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A definite relationship between body build and oxygen absorption in children appears in our study of the basal metabolic rate of 573 normal children. In our series slender-built children normally have higher basal rates than broad-built children of the same age-sex group. High basal metabolic rates as measured by the conventional standards are the rule for the linear type group, whose 1 width-length indexes of body build are well below average. To test the effect of body build on basal metabolism, we have compared the width-length index with the basal metabolic rate for each of the age-sex groups from 4 to 15 years. The basal metabolic rate was calculated from the Benedict-Talbot standard whenever possible, and from the Harris-Benedict and Aub-duBois standards for boys above 38 Kg. and girls above 58 Kg. of body weight. For clinical interpretation of our data, we have corrected the rates as indicated by our

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INTRODUCTION Reviewing the literature on blood studies one is struck by the comparatively few extensive investigations which have been carried on with the blood of the new-born. The morpohologic variations in hemoglobin and cells have received more consideration than any other phase of the problem. The chemistry of the blood of the new-born has been given little attention. Sedgwick's1findings stand out as the most extensive and illuminating, and Slemon's2investigations on maternal and fetal blood are fundamental, furnishing conclusive evidence of the mechanistic function of the placenta. Coagulation has been given little real attention and except for isolated studies on individual cases of hemorrhages of the new-born few, beside Rodda,3have attempted to analyze the factors entering into this problem. We have, therefore, attempted to bring together all these phases—morphology, chemistry, coagulation and pigment metabolism—into a combined study of the blood of the normal new-born

Text-books which deal with the examination of the spinal fluid give much space to elaborate schemes for a positive diagnosis from the spinal fluids in the different forms of meningitis. However, if one has had these same spinal fluids to examine, one is immediately impressed with the fact that no absolute rules will hold. This is especially true in cases of suspected tuberculous meningitis. Several recent articles have claimed a cure in cases of tuberculous meningitis, the diagnosis of which has been based on the mere counting of the cells, and a differential study of these cells. In direct opposition to this point of view it may be interesting to note the findings in several different conditions, that have come under observation, which commonly occur in children. The diagnosis of epidemic meningococcus meningitis is never based solely on the finding of an excess of polynuclears in the exudate. The infecting

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This report is part of a study which is now being carried on in the pediatric department on the problem of the anemias of infancy and childhood. Many studies have been made in this field but most of the work so far done has reference mainly to the blood picture, studies relating to the differential count of the white blood cells, the study of the red blood cells, their number and fragility and to the percentage of hemoglobin; in many instances the postmortem findings are added to these studies of the cells and hemoglobin. All these studies are valuable and have their place in the problem of the anemias but so far they have led to little more than an unsatisfactory classification of the anemias. Even as regards classification there is much confusion and very little has been ascertained as to the etiology of the various anemias which occur so

The work of the Children's Bureau up to January 1 was principally concerned with the immediate care of refugee and rapatrie children, the establishment of hospitals, clinics and refugee homes, and the aiding of both French and American child welfare societies in their work. During these first six months a preliminary study was made of general health conditions in France, as related to mothers, infants and children. These problems, outside of the immediate undertakings referred to, are not, generally speaking, acute, but simply the inevitable result of the withdrawal of physicians from general practice. GENERAL HEALTH CONDITIONS If one could picture cities, towns and villages practically devoid of medical and nursing service for the general population, one would have a fairly accurate idea of the health conditions in France after four years of war. The larger cities have from 50 per cent. to 25 per cent. less physicians than before.

For centuries men have sought a relationship between body form and function. In recent years investigators have been inclined to disregard the individual patient and focus attention on the micro-organisms responsible for his disease. But many individual differences in susceptibility remain unexplained. It is now thought that perhaps the solution of some of the problems in immunity lies in the recognition of certain anatomic and physiologic types or constitutions. Variations in anatomic and physiologic characteristics compatible with health must be defined to establish zones of normality. Most standards of health recognize only one zone as normal. In grading the physical fitness of the children of America, one certain weight for height and age is considered normal. Nutrition properly holds first place in judging the physical status of children. Comprehensive investigations in this field have been carried on by physicians, school nurses, dietitians and health and welfare agencies. A recent report

The types of cases of endocarditis which are seen in an out-patient department vary considerably from those which have had simply one attack of rheumatic fever with very slight involvement of the endocardium, to those cases which have had repeated attacks of rheumatic fever with endocarditis. These cases of rheumatic endocarditis may be divided into three classes. 1. Those patients seen in their first attack. These patients have little or no permanent valvular involvement. 2. Those who have had some permanent damage to the endocardium — a type which is often able to compensate for the child's ordinary life; that is, going to school and playing with certain definite limitations to over-exertion. 3. Those who have serious involvement of the endocardium and myocardium. Cases which may be called cripples, for whom there is no hope of complete cure, but who are perhaps compensating enough to allow them to be up

In considering the therapeutics of cardiac conditions in children, one is rather surprised to find that therapeutic measures have either been handed down or accepted simply from pharmacological experimentation, which is not always an accurate estimate of the clinical value of any therapeutic procedure or of any drug. It is interesting to note the paucity of material which deals with accurate observations of the different drugs used in cardiac conditions. Practically all of the English text-books speak of digitalis and strychnin as the two cardiac stimulants of choice. Digitalis has been tested out both experimentally and clinically, so that there can be very little doubt as to its value. In regard to strychnin, there is conflicting evidence from the side of the pharmacologist and that of the clinician. It is still further interesting to note that in none of the German text-books is strychnin mentioned, and it is very seldom

At the request of the Commission for Relief in Belgium, I spent May, June and July in that part of Belgium occupied by the Germans, in the examination of present health conditions of the population, with special regard to the welfare of the children. In this investigation I had the unremitting aid and counsel of the Belgian physicians and surgeons. The liberty of movement which I enjoyed, as a member of the American commission, enabled me to perform a broad survey of conditions, which, under present military restrictions, is not possible for the very able Belgian specialists themselves to undertake. It is difficult to generalize on the health of the whole population of the country even in normal times, when the aid of every branch of mortality and morbidity statistics can be brought to bear on the investigation, and therefore any generalization which I make in regard to Belgium, in

In seeking further light on the so-called "hunger strike" commonly encountered in the practice of pediatrics, a detailed study of 110 children complaining of anorexia was attempted to determine what characteristics they shared in common. Combining Draper's 1 and Franzen's 2 systems, measurements of the body were made to classify the children according to the type of body, and to obtain a measure of their nutritional status. Basal metabolism tests were made at intervals of three months when possible. Examinations of the blood, urine and stools and intracutaneous tuberculin tests were made; roentgenograms of the chest were obtained after all positive reactions. Analyses were made of the usual diets of these children for a period of three days to determine the caloric intake and the proportion of the food elements habitually consumed. Special diets for individuals were worked out correcting the dietary errors that appeared on analysis of the three

The history of the growth of pediatrics in this country is an interesting one, starting as the subject did as a subdivision in medicine, and developing gradually until in many medical centers it is now accredited as a separate department, and offers in many schools positions for full time teachers of pediatrics parallel with positions in medicine and surgery. Its growth from a purely academic standpoint is of considerable interest and importance. At first the field of pediatrics was limited mainly to that of infant feeding, and growth along this line has probably been greater and more efficient than in any of the other subjects in pediatrics. In almost every university medical school the subject of infant feeding has been developed soundly and broadly, not only in the laboratory, in the hospital and the outpatient department, but also in connection with milk stations and follow-up work. This growth has been

Measles is one of the most interesting of the specific reaction diseases to study, as it has such a definite incubation period and runs such a definite course, not only in its temperature reaction, but also in the manner of the appearance of the eruption. Since making some studies with the measles virus, experimentally reproducing it in monkeys, with E. L. Prizer last year, I have been very much interested in carrying out some of our experimental findings with the idea of using these findings for early diagnosis, especially in reference to isolation, and so preventing the spread of ward epidemics in infants' hospitals. I have had two such opportunities in the wards of the Children's Hospital of the Boston Dispensary: one in June, 1912, and a second in February, 1913. During the first epidemic we had five cases come down with measles and six control cases were followed from

New facts concerning blood destruction and blood regeneration are constantly necessitating a revision of our conceptions of these conditions. Certain results are based upon generally accepted observations so that one is fairly safe in making definite deductions from them. Blood destruction is one of the routine tasks of the body and the replacement is the result of the continuous activity of a widely distributed hematopoietic system. Under normal conditions, the blood tissue is so constituted that it can withstand sudden and considerable changes, and the cells of the blood tissue are so flexible that throughout these changes their normal shape is retained. The rate of regeneration normally depends on the rate of destruction, which has been variously estimated at one tenth, one fifteenth or one thirtieth of the total blood each day. On the other hand, in cases of secondary anemia in which transfusions with a blood of a compatible

The findings which are recorded in the following protocols and charts came out in an investigation for which we received our original material (virus) from Dr. Flexner and Dr. Lewis, whose encouragement and advice have made this work possible. This investigation is being carried on for the purpose of determining some means of early diagnosis and of the treatment for this condition both in the way of prophylaxis and also during the acute stage. If successful in keeping the subjects alive, we hoped that some light might be thrown on the late treatment of the paralyzed muscles. In a more complete report which is shortly to follow, these questions will be more fully discussed. In the attempt at keeping the paralyzed monkeys alive success was only partially obtained. For this partial success we are largely indebted to our laboratory assistant, Mr. J. S. Winslow. We have been able to keep