library of
(Ll]e Untcersity of Hortl] Carolina
COLLECTION OF
NORTH C A R O L I N I A N A
ENDOWED BY
JOHN SPRUNT HILL
of the class of 1889
^w. 'o
n-
This book must not
be token from the
Library building.
orm No. 471
lO'CTi-.i-.Ei'xzisr
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington, i W. P. Ivey, M. D ,Lenoir.
S. Westry Battle, M. D Asheville. Francis Duffy, M. D New Bern
Henry W. Lewis, M. D Jackson. W. H. Whitehead, M. D Rocky Mt.
J. L. Nicholson, M. D Richlands. I J. L. Ludlow, C. E Winston.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XX. APRIL, 1905. No. 1.
THE ELECTION OF COUNTY SUPERINTENDENTS OF HEALTH.
Accordiug to Section 7 of the act relating to tlie Board of Health,
the meeting "of the county sanitary committee for the election of a
county superintendent of health" shall be held "on the first Monday in
May, 1901, and every two years thereafter." This means of course
that the term of every superintendent expires this May and that his
successor must be elected for a term of two years at this meeting.
In section 5 of the law cited above "the county sanitary committee
shall have the immediate care and responsibility of the health in-terests
of their county." To properly meet such a responsibility it
behooves all such committees to select as their executive officers
good men. They should also pay such reasonable salary as will
justify men of character and knowledge in accepting the office. In
arranging the salary question there should be an understanding as to
extra pay when the superintendent is called upon to treat small-pox,
as the private practice of a physician when in attendance upon
smallpox is, for the time being at least, greatly interfered with.
We would thank the secretaries of the sanitary conunittees to send
in i)romptly the name and address of the superiiiten(1(Mits elected.
OUR MILK SUPPLIES.
By the time this issue of the Bulletin reaches our readers warm
weather will be upon us and the annual "slaughter of the innocents"
will have begun. The chief cause of the fearful death-rate among
infants is improper feeding. Cow's 'milk is the principal article in
their dietary. Impure cow's milk is therefore responsible for the
t^
Z BULLETIN 2\'. C. BOARD OF HEALTH.
loss, it is probably within reason to say, of thousands of lives in our
State every year that could have been saved.
The practical question of course is, How can we secure pure milk?
It is not very easy of solution, but much can be done by municipal
supervision. Every city and larger town should require each dairy
selling milk to its people to take out a license. The issuance of
this license should be based upon an observance of such sanitary
rules and regulations as would safeguard the purity of the milk
furnished, revocation of the license protuptly following upon failure
to do so. To insure their observance a system of dairy inspection,
including frequent tests of the milk, should be instituted. A move-ment
in this line has been started in Raleigh, and it is to be hoped
that it will be carried to a successful issue. It is also greatly to be
desired that other cities and towns take the matter up promptly and
earnestly. As directly pertinent to the subject we take ple:isure in
printing below an excellent paper on "Prevention of Summer Diseases
of Infants," read by Dr. Joseph Graham before the Child's Study
Department of the Woman's Club of Raleigh and published in the
^'ews and Ohserver of recent date.
PREVENTION OF SU.MMER DISE.4SES OF INFANTS.
BY JOSEPH GRAHAM, M. D.
Milk is the most suitable cultnro medium for the growth of germs.
These germs grow and elaborate poisons in the milk 1)oth before and
after it is taken into the infant's stomach. This question of impure
milk has been given a great deal of deserved attention in this and
other countries. The agency of milk in the spread of contagious
diseases has only lately been appreciated. Its importance may be
judged by the fact that in 1900 Kobor collected records of 330 epi-demics
which were spread by milk—these illustrate very well how
the milk most frequently becomes infected. There were 195 out-breaks
of typhoid fever, 99 of scarlet fever and 36 of diphtheria. In
the typhoid epidemics the disease prevailed at the dairy in 148
instances: in 67 the milk was diluted with infected well water; in
7 the cows probably waded in polluted water : in 24 cases the
employees acted as nurses and in 10 they continued at work, although
themselves suffering from the disease : in 1 case it was found that
the milk cans were washed with cloths used about patients, in 2 cases
the dairy employees were connected with the night-soil service.
Of the 99 epidemics of scarlet fever there was disease at the farm
or dairy in 68. In the other instances the employees acted as nurses
or lodged in infected homes. In 2 epidemics infection was brought
by cans or bottles from the homes of patients.
BULLETIN N. C. BOABD OF HEALTH. 3
As a result of investigation, every large city in this country has
passed rules and regulations for the control of the milk supply. New
York's milk supply comes from several different States, yet they
have a fairly pure milk supply—for the municipal inspectors of New
York are active, and only milk of a certain purity and quality is
allowed sale. Therefore the dairymen, although they live in other
States, are compelled to provide pure milk, otherwise their milk
would fall below the municipal requirements, and would be refused
sale. To encourage the use of pure milk, and to decrease the mor-tality
among infants, many thousands of dollars have been donated
for the purpose of establishing milk centres, and pure milk is dis-tributed
to the poor free of charge. This has been done on a large
scale in many American cities, notably Boston, Brooklyn, Buffalo and
Rochester, and it has effected a very decided reduction in the death-rate
of children.
The milk of Raleigh, so far as I have investigated, is unnecessarily
impure. This fact I have learned through sad bed-side experiences
and by repeated examination of samples of milk bought in the open
market.
Why is our milk supply bad? Because there is no supervision of
the milk supplied to our homes. In several instances the owners of
our dairies are interested in other business, and leave the manage-ment
of their dairies more or less to the care of their employees,
who are not responsible to any authority, for there is absolutely no
supervision or inspection of either the milk or the dairies.
Much of the milk sold in Raleigh is transported from the farm to
the city in tin cans, and is measured out to the consumer in a tin
quart can. This measuring-pot is not washed from the time it leaves
the farm until the wagon returns, and during the entire trip it is
placed uncovered by the milk can. where it can receive all the dust
and dirt from the street.
I have been told by a driver of a milk delivery wagon that he has
an insufficient supply of bottles and that very often he has to use
the empty bottles collected on his rounds to supply his next custom-ers.
Under such circumstances it would be impossible to deliver
anything but dirty milk. Often the farm sends In more milk than
is delivered by the wagon—this surplus is carried back to the farm.
Who prevents the return of this milk to the market on the following
day? I firmly believe that such milk is often sold in Raleigh. At
present there is no way of preventing an individual who has been
nursing a case of diphtheria, scarlet fever or ty])Iioid fever, or any
other infectious disease, from attending to his usual duties of the
dairy.
We have no simple means by which we can definitely determine
the purity of milk. The fact that milk appears perfectly sweet is not
a proof of its purity, for. if the germs are already in it. the harmful
changes may take place even after the baby has had its meal ; then.
4 BULLETIN jST, C. BOAKD OF HEALTH.
too, some disease-producing germs do not cause souring of the milk,
and therefore their presence is not detected.
As it Is generally impossible to procure cow's milk sufficiently free
from germs, we have to use some measure to destroy the germs in
already present. The great principle of all s'.erilizing is, first, the
^^
killing of germs present in milk ; and second, the preventing of other '
germs from entering into it later : if both these ends are accom-plished
the milk will keep sweet for several days. There are two
classes of apparatus used to destroy germs ; one known as a steril-izer,
which sterilizes the milk at a boiling temperature 212 degrees
F. ; the other called a Pasteurizer, which is really a modified steril- f
izer, killing the germs at a much lower temperature.
There are certain disadvantages in sterilizing milk—the taste is
very considerably changed ; such milk is very much more constipating
and more difficult of digesting, also it seems to be less nutritious
—
certainly children do not thrive as well when fed on sterilized milk
as when nourished with pure raw cow's milk.
Pasteurization of the milk produces less change in the constit-uents
of milk than sterilization, and as it is sufficiently thorough in
the destruction of germs it has become the most popular method of
sterilization. Sterilization of milk has certain limitations. Heating
milk destroys only living organism ; it does not kill spores, nor does
it remove toxins or poisons. Before sterilization, milk may already
contain the products of bacterial growth in such quantity and of
such a character as to render it wholly unfit for food. Even though
just sterilized, it may still be poisonous to an infant, for steriliza-tion
will not kill the products of bacterial growth—it is therefore''
very important that sterilization be done at the earliest possible
moment. We must always remember that sterilized milk is more
difficult of digestion ; the only value of sterilization is in preventing
disease, first, by enabling us to feed infants upon milk in which no
considerable fermentative changes have taken place; and second, by
destroying disease-producing germs with which the milk may have
become accidentally contaminated.
It would be far more desirable to use pure milk, but this result
will not be secured until the public is educated to appreciate and
dealers to produce a better and a cleaner milk ; also it will be neces-sary
to give the health authorities of the city greater power than
heretofore in the matter of milk inspection.
The above facts are gleaned from observation in my own practice
and from study of the works of others who have given this matter
serious consideration.
BULLETIN N. C. BOARD OF HEALTH.
REVIEW OF DISEASES FOR MARCH, 1905.
EIGHTY-ONE COUNTIES EEPORTING.
Niuety-five conuties luave Superintendents of Health.
Except in the case of the more contagious and dangerous diseases
the Superintendent has, as a rule, to rely upon his own information
alone, since few physicians can he induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a dis-ease
otherwise indicated, its mere presence in the county is to be
understood as reported.
For the month of ]March the following diseases have been reported
from the counties named.
Measles.—Alamance, in all parts ; Anson, 7 cases ; Bertie, in all
parts ; Bladen, a few ; Brunswick, several ; Cabarrus, 10 ; Camden, 15 ;
Carteret ; Chatham ; Chowan, epidemic ; Clay, several ; Craven
;
Davidson ; Duplin, 10 ; Durham, a few ; Edgecombe, a few ; Frank-lin,
in all parts ; Gates, 11 ; Graham, several : Guilford, many
Halifax, 1 : Hertford. 5 ; Jackson. 2 : Madison, in all parts ; Martin,
many : Mecklenburg : New Hanover, 28 ; Onslow. 20 ; Orange, many :
Pender, a few : Person, in all parts ; Pitt, 1 ; Randolph, 1 ; Richmond,
90 ; Robeson, several : Rockingham ; Sampson : Union. 20 ; Vance, in
all parts; Wake, epidemic; Warren, a few: Washington. 12—42 coun-ties.
Whooping-cough.—Cabarrus, 40 ; Chatham : Clay, several ; Dare,
7 ; Durham, a few ; Edgecombe, 1 ; Guilford, many ; Madison, in all
parts ; ]Martin, many ; Mecklenburg ; Mitchell ; Nash ; Onslow, 10 ;
Richmond, 15 ; Rutherford, many ; Transylvania, several ; W^ake, epi-demic
; Yadkin, many ; Yancey—-19 counties.
Scarlatina.—Bladen, a few; Mecklenlmrg: New Hanover, 1 ; North-ampton.
4 ; Rockingham.
Diphtheria.—Bladen, 1 ; Caldwell. 1 : Davie. 1 : Edgecombe. 1 ;
Granville, 1; Guilford, 2; New Hanover, 2; Pitt. 1: Union. 2; Wake,
1—10 counties.
Typhoid Fever.—Beaufort, 1 ; Caldwell, 16 ; Chatham ; Dare, 3 ;
Jackson, 2 ; New Hanover, 2 ; Onslow, 1 ; Pitt, 1 ; Randolph, 3 or 4
:
Robeson, a few: Stanly, 2; Union. 10; Wake. 2; Wayne. 1—14
counties.
Malarial Fever.—Brunswick; Gates: Halifax: Pender.
Bowel Diseases.—Currituck, a few.
Influenza.—Alleghany, general : Catawba, general ; Cumberland,
general ; Currituck ; Davie, general ; Gates, general ; Hertford, gen-eral
; Hyde, general ; Lincoln ; Martin ; Onslow, general ; Randolph ;
Richmond; Scotland: Washington, general; Wilkes; Yadkin—17
counties.
b BULLETIN N. C. BOARD OF HEALTH.
Pneumonia.—Alamance, 10 ; Alleghany, in all parts ; Bladen, 1
Cabarrus, 7 ; Cumberland, in all parts ; Davidson ; Duplin, 4 ; Green,
6 ; Hyde, in all parts ; Jackson, 4 ; Martin, in all parts ; Mecklenburg
;
New Hanover, 4 ; Pender, a few ; Person ; Randolph ; Sampson, many ;
Transylvania, a few ; Wake, 25 ; Warren, a few ; Wayne, several
Wilson ; Yadkin, a few—23 counties.
Mumps.—Guilford, a few ; Sampson, epidemic ; Surry.
Smallpox.—Alamance,! ; Anson, 7 ; Beaufort, 5 ; Bladen, 5 ; Bruns-wick,
several ; Buncombe, 2 ; Caldwell, 1 ; Carteret, 12 to 15 ; Chowan,
22 ; Cleveland, 7 ; Craven, 3 ; Cumberland, 4 ; Currituck, several
;
Davie, 15 ; Duplin, 17 ; Durham, 10 ; Edgecombe, 14 ; Franklin, 15
Gaston, 10 ; Gates, 20 ; Green. 2 ; Guilford, 8 ; Halifax, 16 ; Henderson,
1 ; Hertford, 1 ; Mecklenburg. 18 ; Nash. 3 ; New Hanover, 47 ; North-ampton,
15 ; Pasquotank, 3 ; Perquimans. 10 ; Person, 7 ; Pitt. 3 : Ran-dolph.
12 ; Richmond. 25 ; Robeson. 2 : Rockingham, 6 ; Scotland, a
few ; Stanly. G ; Transylvania, several ; Union. 10 : Wake, 5 ; Wayne,
several ; Wilson. 5 ; Yancey, a few—45 counties.
Choleba, in Hogs.—Onslow.
Distemper, in Horses.—Orange.
No diseases reported from Burke, Forsyth, Haywood, Iredell,
Johnston, McDowell. Polk and Watauga.
No reports received from Alexander, Ashe. Caswell, Cherokee,
Columbus, Harnett, Jones. Lenoir, Macon, Montgomery, Moore,
Pamlico, Rowan and Swain.
BULLETIN N. C. BOARD OF HEALTH.
SUMMARY OF BIORTUARY REPORTS FOR MARCH, 1905.
TWENTY-FOUB TOWNS.
White.
Aggregate population 87,750
Aggregate deaths 125
Representing temporary annual death-rate
per 1,000 16.7
Cause of Death.
Malarial fever 1
Measles 1
Pneumonia 24
Consumption 18
Brain diseases 12
Heart diseases 7
Neurotic diseases 2
Diarrhoeal diseases 1
All other diseases 54
Accident 3
Suicide 1
Violence 1
125
Deaths under five years 24
Still-born 10
Colored. Total.
64,150 153,900
129 254
24.1 19.8
22
BULLETIN N. C. BOARD OF HEALTH.
Mortuary Report for Iflarcli, i905*
BULLETIN X. C. BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. H. R. Moore.
Alexander Dr. C. J. Carson.
Alleghany Dr. Robt. Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. Manley Blevins.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. W. P. Ivey.
Camden Dr. C. G. Ferebee.
Carteret Dr. F. M.Clarke.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. T. A. Kirkman.
Cherokee Dr. B. B. Meroney.
Chowan Dr. T. J. Hoskins.
Clay Dr. P. B. Killian.
Cleveland Dr. B. H. Palmer.
Columbus Dr. N. A. Thompson.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare .Dr. W. B. Fearing.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. A. J. Jones.
Durham Dr. N. M. Johnson.
Edgecombe Dr. W. J. Thigpen.
Forsyth Dr. W. 0. Spencer.
Franklin Dr. R. F. Yarborough.
Gaston Dr. H. F. Glenn.
Gates Dr. W. O. P. Lee.
Graham Dr. V. J. Brown.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy, Jr.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. O. L. Denning.
Haywood Dr. J. F. Abel.
Henderson Dr. J. G. Waldrop.
Hertford Dr. C. F. Griffin.
Hyde Dr. E. H. Jones.
Iredell .Dr. M. R. Adams.
Jackson Dr. R. L. Davis.
Johnston Dr. Thel Hooks.
Jones Dr. N. G. Shaw.
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. John W. Saine.
McDowell Dr. B. L. Ashworth.
Macon Dr. W. A. Rogers.
Madison Dr. W. J. Weaver.
Martin Dr. W. H. Harrell.
Mecklenburg Dr. C. S. McLaughlin
Mitchell Dr. Virgil R. Butt.
Montgomery Dr. M. P. Blair.
Moore Dr. Gilbert McLeod.
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. E. L. Cox.
Orange Dr. C. D. Jones.
Pamlico Dr. H. P. Underbill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. R. J. Williams.
Perquimans Dr. C. C. Winslow.
Person Dr. J. A. Wise.
Pitt Dr. Zeno Brown.
Polk Dr. C. J. Kenworthy.
Randolph Dr. W. J. Moore.
Richmond Dr. F. J. Garrett.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. AV. L. Crump.
Rutherford Dr. T. B. Twitty.
Sampson Dr. John A. Stevens.
Scotland Dr. A. W. Hamer.
Stanly Dr. V. A. Whitley.
Stokers
Surry ........ ..!!r....Dr. John R. Woltz.
Swain Dr. A. M. Bennet.
Transvlvania Dr. C. W. Hunt.
Tyrrell
Union Dr. John M. Blair.
Vance Dr. H. H. Bass.
Wake Dr. J. J. L. McCullere
Warren Dr. M. P. Perrv.
Washington Dr. W. H. Ward.
Watauga Dr. H. McD. Little.
Wayne Dr. Williams Spicer.
Wilkes Dr. W. P. Horton.
Wilson Dr. W. S. Anderson.
Yadkin Dr. T. R. Harding.
Yancey Dr. J. L. Ray.
BULLETIN X. C. BOARD OF HEALTH. 11
[You are asked to fill out and mail one of these forms to the Superintendent of Health of your
county on or before the third of each month, that he may use it in making his report to the Secretary
of the State Board.]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough Typhoid Fever -
Measles Typhus Fever
Diphtheria Yellow Fever
Scarlet Fever _-- Cholera
Pernicious Malarial Fever Smallpox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis-
VVhat have been the prevailing diseases in your practice ?
Has any epidemic occurred among domestic animals? If so, what?
What is the sanitary condition of your section, public and private?
General Remarks:
M. D.
190--- N. C.
:BTJ1L-.2L.:S'Z:Z2^T
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington. I W. P. Ivey, M. D. Lenoir.
S. Westry Battle, M. D Asheville. Francis Duffy, M. D New Bern.
Henry W. Lewis, M. D Jackson.
j W. H. Whitehead, M. D Rocky Mt,
J. L. Nicholson, M. D Richlands. I J. L. Ludlow, C. E Winston.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XX. MAY, 1905. No. 2.
THE PATENT MEDICINE CURSE.
By Gerald McCarthy.
(Biologist, N. C, Board of Health.
)
According to the census of 1900 the wholesale value of the "pateut
medicines" consumed in the United States during the census year
was about $00,000,000. Adding to this one-third for the retailer's
profit, we get the enormous sum of about eighty million dollars annu-ally
worse than wasted by the .Vmerican people, or, to speak more
particularly, by the po<irer and more ignorant classes of the Ameri-can
people.
It is well known to those informed in regard to the manufacture
of medicines that tlie great majority of these nostrums, intended for
internal use. contain alcohol and some narcotic like opium or cocaine
or one of the newer class of synthetic nerve stimulants as the active
agents. Cosmetics all contain corrosive sublimate or some other
poisonous salt of merciu-y. Ilair-dyes invariably contain lead.
The following list of proprietary nostrums and some of their active
ingredients has recently been published by the Massachusetts Board
of Health. It would be well for honest newspaper editors and
others who have the public ear to inform the poor ignorant dupes
who jtay money they can illy spare for those secret drugs just what
they are buying and taking into their systems.
14 BULLETIN N. C. BOARD OF HEALTH.
ANALYSES BY THE MASSACHUSETTS BOARD OF HEALTH.
COSMETICS.
The following were found to contain acetate of lead (sugar of lead)
or some other active lead compound
:
Per Cent, of
Lead
Contained.
Ayer's Hair Vigor contained the equivalent of about 0.30
"Renown" Hair Restorer contained the equivalent of about. .. 1.8G
Mrs. Allen's Hair Restorer contained the equivalent of about. . 2.30
American Hair Restorative contained the equivalent of about. . 0.61
Barrett's Vegetable Hair Restorer contained the equivalent of
about 0.22
Chevalier's Life for the Hair contained Much
Hall's Vegetable Sicilian Hair Renewer contained the equiva-lent
of about 1.75
Wood's Hair Restorative contained the equivalent of about. . .
.
1.59
Ring's Vegetable Ambrosia contained the equivalent of about. . 1.51
Parker's Hair Balsam contained the equivalent of about 2.32
Wolf's Vegetable Hair Restorer contained the equivalent of
about 0.95
Champlln's Liquid Pearl Much
Instances of lead poisoning have been known to occur from the
free external use of such preparations as the foregoing.
The following contained corrosive sublimate, or some other poison-ous
salt of mercury, in the proportion of 1 to 15 gi-ains per ounce
:
Harriet Hubbard Ayer's Recamier Cream. Balm and Lotion.
Madam Rupperfs World Renowned Face Bleach.
Madam Yale's Excelsior Complexion Bleach.
Hill's Freckle Lotion.
Soule's Freckle and Moth Eradicator.
Perry's Freckle Lotion.
Oriental Cream.
Mrs. McCorrison's Famous Diamond Face Lotion (14.7 grains to
the ounce).
Royal Cream.
In one Instance a six-ounce bottle contained 47 grains of corrosive
sublimate ; another contained 14 grains of the bichloride per ounce.
It Is not surprising that Instances of serious harm were reported
from the use of such articles.
BL'LLETIX X. C. BOARD OF HEALTH. 15
TOXICS AXD BITTERS.
The following were examined for the purpose of ascertaining the
percentage of alcohol in each. Some of them have been recom-mended
as temperance drinks
:
Per Cent, of
Alcohol
(by Volume).
"Best" Tonic 7.6
Carter's Physical Extract 22.0
Hooker's Wigwam Tonic 20.7
Hop Tonic 7.0
Hoofland's German Tonic 29.3
Howe's Arabian Tonic, "not a rum drink" 13.2
Jackson's Golden Seal Tonic 19.6
Liebig Company's Coca Beef Tonic 23.2
Mensman's Peptonized Beef Tonic 16.5
Parker's Tonic, "purely vegetable." recommended for ine-briates
41.6
Schenck's Sea Weed Tonic, "entirely harmless"' 19.5
Atwood's Quinine Tonic Bitters 29.2
L. T. Atwood's Jaundice Bitters 22.3
Moses Atwood's Jaundice Bitters 17.1
Baxter's Mandrake Bitters 1G.5
Boker's Stomach Bitters 42.6
Brown's Iron Bitters 19.7
Burdock Blood Bitters 25.2
Carter's Scotch Bitters 17.6
Colton's Bitters 27.1
Copp's White Mountain Bitters, "not an alcoholic beverage".. 6.0
Drake's Plantation Bitters 3.3.2
Flint's Quaker Bitters 21.4
Goodhue's Bitters IG.l
Greene's Nervura 17.2
Hartsliorn's Bitters 22.2
Hoff's Extract of Malt and Iron 5.24
Peruna 28.59
Vinol, Wine of Cod Liver Oil 18.88
Lydia Pinkham's Vegetable Conijiound 20.61
Dr. Kilmer's Swamp Root 7.32
Dr. Peter's Kuriko 14.00
Hoofland's German Bitters, "entirely vegetable and free from
alcoholic stimulant" 25.6
Hop Bitters 12.0
Hostetter's Stomach Bitters 44 3
Kaufman's Sulphur Bitters, "contains no alcohol" (as a matter
of fact it contains 20.5 per cent, of alcohol and no sulphur) . . 20.5
Kingsley's Iron Tonic I4
16 BULLETIN N. C. BOARD OF HEALTH.
Per Cent, of
Alcohol
(by Volume).
Laugley's Bitters 1^-^
Liverpool's Mexican Tonic Bitters ---^
Paine's Celery Compound '^^•'^
Pierce's Indian Restorative Bitters 6.1
Puritf 22.0
Z. Porter's Stomach Bitters 27.9
Pulmonine . .
.
Rush's Bitters
16.0
35.0
Richardson's Concentrated Sherry Wine Bitters 47.-5
Secor's Cinchona Bitters 131
Shonyo's German Bitters "-l..>
Job Sweet's Strengthening Bitters 29.0
Thurston's Old Continental Bitters 11-4
Warner's Vinegar Bitters, "contains no spirit" 6.1
Warner's Safe Tonic Bitters 35.7
Warren's Bilious Bitters 21.5
Wheeler's Tonic Sherry Wine Bitters 18.8
Wheat Bitters 13-6
Faith Whitcomb's Nerve Bitters 20..3
Dr. Williams' Vegetable Jaundice Bitters 18.5
Whiskol, "a non-intoxicating stimulant, whiskey without its
sting" • • 28.2
Colden's Liquid Beef Tonic, "recommended for treatment of
alcohol habit" 2G.5
Ayer's Sarsaparilla 26.2
Thas'er's Compound Extract of Sarsaparilla 21.5
Hood's Sarsaparilla .• 18-8
Allen's Sarsaparilla 13-5
Dana's Sarsaparilla 13-">
Brown's Sarsaparilla 13-5
Corbett's Shaker Sarsaparilla 8.8
Radway's Resolvent '''���9
The dose recommended upon the labels of the foregoing prepara-tions
varied from a teaspoonful to a wineglassful, and the frequency
also varied from one to four times a day. "increased as needed."
"blood purifiers."
An examination of the "sarsaparilla" remedies, or "blood puri-fiers,"
was made in 1892, and in nearly every instance the remedy
was found to contain iodide of potassium in variable amounts.
The following list presents the percentage of iodide of potassium
found in those samples which have been submitted to the analyst
for examination
:
BULLETIX X. C. BOARD OF HEALTH. 17
SARSAPARILLA REMEDIES.
Wilson's
Howe's
White's
No name
Charles's
Mahem's
Ayer's
Bartlett's
No name
No name
Packard's
Coleman & Co.'s
Bass's
Brown's
Leavitt's
Moriarty's
Dana's
0.32 Woodward's
0.33 Dudley's
0. 38 Cherry & Wingate's
0.41 Jaynes's
0.41 Nim's
0.41 Raynsfoi'd's
0.45 Adams's
0. 50 Broad & Co.'s
0.50 Hood's
0.50 Hutchinson's
0.58 Dr. White's
0.83 i Cherry & Wingate's
0.84 Mattison's
1.00 Myrick's
1.00 Leavitt's
1.11 Church's
1.17
1.33
1.50
1.55
1.59
1.67
0.58
0.75
0.75
0-75
0.75
0.75
1.67
2.00
2.12
2.17
2.25
MISCELLANEOUS DRUGS.
Intemperance Cures.—Dr. Grant's "Goklciira,'' for the liquor and
drug habits, manufactured by tlie Canadian Chemical Company, Rut-land,
Vt.. and sold for .$.5 per package, consisted of two bottles of
liquid and one small bottle containing pills. The two liquids were
found to contain 41.11 per cent, and 28.22 per cent, of alcohol by
volume respectively, while the pills contained nux vomica and were
coated with a very thin layer of gold foil, which, by the way, was
the only gold found in the preparation.
The White Ribbon Remedy, put up by Dr. W. R. Brown of Bos-ton,
purporting to contain gold and alkaloids, consisted of twelve
powders in a box sold for $1. These powders were found to contain
ammonium. chloride and milk sugar. Neither gold nor alkaloids were
found to be present.
Champagne Tablets.—This preparation, prepared by the Cham-pagne
Tablet Company of Boston, claiming to be a stimulating and
exhilarating substitute for bi-andy. champagne, whiskey, etc.. was
put out in the form of lozenges containing .0.5 gram of caffeine per
tablet.
Catarrh Remedy.—One of these preparations was found to contain
a considerable amount of cocaine hydrochlorate.
Supplementary to the above lists as quoted from the 1S9G report
are given the following results, obtained more recently
:
18 BULLETIN X. C. BOARD OF HEALTH.
STARCH IN DIABETIC FLOUR OR GLUTEN.*
Per Cent.
Starch.
Price
Per Pound
(Cents).
Label on Package. Manufacturer.
10.00
BULLETINS" N. C. BOARD OF HEALTH. 19
to forty-four per cent, of alcohol—to saj^ nothing of opium and co-caine
! I have seen a temperance woman, who raged at the thought
of whiskey, take bottle after bottle of some 'bitters,' which contained
five times as much alcohol—and compared to which sherr.v, port,
claret aud champagne were as harmless as the pink lemonade at
Sunday-school picnics."
"It is not by any means putting the matter too strongly to say that
the patent-medicine habit is one of the gravest curses, with the most
dangerous results, that is inflicting our American national life.
Sooner or later the people of America must awaken to the fearful
dangers that lie in these proprietary preparations. The mothers of
our children, in particular, must have their eyes opened to the dan-gers
that lurk in these patent medicines. Here and there a hopefiil
sigu of an awakening is seen. Slowly but surely the best magazines
are falling into line in their refusal to accept patent-medicine adver-tisements
of any kind. Not long ago one of the insurance companies
made an excellent move by requiring its medical examiner to ask
of each subject for insurance, 'What patent medicines have you used
during the last five years?' aud gradually other insurance companies
are realizing the fact that the use of patent medicines is even more
injurious than the use of alcoholic liquors. But much still remains
:
more should be done. Public interest must be more widely aroused."
"Let the oflicers of the Woman's Christian Temperance Union look
into the advertising columns of the religious papers of the country,
and see how their cohunns fairly reek with the advertisements of
these dangerous concoctions. Yet in these very same so-called re-ligious
papers there are official Woman's Christian Temperance Union
columns setting forth the 'officiar news of the organization and its
branches. A pretty consistent picture do these two portions of the
average religious paper present—advocating, with one hand, alco-holic
prohibition, or temperance, and receiving, with the other hand, '
money for advertising—and thereby recommending to their readers
—
preparations filled ten times over with more alcohol than the beer
which fills them with so much horror in the editorial columns
!
There are no papers published that are so flagrantly guilty of ad-mitting
to their columns the advertisements not only of alcohol-filled
medicines but preparations and cure-alls of the most flagrantly ob-scene
natui-e, as the so-called religious pajiers of this country. Let
the Woman's Christian Temperance Union oflicers counsel its mem-bers
who subscribe for these papers to compel their publishers to
omit these advertisements, and if they refuse, let these people dis-continue
their patronage of the paper. Such measures would very
quickly shut out from publicity the majority of these baneful patent
medicines. There is vital, important work here for the Woman's
Christian Temperance Union—work in a cause which is aiming with
far greater danger at the very heart of American homes than the
20 BULLETIX X. C. BOARD OF HEALTH.
cracking of a bottle of cbampagne over the hull of a newly-launched
craft."
"Far better, ladies, that the contents of a bottle of champagne
should go into the water, where it will do no one any harm, than that
the contents of a bottle of 'patent ijiedicine,' with forty per cent,
of alcohol in it, should be allowed to go into the system of a child
and strike at his very soul, planting the seed of a future drunkard '."
REVIEW OF DISEASES FOR APRIE, 1905.
EIGHTY-TWO COUNTIES REPORTING.
Ninety-five counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases
the Superintendent has. as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a dis-ease
otherwise indicated, its mere presence in the county is to be
understood as reported.
For the month of April the following diseases have been reported
from the counties named
:
Measles.—Bertie, many cases ; Bladen, many : Camden. 4 : Car-teret
; Caswell, several ; Chowan, in all parts : Cleveland, a few
;
Craven, epidemic; Cumberland; Currituck, several; Dare; Davidson;
Davie, 2; Duplin, G; Durham, a few; Edgecombe, a few; Frank-lin,
general ; Gates. 150 ; Graham, many ; Guilford, many ; Har-nett,
several ; Johnston, in all parts ; Lenoir, several ; Madison, in
all parts; Martin, many; Mecklenburg; New Hanover, many; Ons-low,
20 ; Fender, a few ; Perquimans, .3 : Person, epidemic ; Pitt, 3
;
Richmond, 75 ; Rockingham, many ; Sampson, many ; Union, 60 ; War-ren,
a few ;" Wilkes. 1—38 counties.
Whooping-cough.—Ashe. 40 ; Cabarrus. 12 ; Caswell, a few ; Chat-ham
; Clay, 2 ; Cumberland, many ; Dare : Durham, a few ; Franklin,
a few ; Greene, 1 ; Guilford, many ; .Johnston, in all parts ; Lincoln. 5
:
Madison, in all parts ; Martin, many ; Mecklenburg ; Mitchell : Ons-low,
25; Pitt, 6; Richmond, 40; Rutherford, many; Transylvania,
several ; Union. 20 ; Yancey, several—24 counties.
Scarlatina.—Gaston. 1 ; Northampton, 1 : Onslow, 1.
Diphtheria.—Alamance. 3 ; Caldwell. 4 : Guilford, 1 ; Haywood. 1 :
Martin, 1 ; New Hanover, 4 ; Stanly. 2 ; Union, 3—8 counties.
Typhoid FE^•ER.—Ashe. 2 ; Caldwell. 1 ; Chatham ; Edgecombe. 1
;
Franklin, a few ; Gates. 3 ; Graham. 2 : Lenoir, a few ; Martin, sev-
BULLETIN y. C. BOARD OF HEALTH. 21
eral ; Onslow, 1 ; Pender, 2 ; Perquimans. 1 ; Pitt. 1 : Kandoiph. 2 or 3
;
Rockingham, a few ; Scotland, 3 ; Stanly, 2 ; Union, 10—IS counties.
Malarial Fever.—Brunswick ; Caswell ; Dare, a few ; Greene
Pender, in all parts ; Sampson—6 coimties.
Bowel Diseases.—Lenoir ; Sampson.
Influenza.—^Ashe. in all parts ; Clay, in all parts : Currituck :
Gates; Greene: Lenoir, in all parts; Onslow, in all parts; Sampson;
Scotland—9 counties.
Pneumonia.—Ashe, in all parts; Burke, a few; Catawba. 4; Curri-tuck,
a few ; Davidson ; Durham, 2 ; Jackson, 4 ; Lenoir, many ; Mar-tin,
many ; Mitchell ; Pasquotank ; Pender. 1 ; Person ; Randolph, in
most parts—14 counties.
Mumps.—Caswell ; Guilford ; Sampson ; Scotland.
^'ARICELLA.—Clay ; Pasquotank.
Smallpox.—Alamance. 1 ; Alexander, 10 to 1.5 ; Ashe. 2 ; Bladen,
about 10 ; Brunswick, several ; Cabarrus, 2 ; Caldwell. 4 : Camden, 2 ;
Carteret, 18 to 20 ; Catawba, 3 ; Chatham. 1 ; Chowan, 23 ; Cleveland,
12 ; Craven, 5 ; Cumberland. 2 : Currituck reports no cases for April
and reported' none for March, the statement in the last Bulletin of
several occurring in March being a clerical error ; Davie, 7 ; Duplin,
4; Durham, 5: Gaston. 12; Gates, 3; Greene. 25; Harnett, 10; Hen-derson,
13 ; Hertford, 2 ; Mecklenburg. 5 ; Moore, 4 ; Nash. 3 ; New
Hanover. 10 ; Northampton. 1.5 ; Pasquotank, 8 ; Perquimans. 32 ; Per-son.
3: Pitt. 2; Randolph. C; Richmond, 10; Robeson, 15; Rocking-ham,
1 ; Sampson. 2 ; Scotland, a few ; Stanly, 2 ; Transylvania, sev-eral
; Union, 10 ; Wake. 20 ; Washington, 5—i5 counties.
Cholera in Chickens.—Clay.
Cholera in Hogs.—Clay ; Pender.
No diseases reported from Alleghany, Anson. Buncombe, Gran-ville,
Hyde. Iredell. :McDowell. Polk. Surry. Tanee. Watauga and
Wilson.
No reports received from Beaufort, Cherokee, Columbus. Forsyth,
Halifax. Jones, Macon. INIontgomery. Onslow. Pamlico, Rowan, Wayne
and Yadkin.
22 BULLETIN X. C. BOARD OF HEALTH.
SmSIARY OF MORTUART REPORTS FOR APRII/, 1905.
T\VE^-TY TOWNS.
White. Colored. Total
Aggregate population 68.250 44,650 112.900
Aggregate deaths 78 85 163
Representing temporary annual death-rate
per 1,000 13.7 22.8 17.3
Cauf:es of Death.
Typhoid fever 2 2
Malarial fever 1 1
Measles 1 1
Whooping-cough 1 1
Pneumonia 7 14 21
Consumption 9 18 27
Brain diseases 4 3 7
Heart diseases 4 7 11
Diarrhoeal diseases 3 2 5
All other diseases 45 35 80
Accident 2 1 3
Suicide : 1 1
Violence 1 2 3
78 85 163
Deaths under five years 14 18 32
Still-horn 4 G 10
BULLETIN N. C. BOARD OF HEALTH. 23
Mortuary Report for April, 1905*
Towns
AND REPOBTEaS.
Popula-tion.
I Tempobaby
I Annual
Death-ratb
FEB 1,<JOO.
I
Charlotte \
Ur. F. O. Hawley. (
Durliam I
Dr. N. .M. Johnson. f
Edeutou )
Dr. T. J. Hoskiu-s. )
Fayetteville 1
Dr. A. S. Ko.'^e. J
Greensboro >
Jno. S Michaux.C.C.)
Heudersou 1
Dr. John H. Tucker. J
Lanriulinrg (
Dr. G. D. Everington. )
liexliigtou I
J. H. vioyer, Mayor, j
DIariou )
Dr. B. S. Cheek. J
Monroe )
Dr. Jno. M. Blair. )
Oxford \
Dr. S. D. Boolh. )
Raleigh 1
T. P. .Sale, Clerk B. H. j
Salem I
S. E. Butner, Mayor. (
Salisbury I
Dr. H. T. Tranthana. (
Sontb|>ort I
Dr. D. I. Watson. (
Tarboro (
Dr. W. J. Thigpen. (
Waiiesboro I
Dr. J. H. Bennett. (
Weldon I
J. T. Gooeh, Mayor. (
Wilson )
Dr. W. 8. Anderson. )
Winston I
Dr. J. L. Hanes. (
w.
c.
24 BULLETIN N. C. BOARD OF HEALTH,
County Superintendents of Health.
Alamance Dr. H. R. Moore.
Alexander Dr. C. J. Carson.
Alleghany Dr. Robt. Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. Manlev Blevins.
Beaufort Dr. D. T. tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. W. P. Ivey.
Camden Dr. C. G. Ferebee. .
Carteret Dr. F. M. Clarke.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. T. A. Kirkman.
Cherokee Dr. B. B. Meroney.
Chowan Dr. T. J. Hoskins.
Clay Dr. P. B. Killian.
Cleveland Dr. B. H. Palmer.
Columbus Dr. N. A. Thompson.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare .Dr. W. B. Fearing.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. A. J. Jones.
Durham Dr. N. M. Johnson.
Edgecombe Dr. W. J. Thigpen.
Forsyth Dr. W. O. Spencer.
Franklin Dr. R. F. Yarborough.
Gaston Dr. H. F. Glenn.
Gates Dr. W. O. P. Lee.
Graham Dr. V. J. Brown.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy, Jr.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. 0. L. Denning.
Haywood Dr. J. F. Abel.
Henderson Dr. J. G. Waldrop.
Hertford Dr. C. F. Griffin.
Hyde Dr. E. H. Jones.
Iredell Dr. M. R. Adams.
Jackson Dr. R. L. Davis.
Johnston Dr. Thel Hooks.
Jones Dr. N. G. Shaw.
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. John W. Saine,
McDowell Dr. B. L. Ashwortb.
Macon Dr. W. A. Rogers.
Madison Dr. W. J. Weaver.
Martin Dr. W. H. Harrell.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Virgil R. Butt.
Montgomery Dr. M. P. Blair.
Moore Dr. Gilbert McLeod
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan
Northampton Dr. H. W. Lewis.
Onslow Dr. E. L. Cox.
Orange Dr. 0. D. Jones.
Pamlico Dr. H. P. Underbill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. R. J. Williams
Perquimans Dr. C. C. Winslow.
Person Dr. J. A. Wise.
Pitt Dr. Zeno Brown.
Polk Dr. C. J. Kenworthy.
Randolph Dr. W. J. Moore.
Richmond Dr. F. J. Garrett.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. W. L. Crump.
Rutherford Dr. T. B. Twitty.
Sampson Dr. John A. Stevens.
Scotland Dr. A. W. Hamer.
Stanly Dr. V. A. Whitley.
Stokes
Surry Dr. John R. Woltz
Swain Dr. A. M. Bennet.
Transylvania Dr. C. W. Hunt.
Tyrrell
Union Dr. John M. Blair.
Vance Dr. H. H. Bass.
Wake Dr. J. J. L. McCullere.
Warren Dr. M. P. Perry.
Washington Dr. W, H. Ward.
Watauga Dr. H. McD. Little.
Wavne Dr. Williams Spicei
Wilkes Dr. W. P. Horlon.
Wilson Dr. W. S. Anderson
Yadkin Dr. T. R. Harding.
Yancey Dr. J. L. Ray.
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Geo. G. Thomas, M. t)., Pres., Wilmington. I W. P. Ivey. M. D. Lenoir.
.S. Westry Battle, M. D.- -Asheville. [ Francis Duffy, M. D New Bern.
Henry W. Lewis, M. D Jackson. j W. H. Whitehead, M. D Rocky Mt.
J. L. Nicholson, M. D Richlands. ! J. L. Ludlow, C. E Winston.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XX. JUNE, 1905. No. 3.
NORTH CAROL.I1VA BOARD OF HEAL.TH-AXNXJAL. REPORT OF
THE SECRETARY MAY 1, 1904, TO MAY 1, 1905.
(Read at the Conjoint Session of the Board of Health with the State Medical Society
at Greensboro, May 23, 1905).
During the past year the special work of your secretary—in addi-tion
to the usual routine work of the office, which is a-lways to the
fore, and a statement of which in detail will be found in the biennial
report for 1903-1904—has consisted in promoting the crusade against
tuberculosis inaugurated in our last report. The suggestions therein
made have been carried out as fully as our very limited facilities
—
lialf the time of one stenographer—have permitted. The plan pur-sued
has been as follows :
First, the preparation of a pamphlet on the "Causes and Preven-tion
of Consumption." The attempt was made to put the matter to
the people as simply and clearly as possible and at the same time
to make it as interesting as the narrow limits demanded by the
necessary conciseness would permit. As a copy of this publication
has been sent to you it is superfluous to further dwell upon it.
The question of getting the pamphlet into the hands of the people
was carefully considered, and it was decided that it would be much
better to send it directly to tlio individual instead of depending
upon the "take one" principle. In a population as large as ours a
selection of the individuals had to be made, of course, and the fol-lowing
classes, which were regarded as the most intluentinl in this
26 BULLETI^NT N. C. BOARD OF HEALTH.
work, were selected to be served first : Editors, physicians, minis-ters,
lawyers, teachers, and manufacturers employing in-door labor.
Realizing that literature that is not read is usually so much waste
paper, it was thought that if a short letter printed in typewriter type,
with the signature of the Secretary in script, was enclosed with the
pamphlet, it might excite interest, to some extent, at least. So a
letter to each of the classes named above was specially composed
to suit, and earnestly appealing to them to read it and assist in
spreading the information contained in the pamphlet, promising in
every case to send, free of charge, as many copies as the reader
would agree to distribute, was enclosed with each pamphlet. The
editors of our State were exceedingly kind in noticing the article in
their papers, and in consequence there have been calls for it from
Indiana to Texas. Ministers and teachers have shown the most
interest and have agreed to do more distributing than any of the
others. While by far the most important of all in the solution of
this great problem is our own profession, they have, I deeply regret
to say, apparently felt no concern about it. I say apparently, because
they may, and in very many cases no doubt have exerted them-
, selves to instruct their tuberculous patients and the members of
their households in the proper methods of prevention. For human-ity's
sake, and for the honor of the profession, let us hope and be-lieve
so at any rate. It was hoped that there would be a large de-mand
from them for the pamphlet for distribution among their
tuberculous families, but that hope, much to my disappointment, not
to say mortification, has proven an "iridescent dream" so far. But
we will not despair. We cannot abandon the hope of securing the
earnest and interested co-operation in this great work, which means
more for suffering humanity than any other that can be mentioned,
and which is receiving at this time so much attention and sympa-thetic
aid from so many persons of all callings who love their fel-low-
men all over this great country of ours and throughout the
civilized world, from the one class who can do so much to advance it.
The county medical societies could be of much service in this
campaign against tuberculosis. I hope they will devote at least one
meeting every year to it. having some one read a paper and then
holding a symposium on the subject. As we know, the curability
of tuberculosis depends most of all upon an early diagnosis—before
the degenerative changes have begun—and a thorough discussion of
this one aspect of the subject would doubtless eventuate in much
good. The chief benefit to be derived, however, would consist in an
increa.sed interest in the subject and a keener appreciation of the
grave responsibility of the physician in relation to it, whether he
wishes to admit it or not. This might suggest to some the advisa-bility
of personally, as Avell as professionally, aiding in the various
forms of effort—in helping towards the formation of anti-tuberculo-sis
societies and by giving an occasional lecture, for example.
BULLETIN N. C. BOARD OF HEALTH. 27
As this subject has been cousidered more or less fully in the
tenth biennial report, the manuscript of which has been in the hands
of the printer for months, I will not further tax your patience with
it. Anybody desiring a copy of this report can get it, as soon as it
is printed, by sending a request for it to the Secretary.
Smallpox has continued to prevail throughout the State, and more
widely than ever before—the number of counties infected is 78.
The number of cases is, white 3,636, colored 3,741, total 7,377 ; num-ber
of deaths, white 13, colored 18, total 31. Death-rate per cent,
for the whites 0.36, for the colored 0.48, for both races combined
0.42. The figures for the last smallpox year were, respectively, cases,
2,840, 2,530, 5,370; death-rate, 1.23, 1.34, 1.28; for the year before
that—1902-"03—1,861, 2.595, 4,456, with a death-rate per cent, of
3.12, 4.04. 3.60. From these figures it appears that the disease has
been becoming more abundant and decidedly less fatal. As a conse-quence
of this mildness the difficulty in controlling it has become
greater than ever. Indeed, it gives some color for reasonableness to
the suggestion that has been made to abandon the attempt to control
it at all, although, of course, that cannot be seriously considered.
There is no telling when it may become very much more fatal. The
following is a tabulated statement of the smallpox in the State for
the past year. While it shows a larger number of eases than ever,
I am sure that a great many cases have never been reported
:
SMALLPOX REPORT FROM MAY 1, 1904, TO :\IAY 1, 1905.
County.
Alamance —
Alexander---
Anson
Ashe
Beaufort
Bertie
Bladen
Buncombe—
Brunswick -
Burke
Cabarrus
Caldwell
Camden
Carteret
Catawba
Chatham
Chowan
Clay
Cleveland —
.
Craven
Cumberland
Currituck —
.
Davidson
Davie
Duplin
Durham
Edgecombe
-
Forsyth
Franklin
Number of Cases.
White. Colored. Total
23
45
243
286
78
.30
31
100
7
17
4
7
32
5
3
21
8
10
2
63
60
112
1
70
7
200
3
13
205
2
"23"
36
"40"
43
6
10
3
7
53
34
40
15
23
45
306
346
190
1
100
38
300
7
20
17
212
34
5
26
57
8
50
45
14
10
5
28
54
45
58
50
20
Number of Deaths.
White. Colored. Total,
28 BULLETIX X. C. BOAED OF HEALTH.
SMALLPOX report-Continued.
County.
Number of Cases. Number of Deaths.
White. Colored. Total. White. Colored. Total.
Gaston
Gates
Granville
Greene
Guilford
Harneit
Haywood
Henderson
Hertford
Hyde
Iredell
Jackson
Johnston
Lenoir
Macon
Madison
Mecklenburg-.
Mitchell
Moore
Nash
New Hanover -
Northampton
Onslow
Orange
Pamlico
Pasquotank —
Pender
Perquimans -—
Person
Pitt
Randolph
Richmond
Robeson
Rockingham-—
Rowan
Rutherford
Sampson
Scotland
Stanly
Swain
Transylvania
-
Wake
Washington —
.
Warren
Wayne
Wilkes
Wilson
Yancey
Total in 78 counties --
Death-rate, per cent.-
100
4
57
2
6
27
6
24
17
39
26
126
1
191
5
5
25
100
35
25
40
12
4
1
12
1,000
10
9
39
177
3,636
225
62
36
7
122
4
4
63
165
15
1,350
1
47
2
4
100
96
2
3,739
40
25
300
83
64
38
93
127
100
9
108
2
6
34
6
28
80
204
41
126
1
191
23
13
32
32
150
35
65
70
20
5
10
102'
2,350
11
9
39
224
2
4
130
130
13
26
7,375
1
BULLETIX X. C. BOARD OF HEALTH. 29
sessiou of the General Assembly to put us ou au iudepeutleut basis.
We cau then offer still greater facilities to the profession, although
it must be confessed that they do not take advantage of what we
have been offering as we believe they should.
In conclusion, I wish to bespeak the cordial co-operation and as-sistance
of our brethren of the profession in our work. While we
may accomplish something without this, their aid and help would
be simply invaluable.
REVIEAV OF DISEASES FOR MAY, 1905.
EIGHTY COUNTIES REPORTING.
Ninety-five counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases
the Superintendent has. as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a dis-ease
otherwise indicated, its mere presence in the county is to be
understood as reported.
For the month of May the following diseases have been reported
from the counties named
:
Me.\sles.—Alamance ; Camden, 4 ; Carteret ; Craven, several ; Da-vidson
; Davie, several ; Duplin, many ; Edgecombe. 1 ; Forsyth,
many : Franklin, many : Gates, many ; Graham, a few ; Guilford, 2
;
Halifax, epidemic; Harnett, a few; Hertford, a few; Johnston, sev-eral
; Martin, many ; Mecklenburg ; Northampton, many ; Onslow
Orange ; Person ; Pitt ; Rockingham, several : Sampson, many ; Surry.
o: Transylvania, epidemic; Union. .30; Vance, many; Wake. 7:
Warren, several ; Washington, 12—3.3 counties.
WHOOPixG-cotGH.—Anson, in all parts: Cabarrus, 12; Caldwell.
41 ; Catawba. 45 ; Cumberland, general ; Davidson ; Franklin, many ;
Gaston, many ; Hertfoi'd, a few ; Lincoln, 6 ; Martin, many ; Meck-lenburg
; Northampton, many; Onslow; Pitt; Richmond, epidemic;
Rockingham, a few ; Rowan, 40 ; Rutherford, a few ; Surry, 10
;
Transylvania, sevex'al ; Union, 2.5 ; Wake, 4 ; Yadkin, many ; Yan-cey—
25 counties.
ScARLATix.\.—Ashe. S ; Camden, 1 ; Catawba, 2 ; Forsyth. 2 : [Meck-lenburg
: New Hanover, 1—G counties.
Diphtheria.—Cabarrus, 2; Cumberland. 1: Durham. 1: Guilford,
1 : Union. 3 ; Yancey, 1—G counties.
Typhoid Fever.—Alleghany, 1; Caldwell, 8; Davidson; Duplin. 1:
Edgecombe. 1 : Gates, 2 ; Harnett, many ; Hertford. 5 ; Iredell, 3
;
30 BULLETIN N. C. BOAED OF HEALTH.
McDowell, 1 : Martin, several : Mecklenburg:, several ; INIontgomery.
1 ; Nasli, 2 ; New Hanover, 4 ; Onslow, 1 ; Robeson, a few ; Rocking-ham
; Rutherford, 2 ; Sampson, a few ; Scotland, a few ; Union. 20
;
Wake, 4 ; Warren, 2 ; Watauga, 1 ; Yadkin, 2 ; Yancey, 1—27 counties.
Malarial Fever.—Camden ; Edgecombe ; Halifax ; Martin.
MALABL4.L Fever, HEMORRHAGIC.—Camden, 2.
Bowel Diseases.—Alamance ; Alexander ; Bladen : Burke : Clay ;
Cleveland; Currituck; Duplin; Edgecombe; Forsyth; Gates: Guil-ford
; Halifax ; Harnett ; Henderson ; Hertford ; Northampton ; Ons-low
; Pender ; Richmond : Robeson ; Rockingham ; Wake ; Warren ;
Washington ; Yadkin—26 counties.
MuJiPS.—Person and Sampson.
Pneumonia.—Alleghany, 1 ; Ashe, 3 ; Caban-us, 3 ; Martin, several
;
Mecklenburg ; New Hanover, 1 ; Wake, 19—7 counties.
Smallpox.—Bladen, 2 ; Brunswick, several ; Cabarrus, 1 ; Catawba.
1 ; Cherokee, 17 ; Cleveland, 2 ; Cumberland, 14 ; Davie, 10 ; Du-plin,
2 ; Durham, 2 ; Forsyth, 2 ; Franklin, 1 ; Granville, 1 ; Hender-son,
1 ; Hyde. 1 ; Montgomery, 2 ; Nash, 15 ; New Hanover, 15
;
Northampton, 10 ; Pasquotank ; Pender, several ; Person, 5 : Robe-son,
10 ; Rockingham, 1 ; Rowan, 4 ; Sampson, 2 ; Washington. 30—27
counties.
Cholera, in Chickens.—Hertford and Lincoln.
Distemper, in Horses.—Hertford.
No diseases reported from Beaufort, Bertie. Buncombe, Dare,
Haywood, Jackson, Polk, Randolph, Wilkes and Wilson.
No reports received from Caswell, Chatham, Chowan, Columbus,
Greene, Jones, Lenoir, Macon, Madison, Mitchell. Moore, Pamlico,
Perquimans, Stanly and Wayne.
BULLETIX X. C. BOARD OF HEALTH.
SUMMARY OF MORTUARY REPORTS FOR MAY, 1905.
TWENTY-TWO TOWNS.
White.
Aggregate population 86,250
Aggregate deaths 89
Representing temporary annual death-rate
per 1,000 12.4
CAUSES OF DEATH.
Typhoid fever 1
Malarial fever 1
Measles
Pneumonia 6
Consumption 10
Brain diseases 9
Heart diseases 8
Neurotic diseases 4
Diarrhoeal diseases 14
All other diseases 33
Accident 1
Suicide 1
Violence 1
89
Deaths under five years 28
Still-horn 9
Colored.
32 BULLETIN N. C. BOARD OF HEALTH.
Mortuary Report for May, 1905.
BULLETIN N. C. BOARD OF HEALTH. 33
County Superintendents of Health.
Alamance Dr. George W. Long.
Alexander Dr. C. J. Carson.
Alleghany Dr. Robt. Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. Manley Blevins.
Beaufort Dr. John G. Blount.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C. G. Ferebee.
Carteret Dr. F. M. Clarke.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. T. A. Kirkman.
Cherokee Dr. J. A. Abernethy.
Chowan Dr. T. J. Hoskins.
Clay Dr. J. M.Sullivan.
Cleveland Dr. B. H. Palmer.
Columbus Dr. X. A. Thompson.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare .Dr. W. B. Fearing.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. A. J. Jones.
Durham Dr. T. A. Mann.
Edgecombe Dr. S. N. Harrell.
Forsyth Dr. S. F. Pfohl.
Franklin Dr. R. F. Yarborough.
Gaston Dr. H. F. Glenn.
Gates Dr. W. O. P. Lee.
Graham Dr. R. J. Orr.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy, Jr.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. O. L. Denning.
Haywood Dr. J. R. McCracken.
Henderson Dr. J. G. Waldrop.
Hertford Dr. C. F. Griffin.
Hyde Dr. E. H. Jones.
Iredell Dr. M. R. Adams.
Jackson Dr. William Self.
Johnston Dr. Thel Hooks.
Jones Dr. N. G. Shaw.
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. John W. Saine.
McDowell Dr. B. L. Ashworth.
Macon Dr. W. A. Rogers.
Madison Dr. W. J. Weaver.
Martin Dr. W. H. Harrell.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Virgil R. Butt.
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod.
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico Dr. H. P. Underhill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. R. J. Williams.
Perquimans Dr. C. C. Winslow.
Person Dr. J. A. Wise.
Pitt Dr. Joseph E. Nobles.
Polk Dr. C. J. Kenworthv.
Randolph Dr. A. M. Bulla.
Richmond Dr. L. D. McPhail.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. J. S. Brown.
Rutherford Dr. E. B. Harris.
Sampson Dr. J. O. Matthews.
Scotland Dr. A. W. Hamer.
Stanly Dr. V. A. Whitley.
Stokes
Surry Dr. John R. Woltz.
Swain Dr. R. L. Davis.
Transvlvania Dr. C. W. Hunt.
Tvrreil
Union Dr. John M. Blair.
Vance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. P. J. Macon.
Washington Dr. W. H. Ward.
Watauga Dr. H. McD. Little.
Wavne Dr. William Spicer.
Wilkes Dr. W. P. Horton.
Wilson Dr. W. S. Anderson
Yadkin Dr. M. A. Royal!.
Yancey Dr. J. B. Gibbs.
BULLETIN X. C. BOARD OF HEALTH. 35
[You are asked to fill out and mail one of these forms to the Superintendent of Health of your
county on or before the third of each month, that he may use it in making his report to the Secretary
of the State Board.]
Have any of the following diseases occurred in your practice during the month
just closed ? If so, state number of cases.
Whooping-cough Typhoid Fever
Measles — Typhus Fever
Diphtheria Yellow Fever
Scarlet Fever _-- Cholera
Pernicious Malarial Fever Smallpox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis
What have been the prevailing diseases in your practice?
Has any epidemic occurred among domestic animals? If so, what?
What is the sanitary condition of your section, public and private?
General Remarks:
M. D.
190--- N. C.
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington. : W. P. Ivey, M. D Lenoir.
S. Westry Battle, M. D Asheville. Francis Duffy. M. D New Bern
Henry W. Lewis, M. D Jackson. ; W. H. Whitehead, M. D Rocky Mt.
J. L. Nicholson, M. D Richlands. i J. L. Ludlow, C. E Winston.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XX. JULY, 1905. No. 4.
PHYSHTAl. EVILS OF CHILD LABOR.
By A. J. McKelway, Assistant Secretary of National Child Labor Committee.
(Abstract of Address before the Board of Health, at its meeting in Greensboro,
May 24, 1905).
When the health and the vitality of a large number of our own peo-ple
are coiK-erued. to whom shall we go save to the physicians, whose
ministry it is to usher life into the world, to save it and to prolong it,
and to whom, therefore, life itself should be a more sacred thing than
to the ordinary man? When I thinlc of our little children of the
Southern States, with their splendid physical inheritance, and how
much it costs to bear them and rear them and train them, it does
seem a pity that this stock should be depreciated by putting the child
to work for the man's long working-day.
The evil is a national and not a sectional evil. But because of its
newness in the South we have been the last to remedy it by legisla-tion,
and the proportion of child to adult workers is four times as
large in the South as it is in the Northern or Western States. The
physiological question is, whether children under fourteen should be
allowed to work in a factory for twelve hours a day ; especially
whether young girls between the ages of twelve and fourteen, in this
climate, should be allowed to do the spinning and weaving that falls
to them, at this critical period of their lives, during the twelve-hour
working day which is the rule in North Carolina and the cotton manu-facturing
States of the South : whether children of either sex under
fourteen should be allowed to work during the night.
38 BULLETIN N. C. BOARD OF HEALTH.
It may be of interest for you to know that the first public protest
made against this evil, which has been the curse of the cotton mills
especially for a hundred and fifty years, was made by physicians.
Dr. Thomas Percival. author of "Medical Ethics." made an investiga-tion
of the causes of an epidemic of fever in the Manchester mill dis-tricts
which had been accompanied by frightful mortality among the
children. Dr. Percival and his associates were unable to ascertain
how the fever originated, but they were unanimous in their opinion
that it had been "supported, diffused and aggravated by the injury
done to young persons through confinement and too long continued
labor, to which evils the cotton mills have given occasion." And they
passed the following recommendations to the Manchester magistrates :
"We earnestly rec-onunend a longer recess from lal)or at noon and a
more early dismissal from it in the evening to all those who work in
the cotton mills ; but we deem this indulgence essential to the present
health and future capacity for labor for those who are under the age
of fourteen : for the active recreations of childhood and youth are
necessary to the right conformation of the human body."
This was in 1784. In 1796 Dr. Percival and his associates in the
medical profession had formed themselves into the Manchester Board
of Health. They felt it incumbent to lay before the public the result
of their inquiries into the condition of the cotton mills of Manchester.
They said: "It appears that the children and others who work in
large cotton factories are peculiarly disposed to be affected by the
contagion of fever." And among the causes of this they found one
to be "the want of active exercise which nature points out as essen-tial
in childhood and youth to invigorate the system and to fit our
species for the employments and the duties of manhood." They went
on to say
:
"The untimely labor of the night and the protracted labor of the
day, with respect to children, not only tends to diminish future ex-pectations
as to the general sum of life and industry by impairing
the strength and destroying the vital stamina of the rising genera-tion,
but it too often gives encouragement to idleness, extravagance
and profligacy in the parents, who. contrary to the order of nature,
subsist by the oppression of their offspring."
It would have been well if England had followed the advice of her
physicians at once instead of fighting over the question inch by inch
for a hundred years : for in that time the physical vitality of the fac-tory
populations has been fatally sapped. This is now known to be
the real secret of the disaster to the British army in the South Afri-can
war.
Dr. Charles W. Roberts of England gives the following striking
results of the examination of 19.846 boys and men. of whom 5,915
belonged to the non-laboring class and 13.931 to the arti.sau class.
BI'LLETIX X. C. BOARD OF HEALTH. 39
The difference in height, weight and chest girth, from thirteen to six-teen
years of age, is as follows
:
HEIGHT (inches).
Age 13 14 15 16
Non-laboring class 58.79 61.11 63.47 66.40
Artisan class 55.93 57.76 60.58 62.93
2.86 3.35 2,89 3.47
WEIGHT ( POUNDS )
.
Age 13 14 15 16
Non-laboring class 88.60 99.21 110.42 128.34
Artisan class 78.27 84.61 96.79 108.70
10.33 14.60 13.63 19.64
CHEST GIRTH (INCHES).
Age 13 14 15 16
Non-laboring class 28.41 29.65 30.72 33.08
Artisan class 25.24 26.28 27.51 28.97
3.17 3.37 3.21 4.11
And among artisans the people of the cotton mills stand lowest in
the physical scale.
(."ommenting on these figures. Dr. W. W. Keen of Philadelphia says
:
"Constant standing and superintending a loom, or other similar
work requiring constant standing, itself stunts the growth of children
at these plastic ages. The ages In question, thirteen to sixteen years,
are precisely the ages when, under favorable circumstances, these
children develop physically with great rapidity. This is especially
true of girls. To confine these children in mills, with lack of oppor-tunity
for schooling, is to prevent both the physical and mental de-velopment
of such children to a degree which is most injurious, not
only to them, but also to the community—that is to say, the State.
"In my clinics for the past forty years I have had many hundreds
of such children, under-developed in mind and body, ill-fitted to enjoy
life themselves or to transmit vigorous minds and healthy bodies to
their children."
The same process which Mr. Chamberlain is trying to counteract in
England by a protective tax on the products of the farm, thus send-ing
the people back to the country from the overcrowded factory dis-tricts,
is being repeated on a tremendous .scale in the South and in
North Carolina. From one little village called Clyde's, near Waynes-
40 BULLETIX Is. C, BOARD OF HEALTH.
yille. during the past year, fifteen hundred of our splendidly de-veloped
mountain people have gone in the past year to the cotton
mills of South Carolina. They are being tempted from the farm by
the prospect of getting wages from every member of the family from
eight or ten years up. There is just now an unprecedented demand
in the factories for labor, and the demand is being met by the em-ployment
of children on a larger scale than ever before. It is a con-servative
estimate to say that there are fifteen thousand children
under fourteen working in the cotton mills of North Carolina twelve
hours a day or night, and the greater part of these are girls, the
future mothers of the race. "It is a shame for a nation to malie its
young girls weary."
Is it not time for such protest to be made by the physicians of
North Carolina against the extension of this evil as was made by the
physicians of old England more than a hundred years ago? The
science of medicine has advanced almost infinitely since that day.
But the fundamental facts regarding childhood and its rights remain
unchanged witn the centuries.
REVIE\l^ OF DISEASES FOR JUNE, 1905.
SEVEXTY-TWO COUNTIES REPORTIXG.
Ninety-five counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases
the Superintendent has. as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a dis-ease
otherwise indicated, its mere presence in the county is to be
understood as reported.
For the month of .June the following diseases have been reported
from the counties named :
Measles.—Camden. 7 cases : Cleveland, a few : Craven, a few : Cur-rituck,
many : Davidson : Duplin, 4 ; Durham. 2 ; Forsyth. 4 : Hender-son,
6; Onslow: Richmond, epidemic: Robeson, a few: Rockingham, a
few ; Sampson, a few ; Scotland ; Surry, 5 : Transylvania, several
:
Union, 150 ; Wake, 17 : Washington, 10—20 counties.
Whooping-cough.—Alexander, 2.5 : Anson, in all parts : Caldwell, 8 :
Catawba, 31; Cleveland, a few; Cumberland, a few ; Dare ; Davidson:
Durham. 7 : Hertford. .3 : Madison ; Mecklenburg ; Nash : Onslow ; Pas-quotank
: Pitt : Richmond, epidemic : Rockingham, a few : Rowan. 25
;
Surry. 10: Transylvania, a few: Union. .50: Wake. 2—23 counties.
Scarlatina.—Forsvth. 1 : Mecklenburg ; Rockingham, a few.
BULLETIJf X. C. BOAKD OF HEALTH. 41
Diphtheria.—Cabarrus, 1 ; Durham, 1 ; Edgecombe. 1 ; Guilford, 1
:
Haywood, 1 ; Rutherford, 1 ; Warren, 1—7 counties.
Typhoid Fever.—Ahiinance, 1 ; Alexander, 10 or 15 : Bertie, 1 ; Bla-den.
2: Burke. (J : Cabarrus, 2; Caldwell, 31; Camden. 1; Catawba. 3;
Cleveland, a few : Craven, 5 ; Cumberland, a few ; Davidson : Davie, a
few : Duplin, 1 : Durham, 4 ; Forsyth. 12 ; Gaston, a few : Gates. 2
Guilford. 3 : Harnett. 23 : Haywood. 3 : Hertford, a few ; Iredell, 22
;
Jackson. G ; Lincoln. 2 ; McDowell ; Mecklenburg ; Montgomery. 2
Nash. 3 ; New Hanover. 14 ; Northampton, many ; Onslow ; Person, (i
;
Pitt, a few : Randolph, 2 ; Robeson, a few ; Rockingham : Rowan. 2
Rutherford, 4 ; Sampson, a few : Scotland. 7 : Surry. 3 : Union. 20
Vance, a few: Wake. 2; Warren. 10: Washington, 2; Watauga. 1:
Yadkin. : Yancey. 1—51 counties.
:Malarial Fever.—Currituck, a few ; Duplin : Edgecombe, in all
parts : Gates. G : Onslow : Randolph ; Robeson : Wake. 3—8 counties.
Malarial Fe\'er, Pernicious.—Randolph. 2 : Robeson. 1 ; Wake, 3.
Bowel Diseases.—Alamance ; Alleghany, in all parts : Burke, in
most parts ; Camden, in all parts ; Cherokee, dysentery locally epi-demic:
Currituck; Davie; Forsyth, in all parts; Gates; Hertford and
Hyde, in all parts ; Montgomery ; Northampton. Onslow. Orange. Per-son.
Randolph. Rockingham and Sampson, in all parts ; Stokes ; Wake,
in all parts: Warren : Yadkin, in most parts; Yancey, in all parts��24
counties.
Mumps.—Scotland.
Pneumonia.—Davidson ; Nash. 1.
Varicella.—Pasquotank, a few.
Smallpox.—Brunswick, 1 ; Burke, 3 ; Catawba. 2 ; Craven. 4 ; Cum-berland.
4 ; Duplin. 1 ; Harnett, 5 ; Henderson. 2 ; Hyde. 5 ; Mont-gomery.
1 ; New Hanover. 8 : Ni>rthampton, 1 ; Pasquotank ; Robeson.
10 ; Union. 10 ; Washington, only one new case in June. 25 others left
unrecovered from May—IG counties.
Cholera, in Chickens.—Cleveland. Gates.
Cholera, in Hogs.—Edgecombe. Sampson.
Influenza, in Horses.—Rowan.
Meningitis, in Horses.—Warren.
No diseases reported from Buncombe. Carteret. Johnston. Polk.
Wilkes and Yadkin.
No reports received from Ashe, Beaufort. Caswell. Chatham. Cho-wan.
Clay. Columbus. Franklin. Graham. Greene, Jones, Lenoir. Ma-con.
Martin. Mitchell. Moore. Pamlico. Pender. Perquimans. Stanly.
Swain and Wavne.
42 BULLETIX X. C. BOARD OF HEALTH.
SUMMARY OP MORTUARY REPORTS FOR JUNE, 1905.
TWENTY-ONE TOWNS.
White.
Aggregate population 91,150
Aggregate deaths 163
Representing temporary annual death-rate
per 1,(XX) 21.4
Causes of Death.
Typhoid fever 4
Malarial fever
Diphtheria 1
Whooping-cough
Measles
Pneumonia 4
Consumption 14
Brain diseases 15
Heart diseases 11
Neurotic diseases 8
Diarrhoeal diseases 48
All other diseases 52
Accident 4
Suicide 2
Violence
16:3
Deaths under five years 78
Still-born 5
CoVd.
60,250
155
29.2
Total.
151,400
318
11
1
BULLETIN X. C. BOARD OF HEALTH. 43
Mortuary Report for June, 1905.
Towns
AND Reporters
Charlotte
Dr. F. O. Hawley.
Durham
Dr. T. A. Mann.
Elizabeth City
Dr. H. D. Walker.
PayettevlUe
Dr. A. S. Rose,
Ootdsboro )
Robt. A. Creech, H.O.;
Greensboro (
.J no. S Miohaux, C. C.f
liCXlUgtOIl
J. H. Aloyer, Mayor,
Marloii
Dr. B. L. Ashwortii.
Oxford
Dr. .?. D. Booth.
Raleigh. (
T. P.Sale.CIerkB.'H!/
Salem i
S. E. Butner, Supt'S! f
Sallsbnry.
Dr. H. T. Trantliam.'
Sonthport
Dr. J. A. Dosher.
Tartaoro
Dr. S. N. Harreli!
Wadesboro
Dr. J. H. Bennett.
AVashliigtoii
Dr. .John G. Blount.
Waynesville
Dr. Thos. Stringfieid
Weldon
J. T. Gooeh, Mayor.
Wllmlngtoji
I w
Dr. Chas. T. Harper." f C.
Wilson ] VV,
Dr. W. S. Andenson." / C.
'Winston I w.
Dr. J. L. Hanes. "
( , C.
^SlIBiB^^'^''^'''^'^'^ "-- - J'»'.s'^o^-„ar;r.sr» s-s^^s;
44 BULLETIN N. C. BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. George W. Long.
Alexander Dr. 0. J. Carson.
Alleghany Dr. Robt. Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. Manley Blevins.
Beaufort Dr. John G. Blount.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C G. Ferebee.
Carteret Dr. F. M. Clarke.
Caswell Dr. 8. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. T. A. Kirkman.
Cherokee Dr. J. A. Abernathj'.
Chowan Dr. T. J. Hoskins.
Clay Dr. J. M.Sullivan.
Cleveland Dr. B. H. Palmer.
Columbus Dr. H. B. Maxwell.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare Dr. W. B. Fearing.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. A. J. Jones.
Durham Dr. T. A. Mann.
Edgecombe Dr. S. N. Harrell.
Forsyth Dr. S. F. Pfohl.
Franklin Dr. R. F. Yarborough.
Gaston Dr. H. F. Glenn.
Gates Dr. W. O. P. Lee.
Graham Dr. R. J. Orr.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy, Jr.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. L. J. Arnold.
Haywood Dr. J. R. McCracken.
Henderson Dr. J. G. Waldrop.
Hertford Dr. C. F. Griffin.
Hyde Dr. E. H. Jones.
Iredell Dr. M. R. Adams.
Jackson Dr. William Self
Johnston Dr. Thel Hooks.
Jones Dr. N. G. Shaw.
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. John W. Saine.
McDowell Dr. B. L. Ashworth.
Macon Dr. W. A. Rogers.
Madison Dr. W. J. Weaver.
Martin Dr. W. H. Harrell.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Virgil R. Butt.
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod.
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico Dr. H. P. Underhill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. R. J. Williams.
Perquimans Dr. 0. C. W^inslow.
Person Dr. J. A. Wise.
Pitt Dr. Joseph E. Nobles.
Polk Dr. 0. J. Kenworthy.
Randolph Dr. A. M. Bulla.
Richmond Dr. L. D. McPhail.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Elhngton.
Rowan Dr. J. S. Brown.
Rutherford Dr. E. B. Harris.
Sampson Dr. J. O. Matthews.
Scotland Dr. A. W. Hamer.
Stanly Dr. V. A. Whitley.
Stokes
Surry Dr. John R. Woltz.
Swain Dr. R. L. Davis.
Transvlvania Dr. C. W. Hunt.
Tyrrell
Union Dr. Henry D. Stewart.
Vance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. P. J. Macon.
Washington Dr. W. H. Ward.
Watauga Dr. H. McD. Little.
Wayne Dr. William Spicer.
Wilkes Dr. W. P. Horton.
Wilson Dr. W. S. Anderson.
Yadkin Dr. M. A. Royall.
Yancey Dr. J. B. Gibbs.
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, RaXeigh, N. C.
Geo. G.Thomas, M.D.,Pres., Wilmington. T. E. Anderson, M. D.-Statesville.
S. Westray Battle. M. D.- Asheville. J. Howell Way, M. D Waynesville.
Henry W. Lewis, M. D Jackson. W. O. Spencer, M. D Winston- Salem.
W. P. Ivey. M. D. Lenoir. I J. L. Ludlow, C. E. Winston -Salem.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XX. AUGUST, 1905. No. 5.
YELLiOW FEVEK.
While liiiiitfd, so I'ar. to a siuall section ot our country -.Xcw
Orleans and a few tinvns in the vicinity—the outbreak of yellow fever
there is the most interesting and important sanitary snbjeet of the
day. 'J'o the peojile (jf our Southern States it is one of absorbing- aiixi
ety, foi-, notwithstanding all the precautions taken, there are so many
way.s in which an inland quarantine can be evaded that no susceptible
community can tell when it may a])pear therein. In s\nte of the fact
that its method of transmission liy a certain s])ecies of mos(iuito,
the t^tcyoniyiu fd.sciata. has been demonstrated, and the sjiread of the
disease can !)e surely prevented by the immediate and complete screen-ing
of the jiatient against this insect, we tind that it has spread and
continues to do so. The cause of this Is the same as in other trans-missilde
diseases—tlie failure of pronijil notitication. owing to tlie
patient's having no jibysician in time, a mistaken diagnosis, or, in
some Instances—rare, we lioi)e and l)elieve—deliberate concealment.
Our own e.\i)erience with smallpo.v confirms this. In susceptible com-munities
every case in the least resembling yellow fever, whether
called malarial fever or dengue, should be rigidly screened until the
diagnosis is settled beyond peradventure. Of course every breeding
place of inos<iuitoes should be destroyed.
The best account of yellow fever to date that we have found is in
the last edition of the admirable work on Hygiene by Dr. Charles
Harrington, the able professor of hygiene in Harvard University and
secretai-y of the State Hoard of HeaHli of .Massachusetts. H is as
follows :
4(J JILLLKTIX X. C. BOAUD OF JlKALTIl.
YKl.LOW FEVER AXI) MOSQLITOKS.
Siiuc U't'.Ki. wbeii yellow fever made its tirst aiiiiearaiice iu this
eountry. there ba\e beeu uo less than uiuety-tive eiiideuiies uf greater
or lesser inaguitude within the I'liited States. According to Keed
and Carroll (Medical Re<^ord. October 26, 1901. p. (J41). since 1793 the
disease has been the cause of no less than lOO.ttCK* deaths, 41.348 of
which have occurred in New Orleans. 10,038 in Philadelphia and 7,759
in Memphis (18.35. 1873. 1878. 1879). Between 1851 and 1883 it
caused 23.338 deaths in Rio de Janeiro, where, according to Gouvea
(Bulletin Medical. October 12. 1901, p. 861), previous to 1849 it was
unknown, being introduced iu that year by the Brazil from New-
Orleans and Havana, and l)y the Navarre from Bahia. From Rio it
spread to all the towns iu the l)ay. Between 1853 and 1900 it caused
35.952 deaths at Havana, where it had flourished continuously for
more than a century, and where, after a practical application of the
knowledge concerning the method of its dissemination—the outcome
of l)rilliant work on the part of Reed and his assfx-iates. of the Unitetl
States army—it was demonstrated that it could be completely eradi-cated,
and that even though outbreaks should wcur on ships arriving
from infected ports, removal of the victims to the fever hospital need
give rise to no new cases.
Inability to control the spread of the disease has hitherto been due
to the fact that the manner of its dissemination was not known, and
that all efforts to control it were exerted in the wi'ong direction, iu
the belief, now shown to have been unfounded, that fomites, filth and
soil conditions were the distributing agencies.
It was in 1848 that Dr. .Tosiah N\)tt. of Mobile, suggested that mos-quitoes
might be responsible for or connec-ted with the spread of yel-low
fever, but the idea seems to have been received with indifference.
In 1881 Dr. Finley. of Havana, announced his theory of mosquito
transference, and began his experiments, but it remained for Reed
and his associates to demonstrate conclusively that mosquitoes are
the principal if not the sole carriers of the exciting cause, and that
fomites and filth have absolutely no influence whatevei-.
The experiments i)roving both statements are exceedingly interest-ing.
In October. 190(». Reed (Philadelphia Medical .Journal. October
27. 19(H)). reported positive results of experiments conducted by him-self
and Drs. Carroll, Agramonte and Lazear with mosquitoes, Stefjo-uiyia
fasciata. furnished by Dr, Finley. Carroll was bitten by one
that had bitten four yellow-fever patients, alternately severe and mild
cases, respectively, twelve, six, four and two days previously. Four
days afterward he took to his bed. and on the fifth day his disease
was diagnosed as yellow fever. Another subject was bitten by the
same mosquito and by three others that had previously bitten jiatients
with the disease, and in seven days he also had the fever.
BULLETIN N. C. BOARD OF HEALTH. -it
Dr. Lazear \yas bitten without result by an infected mosquito on
August IGtli, and bj' anotlier, an accidental stranger, on September
13tb. In five days be had a chill ; on the day following, the diagnosis
of yellow fever was made, and in a week the case terminated fatally.
Between August 17th and October 1.3tb (fifty-seven days) these three
were the only cases which oc-curred among 1,400 non-immune Ameri-cans
at Quemados.
On November 20, 19()t), an experiment station—Camp Lazear—was
established at Columbia Barracks, Cuba, under the direction of Reed,
who, with his former associates, continued the work with gratifying
results. A very strict quarantine was established, and no non-immune
was subjecteil to mosquito inoculation (with one exception)
who had not passed the full period of incubation of yellow fever under
close observation, nor was any non-immune wlio left camp permitted
to return under any circumstances. Twenty-one subjects presented
themselves, mostly immigrant Spaniards seeking immunity, and the
result in each case was positive.
Experiments with fomites (reported in Medical Record, October 20,
1901, and in other American journals) were equally convincing in
results. Three large boxes of sheets, pillow-slips, blankets, etc., con-taminated
with the discharges of yellow fever patients, many of them
jiurposely soiled with black vomit, urine and fteces. were placed in a
building of 2.800 cubic feet capacity, tightly ceiled and battened, with
small windows to prevent thorough circulation of air. and wooden
shutters to prevent the disinfectant action of sunlight. The win-dows
were screened with wire gauze and the entrance with a screen
door. The articles were unpacked by Dr. Cooke and two privates,
and they were shaken, so that the specific agent might be dissemi-nated
throughout the room, if it were present. They were then iised
on the three beds provided, and some were hung about the room and
near the beds. For twenty consecutive nights the three slept ia the
uninviting beds, and every morning they packed the filthy articles
back into the boxes, and every evening unpacked and distributed
them again. They passed their days in tents in quarantine. During
their tour of service, other bedding soiled with the bloody stools of a
fatal case was received in a most offensive, stinking condition, and
used with the rest. Then other non-inununes rojjoated the exjieri-ment
for twenty-one nights, sleeping in the very garments which had
been used by patients. Then these subjects were followed by others.
who, for fourteen nights out of twenty, slept with pillows covered
with towels that had been thoroughly soiled with blood drawn from
a case of well-marked yellow fever on the first day of the disease.
The result of the exposure of these non-immunes in relays for nine
weeks was wholly negative, for not one had the first symptom of
yellow fever. Not so, however, in the case of a man who was
exposed in a building of similar size, thoroughly ventilated and con-taining
only disinfected articles, plus infected mosipiitoes. On De-
48 BULLETIN N. C. BOARD OF HEALTH.
\
cember 15, 1900. fifteen of the insects were set free and he was soon
bitten several times. Later he was bitten again, and also on the fol-lowing
day. He contracted the disease ; but two men who slept for
eighteen nights in a half of the room, which was screened from the
other and from the mosquitoes by netting, had no symptoms.
Whatever the nature of the parasite, its life cycle would appear not
to need the passage of the parasite through the intermediate host, for
Reed (Philadelphia Medical Journal, July 6, 1901) and his as.sociates
succeeded in producing the disease by injection of blood drawn from
the general circulation. Although the specific ciiusa morhi has not
been discovered, it appears to be definitely settled that it is not Sana-relli's
B. icteroides. The conclusions arrived at by Reed, Carroll and
Agramoute, and reported to the American Medical Association, are, in
brief, as follows: The intermediate host is the Stegamyia fasciata,
which is capable of transmitting the disease after an interval of
about twelve days, or longer, after becoming contaminated by biting
a person already sick. The disease can be caused by subcutaneous
injection of blood from the general circulation during the first or
second day of sickness. Immunity is not conferred by the bite of a
mosquito at an earlier i>eriod after contamination ; but when the dis-ease
is produced through the agency of a mosquito the subject is
immune against infection by subcutaneous injection of blood. The
period of incubation in cases of induced fever varied from forty-one
hours to five days and seventeen hours. The disease is not conveyed
by fomites, and hence disinfection of a house, except as to mosquitoes,
is unnecessary. The spread of the diseases can be controlled most
effectually by measures directed to the destruction of mosquitoes and
to protection of the sick against them. That not less than twelve
days are required for the contaminated mosquito to acquire the power
to transmit the disease is borne out by the observations of Dr. H. R.
Carter (Medical Record, June 15, 1901, p. 933), who found that in
sixteen houses in which ninety-five secondary cases of yellow fever
occurred the interval between the first and second cases ranged be-tween
twelve and twenty-three days.
The yellow fever mosquito, f^tecjomyia fasciata. formerly known as
Culex fasciatus, is. in this country, confined principally to the tropical
and subtropical i-egions along the Atlantic Ocean and the Gulf of
Mexico, but may be transferred from one region to another by the
usual vehicles of travel. It is found in all the principal cities and
in some of the smaller towns of Cuba ; in Jamaica, Isle of Pines and
Nicaragua; in Louisiana, especially in' New Orleans; in eastern
Texas, in various places in other Southern States, in a number of
towns and cities in Brazil, and in certain other hot countries. It is
not essentially an American species, for Mr. Theobald, of the British
Museum, states that he has received specimens from Italy. Greece.
Spain, Portugal and Malta. Its presence in Spain may explain the
BULLETIN N. C. BOAED OF HEALTH. 49
occurrence, iu ISOO, of a very extensive epidemic of yellow fever iu
the province of Andalusia, and in 1821 of anotlier at Barcelona.
Wherever it is found it appears to prefer the larger, populous centers
and to be but little common in rural districts.
The Stegomyia breeds, like Cnlices, in small collections of water.
Reed and Carroll found the larvae in rain-water barrels, sagging gut-ters
containing rain water, cess-pools, tin cans used for removing
excreta, tin cans placed about table legs to prevent inroads of re<l
ants, horse-troughs, leaves of the Agave Americana, and generally iu
any collection of still water. The New Orleans Mosquito Commis-sion
(New Orleans Medical and Surgical Journal, January, 1902)
found the larvae in 128 of 210 cisterns examined by them. According
to this authority, the life cycle of Stegomyia is somewhat different
from that of other genera, and these differences may necessitate more
stringent measures than will suffice for the suppression of CuTiecs
and Anopheles, for the eggs hatch earlier (ten to twenty-four hours),
and the larval (six and one-half to eight days) and pupal stages (two
days) are much shorter; so that, full development requires from two
to four days less than for Culex pungens, and two weeks less than for
any species of Anopheles. According to Reed and Carroll, the eggs
begin to hatch, as a rule, on the third day, and the process may last
about a week : the larval stage lasts about seven or eight days, and
the pupal stage two days. The shortest time for complete develop-ment
observed by them was nine and one-half days. At an average
temi>erature of 75 degrees F., or higher, the species multiplies abun-dantly,
but exposure to a lower temperature for even a short time
daily causes much retardation, and eggs kept at 68 degrees F. do not
hatch. They found that newly-hatched larvae kept at 08 degrees F.
develop slowly and require twenty days to reach the pupal stage.
Kept at 50 degrees F.. they fail to reach the pupal stage.
Although low temperatures are destructive of the larvae, it is other-wise
with the eggs, which Reed and Carroll found to be very resist-ant
to the influence of the dryness and cold. They observed that
eggs which had been dried on filter-paper and kept ninety days
hatched promptly on being placed in water. Dried eggs brought
from Havana to Washington in February were easily hatched in INIay
and furnished about CO per cent, of the u.sual number of larvae
hatched from fresh eggs. Eggs frozen for an hour, thawed out at
room temperature and placed in an incubator at 95 degrees F.. began
to hatch on the sixth day. and furnished active larvae on the eighth :
while others frozen for a half-hour on two successive days began to
hatch under the same conditions on the third day. Thus, it would
appear that eggs may survive the Havana winter, and tlmt the pres-ence
of hiliernating females is not necessary.
The female imago, when impregnated, is generally ready to bite on
the second or third day. In New Orleans, according to the Mosquito
Commission, the mosquitoes are active during the day. and particu-
50 BULLETIN N. C. BOAKD OF HEALTH.
larly iu the afternoon. In Cuba, Reed and Carroll found them to
be especially active from 4 P. M. until midnight, although iu captivity
the hungry impregnated female will bite at any hour. When freed
iu a room she does not appear to bite a second time within five to
seven days.
Having bitten a yellow-fever patient, it appears that the mosquito
is incapable of inducing the disease before twelve days have passed.
Those which failed to infect on the eleventh day were successful on
the seventeenth. How long the ability to infect continues was not
determined, but successful inoculation was brought about as late as
fifty-seven days after contamination.
How long the infected mosquito will live is not known. The speci-men
which conveyed the disease on the fifty-seventh day lived seventy-one
days ; others have been known to live five months, but the ma-jority
die in captivity within five weeks. In a state of freedom their
length of life depends largely upon access to water.
At temperatures below 62 degrees F., Stegomyia will not bite, and
thus Reed accounts for the decline in epidemics of yellow fever at
New Orleans in November, when the mean temperature is 61.8 de-grees
F., and their cessation in December, when it falls to 55.3 degrees.
Preventive Measures.—To avoid epidemics of yellow fever, Reed
advocates the prevention of importation of cases of the disease from
infectetl localities, and, when cases do appear, the application of
measures to protect the sick from attacks of mosquitoes. Screens
should be used for this purpose, and even the dead should be thus
protected, for Stegonijjia will bite even these. All mosquitoes in a
house where a ease occurs should be caught, and search should be
made for them in all the houses In the immediate vicinity. They
may be destroyed by fumigation with sulphur-dioxide (one pound of
sulphur for each 1,000 cubic feet of air space), which Rosenau (Bul-letin
No. 6. Hygiene Laboratory of the U. S. M.—H. S.. September,
1901) finds far superior for this purpose to formaldehyde, for very
small amounts of the dry gas will kill them, even when they are pro-tected
by four layers of toweling, while formaldehyde acts feebly and
with uncertainty. Pyrethrum (Dalmatian) powder may be burned
in the same proportion, and will either kill or stupefy them, so that
in three hours they may be swept up and burned.
Non-immunes entering infected houses are advised to rub all ex-posed
surfaces, including the ankles, with spirits of cam]ihor, oil of
pennyroyal, or five per cent, menthol Ointment ; but these agents exert
only a temporary protective influence against being bitten.
Of very great importance is the destruction of larvre and of breed-ing
places. The results of systematic work in this direction, and of
other preventive measures, are manifest in the immense improvement
in the sanitary condition of Havana. Under the direction of Dr.
W. C. Gorgas. U. S. A. (Public Health Reports, February 14, 1902.
p. 363). the "Stegomyia Brigade" began its work of inspection in
BULLETIX IN'. C. BOARD OF HEALTH. 51
March, 1901. when, in 10.000 houses examined, hii-vje were found "at
the rate of 100 per cent. This does not mean that every house ex-amined
had larvae ; many houses were found that had several recepta-cles
which contained larvae." During December, 1901. 16,121 houses
were inspected, and in but 1.5 per cent, were the larvae found. From
May 7th to July 1st (fifty-four days) no case of the disease occurred;
then it was introduced from Santiago de Las Vegas, and later from
other places ; and yet. during July there were but four cases, and in
August but eight. During the whole year (1901) there were but
eighteen deaths from yellow fever, and twelve of those occurred in
January and February, before the work of prevention was begun.
During the preceding forty-five years the average number of deaths
therefrom was 751.44—the minimum, 51, occiu-ring in 1866.
RETIEVV OF DISEASES FOR JL I.Y, 1905.
EIGHTY COUNTIES REPORTING.
Ninety-five counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases
the Superintendent has, as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a dis-ease
otherwise indicated, its me»"e presence in the county is to be
understood as reported.
For the month of July the following diseases have been reported
from the counties named :
Measles.—Anson, many cases: Beaufort, 2; Bladen. Chatham,
Craven. Davidson and Duplin, a few each ; Durham, 1 ; Gates, gen-eral
: Granville. 30; Henderson, a few: Iredell. 1; Onslow; Yancey,
10—14 counties.
Whooping-cough.—Alamance ; Anson, many ; Ashe, 6 ; Cabarrus, 10 ;
Caldwell. 12 ; Chatham, a few ; Craven, a few ; Cumberland ; Dare, 8
;
Davidson, a few ; Duplin, 8 ; Forsyth ; Guilford, 2 ; Henderson, sev-eral
: Onslow ; Rowan, 10—16 counties.
ScART^TiNA.—Davie. 2 : New Hanover. 1
.
Diphtheria.—Beaufort, 3 ; Cabarrus. *2
: Duplin, 1 ; Gaston, 1 ; Guil-ford.
1 : Pender. 1 ; Pitt. 3 ; Randolph. 1 ; Richmond, 1 : Rowan, 3
:
Surry. 2 ; Swain. 6—12 counties.
Typhoid Fever.—Alamance : Alexander, 5 ; Anson, a few : Ashe. 8
Beaufort, 5 ; Bertie, several ; Burke, 20 ; Cabarrus. 2 ; Caldwell. 49
Camden, 3; Caswell. 1; Catawba, 4; Chatham, 20; Cherokee. 4;
Chowan, 3 ; Clay, 2 ; Cleveland, many ; Craven, 10 ; Cumberland ; Cur-
52 BULLETIN N. C. BOARD OF HEALTH.
rituck, 1 ; Dare, 3 ; Diividson, 10 ; Davie, several ; Dupliu, 2 ; Durham,
8 ; Edgecombe, 6 ; Forsyth, 30 ; Franklin, several ; Gaston, a few
;
Madison, 10 ; Martin, several ; Folk, 1 ; Randolph, several ; Richmond,
1; Robeson, several; Rowan, 5; Rutherford, 3; Sampson, many; Scot-land,
a few ; Surry, 5 ; Swain, 10 ; Vance, a few ; Wake, 19 ; Warren,
8 ; Washington, 3 ; Wilkes, 6 ; Yadkin, many ; Yancey, 5—48 counties.
Malarial Fever.—Alamance; Bertie; Brunswick; Camden, Cas-well,
Currituck, Dare, iu all parts ; Duplin ; Edgecombe, in all parts
;
Gaston ; Gates, 12 ; Hertford and Hyde, iu all parts ; .Johnston ; Mar-tin,
in all parts ; New Hanover ; Northampton ; Onslow, in all parts
Pender ; Randolph ; Richmond, in all parts ; Robeson ; Sampson
Wake, in all parts ; Warren ; Washington, in all parts—26 counties.
Malarial Fever, Pernicious.—Hyde, 2 ; Sampson, a few ; Wake, 1.
Malarial Fever, Hemorrhagic.—Hyde, 1 ; Pender, 1.
Bowel Diseases.—Alamance ; Alexander, in all parts ; Anson, in all
parts ; Burke ; Carteret.
Cerebro-spinal Meningitis.—Camden.
Tonsillitis.—Brunswick.
Smallpox.—Alamance, 1 ; Bladen, 6 ; Cherokee, 2 ; Craven, 1 ; Cum-berland,
7 ; Edgecombe. 3 ; Granville, a few ; Harnett, 2 ; Hyde, 4
New Hanover, 8 ; Northampton, 1 ; Pasquotank, several ; Robeson, a
few ; Sampson, 8—14 counties.
Cholera, in Chickens.—Gates.
Cholera, in Hogs.—Chowan, Perquimans.
Hydrophobia.—Forsyth, 1.
No diseases reported from Buncombe and Wilson,
No reports received from Columbus, Graham, Greene, Halifax,
Jones, Lenoir. Macon, Moore, Pamlico, Perquimans, Rockingham,
Stanly, Transylvania, Union, Watauga and Wayne.
BULLETIN N. C. BOARD OF HEALTH, 53
SVMMART OF MORTUARY REPORTS FOR JILY, 1905.
TWEXTY-ONE TOWNS.
White.
Aggregate population 92,050
Aggregate deaths 137
Representing temporary annual death-rate
per 1.000 17.7
Causes of Death.
Typhoid fever 14
Malarial fever
Diphtheria
Whooping-cough 1
Measles 1
Pneumonia 3
Consumption 15
Brain diseases 4
Heart disea.ses 8
Neurotic diseases
Diarrhoeal diseases 30
All other di.seases 57
Accident 3
Violence 1
137
Deaths under 5 years 51
Still-born 9
Col'd.
61,500
153
30.0
11
Total.
1.54.150
290
22.G
1
54 BULLETIN N. C. BOARD OF HEALTH.
Mortuary Report for July, 1905.
Towns
AND Repobtees.
Charlotte )
Dr. F. O. Hawley. /
Durliam I
Dr. T. A. Mann. f
Edeutoii (
Dr. T. J. Hoskins. /
Elizabetb City )
Dr. H. D. Walker. (
Payettevllle )
Dr. A. S. Rose. J
Goldsboro \
Robt. A. Creech, H.O.j
Greensboro >
Jno. S. Michaux, C.C.J
Lexin^oii i
J. H. Meyer, Mayor. (
Marlon. 1
Dr. B. L. Ashworth. j
Oxford 1
Dr. S. D. Booth. (
ELalelgb \
T. P. Sale, Clerk B.H.;
Saleni I
S. E. Butner, Supt. H. (
Salisbury 1
Dr. H. T. Trantham. (
Sontbport |
Dr. J. A. Dosher. j
Tarboro /
Dr.S. N. Harrell. <
Wailesboro )
Dr. J. H. Bennett. (
Wasbiugton |
Dr. John G. Blount, f
Wayiiesvllle )
Dr. Thos. Stringfleld. f
AVllmiu^oii 1
Dr. Chas. T. Harper. )
Wilson \
Dr. W. 8. Anderson. J
Winston I
Dr. J. L. Hanes. (
Popula-tion.
W. 12,000
C. i 8.900
12,000
6,000
1,200
1,800
5,C00
3,000
2,500
2,300
3,500
2,600
6,100
4,
000
I
3,000!
600
800
400
1,250
1,250
9,000
6,000
3,3(10
350
3,900
2,500
900
500
1,800
700
1,000
700
3,000
2,900
1,600
400
11,000
10,000
3,800
3,000
6,000
4,500
Tempobabt
Annual
Death-eate
PEE 1,000.
CO
20
BULLETIN X. C. BOAKD OF HEALTH. 55
County Superintendents of Health.
Alamance Dr. George W. Long.
Alexander Dr. C. J. Carson.
Alleghany Dr. Robt. Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. Manley Blevins.
Beaufort Dr. John G. Blount.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C. G. Ferebee.
Carteret Dr. F. M. Clarke.
Caswell Dr. R. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. T. A. Kirkman.
Cherokee Dr. J. A. Abernathy.
Chowan Dr. T. J. Hoskins.
Clay Dr. J. M. Sullivan.
Cleveland Dr. B. H Palmer.
Columbus Dr. H. B. Maxwell.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare Dr. W. B. Fearing.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. A. J. Jones.
Durham Dr. T. A. Mann.
Edgecombe Dr. R. N. Harrell.
Forsyth Dr. S. F. Pfohl.
Franklin Dr. R. F. Yarborough.
Gaston Dr. H. F. Glenn.
Gates Dr. W. 0. P. Lee.
Graham Dr. R. J. Orr.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy, Jr.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. L. J. Arnold.
Haywood Dr. J. R. McCracken.
Henderson Dr. J. G. Waldrop.
Hertford Dr. C. F. Griffin.
Hyde Dr. E. H. Jones.
Iredell Dr. M. R. Adams.
Jackson Dr. William Self
Johnston Dr. Thel Hooks.
Jones Dr. N. G. Shaw.
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. John W. Saine.
McDowell Dr. B. L. Ashworth.
Macon Dr. W. A. Rogers.
Madison Dr. W. J. Weaver.
Martin Dr. W. H. Harrell.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Virgil R. Butt.
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod.
Nash ...Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico Dr. H. P. Underbill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. R. J. Williams.
Perquimans Dr. C. C. Winslow.
Person Dr. J. A. Wise.
Pitt Dr. Joseph E. Nobles.
Polk Dr. C. J. Kenworthv.
Randolph Dr. A. M. Bulla.
Richmond Dr. L. D. McPhail.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. J. S. Brown.
Rutherford Dr. E. B. Harris.
Sampson Dr. J. O. Matthews.
Scotland Dr. A. W. Hamer.
Stanly Dr. V. A. Whitley.
Stokes
Surry Dr. John R. Woltz.
Swain Dr. R. L. Davis.
Transylvania Dr. C. W. Hunt.
Tyrrell
Union Dr. Henry D. Stewart.
Vance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. P. J. Macon.
Washington Dr. W. H. Ward.
Watauga Dr. H. McD. Little.
Wavne Dr. William Spicer.
Wilkes Dr. W. P. Horton.
Wilson Dr. W. S. Anderson.
Yadkin Dr. M. A. Royall.
Yancev Dr. J. B. Gibbs.
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Geo. G. Thomas. M. D., Pres., Wilmington. ] T. E. Anderson. M. D.--Statesville.
S. Westray Battle, M. D.—Asheville. ! J. Howell Way, M. D Waynesville.
Henry W. Lewis, M. D Jackson. W. O. Spencer, M. D Winston-Salem.
W. P. Ivey. M. D. Lenoir. J. L. Ludlow, C. E Winston-Salem.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
V©L. XX. SEPTEMBER, 1905. No. 6.
/ L.EST "IVE FORGET.
The rather unusual prevaleuee of diphtheria at the present time,
together with the fact that the schools are opening throughout the
State, suggests to us the advisability of calling attention as forcibly
as we can to certain provisions of the Act Relating to the Board of
Health, which, if heeded, would save much sickness and many lives.
This act our Supreme Court has referred to as a "well-considered
law," and we feel sure that the importance and reasonableness of the
requirements to which we propose to call attention cannot be denied.
But the ti'ouble is to secure the observance of these requirements.
The responsibility in this matter rests upon all householders, and
especially upon physicians, county superintendents of public instruc-tion,
superintendents of graded schools, the school committees of pub-lic
schools, the heads of private schools, and all teachers.
Couditions more favorable to the spread of infectious or contagious
diseases cannot be imagined than those found in a school. This is
especially true of diphtheria and scai'let fever, to which, being essen-tially
diseases of childhood, the pupils are peculiarly susceptible. The
children not only come into contact with one another, but they are
kept crowded together for hours in rooms all too frequently badly
ventilated. These conditions practically cannot be entirely remedied,
and so we must look for protection to the observance of certain simple
and reasonable precautions that are not only within the reach of all,
but are made positively obligatory by the law. No disease can spread
in a school unless it is introduced by some child actually the subject
of it or carrying the germs in his clothes. Of course, a child actually
and manifestly sick will not be allowed by his parents to attend
58 BULLETIX X. C. BOARD OF HEALTH.
school, but in some mild attacks of diplitlieria, especially, the child is
not manifestly sick enough to be kept at home, although none the less
a source of infection. It is for this reason, as well as because of the
danger of carrying the germs in their clothes, that children of families
in which a case of infectious disease exists are not allowed to attend
school in less than two weeks after the death or recovery of such case,
and then only upon presentation of a certificate from the family phy-sician
or health officer. In this way the State attempts to prevent the
sowing of the seed of disease in a soil ready for its reception and
propagation. This is the only way to prevent a harvest of sickness
and death that could have been avoided.
One would think that people would not be willing to jeopardize the
lives of their neighbors' children, and most people would not know-ingly
do it, but there are some, we regret to know, so utterly selfish
that rather than keep their own children away from school they
would run the risk of infecting a whole neighborhood.
Prompt notification of the presence in a family of a case of infec-tious
disease is incumbent upou both the householder and the attend-ing
physician—upon them rests this grave responsibility, and as the
Bulletin is sent to all physicians, we earnestl.v entreat them not to
fail in this duty.
"We also make a special request of county superihtendents of public
institiction, who are in touch with all public school teachers, to call
their attention to the law, and to urge upon them the Importance of
their seeing that it is carried out. We would commend to county
superintendents of health, and city health officers, the form of notifi-cation,
for both householders and teachers, printed on postal card,
used in Wilmington. They are as follows
:
Office of Superintexdext of Health.
WiLMINGTOX, X. C 190. .
Mr
No Street.
Dear
The quarantine for at .vour residence is dis-continued
from this date. The children of the household cannot return
to school mitil 190. . i. e., fourteen days from the
above date. Any violation of this instruction will be punished in
accordance with provisions of Public Laws 189.3, chapter 214, sections
11 and 12.
Superintendent of Health.
3ULLETIX X. C. BOARD OF HEALTH. 59
Office of Superintendent of Health.
Wilmington, N. C 190.
.
School.
Dear
I hereby notify yon that the qnarantine established at the residence
of Mr No Street, for
has been discontinued. The children from that
house cannot return to school until , 190. ., /. e.,
fourteen days after the discharge of quarantine. Please report to
this office any violation of the order. See chapter 214, Public Laws
1893, sections 11 and 12.
Superintendent of Health.
The sections of the law (chapter 214, Laws of 1893, as amended in
1901) bearing particularly upon this subject, are as follows:
Sec. 9. When a householder knows that a person within his family
is sick with either of the diseases enumerated in sec-tion eight (small-pox,
diphtheria, scarlet fever, etc.). he shall immediately give notice
thereof to the health officer or mayor, if he resides in a city or incor-porated
town, otherwise to the county superintendent of health, and
upon the death or recovery or removal of such person, the rooms occu-pied
and the articles used by him shall be disinfected by such house-holder
in the manner indicated in section eight. Any person neglect-ing
or refusing to comply with any of the above provisions shall be
deemed guilty of a misdemeanor, and upon conviction shall be fined
not less than one dollar nor more than fifty dollars.
Sec. 10. When a physician knows that a person whom he is called
to visit is infec-ted w-ith smallpox, diphtheria, scarlet fever, typhus
fever, yellow fever or cholera, he shall immediately give notice
thereof to the health officer or mayor, if the sick person be in a city
or incorporated town, otherwise to the county superintendent of
health, and if he refuses or neglects to give such notice of it in twenty-four
hours he shall be guilty of a misdemeanor and shall be fined for
each offense not less than ten nor more than twenty-five dollars. And
it shall be the duty of the said county- sui)erintendent, health officer or
mayor rec-eiving such notice of the presence of a case of smallpox,
yellow fever, typhus fever or cholera within his jurisdiction to com-municate
the same inmiiKliately by mail or telegraph to the Secretary
of the State Board of Health. A failure to perform this duty for
twenty-four hours after the receipt of the notice shall be deemed a
misdemeanor, and shall subject the delin(iuent upon conviction to a
fine of not less than ton nor more than twentj'-five dollars.
Sec. 11. * * * The boards of health of cities and towns where-ever
organized, and where not, the mayors of the same, and in other
cases the county superintendent of health, shall give the school com-
(50 BULLETIX X. C. BOARD OF HEALTH,
mittee of the city or town, the principals of private scliools and the
superintendent of public instruction of the county, when the schools
are in session, notice of all such cases of contagious diseases reported
to them according to the provisions of this act. A failure to perform
this duty for tn'enty-four hours after the receipt of the notice shall
be deemed a misdemeanor, and subject the delinquent upon conviction
to a fine of not less than ten nor more than fiftj' dollars.
Sec. 12. The school committees of public schools, superintendents
of gi-aded schools and the principals of pi'ivate schools shall not allow
any pupil to attend the school under their control while any member
of the household to which said pupil belongs is sick of either small-pox,
diphtheria, measles, scarlet fever, yellow fever, typhus fever or
cholera, or during a period of two weeks after the death, recovery
or removal of such sick i^erson ; and any pupil coming from such
household shall be required to present to the teacher of the school
the pupil desii-es to attend a certificate from the attending physician,
city health officer or county superintendent of health of the facts
necessaiy to entitle him to admission in accordance with the above
regulations. A wilful failure on the part of any school committee to
perform the duty required in this section shall be deemed a misde-meanor,
and upon conviction shall subject each and every member of
the same to a fine of not less than one nor more than twenty-five dol-lars
: Provided, that the instructions in accordance with the provi-sions
of this section given to the teachers of the schools within twen-ty-
four hours after the receipt of each and every notice shall be
deemed performance of duty on the part of the school committee. Any
teacher of a public school and any principal of a private school fail-ing
to carry out the requirements of this section shall be deemed
guilty of a misdemeanor, and upon conviction shall be fined not less
than one nor more than twenty-five dollars.
REVIEIV OF DISEASES FOR AUGUST, 1905.
SEVENTY-EIGHT COUNTIES REPORTING.
Ninety-five counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases
the Superintendent has, as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-con-tagious
diseases to him.
Where the number of cases is not given, or the prevalence of a
disease othen\-ise indicated, its mere presence in the county is to be
understood as reported.
For the month of August the following diseases have been reported
from the counties named :
BULLETIN^ !«:. C. BOARD OF HEALTH. 61
Measles.—Auson, several cases ; Beaufort, 2 ; Gates, 15 ; Granville,
20 ; Martin, several ; Mecklenburg ; Person, a few ; Pitt, a few ; Vance,
many ; Yancey, a few—10 counties.
Whooping-cough.—Alamance; Anson, many; Cumberland; Duplin,
several; Gaston, a few; Henderson, 30; Martin, many; Mecklenburg;
Person, a few ; Pitt ; Richmond, epidemic ; Rockingham ; Rowan, 5 ;
Union, epidemic ; Vance, a few ; Wake, 12 ; Yadkin, many—17 coim-ties.
. ^
Scarlatina.—Cleveland, 2 ; Cumberland, 2 ; Forsyth, 4 ; Guilford, 1
;
New Hanover, 2 ; Orange, 2 ; Person, 1 ; Rockingham, a great many
Wilkes—9 counties.
Diphtheria.—Beaufort, 3 ; Bertie, 2 ; Cabarrus. 1 ; Carteret, 2
Cumberland. 45 or 50 in one section ; Duplin. S ; Forsyth, 3 ; Gaston,
a few ; Guilford, 7 ; Halifax, 26 ; Haywood, 4 ; Henderson, 1 ; Hertford,
4 ; Iredell, 1 ; Johnston, 1 ; McDowell, 4 ; Martin, several ; Montgom-ery,
1 ; New Hauovei-, 1 ; Onslow, 10 ; Pender, 8 ; Pitt, 6 ; Rockingham
;
Rowan, 4 ; Rutherford, 2 ; Surry, 2 ; Swain, 10 ; Wake, 5 ; Warren, 1
Wilkes, 3 ; WiLson, 4—31 counties.
Typhoid Fever.—Alamance ; Alleghany ; Anson, a few ; Beaufort. 5
Biimswick, 1 ; Burke, 6 ; Cabarrus, 2 ; Camden, 2 ; Caswell, 5 ; Ca-tawba,
4; Cleveland, many; Columbus, 7; Craven, 3; Cumberland;
Dare, 5 ; Davidson ; Duplin, 4 ; Durham, 9 ; Edgecombe, many ; For-syth,
18 ; Franklin, several ; Gates, 1 ; Granville, 8 ; Greene, 12 ; Guil-ford,
5 ; Harnett, 4 ; Haywood, 8 ; Hertford, a few ; Iredell, 2 ; Jackson,
16 ; Johnston, several ; Lincoln, 3 ; McDowell, 5 ; Martin, many ; Meck-lenburg
; Montgomei-y, 5 ; Nash, 7 ; New Hanover, several ; Northamp-ton,
a few ; Onslow ; Orange, 6 ; Pasquotank ; Pender, several ; Pitt,
20 ; Randolph, 10 ; Richmond, a few ; Robeson, several ; Rockingham,
in all parts ; Rowan, 12 ; Sampson, a few ; Surry. 4 ; Swain, a few
:
Union, 25 ; Vance, a very few ; Wake, 5 ; AVarren, 12 ; Watauga. 3
Wilkes, 8 ; Yadkin, many ; Yancey, several—62 counties.
Malarial Fever.—Alamance, Bertie, Bladen, Brunswick, in all
parts ; Cleveland, Columbus, Currituck, many ; Dare, Edgecombe, in
all parts ; Gaston ; Gates, 9 ; Granville, several ; Halifax, Hyde, in all
parts ; Johnston ; Lincoln ; Martin, in all parts ; Montgomery ; Onslow,
Pender, in all parts; Randolph; Richmond, in all parts; Sampson;
Wake, all parts ; Warren ; Washington, in all parts—29 counties.
Malarial Fever, Pernicious.—Brunswick, 2 ; Randolph, 1 ; Samp-son,
a few ; Wake, 1.
Malarial Fever, Hemorrhagic—Camden, 3 ; Onslow.
Bowel Diseases.—Burke, a few ; Camden ; Currituck, many ; Gates ;
Randolph, in all parts; Sampson, many—5 counties.
Cerebro-spinal Meningitis.—Camden, 1.
Pneumonia.—Cabarrus, 2 ; Davidson ; Duplin, 1 ; Jackson, 4 ; Mar-tin,
many—5 counties.
62 BULLETII^ N. C. BOAED OF HEALTH.
Smallpox.—Columbus, 1 ; Craven, 3 ; Cumberland, 5 ; Henderson, 4 ;
Hertford, 14; Mecklenburg, 1; New Hanover, 8;*Pender, a few; Rich-mond,
5 ; Sampson, 7 ; Washington, 1—11 counties.
Cholera, in Hogs.—Martin, Onslow.
No diseases reported from Buncombe, Davie, Macon, Polk, Scotland
and Transylvania.
No reports received from Alexander, Ashe, Caldwell, Chatham,
Cherokee, Chowan, Clay, Graham, Jones, Lenoir, Mqdison, Mitchell,
Moore, Pamlico, Perquimans. Stanly and Wayne.
SUMMARY OF MORTUARY REPORTS FOR AUGUST, 1905.
TWENTY-TWO TOWNS.
White.
Aggregate population 90,.3.5O
Aggregate deaths 123
Representing annual death-rate per 1,000. . . . 15.3
Causes of Death.
Typhoid fever 19
Scarlet fever 1
Malarial fever 2
Diphtheria 2
Whooping-cough 6
Pneumonia 4
Consimiption 9
Brain diseases 2
Heart diseases 10
Neurotic diseases 2
Diarrhoeal diseases 20
All other diseases 39
Accident 5
Suicide 1
Violence 1
123
Deaths under 5 years 35
Still-born 7
CoViJ.
I
BULLETIN N. C. BOARD OF HEALTH.
mortuary Report for August, X905.
63
Towns
AND RbPOBTEBS.
Charlotte
Dr. F. O. Hawley.
Durham
Dr. T. A. Mann.
Elizabeth City
Dr. H. D. Walker.
Fayettevllle
Dr. A. S. Rose.
Goldsboro
Robt. A. Creech, Esq.
Greensboro
Jno. S. Michaux, C. C.
Ijexlu^ou
J. H. Moyer, Mayor.
Marlon
Dr. B. L. Ashworth.
Mouroe
Dr. Jno. M. Blair.
Oxford
Dr. S. D. Booth.
Raleigh
T. P. Sale, Clerk B.H.
Saleai
S. E. Butner, Supt. H.
Salisbury
Dr. H. TJTranthana.
Southport
Dr. J. A. Dosher.
Tarboro
Dr. S. N. Harrell.
Wailesboro
Dr. J. H. Bennett.
Washiugton
Dr. John G. Blount.
Wayiiesvllle
Dr. Thos. Stringfield.
Weldon
J. T. Gooch, Mayor.
AVllmlugtou
Dr. Chas. T. Harper.
Wilson
Dr. W. S. Anderson.
Winston
Dr. J. L. Hanes.
Popula-tion.
W.
C.
W.
C.
W.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
w.
c.
12,000
8.000
12,000
6,000
5, coo
3,000
2,500
2,300
3,500
2,600
7,000
5,000
3,000
600
800
400
2,000
800
1,250
1,250
9,000
6,000
3,300
350
3,900|
2,500
900
500
2,000
500
1,000
700
3,100
2,900
l,60o!
400
700
7501
11,000,
10,000,1
3,800|
3,000
7,000
5,000
Tempobabt
64 BULLETIN N. C. BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. George W. Long.
Alexander Dr. C. J. Carson.
Alleghany Dr. Robt. Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. Manley Blevins.
Beaufort Dr. John G. Blount.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C. G. Ferebee.
Carteret Dr. F. M.Clarke.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. J. H. Taylor.
Cherokee Dr. J. A. Abernathy.
Chowan Dr. T. J. Hoskins.
Clay Dr. J. M.Sullivan.
Cleveland Dr. B. H. Palmer.
Columbus Dr. H. B. Maxwell.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare Dr. W. B. Fearing.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. A. J. Jones.
Durham Dr. T. A. Mann.
Edgecombe Dr. S. N. Harrell.
Forsyth..: Dr. S. F. Pfohl.
Franklin. Dr. R. F. Yarborough.
Gaston Dr. H. F. Glenn.
Gates Dr. W. O. P. Lee.
Graham Dr. M. J. Maxwell.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy, Jr.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. L. J. Arnold.
Haywood Dr. J. R. McCracken.
Henderson Dr. J. G. Waldrop.
Hertford Dr. Robert W. Smith.
Hyde Dr. E. H. Jones.
Iredell Dr. M. R. Adams.
Jackson Dr. William Self.
Johnston Dr. Thel Hooks.
Jones Dr. N. G. Shaw.
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. John W. Saine.
McDowell Dr. B. L. Ashworth.
Macon Dr. W. A. Rogers.
Madison Dr. W. J. Weaver.
Martin Dr. W. H. Harrell.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Virgil R. Butt.
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico Dr. H. P. Underbill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. R. J. Williams.
Perquimans Dr. C. C. Winslow.
Person Dr. J. A. Wise.
Pitt Dr. Joseph E. Nobles.
Polk Dr. C. J. Ivenworthy,
Randolph Dr. A. M. Bulla.
Richmond Dr. L. D. McPhail.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. J. S. Brown.
Rutherford Dr. E. B. Harris.
Sampson Dr. J. O. Matthews.
Scotland Dr. A. W. Hamer.
Stanly Dr. V. A. Whitley.
Stokes
Surry Dr. John R. Woltz.
Swain Dr. R. L. Davis.
Transylvania Dr. C. W. Hunt.
Tyrrell
Union Dr. Henry D. Stewart.
Vance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. P. J. Macon.
Washington Dr. W. H. Ward.
Watauga Dr. H. McD. Little.
Wayne Dr. William Spicer.
Wilkes Dr. W. P. Horton.
Wilson Dr. W. S. Anderson.
Yadkin Dr. M. A. Royall.
Yancey Dr. J. B. Gibbs.
^U^IL.1-:H:X'I1^T
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington. T. E. Anderson, M. D.-Statesville.
S. Westray Battle, M. D.--Asheville. J. Howell Way, M. D. --Waynesville.
Henry W. Lewis, M. D Jackson. W. O. Spencer, M. D Winston- Salem.
W. P. IVEY, M. D. Lenoir. ! J. L. Ludlow, C. E. Winston-Salem.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XX. OCTOBER, 1905. No. 7.
THE PHVSICIAIV'S PARAMOUNT DUTY TO THE PATIENT AND
FAMILY IN PULMONARY TUBERCULOSIS.
By C. p. ambler, M. D., Asheville, N. C.
(Read before the Anti-Tuberculosis League, Atlanta. April 18, 1905. Referred by motion
to the press with request to reproduce same as a means of educating the public to the
necessity of early diagnosis, and cai-eful observation of directions given by physician.)
[We earnestly commend to our readers, especially of the medical
profession. Dr. Amliler's paper. We were present at the Atlanta
meeting of the Anti-Tuberculosis League, and we unhesitatingly ad-judged
it the best we heard. It goes to the very heart of the prob-lem
of preventing and curing tuberculosis, and coincides with the
views heretofore set forth in these columns.
—
Editor. 1
As a profession we have for generations practiced medicine in so
liberal a sense of the word that we have been far too quick to pre-scribe
and in the bustle and huriy of active practice have failed to
grant to the patient the time that his case generally requires and
should be accorded. We are to be censui'ed for having taught the
public to believe that each disease has its medicine or "cure." Our
preceptor believed in "i)laceboes" and proscribed such in numerous
instances where no medicine was realjy indicated. This practice is
in great part dying out, but as we have discarded this foollslmoss we
have fallen into the greater error of depending upon drugs or so-called
or considered "specifics."
It is an unfortunate fact and disgrace to our profession, both city
and country, that a large number of the consumptives living among us
to-day have been "treated" for montlis, and in many instances for
years, before the true nature of their maladv was recognized; that
()6 BLLLETIX X. C. BOARD OF HEALTH.
symptoms which should have been recognized and should at once
have aroused suspicion of tuberculosis, have either been neglected or
attributed to other causes. Thus, during the early stages of the
disease, by our own carelessness, have we, in thousands of cases,
robbed the trusting patient of every chance for recovery, while we
plied him with "tonics" and cough remedies.
Thanks to the medical requirements now enacted by all our States,
this practice is not the result of ignorance on the part of our profes-sion.
It is, however, to our discredit that it can be traced too often
to carelessness. We have not taken the time to thoroughly investi-gate
: in malarious districts, slight chills and fever have been attrib-uted
to ague, while a blood examination would have shown this not to
be the case ; coughs have been bronchial and syrups prescribed ; blood-spitting
has "come from the throat" because the examiner could not
detect the presence of disease in the chest by placing his ear against
the chest, fore and back, over several thicknesses of clothing. Tem-
Ijerature taken once a day for several days has been regarded as
always normal, bec-ause it was so found at the time taken : loss of
weight has been indication for tonics : suppressed menstruation has
meant uterine trouble ; a dry hacking cough has meant laryngitis, and
pains in the chest inter-costal neuralgia.
But rarely indeed do physicians point out to-day to the head of the
family in which occurs a case of tuberculosis the necessity of exam-ining
each and every member of the family periodically for several
years after the initial case has died or recovered. And yet, right
here is where the most brilliant results are being accomplished by
men who are careful and thoughtful.
It is not the purpose of this paper to censure the profession, but as
this association is organized for the prevention of consumption, I wish
to place myself upon record in your halls as advocating that the best
means of "preventing consumption" is to discover the tuberculous
disease in the patient before the stage of consumption has been
reached.
Consumptives are persons dying with a tuberculous disease. Not
one case in live hundred fails to consult a physician on account of
some symptom or other, long before the disease is far advanced.
Tuberculosis is not the fatal disease that past generations have re-garded
it. It can be proven that a great number who develop the
disease recover without discovering that they have ever had it. For-merly
it was rarely discovered before the patient was in a dying con-dition.
Such cases promptly died, and do to-day. with the result that
the laity has grown, or been taught by us. to believe that the disease
means death.
We are awakening in this country to the realization that this
disease is the greatest destroyer among us to-day. One in every six
or seven of our deaths is due either directly or indirectly to this
disease. Of a given number of cases which have occurred in your
I
BULLETIN :S'. C. BOARD OF HEALTH. 67
practice iudividually. iu bow many instances did you discover tLie
disease before tbe destruction of lung tissue bad already occurred?
Go furtber—in tbose cases not discovered early, was it not due to one
of two facts, eitber tbe patient did not consult you until the disease
was advanced, or, as you look back, was not your own carelessness
and burry tbe cause of tbe delayed diagnosis?
Our States may legislate, our National Government may investi-gate,
our pbilantbropists give tbeir millions, and as pbysicians we
may organize sucb societies as tbis, but in tbe end tbe only way it
can at present be logically met Is by tbe pbysician individually.
If we as pbysicians would recognize tbe disease earlier tbe battle
would be over balf won. It will continue to be tbus ; if we fail to do
our duty in tbe future, as our confreres bave done in tbe past, tbe
disease will go on uncbecked.
Next to an early diagnosis, tbe most important point for tbe pbysi-cians
is tbe instruction of tbe patient. So long as tbe cowardly eva-sion
of tbe truth to the patient be continued by our profession, we
must expect to see the disease become more wide-spread. Tbe profes-sion
over the covmtry is not as a rule telling the patient the truth.
Tbose of us who reside at health resorts find that only those men in
our profession who are giving this disease careful and close consid-eration
tell the patient tbe truth and instruct him regarding tbe
disease, bis danger to himself and to others, and point out the neces-sity
for recovery. Tbe rank and file of our profession, especially in
tbe rural communities, apparently believe that the truth will damage
tbe patient; and when they bave carried him tbe whole length of
drug and dope administration, bave robbed him of every opportunity
for recovery by not instructing him and pointing out tbe path to
recovery, they send him away from home in a dying condition, loaded
with stinking and nauseating drugs and directions to eat and exercise,
to keep away from resort doctors and report once a month to them by
letter.
Tbe truth told tbe patient, with explanations and proper instruc-tions,
does not harm him. In fact, in these two points lies tbe secret
of successful treatment of tbis disease. Our first duty to tbe patient
from my point of view is to tell him tbe truth, and then take tbe time
to instruct him ; to point out wherein he improves ; to teach bim
wherever be is a source of danger to himself as well as others, and
especially to show him this danger is as nothing, practically, if your
directions be carefully followed and carried out. With the interest
in tbis disease now developing, we are going to tbe extreme ; as we
bave groped in tbe dark and seen tbe multitudes die in the past : die,
yes. in many instances because we considered the disease fatal, not
realizing that tbe fault lay in ourselves in not discovering tbe true
nature of the trouble earlier ; die, yes. as we stand apart with tbe
friends and look upon it as a part of tbe ways of God, our inaction.
68 BULLETIN N. C. BOAED OF HEALTH.
our do-notbiiigness, our know-nothiugness of those days was one
extreme, aud now we are educating the public to another.
Ah-eady the consumptive is an outcast, publicly to be shunned.
The average consumptive should be kept from public places and gath-erings
; but now, when it becomes known that a person has tuberculo-sis,
be it ever so slight, he is in many quarters looked upon as a leper,
to be avoided as death itself. This is unjust to the patient, and is
the result of telling only part of tlie truth by the physician and those
who are waging the crusade against the disease.
The patient, his friends, his family and the public generally should
know wherein he is in danger to himself and to others. The family
should receive instructions from the physician for their safety, and
as long as the patient observes the rules laid down he should not be
ostracised, or made to feel that he has no place among men. The
secret of prophylaxis and successful treatment lies in the instructions
given by the physician, together with the hearty co-operation of the
patient and family.
The success met with in institution treatment and the administra-tion
of so-called specifics (which reciuire the constant attendance of
the physician) is the result of the constant supervision, careful in-structions
and management of the patient, far more than any other
means, or the specific applied. This being true in the institution,
similar methods should be applied to our outside cases to the fullest
possible extent. The patient with a good heart, a good stomach, an
early diagnosis made and sufficient means of support for several
months without worry, violent or prolonged exertion, will perma-nently
recover in ninety per cent, of the cases.
The day may come when we can as successfully vaccinate against
tuberculosis as we do to-day against small-pox. Until this day arrives
prevention will mean prophylaxis : Prophylaxis will mean three
things
:
Earlier diagnosis,
Instruction of patient.
Instruction of family and friends.
This practically brings the whole matter home to the physician as
it has been in the past : Will we go on as we have done in the past
and depend upon our drugs to cure, while our uninformed and slowly
rotting fellow-creature spreads the seeds of his accursed disease in
the home, on our streets, in our public places of meeting and worship
;
while we, as physicians, raise no protest when even our butchers and
our bakers while they themselves are suffering from the disease are
allowed to handle and sell to the public the foodstuffs of life?
Just now, the proper fad is an outdoor life ; no one who understands