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RECEIVED JUL 20 1981 HEALTH SCIENCES LIBRW BULLETIN OF THE Li Published Monthly at the Office of the Secretary of the Board, at Raleiyh, N. C. Geo. G. Thomas, M. D., P?es., Wllminf<ton. i W. p. Beall, M. D., Greensboro. S. Westuav IS.vrxLE, M. D., Aslieville. | W. J. Lumsden, M. D., Elizabeth City, W. H. Hauukll, M. D., Williamston. | Prof. F. P. Venable, Chapel Hill. JoHK Whitehead. M. D., Salisbury. | J. C. Chase, Civ. Eng., AVilmiiiicton. RiCHAKU H. Lewis, M. D., Secretary and Treasurer, Raleigh. Vol. XII. APRIL, 1897. m>. 1, An Act Relating to the Board of Health (Chapter 214, Laws 1893). Amend-ments by the last (xeneral Assembly. We have just obtained certified cop-ies of the acts amendatory to our health law passed by the Legislature which adjourned last month. One was a gen-eral and the other a special act. They were respectively as follows : A>- Act to Amkxd Chapter 214, Laws 1893. 2'he General Assembly of North Caro-lina do enact : Section 1. That section 5 of chapter 214, laws of 1893, be amended as follows : Strike out all after the word "county,'' as it first appears in line 3 of said sec-tion, down to the word ''from" in line six of said .section. That said section shall be further amended by striking out the word "ballot" in line six'of said section, and inserting between the words "by" and "to" in line six of .said section the following: " Tlie board of commissioners of each con n T v am mall v, on the first Monday in May of each year." That the said section shall be further amended by striking out the words "two years" in line seven of said section. And the said section shall be further amended by inserting after the word "health" and before the word "his" in line seven of said section the following : And the said board of com-missioners shall fix the compensation of said county superintendent of health. Sec 2. That section o of chapter 214, laws of 1893, be further amended by striking out all of said section after the word "commissioner" in line 20 down to the word "provided" in line 24. Sec 3. That section 7 of saitl chapter 214, laws of 1893, be and the same is hereby repealed. Sec 4. That all laws and clauses of laws in conflict with this act are hereby repealed. Sec 5. That this act shall be in force from and after its ratification. Ratified the 2d day of March, A. D. 1897. '2 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. An Act to Amend Sec. 5. Chapter 214, Pnblic Laws of 1893, Prescribing the Salary of Supt. Board of Health. The General Assembly of North Caro-lina do enact : Section 1. That the superintendent of health provided for in section five (5), chapter two hundred and fourteen (314) of the public laws of 1893, shall hereafter be elected by the board of county commissioners. Sec. 2. That the salary of the county superintendent of health shall be fixed by the board of county commissioners, to be not less than one hundred dollars nor more than four hundred dollars : Provided, that the salary shall not be reduced during the term for which such officer may have been elected. Sec. 3. That all laws and clauses of laws in conflict with this act are hereby repealed. Sec. 4. That this act shall apply to the countiesof Warren, Wake, Yadkin, Chatham and Halifax. Sec. 5. That this act shall be in force from and after its ratification. Ratified the 9th day of March, A. D. 1897. Section five, as amended, now reads thus : " Skc. 5. There shall be an auxiliary Board of Health in each county in the State. These boards shall be composed of all registei-ed physicians resident in the county. From this number one physician shall be chosen by the Board of <vommissioners of each county annu-ally on the first Monday in May of each year, to serve with the title of Superintendent of Health. And the said Board of Commissioners shall fix the compensation of said County Superintendent of Health. His duty shall be to gather vital statistics upon a plan designated by the State Board of Health. He shall always promptly advise the Secretary of the State Board of the unusual prevalence of disease in his county, especially of typhoid fever, scarlet fever, diphtheria, yellow fever, small-pox, or cholera. His report shall be made regularly, as advised by the State Board, through their Secretary; and he shall receive and carry out as far as possible such work as may be directed by the State Board of Health. He shall make the medico-legal post-mortem examinations for coroners' inquests, and attend the prisoners in jail, home for the aged and infirm, and house of correction,and make an exam-ination of lunatics for commitment. He shall be the sanitary inspector of the jail and home of his county, mak-ing monthly reports to the board of county commissioners: Provided, fur-ther, that it shall be unlawful for said county commissioners to elect any one not eligible to membership in the county board to the office of county superintendent of health, if any such qualified physician can be found in the county willing to accept the office." Section seven, which was repealed, related to the salary or remuneration by the usual fees of the superintendent, he having the privilege of demanding payment " in accordance with the med-ical fees usual in his county " if the definite salary offered him by the board of county commissioners in lieu of fees was not satisfactory. We are very sorry that these changes have been made, particularly because it does seem ungracious, w^hen sanitary work is promoted almost entirely by medical men,and that,too,in opposition to their own pecuniary interests, to deprive them of a voice in the selection BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. of their county health oflBcer ; and because we fear that the interest in sanitation on the part of the profes-sion, ah-eady discouragingly feeble, will be still further weakened. Of course it will have no appreciable effect on those who are sincerely interested in the welfare of their fellow beings, but unfortunately there is a great deal of "human nature'' in man, even though he be a member of the noble profession of medicine. At the same time, as is nearly always the case, there are two sides to this question,and we always felt that if the '^latter were ever brought to the atten-tion of a legislature constituted as we have known them for the past fifteen or twentj' years these changes would be made. Under the act of 1893, while they had to pay the salarj^ of the super-intendent of health, the county com-missioners had no control over his selection, and practically none over his pay. Since we suppose it would be safe to say that there is a great deal of " human nature "' in county commis-sioners, as well as in physicians, we are constrained to admit that it was not unnatural for the men who had to nay for the service to desire the right to say who should render the service and what the amount of his compensa-tion should Vje. But, after all has been said, we are afraid, looking at the mat-ter from the points of view of the poor and the prisoners, that a mistake has been made. Most of our county commis-sioners are. we are sure, kind-hearted, humane men, but even kindly men are noT always as observant and thought-ful as they might be, and, from what has sometimes happened heretofore, there is ground to fear that in the inter-est of a false economy the health of the people as a whole, and particularly of the unfortunate inmates of our county homes and jails, will be allowed to suffer. On more than one occasion, even under the old law, a disposition has been shown to let the office to the low-est bidder,and everybody knows what that would mean. But it cannot be helped now,and could not at the time : so there is nothing for us to do but to hope for the best. Summary of Reports from County Superintend-ents of Health for March, 1897, 'Eighty-two counties reporting). In the blanks on which these reports are made the following items are called for : 1. The number of cases of small-pox, measles, whooping cough, scarlatina, diphtheria, typhoid fever, pernicious malarial fever, hemorrhagic malarial fever, yellow fever and cholera which have occurred in the county during the past month. 2. The diseases which have been prevalent in the county, and in what parts. 3. Epidemics among domestic ani-mals. 4. Remarks as to special unsanitary conditions in the county. In few counties do physicians gener-ally report these details to the Super-intendent, though furnished with blanks for that purpose, and in most cases he has to depend upon himself alone in making his report. Details as to the jails, houses of cor-rection, and county homes are also given in these reports, and will be found tabulated on other pages. Alamance—Dr. R. A. Freeman, Bur-lington. A few cases of measles, whoop-ing cough and typhoid fever. BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Alexander—Dr. T. F. Stevenson, Taylorsville. No diseases to report. Alleghany—Dr. Robt. Thompson, Sparta. Pneumonia to some extent in the centre. Influenza has subsided. Great improvement in the health of the county. Anson—Dr. E. S. Ashe, Wadesboro. No report. Ashe—Dr. L. C. Gentry, Grumpier. No diseases to report. Beaufort — Dr. Joshua Tayloe, Washington. Two cases of typhoid i'ever. Bertie—Dr. H. V. Dunstan, Wind-sor. Bronchial diseases in all parts. An epidemic of distemper in horses. Bladen — Dr. Newton Robinson, Elizabethtown. Several cases of whoop-ing cough. Very little sickness. Brunswick — Dr. D. I. Watson, Southport. No diseases to report. Buncombe—Dr. E. C. Stai-nes, Ashe-ville. No diseases to report. BuRKE^Dr. J. L. Laxton, Morgan-ton. Eight cases of whooping cough, two of pneumonia and colds in all parts. More room is needed at the county home. Cabarrus— Dr. Robt. S. Young, Con-cord. Sixty two cases of whooping cough and two of diphtheria. Pneu-monia and mild malarial attacks in all parts. Caldwell—Dr. A. A. Kent, Lenoir. Twenty-five cases of whooping cough. Camden—No Board of Health. Carteret — Dr. Geo. N. Ennett, Beaufort. Grip in all parts. Caswell—Dr. W. O. Spencer, Yan-cey ville. Catarrhal fever and pneumo-nia in all parts. My efforts at improve-ment liave been so far without effect. Catawba—Dr. D. McD. Yount, New-ton. Whooping cough to some extent in all parts. Chatham—Dr. J. B. Matthews, Pitts-boro. A few cases of whooping cough and one of typhoid fever. The jail is badly in need of sewerage. Cherokee—Dr. J. F. Abernathy, Murphy. No diseases to report except roup among fowis. The sewer from the jail becoming blocked up and in bad condition, work has been begun to amend it. Chowan — Dr. R. H. Winborne, Rockyhock. Catarrhal troubles, with bronchitis and rotheln in some p?T , but more healthy than usual for March. Clat—Dr. W. E. Sanderson, Hayes-ville. One case of typhoid fever and one death from acute rlieumatism. General liealth never better. Cleveland—Dr. O. P. Gardner, Shelby. No diseases to report. Columbus—Dr. I. Jackson, White-ville. No diseases to report. Craven—Dr. J. W. Duguid, New-bern. Malarial and catarrhal fevers in all parts. Hog cholera in the West. The public building is now finished, and is a handsome ornament to New-bern and a convenience long needed. Cumberland—Dr. J. Vance McGou-gan, Fayetteville. Five cases of meas-les. La grippe in all parts. Currituck—No Board of Health. Dare—Dr. W. B. Fearing, Manteo. No diseases to report. Davidson—Dr. John Thames, Lex-ington. One case of diphtheria. Davie—Dr. James McGuire, Mocks-ville. La grippe and colds in all parts. Duplin—Dr. J. C. Grady, Magnolia. No report. BULLETIN OF THE NOKTH CAROLINA BOARD OF HEALTH. Durham—Dr. JohnM. Manning, Dur ham. One ease of whooping cough. Very healthy. Edgecombe—Dr. L. L. Statou, Tar-boro. One case of scarlatina. Very healthy. Forsyth—Dr. E. F. Strickland, Beth-ania. Measles in Rural Hall township. Influenza and pneumonia in many parts. The sanitary condition of the jail will he improved when the contem-plated repairs are made to the sewer pipes. Franklin—Dr. E. S. Foster, Louis-burg. No diseases of importance. Gaston—Dr. J. H. Jenkins, Dallas. Mumps and pneumonia. A few cases of grippe. Gates—No Board of Health. Graham—No Board of Health. Granville—Dr. T.L. Booth, Oxford. Twelve cases of measles and one of typhoid fever. Greene—Dr. Joseph E. Grimsley, Snow Hill. Seven cases of measles and one of typhoid fever. Intermittent fever and influenza in all parts. Guilford—Dr. W. J. Richardson, Greensboro. Bronchial and catarrhal troubles in all parts. Halifax—Dr. I. E. Green, Weldon. Very little sickness. Some cases of German measles in one section. Harnett—No Board of Health. Haywood — Dr. J. Howell Way, Waynesvilie. Four cases of typhoid fever. Very little sickness. Henderson—Dr. H. L. Ashworth, Hendersonville. Two cases of typhoid fever. La grippe. The grounds around the jail have been improved. Hertford—Dr. John W. Tayloe, Union. Verv little sickness. Hyde—No Board of Health. Iredell—Dr. W. J. Hill, Statesville. Two cases of typhoid fever. Mumps, grippe and malarial fever. Jackson—Dr. Wm. Self, Webster. One case of mumps. Grippe and pneu-monia in all parts. The construction of the jail renders it unsanitary when crowded. The ventilation is poor and there is need of a good water supply. The jailer does all in his power to keep it clean. Some improvement is being attempted. Johnston—Dr. R. J. Noble, Selma. One case of hemorrhagic malarial fever. Very little sickness. Jones—No Board of Health. Lenoir—Dr. James M. Parrott, Kinston. No report. Lincoln—Dr. Thos. F. Costner, Lin-colnton. Three cases of whooping cough. If the lowlands along Clark's creek were drained, the sanitary con-dition of that community would be much improved. McDowell — Dr. George I. White, Marion. A few cases of grippe and measles. Very little sickness. Macon—Dr. S. H. Lyle, Franklin. Three cases of typhoid fever. An epi-demic of influenza of unusual severity is just disappearing. Madison—Dr. Jas. K. Hardwicke, Marshall. No serious disease to report. Martin—Dr. W. H. Harrell, Will-iamston. Pneumonia and bronchitis in all parts. Mecklenburg—Dr. H. M. Wilder, Charlotte. No report. Mitchell—Dr. C. E. Smith, Bakers-ville. Fifty cases of whooping cough and a few of la grippe. Otherwise, very little sickness. The sanitary con-dition of the jail is bad. The legisla- 6 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. ture at its late session passed a bill allowing the commissioners to levy a special tax for the purpose of building-a new one. Montgomery—Dr. W. A. Simmons, Troy. Two cases of typhoid fever. The grippe has almost disappeared. MooRE—Dr. Gilbert McLeod, Car-thage. ]S^o report. Nash—Dr. J. J. Mann, Nashville. Very little sickness. New Hanover—Dr. J. C. Shepard, Wilmington. Sixty cases of whooping cough and four of typhoid fever. Malarial diseases. Northampton—Dr. H. W. Lewis, Jackson. La grippe, measles and whooping cough. Onslow—Dr. E. L. Cox, Jackson-ville. A few cases of ordinary and of hemorrhagic malarial fever. Not much sickness. Orange—Dr. D. C. Parris, Hillsboro. Some measles and whooping cough. Catarrhal diseases in all parts. Pamlico—No Board of Health. Pasquotank—Dr. J. E. Wood, Eliza-beth City. La grippe in several parts. The county home needs enlarging, and the prosjject for enlarging it seems good. Pender—Dr. Geo. F. Lucas, Currie. No diseases to report. Perquimans—Dr. C. C. Winslow, Winfall. Two cases of whooping-cough, one of diphtheria,one of typhoid fever and nine of pneumonia. Person—Dr. J. A. Wise, Roxboro. Measles and whooping cough. Im-provements in the jail and court house deserve special mention. Pitt—Dr. Frank W. BroAvn, Green-ville. Colds and influenza. Polk—Dr. C. J. Kenworthy, Tryon. Health of county excellent. Randolph—Dr. T. T. Ferree, Ash-boro. Very little sickness. The epi-demic of la grippe has now subsided. There have been some improvements at the county home and jail. Richmond—Dr. W. H. Steele, Rock-ingham. Several cases of diphtheria and one of typhoid fever. Robeson—Dr. T. A. Norment, Jr., Lumberton. No diseases rei^orted. , Rockingham—Dr. Samuel Ellington Wentworth. La grippe in all parts. The sanitary condition of the jail is not good owing to the construction of the building. Rowan—Dr. John Whitehead, Salis-bury. Five c-ises of typhoid fever. Pneumonia and malarial fe^er. Rutherford—Dr. E. B. Harris, Rutherfoi'dton. Two cases of scarla-tina. Sampson—Dr. Jno. A. Stevens, Clin-ton. A few cases of whooping cough, measles, influenza and pneumonia. Two cases of typhoid fever in the same family. Stanly—Dr. D. P. Whitley, Milling-port. A few cases of whooping cough and one of typhoid fever. I have sug-gested to the commissioners the necessity of rebuilding at the county home, but the county is heavily in debt, and as yet nothing has been done. Stokes—Dr. W. L. McCanless, Dan-bury. Five cases of measles. Influenza in all parts. Surry—Dr. John R. Woltz, Dobson. La grippe and colds. The jail and home are being scoured and white-washed. Swain—Dr. A. M. Bennett, Bryson City. No diseases to report. BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Transylvania—Dr. M. M. King, Brevard. La grippe in all parts. Tyrrell—JS^o Board of Health. Union—Dr. .T. E. Asheraft, Monroe. La grippe and catarrhal troubles in town and country. Vance—Dr. J. H. Tucker, Hender-son. A few eases of whooping cough; bad colds, bronchitis, influenza and many cases of pneumonia throughout the county. Wake—Dr. P. E. Hines, Raleigh. Five cases of measles, twenty-four of whooping cough, and one of scarlatina. Bronchitis, influenza and pneumonia in all parts heard from. Some cholera among fowls. Dr. Utley reports a good many cases of measles and whoop-ing cough about Holly Springs not attended by any physician. All the buildings at the county home are in good order. Two of those at the work-house need shingling. Only four replies received from thirty blanks sent out. Warren—Dr. Geo. A. Foote, War-renton. Many cases of measles and one of diphtheria; slight bronchitis and grippe. Washington—Dr. W. H. Ward, of Plymouth. Very little sickness. Watauga—Dr. W. B. Council!, Boone. Forty cases of measles and seven of typhoid fever in western part of county. Wayne—Dr. W. J. Jones, Golds-boro. Ten cases of measles. Catarrhal inflammations. Wilkes—Dr. J. M. Turner, Wilkes-boro. Not much sickness. The sani-tary condition of the jail is somewhat improved. Wilson—Dr. N. Anderson, Wilson. Measles epidemic. Yadkin—Dr. T. R. Harding, Yad-kinville. No sickness of note. Yancey—Dr. J. R. Ray, Burnsville. Health of county good. A little pneu-monia. Review of Diseases for March, 1897. Bronchitis—From Bertie, Chowan, Gruilford, Martin, Vance, Wake and Warren—7 counties. Cholera in Fow^ls—From Wake. Cholera in Hogs—From Craven. Diphtheria—From Cabarrus, Da-vidson, Perquimans and Warren. Distemper in Horses—From Beau-fort. Influenza—From Alleghany, Car-teret, Cumberland, Davie, Forsyth, Graston, Greene, Henderson, Iredell, Jackson, McDowell, Macon, Mitchell, Montgomery, Northampton, Pasquo-tank, Pitt, Randolph, Rockingham, Sampson, Stokes, Surry, Transylvania, Union, Vance, Wake and AVarren—27 counties. Malarial Fever—From Cabarrus, Craven, Greene, Iredell, Johnston, New Hanover, Onslow and Rowan— 8 counties. Malarial Fever, Hemorrhagic— From Johnston and Onslow. Measles—From Alamance, Cumber-land, Forsyth, Granville, Greene, Northampton, Orange, Sampson, Stokes, Wake, Warren, Watauga, Wayne and Wilson—14 counties. Mumps—From Gaston, Iredell, Jack-son and McDowell. PNEUMONIA-From Alleghany, Burke, Cabarrus, Caswell, Forsyth, Gaston, BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Jackson, Martin, Perquimans, Rowan, Sampson, Vance. Wake and Yancey — 14 counties. Rheumatism—From Clay. Roup in Fowls—From Cherokee. RoTHELN—From Chowan and Hali-fax. Scarlatina — From Edgecombe, Rutherford and Wake. Typhoid Fever—From Alamance, Beaufort, Chatham, Clay, Granville, Greene, Haywood, Henderson, Iredell, Macon, Montgomery, Isew Hanover, Perquimans, Richmond, Rowan, Samp-son, Stanly and Watauga—18 counties. Whooping Cough—From Ala-mance, Bladen, Burke, Cabarrus, Cald-well, Catawba, Chatham, Durham, Lincoln, Mitchell, New Hanover, Northampton, Orange, Perquimans, Person, Sampson, Stanly, Vance and Wake—19 counties. Summary of Mortuary Reports for March, 1897. (Twenty-four towns. The town.s whose reports are uot vouched for, printed lii small type, are not included. White. CoVd. Total. Aggregate population 73,173 5.5,21.3 128,385 Aggregate deaths 51 100 151 Representing annual death rate per 1000 8.4 21.7 14.1 Causes of Death. Typhoid Fever 10 1 Malarial fever 10 1 Whooping cough Oil Measles 112 Pneumonia 4 13 Consumption 12 35 Brain diseases 6 4 Heart diseases 3 6 Neurotic diseases 1 3 Diarrhceal diseases 1 1 All other diseases 31 47 Accident 1 5 100 Deaths under 5 years 8 .30 still-born 1 6 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Condition of Jails and County Homes by Counties for March, 10 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Condition of Jails and County Homes by Counties.—Continued. ^ BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 11 Condition of Jails and County Homes by Counties.—Continued. 12 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. la METEOROLOCHCAL SUMMARY FOR NORTH CAROLINA, MARCH, 1897. Furnished l)v the North Carolina Section of the (Jlimate and Crop Seryice. C. F. VON HERRMANN, Director. ! BULLETIN OF THE IIILl Published Monthly at the Office of the Secretary of the Board, at Raleigh, N. C. Geo. G. Thomas, M. D., Pres., Wilmington. S. Westkay Battle, M. D., Asheville. W. H. Harrell, M. D.,. Williamston. John Whitehead, M. L)., Salisbury. W. P. Beall, M. D Greensboro. W. J. LUMSDEN, M. D., Elizabeth City. Prof. F. P. Venable, Chapel Hill. J. C. Chase, Civ. Esq., Wilniiugton. Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh. Vol. XII. MAY, 1897. No. 2. Comity Superintendents, Term Office. of As there seemed to be some doubt as to when the County Superintendent of Health, elected on the first Monday in May under the amendment to the act relating to the Board of Health, should assume office, the opinion of the At-torney General on that point was asked. The following is th e corre spondence : North Carolina State Board of Health, Raleigh, May 7, 1897. Ho2f. Z. Y. Walser, Attorney General : Dear Sir:—The question having come up in this office, I write to ask your opinion as to when a County Superintendent of Health, elected on the first Monday of the current month in accordance with the amendments to Chapter 314, Laws of 1898, adopted by the last General Assembly, should assume the duties of the office—imme-diately, or on the first Monday in Sep-tember next, when the term for which the present incumbents were elected expires"? As the Laws of 1897 have not been published, I enclose for your conven-ience certified copies of the amenda-tory acts as printed in the last issue of the Monthly Bulletin of the Board. Awaiting your reply, I am, Very respectfully yours, RiCH'D H. Lewis, Secretary. North Carolina, Executive Depart-ment, Office of the Attorney General, Raleigh, May 15, 1897. Dr. R. H. Lewis, Secy, and Treas. N. C. Board of Health, Raleigh, N. C. : Dear Sir :—In answer to your com-munication of the 7th instant, in regard to the term of office of County Superintendent of Health, elected on the first Monday in the present month, under Sec. 1, Laws 1897, I have to say that, under the decision of the Supreme Court in the recent " Asylum Cases," those Superintendents elected 16 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. on the tirst Monday in September, 1895, will serve out a two years' term of office, ending the first Monday in Sep-tember, 1897. Those elected under the new law on the first Monday in May of the present month will not take office until the expiration of the terms of the Superintendents elected on the first Monday of September, 1895, that is to say, on the first Monday in Septem-ber of the present year. Very truly, Zeb. V. Walser, Attorney Oeneral. Mr. John C. Cliase. Since our last issue, the following let-ter has been received : April 15, 1897. Dr. Richard H. Lewis, Secy. N. C. Board of Health, Raleigh, N. C. : Mt Dear Sir :—You are aware that my business engagements have been such of late as to re(iuire my absence the greater portion of the time, with a prospect that ere long I shall become a resident of another State. As I am not likely to be able to attend another meeting of the Board, it is perhaps best that I should sever my connection therewith, although the close prox-imity of the end of the term would hardly call for a formal resignation. Please accept for yourself and the other members of the Board my best wishes for your future prosperity, both personal and official, with the assurance that I shall ever cherish pleasant recol-lections of my associations with you for the past four years. Sincerely yours,' John C. Chase. This letter was read with genuine regret, both professional and personal. Without making any invidious distinc-tions, we feel safe in saying that the Board never had a more faithful or efficient member than Mr. Chase. His interest in everything pertaining to saViitation was active, and he was always a cheerful intelligent and en-ergetic worker. Our personal relations have always been of the pleasantest, and we realize that we have not only lost a valuable member of the Board, but the pleasure of frequent meetings with a friend. The best wishes of every member of the Board for success in his new work among his native granite hills at Der-ry, N. H., goes with him. Bottle fed Babies and the Hot Season. As is w-ell known, the greatest mor-tality occurs among bottle-fed babies during the heated term. The sum-mer, which lasts so long in this latitude, is upon us, and we feel it to be our duty to direct the attention of our medical readers to the importance of impress-ing upon the mothers in their clientele who are debarred, from any cause, the privilege of nursing their children, noto, before the little ones become sick, the imperative necessity for the proper care of the milk, and the perfect cleans-ing and disinfection of the bottle and other utensils employed. A lady in our office today informed us that neither in the family of her mother with ten children nor in that of a sister with seven, all artificially fed, had a single case of summer diarrhoea or "teething disease" ever occurred, and that it was the habit of both mothers to invariably prepare the milk in person, and always to taste it before giving it to the child. The reward of unceasing care and eternal vigilance, which is the price of health * BULLETIN OF THE NORTH CAROLIXA BOARD OF HEALTH. 17 in bottle fed babies, as well as of liberty is thus clearly shown. And, too, this was before the value of sterilization , and pasteurization of milk was known. As we cannot hope for such care and vig:ilance in general we must look to some method that will correct lapses in their application. We find this method in pasteurization, Avhich, while it does not injure the nutritive quali-ties of the milk does effectually destroj" its pathogenic qualities. It is a sim-ple and cheap method, easily followed, and we believe that its routine use in all cases of artificially fed infants, from , the beginning to the end of the Avarm §>, season, not waiting until disease ' appears to introdube it, would be the means of saving numberless young lives, and saving at the same time an infinite amount of trouble and anxiety on the part of parents besides. In the . light of the facts familiar to every well . informed medical man it does seem to ; us clearly the duty of every family ph5-sician to impress upon the mothers among his patients the value of pasf eurization in preventing diseases among babies fed by hand. If there is any one thing in this world of ours that we can count on with certainty it is the love of a mother for her offspring, and if she can be made to realize that by thus treating the milk, and at the same time seeing that the bottle and its accompaniments are kept clean, her little one will, Avith reasonable certain-ty, be protected against much sickness and perhaps death, she will be more than apt to carry out the directions. The reader desiring more detailed in-formation on this subject is referred to a paper on " The Infectiousness of Milk,'' printed in the January number of the Bulletin. Summary of Reports from County Superintend-ents of Health for April, 1897. Eighty-two counties reporting). In the blanks on which these rejiorts are made the following items are called for: 1. The number of eases of small-pox, measles, whooping cough, scai'latina, diphtheria, typhoid fever, pernicious malarial fever, hemorrhagic malarial fever, yellow fever and cholera which* have occurred in tlie county during the past month. 2. The diseases which have been prevalent in the county, and in what parts. 3. Epidemics among domestic ani-mals. 4. Remarks as to special unsanitary conditions in the county. In few counties do phj'sicians gener-ally report these details to the Super-intendent, though furnished with blanks for that puri^ose, and in most cases he has to depend upon himself alone in making his report. Details as to the jails, houses of cor-rection, and county homes are also given in these reports, and will be found tabulated on other pages. Alamance—Dr. R. A. Freeman, Bur-lington. Mumps and whooping cough in some parts. Several cases of ty-phoid fever. Alexande:^—Dr. T. F. Stevenson, Taylorsville. No epidemic. The Yad-kin river in the northeastern part of the county is in bad sanitary condi-tion. The people up and down the river are having chills. Alleghany—Dr. Robt. Thompson, Sparta. One case of dysentery. Anson—Dr. E. S. Ashe, AVadesboro. 18 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Ashe—Dr. L. C. Gentry, Grumpier. La grippe is still prevailing, causing quite a number of deaths among the aged. Beaufort — Dr. Joshua Tayloe, Washington. Three cases of typhoid fever. Bertie—Dr. H. V. Dunstan, Wind-sor. No diseases to report. Less sick ness than usual. Bladen — Dr. Newton Robinson, Elizabethtown. Very little sickness. Brunswick — Dr. D. I. Watson, Southport. Twenty two cases of mea-sles and eleven of whooping cough, principally in town. The County Com-missioners say that no improvements can be made in the public buildings because there is no money in the treas urJ^ The county is in debt, and the Legislature refused to allow them to issue bonds for the purpose. Buncombe—Dr. E. C. Starnes, Ashe-ville. No contagious diseases. Burke—Dr. J. L. Laxton, Morgan-ton. Twenty cases of whooping cough, and one of typhoid fever. More room is needed at the Home. Cabarrus— Dr. Robt. S. Young, Con-cord. Fourteen cases of measles, nine-ty- one of whooping-cough and one of diphtheria. Caldwell—Dr. A. A. Kent, Lenoir_ Ten cases of whooping cough and two of diphtheria. Camden—No Board of Health. Carteret — Dr. Geo. N. Ennett, Beaufort. Bronchial troubles. Caswell—Dr. W. 0. Spencer, Yan-ceyville. Measles and inumps in all sections and a few of whooping cough The condition of the jail is about as good as the building will admit. Catawba—Dr. D. McD. Yount, New-ton. Whooping cough is subsiding. Clark's Creek, a very sluggish stream, is in a condition which develops mala-ria all along its course. The jail and Home are well kept now, and are neat, except that there is one very large room in the jail in which a number of prisoners, usually negroes, are huddled together, and it is impossible to keep this decent. Chatham—Dr. J. B. Matthews,Pitts-boro. No diseases to repoi-t. Thp jail and County Home buildings have been cleaned and lime used freely during the month. . Cherokee—Dr. J. F. Abernathy, Murphy. No epidemics among the people. County very healthy. Hog cholera in some parts. Chowan — Dr. R. H. Winborne, Barnitz. There was a supposed case of small-pox in Edenton, but it proved to be a mistake in diagnosis. We still have isolated cases of hog cholera. The great number of imperfectly drained swamps, and the almost uni-versal use of surface water from shal-low wells, are undoubtedly the causes of our endemic fevers. The officials endeavor to keep the jail and Home as clean as possible, and the Commis-sioners at the beginning of summer' usually order a thorough white-washing. Clay—Dr. W. E. Sanderson, Hayes-ville. Health of county better than in many years. An epidemic of hog and chicken cholera. The sanitary condi-tions of public buildings better than any time in two years. Cleveland—Dr. O. P. Gardner, Shelby. No diseases reported. Columbus—Dr. I. Jackson, White- BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH, 19 ville. A few cases of mild catarrhal fever. In the last three months there have been a number of driven wells sunk in the lower part of the county, and I am glad to say the health of that section has been wonderfully im-proved. Where once malarial fever held hiorh carnival, you now do not hear of it. Craven—Dr. J. W. Duguid, jN^ew Bern. One case of hemorrhagic malarial fever. Cumberland—Dr. J. Vance McGou-gan, Fayetteville. Six cases of measles and four of whooping cough. Dare—Dr. W. B. Fearing, Manteo. No diseases reported. Davidson—Dr. John Thames, Lex-ington. Some malaria and dysentery. Davie—Dr. James McGuire, Mocks-ville. Very little sickness. Duplin—Dr. J. C. Grady, Magnolia. No report. Durham—Dr. JohnM. Manning, Dur-ham. No diseases to report. Edgecombe—Dr. L. L. Staton, Tar-boro. Five cases of measles in the southern part, one of diphtheria, and two of hemorrhagic malarial fever. Forsyth—Dr. E. F. Strickland, Beth-ania. Dysentery in some parts. Very little sickness. Franklin—Dr. E. S. Foster, Louis-burg. La grippe, with some pneu-monia here and there. Gaston—Dr. J. B. Jenkins, Dallas. One case of diphtheria and one of typhoid fever. Mumps not quite so prevalent as last month. Gates—No Board of Health. Graham—No Board of Health. Granville—Dr. T.L. Booth, Oxford. Eight cases of measles. Health of county exceptionally good. Greene—Dr. Joseph E. Grimsley, Snow Hill. Measles (100) and malarial troubles in all parts. A few cases of pneumonia. Guilford—Dr. W. J. Richardson, Greensboro. Whooping cough in all parts. Bronchial, catarrhal and malar-ial diseases. Halifax—Dr. I. E. Green, Weldon. Thirty-five cases of measles and four of whooping cough. Very little sickness in most parts. Harnett—No Board of Health. Haywood — Dr. J. Howell Way, Waynesville. Six cases of typhoid fever. Very little serious sickness. Mild acute catarrhs of respiratory and digestive tracts. Henderson—Dr. H. L. Ashworth, Hendersonville. Two cases of typhoid, fever. Hertford—Dr. John W. Tayloe, Union. One case of typhoid fever. Very little sickness. Hyde—No Board of Health. Iredell—Dr. W. J. Hill, Statesville. Malarial fever, laryngeal, pulmonary and bronchial troubles. Jackson—Dr. Wm. Self, Webster. No diseases to report. Improvements have been made in the jail that will add to the comfort of prisoners. Johnston—Dr. R. J. Noble, Selma. A few chills in all parts. Jones—No Board of Health. Lenoir—Dr. James M. Parrott, Kinston. Six cases of whooping cough. Little sickness. 20 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Lincoln—Dr. Thos. F. Costner, Lin-coln ton. No report. McDowell — Dr. George L White, Marion. Very little sickness. A few cases of diarrhoea and dysentery, and several cases of ulcerated sore throat. Macon—Dr. S. H. Lyle, Franklin. A few eases of whooping cough. Madison—Dr. Jas. K. Hardwicke, Marshall. No serious disease has pre-vailed. Martin—Dr. W. H. Harrell, Will-iamston. Xo diseases to report. The County Home needs repairing and needs extra help. Mecklenburg—Dr. H. M. Wilder, Charlotte. Dysentery in several parts. Mitchell—Dr. C. E. Smith, Bakers-vi! le. Xo report. MoNTGOiiERY—Dr. W. A. Simmons, Troy. Xo diseases to report. Xash—Dr. J. J. Mann, Xashville. Some dyt<entery. Xew Hanover—Dr. J. C. Shepard, Wilmington. Whooping cough, 100; scarlatina, 1 ; typhoid fever, 3 ; jjerni-cious, 1, and hemorrhagic malarial lever, 1. Northampton—Dr. H. W. Lewis, Jackson. Whooping cough and mea-sles prevalent in some parts. Onslow—Dr. E. L. Cox, Jackson-ville. A few cases of malarial fever and of pneumonia. Orange—Dr. D. C. Parris, Hillsboro. Measles, respiratory and malarial dis-eases. ^ Pamlico—No Board of Health. Pasquotank—Dr. J. E. Wood, Eliza-beth City. Several cases of whooping cough ; two of typhoid fever. La grippe and malarial fever. Pender—Dr. Geo. F. Lucas, Currie. Five cases of whooping cough. Good sanitary laws rigidly enforced are needed in our small towns and vil-lages. Perquimans—Dr. C. C. Winslow, Winfall. Two cases of pneumonia. Very little sickness. Person—Dr. J. A. Wise, Roxboro. Whooping cough. Pitt—Dr. Frank W. Brown, Green-ville. A dozen or more cases of erysip-elas. Some influenza, pneumonia and dysentery. Polk—Dr. C. J. Ken worthy, Tryon. No diseases reported. Randolph—Dr. T. T. Ferree. Ash-boro. Little sickness. Richmond—Dr. W. H. Steele, Rock-ingham. Two cases of typhoid fever and a few of dysentery. Robeson—Dr. T. A. Norment, Jr., Lumberton. Lumberton has voted for sewer bonds, and we will have great improvement in our sanitary condi-tion. Rockingham—Dr. Samuel Ellington, Wentworth. Five eases of scarlatina. Influenza in all parts. The sanitary arrangement of the jail is bad, but its condition is as good as can V>e expected. Rowan—Dr. John Whitehead, Salis-bury. Six cases of typhoid fever. Bronchitis and malarial fever in vari-ous parts. Rutherford—Dr. E. B. Harris, Rutherfordton. No diseases to report. The sanitary condition of the jail is as good as can be under the circum-stances ; the building is a bad one. Sampson—Dr. Jno. A. Stevens, Clin-ton. Health of county fairly good. No epidemic diseases to report. The jail is being overhauled and thor- BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 21 oughly cleaned and a new sewer put in. Dr. Stevens has been re-elected Superintendent of Health. Stanly—Dr. D. P. Whitley, Millingr-port. Whooping cough in nearly all parts One case of tj^phoid fever. Stokes—Dr. W. L. McCanless, Dan-bury. Influenza in all i:»ai'ts. Surry—Dr. John R. Woltz, Dobson. Measles in the southwestern part. A few cases of influenza, diarrhf^a and dysentery. Attention is behig paid to having cells at the jail and houses at the Home whitewashed. Since the formation of the chain-gang at work on the public roads the health of pris-oners, heretofore confined in cells, is much iiupi'oved. Savain-Dr. A. M. Bennett, Bryson City. No diseases to rei)ort. Transylvania—Dr. M. M. King, Brevard. One case of scarlatina. Quai-antine and disinfection carried out according to law. Union—Dr. J. E. Ashcraft, Monroe. One case of diphtheria and three of typhoid fever. Some dysentery. Vance—Dr. J. H. Tucker, Hender-son. A few cases of whooping cough, pneum'^>nia, catarrhal and mild mala-rial fevers throughout the county. Wake—Dr. P. E. Hines. Raleigh. Twelve cases of wliooping cough. Scattered cases of browchitis, colds, imeumonia, diarrhwa and malarial troubles. Health of county very good. An epidemic of chicken cholera near Wakefield. AVarren—Dr. Geo. A. Foote, War-rcaton. Measles and influenza in many parts. Washington — Dr. W. H. Ward, Plymouth. Chicken-pox, German measles and pneumonia in all parts. Watauga—Dr. W. B. Councill, Boone. Ten cases of measles in the western part. Measles has about subsided. Nothing else to report. Wayne—Dr. W. J. Jones, Golds-boro. Measles 77, in town and rural districts. Wilkes—Dr. J. M. Turner, Wilkes-boro. Two cases of typhoid fever. No other disease to report. I think our Commissioners will have a long-needed improvement made in our jail very soon, i. e., the putting in of a sewerage system. Wilson—Dr. N. Anderson, Wilson. A few cases of measles. Yadkin—Dr. T. R. Harding, Yad-kinville. Not much sickness of any kind. Yancey—Dr. J. L. Ray, Burnsville. No epidemic of consequence in any part. The jail is in pretty fair condi-tion. The present jailer is very care-ful. The Home is tolerably well kept. Eeview of Diseases for April, 1897. Bronchitis—From Guilford, Rowan and Wake. Cholera in Hogs—From Cherokee, Cliowan and Clay. Cholera in Chickens—From Clay and Wake. Diarrhoea—From Iredell, McDow-ell, Surry and Wake. Diphtheria—From Cabarrus, r^ald-well and Edgecombe. Dysentery—Fiom Alleghany, Dav-idson, Forsyth, McDowell, Mecklen-bui- g, Nash, Pitt, Richmond, Surry and Union—10 counties. Erysipelas—-Prom Pitt. Influenza — From Ashe, Pasquo- 22 BULLETIN OF THE NORTH uaKOLINA BOARD OF HEALTH. tank, Pitt, Rockingham, Stokes, Surry and Warren. Malarial Fever — From Craven, Davidson, Edgecombe, Guilford, Ire-dell, Johnston, New Hanover, Onslow, Orange, Pasqu'^tank, Rowan, Vance and Wake—13 counties Malarial Fever, Hemorrhagic— From Craven, Edgecombe and New Hanover. Malarial Fever, Pernicious— From New Hanover. Measles—From Hrunswick, Cabar rus, Caswell, Cumberland, Edgecombe, Halifax, Northampton, Orange, Surry, AVarren, Watauga, Wayne and Wilson —13 counties. MuMP^s — From Alamance and Cas-well. Pneumonia—From Onslow, Perquim-ans, Pitt and Wake. RoTHBLN—From Washington. Scarlatina—From New Hanover, Rockingham and Transylvania. Typhoid Fever—From Alamance, Beaufort, Burke, Haywood, Hender-son, Hertford, New Hanover, Pasquo-tank, Richmond, Rowan, Stanly, Union and Wilkes—13 counties. Varicella—From Washington. Whooping Cough—From Alamance, Brunswick, Cabarrus, Caldwell, Cas-well, Cumberland, Guilford, Lenoir, Macon, New Hanover, Northampton, Pasquotank, Pender, Person, Stanly and Wake—IG counties. Summary of Mortuary Eeports for April, 1897. (Twenty-four towns.) The towns wliosse reports are not vouched lor, printed in small type, are not included. White. CoVcl. Total. As^gregate population 7:i.;:i23 .-)5,163 138.48.5 Aggregate deaths 60 86 146 Representing annual death rate per 1000 9.8 18.8 1.3.7 Causes of Death. Typhoid fever :3 1 3 Malarial fever Oil Whooping cough 16 7 Measles 3 8 Pneumonia 7 15 22 Consumption 8 13 21 Brain diseases ,5 4 9 Heait diseases 3 8 11 Neurotic diseases 112 Diarrhoeal diseases 3 6 All other diseases 27 30 57 Accident Oil 60 86 146 Deaths under 5 years 19 30 46 ^till-born ". 4 12 19 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 23 Condition of Jails and County Homes by Counties for April, 24 BULLETIN OF THE NORTH CAKOLINA BOARD OF HEALTH. Condition of Jails and County Homes by Counties BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 25, Condition of Jails and Connty Homes by Connties.—Continued. JAIL. (BrH COUNTIES Pasquotauk... Pender Perquimans . Person Pitt Polk Randolph Richmond Rohesou Rockingham Rowan Rutherford ... Sampson Stanly Stokes Surry Swain r< S rt "3 'S , O 3 C HOME. 0) - © <v as <BOQO CD S?o ~ sf, >M o •:; a -7^ I C 2 *. c3 a cS s fair good good fair fair i 3 13 3 5 14 11 ' fair good good I 13 30 „ aj a .a 39 goo ~ Q,<B a , O 3 C - (B S O »- r- ^-1 CO S.3 O > 500 Transylvania .. Tyrrell + t no change good I + good fair 600 360 400 3 26 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH, Mortuary Report for April, 1897. Towns BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. METEOROLOGICAL SUMMARY FOR NORTH CAROLINA, APRIL, 189 Furnished by the North Carolina t'limate and Crop Service. 2r C. F. VON HERRMANN, DIRECTOR. STATIONS. TEMPERATURE, (Degrees Fahr.) Asheville 54.3 Beaufort I 61.2 Chavlotte 59.6 Chapel Hill 58.4 Highlands Henderson .... Littleton Louisburg Lenoir Monroe Morgantou Mt. Aii-y Moncure Newbern Oak Ridge , Pittsboro Raleigh Roxboro Rockingham.. Southport Salisbm-y Selma Saxon Tarboro Weldon , Wilmington.... 49.7 58.0 56.3 58.9 54 7 59.0 53.6 54.6 59.9 63.2 56.4 56 60.0 57.0 61.3 61.7 59.6 59.3 56.8 59.0 57.8 614 67 5 BULLETIN OF THE IKI iiELAnLiii. rr Published 3Ionthly at the Office of the Secretary of the Board, at Raleigh, N. C. Geo. G. Thomas, M. D., Pres., Wilmington, i C. J. O'Hagan, M. D., Greenville. S. Westray Battle, M. D., Asheville. j J. D. Spicer, M. D Goldsboro. W. H. Harrell, M. D., WllUamston. J. L. Nicholson, M. D., RicMands. John Whitehead, M. D., Salistam-y- I A. W. Shaffer, Civ. Eng., Raleigli. Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh. YoL. XII. JUNE, 1897. No. 3. Annual Meeting of the State Board of Health. In accordance with Section 8 of the " Act relating to the Board of Health '^ this occurred " on the second day of the annual meeting of the Medical Society of the State of North Carolina," and therefore at Morehead City on Wednes-day, 9th instant. The term of ofBce of all the members of the board expiring at this meeting, his Excellency CTOvernor Russell ap-pointed Drs. C. J. O'Hagan of Grreen-ville, J. D. Spicer of Goldsboro, J. L. Nicholson of Richlande, Col. A. W. Shaffer, Civil Engineer of Raleigh, and re-appointed the present Secretary. At the conjoint session of the old board with the State Medical Society, Drs. George G. Thomas of Wilmington, S. Westray Battle of Asheville,W. H. Har-rell of Williamston and Jobn White-head of Salisbury were re- elected. As thus constituted the Board met, all the members, except Dr. Battle, absent in Europe, and Dr. Whitehead, detained, we deeply regret to say, by the fatal illness of his young son, were present. Drs. George G. Thomas and Richard H. Lewis were unanimously re-elected President and Secretary respectively. A chemical and a bacteriological exam-ination of all municipal water supplies in the State was ordered, and the Engi-neer of the Board was appointed to collect, pack and ship the samples, and at the same time to inspect the works and water-sheds, and make report thereon. Upon the statement by the Secretary that, for various satisfactory reasons, the new edition of health pam-phlets ordered at the last meeting had not been printed, it was decided, in view of the present condition of the State treasury, to postpone their re-issue until a more favorable time. This necessity is much to be regretted, as the pamphlets, according to the testimony given by some of the mem-bers of the Board, have been eagerly read and discussed by the people, and have therefore done much to advance the cause of sanitation in the State. For the same reason the discontinu-ance of the Bulletin was discussed,but it was felt that such a step would plainly be backward, and the idea did not meet with favor. Instead, it was 30 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. decided to cheapen it by omitting some of the tables and the monthly reports from County Superintendents, and to change its character somewhat, in the discretion of the Secretary, so as to make it a more jjotent agency of in-struction rather than of statistics. The number of copies printed was or-dered to be increased sufficiently for the purpose, and one mailed regularly to every registered phj^sician in the State. We feel sure that both actions will be of benefit. The inertia of the medical profession being one of the greatest obstacles to sanitary progress (although the President of the Medical Society in his address suggested that it was a question as to what extent a physician ought to be expected to take bread out of his own mouth and those of his wife and children), we hope, by this monthly talk with all our doc-tors to quicken their interest in this truly noble work of saving their neighbors from sickness and death, re-gardless of its effect upon the bread question. Goldsboro was selected as the place for the next annual health conference with the people, the time to be fixed by the President and Secretary of the Board, after consultation with the resi-dent health officials. The Engineer of the Board was appointed to attend the next annual gathering of his profession and the Secretary the National Conference of State Boards of Health which is to meet in Nashville in August. The conjoint session with the medical society was one of the most successful in the history of the Board. While the usual hegira promptly began upon the announcement that the hour for the joint meeting had arrived, it was com-paratively small, and a number of the best men in the society remained. After suitable remarks by President Thomas on assuming the chair, the Sec-retary's annual report was read. Thereafter the question of the advis-ability of asking for legislation requir-ing the quarantining of measles—sug-gested by the President in his opening remarks—was taken up and elicited a lively discussion. While as a matter of theoretical sanitation it was consid-ered to be all very well, as a practical question applied to the rural districts of North Carolina it was not favored. Measles in childhood is generally regarded as a matter of course, a neces-sary and, usually, a trivial evil, and any attempt to impose the inconvenient and irksome restrictions of a quaran-tine for such a disease would cause great dissatisfaction in the present state of public sentiment as to sanita-tion. And after all, heretical as it may sound, is not it just as well that children should have the measles ? It is hardly to be expected that many can go through life without exposure at some time to this wide spread disease, and it is well known that it is much more dangerous to adults, to say noth-ing of its greater inconvenience at that period of life. Think of the mother of a large family of children, to whom her daily ministrations are a necessity, tak-ing it from one of her children. In Utopia doubtless measles has been stamped out but the old North State is not yet Utopia—not quite. In our biennial report the report of the bacteriologist on one of the water supplies in the State showed a very large number of bacteria, and a news-paper in another State commented editorially on it, and warned its read-ers to avoid that town. In conse-quence the representatives in the BULLETIN or THE NORTH CAROLINA BOARD OF HEALTH. 31 society from that community were dis-posed to find fault with us for printing it. But the bacteriologist stated that there was no ice with the sample, and no one who knows anything about it would therefore condemn the water on that score, and if the newspaper failed to call attention to that fact it would seem that there was some malice behind the pen that wrote the article. After writing instructions for taking, pack-ing and shipping the sample of water so plain and simple that we were almost afraid that we had insulted the intelli-gence of our health officers, and paying all the expenses incident thereto, the responsibility rests upon the local health officer. But nothing could have happened so calculated to insure the purity of that particular municipal water supply hereafter. The con-sciousness of being watched, and of the danger of being criticized by the un-friendly newspaper, practically guar-antees the future purity of that par-ticular water. It was just what the Board hoped to accomplish when a year ago it ordered a single examina-tion (all it could pay for) made. The water company itself will see to the purity of its water. Hereafter the samples will be taken by a member of the Board in person, as indicated above. We shall miss the retiring members of the Board greatly, and we feel that some special acknowledgment should be made to Prof. Venable and Mr. Chase for their long and faithful service, both being always so interested and so help-ful, by writing papers and talking at the health conferences, as well as in the routine ways. But the new ap-pointments of His Excellency are all strong men—" present company, of course, excepted "—and we feel that the Board will continue to be a benef-icent infiuence in the State. Summary of Reports from County Superintend-ents of Health for May, 1897. (Eighty counties reporting). In the blanks on which these reports are made the following items are called for : 1. The number of cases of small-pox, measles, whooping-cough, scarlatina, diphtheria, typhoid fever, pernicious malarial fever, hemorrhagic malarial fever, yellow fever and cholera which have occurred in the county during the past month. 2. The diseases which have been prevalent in the county, and in what parts. 3. Epidemics among domestic ani-mals. 4. Remarks as to special unsanitary conditions in the county. In few counties do physicians gener-ally report these details to the Super-intendent, though furnished with blanks for that purpose, and in most cases he has to depend upon himself alone in making his report. Details as to the jails, houses of cor-rection, and county homes are also given in these reports, and will be found tabulated on other pages. Alamance—Dr. R. A. Freeman, Bur-lington. Several cases of whooping-cough and some typhoid fever. Alexander—Dr. T. F. Stevenson, Taylorsville. Two cases of typhoid fever. The Yadkin river in the north-eastern part of the county is the cause of malarial fever. Alleghany—Dr. Robt. Thompson, Sparta. Dysentery in the eastern and northern parts. 32 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Anson—Dr. E. S. Ashe, Wadesboro. No report. ASHB—Dr. L. C. Grentry, Grumpier. General health of county never better. Beaufort — Dr. Joshua Tayloe, Washington. Twenty cases of measles and three of typhoid fever. Bertie—Dr. H. V. Dunstan, Wind-sor. Slight bowel troubles. Less sick-ness than usual. Bladen — Dr. Newton Robinson, Elizabethtown. No diseases of an epi-demic nature. Brunswick — Dr. D. I. Watson, Southport. Measles and whooping cough in many sections. Some typhoid fever. Buncombe—Dr. E. C. Starnes, Ashe-ville. Two cases of measles. Burke—Dr. J. L. Laxton, Morgan-ton. Bowel troubles among children in some parts. Very little sickness. More room is needed at the home. Cabarrus— Dr. Robt. S. Young, Con-cord. Thirty-seven cases of measles, 23 of whooping-cough, 2 of diphtheria, 4 of typhoid fever, and many of dysen-tery. Caldwell—Dr. A. A. Kent, Lenoir. One case of typhoid fever ; stomach and bowel troubles of rather mild form prevailing generally. Camden—No Board of Health. Carteret — Dr. Geo. N. Ennett, Beaufort. No diseases reported. I w^ould recommend that separate cells be fitted up in the jail for the colored and white prisoners. Caswell—Dr. W. O. Spencer, Yan-ceyville. Mumps,whooping-cough and bowel troubles in nearly all parts. Some remittent and intermittent fever in scattered sections. The jail is in about as good condition as the build-ing Avill permit. Catawba—Dr. D. McD. Yount, New-ton. Whooping-cough in all parts. Two cases of typhoid fever and three of hemorrhagic malarial fever. The jail and county home are as clean and as well kept as the faulty construction will admit. Chatham—Dr. J. B. Matthews,Pitts-boro. Two cases of scarlatina. The jail has recently been cleaned up and disinfected. Cherokee—Dr. J. F. Abernathy, Murphy. Erysipelas unusually pi-eva-lent. Four cases of fatal puerperal septiegemia in the last three weeks. Hog cholera in all parts, though not so fatal as usual. An epidemic of roup in fowls. Chowan ��� Dr. R. H. Winborne, Rockyhock. A few cases of intermit-tent fever and bowel trouble in all parts. The county commissioners have ordered all buildings at the county home whitewashed inside and out. Clay—Dr. W. E. Sanderson, Hayes-ville. No contagious or infectious dis-eases. Cleveland—Dr. O. P. Gardner, Shelby. No diseases to report. Columbus—Dr. I. Jackson, White-ville. Two cases of measles and of typhoid fever, and many of whooping-cough. Some diarrhoea. Hog cholera in many parts, but not to the extent of former years. Craven—Dr. J. W. Duguid, Dover. No report. Cumberland-Dr. J. Vance McGou-gan, Fayetteville. No diseases re-ported. Currituck—No Board of Health. BULLETIN OF THE NORTH CAKOLINA BOAKD OF HEALTH. 33 Dare—Dr. W. B. Fearing, Manteo. No sickness to report. Davidson—Dr. John Thames, Lex-ington. Two cases of typhoid fever. Dysentery in all parts. The jail and county home have recently been white-washed and are in good condition. Davie—Dr. James McGuire, Mocks-ville. No diseases reported. Duplin—Dr. F. H. Arthur, of Mag-nolia, was elected Superintendent of health in January. Durham—Dr. JohnM. Manning, Dur-ham. No report. Edgecombe—Dr. L. L. Staton, Tar-boro. Diarrhoea to some extent. Forsyth—Dr. E. F. Strickland, Beth-ania. Dysentery in all parts. The sanitary condition along " Muddy Creek'' is bad, as there is much decay-ing organic matter in said creek, caus-ing malarial fever. Franklin—Dr. E. S. Foster, Louis-burg, Dysentery of mild type in many parts. GrASTON—Dr. J. H. Jenkins, Dallas. Typhoid fever reported from dif-ferent sections. One case of pneumonia. A few cases of mumps. Gates—No Board of Health. Graham—No Board of Health. Granville—Dr. T.L. Booth, Oxford. An unusual amount of malarial dis-ease over the county. Greene—Dr. Joseph E. Grimsley, Snow Hill. Measles all over the county —a hundred or more cases. One case of typhoid fever. Guilford—Dr. W. J. Richardson. Whooping-cough. Dysentery very prevalent. Halifax—Dr. I. E. Green, Weldon. Fifty cases of measles. Bowel troubles in some parts. Haywood — Dr. J. Howell Way, Waynesville. Very little sickness. A few cases of enteric troubles of simple form. Dr. Way has been re-elected Superintendent of Health |by the County Commissioners. Henderson—Dr. H. L. Ashworth, Hendersonville. Five cases of typhoid fever. Improvements have been made in the jail building and grounds. Hertford—Dr. John W. Tayloe, Union. General health of county good. Hyde—No Board of Health. Iredell—Dr. W. J. Hill, Statesville. Mumps and bowel troubles. Jackson—Dr. Wm. Self, Webster. Four cases of typhoid fever. The san-itary condition of the public buildings is good, except that the spring at the home has been condemned until cleaned and that the ventilation of the jail has been reported to the County Commis-sioners as bad. Johnston—Dr. R. J. Noble, Selma. Measles in the eastern part of the county. Jones—No Board of Health. Lenoir—Dr. James M. Parrott, Kinston. No report. Lincoln—Dr. Thos. F. Costner, Lin-colnton. Two cases of whooping cough. Dysentery and malarial fever in all parts. McDowell — Dr. George I. White, • Marion. Several cases of whooping-cough and a few of dysentery and typhoid fever. One of pneumonia. Macon—Dr. S. H. Lyle, Franklin. Two cases of typhoid fever. Diarrhoea and dysentery in all parts. 34 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Madison—Dr. Jas. K. Hardwicke, Marshall. Stomach and intestinal dis-eases. Martin—Dr. W. H. Harrell, Will-iamston. A few cases of diarrhoea and dysentery. Mecklenburg—Dr. H. M. Wilder, Charlotte. No report. Mitchell—Dr. C. E. Smith, Bakers-ville. Some pertussis in the western part. Less sickness than for months. The sanitary condition of the jail is very bad. Preparations for a new jail are going on. Dr. Smith is a member of the building committee. Montgomery—Dr. W. A. Simmons, Troy. Bowel complain ts in many parts. Moore—Dr, Gilbert McLeod, Car-thage. No report. Nash—Dr. J. J. Mann, Nashville. No report. New Hanover—Dr. J. C. Shepard, Wilmington. Whooping-cough and diarrhoea in all parts. Northampton—Dr. H. W. Lewis, Jackson. A great many cases of measles and whooping cough in some parts. Onslow—Dr. E. L. Cox, Jackson-ville. One case of whooping-cough. Diarrhoea and dysentery in some parts. An epidemic of hog cholera. Orange—Dr. D. C. Parris, Hillsboro. Some cases of whooping-cough and measles. Bowel diseases in all parts. Malarial diseases are with us early this season. * Pamlico—No Board of Health. Pasquotank—Dr. J. E. Wood, Eliza-beth City. One case of typhoid fever. Malarial diseases in several parts. Pender—Dr. Geo. F. Lucas, Currie. No diseases to report. Perquimans—Dr. C. C. Winslow, Winfall. One ease of diphtheria. A few cases of cholera infantum and dys-entery. Person—Dr. J. A. Wise, Roxboro. Whooping-cough in all parts. The jail is now in especially good sanitary condition. Pitt—Dr. Frank W. Brown, Green-ville. Diarrhoea, some dysentery and malarial fever in most parts. The sanitary condition of the county home has lately grown worse, and the food supplied is not so good as formerly. Polk—Dr. C. J. Kenworthy, Tryon. Health of county excellent. Have noticed within the last two months an unusual number of cases of ca-tarrhal inflammation of the frontal sinuses. Randolph—Dr. T. T. Ferree, Ash-boro. Two cases of scarlatina and two of diphtheria. Little sickness. Richmond—Dr. W. H. Steele, Rock-ingham. Dysentery, rubella and typhoid fever to a limited extent. Robeson—Dr. T. A. Norment, Jr., Lumberton. No diseases reported. Lumberton will soon have a system of water works and sewers. Dr. H. T. Pope, of Lumberton, has been elected Superintendent of Health. Rockingham—Dr. Samuel Ellington, Wentworth. Dysentery in all parts. Six cases of whooping-cough. The san-itary arrangement of the jail is bad. Rowan—Dr. John Whitehead, Salis-bury. No report. Rutherford—Dr. E. B. Harris, Rutherfordton. No diseases to report. Sampson—Dr. Jno. A. Stevens, Clin-ton. Bowel diseases common ; a few cases of whooping-cough and malarial fever, and one of typhoid fever. BULLETIN OF THE NOETH CAEOLINA BOAKD OF HEALTH. 35 Stanly—Dr. D. P. Whitley, Milling-port. Whooping-cough of a severe type epidemic. Diarrhoea and dysen-tery in all parts. Stokes—Dr. W. S. McCanless, Dan-bury. Six cases of measles. Whoop-ing- cough (25) in all parts. Surry—Dr. John R. Woltz, Dobson. Two cases of typhoid fever. Measles in the southwestern part. Dr. Woltz was re-elected Superintendent of Health on the first Monday in May. Swain—Dr. A. M. Bennett, Bryson City. No diseases reported. Transylvania—Dr. M. M. King, Brevard. No diseases reported. Tyrrell—No Board of Health. Union—Dr. J. E. Ash craft, Monroe. Fifteen cases of whooping-cough and three of typhoid fever. Diarrhoea and dysentery in town and county. Vance—Dr. J. H. Tucker, Hender-son. A few eases of whooping-cough Two cases of scarlatina : they were iso-lated, and there has been no spread of the disease. Diarrhoea, dysentery and gastro-intestinal ailments have pre-vailed to a moderate extent. Wake—Dr. P. E. Hines, Raleigh. Twelve cases of whooping-cough and three of diphtheria. Diarrhoea, dysen-tery and malarial fevers. A mild epi-demic of hog and chicken cholera in the southwestern part. Some im-provement in the buildings is needed at the work-house. Seven reports were received for May. Warren—Dr. Geo. A. Foote, War-renton. Measles, grippe, bronchitis and iDneumonia. Washington — Dr. W. H. Ward, Plymouth. One case of typhoid fever. Dysentery, r5theln and malarial fever in all parts. Watauga—Dr. W. B. Councill, Boone. Whooping-cough in all parts. Very little sickness. Wayne-Dr. W. J. Jones, Golds-boro. Measles in all parts. Wilkes—Dr. J. M. Turner, Wilkes-boro. Four cases of typhoid fever. The sewerage in the jail, spoken of in the last report, has been put in, and will doubtless prove of great benefit to the health of the prisoners. Wilson—Dr. N. Anderson, Wilson. No diseases reported. Yadkin—Dr. T. R. Harding, Yad-kinville. Some dysentery of mild type and some malarial fever. There are some creeks that need drainage and a pond that causes fever. Yancey-Dr. J. L. Ray, Burnsville. Several cases of typhoid fever. Review of Diseases for May, 1897. Bowel Diseases— From Alleghany, Bertie, Burke, Cabarrus, Caldwell, Chow^an, Davidson, Edgecombe, For-syth, Franklin, Guilford, Halifax, Hay-wood, Iredell, Lincoln, McDowell, Ma-con, Madison, Martin, Montgomery, New Hanover, Onslow, Orange, Per-quimans, Pitt,Richmond, Rockingham,* Sampson, Stanly, Union, Vance, AVake, Washington, Yadkin—34 counties. Cholera in Hogs—From Cherokee, Columbus, Onslow and Wake. Cholera in Fow^ls—From Cherokee and Wake. Diphtheria—From Cabarrus, Per-quimans, Randolph and Wake. Erysipelas—From Cherokee. 36 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Influenza—From Warren. Malarial Feve;r.—From Alexan-der, Caswell, Catawba, Chowan, For-syth, Granville, Lincoln, Orange, Pas-quotank, Pitt, Sampson, Wake, Wash-ington and Yadkin—14 counties. Malarial Fever, Hemorrhagic— From Catawba. Measles—From Beaufort, Bruns-wick, Cabarrus, Columbus, Greene, Johnston, Northampton, Orange, Richmond, Stokes, Surry, Warren and Wayne—13 counties. Mumps—From Caswell, Gaston and Iredell. Pneumonia—From Gaston, McDow-ell and Warren. Puerperal SEPTiciEMiA — From Cherokee. RoTHELN—From Washington. Scarlatina—From Chatham, Ran-doli^ h and Vance. Typhoid Fever—From Alamance, Alexander, Beaufort, Brunswick, Ca-barrus, Caldwell, Catawba, Columbus, Davidson, Gaston, Greene, Henderson, Jackson, McDowell, Macon, Pasquo-tank, Richmond, Sampson, Surry, Union, Washington, Wilkes and Yan-cey— 23 counties. WHOOPiNG-CouGH-From Alamance, Brunswick, Cabarrus, Caldwell, Co-lumbus, Guilford, Lincoln, McDowell, Mitchell, New Hanover, Onslow, Orange, Person, Rockingham, Samp-son, Stfanly, Stokes, Union, Vance, Wake and Watauga—21 counties. Summary of Mortuary Reports for May, 1897. The towns whose reports are not vouched for, printed in small type, are not included. White. CoVd. Total. Aggregate population 61,467 45,867 107,334 Aggregate deaths 59 89 148 Representing annual death rate per 1000 11.5 23.3 16.5 Causes of Death. Typhoid fever 3 14 Malarial fever Oil Whooping cough 3 8 10 Measles Oil Pneumonia 16 7 Consumption 3 19 23 Brain diseases 4 6 10 Heartdiseases 8 2 10 Neurotic diseases 4 2 6 Diarrhoeal diseases 15 9 24 All other diseases 18 34 53 Accident 10 1 59 89 148 Deaths under 5 vears 20 40 60 Still-born 4 13 17 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 37 Condition of Jails and County Homes by Counties for May, 1897. 38 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Condition of Jails and County Homes by Counties.—Continued. BULLETIN OF THE NOKTH CAROLINA BOAKD OF HEALTH. • 39' Condition of Jails and County Homes by Counties.-CoNTiNUED. COUNTIES. Pasquotank Pender Perquimans . .. Pei-son Pitt Polk Randolph Richmond Robeson Rockingham . Rowan Rutherford .... Sampson Stanly Stokes Surry Swain Transylvania JAIL. !>>0 (D ^ S C »S O o no change fair very good very good . 2 ® pPiO good no change fair good toad 3 3 12 3 3 16 33(0.) 14 "3 .3 "I" gS " _ r^ O S c^ > -) ^ • c? . ^ T v^ \ ^ -^ ' ~ "* »- CO > S o P Cos; very good no change good crowded 950 HOME. s C fl no change fair jvery good good not goodt . 0) r3 .S 11 Tyi-rell Union Vance Wake Warren Washington Watauga. . .. WajTie Wilkes Wilson Yadkin Yancey good good goodt good 34 (7j) 10 3 360 good good t good good fair 13 8 83(c) o i 3 6 4 13 no change fair good good 600 3 > 2.S o <s s o Zi 2S Sol? 835 14 very good 33 no change good good good good good good good 15 good ?ood good fair fair 600 ]3 * Space exceeds 1,000 cubic feet. tSee Summary of Reports of County Sui^er^^^^^^^^ Health, (n) Includes 10 in House of Correction, (b) Includes 2 in House of Collection. (O in eludes 60 in House of Correction. 40 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Mortuary Report for May, 1897. Towns AND Reporters. FAYETTEVILLE I Dr. J. y. McGougan. f GOLDSBORO ( T. H. Bain, Sec. B. H. f GREENSBORO / J. S. Michaux, City Clk f HENDERSON ) Dr. W. J. Judd. HILLSBORO Dr. D. C. Parris. LENOIR Dr. A. A. Kent... MARION-Dr. G. I. ^yhite... MONROE Dr. J. M. Blaii-. OXFORD Dr.T. L. Booth Races. RALEIGH / T. P. Sale, Clerk B. H. f ROCKINGHAM ; Dr. W. H. Steele f ROCKY MOUNT i Dr. G. L. Wimberlej'. f SALEM / F. E. Keehln, H. Offl'r. \ SALISBURY / Dr. Jolin W^hitehead. f SCOTLAND NECK ( Mayor J. A. Perry. ) SOUTHPORT I H. K. Kuark, CityCrk. f Statfesville i Dr. W. J. Hill. f TARBORO / Dr. L. L. Staton. f WASHINGTON I Dr. .Joshua Tayloe. \ WELDON I Mayor J. T. Gooch. f WILMINGTON I Dr. J. C. Shepard. f WILSON I Dr. N. Anderson. j" WINSTON I Dr. John Bynum. f White. Colored. White. Colored. White. Colored White. Colored. White. Colored. White. Colored White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. White. Colored. I White. Colored. Popula-tion. ai BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 41 METEOROLOGICAL SUMMARY FOR NORTH CAROLINA, MAY, 1897. Furnished by the North Carolina (jlimate and Crop Service. C. F. VON HERRMANN, Director. STATIONS. Asheville Beaufort Charlotte Chapel Hill... Edenton Henderson .... Littleton Louisburg , Lenoir Monroe Morganton.... Mt. Airy Moncure New Bern Oak Ridge Pittsboro Raleigh Roxboro Rockingham. Southport Salisbury , Selma Saxon , Tarboro Weldon Wilmingtoji.. TEMPERATURE, (Degrees Fahr.) 59.8 67.8 66.6 64.8 67.3 66.1 63.6 66.3 63.1 &5.3 64.6 61.4 65.3 68.2 63.6 64.0 66.0 63.3 68.5 68.0 66.6 66.4 64.6 66.2 64.8 68.4 BULLETIN OF THE Ilorth Carolina Board of Health Published MontJdy at the Office of Secretary of the Board, at Raleigh, N. C. Geo. G. Thomas, M. D., Pres., Wilmington. S. Wkstray Battle, M. D.,..Asheville W. H. Harrell, M. D., Williamston. John Whitehead, M. D., Salisbury. C.J. O'Hagan, M D., Greenville. J. D Spicer, M. D., Goldsboro. J. L. Nicholson, M. D., Riehlands. A.W.Shaffer, San Eng., Raleigh. Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh. Vol. XII. JULY, 1897. No. 4. The Bulletin. As intimated in our last issue, a change in the make-up of the Bui,i.ETiN is inavi-gnrated with this number. The object of the change is to make it more popular in character, giving more reading matter and fewer statistics. It is not intended, how-ever, to do away -mih. the collection of statistics, and county superintendents are requested to take notice that they are ex-pected to make as full reports as hereto-fore. They will be tabulated and pub-lished in the Biennial Report. Comments on Monthly Reports of County Su-perintendents of Health for June. In lieu of the more or less full report of each superintendent heretofore printed, we have thought it well, instead of omit-ting them altogether, to call attention to and comment upon such matters reported as deserve special notice. The condition of the county jails, in the State, some years ago, was, in too many instances, a reproach to the local authori-ties, but we are happy to say that, owing, we believe, to the efforts of the Board of Health, and to the Board of Public Char-ities, a great change for the better has been effected, until now the abuses are few. For the month of June there was only one report of unsanitary conditions in the jail, of a general character, although the amount of air-space provided for each prisoner was, in two others, entirely too small. In both instances the over-crowd-ing was probably due to the presence of United States prisoners—the presence of whom, doubtless, was not taken into ac-count in the planning of the buildings — but the over-crowding is none the less to be deprecated on that account. Fortu-nately, at this season of the year, it does not practically make so much difference; all the ^^^ndows can be left open, but this over-crowding frequently occurs in winter, when it is a much more serious matter and should be corrected. The remedy, it seems to us,is a very simple one, and one,too,that would be of positive benefit to the county, and that is: Put the prisoners to work on the public roads, as is already the case in many counties. To show how this plan works, we quote the report for last month from Randolph county. Says Su-perintendent Ferree: "The jail business in this county is rather unprofitable, as most of the inmates or prisoners are on the public roads. The jailer resigned his 44 BULLEITN OF THE NORTH CAROLINA BOARD OF HEALTH. position some time ago." In this connec-tion, while it may not be entirely germane, we cannot refrain from giving our read-ers, upon the authority of one of its most prominent and substantial citizens, an ac-count of the method pursued in Lenoir county, which, so far as we are informed, is unique in the anfaals of penology. In that county the prisoners, except those guilty of the more serious crimes, are all kept upon the roads. While they are required to do an honest day's work, under the direction of an overseer, they are treated kindly, are well fed and clothed, are given a plug of tobacco, and twenty-five cents for washing, a week, and are allowed to stop work Saturday afternoon at 4 o'clock, go home and spend Sunday with their friends, reporting at 7 o'clock Monday morning. In several years only one at-tempt to escape had been made—by a white man, sentenced for two years, but he was recaptured and sent to the peni-tentiary. In our last conversation with the gentleman referred to, he told us of the astonishment of a deputy-sheriflf who had brought, one Saturday, from an ad-joining county, several convicts that had been loaned to Lenoir, securely manacled, when the Chairman of the Board of County Commissioners, to w^hom he delivered them, said to him, "Take off their hand-cuffs," and then to the prisoners: "Now boys, you go home, wash yourselves, put on clean cloths, and be back here bright and early Monday morning ready for work." And the last one of them reported for duty. Work on the public roads is the solution of the problem. It is somewhat interesting to note that, during June, malarial diseases, according to the reports, were relatively more preva-lent in the middle or rolling, than in the eastern or fiat section of the State, even one of the mountain counties, Cherokee, reporting a few cases. Some of the results of our crusade, two years ago, against the drinking of surface water from shallow, open wells, as a cause of malarial diseases, is gratifying, as shown by the report from Co-lumbvis county. It is to this effect: "The county is unusually free from fever. In the lower part of the county artesian wells are being sunk all over the county, and the health of every community using the water has materially improved." Since our last issue we have received the appended circular letter which explains itself. While we are quite an admirer of the Neivs and Courier, having been most favorably impressed by its efforts to ad-vance the cause of sanitation, and gratified by the many kind words it has had for our Board, we nmst confess that it did not ' ' tote fair ' ' with our charming and beau-tiful city of Asheville in this instance. We do not believe that the Editor would have deliberately done injustice to any-body, man or town, and so in the spirit of charity we will assume that he was awful-ly dyspeptic that day. Asheville, N. C, Jiily 6, '97. Dear Doctor : You have no doubt noticed an unfavor-able report on Asheville 's water supply, published in the Charleston News and Courier on May 28th, 1897, containing a garbled report from the North Carolina Board of Health report for 1896. The water on which this report was made, by the confession of the State Board Analyst, arrived in an unfit condition for analysis owing to the melting of the surrounding ice in transit, and yet the Nervs and Cou-rier, knowing this fact, and with a later favorable report before it, undertook in its editorial columns to damage the reputa-tion of our town as a sunmier resort and to warn summer tourists against the dan-ger of a residence here. The Health Board of our city, being convinced of the superior quality of our BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 45 water supply, not only by abundant clini-cal experience every summer with chil-dren and adults, who come here for health and recreation, and uniformly benefit by their stay, but also from the fact that its source is a clear mountain stream, several miles above town, determined to have an analysis made by a man of such national repute in his line as could leave no room for doubt about the thoroughness of the work . Prof. A. C. Abbott, of the University of Pennsylvania, being selected, the water was carefully collected, according to his di-rections, and sent to him, packed in ice to prevent multiplication of germ-life in transit, thus avoiding the error of the iirst analysis. The report of Dr. Abbott we take pleas-ure in now calling to your attention, feel-ing sure that no more complete indication of the purity and excellence of our water could be demanded. M. H. Fletcher, Chas. Iv. Minor, C. V. Reynolds, Committee of Board of IlealtJi. I certify that the two samples of the Asheville cit}^ water, the analysis of which, by Prof. A. C. Abbott, is herewith ap-pended, were collected by me directlj-from taps on the city water-mains, on June 24, 1897, the water passing directly from the tap into the container, and being at once sealed and packed in ice and for-warded to Professor Abbott; and the ap-pearance of said sample of water was in no wise different from that ordinarily drawn from the city mains. Chas. L. Minor, M. D. July f 1S97. NORTH CAROIvINA, 1 Buncombe County, j" Personally appeared before me, J. E. Gudger, a Notary Public in and for the county of Buncombe, State of North Caro-lina, Dr. Charles L. Minor, personally known to me, who maketh oath that the foregoing certificate is true. Witness my hand and notarial seal, this first (ist) day of July, 1897. J. E. Gudger, Nota>y Public. IvABORATORY OF HYGIENE, University of Pennsyi^'ania, Phii.adei.phia, June 28, 1897. Report of chemical analysis of a sample of water from Asheville, N. C, collected June —, 1897, by Dr. Charles \^. Minor, and received June 25, 1897: Condition of container. . . good condition Condition of sample good condition Color colorless Odor and taste odorless and tasteless Reaction neutral Parts per milliov. Total solid 60 Chlorine 2 Nitrogen as nitrates 0691 Nitrogen as nitrites Nitrogen free ammonia 0016 Nitrogen albuminoid ammonia . . 0295 Organic matter 9574 Indications: Chemically, this is a "pure" water, according to the classification of Dr. Chaumont. The result of the bacteri-ological examination—191 bacteria per cu-bic centimeter—is also exceptionally good for domestic water supply. Altogether, we consider the result of the examination to be indicative of a very satisfactorj-water. A. C. AbboTT, Per D. II. B. Cycling From the Standpoint of Health. Another note of warning has been sounded in regard to the possible evils of C3'cling. Under the somewhat ambigu-ous title of "The Hidden Dangers of Cyc-ling," an alarmist article recently appear-ed in the National Revic-v, pointing out some of the risks of injury to health to 46 BULLETIN OP THE NORTH CAROLINA BOARD OF HEALTH. which bicychsts are hable, and darkly hinting at others hkely to be incurred. The chief novelty of the article, lies, how-ever, in its suggestion as to cause. The The author. Dr. Shadwell, has written on the subject at various times, so that his views carry a certain amount of weight. To him also belongs the distinction of orig-inating the term "bicycle face," which has been so generally adopted to express the anxious, strained look many bicj-clists wear. The hidden dangers of the exercise, in the opinion of Dr. Shadwell, threaten women, and more particularly 3-oi;ng women, and the prediction is made that, in the course of a year or two, quite a dif-ferent story will be heard concerning the health-giving properties of cycling. Dr. Shadwell says: "Sufficient time has not elapsed since it became a general practice to bring the disadvantages to light—to the light, that is to say, of public recognition. Medical men have been kept stvidiously in the dark on the subject. They alwaj-s are in like cases. The succc^ises are blazoned forth, the failures concealed. So with bi-cycling. The fortunate persons who have derived lienefit, as well as pleasure, from it volubly recount their experiences to the largest audience they can command, and the chorus of praise waxes louder by reiteration. Those who have suffered, conceal the fact as far as possible, and esi)ecially from the doctor, for fear of be-ing forbidden their beloved 'bikes. ' That is noticeably the habit of young women, who are the chief sufferers. ' ' A few cases of serious breakdown that came under the author's notice are cited, one of a girl who developed exophthalmic goitre as the result of a long ride, and which became chronic. Appendicitis and internal inflammation are also laid to the charge of the wheel. But the complaints to which the writer in the N'afioiial Re-view chiefly v^dshes to draw attention, are the various forms of ill-defined nervous effects resulting from even a moderate use of the bicycle. The contention is made that the harmfulness of the exercise does not consist so nuich in excess as in the strain on the nervotis system. The jiropo-sition is laid down, that over-exertion is quite inadequate to explain the effects from which many cyclists suffer. The sj-mptoms are essentially nervous, and point to a cerebral and not a muscular origin. The theory brought forward as to the cause, is not the saddle, the vibration, or mechanical defects of the machine, but its instabilit}', and the constant strain re-quired to kee]3 it in an upright position. Dr. Shadwell holds that this incessant ten-sion is that wliich tells upon the nerves. The arguments introduced in this article are not sufTiciently definite, however, to be of u.se in drawing any conclusions. Tak-ing into consideration the immense num-ber of persons who nowadaj'S ride a wheel , it would be remarkable if among the num-ber there were not some whom cycling did not suit, and some to whom it was decid" edly harmful. Unless statistics can be given, clearly showing that to a fair pro-portion of riders the exercise is pernicious, a vagiie statement of hidden dangers will deter but few. That the nervous system is affected by the exercise is perfectly true, but here again the question of constitution and temperament comes in. Some can ride and experience no nerve trouble; some suffer slightly, while there are others to whom continued riding means a complete shattering of the nervous system. The anti-cycling idiosyncrasy does exist, but those with whom it is present must be aware of it, and, if wise, will use corre-sponding caution. The question of harm, resulting from nervotis tension, has been greath'^ exaggerated; cases of complete or even partial breakdown from this cause, are comparatively rare, probably fewer than in the old cj-cling days. In bicycles, as thev are made now, with better saddle- BULLKTIN OF THE NORTH CAROLINA BOARD OF . HEALTH. 47 springs and the pneumatic tire, vibration has been reduced to a minimum, and the trennilousness that iised to exist after rid-ing one of tlie earher machines has prac-tically ceased to occur. It should not be forgotten that tlie effect of bicycle exercise on health has already been very fairly tested as regards men. In England, cyc-ling has been in vog-ae for twenty-five years; ten years ago there were thousands of riders in that country, and if the con-sequences had been as disastrous as its opponents endeavor to prove they rnust be, the truth would have been brought to light ere this. Various theories have been advanced to account for cycling affecting the nervous S3'stem in the way it does, but none of these explanations is quite satisfactory. That it lies wholly in the action of balancing is certainly not the case. Naturally, with an unpractised rider, the effort to keep in an upright position will prodtice consider-able nerve tension; on the other hand, to the expert, balancing has become as auto-matic an action as walking or running, and the strain will be infinitesimal. E^id-in crowded streets, on a rough road, down' a steep hill, or under any circvimstances when the senses of sight, touch, and hear-ing must be continually on the alert, would seem more likely to have a harmful effect than the act of'keeping Die equi-lil) riuni to one who is a master of the ma-chine. Cycling with women has r.ot )'fct recei\ed the test it has undergone with men, but the time has been long enough to prove that, on the whole, the exercise is decidedly good for them, and the bogy of hidden dangers need spread no alarm among their ranks. A woman organically sound can, under proper conditions, and using ordinary precautions, cycle with as little dread of bad results as a man, and, so long as she keeps strictly within the limits of her endurance, for pleasiire and health, and not for enmlation, it will cer-tainly benefit. Long rides and century runs can do no good, and probably may do harm. Hill-climbing should be avoided as much as possible, as it puts too great a stress on the large abdominal muscles, and a woman, wath her physiological peculiar-ities, should not submit herself to an undue strain. In the case of anaemic girls, cy-cling usually acts like a charm. The gen-eral tonic effect of an out-door life, and the change of thought and scene, have an invigorating action on the entire system, and all the organs of the body participate ill this beneficial result. The fact that there are dangers connec-ted with cycling cannot be denied; these, however, are not hidden ones, but are more or less palpable to every observer. It may be said that there is danger in teaching the practice to the quite young. Properly, cycling should not be carried on to any extent while the body is undergo-ing development. Any valvular disease should be an absolute bar to cycling, as the heart is the organ principally exer-cised. Acute inflammation of the genital organs should forbid the use of the ma-chine to women, although the exercise is often beneficial in chronic cases of uterine disease. The question finally resolves itself into one of moderation or excess, an<l the personal ecjuation in this respect is variable. A healthy man may be able to do one hundred or one hundred and fifty miles without exerting himself, while another, lo all appearances equally as healthy, should not do more than forty or fifty. Cyclists are too apt to be carried away by the spirit of emulation, and when they do so wth riders of a superior ca-pacity, they must expect to suffer. Each cycli.st should be a judge of his or her own capacity. — Medical Record. 48 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. The Bubonic Plague Bacillus as Studied at the Pasteur Institute. ( Report to Surgeon-General U. S. Marine Hos-pital Service.) 77-79 Rue Notre Dame Des Champs, Paris, France, June 14, 1897. Sir: I have the honor to submit the following for yonr consideration, concern-ing the epidemic of plague in Bombay and Kerachi, most of the information be-ing derived from the reports of Dr. Yer-sin to the Institute Pasteur, and imparted by Professor Roux in an address delivered at the weekl}' reunion of the workers at the institute : Mortality.—From the most reliable in-formation collected from all sources, it would seem that the average mortality in this epidemic in India has reached the ap-palling figure of 90 to 95 per cent, of those attacked. This is open to some doubt, as the Hindoos have displayed an aversion to treatment in hospitals, and compulsory removal to these institutions having been adopted as a rule, many cases occuring among the native population have been concealed, and do not appear in the total of cases or deaths. The mortality as re-ported is, therefore, probabh- rather be-low than above the truth. It will also be understood that these figures do not in-clude those subjected to serum therapy, of which s^Decial mention will be made in another portion of this summary. Types of the disease.—For convenience of classification, and in accordance with the clinical symptoms presented, the dis-ease in this epidemic has been classified as («) bubonic, or ganglionic; {b') sep-ticaemic; (c) pneumonic. Of these forms the bubonic has been the most com-mon; the pneumonic the most fatal. The method of infection, that is to say the point of entrance of the sjjecific microbe, is a point still under active discussion, and is different not only for the various types and forms given, but also varies in difTerent countries and in different sec-tions of the same coiintry. For example, in Hongkong, where the natives as a rule go barefooted, infection in a large num-ber of cases has been traced to abrasians and wounds of the lower extremities; in India, some covering ~or protection for the foot is usually worn, but the natives suffer from the bites of insects and ver-min, consequently the point of entrance of the infection has been largely upon the hands and arms. Infection through the intestinal or respiratory tract, while admitted, is as yet largely unexplained, for, in spite of the assertions of Wilm, soine breach of continuity would seem to be necessar}- for the entrance of the micro-organism. As a rule, a small red spot marks the point of infection; this be-comes successivel}- a vesicle and a pustule and in the ganglionic form, and in a large proportion of cases a general redness or a series of vesicles marks the passage of the infection along a l^-mphatic tract or chan-nel. These vesicles have been of very frequent occurrence in the Bombay epi-demic. Symptoms and course.—In the bubonic form the victim is seized wath a chill, follow^ed by a fever of greater or less in-tensity, sometimes reaching 41° to 42° C; there is an ovenvhelming prostration; nausea and vomiting and the rapid for-mation of a glandular enlargement, sur-rounded by an extensive oedema, forming the bubo which has given the most com-mon name to the disease. The bubo may or may not break down and go on to sup-puration. If it does the ganglionic form merges into the septicsemic, without any distinct line of demarkation between the two types. Early in the disease stupor, delirium, and a more or less profound unconsciousness mark the existence of aii intoxication or general .S3-stemic infection. In the septicsemic form it would seem that the infection has taken place through buij.?:tin of the north Carolina board of health. 49 rhe iutestinaL digestive, or respiratory passages, or has been secondary to the suppuration of a bubo. These cases are as a rule not as violent in their course as tlie other tj-pes, and furnish the larger ])ortion of the small number of recoveries. The pneumonic form is at once the most in.sidious in its onset, the most difficult of diagnosis, and the most fatal in its results. It is usually ushered in by a pain in the side, which becomes more pronounced as the disease progresses; the respiration l)e-comes difficult and embarrassed, and there is cough with a tenacious, dark colored, or bloody expectoration. It is through the examination of this expector-ation that the diagnosis is most easily made, as, spread upon a slide, stained and examined under the microscope, the presence of the plague bacillus in large numbers is at once established. The l)acillus is not in pure culture, but is ac-companied by diplococci, staphylococci, and streptococci, and in making the diag-nosis by this method the property of the plague bacillus of completely decoloriz-ing b}^ the method of Gram nmst be borne in mind. Post-mortem, the pneumonia is found to be generally lobular or disseminated in character, though it is sometimes lobar, sometimes involves a whole lung, or may indeed involve both lungs. The general characteristic of the lesions of plague is a tendency to hemorrhages, either into the parenchyma of the spleen or kidneys, the subdural and arachnoid spaces, the spinal cord, or into the loose connective tissue of various regions of the body. This ten den C3' to hemorrhages would seem to be a manifestation of the peculiar properties of the toxines formed by the plague bacillus in the process of growth, as it has been observed alike in animals subjected to inoculations with the culture of the bacillus and its isolated toxines. Among the sequelae of the plague may be mentioned, as most freqitent, long con-tinued suppuration of glands, boils, and carbuncles, and eruptive diseases of the skin, and paralyses, sometimes of a par-ticular set of muscles, sometimes of the lower and sometimes of the upper extrem-ities. These manifestations may persist, or the affected muscles may gradually ac-quire strength and tone. These manifes-tations ma)' be accounted for as to the suppurations by the fact that the plague bacillus is usually accompanied by the organisms of suppuration; as to the paraly-ses by the above-mentioned tendency to hemorrhages into the meninges and spinal cord. Viabilitv of the flagiic bacillus.—It would seem that the bacillus of plague, while not as sensitive to desiccation as the cholera spirillum, still loses its virulence by drying, and that to retain its virulence it requires the action of both heat and moisture. In ordinar}' water it will retain its activity for some time, but its existence in sterilized water seems to be limited to a period of from twenty-foiir to forty-eight hours. The presence of organic matter, animal or vegetable, and in a state of de-composition, would seem to furnish the most favorable nidus for its growth, which will account for its more or less pro-longed existence in Oriental countries, and the comparative rarity of its appear-ance in Evirope since the existence of modern and improved hj'gienic conditions. This does not mean, however, as was main-tained by some at the Venice conference, that filth and crowding are alone respon-sible for the disease. The malady is pre-eminently of bacterial origin, and wher-ever the microbe is found, there the plague is likely to develop. Scrian therapy and prc-ccutivc iuocu-latioii.— This branch of the subject I a]i-proach with considerable reluctance, for the reason that the serum therapy has not 50 buli,f:tin of the north Carolina board of health. in the Boni1)ay epidemic given results as brilliant as were hoped for from the emi-nently siiccessful experiments made upon avery small scale by Yersin in the epidemic at Hongkong. For this there are good and sufficient reasons, well understood by those best acquainted with the manufac-ture and preparation of the antipest serum. The figures will first be given, and expla,- nations entered into afterwards. In the Bombay epidemic there have been used serums from two sources, the one prepared by Yersin at the Pasteur Institute at Saigon, the other prepared at the Pasteur Institute at Paris, and forwarded to Yersin at Bombay. With the former serum, the mortality of all cases treated amounted to 33 per cent.; with the latter, the mortality has been approximately 50 per cent. The total mortality of all cases in which the serum therapy was inaugurated prior to the systematic intoxication—that is to say, on the first or second day of the disease—is 12 per cent. Compared with the mortality without the serum treatment, 90 to 95 per cent., there is nothing to be ashamed of even in these figures, but it is not the result that was hoped for. As a proph3'lactic meas-vire the results have been much more fav-orable. It has proved in this respect emi-nently successful, but a point involved in some doubt is the length of the immunity conferred. In one case the disease mani-fested itself in a person constantly ex-posed forty-two days after the preventive inoculation. This would point to a desir-ability of inoculations for those exposed, as physicians and attendants, at intervals not exceeding thirty to-thirty-five days. Fortunately we are able to cite cases where the inoculation was instrumental in preventing the disease, and this, I think, should establish the principle that in future epidemics it will be just as rational and scientific to practice preventive inoc-ulation as it is now customary to vaccinate those exposed to an infection of small-pox, with a view of preventing the spread of the disease. I would beg to relate the following in-cident: The Bombay manager of the local branch of the Credit Lj'onnaise resided with his wife, children, and a numerous retinue of native ser\'ants in a dwelling in an infected portion of the city. His little daughter was stricken with the pest in a virulent form; was treated -with the senim, and made a rapid and uneventful recovery. As a precautionary measure, the whole family were subjected to inoculation, and the same measure of treatment was of-fered to the native domestics. Some accepted and escaped infection, while six who declined on the ground of religious scruples, were all stricken, and five died. It seems that a more crucial test could not have been devised, or a more triumphant vindication obtained. I will endeavor now to briefly explain why the therapeutic results obtained have not been more brilliant, and the success more uniform. In the first place, the epidemic has been largely confined to the natives, a class notoriously suspicious and superstitious. It has been only with the greatest difii-cidty that they have been persuaded to accept the protective inoculation, and when stricken with the pest, their religi-ous scruples have often led them to de-cline the serum therapy until almost mori-bund. These cases have, of course, only served to reduce the ratio of recoveries to treatments, and to bring the method into disrepute among those prone to criticise and sneer, of whom unfortunately there have been too man}- in high places during this epidemic. Secondly, to be perfectly frank, the fault has been in the serum itself, as can thus be explained; The serum prepared by Yersin at Saigon had not only a strong immunizing power, but also very high BULLETIN OK THE NORTH CAROLINA BOARD OF HEALTH. 5 1 antitoxic or curative power, as is conclus-ively proved by the results in his twenty-three cases treated at Hongkong. Un-fortunately, the supply was small; Yersin departed for Bombay and an unfortunate accident in his laboratory prevented the continuance of this supply, and the further treatment and preparation of his already immunized and seasoned horses. Recourse, therefore, had to be had to serum prepared in the Pasteur Institute in Paris. A large demand had not been an-ticipated here, and the supply on hand was' also small, but in the belief that even a weak serum was better than none, there was issued to Dr. Yersin a quantity of serum which was known to have a high immunizing, but a comparatively low, an-titoxic or curative power. This is, in brief, the whole explanation. Every ner\'e is being strained to produce a stronger serum, but it is a matter which, in the very nature of things, takes a long time, and with a demand constantly ex-ceeding the supply, it is impossible at this time to do better, though, if only sufficient time is allowed, there is no shadow of a doubt that a product will be reached, whose potency vdll be a perfect vindica-tion of the faith of such men as Professor Roux and his assistants. The technical reason in brief is the following: If a horse is injected intra-peritoneally with a cul-ture of the plague bacillus, killed by ex-posure to heat, the animal in time ac-quires a certain immunity to these injec-tions, and his serum is found to have cer-tain preventive properties, viz.: it will protect an animal into which it is injected against a culture of the plague bacillus; in other words, it is preventive or prophy-lactic. This result has been arrived at by the action of the toxines contained in the killed culture, but it is to be borne in mind that the toxine is not in a soluble condi-tion, but it is largely held enveloped in the bodies of the dead microbes. On the contrar}-, if the horse is injected with a live culture of plague, or a soluble toxine, and intravenously instead of intra-peritone-ally, an immunity will be established, and the serum of the animal will be fovmd to have not only an immunizing power as before, biit in addition an antitoxic or curative power—that is to say, it will pro-tect an animal against the toxines of plague, or, the animal having been inocu-lated with plague, it vn\l exert its curative or antitoxic influence. The difference is one of degree and not of kind. Every antitoxic serum is immunizing to a high degreee, but the reverse does not hold good. It can therefore be laid down as a general rule that to prepare an immuniz-ing seriim the injection of killed culture or enveloped toxine is sufficient, while, to prepare an antitoxic one, either the cul-ture must be living, or the toxines in a soluble form and injected into a vein. Hence the difficulty. It is a most complex problem to dissolve the celluluse envelope of the microbe, and set free its toxine Avithout producing a chemical change in the product, and the matter is under con-tinual experiment. That it will be solved eventually there is no doubt, but in the meantime the horses have to be treated with live culture, and the process is one requiring great caution and care, as acci-dents not infrequently happen, and the treatment of the horse has to be suspended. It will thus be seen that the whole matter is one involved in a great deal of difficulty, and requiring much earnest thought and work for its solution. Nevertheless, I do not think it possible at this time to overrate^the importance of the stiidy of the toxines and antitoxines of the infectious and contagious disea.ses, as, to my mind, upon its development rests the whole future of preventive medi-cine. The study is at once fascinating and discouraging, for new difficulties con-stantly arise to take the place of those 52 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. which liave been overcome Ijy laborious effort. I have the honor, sir, to remain, very respectfully, yours, H. D. Geddings, Piis,<!cd Assishnit Surs^eon, U. S'. M. H. S. —Piihllc Ilralth Report, U S. M. H. S. Review of Diseases for June. 1897. (Eighty Counties Reporting.) Eight3--six counties have Superinteml-ents of Health. Except in the case of the more conta-gious and dangerous diseases, the super-intendent has, as a rule, to rely upon his own information alone, since few physi-cians can be induced to report cases of non-contagious disease to him. Where the number of cases is not given or the prevalence of a disease 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 coun-ties named: Measles.—Brunswick, ii; Cabarrus, 4; Cumberland, 3; Greene, 12; Halifax, 30; Hertford, 4; Johnston, 1; New Hanover, i; Northampton, manj-; Orange, epi-demic; Pasquotank, 10; Vance, a few; Wayne, 20; Washington, 10; Wilson, i — 14 counties. Whooping Cough.—Alamance, sev-eral; Bladen, a few; Brunswick, iS; Ca-barrus, 21; Carteret, 50; Catawba, a large number; Columbus, epidemic; Cumber-land, 3; Davidson, 4; Guilford, many; Hertford; Mitchell; Northampton, many; Onslow, 20; Pasquotank, 2; Perquimans, 8; Person; Rockingham, 8; Rowan, 2; Stokes, 27; Union, 20—40; Vance; Wake, 4; Watauga, 50; Yadkin, a few—25 coun-ties. Scarlatina.—Wake, i. Diphtheria.—Guilford, i; Perquim-ans, i; Rockingham, i; Wake, i. TvpHOiD Fever.—Alamance, several; Alexander, 4; Beaufort, 4; Burke, 5; Ca-barrus, 8; Caldwell, 15; Catawba, 5; Chowan, a few; Clay, 3; Cumberland, 2; Davidson, 12; Durham, i; Franklin, sev-eral; Gaston, in nearly all parts; Greene, 2; Guilford, 4; Henderson, 3; Hertford, 2; Jackson, 10; Lincoln, 4; McDowell; IVIartin, 3; Nash; New Hanover, 9; North-ampton, 5,; Orange; Pasquotank, i; Per-quimans, 4; Pitt, i; Richmond, 3; Rock-ingham, 3; Rowan, 4; Sampson, a few; vStanl}^, jo; Stokes, 7; Surry, 2; Swain, 2; L^nion; Vance; Wake, 4; Warren, i; Wa-tauga, i; Wajme, 10; Wilkes, in nearly all parts; Yadkin, several; Yancey—46 counties. jNIalarial Fever.—Alexander; Bertie; Bladen, a few; Cabarrus, in all parts; Ca-tawba; Chatham; Cherokee, a few; Davie; Durham, in all parts; Gaston; Granville, in all parts; Greene, in all parts; Guilford, Hertford; Lincoln, in all parts; Nash; New Hanover, in all parts; Orange, in all parts; Pender; Perquimans, in all parts; Person; Pitt; Richmond; Sampson; Union; Vance; Wake; Warren; Wayne; Wilson, a few; Yadkin, along certain creeks—32 coun-ties. Pernicious Malarial Fever.—Ca-tawba, i; Hertford, i. Hemorrhagic Malari.\l Fever.— Catawba, 2. DiarrhcEal Diseases.—Alleghany, in all parts; Ashe; Burke, to a limited extent; Carteret; Cherokee; Chowan, in all parts; Clay, a few; Cumberland, in all parts; Forsythe; Greene, in all parts; Halifax; Ha\-wood, in all parts; Macon; Madison; Martin, in all parts; Montgomery, in all parts; New Hanover, in all parts; Onslow, in all parts; Orange, in all parts; Pitt; Richmond; Rockingham, in all parts; Rutherford, a few; Samp.son; Stanly; Swain, in all parts; L'f^nion; Vance; Wake; Washington, in all parts; Wilson, a few; Yancey—32 counties. BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 53 Cholera in Chickens.—Cabarrus, Or-an,£ je, Perquimans. Cholera in Hogs.—Chowan, Colum-bus; Onslow, Pasquotank, Washint^^on. Distemper in Horses.—Cabarrus. JIURRAiN IN Cattle.—Jackson. The following counties report that there are no diseases worth mentioning: Bun-combe, Caswell, Cleveland, Dare, Edge-combe, Polk and Transylvania. No reports have been received from the vSuperintendents of Health of Anson, Cra-ven, Iredell, Lenoir, INIecklenburg and IMoore. Summary of the Mortuary Reports for June. 1897, (Twenty-two Towns). Onl}' the towns from which certified re-ports are received are inckided: W/iitc. CoVd. Total. Aggregate popvila-tion 62,917 46,417 io9,3;,4 Aggregate deaths . . 73 87 160 Representing annu-al death rate per 1,000 13.9 22.5 17.6 Causes oj Death. White. Col'd. Totah Typhoid fever 4 5 Malarial fever _ . o 4 AVhooping-cough . . 2 6 IMeasles i 2 Pneumonia i 3 Consumption 4 8 Brain diseases 4 3 Heart diseases 5 4 Neurotic diseases, . 2 o Diarrhceal diseases . 26 All other diseases , 24 Accident o 73 Deaths vinder five years 29 36 65 vStill-born 7 ib -"3 18 32 2 «7 16 9 4 8 3 4 12 7 9 2 44 56 2 160 54 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. Mortuary Report for June, 1897. Towns AND REPOKTEKS. Ashevllle... ( Dr. E. C. Starnes. I Durham ) Dr. J. M. Manning, i Fayetteville } Dr. .1. V. McGougan. ( GOLDSBORO ) T. H. Bain, Sec. B.H. ( Gkkbxsboho.. , j J.S.Mictiaux,C'y GPk ( Henderson ) Dr. .1. H. Tucker. ( HiLLSBORO } Dr. D. C. Parrls. ( Lenoik / Dr. A. A. Kent. ( Makion ) Dr. George I. White. ( Monroe. ) Dr. J. M. Blair. ( Oxford / Dr. T. L. Booth. S Raleigh ) L\ P. Sale, Cl'k B. H. i Rockingham ( Dr. W. H. Steele ( Rocky Mount ) Dr. G. L Wlmberley. ( Salem ) Mayor S. E. Butner. ( Salisbury ) Dr. John Whitehead. ( Scotland Neck > Mayor J A. Perry. ( Tarboko ( Dr. L L. Staton. j Warrbnton ) Dr. G A. Foote. S Washington ) Dr. Joshua Taj'loe. ( Weldon } Mayor J. T Gooch. ( Wilmington ) Dr. J. C. Shepard. ( Wilson ( Dr. N. Anderson. ( AViNSTON ) Dr John Bj-num. ( Popula-tion. n w. c. w. c. w. c. w. c. w. c. w. c. w. c. w. c. w. c. w. c. w. u. w. c. w. c. w. c. w. G. w. c. w c. w. G. w. G. w. c. w. G. w. G. W. G. W. G 8,0(KJ 5,00() 4,000 2,000 3,500 2,5(K) 3.600 2,000 5,.500 2,5(X) 2.250 2,0(K) 400 ,300 800 3(Kl 750 250 1,800 (iOO l,.'i(X) 1,(X)0 8,000 7,000 1,300 450 1,6(X) 1,0(X) 3,942 342 4,000 1,500 775 425 1,200 1,»00 1,000 ,500 3,000 2,.5rX) 700 750 9,000 13,0(;hi 2..500 2,(XK) 5,800 4,200 13,000 6,000 6,000 5,600 8,000 4,250 700 1,100 1,000 2,400 2,500 15,000 1,750 2,600 4,284 5,500 1,200 2,,500 1,5a) 5.500 1,450 22,000 4,500 10,000 Tempo-rary Annual Death-rate per 1,0(X). 12.0 0.0 12.0 12.0 6.8 19.2 3.3 36.0 4.4 52 8 16.0 12.0 0.0 40.0 0.0 800 32.0 0.0 13.3 20.0 16.0 24.0 9.0 8.6 9 2 80.0 22.5 0.0 6.1 70.2 33.0 32.0 46.4 28.2 10.0 0.0 12.0 0.0 12.0 19.2 0.0 16.0 21.3 24 9.6 60 20 7 32.8 7.4 12.0 12.0 15.0 19.5 14.1 17.1 21.8 24.0 15.0 19.2 8.8 27.4 13.8 11.2 32.7 40.0 4.8 8.0 15 3 83 22.4 8.0 25.2 c BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 55 County Superintendents of Health. Alamance Dr. Alexander Dr. Alleghany Dr. Anson Dr. Ashe Dr. Beaufort Dr. Bertie Dr. Bladen Dr. Brunswick Dr. Buncombe Dr. Burke Dr. Cabarrus Dr. Caldwell Dr. Camden No Carteret Dr. Caswell Dr. Catawba Dr. Chatham ; . . Dr. Cherokee Dr. Chowan Dr. Clay Dr. Cleveland Dr. Colum1)us Dr, Craven Dr. Cumberland Dr. Currituck No Dare Dr. Davidson Dr. Davie Dr. Duplin Dr. Durham Dr. Edgecombe Dr. P'orsyth Dr. Franklin Dr. Gaston Dr. Gates No Graham No Granville Dr. Greene Dr. Guilford Dr. Halifax Dr. Harnett No Haywood Dr. Henderson Dr. Hertford Dr. Hyde No Iredell Dr. Jackson Dr. R. A. Freeman. T. F. Stevenson. Robert Thompson. E. S. Ashe. L. C. Gentry. Joshua Tayloe. H. V. Dunston. Newton Robinson. D. I. Watson. E. C. vStarnes. J. L. Laxton. Robert S. Young. A. A. Kent. Board of Jlealth. George N. Ennett. W. O. Spencer. D. McD. Yount. J. B. Matthews. J. F. Abernathy. R. H. Winborne. W. E. Sandei-son. 0. P. Gardner. 1. Jackson. J. W. Duguid. J. Vance McGoiigan. Board of Health. W. B. F'earing. John Thames. James McGuire. F. H. Arthur. John M. Manning. L. L. Staton. E. F. Strickland. E. S. Foster. J. H. Jenkins. Board of Health. Board of Health. T. L. Booth. Joseph E. Grimslej-. W. J. Richardson. I. E. Green. Board of Health. J. Flowell Way. B. L. Ashworth. John W. Tayloe. Board of Health. W. J. Hill. William Self. Johnston Jones Lenoir Lincoln McDowell Macon Madison Martin Mecklenburg . . Mitchell Montgomery . Moore Nash New Hanover . . Northampton. . Onslow Orange Pamlico Pasquotank . . Pender Perquimans . . Person Pitt Polk Randolph .... Richmond . . Robeson Rockingham . Rowan Rutherford. . . Sampson Stanly Stokes Surry Swain Transylvania . Tyrrell Union Vance Wake Warren Washington . . Watauga Wayne Wilkes Wilson Yadkin Yancey .Dr. R. J. Noble. .No Board of Health. .Dr. James M. Parrott. . Dr. Thomas F. Costner. .Dr. George I. White. .Dr. S. H. Lyle. .Dr. Jas. K. Hardwicke. Dr. W. H. Harrell. .Dr. H. M. Wilder. .Dr. C. E. Smith. .Dr. W. A. Simmons. .Dr. Gilbert McLeod. .Dr. J. J. Mann. . Dr. J. C. Shepard. .Dr. H. W. Lewis. .Dr. E. L. Cox. .Dr. D. C. Parris. .No Board of Plealth. .Dr. J. E. Wood. .Dr. George F. Lucas. .Dr. C. C. Winslow. .Dr. J. A. Wise. Dr. Frank W. Brown. .Dr. C. J. Kenworthy. . Dr. T. T. Ferree. Dr. W. H. Steele. .Dr. H. T. Pope. .Dr. Sam Ellington. . Dr. John W. Whitehead. ,Dr. E. B. Harris. . Dr. John A. Stevens. .Dr. D. P. AVhitley. .Dr. W. L. McCanless. . Dr. John R. Waltz. .Dr. A. M. Bennett. Dr. M. M. King. .No Board of Health. . .Dr. J. E. Ashcraft. .Dr. J. H.Tucker. .Dr. P. E. Hines. . Dr. George A. Foote. . Dr. W. H. Ward. . . Dr. W. G. Councill. .Dr. W. J. Jones. Dr. J. M. Turner. .Dr. N. Anderson. , . Dr. T. R. Harding. ..Dr. J. L. Ray. 69-8-18-97-HOO. In.. •< BULLETIN '579 OF THE / florth GaFolma Board o Published Monthly at the Office of Secretary of the Board, at Raleigh^ N. C. Geo. G. Thomas, M D., Pres.^ Wilmington. S. Westkay Battle, M. D.,..Asheville W H. Harrel,l, M. D.,. ...... Wllliamston. John "SVhiteheab. M. D., Salisbury. C.J. O'Hagan, M D., Greenville. J. D Spicer, M. D., Goldsboro. J L. Nicholson, M. D. Richlands. A.W.Shaffer, Sak Eng., Raleigh. Richard ±I. Lewis, M. D , Secretary and Treasurer, Raleigh. Vol. XII. AUGUST, 1897. No. Comments on Monthly Reports of County Su-perintenrjenls of Health for July. We sincerely regret to chronicle the death of Dr. George X. Ennett, Super-intendent of Health of Carteret Cotinty. Our information ha\'ing been derived from a simple announcement of the fact in the newspaper, we cqn give no partic-ulars. May he rest in peace. Dr. J. M. Turner was elected on the first Monday in the month County Super-intendent of Health of Wilkes to succeed himself. Typhoid fever is reported by ten more counties this than last month, though in many instances it is said to be mild in character. We cannot tell to what ex-tent the law on the subject of typhoid fever has been violated, but we fear many times—through ignorance on the part of the householder, no doubt; but the at-tending physicians, if there be any against whom the charge would lie, have no ex-cuse, for a copy of the law was sent to every registered practitioner in the State. But even if the law had never been en-acted, the physician's responsibility would remain, for if he is competent to practice medicine he knows perfectly well that typhoid fever is spread ^nerally by the contamination of drinking water by the bowel discharges of a case of that disease emptied without ha\4ng been thoroughly disinfected. We sincere!}- hope that none of our readers have been g^iilty of this negligence, which we think, in the light of modem medicine, could properly be de-nominated criminal. As the best of vis are liable to become lax at times, we do not feel any apology to be necessary for print-ing the section bearing on the subject. It is this : "Sec. 21. Any householder in whose family there is, to his knowledge, a person sick of cholera «r t3-phoid fever, who shall permit the bowel discharges of such sick person to be emptied \rithout first hav-ing disinfected them according to the in-structions to be obtained from the attend-ing physician or the county superintend-ent of health shall be guilt}' of a misde-meanor, and upon conviction shall be fined not less than two nor more than twenty-five dollars, or imprisoned not less than ten nor more than thirty days. And in cases where such undisinfected discharges are emptied on the water-shed of any stream or pond furnishing the source of water supply of an}- public in-stitution, city or town, the penalty shall 58 BULIvETIX OF THE NORTH CAROLINA BOARD OF HEALTH. be a fine of not less than twenty-flve nor more than fift}' dollars, or imprisonment for not more than thirty days. And any physician attending a case of cholera or typhoid fever who refuses or neglects to give the proper instruction /or such dis-infection as soon as the diagnosis is made, shall be deemed guilt}- of a misdemeanor, and upon conviction shall be fined not less than ten nor more than fifty dollars. ' ' In this connection we think it proper to quote the following ' ' personal ' ' note, and therefore the county shall be name-less on one of the reports. ' ' I regret to have to report typhoid fever in , while a large and populous count}- near has no cases reported. Yet we who live near know of several deaths from that disease in said count}- this summer. ' ' If this be true, and we have no reason to doubt it, knowing the reporter, it means that at least one superintendent is care-less in making his reports, or, as is more . likely, we hope, has a right to complain of the failure of the physicians of his county to report their cases to him. This state of things is manifestly unfair, and we trust superintendents will be careful to make as full reports as possible. Scarlet fever, we are gratified to note, was promptly stamped out in Granville county by the faithful efforts of the super-intendent enforcing a strict quarantine. Milk sickness, that curious and inter-esting disease, is reported in the "heavy mountainous portions " of Cherokee. Malarial diseases are somewhat less prevalent than in June. While more widespread in the flat country they seem to be milder in character than in the hill countr}', as only one case of the perni-cious form is reported from the East-ern section, and five cases of the hemor-rhagic from the Middle section of the vState. The following reports from Franklin and Mitchell counties, respectively, in re-gard to improvements in their jails are encouraging: ''The jail" (in Franklin) "has just undergone alterations which will add very much to the comfort of those confined therein, and enable us to practice such sanitary measures as could not be done before the alterations were made." From Mitchell: "Contract let yesterday, August 27, 1897, for the erec-tion of a first-class jail, at a cost of |5,30o. Jail to be completed by December i, 1897. Pure Water versus Malaria. (By Charles \V. Dabtiey, Jr., Ph. D.) Dr. Dabney made such an enviable reputation wdth our peoj^le when State Chemist, and has since grown so rapidly in the estimation of the whole countrv, that anything from his able pen will attract attention ; and we are very glad to be able to lay his views on so important a subject before our readers. It is a subject very near to our heart; and, while it is essen-tially a repetition of the views set forth in the health pamphlet issued by the Board two years ago on " Drinking Water in its Relation to Malarial Diseases," and by other writers on the subject, it is interest-ing and to the point. ' ' Line upon line, precept upon precept," etc., obtains in sanitation as in other things. — Ed. INIany persons not familiar with the country have the idea that malaria is uni-versally prevalent in the South, and that the large majority of the inhabitants of that section spend much of their time dur-ing the fall and spring in having chills. The fact is, that the South is no more sub-ject to malaria than any other section of our country. It is only necessary to ex-plain the cause of malaria and the condi-tions which promote it, to show that the people of the Southern »States need not fear malaria any more than those residing in other sections. The discoverv that malarial fevers are BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 59 caused by specific micro-organisms is justly considered as one of the greatest achievements of modern science. Bacte-riologists have now studied a number of these organisms, and, although their life-history has not been completelj^ worked out, they are prepared to tell us a good deal about them. These bodies belong to the order called by zoologists protozoa, and to a group of minute organisms known as hsematozoa, or parasites of the red-blood corpuscles. It is now generally agreed by advanced pltysicians, in all countries where these .organisms have been studied, that one or the other of them is always present in malarial fevers. So far, there is no evidence to show that they are ever characteristicall}- present in any other disease. At least four or five different forms of hsematozoa have been examined and partially studied, which differ not only in form, but in period of development. The relations of the para-sites to the symptoms of the disease have also been partially worked out, and it is most interesting to note that, in the case of several fevers at least, the paroxysm or chill corresponds in time to the process of segmentation or division. These little or-ganisms multiply by division. They will grow and divide into from twelve to twenty other lively young germs in sixty hours frofn the time they started. As soon as it separates, the new germ immediateh^ goes to feeding vigorously, preparatory to becoming a parent itself. Some microscopists have now become so expert that they can tell, by examining a drop of the blood of a patient, exactly what kind of fever, whether intermittent or remittent, and, in the case of intermit-tent fever, what the period of the recur-ring chill is. Some claim also that they can tell by the appearance and develop-ment of the organism approximately when the chill will occur. In intermittent cases there are at least two distinct forms of organisms, which cause tertian (or every other day) and quartan (or every fourth day) chills. It is now believed that other tj'pes of inter-mittent fevers are combinations of these, though some believe that thej- are due to other forms of hasmatozoa having differ-ent periods of development. The organisms of remittent fevers ap-pear to be more complicated, though one investigator has discovered in these cases a peculiar crescent-like hsematozoa, which develops vtithin the blood corpuscles and forms very characteristic and distinct structures. THese crescent hsematozoa are now believed to be the cause of the pernicious malarial fever of Italy. It is well known that malaria occurs particularly in low, marshy regions, where there is much decaying vegetable matter. Low-lying districts along bodies of fresh water, old river-beds and tracts of land which are rich in vegetable matter, and particularly those which are insufficiently drained, are favorable localities for the development of these germs. It is not meant that wherever these conditions oc-cur there malaria is certainl}' to be found. This is not the rule by any means. There are many districts that appear favorable for malaria which never have any. We only mean that wherever malaria actually oc-curs both conditions, viz., decaying vege-table matter and moisture, are sure to be found somewhere in the neighborhood. Malarial germs are distributed all over the world. Malaria is common in South-ern Russia, and malarial fevers are very severe in certain parts of Italy. Different kinds of malarial fevers prevail in Ger-many and France and England, and, in fact, in some portions of almost every countr}- on the globe. In America malaria has occurred in the past at different points throughout the entire Atlantic slope, and at some places along the great lakes, and in the West 6o BULLETIN OP THE NORTH CAROLINA BOARD OF HEALTH. and Northwest. It is now very rare in the Western and Northwestern States and along the Pacific coast, and seems to be disappearing graduallj' from the lake re-gion. It is encouraging also to be able to affirm that, beginning at the North, it seems to be disapppearing from the At-lantic States with the opening up of the '^'^untrv and the more perfect drainage of the land, though it is still frequently found in isolated regions along the coast from New York, south. It is distinctly a disease that characterizes new and un-opened countries, and recedes as the coun-try is thoroiighly opened lap and drained. The relations of malaria to climate are not so thoroughly understood. It does not belong exclusively to hot countries. All we know now is that malarial germs become more prevalent with the increas-ing heat. Along the Atlantic coast we ma}' have a few cases in May, and more as the heat increases, continuing into Sep-tember and October. A tolerably high summer temperature seems to be one of the essential conditions for the develop-ment of the germ where it occurs, but it is not necessary for this heat to be con-tinued over a long time, as in the tropical regions. As regards the relation of the germs to hot and wet seasons, little can be positively asserted, though it appears that in the tropics malarial fevers are most prevalent in rainy seasons, while in the temperate zone they are more numer-ous after a long, hot season, followed by abundant rain. If either the heat or moist-ure is excessive the development of mala-rial germs appears to be cheeked for the time. We do not know how these germs prop-agate in the swampy lands, 'or how they get into the system. Many facts indicate that they are carried to some distance by winds. They certainly appear to survive better in damp weather than in dry. Thiis the infection seems most liable to occur at night or through exposure to damp air or falling dew. It is believed that in this way the natural waters in malarial re-gions, especiall}- those of sluggish streams or marshes, become the carriers of the germs. The above facts suggest certain simple means of prevention, which ought always to be observed by those who reside in a region liable to be infected by malaria. Thorough drainage of all lowlands, esjDe-cially those containing decaying vegetable matter, or other means for removing the conditions favorable to the development of those germs, should always be adopted where possible. Where this is not practi-cable, and in all cases where any doubt prevails as to the existence of malaria, the people should avoid exposure to the night air while the dew is falling, or, better still, at an}' time of night. In all cases care should be taken that the drinking-water is free from the infection. The planting of trees has been held to interfere with the transmission of the germs by the prevailing winds. In many portions of the country where malaria occurs this is well understood by the older inhabitants, who always build their houses so that a large body of woods stands be-tween them and the dangerous swamp or river bottom. In malarial sections the cotton crop, especially when grown on rich, damp bottom lands, leaves a great de
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 | 1897; 1898 |
Subjects |
Diseases--Reporting Genealogy Institutional care Meteorology--Observations Mortality--Statistics Prisons--Statistics Public Health--North Carolina--Periodicals |
Place | North Carolina, United States |
Time Period | (1876-1900) Gilded Age |
Description | Volume 12, Issues 1-13, April 1897-May 1898 |
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 | 12,862 KB; 218 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_bulletinboardofhealth189798.pdf |
Pres Local File Path-M | \Preservation_content\StatePubs\pubs_edp\images_master\ |
Full Text |
RECEIVED
JUL 20 1981
HEALTH SCIENCES LIBRW
BULLETIN
OF THE
Li
Published Monthly at the Office of the Secretary of the Board, at Raleiyh, N. C.
Geo. G. Thomas, M. D., P?es., Wllminf |