Health Commissioner Emerson has mobilized practically all the available medical forces of the Health Department to combat the further spread of infantile paralysis  Forty-nine new cases of the disease were reported yesterday and thirty-two cases the day before, making a total of 255 cases since the epidemic began.  Most of them are in crowded parts in Brooklyn, although cases have been reported from all boroughs except Queens.  Manhattan has twenty cases.  So far there have been twelve deaths, eleven in Brooklyn and one in Manhattan.

Dr. Simon Blatteis of the Bureau of Preventable Diseases has been put in charge of the fight against infantile paralysis and every available man in the Department of Health has been turned over to him.  Other special department activities will be dropped until the epidemic is under control.  Yesterday there were two department physicians, two nurses, and sixteen sanitary inspectors at work in the infected districts looking for new cases, putting into effect a strict quarantine of cases already reported, and attending the sufferers.

Dr. Emerson does not fear that the disease will get beyond control.  "We believe," he said, "that application of well organized sanitary measures will limit this outbreak.  The Health Department cannot possibly carry out all measures necessary unless the people do their part and promptly report every case even remotely suspicious.  Reports from janitors, neighbors, visiting nurses, as well as physicians will be welcomed.  No names of persons making them are necessary.  Our chief reliance must be in complete and quick isolation of patients for not less than eight weeks and "on perfect cleanliness of the patient's surrounds."  A bulletin issued by the Board of Health says:

"There is little doubt as to the transmissibility of the disease, either directly or through a third person.  There is also some evidence that the disease can be spread by apparently healthy individuals who harbor the virus, although themselves immune.

The disease is eminently one of childhood, but adults are frequently affected, no age being immune.  Children between 1 and 8 years are most susceptible.  The disease occurs most frequently during the Summer months, from June to October, inclusive, which usually constitute the dry months, but cases are reported every month throughout the year.

Acute poliomyelitis can occur in many different forms and in varying degrees of severity.  The most frequent type is characterized by a sudden onset with fever, followed usually in from twelve hours to three or four days by a general or localized paralysis....  Vomiting and convulsions occur frequently at the onset, but are not constant symptoms.  Rather more significant may be considered the headache, restlessness, irritability, and sleeplessness which occur early in a large proportion of cases.  However, some cases may be drowsy and stuporous.

A special pavilion has been established in the Kingston Avenue Hospital, Brooklyn, where patients who cannot be properly isolated in their homes, or who are not otherwise able to command proper treatment, may receive attention of specialists.

Dr. H. L. Amoss of the Rockefeller Institute has been assigned to work with the specialists who are studying the outbreak in Brooklyn.  A meeting of these experts will be held this afternoon at the Health Department.  Tomorrow the Brooklyn physicians living in the infected areas will meet in the Polhemus Memorial Clinic under the joint auspices of the Health Department and the special poliomyelitis committee.

As to the seriousness of the disease in Manhattan, Dr. Emerson said:

"The situation in Manhattan is not encouraging.  Most of the cases are confined to the crowded lower and upper east sides and follow the line of population.  The epidemic of 1907 began similarly."

Helen Elizabeth Downing, 14 years old, daughter of Walter Downing of 221 Webster Avenue, Brooklyn, died on Wednesday night of infantile paralysis on the eve of her graduation from Public School 124.  According to the records of the Board of Health, she was the oldest child known to have died of the disease.

The girl became ill on Saturday night.  The diploma she was to have received was taken to the parents last night by one of her classmates.

Dr. H. L. Amoss of the Rockefeller Institute explained last night that much can often be done toward successfully treating infantile paralysis, although no cure has been discovered.

"Much depends upon the treatment," he said.  "To say that there is no cure, although strictly true in the sense that there is no known antitoxin, would be likely to mislead, for many cases have completely recovered."

The Police Department, Street Cleaning Department, and the Society for the Prevention of Cruelty to Animals have been called upon, it was announced yesterday, to unite with the Department of Health, the Rockefeller Institute, and private physicians in a city-wide fight against the spread of infantile paralysis, which has recently attacked 302 children in the city, causing sixty-four deaths since the first of the year, forty-seven occurring since last Saturday, forty-two in Brooklyn and five in Manhattan.  Italians living in crowded tenements have been the chief sufferers.

The Health Department announced forty-seven new cases in the twenty-four hours ended at noon yesterday.  Eight of these were found in Manhattan, five in the lower east side. The rapid spread of the disease and its extraordinary record for fatality have stirred the Health Department to great activity.

"The outbreak," said Dr. Emerson, the Health Commissioner, yesterday, "threatens to go beyond that of 1907 when there were 2,500 cases in the city.  It is characterized by a high degree of virulence.  Whereas in 1907 the mortality was approximately 5 per cent., the mortality in the present outbreak is probably four times as great.  The Health Department records show that in the entire year of 1915 there occurred in the city only thirteen deaths from infantile paralysis.  In 1914 there were thirty-four deaths, and in 1913 fifty-five.

"Everything possible is being done to combat the disease.  The department has called the attention of the Society for the Prevention of Cruelty to Animals to the large number of cats which frequent many infected houses.  The society has agreed to meet the situation promptly.  The Department of Street Cleaning has agreed to devote special attention to the cleaning of the streets in the infected districts.  The police are giving valuable assistance in enforcing city and Health Department regulations.

"Our method of fighting the disease is this:  Whenever a case is reported in a block not previously affected, a house-to-house canvass of that block is made.  In this way many unreported cases have been found.  All cases are isolated at once, and, except where home conditions are equal to the accommodations of a hospital, the patient is removed to a hospital.  Forty patients were moved today to the special pavilion at the Kingston Avenue Hospital, Brooklyn.

"The infected area contains many old tenements and garbage and ashes are deposited in the halls.  It is reported that these areas are infested with cats and the garbage and ash piles draw flies.  With the co-operation of the various departments these areas are being cleaned up."

The Commissioner added that nurses and other workers were being drawn from various branches of the Health Department and that he stood ready to divert many more from their regular occupations.

Concern over the spread of the disease has aroused interest in its origin, and the department has started its machinery of investigation.  There was a report yesterday that the disease had been brought to America by Italian immigrants, and the Health Commissioner, upon hearing this, communicated with the Quarantine Station down the Bay.  The report from there was that no cases had been noticed among immigrants and that Quarantine had no record of epidemics in any of the towns of Italy.

Dr. Emerson, however, communicated with Surgeon General Rupert Blue of the United States Public Health Service and requested him to ascertain through the consular service whether infantile paralysis was present in any Italian towns.  Under ordinary circumstances, it was said, an answer should be received by cable within three or four days.

A special meeting of health experts was held yesterday in the office of Commissioner Emerson for discussion of methods of combating the disease.  Another conference of experts will be held at 2 o'clock this afternoon at the Polhemus Memorial Clinic, Brooklyn, at which Dr. Simon Flexner, of the Rockefeller Institute, will be present.

State and city health authorities as far West as Illinois have been warned by the City Department to watch children coming from New York.  No quarantine outside of New York has been declared, so far as is known, but other cities are expected to take due precautions.

Attention of the public was called yesterday to the fact that in 1907 a number of adults died from the disease, so that grown persons, confident of immunity, might not take unnecessary risks.  The oldest victim in the present outbreak was fourteen years of age.

Infantile paralysis continued to spread through the city yesterday, fifty-two new cases being reported to the Board of Health for the twenty-four hours ended at noon.  Of these cases, forty-three were in Brooklyn, eight in Manhattan and one in the Bronx.  The total of cases for the year, according to the department's figures is 350.

The death rate also continued at about 20 per cent., or four times as high as in the epidemic of 1907.  There were twelve deaths yesterday, ten in Brooklyn, one in Manhattan and one on Staten Island.  Fifty-nine children died of the disease during the week ended at noon yesterday, of whom thirty-six were boys and twenty-two were girls.  By far the largest number of deaths occurred in Brooklyn, where fifty-one were reported.  The number of deaths from the disease since the first of the year is seventy-five, almost all of which occurred in the month of June.

All except two of the year's deaths were of children under 10 years of age; nine were less than 1 year old, seventeen were between 1 and 2 years, and thirteen were between 2 and 3 years.

In addition to combating the spread of the disease with all of the resources at his command, Dr. Haven Emerson, Health Commissioner, turned his energies yesterday toward his campaign of public education.  He was assisted by Dr. Simon Flexner of the Rockefeller Institute, who addressed 200 physicians at the Polhemus Memorial Hall in Brooklyn, under the joint auspices of the Department of Health and the Special Poliomyelitis Committee appointed to assist in the fight against the disease.

Commissioner Emerson's most frequently reiterated advice to parents yesterday was that they keep their children away from all crowds, especially indoor crowds.  Infantile paralysis is conveyed in coughing and sneezing, and for this reason, Dr. Emerson said, a child carrying the disease may infect many others by coughing or sneezing in a crowd.  The approach of the Fourth of July made the Health Commissioner especially apprehensive.

"I would warn parents to keep their children away from others," he said.  "The children should be kept out of moving picture theatres and other places of amusement.  They should be kept away from church, picnics and all gatherings, especially indoor ones."

Dr. Emerson also announced that inspectors of the Department of Health were investigating conditions in all grocery stores, fruit markets, and other places where edibles are sold in infected districts.  He said that if any case of paralysis was found in the family of any vendor of foodstuffs the vendor's place of business would be closed if the case could not be immediately removed to a hospital and all danger of infection removed from the place.

The Health Commissioner also warned all persons against quack and advertised remedies and preventives of the disease.

"There is no preventive of the disease," he said, "and there is no cure.  But--and this should be carefully remembered--parents can lessen the chances of their children catching the disease by proper precautions and a physician can give valuable treatment in any case.  So my advice to parents is to observe the precautions and, if the disease makes itself manifest, to summon the family physician at once.  While there is no cure for infantile paralysis, treatment by nurses and physicians may often save life and will always improve chances of recovery.

"Physicians have been urgently requested to report all suspicious cases to the Department of Health, and, as a rule, they are doing so regularly.  When a case is reported it is often necessary to remove the patient to one of the isolated pavilions of a public hospital.  Fortunately, we have had little trouble with parents about removals, and to those inclined to distrust hospital treatment I would say that the wards provided for infantile paralysis are not what are commonly feared as pest houses.  They are all open, airy, sunny, cheerful rooms, where the children not only receive the best of care and attention, but where they have the advantages of absolutely sanitary and healthful surrounding not possible in many homes.  Also parents should remember that when a patient is removed to a hospital the danger to others in the household and in the city is greatly diminished and, in many cases, avoided.

"Parents should not resort to the use of drugs or chemicals on themselves or their children without the advice of a competent physician.  I do not recommend the use of any antiseptics, as it is a physical impossibility to cleanse the mouth and nose of all germs.  My suggestion is that the mucous membrane of the mouth and nose be washed frequently in boric acid or in a normal sat solution, that is, a solution of pure water and ordinary table salt in the proportion of one teaspoonful of salt to a pint of water.  If the solution is stronger it may irritate the membrane.  This salt solution or boric acid has no antiseptic quality, but simply cleanses the membranes, thus giving it a better chance to maintain a healthy condition in which it may throw off germs.

"The general health should also be kept up.  Keep the nose and throat clean, and the body up to par in health, and one will do more to prevent the disease than by using any chemicals."

One of the discouraging announcements of the day was made by Dr. Flexner in saying that infantile paralysis, according to all records, seemed "to pick the strong and well children in preference to the weak."

"Vigorous health," said Dr. Flexner in Brooklyn, "seems to be no protection against the disease."

Dr. Flexner said that the disease may be spread by kissing, coughing and sneezing, and that flies often carried the disease.  Dr. Flexner added:

"The infectious agent enters the body chiefly, if not exclusively, through the mucous membranes of the nose and throat.  Poliomyelitis, or infantile paralysis, affects chiefly, but not exclusively, young persons.  It may and not infrequently does affect adults and no age is absolutely free of danger of infection."

Dr. Louis C. Ager, the child specialist, presided at the meeting as the representative of Brooklyn physicians in private practice.  He urged his fellow practitioners to lose no time in reporting suspicious cases to the Department of Health.

Announcement was made by the department last evening that the field agents of two large life insurance companies, who visit a large number of families each week, would co-operate with the department by warning all persons whom they saw to read the Health Department news in the daily newspapers and to follow the instructions issued from Dr. Emerson's office.

Most of the cases reported in Manhattan are in the lower east side....  The disease is not limited, however, to this section.  Cases on the upper east side as far up as East 118th Street have been reported, and there are a few cases on Seventh Avenue and West Fifteenth, Twenty-fifth, and 100th Streets....

The many Brooklyn cases are more or less scattered, the greatest number being among Italians.

With seventy-two new cases of infantile paralysis reported yesterday and twenty-three deaths in the forty-eight hours ended at noon yesterday, Health Commissioner Emerson yesterday afternoon definitely and drastically extended his efforts to prevent the spread of the disease.

At his request the Commissioner of Licenses notified every motion-picture theatre in the city not to admit children under 16 years of age from July 5 until such time as the Board of Health declares the danger of an epidemic of infantile paralysis has passed.  Also, at the request of the Commissioner of Health, the Police Department revoked fifteen of the fifty-one licenses which it had issued for neighborhood Independence Day celebrations in Brooklyn today....

Yesterday's action of the Commissioner of Licenses means, in all probability, that children under 16 years of age will be forbidden the motion-picture theatres in this city all Summer, for an outbreak of infantile paralysis beginning during the warm weather invariably lasts until cool weather comes, according to records of the disease....

The Department of health has abandoned its own plans for free open air 'movies" for children in Manhattan, Brooklyn, and the Bronx, which were to have opened this month....

As another step in the fight against infantile paralysis, the Department of Health yesterday had printed 500,000 leaflets, which will be distributed today throughout every district from which the disease has been reported.  they read:

Infantile paralysis is very prevalent in this part of the city.

Keep your children out of the street as much as possible, and be sure to keep them out of the houses on which the Department of Health has put a sign.

The daily paper will tell you in what houses the disease is.

This is the disease which babies and young children get; many of them die, and many who do not, become paralyzed for life.

Do not let your children go to parties, picnics, or outings.

If your child is sick, send for your doctor or notify the Board of Health....

Commissioner Emerson and his lieutenants in the fight discussed yesterday a proposal for the police to compel every child in the city under 16 years of age to remain at home continuously for two weeks and this measure would have been adopted, without doubt, had not the health officers feared any benefit to the fight against infantile paralysis would have been more than offset by the general disease and ill-health resulting from confining children.

Also because of the dangers from the confinement of children the department decided yesterday not to quarantine every apartment and tenement house in which a case of paralysis might be found.

Commissioner Emerson will participate actively in the field work in Brooklyn this morning and most of the afternoon, inspecting the work of his agents.  From the first he has been in personal command of the forces engaged in combating the disease, and he has not conducted this war from his office in Centre Street....

Three or four cases among adults have been reported in the Department of health within the last few days....

Twenty-five deaths, 59 new diagnosed cases and 31 new suspected cases--this measures the 24-hour toll of infantile paralysis in New York, from 9 o'clock Monday night to 9 o'clock last night.

The ravages of the disease reported to the Health Department yesterday exceeded those reported Monday night for both Sunday and Monday--72 new cases and 23 deaths.

With the spread of the disease, many thousands of children of well-to-do parents--50,000 is considered a conservative estimate--have been sent out of New York.  This has caused the New York State Health Authorities to issue strict orders that State Health Commissioner Biggs be notified by telephone immediately of the discovery of a case of infantile paralysis.  The authorities in nearby States have taken similar precautions....

The disease continues most prevalent in Brooklyn, in the Italian quarter of the southern district of the borough, where the paralysis first appeared....

A striking feature of the situation has been the high mortality.  In 1907, when there were 2,500 cases reported, the death rate was 5 per cent., while in the present outbreak it has been more than 20 per cent., the death toll up to last night being equal, approximately, to that of the entire 1907 epidemic.

Health Commissioner Haven Emerson said last night that there was little hope of checking the disease until the cool weather of September, and that he expected it to continue through July and August....

The most pathetic side of the situation is that there is no known positive treatment for the disease.  It is simply a question of the child's physique being able to defeat the germs.  The best that can be done is to keep the patient in quiet sanitary surroundings until the disease has run its course.  The great good the doctors can do is to lessen the probability of permanent injury.

"The restoration of the use of the affected limbs depends largely upon the conditions in which the patient is kept," Dr. Emerson said last night.  "If a strain is allowed to fall upon the affected limb, there is great danger of permanent paralysis.  The limb must be supported by bags and other means so that there is no strain upon it.  That is where good treatment may make a world of difference."

It was explained, however, that permanent injuries to the 75 per cent. or more of the patients who recover, were, to a great extent, a matter of chance.  If the germs centralize in the region of nerves which control important muscles, there is much more danger than if they centralize even a quarter of an inch distant from nerve centres.

The order of the Health Commissioner excluding children under 16 years of age from moving picture shows goes into effect today.  There is also being considered the forbidding of Summer school and night school classes where children attend, but the playgrounds will not be closed.  While this step was considered it was decided that the poorer children of the city would be placed in a more dangerous position as regards general health if they were excluded from the playgrounds than if the grounds were kept open.

Dr. Emerson, however, has put an absolute ban to all picnics for children for the present.

Dr. George L. Nicholas, head of the Bureau of Epidemology of the Department of Health, said yesterday:

"It is striking to note that the virulence of this disease is constantly on the increase.  It is more fatal now than in 1907.  I think that shows that there is some great underlying cause back of this and its results that we have not reached."

Dr. Nicholas warned against children going swimming in the Hudson and East Rivers while the outbreak continued, and urged that flies be kept away from babies and all food this Summer.  He said children in the hospitals would probably be kept there about two months....

Detection of the disease is a difficult task as it is hard to diagnose in its earlier stages and because of the atypical nature of many of the cases found.

It has been found by the Health Department that negro children are less susceptible to the disease than white children.

A quarantine was ordered yesterday on the School Camp Association boys' camp at Fort Hamilton, where 500 boys have been encamped on the Government property...

There were 2,500 cases during the epidemic of poliomyelitis, or infantile paralysis, in New York nine years ago, and the death rate was only 5 per cent.  In the epidemic of this year there have been 637 cases, with a mortality rate of about 21 per cent.  Daily reports show that the summit of the rising curve which marks the number of those taken ill has not yet been reached.  It is quite probable that the end of the epidemic will not be seen until the beginning of October.

For several reasons the treatment of an epidemic of this disease presents great difficulties to physicians as well as to the sanitary authorities.  The cause of the malady is a microbe, a germ, the existence of which is known, although, because it is very small, it has not been isolated and recognized.  No antitoxin serum, curative or preventive, is yet available.  The period of incubation after infection has not been determined, nor is it known how long there may be danger of infection from a patient who has recovered.  The method of infection has not been surely ascertained, at least so far as carriers are concerned, but the germs enter through the nose or throat.  There is no known curative remedy.  Much depends upon the care given to a patient and the efforts made to prevent the permanent crippling of those who do not die.  Unfortunately, more than half of those who avoid death suffer afterward from paralysis.

Health authorities, city and State, are doing all they can.  Many physicians and nurses are very busily engaged in caring for the victims of infection, whether those be in their houses or in hospitals to which they have been carried.  Sanitary laws must be ordered rigidly; rooms where patients have died must be carefully disinfected; parents must be instructed about the signs of the disease and the sanitary rules which they should obey.  A large majority of the cases have been found in families where such instruction is needed.  As the malady spreads by contact or association, orders have been wisely given for the exclusion of children from moving-picture houses and for the prevention of certain picnics and other gatherings that had been planned.  The food supply is guarded.

Health officers and those who work under their direction should be aided in all possible ways by citizens.  Those who obey sanitary laws should instruct neighbors who do not.  It should be impressed upon the minds of all parents in the infected districts and those clearly exposed to infection that the illness of a child, whatever it may seem to be, must be reported to a physician or an officer of the Health Department.  All should be made to feel how important cleanliness is....

Infantile paralysis made greater headway in the city yesterday than on any day since the beginning of the outbreak.  One hundred and thirty-three new cases and twenty-four deaths were reported.  The number of new causes was a record for any twenty-four hours since the beginning of the outbreak.

Coincident with the announcement of the accelerated spread of the disease Health Commissioner Haven Emerson said that William G. McAdoo, Secretary of the Treasury, had offered to the city the services of the United States Public Health Service, and that the offer had been accepted.

The timeliness of Secretary McAdoo's offer was manifested in the fact that within an hour after accepting it Dr. Emerson telegraphed to the Acting Surgeon General in Washington asking him to relieve the local Health Department of definite responsibilities in combating and studying infantile paralysis, and the need for all available help in the present crisis was emphasized in Dr. Emerson's admission late yesterday afternoon that he had done everything possible and still did not consider the outbreak under control.

"We've gone the limit in our efforts to prevent and control the disease," Dr. Emerson said, "and we shall continue to go to the limit, but I have no confidence that it is under control.  My experience with other epidemics of infantile paralysis causes me to believe that the present one will continue through the hot weather."

Secretary McAdoo's offer was made in person to Mayor Mitchel yesterday afternoon.  Because of the high standing of the United States Public Health Service in medical research the Mayor and the Health Commissioner were highly pleased with the offer.

But it was not distinctly medical assistance that the Health Commissioner first requested of the Public Health Served.  It was more of a diplomatic matter, for Dr. Emerson asked the Acting Surgeon General to obtain, if possible, the release for shipment to the United States of 100 monkeys in the Philippines.  In its efforts to solve the all-important problem of how infantile paralysis is "carried," the department of Health and co-operating research agencies are seriously embarrassed by a shortage of monkeys.  The monkey is the only animal upon which tests to identify the mediums of communication of the disease can be made.

The Rockefeller Institute, however, has 100 monkeys collected in the Philippines ready for shipment, but because of disease among animals on the islands there has been an embargo on their exportation. This is why the monkeys have not come to New York.  If the efforts of the Public Health Service are successful in having the embargo raised, so far as the  monkeys are concerned, although the animals will not arrive for some weeks, Dr. Emerson believes that the scientists of the Federal Government, of the Rockefeller Institute, and of other research bodies will be able to make great headway in solving the problem of who and what are the most dangerous "carriers" of infantile paralysis.

Although the theory that the disease is spread through the contact of infected persons with uninfected ones, the authorities do not know exactly what persons or things carry it most dangerously to the community--whether incipient cases, actual patients, patients in convalescence, nurses, doctors, dust, house flies, or tainted foodstuffs.  Dr. Emerson, therefore, asked the Public Health Service to assign six of its best men to take up the question of carriers, some to do field work and some to experiment in laboratories.

The most alarming of yesterday's reports of the spread of the disease came from Staten Island, where thirty-three cases were recorded.  No cause for this sudden breaking out of the disease could be learned, but preparations to meet a more difficult situation on the island were made.  Dr. Emerson yesterday requested the United States Public Health Service to perform the routine laboratory diagnostic work for Richmond County at its laboratory in the Quarantine Station, and the took under consideration the question of requesting Dr. Leland E. Cofer, the Health Officer of the Port, to provide hospital facilities for isolating the Staten Island cases at Quarantine.  These cases have been going to the Willard Parker Hospital....

The work of checking infantile paralysis in the city is seriously handicapped, Health Commissioner Emerson said yesterday, by a shortage of nurses, doctors, ambulances, and Inspectors.  At an afternoon conference held by Dr. Emerson and the physicians who have been assisting him in his work it was decided to appeal to the American Red Cross for nurses, but late last night Dr. Emerson announced that the appeal would not be made "at present."  He added:

"We felt that, if we could arrange to have the cases cared for by the Red Cross doctors and nurses temporarily, so as to free our local doctors and nurses for the general work, it would be an aid.

But, on further considering the matter, I believe we shall be able to show it will not be necessary.  We believe that it will be wiser to ask no outside aid at this time and that, with the offers of hospitals in the city to aid freely, which offers we expect to receive tomorrow, we will be able to take care of the situation and overcome the present difficulties of threatened overcrowding.

"I feel certain that we will need no outside aid, but that we will be able to develop, within the city, the requisite facilities for meeting the situation."

The action of the conference, however, indicated the pressing needs of the situation.  After advertising for three days for nurses and offering $50 a month and maintenance for any who might be accepted, Commissioner Emerson received applications from only thirty-one, and of these only one agreed to do the work required for the compensation offered.  And Dr. Emerson said that he needed 150.

He is also in great need of doctors, but his advertisement for internes at from $20 to $100 a month, with maintenance, had not received a single answer yesterday.

From cities not in the environs of New York came reports yesterday of new infantile paralysis cases and measures against the disease.

There was one death from the disease in Chicago yesterday...

Five cases were reported in Montreal, where a campaign against the further spread of the disease was inaugurated.  Three cases were reported at New Bedford Mass., and two each from Philadelphia and Springfield, Ill.  One Death and two other cases were reported from South Bethlehem, Penn.

One case was reported in each of the following places:  Boston, Baltimore, Pittsburgh, Terre Haute, Ind.; Fort Wayne, Ind.; Cleveland, Ohio; Columbus, Ohio; Providence, R.I.; Lowell, Mass.

With 296 cases of infantile paralysis in the Kingston Avenue Hospital, in Brooklyn, 104 cases in the Willard Parker Hospital, in Manhattan, and new cases coming in at the rate of seventy-five to 100 a day, the Department of Health, although drafting every available employe to the work of fighting the disease, has been unable to muster only an inadequate force.  Commissioner Emerson, himself tired of brain and body from overwork and undersleep, said as much yesterday, though he firmly refused to complain.

He said vigorously that the Department was doing everything possible and would ask no one to do anything to lighten its work.  His appeal, he said, was for outsiders to do work which the Department found it impossible to perform.

Commissioner Emerson also said that his work was suffering from a shortage of ambulances.  He requisitioned ten automobiles from the city for use as ambulances, and will probably obtain more today.  As the patients in the present outbreak are small children, any automobile can be used as an ambulance.

Dr. Emerson also requested the Borough Presidents of Manhattan and Brooklyn to lend him some of the automobiles at the service of their departments.  He promised to disinfect every automobile before its return, and guaranteed that they would not carry infantile paralysis to any one who used them.

At the request of the Health Commissioner all public libraries in the city issued notices yesterday that no child under sixteen would be admitted to their reading rooms until further notice.  The children's rooms in the various library buildings in the city have been closed, and it was said that children would not be admitted to the general reading or other rooms for adults.

Simultaneously, Acting Police Commissioner Godley closed sixteen play streets in the city in infected districts.  Also the scheduled opening of twenty play streets today and of nineteen on Saturday was indefinitely postponed.  The Health Commissioner has not yet requested the closing of any playgrounds and will not do so unless the spread of the disease makes such an action absolutely necessary.

Park Commissioner Cabot Ward, while he has not closed these parks to children, yesterday placed restrictions upon their use, canceled all arrangements for the usual Summer playground festivals, and directed that all recreational work in the parks be carried on in small units.

He also ordered that all sand boxes in parks and playgrounds be emptied and disinfected, and said that sand boxes would not be used by children as play places until the outbreak of infantile paralysis had been controlled.  The Commissioner further took steps to divert the money hitherto appropriated for sand to the purchase of oil to be used in coating the surfaces of playgrounds.

This oil, the Commissioner said, would keep down dirt, and so probably aid in checking the spread of the disease.  All buildings in the parks and playgrounds--gymnasiums, public baths, and comfort stations--were thoroughly cleaned and disinfected yesterday, and, the Commissioner said, will be the objects of special attention throughout the run of the outbreak.

The United States Public Health Service was quick to respond to Commissioner Emerson's appeal of Thursday.  Acting Surgeon General Glennan, in charge of the service, yesterday replied to the Commissioner's telegram as follows:

Cooperation requested in your telegram of July 6 will be immediately furnished.  Dr. Lavinder will be senior of service officers detailed.  Five other officers have been directed to report to him immediately.  Am sending Assistant Surgeon General William Colby Rucker to confer with you and Lavinder as to further details, particularly with regard to prevention of an interstate spread of the disaster.  The importation of the monkeys has been taken up with the Agricultural Department.

Dr. Lavinder whose work in recent months has been the examination of immigrants after they had passed quarantine--called the "second line of defense" in the immigration service--conferred with Dr. Emerson for two hours yesterday, and, in addition to laying plans for his immediate activity, at the request of the Commissioner telegraphed to his department in Washington to send at once, if possible, twenty monkeys for experimental work.

Dr. Rucker left Washington at midnight last night and will report at the Health Commissioner's office this morning ready for work.  As stated in the Acting Surgeon General's telegram, he will devote himself to the task of preventing a spread of the disease to other States.  No State Health Department can follow its cases from State to State, Dr. Emerson explained, but a Federal health officer will be able to keep an eye on any outbreak of infantile paralysis and take measures to head off the jumping through carriers to another locality.  Dr. Rucker was said yesterday to be one of the best experts on epidemic diseases in the country.

In addition to sending more assistance in the matter of surgeons than Dr. Emerson had asked, the Public Health Service also took steps yesterday to have released for shipment to the United States the one hundred monkeys collected by the Rockefeller Institute in the Philippines.  William G. McAdoo, Secretary of the Treasury, under whose office the Public Health Service is conducted, yesterday wrote to Mayor Mitchel that the matter was in the province of the Department of Agriculture, that he had seen Secretary Houston personally, and that Secretary Houston had assured him that he would "do everything in his power to facilitate the shipments."

Emergency measures for fighting the infantile paralysis in the homes of the poor were adopted yesterday by the Executive Committee of the Charity Organization Society.  Reports received by the committee from the fourteen districts of the society in Manhattan and the Bronx were that flies were numerous and screens scarce.  The committee therefore voted to supply screens for the windows of houses in which children live.

The committee also ordered its agents to make strict inspections of the houses visited by them, and to compel every possible sanitary protection.

For fear of spreading the disease through country districts and of infecting city children by bringing them together, the committee voted to postpone indefinitely all of its planned fresh-air outings, with one or two exceptions.  Reports received by the committee were to the effect that persons in the poorer sections of the city had been thoroughly aroused to the situation and were zealously following the instructions of the Health Department as to cleanliness, keeping the children away from crowds, and reporting disease.  Many others, incidentally, who had occasion to visit the crowded districts yesterday, reported the streets nearly deserted and the windows filled with children kept indoors by parents.

Nurses of the Society for Improving the Condition of the Poor reported that the children were being too much confined, but that they were doing all they could to see that the children got plenty of fresh air and exercise, without exposing themselves to risks.

The society, it was announced, was continuing all its fresh air and country homes at full capacity, having 350 mothers and children at Sea Breeze, Coney Island; 120 mothers and children at Caroline Rest, Hartsdale, and 150 boys in the Summer camp at Southfields, N.Y.  No children have been admitted to these and other places, it was said, without examination by physicians and nurses; all are under constant watchfulness, and none has been admitted from an infected house.

St. John's Guild reported yesterday that all children entering its floating and seaside hospitals were carefully examined and that the society was working energetically among the poor of the city.

The criminal law may soon be called upon to assist the Department of Health in its way.  Infantile paralysis is a reportable disease and the department has the power to assume full control of any person suffering from it.  Any one ignoring these facts, Dr. Emerson said yesterday, would be dealt with through the courts.  He mentioned one case in particular.

"There was a case of infantile paralysis in New York," he said, "which was not reported.  The attending physician allowed the parents of the child to take it to New Jersey.  Later these parents returned to New York and another physician attended the sick child, and permitted its parents to take it to Albany, where the case was discovered by the public authorities.  I understand that that is the only case in Albany so far.  The Albany authorities are sending me the names and data in the matter, and, if I have sufficient evidence, I shall officially proceed in the courts against the two physicians who violated the law in not reporting the case and in permitting it to leave the State."

Dr. Emerson also told of another incident in which he had directed that a court summons be served upon parents.  A case of infantile paralysis, discovered by a physician, was reported to the Department of health, but before an official of the department reached the affected child--the parents had removed it and refused to tell the officer where it was.  They will have to make explanations in court, and in the meantime agents of the department fear that the child has been sent out of the State.

A number of physicians have reported to the department that many ignorant parents resent the department's coming into their homes, and that such parents have threatened to hide children if their cases were reported.

One doctor narrated to the Commissioner a typical case.

"I diagnosed a child's illness as infantile paralysis, and at once the mother said to me:  "If you say my child has that disease and report it to the Department of Health, you can go away and you needn't come back, and before the department gets here the child will be gone."

Another example of resistance to the department came in the case of a Brooklyn woman who protested against the forcible removal of her child to the Kingston Avenue Hospital in Brooklyn on the ground that the child did not have infantile paralysis, but would catch it from other children in the hospital.  The case was a "suspected" one, and as such was kept at the hospital for observation and was not placed in contact with positive cases.

Dr. Emerson said yesterday that all suspected cases were kept thus under observation, and that the field diagnosticians has made few mistakes.  None of these, he added, had resulted in the disease being communicated to a healthy child.

Complaints against the efficiency of the work against the disease were voiced yesterday, though no one even intimated that Commissioner Emerson and all others in the work were doing less than they could.   The complaints were chiefly against systems of management and poor service, due to the piling of work upon insufficient workers.

Brooklyn made the loudest criticism.  Persons there said that the Brooklyn branch of the department was under the direction of no one person empowered to carry on the work as it should be carried on.

"A handful of clerks, headed by a minor official," it was said, composed the Brooklyn staff, while the directing officers, contrary to law, remained in Manhattan.  It was further stated that there were not enough inspectors in the Borough, and that, because the Brooklyn office closed at noon on Saturdays, undertakers had to go to Manhattan for burial certificates after that hour.  There was a report that Brooklyn physicians intended to form "a vigilante committee."

Some complaints of the collection of garbage in Manhattan and Brooklyn were also received, and a number of witnesses said that not only was this garbage allowed to stand for hours, but that numerous cats fed upon it, and that, when it was finally removed, it was hauled away in open carts.  The reply of the Departments of Health and Street Cleaning to these criticisms was that everything possible was being done, and that with forces so over-taxed it was not possible to satisfy every person at all times.

Cats have been destroyed by the hundreds since the outbreak of the disease, it was learned yesterday.  The S. P. C. A. and owners of the pets have ruthlessly done this work.  Many parents have killed their children's pets in fear that the animals might spread infection.

The police of Brooklyn yesterday arraigned more than fifty persons before Magistrate Nash in the Adams Street Police Court, charged with having no covers on garbage cans.  The Magistrate imposed a fine of $2 in each case upon conviction, and warned the offenders that if they came before him again on the same charge he would deal more harshly with them.

Health Department and Street Cleaning Department Inspectors summoned fifty proprietors of stables before Magistrate Dodd in the Municipal Term Court on Butler Street, charged with having failed to keep their stables free from rubbish likely to collect flies.  The Magistrate adjourned the hearing in all the days after warning the offenders to clean their places up thoroughly.  If they failed to do so, the Magistrate said he would be severe with them.

Dr. Louis C. Ager, Chairman of the Brooklyn Committee on Infantile Paralysis, yesterday issued a call for help for the children who were recovering from the disease, but who were afflicted with crippled limbs as a result of it.  The appeal of Dr. Ager was as follows:

Five hundred dollars is needed at once for braces for the children who are now being crippled by infantile paralysis.  There are at present 293 children with infantile paralysis in the Kingston Avenue Hospital and 75 per cent. Of them will have either legs or arms badly deformed.

These need care now, and there is no place in Brooklyn that can give it....  I appeal for contributions.  The work must be done at once, and nobody is ready.

Dr. Ager explained that a hundred Breadford frames for straightening crooked spines and an experienced maker of braces and plaster of paris bandages were needed.  The braces can be bought for a dollar a piece and the brace-maker can be secured for not less than $40 per week.

A contribution of $50 has been received from the Brooklyn Music School Settlement.  It had been planned to give the money for children's vacation purposes, but the outbreak of infantile paralysis interfered with the vacation work.

Policemen were sent to visit the back yards of tenement houses in Brooklyn yesterday, and were instructed not only to give the dwellers directions as to cleaning up, but to summon the offenders to court in the more serious cases of violation of the laws of cleanliness and health.  The police were aided by Inspectors from the Health Department and Tenement House Department, who made thorough examinations of the hallways and cellars of the buildings.

Many vacation Bible schools and Sunday Schools in the city were closed yesterday.

Between 10,000 and 15,000 children who were to have participated as spectators and actors in a school garden pageant in the Bronx Park Botanical Gardens, under the auspices of the School Garden Association of America, were disappointed when it was announced that the pageant had been abandoned because of the infantile paralysis.  Nearly all of the children were advised of this before leaving their homes, but several hundred went to the gardens dressed for the pageant and tearfully returned to their homes when told that their party was not to be.  No child of less than 16 years was admitted to the association's garden festival in Carnegie Hall last night.

George H. Bell, Commissioner of Licenses, made a tour of the infected districts of Brooklyn yesterday and reported nearly all of the motion picture houses closed for the day.  They opened last evening, but, according to reports, had small audiences and did not violate the order prohibiting the admission of children under 16 years of age.  Motion picture men and organizations have petitioned the authorities to reduce the age limit to 14, but Dr. Emerson said that this could not be done at present.  It is expected that Coney Island will be especially hard hit today and tomorrow by the order.

The report on Thursday of thirty-three new cases in Staten Island was a mistake, according to an admission of the Department of health yesterday.  The report should have been that thirty-three cases had been discovered on the Island since the beginning of the outbreak, and it was explained that the mistake was due to the rush of work in the statistical office of the department.  The number of new cases on Staten Island on Thursday was six.

Motion-picture views, which will be shown at special matinées for mothers in the infected districts, will be presented to the Department of Health today by the Universal Film Company.  The pictures were taken for the Animated Weekly Topical News at the Rockefeller Institute under the direction of an official of the institute, and in other places, with two inspectors from the Department of Health.

Included in the film are scenes showing affected districts, stricken children, sanitary precautions necessary, and how mothers may detect symptoms of paralysis.  The pictures cost $4,700, which was paid by the Universal Film Company.

Commissioner Emerson said he did not consider yesterday's slight decrease in new cases and deaths any indication that the disease was under control.

Dr. Emerson said yesterday that soap and water, sunlight and fresh air provided the best disinfectants against the disease.  He said that, in every room where a case occurred, agents of the department had scoured the walls, floors and ceilings and had opened the room to sun and air.

Persons living in infected houses were strongly urged to apply this practice.  The use of chemical disinfectants, the Commissioner said, was not recommended, because they were not as efficacious as the means advised and tended to mislead ignorant persons under the impression that when they were used, cleanliness and ventilation were not necessary.

Since May 15, Dr. Emerson said, ninety immigrant Italians, including twenty-four children under the age of 10, had gone to live in Brooklyn, where the outbreak appeared, at about the date named.  No symptoms of infantile paralysis were found among the Italians at Quarantine, but the Italian Consul has been asked to ascertain whether the disease was present in any of the cities from which the immigrants came.

At a conference of Dr. Emerson and physicians at the Department of Health Yesterday afternoon the subject of a general quarantine of the city was discussed, but it was decided that such a measure was impracticable.

Street Cleaning Commissioner Fetherstone announced yesterday that he had arranged with the Board of Water Supply for extra water in the affected districts so that the streets and sidewalks might be flushed every night.  The Commissioner said that he had also issued orders to the drivers of the departments rubbish wagons to insist that janitors and housekeepers in infected districts put waste from their premises in closely tied packages, instead of loose bags.

All passes to Randall's Island were revoked yesterday by Charities Commissioner Kingsbury, who said that he would also refuse to accept any new patients on the island for the present.  There are no cases of infantile paralysis in the institutions on the island.

Fifty boys yesterday left the camp of 500 boys at Fort Hamilton conducted by the National School Camp Association.  The camp has been rigidly quarantined since the outbreak in the city and no illness has been found there.  Two of the boys were removed by their mother, who, it was said, lives in a street in Brooklyn where there are five cases.

Dr. Francis E. Fronczak, Health commissioner of Buffalo, who conferred with Dr. Emerson yesterday, said that, in an epidemic of infantile paralysis in Buffalo, in 1913, there were fifty-seven deaths out of 650 cases, and that 40 per cent. of the patients remained paralyzed, but that some of these were slowly regaining use of their affected members under proper treatment.  He added that the epidemic lasted from June until September, and that the death rate was higher in the latter month than in any month preceding.

WASHINGTON, July 7.--Secretary McAdoo today followed up his decision of yesterday to give all the aid possible by the Federal Public Health Service by ordering six of the best bacteriologists and pathologists of that service to immediate duty in New York in connection with the epidemic of infantile paralysis.

The instructions from Secretary McAdoo are to bring to the task every facility at the command of the Government.  Its best physicians and laboratories will be drawn on and the strong arm of Federal authority will be employed in the most drastic manner to stamp out the disease.  The ground on which this action is taken is that there is imminent danger that in the dense population in New York, with the steady increase of the disease, it may break beyond the control of the local authorities and spread into other States and cities and become a public menace.

Orders were telegraphed to Surgeon Edward Francis at Savannah, for many years in charge of the hygienic laboratory here, [and other experts] to proceed to New York and report to Dr. Rucker....

The main problem is not connected so much with the treatment of actual cases as it is with the segregation and breaking the channels to other human beings.  The work requires great persistence and prompt knowledge of the occurrence of the disease.  Disinfection will be enforced to the last limit of precaution, and fullest co-operation between the Federal and State and Municipal authorities will be insisted on throughout the struggle to stamp out the epidemic.

One of the singular things about the New York epidemic to the public health authorities is that it was not indicated in the reports to the office here during the past year.  For instance, Cleveland last year, in a population of 656,000 according to official reports, had 138 cases and the disease has not yet assumed an epidemic phase in that city.  New York, last year, according to the reports, had 95 cases in a population of 5,658,000.  Chicago had 31 cases in a population of 2,447,000, and Philadelphia 12 in a population of 1,638,000.  Baltimore, with a population of 584,000, had 26 cases, and Boston, with a population of 745,000, had 20 cases.  In all these cities the occurrence of the disease was mainly in densely populated sections and among the families of poor people.

The health reports of the Public Health Service show the presence of infantile paralysis, generally in a limited way, al over the country.  Alabama had 8 new cases and 12 deaths; California, 62 cases and 19 deaths; Connecticut 35 cases and 4 deaths; Indiana, 36 cases and 17 deaths; Kansas, 48 cases and 15 deaths; Maryland, 66 cases; Michigan, 71 cases and 30 deaths; Minnesota, 127 cases and 26 deaths; Mississippi, 85 cases; New Jersey, 36 cases; New York, 267 cases and 247 deaths; Ohio, 466 cases and no deaths reported; Vermont, 42 cases and 17 deaths reported; Virginia, 231 cases and no deaths reported; Washington, 10 cases and 3 deaths, and Wisconsin, 14 cases and 14 deaths.

Assistant Surgeon General Rucker left on the midnight train for New York.  Before leaving he said he had no plan in mind now as to how the Public Health Service surgeons would conduct their plans.

"It is enough to say," said Dr. Rucker, "that we shall at once get into touch with the health authorities of New York City and State.  We shall co-operate with them. They know the situation as we cannot at this time.  Our first duty will be to observe all we can of the appearance and course of the disease.  When we are fully informed we shall decide what we are able to do."

In calling on United States public health officers, and State and local authorities throughout the country for telegraphic reports regarding the presence of infantile paralysis in all parts of the country, Surgeon General Rupert Blue of the United States Public Service sent this message to them:

"Infantile paralysis should be made a notifiable case.  Isolate all affected persons, preferably in hospitals.  Sick rooms should be screened, and free from insects.  Disinfect, by burning or use of carbolic acid, nasal and mouth secretions, accretions, body and bed clothing.  Limit contacts and control their movements.  Carriers can be determined by inoculation of animals.  Reduce dust.  Disinfect rooms occupied.  Discourage public gatherings, especially of children, if outbreaks occur."

Infantile paralysis continued to spread outside of the city yesterday, and more stringent measures were taken in affected and threatened localities.

Eight new cases of infantile paralysis in districts of the State outside of New York were reported to the State Health Department at Albany up to noon yesterday.  This brought the total number of cases outside of New York up to forty-five....

The department today sent letters to Presidents of all railroads in the State requesting that special care be taken in disinfecting all cars that had carried children from New York.  Local health officers were instructed today to see that glasses at soda fountains and other public gathering places were thoroughly cleansed and disinfected after use.

Officials of the department remained optimistic as to their ability to keep the disease from assuming epidemic proportions up State, but their efforts toward keeping parents, physicians, and health officers alive to the gravity of the situation were continued with vigor.

No reports of deaths outside of New York have been received at the department offices, although two fatal cases, one at Binghamton and one on Long Island, have been reported unofficially.

A report from Beacon, N.Y., added a new case to the list.  There have been five cases in Beacon and two deaths.  Dr. William R. May of the State Department of Health visited the town yesterday and examined cases.  One was near the Mount Beacon Summer resort.  The camp of the University Settlement in Beacon has declared a strict quarantine against the outside....

A "shotgun" quarantine was being maintained in all affected districts, Dr. Overton said.  Also the Long Island Railroad stations were being watched for afflicted children coming from New York City....

Three cases of infant paralysis developed in Jersey City yesterday, bringing the total to four.  All but one of the victims have been sent to the isolation hospital at Snake Hill, which was formerly used for smallpox cases, but which has been vacant for some years.  There is accommodation there for more than 200 patients.

It was necessary to resort to force in removing one patient last night, as a family of eleven joined in a refusal to allow the child to be taken away.  The family was informed that unless the case was isolated no members of the family would be allowed to leave the house for some months, and that a police guard would be maintained to enforce the order....

There was alarm in the vicinity of Caldwell yesterday, when it was reported that thirty families had removed to that place from New York.

Residents of Setaucket, L.I., fearful that fugitives from New York will spread infantile paralysis there, yesterday posted the following notice in many places throughout the village:

Warning--We are informed that families from the infected parts of New York City and Brooklyn are offering high prices for rooms and houses here.  While we sympathize fully with all who are suffering from this dread disease, infantile paralysis, we certainly should be very careful to whom we extend the hospitality of our village, that the dread disease may not make its appearance here.

Other steps to exclude New Yorkers with children have been taken elsewhere.

Both the New York Medical Journal and The Medical Record devote their leading editorials in today's (Saturday's) issues to infantile paralysis.

The editor of the latter publication issues a warning against beginning too early the treatment that is intended to overcome the resultant paralysis.  He says that much harm is often done by a too eager resort to massage and electricity.

The editor of The Medical Journal points out that very little, if any, advance in treatment has been made since 1890.  He points out the possibility of domestic pets acting as carriers of the disease.

After discussing the probabilities of poliomyelitis being spread by stable flies, house flies, fleas, and in the same manner as influenza and common colds, The Medical Record says:

"The high morbidity and the disastrous effects of poliomyelitis certainly demand that every precaution against its spread be taken, and , therefore, among other things, the regulations covering the management of stables should be made very stringent.  In view, however, of the more probable means of infection, it is very proper to consider and to treat the disease with respect, to quarantine and isolation in the same way, as the other acute infections of childhood, and this holds, even though instances of apparently direct contagion are rare.

"The assemblage of children in epidemic localities has been discouraged or forbidden, and although this with the closing of moving picture shows to children doubtless seems cruel to them, in face of the danger now threatening nothing that has been done to conserve the public safety can be accounted too harsh.

"The amount of infection, or even the exact foci of infection is difficult to determine, because many of the cases are believed to be abortive without paralytic symptoms, or so slight as to escape detection.  On the other hand, there is little doubt that many cases of ordinary convulsions in children are diagnosed, in times of epidemics, as infantile paralysis in the so-called preparalytic stage, and so the prevalence of the disease is made to appear greater than it really is.

"The amount of paralysis that will remain permanently after an attack of acute poliomyelitis is hard to estimate.  There is usually a great deal of repair, but it is often spread over a long period, even as long as two years.  Even in apparently paralyzed muscles, if they retain their foradic irritability to but a slight degree, there is hope of recovery under proper treatment.

"A great deal of harm is often done by commencing irritative treatment, such as massage and electrical stimulation, too early, that is, during the acute stage of the disease.  Later this treatment must be carried out relentlessly.

"Even when the paralysis is permanent the physician can now hold out a good deal of hope if there are nearby muscles that are intact.  Transplantation of tendons, so that the healthy muscles can do the work of the paralyzed ones, is an advance in surgery that has come to stay, and will help to mitigate the evil of infantile paralysis."

"A condition approaching panic," says The Medical Journal, "has been excited in certain parts of the city by the remarkable outbreak of acute anterior poliomyelitis, commonly known as infantile paralysis.  As pointed out, however, by at least one temperate lay thinker in the daily press, when we think of the population of the greater city, almost 6,00,000, the number of cases reported lose much of their impressiveness.

"It is remarkable that, although infantile paralysis has been a regular Summer visitor to New York for many years, we have learned little or nothing of its etiology or treatment during at least a quarter of a century.  In 1890, to our personal knowledge, the slowly interrupted galvanic current was used at the outdoor clinic on the disabled limbs--usually the lower--while parents were instructed to wrap them in cotton-batting to secure warmth, and to massage the affected muscles morning and evening.  Occasionally strychnine was exhibited.

"Today little, if anything, more is done, although the Department of Health has given excellent advice regarding prophylaxis.  We believe that this would be an opportune time to lay stress on the danger of domestic pets acting as carriers."

So manifest is the inability of the doctors either to cure or effectively to surround with a quarantine wall the disease now exciting so much and such justified apprehension in this city, and its vicinity, that there is likely to arise in the public mind the mistaken impression that infantile paralysis is unique in its mysteries.  In reality, about as much is known concerning its nature, origin, and transmission, and about as much can be done for it, as in the case of several other maladies that are less terrifying only because they are more familiar.

It is no disgrace to medical science that in its vast domain there are still fields the exploration of which is still little more than begun; it is to the great glory of medical science that the number of these unconquered regions is as small as it is, and that, one after another in rapid succession, their difficulties are yielding to vigorous, persistent, and intelligent assault.

The helplessness of the doctor confronted with a case of infantile paralysis--the name "acute anterior poliomyelitis" describes it far more accurately--is, after all, only comparative.  There are diseases which he understands better and therefore can do more for, but in this one, as, for instance, in pneumonia, another that is "incurable" in the ordinary sense of that word, he can treat and alleviate the varying symptoms as they manifest themselves, and he can give to a considerable degree that assistance to the "vis medicatrix naturae," which is, after all and in the last analysis, the only really "curative" agency in any morbid or abnormal condition of the body.

Deplorable as the present situation must be admitted to be, it is vastly better than, and as much different from, what the situation was, little more than a century ago, with respect, not to a small minority, but to the great majority, of all maladies.  As so often, the problem is almost as much social as medical, for, like so many others of our worst scourges, poliomyelitis is a poverty plague, and it is not alone in seeking victims outside of the slums where it originates.  If we could get rid of ignorance, and the filth and carelessness and superstition that go with it, there would be little need to hunt down the mysterious germ that no filter can stop and no microscope disclose.

WASHINGTON, July 11.--The fact that the present law as to the suppression of epidemic diseases makes no mention by name of poliomyelitis, or infantile paralysis, has made it necessary to ask Congress for a special appropriation to maintain the interstate campaign by the Public Health Service to stamp out the disease, and especially to prevent, as early as possible, all tendency to spread through the country from New York and vicinity.  Secretary McAdoo today asked Congress for $135,000, to be used by the Public Health Service in the suppression of the disease....

It is estimated that thirteen additional assistant surgeons will be needed to attend the interstate work.

The cost of conducting the notification and instruction work necessary in the large cities is heavy, and must be done with great care.  Directions have been issued to the Public Health Service to make the most vigorous campaign possible against the disease....

President Wilson today signed the Siegel resolution permitting the use of the hospital facilities at the Ellis Island Immigrantion [sic] Station for the New York victims of infantile paralysis....

At a special conference of the Academy of Medicine called at Aeolian Hall last night to inquire into the nature, manner of conveyance, and means of prevention of infantile paralysis, Dr. S. J. Meltzer of the Rockefeller Institute urged the treatment of all cases of the disease by intraspinal injections of solutions of adrenaline.  On the basis of experiments on monkeys, Dr. Meltzer has reached the conclusion that this method of treating the disease may prevent the spinal lesions which culminate in paralysis and death.

Dr. Meltzer's was the only specific suggestion made as to a possible manner of curing the disease, and his remedy attracted considerable attention among the physicians present.  Dr. Louis C. Ager, specialist on children's diseases and one of the speakers of the evening, declared the proposed remedy was important and should be brought immediately to the attention of the public.

In reading his paper to the large gathering of physicians and laity, Dr. Meltzer declared he had great faith in the adrenaline treatment because of the remarkable results it accomplished with monkeys which had been artificially infected with infantile paralysis.  He conducted a long series of clinical experiments in this direction at the institute in conjunction with other physicians.

"This procedure, said Dr. Meltzer, "may save life and in surviving cases it may reduce the extent of the final lesion.  There is no danger involved.  Monkeys stood as large a dose as 2 c.c. in a single injection.  However, in human infantile paralysis, the injection should begin with a dose of [0.3] c.c. of adrenaline until more is learned about the effects."...

Dr. Simon Flexner ... spoke at considerable length of the status of infantile paralysis, its origin, development, and methods of transmission....  [It] is caused by the invasion of the central nervous organs--the spinal cord and brain--by a minute, filterable micro-organism which has now been secured in artificial culture, and as such is distinctly visible under the higher powers of the microscope.

Notwithstanding the minute size of the organism which causes the disease, Dr. Flexner laid special stress on the fact that it was alive just as much as any human being, had a life history, was born, grew up and died just as any human being.  The virus of the disease, he said, exists constantly in the central nervous organs, and upon the mucous membrane of the nose and throat and of the intestines in persons suffering from the disease.  Thus far, the virus has never been detected to Dr. Flexner's knowledge in the blood of patients.

"The chief mode of demonstrated conveyance of the virus," said Dr. Flexner, "is through the agency of human beings.  Whether still other routes of dissemination exist is unknown.  According to our present knowledge, the virus leaves the body in secretions of the nose and throat.  The conveyors of the virus include persons ill of infantile paralysis in any of its several forms and irrespective of whether they are paralyzed or not, and such healthy persons who may have become contaminated by attendance on or association with, the ill.  How numerous the latter class may be is unknown.  But all attendants on or associates of the sick are suspect.  These healthy carriers rarely themselves fall ill of the disease; they may, however, be the source of infection in others.

"The chief means by which the secretions of the nose and throat are disseminated is through the act of kissing, coughing or sneezing.  Hence during the prevalence of an epidemic of infantile paralysis care should be exercised to restrict the distribution as far as possible through these common means.  Habits of self-denial, care and cleanliness and consideration for the public welfare can be made to go very far in limiting the dangers from these sources."

Dr. Flexner warned against the presence of flies, insects, and especially the stable fly, as possible carriers of the germ which causes infantile paralysis.  He said this particular method of carriage no longer receives the attention it had in former years, because an insect as a carrier of disease transmits the germ from the blood of one to the blood of another and the infantile paralysis virus has never been found in the blood....

Dr. Emerson sketched briefly some of the important facts of the present epidemic, and said there had been undue hysteria on the part of the public.  He drew attention to the heavy toll of deaths exacted each year by such diseases as measles, diphtheria, scarlet fever, and whooping cough, in comparison with the much lighter fatalities caused by infantile paralysis....

Certificates stating that the rightful holders were not suspected of being carriers of infantile paralysis were issued yesterday by the Department of Health to those who applied for them and were able to convince the authorities that they had not come into dangerous contact with the disease by living in infected houses, or in any other way....

Dr. Emerson said the certificates were not passports which had to be accepted, and admitted that in some towns where absolute quarantine against New York had been declared the authorities might refuse to honor them, but he was sure that the holders would have less trouble with them than without them, wherever they might go.  He further emphasized the care with which the certificates were issued, saying that every applicant had to satisfy the examining official of his identity and of the fact that he had lived since the beginning of the outbreak at the address given....

The [Charity Organization Society] issued the following "seven prophylactic suggestions which should be of help to salesmen, expressmen, delivery men, and other persons who are obliged to enter districts where the disease is prevalent:

1.  So far as possible, wear clothes that can be washed.

2.  In returning from the making of visits, wash hands and face at home, and frequently during the day.

3.  Use antiseptic nose and throat douches at the slightest suggestion of a cold or irritation in the throat.

4.  If you are accustomed to use an ordinary tooth powder, substitute for it during the present epidemic an antiseptic dentifrice.

5. Shampoo the head at least once a week.

6.  Keep a close watch upon your general health and report promptly to your physician and your superior officer any suspicious symptoms.

7.  See that door knobs, telephones, and other frequently handled objects in your office are washed daily with a disinfectant.

....Much interest centred yesterday in the paper read on Thursday evening before the Academy of Medicine by Dr. S. J. Meltzer of the Rockefeller Institute, in which Dr. Meltzer recommended a treatment for infantile paralysis which he had used upon monkeys with promising results.

"Suggestions for treatment having the authority of such an investigator as Dr. Meltzer, especially when they are based upon careful clinical or experimental observations always receive serious consideration at the hands of the Department of Health," Dr. Emerson said.  "In this case the suggestions were at once referred to the members of the Medical Board, who will doubtless be able to report on their experiences with the treatment at a later date."

Dr. Emerson explained that the Department of Health did not treat patients itself, but simply put them in the care of competent physicians who followed their own ideas as to treatment.  Any physician, Dr. Emerson said, was free to use the Meltzer treatment with the assurance that the department approved and would watch the results with interest.

Dr. Emerson cautioned those discussing the treatment against proclaiming it as a cure.

"I do not wish to detract from what Dr. Meltzer has done," he said, "but his paper was made disproportionately prominent in the newspaper reports of Thursday night's discussion."

Many physicians who were unable to attend this meeting inquired for details concerning the treatment yesterday, and Dr. Meltzer was asked to supply a statement of his work and recommendations.  He had nothing to say, he said, in extension of his remarks before the Academy of Medicine....

"Monkeys dying from experimental poliomyelitis received intraspinal injections of adrenaline.  The beneficial effect was most striking.  Animals which were paralyzed and moribund at the time of the injection were seen several hours later eating bananas which they held themselves.  The paralytic conditions were strikingly improved and the life of the animals was prolonged in some cases for several days.  The animals finally died; but in this series of Dr. Clark's experiments, all animals received reliably fatal doses of the virus.

"It is important to bear in mind that the mortality in human infantile paralysis is generally not more than 25 per cent.  The death is usually due to respiratory paralysis.  It is highly probable that in many instances the respiratory paralysis is not produced by the chief inflammatory focus, but by the extensive peripheral zones of exudation and edema, which are surely capable of interfering with the vitality of the nerve centres controlling the respiratory mechanism.

"If the exudation and edema could be removed for some time, the lives of a few or of many cases might be saved, namely, if in these cases, it just happened that the ascending progress of the actual inflammation came to standstill....

"There is no danger to this procedure...."

Another treatment advanced as a possible preventive measure against infantile paralysis was suggested yesterday by Dr. George Frederick Laidlaw ... in the following letter to THE TIMES:

Among the efforts that are being made to check the spread of poliomyelitis, or infantile paralysis, I wish to bring to the attention of physicians practising in the infected districts a simple remedy that I am giving my own children and those of my patients.  Many physicians have observed the resemblance of infantile paralysis to diphtheria and some have advised protective injections of diphtheria anti-toxin to check the present epidemic.  My plan is based on the resemblance of the two diseases, but instead of antitoxin I use the following mixture that was devised by Dr. Alexander H. Laidlaw many years ago as a preventive:

Tincture of belladonna,
Tincture apis mellifica,
Tincture phytolacca
Tincture veratrum veride.

Drop ten drops of each tincture into an ounce bottle.  Fill the bottle with homeopathic sugar pills, size No. 50, and shake.  Each pill soaks up a fraction of a drop.  Give one pill six times daily.

I do not say that this remedy will prevent infantile paralysis because I have no experience with it in that disease, but I have wintered and summered with it in diphtheria and know its value there.  In our present lack of precise knowledge of the prevention and cure of the present epidemic some physician or Health Board may care to give it a trial.  Its advantage over antitoxin is cheapness, ease in administration, instant availability and safety.  It can be given to nursing infants without harm....

Suburban authorities yesterday increased their precautionary measures against infantile paralysis. Hoboken led the way by isolating itself from the world, so far as new residents were concerned.  the city has not had a case of infantile paralysis, and if Health Commissioner John Stack's drastic measures are efficacious, no case of contagion will come into the city.

Policemen were stationed at every entrance to the city--tube, train, ferry, road, and cowpath--with instructions to turn back every van, car, cart, and person laden with furniture and to instruct all comers that they would not be permitted under any circumstances to take up their residence in the city.  Four families who tried to enter Hoboken were thus refused admission, although only two of them were from New York. 

Furthermore, every unoccupied  building in the city--dwellings, offices, lofts, and stores--was listed, and notices were sent to all owners and renting agents that they must report to the Health Department the name and previous address of any person who rented space for any purpose.  If any such persons, it was said, were found to have come into the city from the outside, the space would be refused them and they would be sent out of town.

Last night seven gangs of men disinfected gutters and receiving basins in the city, and other gangs flushed the streets and sidewalks with water.  All playgrounds were closed yesterday, and many prohibitions were placed on the movements of children of less than 16 years of age....

The idea of quarantining against New York because of the paralysis epidemic is as absurd as the shotgun quarantines against yellow fever in the South or against cholera, which used to be imported with the immigrants, and which followed river courses because the immigrants traveled on boats for lack of railroads in those times.  The things to quarantine against were mosquitos and the cholera germs in the immigrants baggage.  Sanitation was the remedy, not prevention of intercourse.  The proposed paralysis quarantine is preposterous because the proportion of cases is small compared with other dangerous diseases which attract less attention.  There are many diseases equally communicable which are more numerous in their total of cases, and others, like croup and diphtheria, which are more deadly.  Yet nobody thinks of quarantining against them, except locally, as a measure of sanitation rather than of prevention of intercourse.

The lesson for communities which are drawing aside their skirts from contamination by contact, with New Yorkers is the same as for New York itself, and that is, "clean up."  A paralysis-stricken infant loses its threat in a clean community.  Pity is more rational.  It is unworthy of New York itself to lose balance over the disease when it is considered how much worse diseases have been conquered, and how much higher a range of health the community enjoys than in the old days.  The list of deadly diseases which have been prevented by vaccines and healed by serums is long.  Smallpox and cholera and a long list of fevers are harmless, comparatively, as is shown by the lengthening expectation of life.  And yet paralysis is thought as frightful almost as leprosy, that unconquered scourge of humanity.

The epidemic has its uses as well as its threats.  It strengthens the hands of those who have been as those crying aloud in the wilderness for purity of living conditions.  How far we are from attaining that appears from the statement of Dr. Jenkins that our sewer basins are built to hold rather than to discharge their contents.  The sewer catch-basins, therefore, act as settling or fermenting tanks, for the propagation of germs and toxins on a large scale.

The watchword of sanitation should be "purity at the source."  Then there would not be a long line of accumulating filth and filth diseases requiring almost unimaginable effort to remove the cause and cure the results.  Millions throw upon the city the task of dealing with their wastes, which are immense in mass, but easy to deal with at the source.  Millions litter the streets needlessly, and overtask the white wings.  There is much the city can and should do because it can do it better than the individual.  But the individual should be taught not to create dirt wantonly, if not almost maliciously.  Hundreds of such cases have been brought into our courts tardily.  If that policy is persisted in, it will guard us against future epidemics as well as help to reduce this one.

The pure water campaign will not be necessary hereafter, because it was won just in time.  There lies ahead a river and sewer pollution campaign whose importance only experts appreciate.  Manhattan is an island entirely surrounded by sewage, and with neighbors who are outraged by our protests against their throwing their wastes into the national harbor.  The New Jersey Health Board so far forgot itself, only the other day, as to entertain a proposal that defilement of drinking water should be allowed and that the duty of purification should be thrown upon those who sold the dirty water to be drunk.  Nothing has been heard of it since.  THE TIMES mentioned it, and it will no more be revived than the proposal to establish public institutions with their diseased populations upon the Croton watershed.  There is more unreason about the safeguards of health than there is in panics about a few hundred of cases of disease.  The time to be frightened to some purpose was before the trouble, when those urging decency in community life were thought to be tiresome, and suspected of having sordid motives.

The number of new cases of infantile paralysis announced by the Department of Health yesterday was materially smaller than the number on Saturday, and as Saturday's figures were less than Friday's, the Health Department officials were inclined to hope that this continued increase meant progress toward a checking of the epidemic.  No one would let optimism beguile judgment, however, and all agreed that false hopes should no more be built upon what might be a purely temporary slackening in the spread of the disease than that panic should arise from a temporary spurt.

Dr. John S. Billings, Deputy Commissioner of Health, who was in charge yesterday in the absence for the day of Commissioner Emerson, expressed the Department of Health's opinion.

"Of course," he said, "we are all glad that the number of new cases and deaths is less today, and we hope that this is a result of our work, but at the same time it often happens in epidemics that diseases seem to rest for a while and then jump ahead again.  Also, you must take into account that the cases made public in today's and tomorrow's reports represent the work of private physicians and Health Department clerks on Saturday and Sunday, when the numbers on the job are reduced.

"The Health Department investigators, diagnosticians, and nurses do not take a day off, but private physicians do, and as it is on their reports that many cases are found, these reports always decrease on Saturday and Sunday.  I think you will find that the number of new cases on Tuesday will be greater than the number today or tomorrow."

There were ninety-six new cases yesterday....

With the total number of true cases yesterday at 1,959, Health Department officials agreed that by this morning the number of cases would exceed 2,000.  There were 2,500 cases in 1907, when the disease prevailed all Summer, and it has been anticipated that in the present outbreak the number of cases would far exceed those figures....

Dr. Billings was of the opinion that the cooler weather of yesterday was a help in the fight against infantile paralysis, but he said that the good effect would not be felt for a week.

"This week," said Dr. Billings, "I think we will suffer from the very hot weather of last week.  Experience has indicated that the effects of weather changes upon infantile paralysis are not noticed or from five to seven days after the change."...

Concerning the susceptibility of adults to infantile paralysis, Dr. Billings said yesterday that, of the more than 1,900 cases reported up to today, only 17 had been persons of more than 16 years of age.  This, he said, showed that adults need not worry about having the disease, but should take all possible precautions in order to reduce the chance of their becoming carriers....

Dr. Louis C. Ager, who is head of the Brooklyn Committee of physicians co-operating with the Department of Health, and who is physician in charge of the Kingston Avenue Hospital, to which more than 300 cases of infantile paralysis have been removed, said yesterday that the treatment of the disease with andrenalin, as recommended by Dr. S. J. Meltzer of the Rockefeller Institute in an address before the Academy of Medicine on Thursday, was receiving "a reasonable trial" in the hospital.

No decided results from the treatment had been noted, he said, but he added that this did not mean that it was not efficacious.  Two or three months would be required, he thought, before any sure report on the treatment could be made.

The treatment is also receiving trial at the Willard Parker Hospital in Manhattan, where there are also more than 300 cases.  Dr. Ager said the use of adrenalin had not been sufficiently tested to warrant physicians employing it extensively in their private practices.

Responses to Dr. Ager's appeal for funds for the orthopedic after-care of children recovering from infantile paralysis had resulted yesterday in the collection by the Brooklyn Bureau of Charities, of about $1,400....

Dr. Ager was told of the case of infantile paralysis in the family of Isaac Fogle, who lives in Philadelphia and is employed as a draftsman in ... this city.  Mr. Fogle rented a house in Flatbush last month, and intended to move his wife and child there, but because of the prevalence of infantile paralysis changed his mind and kept them in Philadelphia, from which city he came to New York daily, returning from his work to Philadelphia in the evening.

His child developed infantile paralysis on Saturday, and although Mr. Fogle had not come into contact with the disease so far as he knew, he feared that possibly he had become a carrier by catching the germs in his mouth or on his clothing while moving about New York.  Dr. Ager was asked if the father could have conveyed the disease to the child under the circumstances outlined, and he replied in the affirmative.

"Of course," said the doctor, "I do not pretend to say that Mr. Fogle carried the disease to his child, but it is perfectly possible that he did so."...

Dr. C. H. Lavinder, the Public Health Service official in charge of the laboratory study of the carrier problem, with his assistants, will continue the preliminary work started by them.  Within a few days they will begin to make tests on monkeys in the laboratory at Ellis Island.

George W. Perkins, Chairman of the New York committee, which, in connection with a New Jersey committee, has charge of the interstate Palisades Park, yesterday went to the park, and found that local health authorities in New Jersey had closed it to children.  He was displeased with this, being of the opinion that it was better for children to enjoy the fresh air of the park than to seek more dangerous places.  He said that he would take steps today to have the park reopened to the children....

Department of Health officials believe the outbreak of infantile paralysis has been checked.  They are especially strong in the belief that it has passed its high point in Brooklyn, where it began and where it has made its greatest ravages.  They are optimistic, too, concerning Manhattan and the other boroughs, with the possible exception of Queens, which was the only borough in which the number of new cases reported yesterday was materially greater than that on immediately preceding days.

The hopefulness of the Department of Health was expressed by Commissioner Haven Emerson, who for the first time since the beginning of the outbreak voiced positively optimistic feelings yesterday.

"We look upon the diminished number of new cases of infantile paralysis and of deaths in the last few days," Dr. Emerson said, "as evidence that we are reaching new cases sooner than we did at first, that we are controlling them better, and that the outbreak is on the wane."...

In Queens, where there were only six new cases on Sunday, there were twenty yesterday--the high record for the borough.  But whether this figure meant an actual spread of the disease or merely that the extra inspectors and diagnosticians put to work in the borough had discovered cases which should have been reported days ago, could not be decided on the information yet in hand.

Dr. Emerson has found his "onset table" even more encouraging than the table of daily new cases.  This table shows the date on which each case of infantile paralysis began, and, of course, differs from the table of daily new cases, for on any day a case may be reported, confirmed, and published, when the patient really was taken ill two, three, or more days previously.  In the onset table, however, each case is listed as of the day of its beginning.

This onset table, then, shows an even more decided deceleration of the disease's spread than does the table of daily new cases.  It indicates that the "crest of the disease wave" passed several days ago.

Dr. Emerson, however, cautioned yesterday against a too confident optimism....

...Mayor Mitchel ... issued a statement intended to allay the fears of out-of-town persons.  The Mayor's statement was occasioned by the fact that the presence of infantile paralysis here had caused a reduction in the number of Summer visitors to New York.  Reports from hotels and business houses yesterday were that conventions, meeting in the last few weeks, had been far below the normal in attendance, that many convention delegates left their wives and children at home because of the disease here, and that the out-of-town customers of local wholesale and retail houses had been fewer than usual in other years.

All the statistics, the health authorities say, show unmistakably, therefore, that excluding infant paralysis the death rate of persons of all ages has been materially lower this year than last--so much lower, in fact, that including the infantile paralysis the rate would be raised only slightly in a few classes of persons and not at all in others.

This is due, in the opinion of the authorities, to the fact that because of the outbreak sanitary conditions throughout the city have been better this year than last, parents have been more attentive to the ailments of their children, physicians have been more keen in the treatment of their patients, and children have had more care from public and private institutions.

The sum of the matter, health officials said yesterday, was that more intelligent and comprehensive attention had been paid to the health of the city this year than ever before, with the result that the saving of lives, especially of children's lives actually had resulted from the infantile paralysis outbreak.  There were children playing today, it was said, who would have been dead had the present outbreak not stirred citizens--parents, physicians, nurses, officials--to unusual activity.

While Dr. Emerson and his associates think the outbreak is on the wane, they are not, on that account, going to slacken in their preventive measures or give infantile paralysis a chance to get ahead of them again.  This was emphatically shown yesterday in the passage by the Board of Health of the following resolution:

That all children under the age of 16, in families where a case of poliomyelitis (infantile paralysis) has occurred, shall be quarantined on the premises until two weeks after the termination of the case by death, removal, or recovery of the patient....

Every morning, the Commissioner said, each patrolman would be supplied with the addresses of every home under quarantine in his jurisdiction, with the name, age, and number of every child in each home, and each policeman would be expected to visit the homes from time to time during the day and to report every case of violation of the quarantine regulations....

Motion picture men have made many appeals for a reduction in the age limit, and yesterday a delegation representing the Associated Motion Picture Exhibitors of Brooklyn and other organizations called on the Mayor to petition him to modify the prohibition in their favor....

A boy and a girl, each carrying a book, walked up the steps of the Public Library yesterday morning and darting through the entrance headed for the children's room on the ground floor.

"Sorry, but you cannot go in," said the attendant at the door, laying his hand on the shoulder of the boy.

"But we have a card," persisted the little chap, "and we have been coming regularly for a long time."

With amazement mingled with disappointment the children were asked to wait, and one of the assistant librarians from the children's room was called.  She took them to one side and explained that, as so many children were sick with the disease of infantile paralysis the library was obliged to keep all children out of its rooms.  They could leave their books but could not take others out.  How long this prohibition to use the library or its books would last the librarian did not know, as that would depend entirely upon the continuance of the outbreak.

"That was no exceptional case," said Director Edwin H. Anderson, when asked about the prohibition of children to enter the library.  "Hundreds of similar incidents have occurred during the last few days and in order to have the disappointed little ones understand the necessity of the step we have one of the children's librarians talk to them and explain it as nicely as possible.  We are simply carrying out the request of the Board of Health which has barred children from all libraries just as has been done from the moving picture theatres and several other places."...

Not only are all children under 16 years of age denied the use of the libraries, but no children's books are given out.  Not even parents can take out children's books.  What this means to the reading of children, as well as to the circulation of the libraries, may be seen from the statement made by Benjamin Adams, chief of the circulation department of the Public Library, that in the month of June the forty-four branches of the New York Public Library loaned about 311,000 books through the children's rooms....

"If a disappointment to the youngsters, the prohibition is at least giving us a chance to do some much needed housecleaning, and when the Health Department tells us we can resume giving out books the volumes will be in excellent condition and thoroughly sanitary."

During the last week the public has learned more about an acute infectious disease than ever before, probably, in the same period of time.  Along with a lot of valuable facts, both relevant and irrelevant, the average layman has, through a misleading emphasis, learned a good deal that probably isn't so.

Such an undigested mass of information has been heaped upon the public during the last few days through the many news channels, including news stories, special articles, communications, editorials, &c., that an attempt to give relative values to the many factors involved may prove exceedingly difficult.  However, the situation certainly justifies an effort to place the emphasis as regards the immediate disease hazards where it belongs.  Physicians and sanitarians have competed with laymen in pointing out to the public probable sources of infection.  Among other things spoken of as possible carriers of infantile paralysis are the following:  Milk, water, house flies, mosquitos, nose and throat discharges, street dust, healthy human carriers, food, sewers, garbage, &c.  Newspapers throughout the country have insisted that health officers "leave no stone unturned" in attempting to "rout the plague."  This, of course, has meant a desirable if not always relevant clean-up.

To some extent, undoubtedly, the health officer is justified in using the immediate and pressing motive for the accomplishment of ends which he knows have no special bearing on the infantile paralysis situation.  More thoroughly to clean our streets and more decently to remove our garbage can do no harm, in any event, as far as infantile paralysis is concerned, and will accomplish good in other directions; hence the partly conscious exploitation of the infantile paralysis motive for the accomplishment of general sanitary ends, an exploitation infinitely more justifiable than is that of certain private interests in their attempts to seize this opportunity to boost the sale of certain commodities such as tooth pastes, mouth washes, disinfection devices, &c.

The only risk in this misdirection of emphasis is that it may direct public attention into relatively unimportant channels and away from real points of danger, and we must, therefore, not neglect to emphasize the significant and urgent factors in the situation.  Let us remember that the disease is probably either an insect-borne disease or an ordinary nose and throat disease, more likely the latter.  The chief things to emphasize, then, in teaching the public how to combat the spread of infection are thorough screening for protection from insects, the avoidance of sick individuals and of individuals who have been in contact with cases of paralysis, the safe disposal of body discharges, particularly those from the nose and throat, and the enforcement of the rules of respiratory hygiene regarding kissing, sneezing, coughing, candy sucking, apple "swapping," &c.

We have realized that the keynote of modern sanitary precaution is personal hygiene.  Nowhere is this of more importance than in connection with the diseases spread by respiratory and mouth discharges.  The Health Department is doing all it can, and very admirably, to head off the epidemic.  Unfortunately, it has not the mechanism for the enforcement of the rules of personal hygiene, particularly among children.  Now that the schools are closed any important channel for the dissemination of knowledge is cut off.

Yesterday in a Staten Island village, where the playground was closed to prevent the spread of the disease--a wise step on the part of the health authorities--I saw a row of children sitting on a park bench chewing bark off sticks of wood and exchanging pieces of the same, thereby facilitating the exchange of any infectious material.  Here the "anti-plague" measures undoubtedly broke down.  Personal hygiene was lacking.  All the covered garbage cans, all the clean streets, and all the covered food in the shops in the world will not protect these children, unless some one teaches them personal hygiene and puts that first in the program of prevention.

In reality, we are very much in the Middle Ages as regards hygienic and sanitary precautions against anterior poliomyelitis.  However, we do know more than our ancestors about the spread of insect and nose and throat diseases, and we should therefore take pains in our educational work to place first the things which are probably of first importance.  We know that nearly all diseases breed in the human body and rarely "lurk" in filth.  Garbage has ever been accused of disease dissemination, and that is why many of our Health Departments are still required to spend an excessive proportion of their total appropriation for health work on garbage and refuse removal.  From the points of view of decency and aestheticism, it is highly desirable to have our refuse carefully cared for.  At the same time, as far as infantile paralysis is concerned, let us try first to place an effective barrier between the infected and the noninfected nasal mucous membranes.  Let us realize that, as far as this disease is concerned, when the health authorities inspect certain urban districts for sanitary code violations, for garbage accumulations, &c., they are carrying out a practice quite similar to the medieval anti-plague measures of sulphur burning in the streets.  Has any one heard of an excessive incidence of infantile paralysis among the families of our street cleaners or refuse and garbage handlers?

I am told that in one section of the city the Negro children are wearing about their necks bags containing camphor and anafetida.  I learn also that in another section of the city a special effort is to be made to flush the streets.  Of course both of these measures may be important, though I don't believe they have any special bearing in the present emergency.

If infantile paralysis is an insect disease, let us remember our experience with yellow fever, which we fought ineffectively by scavenging methods for years, and which has now been eliminated in this country by means of intelligent care in the prevention of the breeding of the stegomyia or yellow fever mosquito.

If we are here dealing with a nose and throat disease, let us remember the history of diphtheria, thought for a long time to be spread by fomites, now under control through our knowledge of the organism, and the way in which it is carried by the sick and the well from one nose and throat to another.

When the opportunity to teach sanitation and hygiene in a wholesale way occurs, it is, I presume, good policy to make the immediate instrument carry all the knowledge it will bear, even though some of it may not be apropos.  It is important, however, that we put the significant things first.

DONALD B. ARMSTRONG, M.D., M.S.

Thirty-nine deaths from infantile paralysis were reported in the city yesterday, and 135 new cases.  This was a greater number of deaths from the disease than has occurred in any twenty-four hours since the beginning of the outbreak, and the new cases were more than on any day since last Wednesday.

The borough reports of new cases tended to confirm what Health Commissioner Emerson and others have been saying for several days--that the situation in Brooklyn was positively encouraging, while that in Manhattan had elements of uncertainty....

Dr. Emerson has frequently pointed out that the actual number of new cases in any borough on any day is not significant, but that the tendency of the daily number of new cases to increase or diminish through a period of several days really would indicate whether the disease was waxing or waning....

As an indication of the extent to which health authorities were going, Dr. Charles E. Banks of the Public Health Service yesterday received a telegram from the Health Officer of New London, Conn. saying that New London, Norwich, Willimantic, and "way stations" were closed to incoming New Yorkers....

Nor is Connecticut the only State in which such rigid quarantine is maintained.  Many places in New Jersey are as strict.  Hoboken and Paterson are among the most severe upon visitors.  New Yorkers arriving in Paterson are not given any period of grace in which to get out of town, according to reports, but are told to leave immediately upon their arrival.  Even visitors from other towns are said to be barred.

Yet, with all of this, persons living in Paterson may visit relatives or friends in New York and return to their homes without even being asked whether they have come into contact with the disease.

The situation became acute yesterday and on Friday because so many persons sought to leave town for the week-end.  Hundreds of those who obtain health certificates, it was said, were turned back at their destinations, and returning boats and trains yesterday brought in numbers of disappointed travelers....

...Dr. C. H. Lavinder, the expert of the Public Health Service in charge of the corps of surgeons studying the carrier problem, said:

"The city which says that no one shall enter, and simply turns back all arrivals without provision for their protection, simply commits an outrageous act and does not protect itself."...

There was a report yesterday that the city officials were discussing the question of not opening the public schools next September, but when Health Commissioner Emerson was asked about this he said:

"I have heard nothing of it, and I do not believe that any such action will be necessary."

Mrs. Anna Henry of ... Brooklyn, has received a "Black Hand" letter, threatening her life because she had been active in reporting infantile paralysis cases and violations of the sanitary regulations in the Italian colony of Brooklyn near Public School 91, at Albany Avenue and Maple Street, known as "Pigtown."

Mrs. Henry is one of the nurses at a babies' clinic in the public schools.  She found and reported two cases of infantile paralysis and wherever she has discovered unsanitary conditions she forced corrections.

Mrs. Henry took the letter to the Snyder Avenue Police Station and Detectives Owens and Wackery were assigned to the case.  Also a policeman was detailed to meet Mrs. Henry every day at her home and accompany her about her work, for she said she had no idea of quitting....

Dr. Emerson said yesterday that he had conferred with the Mayor concerning the petition of motion picture exhibitors for permission to admit children to their theatres in certain districts, and that he and the Mayor had agreed that the best interests of the city made it necessary to refuse to grant the petition....

Another decided decline in the number of new cases of infantile paralysis in Brooklyn was recorded in the report made pubic yesterday by the Department of Health....

Dr. Emerson said that as the outbreak continued "a slight advance in the age incidence" had been noted.  This, he explained, meant that a few more children of more than 5 years of age were being attacked by poliomyelitis than at the beginning of the outbreak.

When told that some citizens of the Bronx had criticized the Department of Health for sending Brooklyn and Manhattan cases to Lebanon and St. Francis Hospitals in the Bronx, Dr. Emerson said: 

"I have heard no such criticism at all, and wish to take this opportunity for thanking the officials and citizens of the Bronx for their splendid assistance to the city in accepting a few cases from other boroughs  and in general co-operation."...

Dr. Charles F. Pabst, ... a Coroner's physician of [Brooklyn], added yesterday to the advice to mothers concerning preventive measures.

"One of the chief things needed to protect a child from poliomyelitis," said Dr. Pabst, "is sleep, because the disease attacks the nerve tissues, and only sleep will repair worn nerve tissues well in hot tenement rooms.  I can suggest, however, an inexpensive expedient that, in my opinion, will make healthful sleep possible to any child.

"It is this:  The mother of a child should purchase a quantity of grain alcohol.  She can get this from the city dispensaries at cost about 35 cents a pint, or from drug stores for about 50 cents a pint.  She should pour half a cupful of the alcohol over an equal quantity of cracked ice in a small bowl, and then bathe the child in the solution.

"Such a bath will do three things:  It will cool the child's body; it will act as a general tonic and disinfectant; and it will remove waste material from the body.  As a result, the child will go to sleep naturally soon after the bath and probably sleep soundly all night."...

Decrease in the number of new cases, and increase in the number of deaths from the reports of Sunday, yesterday marked the progress of the outbreak of infantile paralysis in the city, but the measures employed to prevent further spread of the disease beyond the city were extended both within the city by the United States Public Health Service officials, and in other communities by local health authorities.

Dr. Charles E. Banks, who is in charge of the medical staff issuing certificates to persons leaving the city, announced that henceforth no children of less than 16 years of age would be permitted to leave the city for interstate travel without both a Federal and a city Department of Health certificate.

Word was received in the city from many places warning all comers that they would not be admitted with children for whom no certificates were held.

"The inspection of children leaving the city for interstate travel," said Dr. Banks yesterday afternoon, "will be compulsory from now on, and all railroad and steamship lines have been notified to that effect.  Ticket punchers at station and pier gates will be instructed not to pass any children who have tickets for points in other States unless the children show the Federal certificate, which, as in the past, will not be issued to any one until a Department of Health certificate has been obtained by the applicant."

The need of uniform quarantine regulations was illustrated yesterday, when an attempt was made to ascertain the requirements of health officials of towns along the railroads leading from New York.

"Why," said the Vice President of one of the big railroads, "they change their regulations overnight.  They establish a certain form of quarantine, then hear of a new case of infantile paralysis in the neighborhood, and decide to make their quarantine more strict.  We can never tell just what the regulations are in any town."

It was said at the offices of the Erie that an attempt had been made by the railroad to keep a list of the quarantine measures of each town on the lines, but that the measures had been subject to such changes that the attempt to keep the list had been abandoned.

All the railroad managers interviewed advised that travelers, before leaving New York, telegraph to the health officers at their intended destinations for definite information regarding quarantine, and then comply with the instructions given....

OYSTER BAY, N.Y., July 24--
Colonel [Theodore] Roosevelt today began war on infantile paralysis in this section.

The Colonel and about one hundred of the most prominent men and women of Oyster Bay met this afternoon at the Town Clerk's office and mapped out a campaign against the disease....

"To my mind," he said, "the most effective way to combat the spread of the disease is to organize a committee of representative residents to immediately take the matter up and see just what must be done.  Matters have been dragging along here for some time without adequate measures being taken.

"For instance, I think this is a most opportune time to do something about a playground for the children.  This matter has been mentioned for some time, and I have heard it said that the township is without funds.  Let me tell you that a number of men in the vicinity have told me that they are willing to pay part of the expense.  We will all chip in and see that the kiddies have some place in the open where they can play and enjoy themselves."....

Infantile paralysis has taken a jump ahead in Manhattan, the Health Department report showing forty-two new cases in this borough in the twenty-four hours ended at 10 o'clock yesterday morning.  The total of new cases in the city in the same period was 150, an increase of more than 68 per cent over the eighty-nine cases of the preceding twenty-four hours....

Now that patients are beginning to convalesce from poliomyelitis, the work of after-treatment is increasing in importance, and realizing this, Dr. Emerson yesterday summoned representatives of orthopedic hospitals and departments to his office for a conference.  It was agreed that many children would require orthopedic treatment for months or years, and it was recognized that hundreds could not pay for treatment.  The representatives of hospitals at yesterday's conference agreed to contribute to the services of surgeons in all needy cases, and plans for paying for electrical treatment, braces, and other appliances were made, a number of representatives of city relief organizations offering to provide funds.  The representatives of hospital and relief organizations at the conference organized a permanent committee to care for the after-treatment of children....

..."Since the beginning of the alarm over infantile paralysis," the Superintendent said, "we have been receiving an average 800 requests a day for our men to call for unwanted domestic pets, mostly cats, in spite of the statement issued by Health Commissioner Emerson that cats do not carry the germs of the disease...."

The Board of Estimate yesterday appropriated $2,000 at the request of Mayor Mitchel to bring between fifteen and twenty scientists and specialists from other cities to New York to join leaders of the medical profession here in the study of infantile paralysis.

Health Commissioner Emerson, said the conference probably would take place on Friday and Saturday of next week.  Those who will be invited to the city will be announced later.

The Mayor's request was based on a letter from Health Commissioner Emerson, in which he said:

The opinion of capable physicians and scientists in this city and elsewhere is that advance in our knowledge of infantile paralysis might be obtained through a conference in the city of leaders in scientific thought and investigation in this country.  There are fifteen to twenty men from Chicago to Boston who have made important contributions to preventive medicine.  I believe their presence here for two or three days would result in organized efforts in various laboratories to supplement the work now done under the Committee on Research in this city.

Mr. Cline said that none of the children had left the post after June 1, and that none of them met any child visiting the post after that date, nor was there any illness among children at the post.  The father made six trips to Manhattan and Brooklyn after June 1, but came into contact with no child and was away from the fort only long enough each time to finish his errand.  Furthermore, the fort reservation has been under quarantine since July 1, and no child has left or entered it.  There have been about 100 children of officers and men at the fort, and none but the Cline children has shown symptoms of poliomyelitis.  About 350 boys are quarantined in the camp of the National School Camp Association on the reservation, and none has shown symptoms of infantile paralysis.

The difference of opinion among doctors as to the value of adrenalin in poliomyelitis was again emphasized yesterday when Dr. Edward J. Bermingham, executive surgeon of the New York Throat, Nose, and Lung Hospital, 239 East Fifty-seventh Street, made public another favorable report on his use of the medicine.  He said:

Hexamethylamine in regular doses every three hours, of 1 1/2 to 3 grains, according to the age of the child, as a diuretic and bactericide.

Interspinous injections of adrenalin, as suggested by Dr. S. J. Meltzer.  We feel that Dr. Meltzer's theory has been sustained.  We will not say proven, because fifty cases cannot prove such an important matter.  We believe that no small degree of the success we have had in the treatment of this dread disease has been due to Dr. Meltzer.  Fifty cases have had these beneficial injections administered every six hours, day and night.  We have had no ill effects, and the improvement in all cases has been so marked that all acute symptoms have subsided in thirty-five cases, and today only fifteen cases, including new admissions received the injection.

"I have no special comment to make.  I accept the report as a correct statement of fact, but I don't see that it lands one anywhere.  Results similar to those described in it are being obtained under similar hygienic conditions in other hospitals without any adrenalin treatment."

Dr. Charles E. Banks, in charge of the United States Public Health Service here, would not say positively yesterday whether or not certificates would be refused to children going to New Jersey and Connecticut resorts, but he said definitely that persons leaving New York with children on excursion boats would not receive certificates.....

Concerning the prevalence of infantile paralysis among certain age groups of children, Health Commissioner Emerson yesterday made public the following statistics compiled in his office:

The first 1,761 cases which occurred in Brooklyn were classified according to the ages of the patients.  It was found that 10.6 per cent., or, in whole numbers, 186 children, were under 1 year of age; 67.5 per cent., or 1,188 children, were under 3 years of age, leaving 1,002 between 1 and 3 years of age.  1,461 children, were under 5 years of age, leaving 273 between 3 and 5 years of age.  Ninety-seven and three-tenths per cent., or 1,713 children were under ten years of age, leaving 262 between 10 and 5 years of age.  Only 2.7 per cent., or 47 children, were more than 10 years old, and only one-half of 1 per cent., or 8 children, were more than 16, leaving 39 children between 10 and 16....

The forty-four deaths from infantile paralysis reported yesterday constituted the largest number in any twenty-four hours since the beginning of the epidemic, the highest previous number being thirty-nine.

Comparison of the figures and a survey of the location of the cases in the five boroughs led Health Department officials, however, to reaffirm yesterday their belief that the outbreak was waning in Brooklyn and Richmond, though it was waxing in Manhattan, Queens and the Bronx.  And the officials made this further deduction from yesterday's reports:  That most of children who have lived in the districts originally attacked by the disease, especially in Brooklyn, without catching it, may be immune, and that the disease may be expected, from now on, to spread most in districts only recently or not yet attacked--unless the preventive measures taken by the Department of Health and co-operating institutions and individuals should prove successful in checking such spread.

This, admittedly, is only a theory, but is based on observations of Dr. Wade A. Frost of the United States Public Health Service, who has made close study of many epidemics of poliomyelitis, and Deputy Health Commissioner Billings and other Health Department officials are almost convinced that the theory is sound.

Dr. Frost, who presented the results of his observations to a recent bulletin of the public Health Service, found, first, that in epidemics of poliomyelitis the virus of the disease was usually widespread in the community attacked; second, that, despite this fact, only a small percentage of the child population of each community developed the disease, and, third, that the disease seemed to die out of its own accord in every community after attacking a small percentage of children.

From these observations Dr. Frost formulated the theory that only a percentage of children were susceptible to poliomyelitis and that, when an epidemic came, it flourished on this fixed amount of susceptible material until the material had been exhausted and then died out just as a fire in a mass of combustible and incombustible material goes out after consuming the substances that will burn.

"It is certainly true," said Dr. Billings yesterday, "that we are getting fewer and fewer cases every day from the sections of South Brooklyn, where the epidemic began, and more and more cases from districts where the disease only recently began to spread.  In Manhattan there seems to be a tendency toward reduction of the number of new cases daily in the lower east side, where this borough first suffered, and a tendency to increase in the upper east side, which, until recently, had almost escaped."....

While this theory holds out hope for children in the districts where the epidemic has begun to wane, it should not, conversely, excite fear for the children in the districts recently or not yet infected, in the opinion of the Health Department officials, because of the preventive measures now so thoroughly applied all over the city.  These measures have protected many children, in the opinion of Dr. Bolduan, and, to support his contention, he pointed to the fact that in the early days of the epidemic, in the originally infected districts, before the preventive forces had been fully organized, big jumps in the number of new cases from day to day were usual, whereas, in the districts infected later, after the organization of the preventive forces, although a persistent rise in the number of new cases occurred on succeeding days, there have been no such sharp advances as in the first Brooklyn outbreak.

The prevalence of poliomyelitis has invited medical fakers of all kinds to work upon the ignorance and superstitions of persons in fear of the disease, and, as soon as this was realized in the Department of Health, Dr. Lucius P. Brown, Director of the Bureau of Food Inspection, and Dr. Bolduan organized an energetic campaign against quacks.

Drug Inspector William Cohen has arrested Joseph Frooks of 223 Chrystie Street on a charge of violating Section 112 of the Sanitary Code and Magistrate Murphy in the Tombs Court has held the man in $1,000 bail for examination on Tuesday.

Inspector Cohen, in his report to Health Commissioner Emerson, charged Frooks with selling bags of "Infantile Disease Protector," which, it was said, would give immunity when hung from the neck of a person.  The inspector said he applied to the man for a commission to sell the bags and was told by Frooks that he might have 1,400 bags for $6 and could sell them with the guaranty that they would "prevent all diseases, including infantile paralysis."

Inspector Cohen said he purchased one bag for 10 cents, examined its contents and found that it contained "one-half ounce of a mixture of wood shavings saturated with some preparation having a napthaline odor."

After Frooks's arrest, the Department of Health issued a warning to the public not to purchase any of the bags from his agents still at large.

Public Health Service surgeons on duty at railroad, ferry, and steamship exits from the city had trouble yesterday with persons wishing to go into another State with children for a day or two, but who had not provided themselves with certificates from the Department of Health, though such persons, probably because of the recent warnings issued by Dr. Charles E. Banks, the senior surgeon, were not so numerous as had been expected.  All of them were refused the Federal certificates and were, therefore, unable to make their expected pleasure trips.

Excursions to New York from out-of-town gave more trouble yesterday than other travel, for persons insisted upon coming to the city from New Jersey and Pennsylvania with children, and, not possessing certificates from their local authorities, had difficulty in identifying themselves and obtaining Federal certificates when they wanted to leave the city in the evening.

In one Pennsylvania Railroad excursion alone there were between 400 and 500 persons, many with children.  Dr. Banks, seeing a source of danger in such needless pleasure travel, and wishing to discourage it, instructed his surgeons in stations to show no solicitude for the difficulties of the pleasure travelers.

More than 2,000 Federal certificates were issued for children leaving the city on Friday and a greater number, it was estimated, was issued yesterday.

Dr. Banks was encouraged yesterday upon receiving advice from Washington that the quarantine measures of States near New York were being made more uniform and reasonable....

The Board of Directors of the New York Hospital yesterday offered to the Board of Health to equip a special hospital of from 50 to 100 beds for infantile paralysis, and the Trinity Church Corporation proffered the use of the old St. John's School building in Varick Street for a similar purpose.  Health commissioner Emerson had left for Washington when the offers were made, and no one took action upon them in his absence.....

The new cases of infantile paralysis reported yesterday were nearly one-third fewer in number than those reported on Wednesday, and the health authorities were led to predict further big drops in the daily reports in the immediate future.  The daily average of new cases for the first four days of last week, was 107, while for the first four days of this week it was 66.

August, however, will remain the worst month of the epidemic.  In June there were 313 cases and 63 deaths, in July, 3,437 cases and 779 deaths, and in August 4,004 cases and 1,082 deaths.

Health Commissioner Emerson said yesterday that he would permit the motion-picture theatres and other places of amusement to admit children more than 12 years old on and after next Monday, Labor Day, and he so notified License Commissioner Bell, who was out of town, but who, it is believed, will today amend his order to the motion-picture men and others, in accordance with Dr. Emerson's opinion.  The original order prohibited the admission of children under 16.

Motion-picture men were jubilant when they heard of the Commissioner's decision.  All of them have suffered and many of them have been forced to close their doors because of the restriction to children.  It is thought that on Sept. 25, or whenever the schools open, the last restriction will be removed.

Concerning the opening of the schools, Dr. Emerson yesterday sent this letter to William G. Willcox, President of the Board of Education:

This department is definitely of the opinion that the public schools should not open for people under 16 years of age before Sept. 25.

While it is now our opinion that it will be safe to open the public schools on that date, it is possible that a further postponement may be deemed advisable, if the epidemic should subside less rapidly than we now expect.  A definite decision regarding this may be expected no later than the 11th of September....

Dr. S. J. Meltzer of the Rockefeller Institute, writing in the number of the New York Medical Journal to be issued today, condemns the widely used treatment of infantile paralysis, which consists of taking the spinal fluid from a patient and then injecting the fluid under the patient's skin; on the theory that the virus of the disease will stimulate the formation of antibodies in the blood.  The Rockefeller Institute scientist thinks this treatment is likely to cause death or worse paralysis than would have occurred.  The treatment is called "auto-inoculation."

It got what was called "deserved mention" in the weekly bulletin of the Department of Health published on Aug. 12.  The treatment was used in the Kingston Avenue Hospital from about the middle of July until the middle of August, and has been, up to date, applied by many physicians in private practice, although its use has been discontinued in the Kingston Avenue Hospital.

Health Commissioner Emerson said last night, that all patients so treated in the Kingston Avenue Hospital had recovered, and that none had developed the evil results feared by Dr. Meltzer.  The treatment had been discontinued in the hospital, he said, not so much because of danger as because the physicians administering it desired to employ it in homes early in the cases rather than to wait until children came into the hospital.  

Dr. Meltzer admits that the method "superficially appears to be based upon a few indisputable scientific premises," and he agrees that the spinal fluid contains the virus of the disease; but he begins his criticisms by maintaining that the value of the method has never been demonstrated on animals; nor is it known that the injections of the fluid are harmless.

"And it seems to me quite clear," he adds, "that such therapeutic experiments should never be made on human beings."

The writer adds that the method would never be applied to tuberculosis or typhoid fever because of the possible fatal outcome.  He adds:

"I come to the conclusion that the treatment of infantile paralysis by the subcutaneous injection of the spinal fluid withdrawn from the patient is not only not based on 'sound scientific principles,' but it is absolutely, contraindicated, and ought to be prohibited by those in authority."

In the same letter, Dr. Meltzer discusses the treatment of infantile paralysis by immune blood serum, and recommends that the treatment be continued, under proper conditions.

In the same number of the Medical Journal Dr. Meltzer has another letter to which he withdraws his former intimation, that the Department of Health was "inimical" to the use of adrenalin as suggested by him.  He finds that the department has been entirely impartial regarding treatments and has used adrenalin in more than 100 cases.

"I gladly apologize to the Commissioner of the department for my incorrect public expression," Dr. Meltzer writes.

Another letter in the Medical Journal is from Dr. Benjamin I. Berman, who suggests that the infection of poliomyelitis may have been spread by poultry.  He says that there is a disease called "chicken rheumatism" which closely resembles poliomyelitis, and that unscrupulous farmers kill chickens dying of this disease and send them to the market.

A number of cases of poliomyelitis, it was learned yesterday, have been treated with serum from the blood of horses in normal health.  Some physicians believe they have obtained encouraging results from this treatment.

Three persons gave thirty-one ounces of immune blood at the Willard Parker Hospital yesterday....

There were only seventeen deaths from infantile paralysis in the entire city yesterday, the number being less than that for any day since early in the epidemic....

Joseph A. Frooks of 62 East Eighth Street, a former Assemblyman of the Tenth District, who was recently convicted in Special Sessions of selling a "fake" cure for infantile paralysis, was yesterday sentenced to serve thirty days in jail and pay a fine of $250.

Dr. Oscar M. Leiser, Assistant Director of the Bureau of Public Health Education, said that all medical frauds would be hunted and prosecuted by the Department of Health....

• History 135F Home Page

• On the Mode of Communication of Cholera (1855), by John Snow, M.D. (1813-1858)

• the testimony given by Dr. John Snow on March 5, 1855, regarding the Nuisances Removal and Diseases Prevention Act

• "The Public Health and Nuisances Removal Bill:  Dr. Snow's Evidence," an editorial from The Lancet (June 23, 1855)

• "Observations on the Filth of the Thames," a letter to the Times of London (July 7, 1855) by Professor Michael Faraday (1791-1867)

• "Monster Soup commonly called Thames Water, being a correct representation of that precious stuff doled out to us..." (ca. 1828) by William Heath (1795-1840)

• News articles from the Chicago Tribune:
• "They Deal in Death...," August 20, 1893
• "Caused by Microbes...," November 23, 1893