It is odd that with the present popularity of medical lay articles, the writers have not shown more interest in teaching the public how to avoid the common contagious diseases.

In the first place, never expose the child to any contagious disease in order that he may have it once and done with it. Even the so-called simple children's diseases, such as measles and whooping cough, have a death rate that is appalling. Nor should you allow politeness to stand in the way when there is any danger of your own child getting a contagious disease. Never take your child into a household where there is any sickness whatever, for it may turn out to be a contagious illness no matter how it begins.

The saliva and other secretions, especially the nasal secretions and the droplets that are spread about during a paroxysm of coughing and sneezing, are laden with the germs of the disease with which the patient is suffering and this is true of most of the contagious diseases including the common cold. So, not only avoid people with these unpleasant symptoms but beware of anything that has touched their lips—drinking cups, eating utensils, telephones, towels, napkins, handkerchiefs and even their hands which have come in contact with these secretions. "Contact" is the word now used to express the mode of contagion and if contact in the above broad sense were possible to avoid, all contagion would cease at once.

Scarlet fever is among the most dreaded diseases of childhood, and rightly so. It is also one of the most contagious, but fortunately the danger of contagion is not so great during the early stages. I have known a child to sleep in the same bed with another child coming down with scarlet fever and not catch it. From this it is evident that we should move the already exposed child away from the contagion as soon as we discover it, no matter how late that may be. In scarlet fever there is a chance, at least, that he has not contracted it from this one early exposure. However, the disease is caught early through the vomitus, and consequently it is safer to avoid a vomiting child in the streets, cars, and public places anywhere. Unfortunately scarlet fever is contagious for a long while after it has actually set in, usually four to six weeks. As long as there is any peeling or discharge from the ears or nose, the danger of contagion is still present. Everything with which the scarlet fever patient has come in contact during his illness may be regarded as a source of contagion.

Measles, on the contrary, is just as contagious in its early stages, when the eyes and nose are running and four days before any eruption has appeared, as it is at the height of the disease. This is why the whole family is liable to come down with it when one member of the family brings it home. Unless the physician is called during this stage, the disease is not diagnosed until the eruption appears, when it is too late to prevent the rest of the family from getting it. This is also another reason why we should keep our children away from any one, especially another child, who has a cold in the head. I have had the misfortune to treat for measles ten children in different families who had all attended a birthday party at which was present a child who was in the catarrhal stage of measles, no eruption having made its appearance in the child when he went to the party. His mother thought he simply had a bad cold and let him go. It is needless to say that that mother was not popular in that particular set for a long while afterward.

Diphtheria, I am happy to say, is one of the contagious diseases which the physician can prevent absolutely after the child has been exposed. An immunizing dose of diphtheria antitoxin will always make it a certainty that a child will not get this dreaded disease in spite of definite exposure to it. There are no dangers in giving antitoxin in its present-day perfection, no matter how delicate the child may be. A person may have diphtheria many times but it can be determined whether an individual is susceptible to the disease by a simple skin test called the "Shick Test." All persons found to be susceptible can be made permanently immune by the administration of a comparatively new serum called "Toxin-antitoxin." This requires three doses at intervals of a week. If the "Shick Test" were used on all children under five years of age and the serum administered where necessary, diphtheria might be eliminated from our list of children's diseases as is small pox today.

Whooping cough is a dangerous disease. The death rate from this so-called benign disease is as great in New York City as that from scarlet fever, diphtheria, and measles combined. Therefore, keep your child away from whooping cough, especially your baby, for it is most fatal among children under a year. The person having it is a source of contagion as long as he has a paroxysmal cough, this period varying from six weeks to three months. Once acquired, do not become pessimistic and think whooping cough must "run its course." Your physician can do something to prevent the severity of the disease, and he can often shorten its duration. He can usually prevent the complications which are the dangerous phases of the disease.

Neither mumps, chicken pox, nor German measles is a dangerous disease if the child is well cared for during its run.

Smallpox may be absolutely prevented by vaccination, provided the vaccination takes properly and provided it is done often enough. I have no sympathy with anti-vaccinationists. They do not recognize the fact that before vaccination was compulsory, epidemics of smallpox swept over the country, leaving one third of the population dead and many others marked for life with the pits of this most dreaded of diseases. It was with the utmost satisfaction that the medical profession in recent years witnessed the deliberate exposure to smallpox of a prominent anti-vaccinationist of Boston. He had claimed that there was no danger to the unvaccinated from the disease. He acquired smallpox at the prescribed time and barely escaped with his life. Every healthy child should be vaccinated before he is six months of age. He should subsequently be vaccinated once in five years and when he is exposed to the disease. There are no dangers at the present time from vaccination if it is done properly and the wound kept clean until it has healed. Any serious trouble always comes from the lack of these precautions.

Colds and coughs, sore throats, and tonsillitis are certainly contagious. Keep your children away from people who have any of these ailments. However, the better your child's hygiene and the better his general condition, the less liable is he to become infected if exposed to them. Kissing is an unfortunate custom of civilization, for it spreads disease, especially coughs and colds. It would hardly seem necessary for parents to be constantly on their guard to prevent the kissing of their children by friends and strangers, but such is the case. Public drinking cups are the cause of many illnesses and the common cup at school should never be allowed.

Mosquitoes are the sole cause of malaria. In malarial districts take the most rigid precautions to prevent mosquito bites. The much-abused house fly deserves his reputation. He is the carrier of typhoid fever, bowel troubles, and many other infectious diseases of the summer season.

Schools are the chief source of the principal contagious children's diseases, as the statistics show that these diseases are most rife during the school months and in children of the school age. In our large cities the public schools are well inspected medically. It is our duty to our children to demand proper medical supervision in the private school, also, before we place them in one.

Tuberculosis is a contagious disease. It has so long been considered an inherited disease that the general public find it hard to get the old notion of transmission from parent to offspring out of their minds. To be sure the tendency may be inherited, that is, a poor and weakened constitution, but this may be overcome with comparative ease under the proper conditions. Children from a tuberculosis family should have especial care paid to fresh air and diet from the moment they are born. They should be kept in robust health by fresh air night and day, and by having the diet a nourishing one. The vigilance of the parents should never be relaxed in either direction. On the other hand, exposure to tuberculosis should be avoided. By this I do not mean that children will acquire tuberculosis upon one exposure, but that they should not live with tuberculous people nor come in contact with them daily. For this reason it would be well if the general public looked upon tuberculosis as a contagious disease. Care should be taken that the nurse has no cough and has not been in contact with people suffering with tuberculosis.

I believe that many cases of tuberculosis in children come from living in houses or apartments where consumptives have formerly lived. When we realize how many families move into a house whose former occupants are not known to them, it is only to be wondered at that this disease is not spread even more than it is.

Milk is a source of tuberculosis in spite of the fact that certain authorities have denied this mode of transmission. In no other way can we explain some of the cases of tuberculosis in children. Therefore, all milk used in making infants' foods, as well as milk for older children, must be from tuberculin-tested cows. Since an infant so often depends entirely upon milk for his sustenance, this is more important in infancy than at any other age.