Regarding hygienic measures, proper disposal of sewage, good drainage, and good ventilation are some of the means suggested. Three would not have the sleeping room on the ground floor, but give no instances to substantiate this preference. Eight would avoid damp night air. Four would avoid damp localities of all sorts, especially where there is much decaying vegetable matter, recent excavations, much shade, etc.

Ten suggest a change of air and soil in obstinate cases of malaria. It is here interesting to note Robinson's observation that malaria of a most pronounced type develops on a rocky soil with a substratum of clay. Two suggest mountainous districts as favorable for patients suffering from malaria. A few mention the importance of avoiding the bites of insects and especially mosquitoes. It is interesting to note here the observations by Emin Pasha quoted in Stanley's Darkest Africa that none of those of the party who slept under mosquito-netting had malaria. The explanation at that time was that the netting acted by breaking the force of the air current that carried the germs, but according to more recent ideas it seems more probable that it was due to shutting out the mosquitoes.

Opinions regarding the development of malaria in a nursing baby after the mother had been ill with malaria do not harmonize. One reporter finds the infant sick just as often before the mother as after.

One writes that it is not uncommon for infants to show signs of malaria when the mother has had the disease for some time. Another reporter writes: I have seen two typical cases of intermittent tertian fever in nursing mothers, one with child four months old, the other with child seven weeks old. In both cases the baby nursed until it became cross and peevish, but both became quiet when placed on the bottle and neither developed the disease.

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Sixteen write that they have seen malaria develop in nursing babies following the disease in the mother, but the most of them cannot report the cases, as they have no records. It is difficult to determine therefore whether the malaria was communicated from the mother or arose from the same source where the mother contracted hers.

The digestive ailments in a nursing baby due to the quality of milk furnished by the mother ill with malaria should not be confounded with malaria itself.

Several report cases of the development of malaria in infants soon after birth, but while these cases are interesting they have no bearing on the question of the comIn such cases the munication of malaria by the milk. plasmodium probably entered the system through the placental circulation before birth.

In infants the most common type of fever is quotidian, in children tertian. Only two reporters have seen any cases of quartan fevers in infancy and childhood. Three reporters state that the type of fever they see is irregular. Forty reporters have seen what they consider continued malarial fevers in infancy and childhood. One writes, Thirty-seven have never seen such cases.

I have seen cases of continued fever attributed to other causes where malaria had been present a long time without treatment.

One reports a case of obstinate continued fever in a child where the blood contained the plasmodium and which readily yielded to large doses of quinine. Another writes, I think all continued malarial fevers, so-called, are either tubercular, typhoid, or if lasting a day or two, irritative fevers.

In addition to the above report on malaria the Committee wish to mention the following interesting cases, reports of which have been sent to the Committee by the county reporters. It would make the report of the Committee too long to read the full reports of these

cases and any abstract would do them injustice. It is hoped that the Society may see fit to publish them in its transactions.

An interesting case of cholecystotomy followed by cholelithotomy and the extraction of 502 stones is reported by Dr. Howe of Hartford.

A case of metastatic suppurative choroiditis following an attack of cerebro-spinal fever is reported by Dr. Peck of Norwich.

The following interesting cases are reported as having occurred during the past year in the surgical service of the Bridgeport hospital: Tuberculosis of the knee, treated by resection: Carcinoma of the liver, exploratory incision: Amputation of the foot for railroad injury, treatment with bovinine: Bullet wound of the skull, exploration, recovery: Wound opening into trachea, suturing, recovery.

The Committee has received the report of a committee of the Hartford County Association, appointed to consider the advisability of establishing a certified milk farm in Hartford County.

The establishment of such a farm is a step in the right direction and should receive the hearty support of the Society.

Respectfully submitted,

S. B. ALMY,
H. A. CRANE,

C. J. FOOTE,

Committee.

PART II.

A CERTIFIED MILK FARM.

REPORT FROM HARTFORD COUNTY.

The committee appointed at the last meeting of the Hartford County Medical Association, to consider the advisability of establishing a certified milk farm in Hartford County, respectfully present the following report:

In seeking a remedy for the difficulties which surround the milk supply of our cities, we must consider the question broadly and thoroughly; first, from the requirements of the physician, second the consumer, and third the producer.

First, for a pure standard of milk for clinical purposes, uniform nutritive value, reliable keeping qualities and freedom from fermentive and pathogenic bacteria are necessary for satisfactory work in infant-feeding and as a dietary for the sick.

Second, the consumer: An important phase of the question in regard to the consumer of milk is not alone a pure standard but the preservation of the milk in its purity in the home where it is to be used. People, as a rule, are not sufficiently careful of the milk to protect it from noxious influences. They do not know or do not realize that milk is one of the best culture-mediums for the growth of bacteria. All too often we find careless management will allow changes to occur which render milk entirely unfit for use. This fact, that people are not sufficiently careful, must influence us very largely in adopting a plan for pure milk. Naturally attention is directed first to the dairy, but if a milk, however pure, is allowed to spoil by carelessness in the home our efforts in the dairy amount to very little.

Third, the producer: While we recognize the difficulties in the home we must also realize that care, be it ever so exact, will not convert a poor milk into a good milk and therefore it is necessary first to regulate the production of milk in the barn, that the standard may be correct; then to direct our attention to its preservation in the home. For a pure milk the greatest care and attenion to the details of cleanliness is necessary.

Cows should not be kept in unhealthy places or fed with food producing unwholesome milk, nor should milk be obtained from animals in a diseased or unhealthy state. The dairy must be kept clean and the cows groomed and kept free from manure on flanks, udders and teats.

The men employed about the barn must be clean and their hands must be washed thoroughly before milking.

The cans and strainers must be washed with boiling water, to which soda has been added, and coolers and tanks must be kept scrupulously clean and free from dust.

In fact cleanliness must be absolute to insure a milk even moderately free from bacteria.

How best to secure this care is a question attracting the attention of scientists and men interested in public health to-day.

Two lines of action may be adopted:

First, by law: In a neighboring city visited by a member of your committee, during the past summer, the Health-Board has exercised its legal power and has issued a circular of rules and regulations governing the milk supply of the city; requiring registration of all persons and corporations engaged in selling or furnishing milk and the inspection of herds, dairies and appurtenances by duly authorized inspectors.

Exact and stringent rules are given for the dairy, care