persons engaged in the work that 
 necessitated its removal. 
 
 PAET VI. 
 
 23. No employer or persons in the processes shall allow machinery or gear 
 to be used by such persons in the processes that does not comply with Part III 
 of these regulations. 
 
 24. If the persons whose duty it is to comply with regulations 4, 5, and 7 fail 
 so to do, then it shall also be the duty of the employers of the persons employed 
 for whose use the means of access and the lights are required to comply with 
 the said regulation within the shortest time reasonably practicable after such 
 faih re. 
 
 2o. The certificate of the ship's register and any other certificate or register 
 referred to in these regulations shall be produced by the person in charge 
 thereof on the application of any of His Majesty's inspectors of factories. 
 
 A. Akebs-Douglas, 
 One of His Majesty's Principal Secretaries of State, 
 Home Office, Whitehall, 24th October, 1904. 
 
 Factoby Engines and Cabs. 
 
 Whereas the nse of locomotives, wagons, and other rolling stock on lines of 
 rail or sidings in any factory or workshop or any place to which the provisions 
 of section 79 of the factory and workshop act, 1901, are applied by that act, or 
 on lines of rail or sidings used in connection with any factory or workshop or 
 any place as aforesaid, and not being part of a railway within the meaning of 
 the railway employment (preventions of accidents) acts, 1900, has been certified 
 in pursuance of the said section to be dangerous: 
 
 I hereby, in pursuance of the powers conferred upon me by that act, make 
 the following regulations and direct that they shall apply to all places before 
 mentioned. 
 
 These regulations shall come into force on the 1st day of January, 1907, 
 except regulations 1, 2, and 22, which shall come into force on the 1st day of 
 January, 1908. 
 
 Subject to the exemptions below, it shall be the duty of— (i) The occupier of 
 any factory or workshop and any place to which any of the provisions of the 
 factory and workshop act, 1901, are applied, and (n) the occupier of any line 
 of rails or sidings used in connection with a factory or workshop, or with any 
 place to which any of the provisions of the factory and workshop act, 1901, are 
 applied, to comply with Part I of these regulations. 
 
 And It shall be the duty of every person who by himself, his agents or work- 
 men, carries on any of the operations to which these regulations apply, and of 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 369 
 
 all agents, workmen, and persons employed to comply with Part II of these 
 regulations. 
 
 And it shall be the duty of every person who by himself, his agents, or work- 
 men, carries on any of the operations to which these regulations apply, to com- 
 ply with Part III of these regulations. 
 
 In these regulations : 
 
 Line of rails means a line of rails or sidings for the use of locomotives or 
 wagons excepting such lines as are used exclusively for (a) a gantry crane or 
 traveling crane, or (b) any charging machine or other apparatus or vehicle used 
 exclusively in or about any actual process or manufacture. 
 
 Wagon includes any wheeled vehicle or nonself-moving crane on a line of 
 rails. 
 
 Locomotive includes any wheeled motor on a line of rails used for the move- 
 ment of wagons and any self-moving crane. 
 
 Gantry means an elevated structure of wood, masonry, or metal, exceeding 6 
 feet in height and used for loading or unloading, which carries a line of rails, 
 whereon wagons are worked by mechanical power. 
 
 Nothing in these regulations shall apply to: 
 
 (a) A line of rails of less than 3 feet gauge, and locomotives and wagons 
 used thereon. 
 
 (6) A line of rails not worked by mechanical power. 
 
 (c) A line of rails inside a railway goods warehouse. 
 
 (d) A line of rails forming part of a mine within the meaning of the coal 
 mines regulation act, 1887, or of a quarry within the meaning of the quarries 
 act, 1894, not being a line of rails within or used solely in connection with any 
 factory or workshop not incidental to the maintenance or working of the mine 
 or quarry or to the carrying on of the business thereof. 
 
 (e) Pit banks or mines to which the metaliferous mines regulation act, 1872, 
 applies, and private lines of rails used in connection therewith. 
 
 (/) Lines of rails used in connection with factories or workshops, so far as 
 they are outside the factory or workshop premises, and used for running pur- 
 poses only. 
 
 (g) Wagons not moved by mechanical power. 
 
 (h) Buildings in course of construction. 
 
 (i) Explosive factories or workshops within the meaning of the explosives 
 act, 1875. 
 
 ij) All lines and sidings on or used in connection with docks, wharves, and 
 quays not forming part of a factory or workshop as defined in section 149 of the 
 factory and workshop act, 1901. 
 
 (k) Wagon or locomotive building or repairing shops, and all lines and sidings 
 used in connection with such shops if such shops are in the occupation of a rail- 
 way company within the meaning of the regulation of railways act, 1871. 
 
 (I) Depots or car sheds being parts of tramways or light railway undertak- 
 ings authorized by Parliament, and used for the storage, cleaning, inspection, 
 or repair of tramway cars or light railway cars. 
 
 PABT I. 
 
 1. Point rods and signal wires in such a position as to be a source of danger 
 to persons employed shall be sufficiently covered or otherwise guarded. 
 
 2. Ground levers working points shall be so placed that men working them 
 are clear of adjacent lines, and shall be placed in a position parallel to the adja- 
 cent lines, or In such other position, and be of such form as to cause as little 
 obstruction as possible to persons employed. 
 
 3. Lines of rails and points shall be periodically examined and kept in efficient 
 order, having regard to the nature of the traffic. 
 
 4. Every gantry shall be properly constructed and kept in proper repair. It 
 shall have a properly fixed structure to act as a stop-block at any terminal 
 point; and at every part where persons employed have to work or pass on foot 
 there shall be a suitable footway, and if such footway is provided between a line 
 of rails and the edge of the gantry the same shall, so far as is reasonably 
 practicable, having regard to the traffic and working, be securely fenced at such 
 a distance from the line of rails as to afford a reasonably sufficient space for 
 such persons to pass in safety between the fence and a locomotive, wagon, or 
 load on the line of rails. 
 
 S. Doc. 644, 60-2 25 
 
370 EEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 5. Coupling poles or other suitable mechanical appliances shall be provided 
 where required for the purpose of regulation 11. 
 
 6. Proper sprags and scrotches, when required, shall be provided for the use 
 of persons in charge of the movement of wagons. 
 
 7. Where, during the period between one hour after sunset and one hour be- 
 fore sunrise, or in foggy weather, shunting or any operations likely to cause 
 danger to persons employed are frequently carried on, efficient lighting shall be 
 provided either by hand lamps or stationary lights, as the case may require, at 
 all points where necessary for the safety of such persons. 
 
 8. The mechanism of a capstan worked by power and used for the purpose of 
 traction of wagons on a line of rails shall be maintained in efficient condition, 
 and if operated by a treadle, such treadle shall be tested daily before use. 
 
 PAST II. 
 
 9. When materials are placed within 3 feet of a line of rails and persons em- 
 ployed are exposed to risk or injury from traffic by having to pass on foot over 
 them or between them and the line, such material shall, as far as reasonably 
 practicable, be so placed as not to endanger such persons, and there shall be 
 adequate recesses at intervals of not more than 20 yards where the materials 
 exceed that length. 
 
 10. No person shall cross a line of rails by crawling or passing underneath a 
 train or wagons thereon where there may be a risk of danger from traffic. 
 
 11. Locomotives or wagons shall wherever it is reasonably practicable without 
 structural alterations be coupled or uncoupled only by means of a coupling pole 
 or other suitable mechanical appliance, except where the construction of loco- 
 motives or wagons is such that coupling or uncoupling can be safely and con- 
 veniently performed without any part of a man's body being within the space 
 between the ends or buffers of one locomotive or wagon and another. 
 
 12. Sprags and scrotches shall be used as and when they are required. 
 
 13. Wagons shall not be moved or be allowed to be moved on a line of rails 
 by means of a prop or pole, or by means of towing by a rope or chain attached 
 to a locomotive or wagon moving on an adjacent line of rails when other rea- 
 sonably practicable means can be adopted; provided that this shall not apply 
 to the movement of ladles containing hot material on a line of rails in front of 
 and adjacent to a furnace. 
 
 In no case shall props be used for the above purpose unless made of iron, 
 steel, or strong timber, hooped with iron to prevent splitting. 
 
 14. Where a locomotive pushes more than one wagon, and risk of injury may 
 thereby be caused to persons employed, a man shall, wherever it is safe and rea- 
 sonably practicable, accompany or precede the front wagon or other efficient 
 means shall be taken to obviate such risk. 
 
 Provided that this regulation shall not apply to the following : 
 (a) Fly shunting. 
 
 (6) Movement of wagons used for conveyance of molten or hot material or 
 other dangerous substance. 
 
 15. No person shall be upon the buffer of a locomotive or wagon in motion 
 unless there is a secure handhold, and shall not stand thereon unless there Is 
 also a secure foot place ; nor shall any person ride on a locomotive or wagon by 
 means of a coupling pole or other like appliance. 
 
 16. No locomotive or wagon shall be moved on a line of rails until warning 
 has been given by the person in charge to persons employed whose safety is 
 likely to be endangered. 
 
 Provided that this regulation shall not apply to a self-moving crane within a 
 building or to a charging machine or other vehicle so long as it is used in or 
 about any actual process of manufacture. 
 
 17. Where persons employed have to pass on foot or work, no locomotive or 
 wagon shall be moved on a line of rails during the period between one hour 
 after sunset and one hour before sunrise, or in foggy weather, unless the ap- 
 proaching end, wherever it Is safe and reasonably practicable, is distinguished 
 by a suitable light or accompanied by a man with a lamp. 
 
 Provided that this regulation shall not apply to the movement of locomotivea 
 or wagons within any area which is efficiently lighted by stationary lights. 
 
 18. The driver In charge of a locomotive, or a man preceding it on foot, shall 
 give an efficient sound signal as a warning on approaching any level crossing 
 over a line of rails regularly used by persons employed, or any curve where 
 Bight Is Intercepted, or any other point of danger to persons employed. 
 
BEPORTS OF THE PRESIDENT'S HOMES COMMISSION. 371 
 
 19. A danger signal shall be exhibited at or near the ends of any wagon or 
 train of wagons undergoing repair wherever persons employed are liable to be 
 endangered by an approaching locomotive or wagon. 
 
 20. (a) The space immediately around such capstan as mentioned in regula- 
 tion 8 shall be kept clear of all obstruction. 
 
 (&) Such capstan shall not be set in motion until signals have been exchanged 
 between the man in charge of the capstan and the man working the rope or 
 chain attached to it. 
 
 (c) No person under 18 years of age shall work such capstan. 
 
 21. No person under the age of 18 shall be employed as a locomotive driver, 
 and no person under the age of 16 shall be employed as a shunter. 
 
 PAST m. 
 
 22. All glass tubes or water gauges on locomotives or stationary boilers used 
 for the movement of wagons shall be adequately protected by a covering or 
 guard. 
 
 H. J. Gladstone, 
 One of His Majesty's Princvpal Secretaries of State, 
 Home Omca, Whitehall, S4th August, 1906. 
 
 Appendix C. 
 
 The following is a letter received from Prof. H. W. Wiley, Bureau of Chem- 
 istry, United States Department of Agriculture : 
 
 Washington, D. C, November 4, 1908. 
 Mr. George M. Kober, 
 
 923 H Street NW., Washington, D. C. 
 
 Dear Sir : Your favor of October 27 at hand, and in reply desire to state that 
 the question of drug habit has received considerable attention by the division 
 of drugs, and could place at your disposal much valuable information. We are 
 collecting this information as rapidly as possible and expect in the near future 
 to submit to the Secretary for approval and publication a bulletin dealing with 
 acetanilid, antipyrin, and phenacetin. 
 
 We also are in possession of information as to the institutions and their meth- 
 ods of treating unfortunate drug habitues, particularly those addicted to the 
 use of opium, morphine, cocaine, etc. 
 
 I am inclosing copies of two bills which were introduced at the last session of 
 Congress. The object of these bills is to regulate and minimize the evil at pres- 
 ent resulting from the indiscriminate sale and use of the agents enumerated 
 therein. If you could make it convenient to visit the drug laboratory of this 
 bureau we would be in a position to place at your disposal much information 
 which would be of great assistance to you in your work. 
 Respectfully, 
 
 H. W. WiLirr, Chief. 
 
 The following is a letter received from Dr. Lyman F. Kebler, chief, division 
 of drugs, United States Department of Agriculture: 
 
 Washington, D. C, Novemher 21, 1908, 
 Dr. George M. Kobeb, 
 
 1819 Q Street, Washington, D. 0. 
 Dear Sir: I am herewith transmitting data on the following subjects: The 
 harmful effects of acetanilid, antipyrin, and acetphenetidin (phenacetin) ; can- 
 cer cures ; female pills ; soft drinks containing caffeine, etc. ; the dope question ; 
 consumption cures; habit cures, and prescription nostrums. I did not include 
 the list of headache remedies, for the reason that they are not as yet complete. 
 We have found approximately 365 which have a fairly large sale — that is, more 
 than the local sale of a drug store — but not more than one-half of same have been 
 investigated in the division of drugs. I shall be pleased to forward you the 
 entire list, with the understanding that there might be one or two which are 
 not actually headache remedies, but are believed to be such from the trading 
 name. 
 
 Respectfully, L. P. Kebler, 
 
 Chief, Division of Drugs. 
 
372 REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 SOFT DBINKS CONTAINING CAFFEINE AND EXTRACTS OF COCA LEAF AND KOLA NUT. 
 
 [By LxHAV F. Kbblbb, M. D., Ph. D., Chief, Division of Drugs, U. S. Department of 
 
 Agriculture.] 
 
 During the past decade soda-fountain specialties containing cafifeine, extract 
 of kola nut and extract of coca leaf, the active principle of which is cocaine, 
 have been offered in considerable quantities and, due to extensive and attractive 
 advertising, both as beverages and as headache remedies and nerve tonics, 
 their sale has assumed large proportions. 
 
 The first appearance of preparations of this type was in the South in the 
 eighties, their introduction following the success which Moxie had attained in 
 the East, though this particular drinli was of an entirely different character. 
 From the South the demand spread to other sections and the number of products 
 has increased until at the present time there are probably over one hundred of 
 them bottled and sold all over the United States. The greatest demand is still 
 in the South, however, and almost every drug store, confectionery shop, and 
 fruit stand has its favorite product on sale. The carbonated goods in bottled 
 form are offered on the trains. People of all classes, young and old, delicate 
 women, and even little children consume these beverages indiscriminately and 
 no warning is ever given of the baneful effect of the powerful habit-forming 
 drugs concealed therein. It is therefore small wonder that the prevalence of 
 the so-called "coca cola fiend" is becoming a matter of great importance and 
 concern. 
 
 It is well known that some of these products are mixed under the most un- 
 sanitary conditions. The sugar, water, and drug material will be dumped into 
 a pot standing in the cellar of some low building, or even a stable, where the 
 ceiling is covered with dust, cobwebs, and dirt of all descriptions and the floor 
 littered with filth. The steam from the boiling kettle, condensing on the ceiling, 
 collects the dirt in the drops of water and this soon falls back into the mixture. 
 Again, the sirup will boil over onto the floor and a sticky mass remains which 
 soon collects straw and filth of all descriptions and becomes a rendezvous for 
 flies and other vermin, for usually no attempt is made to clean it up. 
 
 Judging from the names of most of these products it would appear that ex- 
 tract of kola nut is one of the chief ingredients, and, while in certain instances 
 this drug is undoubtedly present, in most cases the caffeine has been added as 
 the alkaloid caffeine obtained from refuse tea sweepings or made artificialy 
 from uric acid occurring in the Guano deposits of South America, or in the 
 citrated form, and the sirup colored with caramel. The cocaine found is usually 
 added in the form of extract of coca leaf. Some of the manufacturers claim 
 that the extract used is prepared from a decocainized coca leaf, the refuse prod- 
 uct discarded in the manufacture of cocaine. 
 
 An investigation of these products was undertaken about a year ago and it 
 was found ttiat the following products contained both caffeine and extract of 
 coca leaf: 
 
 Afri CJola, The Afri Cola Co., Atlanta, Ga. 
 
 Ala Cola, Ala Bottling Works, Bessemer, Ala. 
 
 Cafe Coca, Athens Bottlmg Works, Athens, Ga. 
 
 Carre Cola, R Carre Co., Mobile, Ala. 
 
 Celery Cola, The Celery Cola Co., Birmingham, Ala. ; Dallas, Tex. ; Nash- 
 ville, Tenn., and St Louis, Mo. 
 
 Chan Ola, L. M. Channell, New Orleans, La. 
 
 Chera Cola, Union Bottling Works, Columbus, Ga. 
 
 Coca Beta, the Coca Beta Co., New York City. 
 
 Coca Beta, Southern California Supply Co., Los Angeles, CaL 
 
 Coca Cola, Coca Cola Co., Atlanta, Ga. 
 
 Pilsbury's Coke, A. L. Pilsbury, jr., Co., New Orleans, La. 
 
 Cola Coke, Lehman-Rosenfeld Co., Cincinnati, Ohio. (This preparation 
 was formerly sold under the name of Rocco Cola.) 
 
 Cream Cola, Jebeles & Calias Co., Birmingham, Ala. 
 
 Dope, Rainbow Bottling Co., Atlanta, Ga. 
 
 Four Kola, Big Four Bottling Works, Waco, Tex, 
 
 Hayo Kola, Hayo Kola Co., Norfolk, Va. 
 
 Heck's Cola, Heck & Co., Nashville, Tenn. 
 
 Kaye Ola, A. W. Kaye, Meridian, Miss. 
 
 Koca Nola, Koca Nola Co., Altanta, Ga. 
 
 Koke, Coleman & McKeever, Frankfort, Ky. 
 
REPORTS OF THE PRESIDENT'S HOMES COMMISSION. 373 
 
 Kola Ade, Wiley Manufacturing Co., Atlanta, Ga, 
 
 Kola Kola, W. J. Stange Ck)., Chicago, 111. 
 
 Kola Phos, John Wyeth & Bro., Philadelphia, Pa. 
 
 Koloko, Halberg Bottling Works, Mobile, Ala. 
 
 Kos Kola, Sethness Co., Chicago, 111. 
 
 Lime Cola, Alabama Grocery Co., Birmingham, Ala. 
 
 Lima Ola, Wine Brew Co., Macon, Ga. 
 
 Mellow Nip, Rainbow Bottling Co., Atlanta, Ga. 
 
 Nerv Ola, Henry K. Wampole & Co., Philadelphia, Pa. 
 
 Revive Ola, O. L. Gregory Vinegar Co., Birmingham, Ala. 
 
 Rocola, American Manufacturing Co., Savannah, Ga. 
 
 Rye Ola, Rye Ola Co., Birmingham, Ala. 
 
 Standard Cola, The Standard Bottling Co., Denver, Colo. 
 
 Toka Tona, California Commercial Co., Los Angeles, CaL 
 
 Tokola, Samuel Smith & Co., Chicago, 111. 
 
 Vani Kola, Vani Kola Company, Canton, Ohio. 
 
 Vim-0, Vim-0 Company, Eagle Lake, Tex. 
 
 French Wine of Coca, Wine of Coca Co., Boston, Mass. 
 
 Wise Ola, The Wise Ola Co., Birmingham, Ala. 
 The following preparations were found to contain caffeine, but there was no 
 evidence to the effect that coca leaf in any form had been used in their manu- 
 facture : 
 
 Calycine, Calycine Co., Norfolk, Va. 
 
 Celery Cocoa, Celery Cocoa Co., Los Angeles, Cal, 
 
 Citro Cola, Miners Fruit Nectar Co., Boston, Mass. 
 
 Deep Rock Ginger Ale, Abney Bros., Athens, Ga. 
 
 Fosko, E. Carre Co., Mobile, Ala. 
 
 Heck's Star Pepsin, Mrs. Ida Heck, Nashville, Tenn. 
 
 Koke, Coan & Harbin, Bluff City Bottling Co., Memphis, Tenn. 
 
 Koke Ola, Eagle Bottling Co., Frankfort, Ky. 
 
 Kalafra, Mead Johnson Co., Jersey City, N. J. 
 
 Kumfort, The Kumfort Co., Atlanta, Ga. 
 
 Lime Juice and Kola, Parke Davis & Co., Detroit, Miclu 
 
 Lon Kola, Lon Kola Co., Danville, Ky. 
 
 Meg-0, Parr Bros., Baltimore, Md. 
 
 Mexicola, Celiko Bottling Works, Raleigh, N. C. 
 
 Pau Pau Cola, Pau Pau Cola Co., Detroit, Mich. 
 
 Pedro, N. J. Parker & Co., Washington, D. C. 
 
 Pepsi Cola, C. D. Bradham, New Bern, N C. 
 
 Speed Ball, E. Pilzer, Speed Ball Co. (Inc.), Washington, D. C 
 
 To-Ko, The To-Ko Company, Hagerstown, Md. 
 
 Vril, Brand Bros., Chicago, 111. 
 Besides the above preparations which have been analyzed a number were 
 reported from different parts of the country but no samples were submitted. 
 From their names, and from what evidence there waa submitted, they contain 
 either caffeine of coca leaf extract, or both: 
 
 Charcola, H. C. Metzger, Meridian, Miss. 
 
 Cherry Kola, Williamsport, Pa. 
 
 Cola Soda, Jacob House & Sons, Buffalo, N. T. 
 
 Coca Ginger, National Beverage Co., Atlanta and Chattanooga. 
 
 Field's Cola, H. C. Field, High Point, N. C. 
 
 Imported French Cola, Alabama Grocery Co., Birmingham, Ala. 
 ( Claimed to be carbonated Wiseola.) 
 
 Jacob's Kola, Tampa, Fla. 
 
 Koko Ale, Salt Lake City Soda Water Co., Salt Lake City. 
 
 Kola Cream, The Henzerling Co., Baltimore, Md. 
 
 Kola Pepsin Celery Wine Tonic, W. J. Miller, Cleveland, Ohio. 
 
 Kola Vena. 
 
 Loco Kola, Norton, Va. 
 
 Mintola, Davis Kelley Co., Louisville, Ky. 
 
 Mate, Mississippi Ice Co., Clarksdale, Miss. 
 
 Pikmeup, Scales, Wilson Co., Greenville, S. C 
 
 Ro-Cola, Savannah, Ga. 
 
 Schelhorns Cola, Evansville Bottling Co., Evansville, Ind. 
 
 Vine Cola, California Commercial Co., Los Angeles, Cal. 
 
 Viz, Alabama Grocery Co., Birmingham, Ala. (Claimed to be carbon- 
 ated Wiseola.) 
 
374 EEPOBTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 HABIT CUBES. 
 
 [By Ltman F. Keblke, M. D., Fh. D., Chief, Division of Drugs, U. S. Department of 
 
 Agriculture. ] 
 
 Nostrums for the cure of the drug and liquor habits are widely advertised 
 throughout the country in the public press. A request for further information 
 with regard to the subject of one of the advertisements is followed by the receipt 
 of printed matter setting forth the virtues of the remedy, and a " symptom 
 blank " whereon the inquirer is expected to state over his signature the kind 
 of drug he is using and the dose which he is accustomed to take daily. Upon 
 returning this blank, filled out, the inquirer is informed as to the price at which 
 the remedy in quesion can be procured. This is usually at a specified price per 
 bottle, or treatment, treatment being reckoned by the month. Some concerns 
 do not employ the symptom blank, but sell their products to all who apply, 
 without question. In almost every case the remedy contains a generous pro- 
 portion of an opiate, usually in the form of morphine. Ostensibly the treat- 
 ment is based upon the reduction plan; the patient is advised to give up the 
 use of the drug which he was formerly taking and to depend entirely upon the 
 remedy, and to reduce the daily dose of this at regular intervals until he finally 
 does away with its use entirely. This, as a matter of fact, he never does, 
 because he finds it just as diflicult to break away from the morphine-containing 
 "support" as from the straight morphine which he formerly took. Meantime 
 the concern which furnishes the nostrum reaps pecuniary benefit. 
 
 Most of the nostrums for the cure of the liquor habit depend for their efficacy 
 upon the nauseating qualities of the ingredients which they contain. * * ♦ 
 The remedy can be taken voluntarily by the patient himself, or administered 
 secretly by introducing it surreptitiously into his food or drink. Promises of a 
 most alluring character are held out with regard to the latter method of admin- 
 istration, and the wives and mothers of drunkards have been known to go great 
 lengths to procure the money wherewith to purchase these nostrums. The 
 result of both methods of administration is the same — the patient's stomach 
 and digestion are injured, perhaps permanently, and no real good is accom- 
 plished. A list of the " cures " for the drug and alcohol habit is given below. 
 
 HABITS. 
 
 Drug cures, 
 
 W. J. Carney, 567 Lebanon street, Melrose, Mass. (Opium.) 
 
 St. Paul Association, 46-48 Van Buren street, Chicago. (Drugs.) 
 
 Purdy Sanitarium, 614^ Fannin street, Houston, Tex. 
 
 Harris Institute, 400 West Twenty-third street. New York. (Drugs.) 
 
 O. P. Coates Co., 917-919 New York Life Building, Kansas City. 
 
 (Drugs.) Habitina. 
 Dr. Stewart-Hord Sanitarium, 360 Franklin avenue, Shelbyville, Ind. 
 
 (Drugs.) 
 Waterman Institute, 14-18 Lexington avenue, New York. (Drugs.) 
 Cedarcroft Sanitarium, Lebanon, Tenn. 
 New Malay Opium Cure, Rev. J. C. Ives, 134 East Twenty-fifth street, 
 
 New York. 
 •*99" Morphine & Opium Cure, Krouskeep, Clark and Van Buren 
 
 streets, Chicago. 
 St. James Society, Suite 245, 1181 Broadway, New York. (Drugs.) 
 Manine Medical Co., 3201 Locust street, St. Louis. (Drugs.) 
 B. M. Wolley Co., Atlanta, Ga., Box 887. (Opium, whisky, etc.) 
 Alexand^ Cooperative Sanitarium Co., Fulton, Ky. 
 Dr. W. A. Steams, Atlanta, Ga. 
 Dr. W. J. Tucker, Atlanta, Ga. 
 Dr. L. F. Myers, Columbus, Ga. 
 Dr. G. W. D. Patterson, Atlanta, Ga. 
 The Acme Opium Cure, Kirk wood, Ga. 
 James Sanitarium, Memphis, Tenn. 
 Drug Crave Crusade, 41 Union Square, New York. 
 Dr. J. L. Stevens Co., Lebanon, Ohio. Hyoscin. 
 Comstock Remedy Co., Lafayette, Ind. (Fluid Extract Coca.) 
 National Aid Society, 134 East Twenty-fifth street. New York. 
 
REPORTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 376 
 
 Windsor Laboratories, 134 East Twenty-fifth street, Yew York. Malay 
 
 Opium Co. 
 Ricbie Co., 105 St. James Place, Brooklyn, N. Y. 
 Mackay Treatment Co., 61 Maiden Lane, New York. 
 Scientific Remedy Co., 45 West Thirty-fourth street, New York. 
 Oppenheimer Institute, 159 West Thirty-fourth street, New York. 
 Mrs. Carney, 567 Lebanon street, Melrose, Mass. 
 World Remedy Co., Syracuse, N. Y. 
 H. C. Keith, Losantville, Ind, 
 
 The Dr. Koonse Cure, 812 Calbtun street. Ft. Wayne, Ind. 
 Compound Oxygen Association, 125 Douglas avenue, Ft. Wayne, Ind. 
 Awaine's Antidote Sanitarium, Cleveland, Ohio, 3731 Cedar avenue. 
 Dr. Rutledge Medical Institute, 477 Ellicott Square, Buffalo, N. Y. 
 Lanoix Cure Co., Kansas City, Mo. 
 Dr. W. J. McKanna, Reidsville, N. C. 
 Delta Chemical Co.. St. Louis, Mo. 
 
 AlcohoL 
 
 Orrine. (Alcohol.) 
 
 White Ribbon Remedy Co., 218 Tremont street, Bdston. 
 
 Dr. J. W. Haines, 1515 Gleen Building, Cincinnati, Ohio. 
 
 The Dr. Brannaman Cure, 210 Chaman Building, Kansas City. 
 
 Aur-Mon-0, 110 West Thirty-fourth street. New York. 
 
 James Sanitorium, Memphis, Tenn. 
 
 Mrs. Margaret Anderson, 512 Home avenue, Hillburn, N. Y. 
 
 Physicians Co-operative Association, Chicago. 
 
 Parker Willis, 16 State Life building, Indianapolis, Ind. 
 
 Kansas Anti-Liquor Society, 601 Gray Buildings, Kansas City. 
 
 Trunk Bros. Drug Co., 400-402 Sixteenth street, Denver, Colo. (Ciga- 
 rette habit.) 
 
 Rogers Drug & Chemical Co., "Easy to Quit," 1982 Fifth and Race 
 streets, Cincinnati. 
 
 DE. KEBLEE'S list OF HEADACHE BEMEDIES. 
 
 A. B. C. Headache Powders. 
 Acetafein (O. C. & Son). 
 Acetalix. 
 
 Acetanilide Comp. U. S. P. 
 Acetanol. Headache Powders. 
 Ache-Head. 
 
 Acme Headache Wafers. 
 A. D. S. Headache Wafers. 
 Dr. Agnew's Headache Tablets. 
 Ake-in-the-Head-Tablets. 
 Alex Harmless Headache Powders. 
 Allen's Headache Powders. 
 Alpha Headache Wafers. 
 Ammonol. 
 
 Analgia (Merrell's) Tablets. 
 Analgine. 
 
 Anti-headache ( Davis ) . 
 Anti-Headache Moroneys. 
 Antikamnia. 
 
 Anthony's Headache Powders. 
 Anti-Pain Pills. 
 
 Armstrong's Headache Powder. 
 Atkinson's "99." 
 Babcock's Headache Pills. 
 " Bar-Ben " Formula A, for headache. 
 Barton's Headache Powders. 
 Beck's Little Wonder Headache Pow- 
 ders. 
 Beck's Universal Headache Tablets. 
 Beekman Headache Wafers. 
 Bell's Coryza Tablets. 
 
 Bensen's Headache Powders. 
 
 B enter's Headache Powders. 
 
 Bergwall's Acme Headache Wafers. 
 
 Big 4 Headache Powders. 
 
 Billington's Headache Powder. 
 
 Bi-Lo-Zone. 
 
 Bird's Headache Tablets. 
 
 Block's Headache Cure. 
 
 Dr. Bob's Headache Powder. 
 
 Dr. Bonker's Headache Powder. 
 
 Bouchard's Capsules. 
 
 Boulanger's Headache Cure. 
 
 Bovine Headache Powder. 
 
 Brain Food. (Harper's.) 
 
 Brangeine. 
 
 Brant's Headache Tablets. 
 
 Brazilian Compound Anti-Headache 
 
 Tablets. 
 Broa's Headache Powders. 
 Bromo Caffeine. (K. & M.) 
 Bromo-Celery. ( Arnold. ) 
 Bromo Compound. (Arnold's.) 
 Bromodine for Headache. 
 Bromo-kamnia. 
 Bromoline. 
 Bromo Lithia. 
 Bromonia. 
 
 Bromo-QHinine-Laxative. 
 Bromo- Seltzer. 
 Bromo-Soda. (Warner's.) 
 Bromo-Tanilid. 
 
376 
 
 REPOKTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 Bromo Vichy. 
 
 Bromo Vin. 
 
 Brook's Headache Powder. 
 
 Bro-tanilid. 
 
 Brow-ease. 
 
 Bull's Headache Specific 
 
 Caf-Aceton. (Wyeth's.) 
 
 Caffeine Compound. 
 
 Campaign Headache Tablets. 
 
 Capudine. 
 
 Carey's Heart Tonic Headache Wafers.i 
 
 Cascara Bromide Quinine. (Hill's.) 
 
 Catarrh & Headache Snuff. (Mar- 
 shall's.) 
 
 Celery-Caffeine. ( Chelf s. ) 
 
 Celery & Caffeine Bromide. (French's.) 
 
 Celery Fomo. 
 
 Celery Tea. 
 
 Celery Vesce. 
 
 Cencura. For headache. 
 
 Cephalgine. 
 
 Cephaline. 
 
 Cerralgine. 
 
 Chinese Headache Cure. 
 
 Dr. Clay's Headache Powders. 
 
 Clover Headache Powders. 
 
 Coffee-no. 
 
 Cold Capsules. (Stott's.) 
 
 Cole's Headache Cure. 
 
 Cole's Headache Powder. 
 
 Coppai's Headache Cure. 
 
 Coronet Headache Cure. (Bacon.) 
 
 Courney's Headache 15 minutes. 
 
 Cran-O-Tone. 
 
 Craemer's Headache Powders. 
 
 Crown Headache Powder. 
 
 Curalgia. 
 
 Daggett & Ramsdeirs Headache Pow- 
 der. 
 
 Daisy Headache Powder. 
 
 Daisy Headache Wafer. 
 
 Dale, Hart & Co.'s Headache Powder. 
 
 Darling's Cold Cure. 
 
 Darlington's Headache Powder. 
 
 Davidson's Headache Powders. 
 
 Davis's Headache Cure. 
 
 De Kalb's Anti-Headache Powders. 
 
 De Kay's Headache Wafers. 
 
 De Loste's Headache Powders. 
 
 Dick's Laxative Cold Cure. 
 
 Dllliard's Headache Powder. 
 
 Doris's Headache Buttons. 
 
 Dutton Headache Powders. 
 
 Duffs Headache Specific. 
 
 Eames's Tonic Headache Wafers. 
 
 EbbS Kolo Caffeine Headache Tablets. 
 
 Eddy's Headache Specific. 
 
 Eezee's Headache Cure. 
 
 Electric Headache Powder. 
 
 Empire Headache Wafers. 
 
 Eureka Headache Powder. 
 
 Eureka Headache Cure. 
 
 Fabra's Headache Cure. 
 
 Falling's Headache Powder. 
 
 Falck's One Minute Headache Cure. 
 
 Father Schubert's Little Headache 
 Tableta. 
 
 Fisher's Headache Capsules. 
 
 Fisher's Quick Headache Cure. 
 
 Five Minute Headache Powder. 
 
 Flag Salt. 
 
 Flower's Sure Headache Cure. 
 
 Dr. Foote's Headache Powder. 
 
 Fowler's Magic Headache Powder. 
 
 Garfield Headache Powders. 
 
 Geneseo Headache & Neuralgia Rem- 
 edy. 
 
 G. E. S. S. Headache Tablets. 
 
 Gessler's Headache Wafers. 
 
 Getman's Headache Powder. 
 
 Gibson's Instant Headache Cure. 
 
 Gipsy Headache Wafers. 
 
 Goldsmith's Headache Wafers. 
 
 Goll's Dollar Headache Cure. 
 
 Good's Headache Cure. 
 
 Gregory's Headache Powder. 
 
 Grosser's Headache Cure. 
 
 Guarana Compound. 
 
 Guy's Headache Powder. 
 
 Hageman's Headache Wafers. 
 
 Haller's Headache & Neuralgia Cure, 
 
 Haller's Relief Headache Powder. 
 
 Hall's One-Minute Headache Cure. 
 
 Hantz's Headache Tablets. 
 
 Harmless Headache Powder. 
 
 Dr. Hart's Headache Powder. 
 
 Hartwig's Headache Tablets. 
 
 Hawley's Celery Headache Capsules. 
 
 Head-A-Cure. 
 
 Headache Antidote. (Edward's.) 
 
 Headache Chocolates. 
 
 Headache Konseals. 
 
 Headache Powders. (Kellogg & Car- 
 rier.) 
 
 Headachine. 
 
 Headache Stop. 
 
 Head-Ease. (Bethea's Liquid.) 
 
 Head-Ease. (Cumming's.) 
 
 Head - Ease. ( Peter - Heat - Richard- 
 son's. ) 
 
 Head-Ease. ( White's. ) 
 
 Head-Easy. (Stedman's.) 
 
 Headline. 
 
 Headache Kolone. 
 
 Headache Kuro. 
 
 Headoria. (Pearson's.) 
 
 Hed-ake. (Preston's.) 
 
 Hedakur. (Hasson's.) 
 
 Hed-Kure. (Saenger's.) 
 
 I. N. Hegeman & Co., Headache Pow- 
 der. 
 
 Henry's (Dr.) Headache Powder. 
 
 Hick's Capudine. 
 
 Hobson's Headache Cure. 
 
 Hoffman's Harmless Headache Pow- 
 der. 
 
 Hogan's Headache Powder. 
 
 Holland's Headache & Neuralgia Pow- 
 der. 
 
 Holloway's Headache Powder. 
 
 Howe's Headache Cure. (P. M. Co.) 
 
 Hufeland's Sure Headache Cure. 
 
 Hutchln's Headache Pills. 
 
 L C. R. Cold k Catarrh Relief. 
 
EEPOETS OF THE PRESIDENT S HOMES COMMISSION. 
 
 377 
 
 Imperial Headache Powder. 
 
 Instant Headache Wafers. (Brown & 
 Hoff.) 
 
 I. S. M. A. Caffanllld. 
 
 James's Headache & Liver Pills. 
 
 Dr. J. W. James's Miniature Headache 
 Powder. 
 
 Japanese Rapid Headache Powder. 
 
 Johnson's Headache Powder. 
 
 Johnson's Utah Headache Salt. 
 
 Jones's Cold & Grippe Cure. 
 
 Joslyn's Instant Headache Tablets. 
 
 Kahle's Headache Powder. 
 
 Kali-Caffein. (Claimed to be a salt.) 
 
 Kalluorine. Headache Powder. 
 
 Kapitol Headache Wafers. 
 
 Kef. 
 
 Kelly's Headache Cure. 
 
 Kennedy's Headache Powder. 
 
 Kennedy's Headache Tablets. 
 
 King's Headache Tablets. 
 
 Knox-a-Cold Tablets. 
 
 Knill's Orange Headache Pills. 
 
 Kohler's Headache Powders. 
 
 Koladine. 
 
 Kolo-Caffein. 
 
 Kolone. (Lakln's Hedake.) 
 
 Koos* Nervine Headache Powder. 
 
 Kopfaline. 
 
 Kramer's Headache Capsules. 
 
 Kra-Nol. 
 
 Krause's Headache Capsules. 
 
 La Belle Headache Tablets. 
 
 Lake's Headache Powder. 
 
 Lamprey's Headache Cure. 
 
 Lane's Headache Capsules. 
 
 Lantz's Gold Coin Headache Cure. 
 
 Lawrence's Headache Powder. 
 
 Laxacold. 
 
 Laxative Bromo Quinine. (Paris 
 Med. Co.) 
 
 Lemon Seltzer. 
 
 Lemke's Headache Powder. 
 
 Lesage's Headache Specific. 
 
 Leslie's Headache Prescription. 
 
 Dr. Little's Headache Specific. 
 
 Little Wonder Headache Powder. 
 
 Dr. Lord's Headache Powder. 
 
 Dr. Lung's Headache Powder. 
 
 Magnet Headache Cure. 
 
 Marquet's Headache Wafers. 
 
 Martin's Headache Cure. 
 
 Man's Headache Powder. 
 
 McGale's Headache Cure. 
 
 McGrath's Headache & Neuralgia Tab- 
 lets. 
 
 Malydor Injection. 
 
 Megrimine. ( Whitehall's. ) 
 
 Metzger's Headache Tablets. 
 
 Meyer's Headache & Neuralgia Cure. 
 
 Microtine. (Lepper's.) 
 
 Migrainin. (Baker's.) 
 
 Migrainoes. (Digestine Co.) 
 
 Migrain Tablets for Headache. 
 
 Migrain Tablets. (Squibbs'.) 
 
 Migrane Tablets. 
 
 Miles's Anti-Pain Pills. 
 
 Momad's Headache Capsules. 
 
 Moore's Harmless Headache Powder. 
 
 Morgan's Headache Wafers. 
 
 Morin's (Dr. Ed.) Headache Wafers. 
 
 Morrison's Headache Cure. 
 
 Moyer's Headache Tablets. 
 
 Mueller's German Headache Powder. 
 
 Munyon's Headache Remedy. 
 
 Narco Headache Remedy. 
 
 Narco Cold Tablets. 
 
 Natronilid. (Peck.) 
 
 Nature's Headache Tablets. 
 
 Nervease Powders. 
 
 Neuralgolyne. 
 
 Neuralgia Capsules. 
 
 Neuralgine. 
 
 Neuralgyline. 
 
 New Era Headache Cure. 
 
 " 999 " Headache Powder. 
 
 Now or Never Headache Powder. (H 
 M. Co.) 
 
 Nyal's Headache Cure. 
 
 Oa Oa Headache Powder. 
 
 O. K. Headache Cure. (Houston Drug 
 Co.) 
 
 Olusa Headache Powders. 
 
 Omega Headache Powders. (Bab- 
 cock's.) 
 
 Orangeine. 
 
 Orien's Headache Cure. 
 
 Otto's " Such A " Headache Powder. • 
 
 Pain in Your Head. (Cooper's.) 
 
 Pain King. (John's.) 
 
 Pain King. (Shaker's) 
 
 Pain Paint. (Goll's.) 
 
 Pain Paint. (Wolcott's.) 
 
 Paragon Headache Remedy. 
 
 Parker's Headache Powder. 
 
 Pasteur's Stop a Pain Tablets. 
 
 Peck's Headache Powder. 
 
 Peek's Headache Powder. 
 
 Peerless Headache Powder. 
 
 Perfection Headache Wafers. 
 
 Perrine's Quick Relief. Headache 
 Powder. 
 
 Perry's Headache Powder. 
 
 Perry's Headache Wafers. 
 
 Phenalgine. 
 
 Phenine. Headache Powder. 
 
 Phenokola. Headache Powder. (B. & 
 SO 
 
 Phenolgin. 
 
 Phenyo-Cafifein. 
 
 Phospho-Caffeine Compound. 
 
 Piatt's Headache Wafers. 
 
 Positivus Headache Tablets. 
 
 Poythress Cold & Grippe Cure. 
 
 Preston's Hed-Ake Cure. 
 
 Princess Headache Powder. 
 
 Pusheck's Cold Tablets. 
 
 Quaker Headache Capsules. 
 
 Quick Cure. (Dr. Wood's.) 
 
 Quick Relief Headache Cures. 
 
 Quickstop. (Mattison's.) 
 
 Ramee's Sick Headache Remedy. 
 
378 
 
 EEPOKTS OF THE PRESIDENT S HOMES COMMISSION. 
 
 Ramsey's Headache Elixir. 
 Raphael's Headache Wafers. 
 Rawleigh's Quinine 15 Minute Tablets. 
 Red Dragon Seltzer. 
 Rennard's Headache Remedy. 
 Requa's Headache Powder. 
 Rexall Headache Pills. 
 Rexall Headache Powder. 
 Rexall Tablets. 
 
 Richardson's Headache Powder. 
 Rich's Headache Powder. 
 Rough on Headache Tablets. 
 Royal Headache Powder. 
 Royal Headache Tablets. 
 Salvitae Headache Tablets. 
 Sanderson's Headache Cure. 
 Sand Mountain Headache Tablets. 
 Sanltatis Headache Tablets. 
 Sano Headache Cure. 
 Sawyer's Headache Powder. 
 Schmidt's Headache Cure. 
 Schrader's Headache Powder. 
 Shilling's Bromo Headache Tablets. 
 Shoop's 20-Minute Headache Tablets. 
 Shrader's 10-Minute Headache Powder. 
 Solan's Headache Wafers. 
 Soda Caffo Headache Tablets. 
 So-Doc. Headache Cure. 
 Spen's Headache Tablets. 
 Stanton's Harmless Headache Powder. 
 Schwalb's Electric Headache Powder. 
 S. & D.'s Headache Salt. 
 Severa's Headache & Neuralgia Wafers. 
 S. & H.'s Headache Salt. 
 Shac-Stearn's Headache Cure. 
 Sherlou's Headache Powder. 
 Sherman's Headache Cure. 
 Stark's Headache Powder. 
 Steam's Headache Cure. 
 Stewart's (Dr.) Headache Powder. 
 Scott's Cold & Grippe Tablets. 
 Sunshine Headache Powder. 
 Swift's (Dr.) Headache Cure. 
 Talbot's Headache Wafers. 
 
 Taylor's Headache Powder. 
 Ten Thousand Dollar Headache Tab- 
 lets. 
 Thieman's Headache Powders. 
 Thurston's Headache Powder. 
 Tousley's Catarrh Powder. 
 Truc's Headache Tablets. 
 Tubb's Cold & Grippe Tablets. 
 Tucker's Fever & Headache Powder. 
 Turkish Headache Powder. 
 Uncle Sam's Kola Headache Powder. 
 Van Marter's Headache Powder. 
 Vegelene Headache Tablets. 
 Vegeta Headache Powder. 
 Vick's " Kadok " Headache Powder. 
 V-0 Headache Relief. 
 Walker's Headache Wafers. 
 Wall's (Dr.) Headache Powder. 
 Ward's Headache Powder. 
 Watkin's Headache Tablets. 
 Wayne's Headache Powder. 
 Webster's Headache Powder. 
 Weeks' Break Up a Cold Tablets. 
 Welliug's Headache Cure. 
 Wheat's Headache Powders. 
 White Seal Headache Powder. 
 White & White Headache Powder. 
 Wing's Headache Specific. 
 Wischerth & Dogler's Headache Pow- 
 der. 
 Wright's Paragon Tablets. 
 Wolfs Headache Cure. 
 Wood's Headache Tablets. 
 Wonder Cure Headache Powders. ' 
 X L Headache Wafers. 
 Yager's Handy Headache Tablets. 
 Yarnell's Columbian Headache Cure. 
 Young's Headache Powder. 
 Yu Kan Headache Powder. 
 Zeman's Headache Powders. 
 Zogat's Headache Powder. 
 Zerbst's Little Giant Headache Remedy. 
 Zerze's Positive Headache Cure. 
 
 FEMALE PILLS. 
 
 [By Lyman F. Kebleb, M. D., Ph. D., Chief, Division of Drugs, U. S. Department 
 
 of Agriculture.] 
 
 The publication of advertising matter inviting attention to means whereby 
 conception can be prevented or abortion produced is specifically prohibited by 
 law. Hence the manufacturers of drug products which are intended to be used 
 for these purposes are careful not to state openly in their advertising literature 
 the purposes for which their preparations are intended. They manage, how- 
 ever, to convey this information in such a way that those who are interested 
 can readily understand. This is effected largely through the character of the 
 name employed for the preparation, and through the agency of more or less 
 guarded statements which appear upon the label or in the advertising literature. 
 The name of most of these preparations are in themselves characteristic. They 
 often contain the names of drugs which have come to be more or less widely 
 known as emmenagogues or abortifiacients, for example, " Pennyroyal Pills," 
 "Tansy Pills," "Cotton-root Pills." Others are so worded as to be equally 
 characteristic : " Female Regulating Pills," " Female Regulator," " French Pills," 
 ** Female Pills," etc. Each of these terms indicate more or less clearly the 
 purpose for which the preparation is intended. In addition more or less 
 guarded statements appear in the advertising literature. These preparations 
 
EEPOETS OF THE PRESIDENT'S HOMES COMMISSION. 379 
 
 are rarely recommended for the purpose mentioned above only, but are in most 
 cases recommended for the cure of about all of the diseases to which the 
 peculiar female organism is liable. Among these conditions, " Suppressed Men- 
 struation " is given especial prominence. The following, taken from the adver- 
 tising literature of some of the products in question, are given in illustration . 
 " French Pills. Safe and Positively Infallible. Believes Painful and Sup- 
 pressed Menstruation," etc. * * ♦ 
 
 Female Beans, Lion Drug Ck)., Buffalo. 
 
 Feminina, Mansfield Drug Co., Memphis. 
 
 Dr. Trousseau's Celebrated Female Cure, Dr. Trousseau Chemical Co., 
 New York. 
 
 Female Pills, Arch Pharmacal Co.^, San Francisco. 
 
 Dr. Arthur's Pennyroyal & Tansy Pills, Palestine Drug Co., St. Louis. 
 
 Dr. Bane's Female Pills, A. V. Bane Medical Co., St. Joseph, Mo. 
 
 Dr. Cheeseman's Female Regulating Pills, Cheeseman Medicine Co., New 
 York. 
 
 Chichester Pennyroyal Pills, Chichester Chemical Co., Philadelphia. 
 
 Fiske Clarke's Female Pills, Williams Mfg. Co., Cleveland. 
 
 Sir Clarke's Female Pills, Job Moses, 150 Nassau street, New York. 
 
 Dr. Constan's Female Pills, Fred'k K. Ingram & Co., Detroit. 
 
 Dr. Conte's Female Pills, Dr. Felix Conte, Paris. 
 
 Madam Dean's Female Pills, United Medical Co., Lancaster, Pa. 
 
 De Koven's Comp. Pennyroyal Pills, Crescent Chemical Co., Elmira, N. T. 
 
 Dubois' Female Pills. 
 
 Du Choin's Female Pills. 
 
 Ducro's Female Pills, Dr. L. Ducro, Paris. 
 
 Duponco's Golden Female Pills. 
 
 Duquoi's Female Pills, Dr. Du Quoi, Paris. 
 
 Duquoin's Pennyroyal Pills. 
 
 Golden Female Pills. 
 
 Female Pills, Hillside Chemical Co., Newburgh, N. Y. 
 
 John Hooper's Female Pills. 
 
 Hooper's Green Seal Female Pills. 
 
 Job Moses' Female Pills, 10 Spruce street, and 150 Nassau street. New 
 York. 
 
 King's Tansy Female Pills, King Medicine Co., Boston. 
 
 La Franco Female Pills, La Franco Medical Co., 145 North Eighth street, 
 Philadelphia. 
 
 La Rues French Tabloids. 
 
 Lane's Female Pills, Allan Pfeiffer Chemical Ch., St. Louis. 
 
 Leslie's Pennyroyal Pills, Arthur Chemical Co., St. Louis. 
 
 Lyon's Tansy Pills, Empire State Drug Co., Buffalo. 
 
 Mangogo Female Pills, New York & London Drug Co., New York. 
 
 Monell's Female Pills, C. E. Monell, New York. 
 
 Mott's Pennyroyal Pills, Williams Mfg. Co., Cleveland. 
 
 Olive Branch Female Pills, Olive Branch Remedy Co., South Bend. 
 
 Piso's Female Pills, The Piso Co., Warren, Va. 
 
 Red Cross Tansy Pills, Norman Lichty Mfg. Co., Des Moines. 
 
 Dr. Sanderson's Female Pills. 
 
 Female Pills, S. B. Medicine Mfg. Co., Portland, Oreg. 
 
 Seguro Compound, Seguro Mfg. Co., 531 K street, Sacramento. 
 
 Dr. J. Simms's Female Pills, J. H. Simms, Wilmington, Del. 
 
 Steam's Tansy Pills, New York & London Drug Co., New York. 
 
 Dr. St. Jean's Female Pills, St. Jean Medical Co., 2004 Lexington avenue, 
 New York. 
 
 Tansy Cotton Root Female Pills, New York & London Drug Co., New 
 York. 
 
 Dr. Thomas's Pennyroyal Pills, Arthur Chemical Co., St. Louis. 
 
 Dr. Larue's Female Regulator. 
 
 Severa's Female Regulator, W. F. Severa Co., Cedar Rapids, Iowa. 
 
 Watkins' Female Remedy, J. R. Watkins Medical Co., Winona, Minn. 
 
 French, Antyseptin Female Remedy, Antyseptin Co., Gouverneur, N. Y. 
 
 Magnolia Blossoms, Female Suppositories, South Bend Remedy Co., South 
 Bend, Ind. 
 
 Orange Blossom Female Suppositories, Dr. J. A. McGill Co., Chicago. 
 
380 EEPOBTS OF THE PRESIDENT'S HOMES COMMISSION. 
 
 Washington, June 15, 1908, 
 Dr. George M. Kober, 
 
 Chairman Committee on Social Betterment 
 
 of the President's Homes Commission, 
 
 Dear Dr. Kober : While you verbally told me to " take my time," pressure 
 of official duty has very much delayed formal reply to your letter, that the 
 committee on social betterment of the President's Homes Commission is very 
 anxious to determine as far as possible the causes of juvenile delinquency, 
 wife desertion, and nonsupport, with special reference to standards of living, 
 intemperance, and other faulty environments, and should be very glad to re- 
 ceive from me the results of my observation and experience. 
 
 Since there are many causes back of every act voluntarily elicited by the 
 human will, it will be difficult to enumerate them all, even though the inquiry 
 be limited, as you suggest, by special reference to standards of living. Yet 
 certain broad conditions, rather than causes, may be indicated, improvement of 
 which may be brought about by the exercise of the police powers of the state, 
 in the interest of the general good of society, and consequently of the individual 
 also; for, as the President has often reminded us, in the long run we are all 
 going up or going down together. 
 
 Over twenty years' service as a volunteer helper of the unfortunate has, of 
 course, given me some ideas relative to what the state might do to alleviate 
 conditions, without destroying individual initiative. First, I was early im- 
 pressed that homes in alleys foster vice and crime. Many citizens fear to 
 enter the alleys even in daylight, the alleys are away or aside from the beaten 
 lines of travel, and their isolation and comparative privacy encourage drunken- 
 ness and vagrancy and kindred evils, not only on the part of denizens, but 
 on the part of outsiders glad to avail themselves of the cover of the alleys 
 in their licentiousness. No more efficient work could be performed for social 
 betterment in Washington than to absolutely abolish all human habitations in 
 alleys. It is a service of such transcendent importance to the whole city that 
 it would even be worth while for the whole city to bear the burden of pur- 
 chasing these alley properties and changing these properties into interior parks. 
 
 Rents in the alleys range from $7.50 to $9 per month for four-room houses, 
 without water in the house, though there may be water in the yard. The 
 renters are drivers receiving from $5 to $7.50 per week as wages, or day 
 laborers, receiving from $1 to $1.50 per day, or hod-carriers, who, when members 
 of the union, receive $2.25 per day, otherwise less. Of course, these work 
 people lose wet weather and are subject to other losses of time from different 
 vicissitudes, such as waiting for building material. Sometimes the renter is a 
 foreigner who is a skilled artisan or stone mason, drawing $4 per day, whose 
 earnings suggest a better environment. When his children are brought into 
 court, charged with shooting crap or other disorderly conduct, with the com- 
 panions made in the alleys, he is brought to a realization that the child is 
 more than the dollar, and readily agrees to get out of the alley into a home 
 more suitable for an aspirant to American citizenship. 
 
 We have building regulations designed to secure the proper amount of air 
 space for sleepers; yet several families will sometimes crowd into these small 
 alley houses, and this is not the limit, for a lodger at 50 cents a week will often 
 be accommodated upon the floor of the kitchen in addition. The family income 
 is almost invariably increased by the laundry work done in these overcrowded 
 tenements by the women occupants. Think of them, therefore, as nuclei for 
 the spread of contagion. These alley women prefer to do laundry work at their 
 homes in the alleys, where there is the least constraint and the most gossip. 
 
 Another serious evil is the commingling of the sexes. Children beyond the 
 age of puberty are in the same room, often sleeping in the same bed. Sad are 
 the results. 
 
 I endeavor in a familiar way to make these people appreciate the situation. 
 In cases of overcrowding, they are reminded that they would not quarter cattle 
 in such cramped shelter, for fear of breeding fever in the animals, and yet 
 the human is infinitely more valuable. Where both sexes are occupying the 
 same sleeping room, the mother or the father is asked if she or he would place 
 in that room a lighted match near a can of gunpowder. Of course not, and 
 they are shown the greater danger from mingling the sexes thus when the 
 passions are strong and there Is much ignorance, and they are reminded that 
 under such conditions common decency becomes impossible. It is not unusual 
 for married couples to have well-grown children sleeping 1^ the same room 
 
KEPORTS OF THE PBESIDENT's HOMES COMMISSION. 381 
 
 with them sometimes in the same bed. If the poverty be great, such are re- 
 quired to use at least cheap screens as an aid to decency. Sometimes a careful 
 survey of the joint income of the members of the family demonstrates the 
 ability to get additional room, or house space, especially if expenditures for 
 vicious indulgences are cut out. And it is possible to get, even for the rents 
 paid for alley houses, houses of similar size upon the streets of certain 
 localities. 
 
 The facts herein referred to are brought out in the court hearings; but I 
 early admonished the probation oflBcers to make tactful inquiries along the 
 same lines in their investigations, being careful, however, not to work at these 
 people, but with them, in an endeavor to awaken ideals within the reach of 
 the occupants of the houses in these hives of humanity. 
 
 The home conditions animadverted on give rise to drunkenness, breaches of 
 the peace, wife desertion, and much of the juvenile delinquency. Out of the 
 habitations of the drunkard or the father who does not provide for those of 
 his own household, go children not with the innocence or the buoyancy of 
 childhood, but children suffering the cravings of hunger and familiar with 
 scenes of debauchery. To satisfy hunger, they must either beg or steal. Often, 
 too, these children find in the tumult of the street, where no one nags them, 
 surcease from the bickerings of the home. The street becomes their most 
 prized rendezvous, to be preferred to the discipline of the school, and, there- 
 fore, herein arises much truancy, and hence arises much of the so-called 
 wanderlust, to be preftxed to the quarrelsome home. 
 
 The nonsupport law is used to remedy these evils as far as practicable. The 
 delinquent husband is made to go, on Saturday night, while he has his weekly 
 wage in his pocket, to the nearest police station and pay there a stipulated 
 amount to be turned over through the clerk of this court for the support of 
 his wife or children, or both. Either drunkenness or infidelity is an incident 
 in these nonsupport cases, and so a pledge is also exacted to refrain from the 
 use of liquor for the space of a year, and to cut out entirely the illegal in- 
 timacy, a short instruction being given upon the venereal diseases following 
 upon such wrongful indulgences. 
 
 During the first year of the operations of this court $6,050.59 were thus dis- 
 bursed to needy families. In the eleven months of this fiscal year the amount 
 was $19,235.36, in small sums weekly, from $1.50 up. There are now 236 
 families upon the relief roll at the court This has saved a burden to the tax- 
 payers, minimized drunkenness, and made lazy men work to support themselves 
 and families. Some of these men have improved so in an economic sense that 
 they have stated they were glad to have been brought into the court. 
 
 I may add that I wish you every success in your noble work for the better- 
 ment of conditions in the capital of our country, which I am proud to say is 
 my own native city. President Roosevelt will ever be remembered as the 
 President who sought to make this city the embodiment of the highest ideals 
 of American life. 
 
 Sincerely, yours, Wm. H. Dk Lacy, Judge, 
 
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