for the direction of its methods of work.  Every city health board which undertakes a serious campaign against syphilis should not be satisfied merely with doing Wassermanns, but should enlist in behalf of the public consultation of the same grade which it expects to employ in the solution of its traction and lighting problems, and in the management of its legal affairs.  No one would think nowadays of placing a physician in charge of a great tuberculosis sanitarium whose knowledge of the chest was confined to what he had learned in medical school twenty or more years before—­yet in a parallel situation one often finds the subject of syphilis handled with as little attention to the value of expert knowledge.  Expert service is expensive, and if the state wishes to command the whole energy of progressive men, it must be prepared to pay reasonably well for what it gets.

+Suppression of Quacks and Drug-store Prescribing.+—­The suppression of quackery is nowhere more urgent than in the control of syphilis.  Every important legislative scheme that has come into existence in recent years has recognized this fact.  The devil may well be fought by fire, and reputable agencies should enter the field of publicity with some of the vigor of their disreputable opponents.  The brilliant success of this scheme was admirably illustrated by the results of the recent efforts of the Brooklyn Hospital Dispensary, which, by replacing the placards of advertising quacks in public comfort and toilet rooms, and running a health exhibit on Coney Island, attracted to a clinic where modern diagnosis and treatment were to be had an astonishing number of young people who would have fallen victims to quacks.  The evil influence of the drug store in perpetuating the hold of syphilis and gonorrhea upon us is just being understood.  The patient with a beginning chancre, at the advice of a drug clerk, tries a little calomel powder on the sore, and it either “dries up” and secondary symptoms of syphilis appear in due course, or it gets worse or remains unchanged and the patient finally goes to a doctor or a dispensary to find that his meddling has lost him the golden opportunity of aborting the disease.  If secondaries appear, a bottle or two of XYZ Specific, again at the suggestion of the all-knowing drug clerk, containing a little mercury and potassium iodid, disposes of a mild eruption, and a year or so later a marriage with subsequent mucous recurrences and the infection of the wife signalizes the triumph of ignorance and public shortsightedness.  The health commissioner of one of the largest and most progressive cities in this country stated before a recent meeting of the American Public Health Association that he had sent a special investigator to twelve representative drug stores in his city, and that simply on describing some symptoms, without even the ceremony of an examination, he had received from ten of them something to use on a sore or to take for gonorrhea.  It is only justice to say that occasionally one finds drug stores which will refer a patient to a doctor or a dispensary.  Drastic legislation to suppress this sort of malpractice is part of the program of Great Britain, Germany, and West Australia, and we in this country cannot too quickly follow in their steps.