Health bulletin

              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hereby repealed.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repealed.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