Dr Welch: Mr. Chairman, Ladies and Gentlemen-The Association for Promoting Hygiene and Public Baths doubtless was formally welcomed to the city of Baltimore by the officials to-day. I would simply like to express in behalf of the Johns Hopkins University, and I think I may add of the medical profession, our gratification that they have chosen Baltimore for their place of meeting. Dr. Baruch in his very interesting and instructive and suggestive address dwelt somewhat upon the fact that gifts had come to Baltimore; he spoke pleasantly about some of the workers here. I do think that perhaps we do sometimes have ideas and occasionally initiative movements in this city. Our sad lack, Dr. Baruch, consists in the lack of funds to carry out the good ideas which we think we have, and if you can divert any funds in this direction, I can assure you that the returns will probably be as good as anywhere.

You have commented upon the lack of support of the public bath movement on the whole in this country. It is true that it is lamentable how little appreciation there is of public sanitation; how utterly inadequate are the funds at the disposal of the municipality and state health officials for that work. At the same time, there is no reason, I think, for despondency. When we compare the progress which has been made, particularly in quite recent years, in this regard, there has undoubtedly been a very considerable awakening of the people to the importance of efforts to improve the health of the people and to prevent disease. I also think it is pertinent, perhaps, to inquire whether even these inadequate

funds at our disposal are used most efficiently, most economically. I venture to say there is need for improvement in that regard—in the better use of the funds, small as they may seem to be, better use of the funds which are now at our disposal. We of the State Board of Health are particularly anxious to secure from our next legislature funds enough to inaugurate a better system for securing well-trained, competent local health officers in sanitary districts throughout the state, which may or may not coincide with county lines; local health officers sufficiently paid to give their whole time to the work. I think there is no need more urgent than that of getting trained men who will give their whole time to the work and will spend the funds which are available so as to secure the best results. There is great waste, surely there is great waste of public funds, not only in this, of course, but in a great many other directions. It is incumbent upon us to inquire whether we do use the funds we have to secure the best results.

Dr. Baruch said, and the name of this association confirms what he said, that the purposes of this association are broad, including both hygiene and public baths. I judge, however, from the membership and from the program that the larger emphasis. for the present is placed upon that of the public baths and that the whole broad field of hygiene is brought into relation with the subject of public baths. The few words that I have to say will relate particularly to this question of the public baths. I cannot claim any great familiarity with the subject, but I do know that it is one of the important chapters in public hygiene; I do

know that public baths constitute an agency of first rate importance in the improvement of the health and well-being of the people and also in increasing resistance to disease. They constitute, therefore, one of the agencies which link pure water, pure milk, clean streets, good, pure food and all those things which have manifest relation to the physical, moral, and social condition of the people together. The argument The argument would be strong if they did not relate to the health of the people, I mean from the mere side of cleanliness, for ethical reasons and for pleasure. The same might be said of the water supply and of the sanitary disposal of sewage. There is a reason why a city should supply those aside from health, but when you learn that they do add to the health of the people, there is added argument for pressing home to the people the need of public baths. Dr. Fulton intends to say something about the development of the subject in this city. My remembrance is a little hazy, but I do recall at the time we had the American Public Health Association Mr. Beadenkoff, Dr. Gichner and Dr. Sherwood were at that time interested in the subject, but I shall not encroach upon the theme which Dr. Fulton will touch upon, but I would like to emphasize a fact relating to public baths. They undoubtedly increase resistance to disease. When we consider the agencies which we employ to reduce the mortality from preventable disease, we will note that some of them are the association for the prevention of tuberculosis, the city and state board of health, the district nurses, etc. The public baths operate more indirectly, but perhaps with equal efficiency by increasing our resistance to disease. It is very difficult to say, when we consider the results of modern sanitation, just how much of the good accomplished belongs to efforts which are directed immediately against the causes of the disease on the one hand, and the efforts which are put forth indirectly -such as the public park, better housing, scientific ventilation of work shops, and here I would include, public bath agencies

-on the other hand. I do not think we can say exactly, but there is no doubt that our knowledge to-day tends to emphasize more and more the need of increasing the resistance to disease. An illustration would make that sufficiently clear to you. There is a great deal of tuberculosis. We all become infected with tuberculosis early in life, practically, so that at the age of fourteen nearly 100 per cent. exhibit tuberculosis and give positive reaction. We have the bacillus within us. Now as long as that period-ten to fifteen years of age— lasts there is very little active tuberculosis. Why is it that at the age of 18, 19 and 20 when young people begin to assume the heavy responsibilities of life, when young men begin their professional studies, when they enter upon the work of life, you may say, that we have this sudden increase in tuberculosis? Is it that there is renewed infection? We have not the facts for positive statements on this point. That is where we need new light. There is no reason to assume reinfection; all that is necessary is that the system be weakened, with the consequent loss of resistance to disease, and the micro-organism already present in the body will develop. Now I speak of that to illustrate what I mean when I say that the public bath as well as other agencies is a very important agency in the campaign for the prevention of in-. fectious diseases. It is very important for the protection of the health of the people. Add to this if you like the arguments of cleanliness, pleasure, increase of selfrespect, all those results which Dr. Baruch has so charmingly and graphically depicted in his remarks. We can go to the proper authorities and say, "Here is something to be done, which is for the health of the people." It belongs in this group. The health and efficiency of the people really are in a very direct and important way influenced by such agencies as the public bath. It is therefore a direction of modern movement in behalf of health, a practise of living which I consider to be of primary importance.

Dr. Fulton: Chairman, Ladies and Gentlemen-As Dr. Welch has already intimated, I have written on the back of my program about a dozen names of persons who have become known to me in connection with the Public Bath Commission. I think an opportunity like this-a public bath meeting-does give us an opportunity to recall the names of those who have been serviceable in the Public Bath Commission. My remarks will not be historical, they will not have the proper chronological order, they will simply show the side line along which I found my way into this question. When I first came to Baltimore, the only person that I knew in this town at that time was Dr. Morton Shafer. Not many of you know Dr. Shafer; he was a man of very high type indeed. He was a very ardent advocate of public baths and was an editor of the Maryland Medical Journal. I always like to recall Dr. Shafer as one who first interested me in this subject, who himself did not live long enough to make very much impression. The history of public baths did not at all begin with Dr. Shafer; he was recently back from Germany and was several years behind the Public Bath Commission. We had in Maryland in 1900 a Maryland Public Health Association; it had one successful and good meeting, and I remember that Dr. Mary Sherwood was an active member of the association, and she proposed to me that we should take up the question of public baths and gave me the first information that I had concerning the Public Bath Commission in Baltimore. It was not making a great row then. We gave We gave invitations to the Public Bath Commission to tell us something about their work at the meeting of the Maryland Public Health Association, and there I met the real patron saint of the public bath propaganda, the Rev. Mr. Beadenkoff. He appeared at the old Faculty Hall round on Hamilton Terrace and brought with him Mr. Norris and Mr. Levering, both of whom are in

struments in a good deal of beneficent mischief in Baltimore. chief in Baltimore. Mr. Beadenkoff had been pastor of a church near the water side and he had to rescue many boys who were having baths off the public docks and re-uniting the boys with their clothes, appropriated regularly by the police. This rescue work was regularly carried on by Mr. Beadenkoff for quite a time; it seems that Mr. Beadenkoff had secured funds by means of which he was able to establish a single bathing shanty or shack for boys in his part of the city. It was in consequence of this work and with the assistance of Mr. Morris and Mr. Levering that with great difficulty he succeeded in getting as much as $500 out of the City Council, and that the Public Bath Commission became a part of the city government. I did not know until that meeting of the American Public Health Association that there was such a set of people in the town. The story they told was very interesting, and in consequence the Maryland Public Health Association evolved the plan that at its next annual meeting a special meeting would be held in this hall-Johns Hopkins University was always very good to us in providing a place for public meetings—and bring this matter more to the attention of the people of Baltimore. It happened while we were discussing that matter that we found two persons who were very much interested in the subject and intended to study it during the summer, and they were Dr. Henry Riach and Dr. Louis Riach. They were intensely interested in the subject of public baths. That was the year in which Dr. George H. Ray was president. of the Faculty. In the loss of Dr. Ray everyone knows we lost an exceedingly important hygienist. In the following autumn we had our meeting in McCoy Hall, and we had invited down Josiah Quincy of Boston. Mr. Quincy gave us a most interesting talk and lantern demonstration on the important public bath arrangements which they had in the city of Boston. His

Dr. Hale: The best authorities do not expect of mechanical filtration a higher efficiency than 97 per cent., which has become the standard specification for city filtration plants. To be absolutely certain of purity hypochloride of lime should also be used.

Mr. Beadenkoff asked which is the bet

ress.

Public interest has no doubt been stimulated somewhat by the formation of this association, and the International Conference on Public Baths at The Hague last August; but the rapid growth of our boro and the increasing popularity of these baths are ever present underlying causes of this interest.

A criterion of this demand is given by the sales of soap and towels which have increased every year, amounting in 1912 to $21,655.10 for our seven interior baths. In addition to this, the Coney Island Bath which had its first full season last year took in $25,309.30 for rent of rooms and lockers at 10 cents each.

The increased receipts of the seven interior baths for the first four months of this year are very significant, amounting to $6,121.67 against $4,855.99 for the same period of 1912. The Coney Island Bath is not yet opened for this season.

The only public swimming pool in Brooklyn is now utilized for instruction in swimming of the female teachers and high school girls of the boro, under direction of the department of education, which system has been inaugurated within the last few months, but no such provision has yet been made for men and boys.

The management of the Coney Island Bath involves the important problem of devising some workable scheme for limiting the time of bathers, as we found last year that many persons, especially women, come early and remain all day; thus excluding others. This has led to a proposition to build another bath alongside. We hope, however, to utilize present facilities so that the bath may accommodate more than double the number that have ever used it on the busiest day.

ter material, non-absorbent tile, cement also about a sand floor. Mr. Crane answered that any which would harbor germs is objectionable. The surface of the pools should be glazed without cracks or roughness, and square corners eliminated. A sand floor is objectionable, because it may act as a filter.

BATHS BY DELEGATES.

How great is the pressure for these seashore baths may be inferred from a statement which appeared in the local papers within the past week, that the estate of the owner of a private bath adjoining the municipal bath and encroaching on the domain of the city, was valued at about $750,000.

Let us hope that aroused public interest following the present meeting, will bring about results in this direction, and in a great expansion of our bath system, for which the time is ripe.

BOSTON-Mr. Hugh McGrath, one of the pioneers of indoor baths: Since last year we have opened an additional bath and in connection with one of our gymnasiums we have a floating bath which is close to beach bath. The South Station, where those who are compelled to work in hot, stuffy rooms during the hot days of the summer will have an opportunity to take a dip in the cool water of Boston Bay. We have opened up another in Charlestown, which has been one of the most neglected parts of the city. We have opened up a house which cost $40,000 to equip, and while it is very inadequate, it will serve as a beginning for better things. There is before the City Council an ordinance calling for an expenditure of $350,000 to install other bath houses. We want more and we are going to get them, eventually, in every part of the city.

In several of the playgrounds, through some lack of foresight, shower baths have not been secured, but before the playground season opens this year, they will be equipped with shower baths.

PHILADELPHIA-By W. L. Ross: We built and opened a new bath in the latter part of November. Our bath houses are not as elaborate or as expensive as the municipal baths. municipal baths. This was erected at a cost of $35,000. It has altogether seven bathrooms. I have had this work for fifteen years.