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The most significant points made by Milyukov in this interview seem to me to be what he said in regard to the position of the peasants, and what he said in regard to his own plans for taking things over in case of a reaction from Socialism. His expression of confidence in the peasants tended to confirm the impression I have gained from other evidence that there may soon be a split in the Cadet party, if there has not been a quiet one already. Nekrasoff, the then Minister of Ways and Communications-now Provisional Minister of Justice is a Cadet whom Milyukov publicly named as the leader of the movement from within the Ministry to eliminate Milyukov from that body. Nekrasoff is willing that Russia should renounce her historic ambition for the possession of the Bosphorus. He represents a faction in the Cadet party, the more radical faction, which might without much difficulty ally itself with the less radical Socialists. The Milyukov faction, on the

other hand, which is the larger faction, has made more than one move apparently calculated to bring about an alliance with the peasants. A great deal of stress is being placed on the party's desire to be called, not Cadet, but the "Party of National Freedom."

The other point is of greater significance. It is reassuring to know that Milyukov and his political allies are not merely idle in the inaction of disorganization and despair, but have definite plans for the future. It is reassuring to know that the most intelligent and most experienced group in the Russian political game is (to expand Milyukov's metaphor) watching the ball of government in its flight to the Left, determined to catch it and pull it down to safe middle ground when it rebounds, providing the rebound is not too high. Let us hope the rebound of the ball will not be over their heads. Tokyo, July 24.

T

HREE or four American ambulances were standing outside of a poste de secours near Verdun waiting for their wounded. Some of the men were lying under their cars, others were in near-by shell holes to escape the hail of shrapnel from the German guns. The poste itself, in the cellar of a ruined house, and the road which led to it, were the objects of a violent cannonade which had driven the ambulance men to

Cover.

Into the hospital in the bombarded cellar a steady stream of wounded was being carried, and as each was laid on the operating-table the first thing done to him was to give him an antitetanus injection. Into every wound is carried a bit of clothing or a tiny morsel of dirt, either of which bears the germs of the dreaded lockjaw, and without the toxin the wounded man would stand no chance at all. But the toxin is a perfect preventive, and here, three thousand miles from its home, and on the bloodiest battle-front the world has ever seen, the New York Health Department was carrying on its work of "prevention first," for the toxin came from its laboratories over on the East River, which had sent out enough to save the lives of two hundred thousand men.

New York has its hot nights, too, and there had been one of them, when the East Side tenements poured their sweltering occupants out upon the fire-escapes, in the hope of catching a breath of a stray breeze. Early the next morning, within the open doors of a spotless Health Department baby station sat a row of mothers with babies in their arms. The room, cool from its electric fans and open ice-chests filled with bottles of pure millk, was like heaven after the agony of the night. Some of the babies had been brought safely into the world through the preventive pre-natal care of the Board's nurses, who taught the foreign mothers, innocent of any knowledge of hygiene, how to care for themselves that they might have healthy babies and pass safely themselves through the ordeal of motherhood. In a little room apart was a kindly doctor with a real love for the little ones, examining each in turn, and prescribing for its ailments. It was a picture never to be forgotten, with the almost naked babies in the arms of Madonna-like Italian mothers, the babies looking for all the world as though they had stepped out of pictures by Gian Bellini or by Fra Bartolommeo, that great est of baby painters. One of them, indeed, looked like the Christ Child in that wonderful picture in the Cathedral in Lucca, so that one almost expected to see him hold out his arms with the ravishing smile which glorifies the monk's masterpiece.

There were Hebrew babies with the touch of mystery in their eyes which betrayed their Oriental origin. There were "little mothers" who carried charges almost as big as themselves; there were sisters who came to interpret the doctor's directions

to mothers who knew no word of English. And it was all a part of that fight of prevention which is the Department of Health's first policy.

Out on the dreary marshes around Jamaica Bay, and in many another spot which has heretofore been sacred to an occasional crabbing party and to the breeding of mosquitoes, the Department is busy too. Sturdy men in high rubber boots are at work among long lines of ditches which drain the standing water into tidal creeks, spraying them with kerosene to keep the larvæ from maturing. It is the very same work which has turned the Isthmus of Panama from the most deadly pest-hole in the civilized world into a health resort. In New York, indeed, we are not threatened with yellow fever, as they are at Panama, but the threat from Italian malaria is only less dangerous. The emigrants from the swampy valley of the Po and other fever-ridden districts of Italy bring in their blood the germs of the malaria which works such havoc there, and the fresh-water mosquito does the rest. Those who live in the district whence comes much of the city's water supply remember that when crowds of Italian laborers were congregated at the great dams which have turned the upper part of Westchester County into a lake district, something like epidemics of Italian malaria were common. With our large Italian population, the same thing is easily possible on Manhattan Island, and here too the Health Department is busy with its preventive efforts, staving off illness and adding not a little to our comfort to boot. When all the neighboring swamps are drained and oiled, as it is hoped that they soon will be (and as most of those in our city limits already are), the pest of mosquitoes which comes to the city every year in the late summer and early fall will be a thing of the past. They cannot all be exterminated, for there are too many obstructed roof gutters and leaders, empty tin cans, and the like, ideal breeding-places for them, but the plague will be infinitely lessened.

The motto of the Department is: "Public health is purchas able. Within natural limitations, a community can determine its own death rate." This sounds simple, but when one comes. to consider the various measures which are necessary to protect the public health their number and variety are staggering. First in importance, perhaps, comes water, because it is the most universally used. Our New York water comes from a great variety of places, with all sorts of people on the watersheds-village slums where the foreign inhabitants jealously conceal every case of illness lest the patient be carried away to the dreaded hospital, in which, it is believed by them, poor people serve only as subjects for the physicians and surgeons, and especially the students, to practice on. The watershed is carefully protected, yet, in spite of all precautions, a single case in one such slum might cause an epidemic of typhoid in the

city, so the water is being constantly analyzed in the Department's laboratories to make sure of its purity. Then there is the question of the food which is sold in the city. This must be examined to take care that no decayed meat, fish, or vegetables are for sale. Dealers are only too glad to palm off inferior articles on their customers very high eggs, technically known as 66 spots and rots," are sold to be made into pastry on the East Side, for instance-and one can still remember a celebrated case in England where a knight of sporting fame got into serious trouble for turning tons of rotten berries into jams.

Not only must the food be pure and in good condition, but there is the question of the people who handle it. These must be free from contagious diseases, such as tuberculosis, and it must be ascertained that there are no carriers among them of typhoid or any other disease. There are known to be nearly forty typhoid carriers in New York alone. The examination extends to cooks and waiters in public eating-places, and when it is considered that these only-without counting food handlers in markets and shops-number some ninety thousand, the magnitude of the Department's job may be seen. Yet every one of these men and women must be able to show a certificate of health from the Board.

Not only must the men and women who handle food be healthy, but the places in which it is prepared must be in sanitary condition. This means every room, from the kitchens of first-class hotels down to macaroni factories in the poorest quarters, and the places where ice-cream cones are made. The investigation into conditions in them revealed the fact that some ninety per cent of hotel kitchens are located in cellars, this fact alone being sufficient to condemn them as not conforming to the most approved conditions in sanitation. The newer hotels have their kitchens above ground, usually on the top floor of the building, and legislation ought to be enacted prohibiting the location of future hotel and restaurant kitchens in cellars. It is a good sign that, when defective conditions were found, in nearly every case the proprietors made efforts to correct the faults.

Not less important is the work of the Department in analyz ing drugs and patent medicines. The necessity for pure drugs is too obvious for discussion; if they are adulterated, they nullify the value of physicians' prescriptions. As to patent medicines, the harm done by them is enormous. Some of them, like certain "headache powders," contain powerful ingredients which, when used to excess, produce disastrous results. Others lay claim to therapeutic effects which are viciously and palpably false. Both classes have been successfully handled by the Department, the former by securing more accurate labeling of the quantity of drugs which they contain, the latter by prosecutions which have either driven the nostrums off the market altogether or have brought the claims advertised within the bounds of reason. One particularly vicious class is the cancer cures, which tempt the patient to put off operation till it is too late.

Another field in which the preventive efforts of the Depart ment are most important is the supervision of the sanitary arrangements in buildings used for such work as the manufacture of garments, for instance. The people who work in these buildings are recent arrivals in this country, with an inconceivable ignorance of the proper use of such arrangements, so that constant watchfulness on the part of the Department is necessary. Its handling of such cases is a delightful combination of the suaviter in modo and the fortiter in re. A very rich man owned a loft building where not long ago the sanitary conditions were found to be scandalous. The Department bombarded him with demands for improvement, to which he paid not the slightest attention, till finally an officer was sent to his office to serve on him personally a notice that if he did not attend to his plumbing his building would be " vacated "-that is, no one would be permitted to enter it while conditions remained as they were. The officer waited patiently for an interview for a couple of hours, and then telephoned to his chief to know what he should do. The answer was to go on waiting, so that the owner might not make the excuse that the officer had not waited till he, the owner, had time to see him. After a further wait of a couple of hours the great man's secretary came out to the anteroom and asked what the officer wanted. "I want to

chose."

serve on Mr. Blank personally a notice that if he does not fix up his building in Nth Street it will be vacated by the Health Department." The secretary went in to his employer and returned with the statement that the Department "could go as far as it pleased." The officer reported at headquarters, whereupon his chief called up Mr. Blank's office and got the secretary. "I'm B., of No. 139 Center Street. Have you had a Health officer up there?" "Yes." "Did you have any trouble with him?" "No." "What did you say to him?" "I told him to go to h- and that the Department could go as far as it "Thank you; that's all. I'm Lieutenant B., in charge of the Health Squad, and I only wanted to verify his report. The building will be vacated to-morrow morning." The next morning at six o'clock ten officers of the Health Squad arrived at the building and were stationed at every entrance, with orders to let nobody in. On his way the officer in charge telephoned to the captain of the police precinct and asked him to hold the outgoing relief in case of trouble. At seven the workers arrived, and, being unable to understand why they were not permitted to go to work, promptly started a small riot and had to be quieted by the police. At seven-thirty the owner arrived at the building. "I want to go in," said he to the officer in charge. "Who are you?" "I'm the owner." "Certainly, go on in; it's your right. ""I want to go in, too," said another man. ?" "I'm his lawyer.' Certainly; you go in too. It's your right.' The owner came out quicker than he went in, and soon a gang of plumbers and carpenters was busy and worked day and night for thirty-six hours putting things to rights. Now when a complaint is made about any of that gentleman's buildings he hurries down to the Department in person to see about it. He has learned his lesson.

"Who are you

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And so on through a list of the most strangely varied activities. Does a ship arrive from a plague-infected port and tie up at a pier? The plague is carried by rats, so the Department sees to it that collars are placed on the cables, so that the rats cannot come ashore by that route, and it has the gangplanks hoisted at night, the only time when the rats come out of their hiding-places.

Have you a chicken slaughter-house next door to you, and are you annoyed by the noise or the vermin or the smell? It is probable that most readers of The Outlook are free from this annoyance, but there are two hundred such slaughter-houses in the city, for poultry must be killed in a particular way to be "kosher," and they can constitute a very real nuisance. When they do, a word to the Health Department will cause the conditions to be remedied. Again, there are the "mikweh" baths, used for the ceremonial purification of the Orthodox Jews. These baths must be prepared under very stringent rules as to size and the quality of the water, and the manner of their use is strictly prescribed, but the proprietors are by no means as careful as they might be, and the Department has to keep a sharp lookout to see that they are cleaned and the water changed every day. In short, the watchful eye of the Department is everywhere, and every complaint, even though anonymous, is investigated; nothing is too trivial to deserve attention when it can affect the city's health.

But everywhere the Department tries to work through educa tion and persuasion rather than by compulsion, for that is the training which sticks best. Educational" movies" and lectures are given all over the city, but most frequently in quarters where newcomers congregate. The nurses of the Department are ubiquitous, teaching the women how to become healthy mothers, caring for the children of pre-school age (for these are the Americans of to-morrow), acting the part of guardian angels all around. And the people who benefit by this watchfulness are not the rich people on Fifth Avenue, but the hard-working millions who live on the East Side, or in the Italian colonies, or in other parts of the city where they congregate. It is they who are the Commissioner's chief concern, for if there is an epidemic of typhoid or infantile paralysis, or what not, they can't get away, but must stay and face the music, and so it is for their welfare more than anything else that the Department is working night and day.

Of course there is another side to the Department's work—the splendid curative_part, represented by the great hospitals in Manhattan and Brooklyn and Queens, besides the Otisville