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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
Object Description
Description
Title | Bulletin of the North Carolina Board of Health |
Other Title | Bulletin of the North Carolina State Board of Health; Bulletin of the North Carolina Board of Health |
Creator | North Carolina. State Board of Health. |
Date | 1905; 1906 |
Subjects |
Diseases--Reporting Genealogy Mortality--Statistics Public Health--North Carolina--Periodicals |
Place | North Carolina, United States |
Time Period | (1900-1929) North Carolina's industrial revolution and World War One |
Description | Volume 20, Issues 1-12, April 1905-March 1906. |
Publisher | Wilmington, N.C. :Secretary of the Board, |
Agency-Current | North Carolina Department of Health and Human Services |
Rights | State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754 |
Physical Characteristics | 61 v. :ill. ;23 cm. |
Collection | Health Sciences Library. University of North Carolina at Chapel Hill |
Type | text |
Language | English |
Format | Bulletins |
Digital Characteristics-A | 8,212 KB; 166 p. |
Digital Collection |
Ensuring Democracy through Digital Access, a North Carolina LSTA-funded grant project North Carolina Digital State Documents Collection |
Digital Format | application/pdf |
Related Items | Imprint varies: published later at Raleigh, N.C. |
Title Replaced By | Health bulletin** |
Audience | All |
Pres File Name-M | pubs_edp_bulletinboardofhealth190506.pdf |
Pres Local File Path-M | \Preservation_content\StatePubs\pubs_edp\images_master\ |
Full Text |
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 |