In Baltimore there is such a sterilizer, and the use of it is very simple. When the nurse arranges about the fumigation, she selects at the same time whatever articles are to be sterilized—pillows, mattresses, blankets, clothing, and so forth. These are then called for by the men from the Fumigation Division. They are placed in large canvas bags, inventoried, labelled, and carried to the sterilizer. Here they are steamed and dried, and returned a day or two later in good condition. The householder signs a receipt to this effect.[5] Footnote 5: Certain articles are ruined by sterilization, and the nurse must be careful not to include these, or there will be a suit for damages. Leather and furs, can never be steamed. Straw mattresses are also injured. Nor is it possible to sterilize carpets and matting, because of their bulk. The sterilizer should be reserved exclusively for material which lends itself readily to treatment of this kind. In selecting what is suitable, the nurse should exclude old and filthy articles, which should be burned. Unfortunately, steam sterilizing plants are rare, and in most communities the nurse will have to protect her patients in other ways. As we have said before, the only alternative is burning, and this often works great hardship on many families. With the very poor, the Federated Charities may be called upon to supply new mattresses, etc., in place of those that have been destroyed, and as a rule this response is prompt. Yet there are many cases where the family is too poor to suffer this loss, yet not poor enough to come within range of a charitable association. These cases constitute a difficult problem—a problem that is entirely solved only by the municipal sterilizer. Except through sterilization, there is no way in which these articles may be made safe. Carbolizing will not do this, neither will sunshine. Valuable as sunshine is, it is difficult to secure prolonged exposure, especially in tenement districts. It is possible, of course, to take a mattress apart and wash and boil the ticking; feathers or hair may be sent to an upholsterer, who has means of steaming them. Pillows may be put into a large wash-boiler, and boiled for half an hour, after which they may be washed—it will take a week or more before they become thoroughly dry and usable. All these alternatives involve a great outlay of time and energy, and we cannot but feel sceptical as to the thoroughness with which this cleaning is likely to be done. A family which objects to parting with dangerous articles, and prefers risk to inconvenience or deprivation, is hardly likely to be scrupulous as to details of this character.