Health bulletin

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DIVlflorOF HEALTH AFFAIRS LIBRARY
N.C. KEM. HOSP. U. N. C.
CHAPEL HILL, N.C.
(i®Mb'!SiI
PuUisKed bvm/TETflcmM smamw^RimR
I TKis Bulletin will be szrd^f^^o dnn cilfzen of tke Stafe upon request I
Entered as second-class nmt^at Postoffice at Raleigh, N. C. under Act of August 24, 1912
Published moiuirty at the office of the Secretary of the Board, Raleigh, N. C.
Vol. 73 ^ JANUARY, 1958 No. 1
JAN 31 ic^'-
DlVlSiOM
HEALTHAFfWRSlff^,^
PENDER COUNTY HEALTH CENTER
BURGAW, NORTH CAROLINA
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
G. Grady Dixon, M. D., President Ayden
John R. Bender, M. D., Vice-President Winston-Salem
Charles R. Bugg, M. D. Raleigh
Lenox D. Baker, M. D. Durham
H. C. Lutz, Ph.G. Hickory
Mrs. J. E. Latta Hillsboro, Rt. 1
John P. Henderson, Jr., M. D. Sneads Ferry
Roger W. Morrison, M. D. Asheville
Z. L. Edwards, D.D.S. Washington
EXECUTIVE STAFF
J. W. R. Norton, M. D., M.P.H., State Health Director
John H. Hamilton, M. D., Assistant State Health Director, Director
State Laboratory of Hygiene, and Editor Health Bulletin
C. C. Applewhite, M. D., Director Local Health Division
Ernest A. Branch, D.D.S. , Director Oral Hygiene Division
A. H. Elliott, M. D., Director Personal Health Division
J. M. Jarrett, B. S., Director Sanitary Engineering Division
Fred T. Foard, M. D., Director Epidemiology Division
E. C. Hubbard, B.S., M.P.H., Director Division of Water Pollution Control
List of free health literature will be supplied by local Health Departments or on
written request.
CONTENTS Page
Your Health and You 2
Notes and Comment 5
YOUR HEALTH AND YOU
BY WILLIAM H. RICHARDSON
State Board of Health
Raleigh, N. C.
There are many people, perhaps, who pose to give you some more which, on
|
are not informed as to what their the face of it, is beneficial to the
health department can do for them
—
average citizen.
what it is doing and what it will do Public health affords protection not
j
upon request. The State Board of only to the public in general, to par-
Health publishes an informative eight- ents, little children and infants, but
page booklet titled: "How Your Health also to the unborn baby, as well as its
Department Serves You." While the mother. i
publication is in condensed form, it The health department is working
does contain much pertinent informa- toward health for mothers and babies.
tion which the general public should Public health nurses make home visits
have. We have referred to portions of for health supervision and encourage
this booklet in the past, and now pro- expectant mothers to seek medical care
January, 1958 The Health Bulletin
early in pregnancy.
Public health nui-ses will visit the home
to teach mothers infant care. To aid in
saving the lives of premature babies,
special services, including transporta-tion
and hospitalization, are provided
for them through the health depart-ment.
Many health departments hold well-baby
clinics to provide medical super-vision
for infants, to give immunizations
and to offer information to parents on
the growth and development of the
infant and pre-school child. Pre-school
clinics are held in cooperation with the
schools and Parent-Teacher Associa-tions,
to give booster immunizations
and examine children for physical de-fects.
The children are referred to their
private physicians for medical care
when indicated.
Your local health department pro-vides
public health nursing service for
school children. Medical inspections are
given to children referred by the
teachers and public health nurses and
to selected groups of other children.
The children found to have physical
defects are referred to their family
physicians. Funds for correction of de-fects
are available through the joint
school and health departments' school
health program for those families un-t
able to pay for corrections.
' When necessary, the public health
nurses make home visits to urge par-ents
to have physical defects corrected.
Special programs of hookworm, nutri-tion,
chest X-ray examination, and
other health programs are offered to
teachers, school children and parents
by many local health departments.
The physically handicapped chUd
1 may come to the health department's
I monthly orthopedic clinic for physical-
' ly handicapped children. The physi-cians
holding the clinic are specialists
' in orthopedic work.
' Keeping the public informed about
i health is an important part of the
public health program. Every member
of the health department staff does
health education work as he or she
carries on public health duties. Many
health departments employ trained
public health educators who work full-time
on developing health education
programs in the communities.
The health educator and other public
health workers will help communities
organize to work on health problems.
The development of health councils,
neighborhood groups, adult study
groups, and community health projects
are all a part of a well-rounded pub-lic
health program.
The health educator and other pub-lic
health workers can assist schools in
developing units of study on health,
aid schools with special health projects,
work on programs of in-service train-ing
for teachers and provide materials
and films for school groups.
Assistance is given to clubs, volun-tary
and official agencies and indi-viduals
in planning for health projects
and programs and by providing them
with materials and information on
health. An effort is made to coordinate
the program planning of groups to
enable maximum benefits in the com-munity
health program.
The health educator and other staff
members use the radio, newspapers,
films, pamphlets, posters, exhibits, bul-letin
boards and other media to pro-vide
the public with accurate, up-to-date
health information.
Keeping the official record of births
and deaths is one of the basic jobs of
many health departments. Birth rec-ords
are important for entrance to
school, for employment and on other
occasions when date of birth must be
established. Death certificates are
necessary in the settlement of insur-ance
and legal matters.
Certain diseases are reported to the
health department by private physi-cians.
This information enables the
health department to plan immediate
action to prevent communicable dis-eases
from spreading and chart the
progress of disease control.
The local health department keeps
records on the services provided to in-dividuals,
families and the community.
Studies of populations, causes of
death, diseases occurring in the com-munity
and studies of rates of disease
and death are made use of by health
departments and are also helpful to
\
The Health Bulletin January, 195S
schools, organizations and other
agencies in planning long-range pro-grams.
The public health program, just like
modern medical care, must have the
services of accurate laboratories. The
public health laboratory services for
your community may be in your local
health department, or your health de-partment
may use the services of the
State Board of Health.
Regular tests are made of milk sup-plies
to safeguard the milk you buy.
Public and school water supplies are
tested for purity. Private approved
water supplies will be tested upon re-quest
to your local health department.
Your health officer and your physi-cian
can use the public health labora-tory
service as an aid in diagnosis.
Services for certain examinations of
blood, feces, urine, sputum and other
specimens are provided by the public
health laboratories.
Cancer detection and diagostic clinics
are jointly sponsored by your local and
state health departments, local and
state medical societies and the local
and state divisions of the American
Cancer Society. The clinics are open to
North Carolina citizens thirty-five years
of age or over and citizens under
thirty-five years of age who have
symptoms of cancer. Ask your family
physician or your local health depart-ment
for information on individual
examinations or for the meeting dates
of the clinic nearest youi- community.
The State Board of Health mobile X-ray
trailers are available to carry on a
chest X-ray survey in counties. Certain
of the local health departments are
equipped to make survey films on
mobile or portable imits. Requests for
the service must be made by your local
health department.
Clinics are open to citizens desiring
guidance in emotional and mental hy-giene
problems. Your local health de-partment
can give you information
about the clinic services nearest to you.
The State Board of Health maintains
a free film service to provide films,
film-strips and slides on health sub-jects
for use by health departments,
clubs, schools and other organizations.
Films may be requested through your
local health department or directly
from the State Board of Health.
Consultation services of trained nu-tritionists
and dietitians are available
to schools, institutions and community
groups from the State Board of Health
upon the request of your local health
department.
The Oral Hygiene Division of the
State Board of Health provides dental
inspections for children under twelve
years of age. Dental care is given to
children under twelve years of age
whose parents cannot meet the cost.
This service is made available periodi-cally
upon assignment from the Oral
Hygiene Division.
The School-Health Coordinating Ser-vice,
supported jointly by the North
Carolina State Board of Health and
the North Carolina Department of
Public Instruction, provides services to
school and health department person-nel
through: consultative services, field
visits, in-service education, production
and use of certain materials and re-sources
in areas of health services,
health instruction, school environment
and physical education. This service
may be requested through the local
health officer or the local superinten-dent
of schools.
Your health department gives pro-tection
against disease. The private
physician and health department work
together to control contagious diseases
in your community. Your health de-partment
holds clinics to give immuni-zation
against whooping cough, diph-theria,
smallpox and typhoid fever and
also other immunizations. When a
serious contagious disease occurs in a
family, the public health nurse, at the
request of the health oflficer or a
private physician, will visit in your
home. The nurse will teach the family
how to carry out the doctor's instruc-tions,
including how to give good home
nursing care, and will instruct the
family in isolation precautions to pro-tect
other members of the family from
catching the disease.
Your local health department main-tains
a register of all known cases of
tuberculosis and their contacts and
January, 1958 The Health Bulletin
holds chest X-ray clinics for studying
these cases, and contacts and the pub-lic
at large. Persons with tuberculosis
are referred to their private physicians
and, when necessary, arrangements are
made for sanatorium care.
Your health department makes diag-nosis
of venereal disease cases and pro-vides
adequate penicillin treatment
where indicated. Each case of venereal
disease is carefully interviewed for
source of infection and for new con-tacts.
When cases of certain communi-cable
diseases occur, your health de-partment
traces down the source of the
diseases in order that additional cases
may be prevented.
Through education of foodhandlers
and regular inspection by the sanitar-ian,
safe methods of preparing, serving
and handling food in restaurants, in
meat markets, in abbattoirs, and in
other food handling establishments are
maintained. A grade sign, indicating
the relative degree of sanitation, is
posted in each food handling establish-ment.
Every citizen should look for
this sign when entering a food hand-ling
establishment. Regular inspections
are made of dairy farms and pasteuri-zation
plants to assure production and
processing of clean, safe milk.
NOTES AND COMMENT
BY THE EDITOR
THE PREVENTION
OF DISEASE
The practice of preventive medicine
is not an individual enterprise. Preven-tive
medicine not only protects indi-vidual
patients from acquiring disease
but, of equal importance, sees to it
that patients do not transmit their
disease to the community at large.
Complete health protection thus en-tails
a dual responsibility which is
more than one person or group can
handle.
At this time of year, in many areas,
the local public health agency appears
before its elected governing body to
justify proposed budgetry requests. On
the average, a health ofBcer asks for
one to three dollars annually for each
person residing in his assigned juris-diction.
In most cases, due to the re-turn
of federal and state tax monies
through grants, only part of the funds
requested comes from local taxes. This,
of course, is not meant to imply a sav-ing
of local tax monies; in fact, such
subsidies tend to increase the overall
cost as well as allow local politicians
to dodge certain responsibilities.
i
There is no need to reiterate the
' many preventive health services a
public health department can perform
for the community and the medical
professon. There is, however, a need
for medical leadership in the support
of adequate local tax appropriations to
maintain necessary preventive health
activities.
It is a curious paradox that two
branches of the medical profession
show their worth so differently. A
family physician is successful by his
overt demonstration of skill and acu-men,
while the success of a health de-partment
depends on the disease or
epidemic that never manifested itself.
Because the medical profession can
more clearly understand such health
services, it is up to them to spearhead
the financial backing needed for suc-cessful
official health programs.
Supporting a health department
budget results in more than just en-vironmental
protection; it is also,
another means for professional guid-ance
to the health department. When
the medical society believes its local
health department is satisfactorily
participating in the over-all health
program, it should not hesitate to
show its appreciation. The greatest
respect and tribute that can be paid
to public health personnel by organized
medicine is the recognition and back-ing
of public health activities, properly
performed. It should be obvious to tax
money custodians that with medical
society support only where applicable,
inadequacies and incompetence wDl
stand out as clearly as efficiency. Medi-
The Health Bulletin January, 1958
cal society participation will promote
health services that the community
understands and accepts and at the
same time will help to avoid duplica-tion
and waste.
As Dr. Gunnar Gundersen, Presi-dent-
elect of the American Medical
Association, pointed out in his recent
address before the American Associa-tion
of Public Health Physicians, "the
success of public health programs de-pends,
to a large degree, upon the
practicing physicians and other medi-cal
personnel and medical facilities in
the community. A health department,
unsupported by the medical profession,
divorced from the community's hospi-tals
and alienated from others in the
community working toward similar
goals, is a sorry thing indeed ....
These responsibilities are civic obliga-tions.
They must be met by all citizens
and especially physicians who are doc-tors
of medicine dedicated to rendering
service to humanity."
Editorial—The Journal of the Ameri-can
Medical Association, January
4, 1958
ACTIVITY RECOMMENDED
AS FATIGUE TREATMENT
Rest is not "a universal panacea" for
fatigue, even among aging persons, a
New York physician said recently.
In many cases, activity is a better
remedy, especially when the fatigue
results from "atrophy of disuse," Dr.
Theodore G. Klumpp, president of
Winthrop Laboratories, Inc., said.
In the absence of specific disease as
a cause of fatigue, it arises in older
persons from the normal physiological
processes of aging which reduce the
body's endurance; from loss of incen-tive,
motivation, and interest; from a
decline of glandular activity, and from
"atrophy of disuse."
Fatigue is "a normal incident of
normal living," but when its pattern
changes radically or it interfers with
ordinary activities, it becomes a serious
problem and needs medical attention.
Dr. Klumpp said in the Journal of the
American Medical Association. His
article is one of a series on aging.
"For a long time, the approach to the
problem of fatigue was thought to be
simple. A brief history of the patient's
mode of life was obtained with one
objective in mind—to cut out some-thing.
"It made little difference how little
the individual was doing—if the patient
was tired, something had to go ... if
the patient did nothing more than sit
in a rocking chair all day long, he was
no doubt advised to stop rocking and
go lie down," he said.
Now physicians know better. Follow-ing
the surgeons' practice of getting
patients up soon after surgery, they
now prescribe physical activity.
The pattern of American life is
especially designed to avoid physical
activity and stress—to the point where
physical exertion is virtually eliminat-ed,
the author said. Young people are
able to keep in relatively good physical
condition through sports and play, but,
as they grow older, they need to give
up these things. With the help of
"labor-saving devices, now including
electric golfmobiles," they begin to
suffer rapidly and too early in life
from atrophy of disuse.
This brings with it a loss of muscu-lar
tone and functional reserve of all
parts of the body, so that the slightest
added stress causes undue fatigue.
Maintaining an adequate physical re-serve
against stress is the best preven-tive
for such fatigue.
Fortunately some degree of fitness
can be regained through a program of
graded exercise at any time, except
where its loss is due to advanced
organic disease. The exercise should be
fun for the patient and should not be
drudgery. Along with the exercise, the
aging patient also needs an adequate
amount of sleep at night and if neces-sary
a short nap at midday.
Undue fatigue occures more com-monly
among overweight persons. In
addition to the obvious diet, the doc-tor
should prescribe some type of
exercise, despite the aditional "hearsay
to the contrary," Dr. Klumpp said. Its
greatest value lies in its stimulating
effect on endocrine gland activity and
in overcoming the tendency "to sleep
and snooze too much — a common
January, 1958 The Health Bulletin
counterpart of obesity."
Dr. Klumpp also noted that much
fatigue in aged persons occurs because
they lose their incentive and interest in
life. Then the doctor must help the
patient find a "new and absorbing in-terest."
RESIDENCY, INTERNSHIP
TRAINING INCREASES
More than 30 thousand physicians
last year took graduate training either
as an intern or as a resident.
According to the annual report on
internships and residencies, prepared
by the American Medical Association's
Council on Medical Education and
Hospitals, the number of medical school
graduates taking further training con-tinued
to increase in 1956-57.
There were 9,893 graduates serving
internships in 1956-57, an increase of
290 over 1955-56, while 23,012 were serv-ing
residencies, an increase of 1,587
over the preceding year. The training
was offered by 1,372 approved hospitals.
The percentage of available intern-ship
and residency positions filled in
1956-57 remained the same as that of
1955-56. Respectively they were 83 and
81 per cent filled.
The report in the Journal of the
A.M.A. also showed:
—During the past 10 years, there has
been an increase of 6 per cent in the
number of approved hospitals and an
increase of 31 per cent in the number
of internships offered.
—The number of interns per hospital
has increased from 11.3 ten years ago
to 13.9 in 1956-57.
—Federal hospitals offered 5.4 per
cent of the available internships, while
nonfederal governmental hospitals
offered 32 per cent and nongovern-mental
institutions the remainder. The
federal hospitals had the highest rate
of filled positions, with Army hospitals
having no vancancies and Public
Health Service hospitals having 99 per
cent filled. County and state hospitals
had occupancy rates of 91 and 89 per
cent respectively.
—There has been an increase in the
average monthly cash stipend paid to
interns. Hospitals affiliated with teach-ing
institutions raised their stipends
from an average of $87 in 1954 to $140
in 1956, while nonaffiliated hospitals
raised their stipends from an average
of $136 to $177. —The report listed those hospitals
with the highest autopsy rates, point-ing
out that the autopsy rate is regard-ed
as "an index of the scientific inter-est
of the medical staff in medical
education and in the progress of medi-cine."
Hospitals with low rates are
being urged to increase the number of
autopsies performed.
—The National Intern Matching Pro-gram,
which matches interns to the
hospitals in which they wish to train,
has matched more than 35,000 students
in the last six years without an error. —There are 17 residency review and
conference committees which function
as joint liaison groups of the A.M.A.
Council on Medical Education and
Hospitals with various specialty boards
and, in certain instances, the American
College of Physicians, the American
College of Surgeons, and the American
Academy of General Practice. —Seven specialties accounting for
more than three-fourths of all approv-ed
residencies offered were surgery,
internal medicine, pathology, obstetric-gynecology,
radiology, psychiatry, and
pediatrics.
AMA ENDORSEMENT
OF FLUORIDATION
On December 5, 1957, the following
recommendation proposed by the
Reference Committee on Hygiene, Pub-lic
Health and Industrial Health, was
passed by the House of Delegates of
the American Medical Association.
"The Committee has carefully re-viewed
the special report on fluorida-tion
of public water supplies prepared
jointly by the Council on Drugs and
the Council on Foods and Nutrition
and transmitted as supplemental Re-port
G, to the Board of Trustees. The
two Councils are to be commended on
their extensive study of the question
and the excellent bibliography and
tables which have been appended.
"After careful consideration of the
report, printed material and testimony.
8 The Health Bulletin January, 1958
your Reference Committee is of the
opinion that fluoridation of water sup-plies
is a safe and practical method
of reducing dental caries during child-hood;
it agrees with the conclusion of
the joint committee of the above-named
Council and recommends the
approval of the report."
The closing paragraph of the Com-mittee's
27 page report, which was also
adopted by the American Medical As-sociation
House of Delegates is as fol-lows:
"Fluoridation of public water sup-plies
should be regarded as a prophy-lactic
measure for reducing tooth decay
at the community level and is appli-cable
where the water supply contains
less than the equivalent of 1 ppm
(parts per million) of fluorine."
DRUG ADDICTION PICTURE NOT
BLEAK, SAYS A.M.A. REPORT
Frightening images of American
youth being preyed upon by unscrupu-lous
dope peddlers aren't very true to
life, according to an article in the
Journal of the American Medical As-sociation.
The article, first of three consecutive
ones scheduled to appear in the Jour-nal,
says that while drug addiction
among younger persons is a problem,
it isn't as alarming as most people
think it is.
The third article in the series states
that recent studies have shown that
"active proselyting by drug peddlers
plays a very small role in spreading
addiction."
Addiction apparently spreads, adds
the article, from person to person, with
addicts giving drugs to the beginner as
a friendly gesture.
The articles constitute the report of
the A.M.A.'s Council on Mental Health
in conjunction with its committee on
narcotic addiction. The report was first
presented to the A.M.A.'s Board of
Trustees in November 1956, and was
adopted by the A.M.A.'s House of
Delegates last June.
Generally speaking, the council mem-bers
feel that drug addiction should
be viewed as an illness. They also feel
there should be a movement toward
treating addicts medically rather than
punitively.
The group points out that in Great
Britain, where the approach to the
problem is more medical than that of
the U.S., addiction is considerably less
in terms of percentages.
In the U.S., the report continues,
"there are probably not more than
60,000 addicts . . . ." And, while addic-tion
in persons under 21 years of age
has increased since World War II, the
problem isn't as great as many people
think it is. Only about 13 per cent of
known addicts are younger than 21.
Nor is the problem of adolescent addic-tion
a new one. A similar alleged in-crease
of drug addiction among young
people followed World War I.
The council feels that while opiate
addiction is undesirable, it is not near-ly
as evil as the public and law en-forcement
ofiBcers think it is.
For one thing, "opiate addiction does
not cause the degree of damage to
physical health that other intoxica-tions
tolerated by our society can
cause."
Also, opiates don't incite addicts to
commit violent crimes which they would
not commit without the drugs. Opiates
are quieting drugs that repress hostile
urges and depress sexual drives.
Among the recommendations made
in the report is one that the A.M.A.
continue to study the problem and "to
support reasonable proposals designed
to improve the treatment and preven-tion
of drug addiction."
Such measures might include, adds
the report:
(a) Development of institutional care
programs in cities and states with
significant problems .
(b) Study of various means to obtain
institutional care in states with small
addiction loads.
(c) Development of programs for
intensive postinstitutional treatment of
addicts.
(d) Development of methods for
commitment of addicts to institutions
by civil action rather than through
actions in the criminal courts.
(e) Continued support and expansion
of mental health programs.
January, 1958 The Health Bulletin
The council strongly recommended
that the policy of voluntary admissions
for addiction treatment be continued
and extended.
The report also says that "in view of
all available evidence," the establish-ment
of clinics to supply drugs to
addicts would not be a wise move.
This latter opinion should, the report
adds, be subject to review from time to
time as new scientific knowledge be-comes
available.
FAMILY DOCTOR MAY HELP
PREVENT MENTAL ILLNESS
"Mood-altering drugs" combined with
good nutrition may help prevent men-tally
ill patients from being commit-ted
to mental hospitals, a Michigan
psychiatrist said recently.
Writing in the Journal of the Ameri-can
Medical Association, Dr. John T.
Ferguson, Traverse City, Mich., said
general practitioners "may well take
the lead in preventive psychiatry"
through the use of drugs and good
nutrition and the practice of the art
of medicine.
He reported on the use of various
neuropharmacological agents among
patients with chronic mental illness at
Traverse City State Hospital. The
study has been conducted for four
years.
In that time the new drugs, "to-gether
with the art of medicine as
practiced by family doctors," have
brought about many changes in the
patients and the hospital.
The number of wards for disturbed
patients has been reduced from four
to one and the number of open wards
has been increased from three to four.
The housekeeping is excellent, the
nursing care has improved, and shock,
sedation, and seclusion have been
practically eliminated. The patients
have taken a new interest in life and
the atmosphere of the wards has be-come
a happy one, although the num-ber
and type of personnel remains the
same.
At the start of the program, only
tranquilizers were used, but it was
found that they helped only the over-active
patients. Then analeptics (drugs
that increase activity) were given to
the more repressed patients. Eventually
combinations of these drugs were
given.
They produced what may be called
a "deep-change" in the patients. Dr.
Ferguson said. It is a change within
the patient that enables him to re-spond
to other treatment methods and
to participate In a rehabilitative pro-gram.
The combination of tranquilizers and
analeptics was especially effective in
confused, disoriented, and mildly over-active
elderly patients, although the
reasons for it are not understood, he
said. The improvement does, however,
give the hope that further research
and newer drugs will soon make it
possible for doctors to lessen, control,
and "even prevent mental changes now
associated with senility," Dr. Ferguson
added.
Early in the program a direct paral-lel
was noted between the physical
well-being of patients receiving drugs
and their rate and degree of improve-ment.
Therefore, all medical and surgi-cal
problems of the patients were
found and treated.
In addition, special diets and extra
feedings high in minerals and vitamins
were begun. Patients who had reached
a "plateau" in improvement on drugs
alone improved further when they were
given supplementary diets. This was
especially marked among elderly pa-tients.
As the patients became more man-ageable,
the attitude of the staff also
changed. This brought about better
understanding and more considerate
treatment, which in turn benefited the
patients.
In conclusion. Dr. Ferguson pointed
out that the drugs by themselves or
even when incorporated into a total
hospital program will not empty the
mental hospitals of the country. How-ever,
"by combining them with nutri-tional
therapy, family doctors may
hope to prevent commitment of mental-ly
ill patients encountered in their
home and office practices."
10 The Health Bulletin January, 1958
HOME IS BEST PLACE TO TEACH
CHILD HOW TO MAKE FRIENDS
The best time and place for learning
how to make and keep friends is in
childhood and at home, according to
an article in Today's Health.
Elizabeth B. Hurlock, Ph.D., outlined
in the American Medical Association's
popular health magazine some tips for
parents on how they can help their
children learn to make friends.
If good foundations for getting along
with others are laid in the home, a
child's chances for being popular are
greatly increased, she said.
Some of her suggestions to parents
are: —Set a good example for social re-lationships
in the family, since child-ren
quickly imitate patterns of be-havior
they observe around them.
—Supervise a child's early play with
his brothers and sisters and with the
neighborhood children. Show him how
to get along with others and explain
why a particular behavior is good or
bad.
As he grows older, discuss as a
family what makes certain children
popular and others unpopular. This
should be kept on an impersonal level.
—Encourage him to bring his friends
home and help him learn how to enter-tain.
—Watch for the first signs of jeal-ousy
toward a brother or sister and
correct the cause before it becomes a
habit.
—Play games with a child, so he can
learn how. Since most contacts with
other children will be in play, he must
be able to play as well as they do if
he is to be included in the group.
—Give him an opportunity to talk
when the family is together and help
him to talk about things that are in-teresting
to others.
—Call on him for help. Children who
develop the habit of helping at home
rarely sit back and expect others to do
all the work, nor do they grumble be-cause
they feel they are expected to do
more than their share.
—Expect him to consider the in-terests
and desires of the family. Teach
him to laugh at himself. And make
sure the home is a cheerful place.
Being cheerful will become a habit and
this goes a long way toward making
anyone popular.
Dr. Hurlock is former secretary-treasurer
of the American Psychologi-cal
Association's division on childhood
and adolescence.
DIAPERS DON'T CAUSE
DIAPER RASH
In spite of its name, diaper rash is
not usually caused by diapers, accord-ing
to an editorial in the Journal of
the American Medical Association.
Diaper rash is a general term for
several types of skin eruptions in the
"diaper region," the editorial said.
The commonest cause of a rash is
the formation of ammonia by bacteria
after urea is broken down. Other erup-tions
may be prickly heat, thrush, chaf-ing,
allergy, and various types of der-matitis.
All of these rashes are aggravated by
lack of cleanliness and softening of the
skin, which may occur if it remains too
long. The best preventive for diaper
rash is changing the diaper as soon as
possible after it becomes wet or soiled.
This prevents softening of the skin and
the formation of ammonia.
Since plastic or rubber pants increase
the likelihood of ammonia formation,
their use should be limited to those
"brief social occasions when prompt
changing would be inconvenient," the
editorial said.
Studies have shown that commercial
laundering of diapers in much more
effective than home laundering in re-moving
and stopping the growth of
ammonia-forming bacteria and in re-moving
irritating detergents, the edi-torial
said. The usual commercial pro-cess
includes three initial warm and
hot rinses, two soapings, bleaching, and
three rinses in hot water followed by
two rinses in chemicals which stop the
growth of ammonia-forming bacteria.
Although commercial laundering is
not essential to the prevention of
diaper rash, the more a home launder-ing
procedure is like that of com-mercial
launderies, the better the pro-tection,
the editorial said.
January, 1958 The Health Bulletin 11
Ti'eatment of diaper rash varies ac-cording
to the cause, but in any case,
the diaper region should be kept dry
and warm.
Preventive measures must be con-tinued
as long as diapers are worn, the
editorial concluded.
PHYSICIAN GIVES MEDICAL
ADVICE ON FLYING
Physicians can do a lot toward eas-ing
the fear and discomfort some
people associate with flying, an Air
Force doctor said recently.
Writing in a recent issue of the
Journal of the American Medical As-sociation,
Lt. Col. Frederick S. Spiegel
(MC), U. S. Air Force, Washington,
D. C, listed some of the things a doc-tor
needs to know if he is to advise
his patients about traveling by air.
He pointed out that more and more
people are flying each year. Last year
over 25 million passengers traveled on
U.S. domestic air lines. Many people
have had no experience with flying and
go to their doctor for advice.
Among the things the doctor should
know about airline regulations is that
permission must be granted by the
public health ofiBcials before any per-son
with a contagious or communicable
disease may be transported across state
lines, the colonel pointed out.
Diabetics requiring insulin may travel
only if their insulin and syringe are
kept in their hand baggage in the
passenger cabin, he said.
Physicians generally agree that a
woman with an imcomplicated preg-nancy
is not "sick" and can travel
safely. However, if she wishes to fly in
the very late stages of pregnancy, she
must present a certificate from her
physician stating that she will not
deliver "for at least 72 hours," Colonel
Spiegel said.
Infants less than six weeks old are
not generally transported by com-mercial
carriers unless there are ex-tenuating
circumstances. Then a pedia-trician's
certificate is requested, stating
that the infant is healthy and physi-cally
fit to fly.
Patients recovering from recent coro-nary
thrombotic attacks or those suf-fering
from coronary insufficiency need
careful examination before being ad-vised
to fly. Anemic patients and those
with certain types of respiratory diffi-culty
also need careful checking, the
author said.
"Children are only fair air travelers,"
the colonel said. Those under five years
of age experience airsickness and ear
trouble five to 10 times more frequent-ly
than adults.
The increased susceptibility to aii'-
sickness may be related to insecurity
and apprehension, while the ear dis-comfort
is associated with the difficulty
of teaching children to swallow while
descending in an airplane.
Airsickness in adults is no longer a
major problem, but when it does occur,
it is five times more frequent among
women than among male passengers.
As with children, this is probably due
to anxiety and apprehension. Fear of
airsickness hastens its development.
There are several effective remedies
for those who develop airsickness. The
same drugs also prevent it if taken be-fore
flight. The value of reassurance
by the doctor in such cases cannot be
over-emphasized, Colonel Spiegel con-cluded.
ELDERLY PERSONS NEED
TO REDUCE FOOD INTAKE
Most aging persons do not need to
alter their normal eating habits, ex-cept
to decrease the amount they eat,
a New York physician said recently.
Basically the nutritional require-ments
for the aged are the same as
for younger adults. How^ever, older per-sons
need fewer calories to maintain
their normal weight, Dr. Herbert Pol-lack
said in the Journal of the Ameri-can
Medical Association. The article is
one of a series prepared under the
auspices of the A.M.A.'s committee on
aging.
Dr. Pollack, associate professor of
clinical medicine. New York University
Postgraduate School of Medicine, said
the "obesity of the elderly is not due
to gourmandizing," but to eating the
same amount of food they did in their
younger years when their bodies need-ed
more food.
12 The Health Bulletin January, 1958
The body needs a decreasing amount
of oxygen as it ages. When this is
coupled with a decreased over-all
physical activity, it means that the
body needs fewer calories to maintain
the same weight.
Many religious rituals and certain
food practices among groups of people
indicate that they have long recognized
the place of periodic fasting and limit-ed
diets in the prevention of overeat-ing.
Now scientific knowledge of nutri-tion
and diet makes is possible to
develop diets that are rich in the
necessary nutrients but do not lead to
overweight, Dr. Pollack pointed out.
In some cases special diets must be
devised for aging persons with chronic
diseases which sometimes influence nu-tritional
requirements. Dr. Pollack said.
For instance, patients with Parkinson's
disease (paralysis agitans) sometimes
have trouble feeding themselves. They
may need concentrated food in liquid
mixtures as between-meal supplements.
Limitation of physical activity be-cause
of heart and circulatory diseases
or arthritis means there must be a
compensating decrease in caloric in-take.
Dr. Pollack said. Otherwise weight
gain is inevitable and this added
weight causes a fui'ther load on the
circulation and on weight-bearing
joints.
In setting up a diet, the doctor must
also pay attention to the "mechanical
state" of the food as well as to its
nutritional content since many elderly
people have difficulty chewing because
of tooth or mouth disorders.
Regardless of the type of patient re-ceiving
the diet, the doctor must make
certain that the diet "not only is
nutritionally adequate on paper but is
actually consumed by the patient," Dr.
Pollack said.
DRIVER TRAINING WOULD
LOWER INSURANCE RATES
Probably the best way to reduce
automobile insurance rates is to teach
teen-agers how to drive properly.
This would increase the number of
accidentless drivers which would help
reduce insurance costs, a New York
high school teacher has said.
Writing in Today's Health, the
American Medical Association's popu-lar
health magazine, David Star, Floral
Park, N. Y., said training would also
help reduce the rising number of fatal
accidents involving drivers under 25
years of age.
Yearly 1,600,000 boys and girls reach
legal driving age; 728,000 receive no
training except what is picked up from
friends and relatives.
"If everyone of our 1,600,000 16-year-olds
passed a driver training course, we
could in a generation put more than
30,000,000 drivers on our highways who
had been trained in safe and skillful
practices," Star said.
Since last February, Michigan has
had a law that says no one under 18
can be licensed to drive unless he has
passed an approved course of driver in-struction.
The cost of instruction in
the high schools is provided for from
licensing fees and the course requires a
minimum of 30 hours of classroom in-struction
and six hours of driving.
Among the subjects taught are the
motor vehicle's effect on social and
cultural life; the driver's physical re-quirements,
mental attitudes and social
responsibilities; characteristics of
streets and highways; legal structures
and codes; automotive mechanics and
maintenance; automotive consumer
education, and skills in driving.
"We used to think anyone could just
pick up driving, but we now realize
that instruction and coaching are just
as important in driving as they are in
athletics, music, or bridge building,"
Star said.
"When a youngster just picks up
driving, he usually acquires bad atti-tudes
from his parents or other drivers.
Faulty attitudes are much more often
at the bottom of young driver acci-dents
than lack of skill."
The more young drivers given knowl-edge
and healthy driving attitudes at
the beginning of their driving careers,
the fewer unsafe drivers of all ages
there will be in the years ahead, he
concluded.
DIVISION OF HEALTH AFFAIRS LIBRARY
N.C. MEM. HOSP, U. N, C.
CHAPEL HILL, N.C. RDtfCr.iViVtO
28 1958
I TKis BulJefm will be sent free to any ciiizen of ri\e 5kite upon reques-t J
Entered as second-class matter at Postoffice at Raleigh, N. C. under Act of Angust 24, 1912
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. 73 FEBRUARY, 1958
DR. J. MARTIN FLEMING
1867-1957
No. 2
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
G. Grady Dixon, M. D., President Ayden
John R. Bender, M. D.. Vice-President Wlnston-Salem
Charles R. Bugg. M. D. Raleigh
Lenox D, Baker, M. D. Durham
H. C. Lutz, Ph.G. Hickory
Mrs. J. E. Latta Hillsboro, Rt. 1
John P. Henderson, Jr., M. D. -» Sneads Ferry
Roger W. Morrison, M. D. Asheville
Z. L. Edwards. D.D.S. Washington
EXECUTIVE STAFF
J. W. R. Norton, M. D., M.PJI., State Health Director
John H. Hamilton, M. D., Assistant State Health Director, Director
State Laboratory of Hygiene, and Editor Health Bulletin
Robert D. Higgins, M. D., M.P.H., Director Local Health Division
Ernest A. Branch, DJ).S., Director Oral Hygiene Division
A. H. Elliott, M. D., Director Personal Health Division
J. M. Jarrett, B. S., Director Sanitary Engineering Division
Fred T. Foard, M. D., Director Epidemiology Division
E. C. Hubbard, B.S., M.P.H., Director Division of Water Pollution Control
List of free health literature wUl be supplied by local Health Departments or on
written request.
CONTENTS Page
A Tribute to Dr. J. Martin Fleming 2
Recently approved Public Health Regulations 4
Notes and Comment 10
A TRIBUTE TO DR. J. MARTIN FLEMING
BY ERNEST A. BRANCH, D. D. S.
State Board of Health
Raleigh, North Carolina
The North Carolina State Board of that dentistry be included in the pro-
Health and, indeed, the cause of public gram of the North Carolina State
health in North Carolina have suffered Board of Health. This motion was
a great loss in the death of Dr. J. carried, and North Carolina became
Martin Fleming on December 18, 1957. the first State to have dentistry as an
Dr. Fleming was a friend of public integral part of its public health pro-health,
in general, and of public health gram. Prom that time on Dr. Fleming
dentistry, in particular. It was he who gave generously of his time and ener- i
made the motion in the meeting of gies to the enterprise, thus rendering ,
the North Carolina Dental Society in great service to his profession, to ;
1918 that the Society give its whole- public health, and to the people of ;
hearted endorsement and approval to North Carolina. He favored and work-the
suggestion of Dr. George M. Cooper ed for all legislation which promoted
February, 1958 The Health Bulletin
public health dentistry in the State.
Dr. naming became the first dental
member of the Wake County Board of
Health in 1931 and served in that
capacity until 1942. In 1942, when the
younger dentists were called into
armed service and a dentist could not
be secured for position of school dentist
with the Wake County Health Depart-ment,
Dr. Fleming closed his office,
took the job and served until his
retirement in 1954.
Dr. Fleming engaged in the private
practice of dentistry in Raleigh from
1895 to 1942. He was one of the best
known and best loved dentists in
North Carolina. He exerted a great and
good influence in the affairs of the
North Carolina Dental Society, and
this Society conferred on him many
honors. He served as president of the
Society in 1903-1904. Dr. Fleming made
an outstanding contribution to dentist-ry
as a member and president of the
State Board of Dental Examiners from
1914 to 1926. In this capacity he had
an opportunity to encourage and in-fluence
many young dentists. For many
years, when the molding and making of
dentistry in North Carolina was in the
process. Dr. Fleming was chairman of
the Ethics Conunittee. To him
membership on this committee, as well
as on the Board of Dental Examiners,
was a mandate to uphold the standards
of the profession and also to protect
the rights of the people of North
Carolina to have the best in dental
service. It can be truly said that. In
carrying out this mandate, he brought
honor to himself and to dentistry in
North Carolina. Dr. Fleming believed
in hewing to the line himself, and he
expected the same of others. Those who
knew him well realized that his seem-ing
sternness was tempered with kind-liness
and a rare sense of himaor.
Perhaps Dr. Fleming's greatest ac-complishment
was writing the
HISTORY OF THE NORTH CARO-LINA
DENTAL SOCIETY. This
scholarly work was the result of years
of painstaking research and of collect-ing,
compiling and editing material.
The "History" is an interesting and
invaluable book which will be a lasting
memorial to his untiring and imselfish
service to the profession.
Though born in Arkansas, whUe his
North Carolina parents were living
temporarily in that State, Dr. Fleming
lived most of his life in North Carolina.
He received his A. B. degree from the
University of North Carolina in 1891
and his D.D.S. degree from the Uni-versity
of Maryland in 1895. He was
made a Fellow of the American College
of Dentists in 1929. He held member-ship
in the Raleigh and Fourth Dis-trict
Dental Societies, the North
Carolina Dental Society and the
American Dental Association.
Fimeral services were held for Dr.
Fleming in the Edenton Street Metho-dist
Church of Raleigh, of which he
had been a faithful and devoted mem-ber,
having served for many years on
the Board of Stewards. It can truly
be said that he was a public spirited
citizen, a Christian gentleman and
a true friend and counsellor.
The Health Bulletin February, 1958
RECENTLY APPROVED PUBLIC
HEALTH REGULATIONS
The following regrulations affecting
public health, approved by the State
Board of Health February 7, 1958, are
published in The Health Bulletin in
accordance with legislation passed by
the 1957 Session of the North Caro-lina
General Assembly. —Editor,
The Health Bulletin.
NORTH CAROLINA STATE BOARD
OF HEALTH
Rules And Regulations Governing
State Aid Mosquito Control Districts
Or Other Local Governmental Units
Engaged In Mosquito Control Under-takings.
For the purpose of administering
State funds received by the State
Board of Health to aid mosquito con-trol
districts or other local govern-mental
units engaged in mosquito con-trol
imdertakings, pursuant to the
provisions of Chapter 832, Session Laws
of 1957, the North Carolina State
Board of Health adopts the following
rules and regulations governing:
State aid to mosquito control districts
or other local governmental units en-gaged
in mosquito control imdertakings.
SECTION I. CREATION OP ZONES
For the purpose of administering
these rules and regulations, the State
of North Carolina is divided into three
zones as follows:
A. Zone I shall be comprised of those
counties in which the studies of the
Salt Marsh Mosquito Study Commis-sion
showed a salt marsh mosquito
problem to exist, and shall include
the following counties: Beaufort,
Brunswick, Camden, Carteret, Chowan,
Craven, Ciurituck, Dare, Hyde, Jones,
New Hanover, Onslow, Pamlico, Pas-quotank,
Pender. Perquimans, Tyrell,
and Washington.
B. Zone II shall be comprised of
those counties not in Zone I where
the highest probability of mosquito-borne
disease outbreaks exists, and
shall include the following coimties:
Gates, Hertford, Bertie, Martin, Pitt,
Lenoir, Duplin, Sampson, Bladen,
Columbus, Robeson, Ciunberland, John-ston,
Wayne, Greene, Wilson, Nash,
Edgecombe, Halifax, and Northampton.
C. Zone IH shall be comprised of
those counties not included in Zone
I, or Zone II.
SECTION II. ALLOCATION OP
STATE FUNDS OR FACILITIES-GENERAL
Before aid is given in the form of
cash, or other items of monetary value,
the county, tov^n, or other government-al
unit applying for such aid shall
submit a project application to the
North Carolina State Board of Health
on a form provided for that purpose.
Project applications shall hst the
cash, materials and supplies, equip-ment,
and other facilities that will
be provided by the applicant during
the fiscal year.
In computing the monetary value
of local fimds and facilities provided
by the applicant, in order to de-termine
the amoimt of State aid that
can be given on a matching basis
credit will be allowed for labor, materi-als,
and general operating expenses, as
well as rental on equipment that has
been approved for use on the project by
the representative of the State Health
Director. The rental rates will be
established by said representative of
the State Health Director. No credit
will be allowed for money spent to
repay loans or to pay interest, pur-chase
equipment or real estate, nor
for overhead expenses such as cleri-cal
help, office and storage space
rental, etc.
State funds shall not be spent by
local governmental units to purchase
equipment, make repasTnents on loans,
pay interest on borrowed money, pur-chase
real estate, pay clerical person-nel,
rent storage or office space, nor for
any purposes other than those directly
connected with the application of
mosquito control operations.
February, 1958 The Health Bulletin
Embodied in project applications
shall be such assurances and agree-ments
as may be required by the of-ficial
of the North Carolina State
Board of Health who is responsible
for the administration of this activity.
These shall include:
(a) The assumption by the applicant
of all responsibility for claims for
damage resulting from the operation
of the project.
(b) An agreement to submit such
plans as may be required to the North
Carolina State Board of Health, and
perform all work in conformity with
the plans that are approved by the
appropriate representative of the North
Carolina State Board of Health.
(c) An agreement to use funds pro-vided
by the North Carolina State
Board of Health and those shown on
the project application as being pro-vided
by the applicant exclusively for
mosquito control, in accordance with
these rules and regulations and the
approved plan,
(d) An agreement to perform all
mosquito control under the direction
of a competent supervisor whose quali-fications
meet the approval of the
North Carolina State Board of Health.
(e) An agreement to submit reports
at the end of each month showing
work performed during the month,
expenditures made, facilities utilized,
and materials expended.
(f) An agreement to submit a certi-fied
financial statement to the North
Carolina State Board of Health no
later than ten days after the last day
of December and June of each year.
Such statement must include an item-ized
account of expenditures during
the preceding six months, of both local
and State funds, as well as an itemized
accoimt of other assets and facilities
that have been utilized to carry out
the mosquito control project. Such
supporting documents as may be re-quired
by the North Carolina State
Board of Health shall be included.
(g) An agreement to return to the
North Carolina State Board of Health
at the end of December and June of
each year all State funds not matched
by local expenditvtres for mosquito
control purposes during the preceding
six months. In Ueu thereof the State
Health Director may allow the excess
of State funds over local fimds expend-ed
during the preceding six-months'
period to be deducted from the State
aid given the applicant during the
next six-months' period.
In Zone I, if the application for
State aid is made by a county, the ap-pUcation
must be signed by the local
Health Director, and the project must
be operated under his direction. If
the application is made by a local
governmental unit other than a county,
a resolution must be adopted by the
governing board of such governmental
imit designating an official to sign
necessary papers in connection with
the mosquito control project. In such
cases, operation of the project shall
be under the direction of the designat-ed
official, but approval of the project
by the local Health Director shall be
reqiiired. In Zones II and III, the
project application shall be signed by
the local Health Director, and the
project shall be carried out under his
direction.
The provisions of these regulations
requiring that the local Health Director
sign, approve, or direct a project shall
not apply to any application made by,
or project conducted by a Mosquito
Control District established under the
provisions of Chapter 1247, 1957 Session
Laws.
SECTION III. ALLOCATION OF
FUNDS
A. Zone I. Seventy-five per cent of
the State funds available for allocation
to local mosquito control projects shall
be set aside for aid to local govern-mental
units within Zone I.
If sufficient State funds are avail-able,
the amounts provided by local
appropriations for mosquito control
projects in Zone I shaU be matched
on a fifty-fifty basis for temporary
control measures, and on a basis of
twice the amount of local appropri-ations,
or the monetary value of other
facilities provided locally, for drainage,
filling or dyking. If insufficient State
6 The Health Bulletin February, 1958
funds are available for matching on
this basis, the State aid is to be
allocated to local projects in any one
county as follows: the first one
thousand dollars ($1,000.00) of State
aid is to be on a fifty-fifty basis;
thereafter, the State aid is to be allo-cated
on a pro rata basis to be de-termined
by dividing the total remain-ing
appropriations and monetary value
of other facilities provided (above the
one thousand dollars ($1,000.00) match-ed
on a fifty-fifty basis) by all of the
local governmental units in Zone I into
the total remaining State aid available
for projects in that Zone. In no case is
the State aid to all projects within a
county to exceed fifteen thousand
dollars ($15,000.00) when there are
insufficient funds to match on a fifty-fifty
basis.
Two or more governmental vmits in
Zone I may jointly employ a supervisor
to look after mosquito control activi-ties.
The North Carolina State Board
of Health may match fimds to pay
the travel and salary of such super-visors
on a fifty-fifty basis, if State
funds are available. The qualifications
of supervisors employed under this
provision must be approved by the re-presentative
of the State Health
Director.
B. Zone II. The local Health Director
shall be the official in Zone II who is
recognized by the North Carolina
State Board of Health as authorized
and empowered to sign and execute
documents necessary in connection
with applications for aid in the con-trol
of mosquitoes, to carry out all
agreements stipulated in the project
applications, and perform other acts
that are necessary in connection with
the operation of the project.
All State funds and other facilities
provided for mosquito control projects
in Zone II shall be disbursed through
the local Health Director on a county
basis.
In Zone II, the first one thousand
dollars ($1,000.00) of State funds allot-ted
to local health departments for
mosquito control project shall be allo-cated
on a fifty-fifty basis with local
fimds. Any additional funds are to
be allotted on a basis of 30 per cent
State fimds for 70 per cent local funds,
with a maximiun allocation of two
thousand doUars ($2,000.00) to any
one coimty.
C. Zone III. The local Health Director
shall be the official in Zone III who
is recognized by the State Board of
Health as authorized and empowered
to sign and execute documents neces-sary
in connection with applications
for aid in the control of mosquitoes, to
carry out all agreements stipulated in
the project applications, and perform
other acts that are necessary in con-nection
with the operation of the proj-ect.
All State fimds and facilities provid-ed
for mosquito control projects in
Zone III shall be disbursed through the
local Health Director on a county
basis.
In Zone III, State funds allotted to
local health departments for mosquito
control purposes shall be allocated on
a fifty-fifty basis with local funds,
with a maximum allocation of five
hundred dollars ($500.00) to any one
county.
SECTION IV. AUTHORIZED
CHANGES IN ALLOCATION RULES
If at the end of a reasonable dead-line
for submission of applications for
State funds to aid in mosquito control
in any zone the funds set aside for
aid in that zone have not been applied
for, and allocated to local government
units in that zone, the State Health
Director is authorized to utilize such
funds for assistance to projects in
other zones, and to change the allo-cation
basis.
If at the end of the second quarter
of the fiscal year it is determined by
the official of the North Carolina
State Board of Health, who is respon-sible
for the administration of this
activity, that State funds allocated to
any project will probably not be spent
and matched by local expenditures, or
other creditable assets by the end of
the fiscal year, said funds may be re-allocated
to other local projects on the
basis of potential mosquito densities
February, 1958 The Health BuixEmN
and local participation.
Other State funds that become avail-able
for allocation to local projects
from any source, after the end of the
second quarter of the fiscal year, may
be allocated to local projects in either
of the three zones on the basis of
potential mosquito densities and local
participation.
SECTION V. RKPEAL
All rules and regulations heretofore
adopted by the North Carolina State
Board of Health in conflict with the
provisions of these rules and regula-tions
are hereby repealed. The regu-lations
concerning State aid to local
governmental imits for mosquito con-trol
purposes, adopted by the North
Carolina State Board of Health on
July 18, 1957, are hereby repealed, and
replaced by these rules and regulations.
SECTION VI. EFFECTIVE DATE
These rules and regulations shall be
in full force and effect from and
after February 15, 1958.
The foregoing rules and regulations
relating to the administering of State
aid to assist local governmental units
in carrying out mosquito control proj-ects
were duly adopted at a meeting
of the State Board of Health at
Raleigh, North Carolina, on February
7, 1958.
viously-used materials; the issuance of
stamp exemption permits; and, the
transfer of manufacturer's licenses and
sanitizer's licenses.
Rules And Regrulations Governing The
Sanitizing Of Mattresses, Previously-
Used Materials, Second-Hand Bedding,
And Bedding Containing Previously-
Used Materials; The Storage of Pre-viously-
Used Materials; The Issuance
of Stamp Exemption Permits; And,
The Transfer Of Manufacturer's
Licenses And Sanitizer's Licenses.
For the purpose of carrying out the
provisions of Article 16 of Chapter
1357 Session Laws of North Carolina,
the North Carolina State Board of
Health hereby adopts the following
rules and regulations governing: the
sanitizing of mattresses, previously-used
materials, second-hand bedding,
and bedding containing previously-used
materials; the storage of pre-
SECTION I. SANITIZING
a. No person shall renovate any
mattress without first sanitizing it in
accordance with one of the processes
authorized in subsection (e) below.
b. Any sanitizing apparatus or pro-cess
used to sanitize articles as required
by Article 16 of Chapter 1357 of the
1957 Session Laws of North Carolina,
or by these rules and regulations, must
comply with the provisions of these
rules and regulations.
c. No person shall manufacture or
sell in this State any bedding contain-ing
previously-used materials without
first sanitizing the previously-used
materials in accordance with one of
the processes authorized in subsection
(e) below.
d. No person shall sell any second-hand
bedding or bedding containing
any previously-used material imless
it is sanitized, since last used, in ac-cordance
with one of the processes
authorized in subsection (e) below;
provided, however, that this require-ment
shall not apply to a mattress
sold by the owner and previous user
from his home directly to a purchaser
for his own personal use, unless such
mattress has been exposed to an in-fectious
or contagious disease.
e. Authorized sanitizing processes
(1). Process Number 1 — Dry Heat
In this process, the bedding must
be heated at a temperature of 230° F.
for a period of one hour.
The chamber in which this process
is performed must be Insulated suf-ficiently
to insure maintenance of a
imlform temperature of 230° F. Articles
to be sanitized must be placed on racks,
or other devices provided therein, in
such a manner that a minimum space
of 6" is left around each item being
sanitized, and between such item and
the walls, floor, ceiling and other items.
Loose materials to be sanitized must
be placed in tiers on slats, or on other
arrangements that permit an even
distribution of heat throughout the
8 The Health Bulletin February, 1958
material. A thermometer that has
been checked for accuracy within 1° P.
must be placed within the chamber at
a point where it can be easily read at
all times through a window provided
for that purpose.
(2) Process number 2 —
Formaldehyde and Sulfur
In tills process, the bedding must be
exposed to formaldehyde and sulfiu-dioxide
gas in a moist and warm
atmosphere for at least 10 hours, using
one pint of 37% formaUn and three
pounds of sulfur to 1,000 cubic feet.
Formaldehyde is generated from the
formalin by adding potassium perman-ganate.
Commercial fumigators which gener-ate
an equivalent quantity of gas may
be used.
The chamber in which this process
is performed shall be sealed in such
a manner as to make it gas tight.
The placing of bedding within the
chamber shall conform with the re-quirements
set out for process number
1 above.
(3) Process number 3 — Washing
In this process, the bedding is boiled
for fifteen minutes, and washed with
an approved soap or detergent. After
drying, the bedding shall be clean to
touch, sight, and smell.
(4) Notwithstanding the provisions
of subsections (e) (1) tlu'ough (e) (3)
of this section, other methods of sani-tizing
may be used after receiving
the approval of the State Board of
Health in writing, if it is demonstrated
that they destroy pathogenic micro-organisms
and arthropods, and remove
dirt and filth.
(5) Notwithstanding the provisions
of subsections (e) (1) through (e) (4)
of this section, second-hand bedding
and previously-used materials that
show evidence of contamination with
feces, urine, pus, vomit, blood, mucus,
or other filth, or are not reasonably
clean, must be sanitized by process
number 3 only.
SECTION II. STORAGE OF
PREVIOUSLY- USED MATERIALS
When previously-used materials that
have not been sanitized are stored in
a bedding manufacturing establish-ment
in the same room with new, or
sanitized bedding or bedding materials,
such previously-used materials must
be segregated from the new, or sani-tized
bedding or bedding materials, by
partitions that are free of holes, cracks,
or other openings. The top of the
partitions must be at least one foot
higher than the level of the vmsani-tized
materials.
SECTION III. STAMP EXEMPTION
PERMITS
(a) Any person who manufactures
bedding in North Carolina or any
person who manufactures bedding to
be sold in North Carolina may, in
lieu of purchasing and affixing the
adhesive stamps provided for by
Article 16 of Chapter 1357 of the 1957
Session Laws, annually secure from the
State Board of Health a stamp ex-emption
permit upon compliance with
the provisions of said article and these
rules and regulations. The holder of
the stamp exemption permit shall not
be required to purchase or affix ad-hesive
stamps to bedding manufactured
or sold in North Carolina. The cost of
a stamp exemption permit is to be
determined annually by the total num-ber
of bedding items manufactured or
sold in North Carolina by the applicant
during the calendar year immediately
preceding the issuance of the permit,
at the rate of Eight Dollars ($8.00)
for each five hundred pieces of bed-ding
or fraction thereof. A maximmn
charge of Four Hundred Dollars
($400.00) shall be made for pieces of
bedding manufactured in North Caro-lina
but not sold in North Carolina.
(b) Applications for stamp exempt-ion
permits must be submitted on
forms supplied by the State Board of
Health. No stamp exemption permit
may be issued to any person imless he
has done business in North Carolina
throughout the preceding calendar
year in compliance with the provisions
of Article 16 of Chapter 1357 of the 1957
Session Laws, and unless he complies
with these regulations,
(c) Any person applying for a stamp
exemption permit must include on the
February, 1958 The Health Bulletin 9
application form furnished by the
State Board of Health a statement in
writing showing the number of bedding
items that were, during the preceding
calendar year: (1) manufactured in
North Carolina and sold in North
Carolina; (2) manufactured outside
of North Carolina and sold in North
Carolina; and (3) manufactured in
North Carolina but not sold in North
Carolina. Provided, however, that if
the applicant's statement sets out the
total nimiber of bedding items which
such manufacturer produced during
the preceding calendar year, it shall
not be necessary for the applicant to
set out what proportion of that total
was manufactured inside or outside
of North Carolina or sold inside or
outside of North Carolina, in which
case the cost of the stamp exemption
permit will be determined as if the
total production were manufactured
in North Carolina and sold in North
Carolina. The statement of the ap-plicant
required by this subsection
must contain a certification by a certi-fied
public accountant that he has
examined the records of the applicant
and finds that the statement correctly
reflects the information contained in
the records of the applicant.
(d) The State Board of Health may
require additional proof of the number
of bedding items sold during the pre-ceding
calendar year when it has
reason to believe that the proof sub-mitted
by the manufactiirer (whether
in-state or out-of-state) is incomplete,
misleading, or incorrect.
(e) The stamp exemption permits
issued pursuant to these regulations
shall be valid from the first day of
March of any calendar year through
the last day of February of the follow-ing
calendar year.
SECTION IV. TRANSFER OP
MANUFACTURER'S LICENSES
AND SANITIZER'S LICENSES
(a) If any person to whom a manu-facturer's
license or sanitizer's license
has been issued shall sell his manu-facturing
or sanitizing establishment,
he may transfer the license with the
business, if such transfer is accomp-lished
in accordance with the provisions
of these rules and regulations.
(b) In order to make such transfer,
and before the purchaser may use
such license of the seller, the pur-chaser
must submit to the State Board
of Health the following: (1) the name
and address of the seller; (2) the
location of the establishment being
purchased; (3) the name of the
establishment being purchased; (4)
the name and address of the pur-chaser;
(5) the effective date of sale;
and, (6) whether the name of the
establishment being purchased is to
be changed, and if so, the name imder
which it is to be operated by the
purchaser.
SECTION V. VIOLATIONS
If any person shall wilfully violate
any rule or regulation adopted by
the State Board of Health pursuant
to Chapter 1357 of the 1957 Session
Laws, or shall wilfully fail to perform
any act required by, or shall wilfully do
any act prohibited by such rules and
regulations, he shall be guilty of a
misdemeanor and upon conviction
thereof shall be punished by a fine
not to exceed Fifty Dollars ($50.00)
or by imprisonment for a period not
to exceed thirty days (30), as provided
in Article 22 of Chapter 1357 of the
1957 Session Laws.
SECTION VI CONFLICTING
RULES AND REGULATIONS
REPEALED
All rules and regulations heretofore
adopted by the State Board of Health
which are in conflict with the pro-visions
of these rules and regulations
are hereby repealed.
SECTION VII. SEVERABILITY
If any provision of these rules and
regulations, or the application there-of
to any person or circumstance, is
held invalid, the remainder of the
rules and regulations, or the applica-tion
of such provision to other persons
or circumstances, shall not be affected
thereby.
SECTION VIII. EFFECTIVE DATE
These rules and regulations shall be
in full force and effect from and after
10 The Health Bulletin February, 1958
February 15, 1958.
The foregoing rules and regulations
governing the sanitizing of mattresses,
previously-used materials, second-hand
bedding, bedding containing previously-used
materials; storage of previously-used
materials; the issuance of stamp
exemption permits; and, the transfer of
manufacturer's licenses and santizer's
licenses were adopted at a meeting of
the State Board of Health on February
7, 1958, at Raleigh, North Carolina.
NOTES AND COMMENT
BY THE EDITOR
STRANGULATION FROM
SWALLOWING TOY BALLOON
Two small children of North Caro-lina
parentage have lost their lives
recently in a rather bizarre type of
accident—strangulation from swallow-ing
a toy boUoon. It appears that in
each case, the child was trying to blow
up the balloon, inhaled it, and strang-led
to death. In both cases the children
were between 2 and 214 years of age.
A newspaper clipping reveals that two
other children—a 2% year old in New
Jersey and a 7 year old in New York
—
died under similar circumstances re-cently.
Tlie tragedy of such deaths is that
they are useless deaths. There is also
irony in the fact that toys given to
children to make them happy can also
produce death and serious injury; a
toy balloon is only one example. Pa-rents
and others who buy toys for
small children should be conscious of
the dangers inherent in toys and
should use great care in selecting them.
THE RECOGNITION OF CHICK-EMBRYO
ORIGIN RABIES VACCINE
IN DOGS FOR A PERIOD OF
THREE YEARS
WHEREAS, the duration of immrm-ity
against rabies in dogs following
the administration of chick-embryo
rabies vaccine has been shown to be
effective for a period of at least thirty-six
months by research conducted by
the United States Public Health Ser-vice,
and
WHEREAS, this research has been
recognized by nvmierous national and
international veterinary and public
health organizations (World Health
Organization, United States Public
Health Service, American Veterinary
Medical Association, United States
Livestock Sanitary Association), and
WHEREAS, the local health officers
of North Carolina have been informed
of this proposal and recormnend its
approval, and
WHEREAS, the North Carolina State
Veterinary Medical Association on June
28, 1956 passed a resolution recom-mending
that the North Carolina State
Board of Health officially approve
chick-embryo rabies vaccine for a
period of three years when administer-ed
by a licensed veterinarian, and
WHEREAS, the Attorney General in
an opinion dated 6 March 1956 has
ruled that the State Board of Health
under G. S. 106 - 365 is authorized to
specify how often a dog must be vac-cinated
against rabies with the single
restriction that vaccination may not
be required oftener that once in each
calendar year,
NOW, THEREFORE, the State Board
of Health in its official meeting, Feb-ruary
14, 1957, does hereby establish
the time or times when a dog shall be
vaccinated against rabies.
"1. When rabies vaccine of nervous
tissue origin is administered, the dog
must be revaccinated annually.
2. When rabies vaccine of chick-embryo
origin is administered by a
licensed veterinarian the dog must be
revaccinated every three years, except
that a dog under 6 months of age
receiving chick-embryo vaccine shall
be revaccinated after a period of one
year and every three years thereafter.
Provided, however, when a district or
county board of health or the State
Board of Health adopts a resolution
stating that in order to control rabies
and protect the public health, annual
vaccination is necessary within the
February, 1958 The Health Bulletin 11
area over which they have jurisdiction,
then the dog must be vaccinated an-nually
regardless of the type vaccine
used."
THE N. C. COMMISSION ON
PATIENT CARE
You might be interested in the fol-lowing
information regarding the above
Commission for the Health Bulletin:
There has been recently organized in
North Carolina a North Carolina Com-mission
on Patient Care. The major
purpose of this Commission is to
stimulate, implement, assist in, and
sponsor activities which will contribute
to the care of the patient. Membership
consists of representatives of the Medi-cal
Society of the State of North Caro-lina,
the North Carolina Hospital As-sociation,
the North Carolina League
for Nursing, and the North Carolina
Licensed Practical Nurses Association.
Mr. George Harris of the Duke Foun-dation
is Chairman.
It shall be the intention of the Com-mission
to obtain a better understand-ing
of the problems and programs of
all represented groups; to serve as a
source of information on trends within
the programs of the participating
organizations; to facilitate the develop-ment
of a more unified public relations
approach by the participating organi-zations;
to explore the needs for and
stimulate studies in areas of patient
care in which the organizations par-ticipate;
and to perform such fimctions
and carry on such activities contribut-ing
to major objectives as may be
mutually satisfactory to the appointing
organizations and to the Commission.
A. M. A. PAMPHLET TELLS
DRIVER FITNESS RULES
Even though a person has a good
safety record and thinks he's in ex-cellent
health, there are certain cir-cumstances
imder which he shouldn't
drive.
Some of the things that can make
a driver dangerous are listed in a new
American Medical Association pamph-let,
"Are You Pit To Drive?"
The pamphlet, to be distributed
through physicians' offices, was pre-pared
by the A.M.A. Committee on
Medical Aspects of Automobile In-juries
and Deaths, in cooperation with
the Center for Safety Education, New
York University.
A doctor can help answer the ques-tion
of driving fitness. The pamphlet
urges drivers to ask their doctors
when they are In doubt about their
fitness.
Some of the things that make a
driver dangerous are:
—Emotional upsets. Unless a person
can keep his mind on the wheel and
not on his worries, he should not take
the wheel.
—The driver's attitude. Some drivers
feel the other fellow is always wrong.
Some are aggressive and intolerant
when they get into a car. They need
to be mature.
—Sleepiness. A sleepy driver is as
much a hazard as a drinking one.
Dozing is not restricted to night driv-ing.
When making long trips, a person
should rest every two hours, drinking
coffee or cola to stay alert. He should
not take any medicine that makes him
drowsy.
—Medicines. Antihistamines, cold
tablets, sedatives, tranquilizers, and
some other drugs may dull reflexes
or impair coordination. Stimulants
may make a person nervous. The
doctor should be consulted about the
side effects of any drugs.
—Faulty vision. A driver needs regu-lar
eye examinations; if he notices
any change in his eyes between exami-nations,
he should see his eye doctor
immediately. To reduce eye strain, he
should wear properly fitted sunglasses,
but not after dark. To avoid tiring the
eyes, excessive night driving should be
avoided if possible. Hay fever or the
common cold can bliu: the vision
dangerously.
—Certain nerve and heart disorders.
Some may -cause convulsions and
others may result in occasional loss
of consciousness. The doctor is the
best judge of whether a patient with
these should drive.
12 The Health Bulletin February, 1958
—Diabetes. Insulin reactions may
cause difficulties, but diabetic patients
who follow their doctor's advice can
be safe drivers. —Old age. After 65, reflexes and co-ordination
tend to be a little slower,
people tire more easUy, resistance to
glare is lessened, and the ability to
see at night is declining. Older drivers
should schedule their trips at non-rush
hours and should not spend long
periods at the wheel. —And, of course, drinking.
NEW THEORY ADVANCED
ON SPEECH MECHANISM
Recent French research has Indicat-ed
that the brain—not the movement
of air in the larynx—caxises the vocal
cords to vibrate and produce soimd.
This new and controversial theory of
how man speaks was reported in
Archives of Otolaryngology, an Ameri-can
Medical Association publication,
by Esti D. Freud, Ph.D. New York,
a teacher of voice and speech patho-logy.
The French researchers believe that
vocalization results from the action
of the brain on the nerves of the
larynx which in tiu-n produce vibra-tions
of the vocal cords.
According to long-accepted theory,
expiration of air from the trachea
causes the thyroarytenoid muscle to
vibrate and thus set up vibrations of
the vocal cords.
In a note preceding the article, Dr.
Ernest M. Seydell, Wichita, Kan., a
member of the Archives editorial
board, pointed out that some of the
article's contents were "very contro-versial,"
but they were published with
the hope of stimulating research io
"a phase of otolaryngology in which
there is much to be proved."
Dr. Freud said the French experi-ments
have shown "beyond doubt" that
vocal cords vibrate in the absence of
an exhaled current of air, and that
the vibrations seem to be governed by
excitations deriving dir^tly from the
recurrent laryngeal nerve.
This means that the exhaled air
current cannot be considered instru-mental
in creating the vibrations of
the vocal cords, hut only as a sound-carrying
medium. The exact roles of
air pressiure, air volume, and the
breathing motions in vocalization are
questions that still must be answered,
she said.
Dr. Freud also reported that French
researchers have shown that singing
and speaking, which produce different
vibratory patterns in the vocal cords,
originate in different centers of the
brain, even though they are both ex-ecuted
by the vocal cords.
This helps explain why persons who
stutter or who have lost their ability
to speak can still sing without diffi-culty.
Dr. Freud said. It also helps
explain why a person with a tenor
singing voice may speak with a very
deep voice.
Dr. Freud, a daughter-in-law of the
late Sigmund Freud, is associated
with New York Hospital, New York,
and a Veterans Administration men-tal
hygiene clinic in Newark, N. J.
NEW HORMONE RELIEVES
SCLERODERMA SYMPTOMS
A new hormone that prevents pre-mature
birth is also useful in the
treatment of a rare skin disease, sclero-derma,
two Florida physicians reported
recently.
The hormone is relaxin (Releasin),
which is synthesized from an extract
of the ovaries of pregnant sows. Work-ing
with other hormones, relaxin in-fluences
the contraction of tte uterus
in pregnancy and labor.
It also has an effect on the elasticity
of the skin. This effect is important
in the treatment of scleroderma, Drs.
Gus G. Casten and Robert J. Boucek,
Miami, said in the Journal of the
American Medical Association.
In scleroderma, the skin hardens,
restricting movement. The blood supply
is cut off, causing fingers, toes, and
ankles to ulcerate. In addition to af-fecting
the skin, the disease eventually
attacks the internal organs.
The Florida doctors gave relaxin to
23 patients. While it had no effect on
the disease itself, it did cause "signifi-cant
improvement."
LIBRARIAN
DIVISION OF HEALTH AFFAIRS LIBRARY
N.C. MEM, HOSP. U. ^» C.
CHAg£L^UlLL«^JL^C,
I TKisBulletmynDb^^ntfre/fodlMj citizen of ri\e Sfai^e upon request I
Entered as second-dlass matter at PostofEce at Raleigh, N. C. under Act of August 24, 1912
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. 73 MARCH, 1958 No. 3
M^ vaSSVV-'
CENTRAL BUILDING, STATE LABORATORY OF HYGIENE
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEIALTH
G. Grady Dixon, M. D., President Ayden
John R. Bender, M. D., Vice-President Wlnston-Salem
Charles R. Bugg, M. D. Raleigh
Lenox D. Baker, M. D. Diirham
H. C. Lutz, Ph.G. Hickory
Mrs. J. E. Latta Hlllsboro, Rt. 1
John P. Henderson, Jr., M. D. Sneads Ferry
Roger W. Morrison, M. D. Afihevllle
Z. L. Edwards, D.D.S. Washington
EXECUTIVE STAFF
J. W. R. Norton, M.D., M.P.H., State Health Director
John H. Hamilton, M.D., Assistant State Health Director, Director
State Laboratory of Hygiene, and Editor Health Bulletin
Robert D. Higgins, M.D., M.P.H., Director Local Health Division
Ernest A. Branch, D.D.S., Director Oral Hygiene Division
A. H. EUiot, M.D., Director Personal Health Division
J. M. Jarrett, B.S., Director Sanitary Engineering Division
Fred T. Foard, M.D., Director Epidemiology Division
E. C. Hubbard, B.S., M.P.H., Director Division of Water Pollution Control
List of free health literature will be supplied by local Health Departments
or on written request.
CONTENTS Page
Fiftieth Anniversary of the State Laboratory of Hygiene 2
Notes and Comment 5
FIFTIETH ANNIVERSARY
OF THE STATE LABORATORY OF HYGIENE
By JOHN H. HAMILTON, M. D., Director
State Laboratory of Hygiene
On February 28, 1958, the State supply, the fee to be used in paying
Laboratory of Hygiene completed fifty the Department of Agriculture for
years of existence and service as an this service which they had rendered
institution. It could have been two since 1900. Still further back we find
years older had the 1905 General As- that in 1896 the State Board of Health
sembly which created it been a little passed a resolution requiring that
more generous with their appropria- certain chemical and bacteriological
tion. Only $500.00 and fees from water examinations be made at the Uni-analyses
were made available that versity of North Carolina. Even in
year. If one wishes to trace our history 1895 the Board had elected two
further back, we would find that in physicians to serve as bacteriologists.
1903 the General Assembly enacted Before that, in 1893, laws had been
a law authorizing the State Board of enacted for the purpose of protecting
Health to charge $5.00 for each analy- the purity of public water supplies,
sis of water from the public water The background for our beginning
March, 1958 The Health Bulletin
was undoubtedly the epochal 15-year
period between 1876 and 1890 when
such phenomenal progress was made
in the development of bacteriology
and our knowledge of infectious dis-eases.
Then too, these outstanding ac-complishments
in Europe were follow-ed
by the establishment of public
health laboratories in our United
States, notably in New York City.
Even though the 1905 General As-sembly
gave us our name, it was the
1907 General Assembly which gave us
our existence, for they appropriated
$2,000 per year and established a
schedule of fees which we are required
to collect from public water supplies.
This established a precedent which has
persisted to this date that the Labora-tory
must be partially self-supporting.
There has been no change in the
schedule of fees which public water
supplies pay since the 1907 General
Assembly; however, there has been
some change in the definitions for
public water supplies.
The Laboratory has been at four
different locations in the City of
Raleigh; the first occupied March 1,
1908 consisted of three small rooms
and a closet in the Agricultural Build-ing
at the corner of Halifax and Eden-ton
Streets. On January 1, 1909, the
Laboratory was moved to more com-modious
quarters on the third floor of
the Holoman Building on Fayetteville
Street. In January, 1917, the Labora-tory
moved into its own building on
Jefferson Street. This building was
designed and constructed for labora-tory
work. In February, 1940, the
Laboratory was moved to its present
plant. The Central Building is on
Caswell Square, facing West Jones
Street, where specimens are examined
and biological products are prepared
for distribution. The Laboratory Farm,
280 acres with seven buildings is
located seven and one half miles
west of the Capitol, on U. S. High-ways
Numbers 1, 64 and 70A. Here are
carried out the initial stages of the
preparation of rabies vaccine and
smallpox vaccine. Here too our larger
animals are quartered, as well as our
smaU animal colonies.
, The Laboratory has participated
actively in many of the battles which
have been fought against communi-cable
diseases in North Carolina. In
1907 many of the public water supplies
were unsafe sources of drinking water.
A considerable number of the munici-pal
supplies were suitable only for
fighting fires and flushing toilets.
Most cities maintained wells at numer-ous
locations within their boimdaries.
Even the wells were frequently con-taminated.
The Laboratory played an
active part in the improvement of
these public water suppliers to their
present high standards, and they have
practically ceased to be a source of
infection.
In 1916 typhoid fever was credited
with causing 702 deaths. Since 1950
we have had only from 1 to 4 deaths
each year from typhoid fever. In the
fight against this disease the Labora-tory
examined not only specimens of
water but specimens from patients as
an aid to the diagnosis of the disease
or detection of carriers. In addition
large voliunes of typhoid vaccine
were manufactured and distributed.
In 1916 there were 410 deaths from
diphtheria in the State. Since 1952
there has been no year in which we
have had more than nine deaths
from this disease. Here the Laboratory
assisted in the fight by examining
specimens as an aid to the diagnosis of
the disease, the detection of carriers,
and the distribution of diphtheria
antitoxin and immimizing antigens.
In 1916 there were 13 deaths from
smallpox in North Carolina. Since
1944 we have not had a single death
from this disease. The Laboratory's
only service in the fight against small-pox
w-as the distribution of smallpox
vaccine, but that service contributed to
the immunization of millions.
Shortly after the armouncement
was made that there was hookworm
infestation in North Carolina, the
Laboratory confirmed the presence of
hookworm disease in our State. By
1912 the Laboratory was not only
making hookworm examinations at the
rate of 22,000 per year; technicians
were also trained in the Laboratory to
make these examinations in the field.
The salaries of these workers were
The Health Bulletin March, 1958
paid by the Rockefeller Sanitary Com-mission.
This hookworm campaign did
much to reduce the prevalence of in-testinal
parasites in the State and to
establish public health as a worth-while
procedure.
The best known work of the State
Laboratory of Hygiene is the exami-nation
of dog heads for rabies. When-ever
the name of the State Laboratory
of Hygiene is mentioned at nearly any
crossroads in North Carolina, people
know that Is the place where dog heads
are examined, although they may be
unaware of any of oiu- other activities.
In addition to aiding in the diagnosis
of rabies in animals, the Laboratory
as early as 1917 administered antirabic
treatments to patients coming to
Raleigh. By 1919 the Laboratory was
distributing antirabic vaccine to phy-sicians
who could administer it in
their own offices. The largest nvunber
of animal heads ever examined in a
single year was in 1935 when some
2000 were received at the Laboratory.
We are winning the fight against
rabies, provided we do not relax our
efforts.
The largest activity ever undertaken
by the Laboratory was in connection
with the fight on syphilis. In 1918 we
started making the Wassermann test.
As with other procedures we have dis-carded
the older tests and adopted
newer ones whenever we were con-vinced
that we were making improve-ment
in our services. The largest
number of blood tests we ever made in
a single year was in 1941 when a total
of 427,488 specimens were examined.
Ninety-four thousand of these were
from draft registrants being made
ready for World War n. Here, too, we
seem to be on the winning side, pro-viding
the efforts which are now being
made are sustained.
During the first calendar year of the
Laboratory's existence — 1909 — 2,902
laboratory examinations were made. In
1912 this number had increased to
5,058. For the calendar year 1957,
more than 500,000 examinations were
made. The intervening years have
generally shown an upward trend in
the volume of work. Some years, as
1941, when syphilis serology was
urgently needed and when additional
workers were available, showed extra-ordinary
activity.
Our specimens come from physicians,
local health departments, state insti-tutions,
hospitals and public water
supplies.
Most people in the State are fairly
familiar with the aid which the
Laboratory renders to physicians in
the diagnosis of disease and to health
departments in the detection of car-riers,
and also with the large volume
of biological products distributed to
those who are authorized by law to
use them. Few people realize that the
epidemiologist can use laboratory find-ings
to detect an impending epidemic
and take steps to prevent it just as
well as he can use the Laboratory to
solve the mysteries of an epidemic in
full bloom—an outbreak of food poi-soning,
for example.
Our oldest activity, yet one as useful
and even more widely used today, is
the work we can do to help safeguard
the quality of drinking water. A newer
endeavor in this general field is to
assist the stream pollution work in
making our rivers and their tributaries
a bit cleaner and more usable, A
newer activity is in the field of viruses —their isolation and identification.
The newest activity is the monitoring
of water and foods for radioactivity.
In addition to the examination of
specimens and the biological products
which we distribute, we have the re-sponsibility
of approving local labora-tories
for serological tests for syphilis
—
some 180 of them—and the certifi-cation
of laboratories for the testing
of milk which may be shipped from
North Carolina to other states. There
are 25 of these certified milk labora-tories.
At present our staff consists of 74
people, 32 of whom have been with us
for more than ten years. Two have
been with us for more than 40 years;
five for from thirty to forty years;
three from twenty-five to thirty years;
five from twenty to twenty-five years;
eleven from fifteen to twenty years;
and six from ten to fifteen years. In
addition, one has retired after forty
years and one after thirty-nine years
March, 1958 The Health Bulletin 5
of service, and one died after twenty-nine
years of service. All members of
our staff are important; some may
draw larger salaries than others, but
each and every one make a contri-bution
to the smooth operation of the
Laboratory and the quality of work
performed. The persons doing labora-tory
work are well trained and pro-ficient
in their particular field of
activity. All hold Bachelor degrees
—
several have advanced degrees. We
have a promotional system. Practically
all of those in the higher classifications
have been promoted from lower classi-fications
in the Laboratory. A young-ster
can come to the Laboratory im-mediately
after graduating from col-lege
and be given an opportunity for
advanced training and promotion. In
fact, a person can make a life career
in the Laboratory of Hygiene with a
reasonable degree of assurance that
he can marry, have a home, rear
children, house, feed clothe and edu-cate
them adequately and have security
in his old age. He will never be rich,
if his sole income is from the State,
but he can enjoy his work because
he knows that he is making a worth-while
contribution to the well-being of
his fellow citizens. He can have pride
in his accomplishments and hopes for
the future. We have a staff of labora-tory
workers of whom any laboratory
director could be proud.
We have endeavored to outline
briefly the State Laboratory of Hygiene
as an institution dedicated to render-ing
service helpful in the detection,
treatment and prevention of disease,
as well as evaluations of unfavorable
environmental conditions.
An institution is more than bviild-ings,
equipment and supplies. It is
people, who motivate it, who give it
intelligence, loyalty, devotion, responsi-bility,
reputation and tradition. The
State Laboratory of Hygiene is fortu-nate
that its foxmder and director for
more than 25 years was Dr. Clarence
A. Shore. He and his associates set
the ideals and traditions of service
which those who followed them have
endeavored to maintain. Mr. J. W.
Kellogg, in the April 1940 Health
Bulletin, gave a brief but meticulously
docvmiented history of the Laboratory
from 1908 to 1940. This, April, 1940,
Health Biilletin is devoted entirely to
the dedication of the present plant
to Dr. Shore.
As we look backward with pride in
the past we also look forward with
hope for the futvire. We have confi-dence
that the service which our in-stitution
has rendered during its first
half century has established us so
firmly as a worthwhile institution
that during the second half century
of our existence we shall render even
greater service. The State Laboratory
of Hygiene has a part in the future.
NOTES AND COMMENT
By the Editor
Dr. Applewhite Retires
After forty-four years in service to
the public health Dr. C. C. Applewhite
has certainly earned the privilege of
retiring. For more than eight and one
half years—July 1, 1949, to January
31, 1958 he served as Director of
Local Health Work for the North
Carolina State Board of Health. He
came to our State with a long and
honorable record of accomplishments
in public health over an area extend-ing
from the Atlantic ocean to the
tier of states west of the Mississippi.
He tackled our problems in North
Carolina with energy, enthusiasm,
knowledge, experience and natural
ability, with which he had been richly
endowed. His tour of duty in North
Carolina was fruitful. The General
Assembly of 1949 had just increased the
appropriation for State aid to local
health departments by $800,000. The
equitable distribution of this new
money among the local health depart-ments,
some of which was for single
districts and some for municipalities
which maintained separate organi-
6 The Health Bulletin March, 1958
zations, helped set the stage for an
expanding health program. After 1949
there was no increase in State funds
and an actual decrease in Federal
fluids; yet Dr. Applewhite was most
helpful in persuading local appropri-ating
boards to increase local funds.
The result tells the story. In 1950
local funds were $2,693,246 of the
$4,372,628 expended for local health
work in the State, the State funds
being $1,500,000 and other soiirces,
mostly Federal, $529,383. Through the
years local health funds increased,
while State funds remained stationary
and Federal funds decreased, until,
in 1958, local money amounted to
$5,334,965 of the $6,905,758 budget for
local health work.
In 1950 only some eight or ten of oiu:
local health departments were ade-quately
housed. Most of them were
crowded into basements or attics. By
1958, 73 new health centers had been
completed to house our local health
departments, and eight more were
under construction. Dr. Applewhite and
Dr. John A. Ferrell of the Medical
Care Commission teamed together to
induce county commissioners to
construct these worthwhile buildings.
Better housing facilities have helped
our local health work in many ways.
They have made it possible to improve
the quality and increase the quantity
of service which could be rendered.
Veteran health workers have been en-couraged
to remain steadfast in the
faith, and recruiting of capable, well-trained
young men and yovmg women
as public health workers should be
less difficult.
While encouraging and stimulating
the procedures which have been con-sidered
a fundamental part of a well
regulated health program. Dr. Apple-white
did much to make mental health
a definite part of our public health
activities. His position is that much
can be done to prevent mental disease
and that public health workers can
make a worthwhile contribution In
that field of endeavor.
Dr. Applewhite's kindly, sympathetic
and understanding attitude won him
a host of friends in North Carolina.
When it was learned that he was re-tiring,
the local health workers were
the first to decide that due recognition
should be made of our love and af-fection
for him. The staff of the State
Board of Health and the North Caro-lina
Public Health Association followed
their lead. On January 31, his last
working day, a special meeting of the
North Carolina Academy of Public
Health was called. A traveling bag was
presented to Dr. Applewhite by Dr.
John Fowler, dii'ector of the Durham
Child Guidance Clinic, in behalf of
the mental health workers. Dr. W. A.
Browne, director of the Edgecombe
County Health Department, speaking
for the local health workers and the
staff of the State Board of Health,
presented him with a lounging chair
with the hope that he would enjoy
many restful and pleasant hours re-clining
in it. Dr. J. W. R. Norton pre-sented
him with a stack of letters
written and signed by numerous well-wishers.
These have been boimd in
book form. Dr. Applewhite has said:
"Frankly, this toiur of duty in North
Carolina will always be considered
by me as the happiest one in my entire
public health career." When we review
his biography we in this State may
justly feel highly complimented.
Born—Winona, Mississippi, 1887
Attended Millsaps College, 1903-1907
—A. B. degree
Taught public school in Mississippi,
1907-1909
Attended Vanderbilt University, 1909-
1913—M. D. degree
Attended Harvard School of Public
Health, 1932-1933—M. P. H. degree
Career:
Rural sanitary surveys, USPHS, in
Mississippi, Georgia, North Caro-lina,
Alabama, Tennessee, Illinois
and Texas, 1914-1917
Extra cantonment sanitation, USPHS,
in Georgia and New Jersey, 1917-
1919
Rural health work in Georgia and
Kentucky 1919-1922
Director of Local Heath Service,
State Health Department, Jackson,
Mississippi, 1922-1932
Rural health work. State Health
Department, Columbia, S. C, 1933-
1935
March, 1958 The Health Bulletin
Regional consultant, USPHS, New
York, Chicago and New Orleans
Districts, 1935-1941
District Director, USPHS, Kansas
City, Mo., 1941-1945
District Director, USPHS, New
Orleans, La., 1945-1949
Director, Local Health Division,
N. C. State Board of Health, 1949-
January 31, 1958
Received Reynolds Award for out-standing
achievement in public
health field in North Carolina for
1953
Diplomate, American Board of Pre-ventive
Medicine and Public Health
Fellow, American Medical Association
Member Wake County Medical
Society
Member, Medical Society of the State
of North Carolina
Member, American Public Health
Association
Member, American College of Pre-ventive
Medicine
Member North Carolina Academy of
Preventive Medicine
President, North Carolina Academy
of Public Health
Dr. Applewhite has left North Caro-lina
to return to Mississippi, the State
of his birth and early manhood. Al-though
we are saddened by his de-parture
from the ranks of public
health workers in North Carolina,
we are pleased that we have known
him and have had the privilege of
working with him in promoting the
well-being of the people of North Caro-lina.
We of the staff of the State
Board of Health join with other health
workers throughout the State in wish-ing
for him many happy years in the
land of the living. Our affection for
him goes wherever he goes. We will
remember him as an honorable
Christian gentleman.
COMPULSORY POLIOMYETITIS
VACCINATION
For nearly two years we have had
suggestions from various and sundry
sources that there should be a law,
rule or regulation requiring that all
children be vaccinated against polio-myelitis.
The frequency with which
these suggestions are made is in-creasing.
There have been newspaper
editorials. The problem has been dis-cussed
by boards of health, both local
and State. The evidence is accumu-lative
that poliomyelitis vaccine is
effective in preventing paralysis due
to this disease. Just how long the
protection induced by the vaccine will
last is yet to be determined. Another
year of experience with the vaccine
will be possible before the General
Assembly of 1958 meets. In the mean-time
it is not necessary that any of
us make a decision as to whether or
not we favor compulsory vaccination
against poliomyelitis.
Physical Therapy
Duke University, Durham, North
Carolina, has inaugurated a program
of graduate credit for specified courses
in the physical therapy program.
This augments the certi,ficate
course in physical therapy offered for
the past fifteen years by Duke Uni-versity
Medical Center and approved
by the Council on Medical Education
and Hospitals of the American Medical
Association.
The new program in physical therapy
is conducted imder the joint auspices
of the Graduate School of Arts and
Sciences and the Duke University
Medical Center. The program has two
phases: (1) The fundamental courses
in physical therapy are studied in
the first fifteen months. During this
period fifteen hours of graduate credit,
which meet one-half of the graduate
residence requirement, may be accimiu-lated.
The Certificate in Physical
Therapy is awarded up>on completion
of this work. The graduate is then
eligible to become a member of the
American Physical Therapy Associa-tion,
to take state and national licen-sing
and registration examinations
and to work as a qualified physical
therapist. (2) Later specialization in
anatomy or in physiology can provide
the additional fifteen hours of gradu-ate
credit necessary for the Master of
Arts degree. This second phase, in-cluding
preparation of a thesis, may
be formally scheduled in one semester.
8 The Health Bulletin March, 1958
Radio Program
The State Board of Health's weekly
radio program, over Station WWNC in
Asheville, heard every Saturday, has
been changed from 9:15-9:30 A.M. to
1:45-2 P.M. The subject of this pro-gram
is "Your Health And You," and
it is designed to reach listeners in the
western part of the State, The Board
also gives a program known as "Your
Public Health Reporter" over Station
WPTP, in Raleigh, each Satiu-day,
beginning at 1:30 P.M. The scripts are
prepared and delivered by William H.
Richardson, publicity officer for the
Board.
AUTOMATION CONTRIBUTING
TO OBESITY PROBLEM
Automation may have its advantages
but it is causing a major problem in
the field of medicine.
More and more people are tending
to become overweight as a result of
our new sedentary life which provides
more leisure time with less heavy
physical work, according to Dr. Robert
H. Barnes, of Seattle.
Writing in the Journal of the Ameri-can
Medical Association, the University
of Washington School of Medicine
doctor said, "Reduction and perma-nent
weight control require healthy
changes in living habits."
In addition to physical examinations
and general health evaluation, a phy-sician
today must also concern himself
with the patient's personal living
habits if he is to recommend an ef-fective
reducing program.
"Usual eating habits and average
daily physical activity are two of the
most important points to be explored,"
said Dr. Barnes. He added, "There is
no single approach to the treatment
of obesity, only lifetime control."
A special history should be the first
step in determining a program to
bring long-term results. This history
will give an index of past and present
weight, maximum weight, and esti-mated
ideal weight.
The second step is to modify the way
of eating, which must be designed to
be followed during the patient's life-time.
This approach is more satis-factory
on the long-range basis than
the conventional rigid diet. Dr. Barnes
said.
Lowering the caloric intake is neces-sary
for anyone to reduce. Despite the
fact that dieting alone has been a
iSLilure, it is still the principal support
in reducing, he said.
In setting up a diet, the patient's
working facilities, meal hours, family
food patterns, and income level must
all be considered.
Additional steps in the program
should include the use of medication
(dispensed under a physican's super-vision),
exercise, and posture control.
He noted, "Moderate exercise, month
in and month out, can be the differ-ence
between following a starvation
regimen and being able to follow a
more normal diet according to one's
appetite.
"Here again modern civilization
makes it difficult for the overweight
patient to do regular exercising such
as walking. The habit of riding every-where,
even three blocks to the store,
has depressed the physical activity of
many to a very low state."
There should also be developed a
close relationship between doctor and
patient, for, according to Dr. Barnes,
"The patient should realize that he
is under the care of a physician not
only to lose weight but also to have
treated the associated medical dis-orders
common to obesity which com-mercial
reducing salons are admittedly
incapable of recognizing and treating."
FACIAL PAIN CALLED
"MOST AGONIZING"
The reasons for facial pain being
"perhaps the most agonizing of all
afflictions" were given by a Georgia
doctor.
There is a reasonabe physical reason
for severe suffering from facial pain.
The "cephalic end of man has been
blessed with the highest degree" of
nervous development, which allows for
the most acute awareness of any
sensory stimulation.
Also the head and face command
more attention than other parts of
the body, Dr. George W. Smith,
Augusta, Ga., said in the Journal of
the American Medical Association.
March, 1958 The Health Bulletin 9
Man is very much aware of his
face and head and its vulnerability
to injury or hui't. Accordingly, he is
quickly and greatly concerned about
any painful sensation.
Awareness of others scrutinizing his
exposed face magnifies any sensation
he might be experiencing, although
there may be no objective change to
the observer, Dr. Smith said.
The way people bear pain depends on
their own personalities, emotions and
neurotic tendency, he said. This dif-ference
among people makes evalu-ation,
diagnosis, and treatment of
facial pain a complicated and difficult
problem for the doctor.
The precise diagnosis and locali-zation
of the origin of facial pain is
difficult because there are so many
nerves and they so overlap that it
is hard to distinguish just what path
the pain is following.
Relief depends on the cause. If it
results from something other than
nerve damage, such as infection in the
mouth or a tumor, it can be relieved
by eradicating the cause. When the
nerves themselves are damaged or dis-eased,
the treatment is more compli-cated,
often involving surgery.
Dr. Smith is in the division of
neurological surgery, the Medical Col-lege
of Georgia.
Hospitals
One out of eight Americans will be
hospitalized during the coming year.
For the first time, many of us will
know what a hospital really is—how
it restores and protects oiur health.
There was a time, according to an
article in the spring issue of Blue
Print for Health, a publication of the
Blue Cross Commission of the Ameri-can
Hospital Association, when the
name "hospital" had an entirely dif-ferent
meaning.
"The Hospital Throughout the Ages"
is the first of an eight-part series
written by Arnold A. Rivin, formerly
of the American Hospital Association.
Riven shows how the modern hospital
was "a long time coming" by tracing its
origin back to the fifth century B. C.
in Ceylon. Even as late as the eight-eenth
century "hospitals" were used
primarily to house human derelicts.
The idea of a voluntary hospital
solely for the curable sick emerged in
the British Isles in the early 1700's.
The Pennsylvania Hospital in Phila-delphia
is generally accepted as the
oldest true American hospital. It was
founded in 1751 with the active aid of
Benjamin Franklin.
In the 1800's the quahty of patient
care and hospital maintenance were
so poor that most hospitals actually
contributed to the spread of disease.
With the development of ether, radical
improvements in sanitation and
hygiene, the use of new techniques
and specialized equipment, hospitals
emerged gradually into the form we
know today.
By the 1900's, more and more people
who had formerly been treated at
home went to the hospital for treat-ment.
As the number of hospital ad-missions
increased, it soon became
apparent that a plan was necessary
which would make hospitalization
available to every family burdened
with illness, regardless of its finan-cial
status. Within the past twenty-five
years, this need has been answered by
steadily increasing nation-wide en-rollment
in prepayment plans for hos-pital
care.
Thus today your hospital has become
a community center for treatment of
the sick. Mr. Rivin closes his article
with the optimistic thought that what-ever
ailment one out of eight of us
has during the coming year, we now
stand an excellent chance of being
released from the hospital soon—in
better health.
Industrial Health Conference
New problems and progress in the
control of occupational health hazards
and the provision of preventive medi-cal
services by industry will be dis-cussed
at the Thirteenth National
Industrial Health Conference, to be
held at Convention Hall in Atlantic
City, New Jersey, April 19-25, 1958.
Over 3,000 occupational health special-ists,
businessmen and labor leaders
will hear papers on problems of grow-ing
significance to industry, workers,
and the community. A total of 134
10 The Health Bulletin March, 1958
papers will be presented on such
subjects as radiation, mental health
in industry, air pollution, noise, medi-cal
care and in -plant health services,
industrial dentistry and industrial
nursing.
Radiation. — Comprehensive sessions
on radiation will cover such specia-lized
facets of the problem as stand-ardization
in nuclear energy; radiation
protection laws and codes—a scramble
for action; radiation dosages to medi-cal
personnel; environmental radio-activity
in the nuclear test airplane
test area; radiation safety monitoring
of reactor demolition; the licensee in-spection
program of the Atomic Energy
Commission; facts and fallacies about
radiation exposure; diagnostic radi-ation
in industry, uses and abuses;
microwave radiation hazards; and the
Pennsylvania radiation protection pro-gram
with its outlawing of shoe-fitting
fluoroscopes.
Mental Health in Industry.—Since
studies have shown that as much as
one -third of sickness absenteeism in
industry is due to mental health prob-lems,
this is a problem of paramount
concern to industrial physicians and
management. A symposium will be
held on this subject centering on early
recognition of emotional problems by
industrial physicians.
Air Pollution.—The pollution session
will cover numerous papers, including
air pollution control in New Jersey, a
progress report of the New Jersey Air
Pollution Control Commission; the ap-plication
of simplified techniques to
air pollution measurement; air pollu-tion
problems in petroleum refining; the
effects of air pollution on human
health; and pollen removal by air
filters.
Noise—Papers on noise will Include a
report of a Public Health Service study
on industrial noise and hearing loss in
a controlled population; industrial
audiometry; hearing loss related to
non-steady noise exposure; reduction
of air flow noise; acoustical treatment
of walls and ceiling; and noise control
methods used in foundry operation.
Medical Care and In-Plant Health
Services.—A symposium will be held
on medical care of industrial workers.
covering labor's health goals; the
medical care plan of Endicott-Johnson
Corporation; and community health
association plans for operation in
Detroit. A special session will also be
held on health services for small
plants, including a paper on the
value of small plant health programs
to management.
Industrial Dentistry. — The sessions
on industrial dentistry will include a
symposium on dentistry as related to
safety in industry, a panel discussion
on the cost of an industrial dental
program to management, and paper on
the possibility of dental coverage in
health insurance programs.
Industrial Nursing. — The industrial
nursing sessions will include dis-cussions
on the effective use of com-munity
resources; automation; and
preparation for catastrophic and
emergency situations in industrial
plants.
Other Sessions. — Nvunerous papers
will be devoted to other aspects of
occupational health, including the
toxicity of various substances used in
industry; engineering, chemical and
analytical procedures as related to
industrial health; rehabilitation and
alcoholism.
Special Conference addresses in-clude
the C. O. Sappington Memorial
Lecture, to be presented by C. W.
Shilling, M. D., Deputy Director, Di-vision
of Biology and Medicine, Atomic
Energy Commission, on "Everybody's
Business—The Problem of Fall Out
and Radiation." The Donald E. Cum-mings
Memorial Lecture will be given
by Major General James P. Cooney,
Deputy Siorgeon General of the Army,
who will speak on "Interpersonal
Relations." In an address commemo-rating
the 20th aimiversary of a pro-fessional
organization participating in
the Conference, Mr. John J. Bloom-field,
known as one of the founders
of modern industrial hygiene in the
United States, and now Regional Con-sultant
in Industrial Hygiene at the
Institute of Inter-American Affairs,
will report on "What the American
Conference of Government Industrial
Hygienists has done for Industrial
Hygiene."
March, 1958 The Health Bulletin 11
The Industrial Health Conference is
sponsored by the Industrial Medical
Association, the American Industrial
Hygiene Association, the American As-sociation
of Industrial Dentists, the
American Association of Industrial
Nurses, and the American Conference
of Governmental Industrial Hygienists.
H. W. Lawrence, M. D., Medical
Director, Procter & Gamble Co., Cin-cinnati,
Ohio, and President-elect of
the Industrial Medical Association, is
General Chairman of the Conference.
C. Scott McKinley, M. D., Medical
Director, Bakelite Corporation, Bound
Brook, New Jersey, and Mr. N. V.
Hendricks, Esso Research & Engi-neering
Company, Linden, New Jersey,
are Deputy General Co-chairmen.
Advance registration forms, as well
as a copy of the program, may be ob-tained
from Edward C. Holmblad,
M. D., Managing Director, Industrial
Medical Association, 28 East Jackson
Boulevard, Chicago 4, Illinois.
FINGERPRINTS CAN BE REMOVED
BY SURGICAL TECHNIQUE
Fingerprints, always considered to be
permanent and unalterable, can be
completely removed by the surgical
technique of skin planing, a New
Orleans doctor reported.
Tu'o Detroit physicians also reported
that they have proved an assumption
of law enforcement officials that
prints of the second or dermal layer
of skin can be used for identification
purposes as well as those of the top
layer or epidermis.
Their reports appeared in Archives
of Dermatology, an American Medical
Association publication.
Dr. James W. Burks Jr.. of the
Tulane University School of Medicine
division of dermatology, said his pre-liminary
report has important legal
Implications because the possible re-moval
of fingerprints makes positive
identification by this means uncertain.
He treated two men with arsenic-caused
horny growths on the hands
by planing the skin with a high speed
electric wire brush. At the same time,
he planed a finger of each man, re-moving
the epidermis and the upper
part of the dermal layer. Skin planing
is often used to remove scars from acne
or small pox.
Weeks after the planing, the fingers
were smooth, slightly pinker, and with-out
visible ridges. A hand lens showed
the normal arrangements of whorls
to be replaced by minute, thin, criss-crossed
and parallel lines similar to
those on the back surface of the web
between the thumb and index finger.
Dr. Burks warned dermatologists
that they must guard against treating
criminals who seek to have their finger-prints
removed. He added, however, that
criminals who have this means of
identification altered may still be re-cognized
through "other equally satis-factory
means." In fact, the "very
absence" of ridge patterns on fingers
could reflect an attempt to conceal
identity. Dermatologists can help law
enforcement officers in determining
the medical reasons for a person's
having planed fingers, he said.
The Detroit physicians, Drs. Harold
Plotnick and Hermann Pinkus, ran an
experiment on the similarity of epider-mal
and dermal fingerprints. Using
recently amputated fingers, they first
took prints of the epidermis. They
then removed the epidemis and took
prints of the dermis (also called the
corium or "true skin").
The two prints were identical except
that the ridges of the dermal prints
appeared split or double, as well as
finer that those of the epidermis. The
dermal print is "just as effective for
identification purposes." they said.
Their study resulted from an actual
case in Boston in which Dr. Pinkus
was asked by the police to explain
the difference between epidermal and
dermal fingerprints.
The police had found the body of a
man and suspected that he had been
murdered by his wife and dumped
into the water. All the skin had come
off the fingers, but prints were taken
from the denuded dermal surfaces.
It was up to the police to convince
the jury of the identity of these prints
with ordinary prints on file.
"They built up a nice case with the
information, but the wife confessed
just before the trial opened, so all the
12 The Health Bulletin March, 1958
effort had been for nought," the
doctors said.
It did, however, lead to the study
proving the vahdity of dermal prints
as a means of identification.
NUTRITION PLAYS NO ROLE
IN ARTHRITIC PROCESS
There is no special diet for the treat-ment
of arthritis, according to the
American Medical Association's Coun-cil
on Foods and Nutrition.
In a special report prepared for the
council. Dr. William D. Robinson, Ann
Arbor, Mich., said joint diseases are
"essentially diseases of the supporting
structiu-e of the body, the connective
tissue." It is "extremely unlikely that
the fimctioning of this tissue can be
directly affected by dietary manipu-lation."
However, patients with diseases of
joints do need to pay attention to their
diet, because of its effect on their
general state of health. Dr. Robinson
said.
Many diets and specific vitamins
and minerals have been suggested for
the treatment of arthritis, but research
has failed to show any relationship
between nutrition and the cause of
most rheumatic diseases.
Gout is the only fairly common
form of joint disease in which diet
and the use of food by the body have
been shown to affect the disease.
Food allergy, high fat diets, and
periods of fasting all precipitate gout
attacks; therefore, patients need to
watch their diets carefully.
Occasionally special diets are needed
by persons with arthritis, even though
they will have no effect on the disease
itself. For instance, overweight patients
often need to lose weight to reduce
the load on the affected weight-bearing
joints. Diets high in calories,
proteins, vitamins, and minerals are
sometimes necessary for patients who
have lost weight and muscle tissue, a
situation frequently encountered in
rheumatoid arthritis.
Dr. Robinson noted that many forms
of rheumatic disease are self-limiting.
with a tendency to subside spon-taneously
after a varying length of
time. Confusion of such conditions as
bursitis or psychogenic rheumatism
with various types of arthritis un-doubtedly
has been responsible for
the claims of value for various diets
and vitamins as treatments for
arthritis. i
Dietary treatment for the arthritic !
patient may be an important aspect
of the total program of effective treat-ment,
but such treatment "must be ,
adapted to the general condition of
the individual patient as well as to
the type of rheumatic disease present,"
Dr. Robinson concluded.
He is in the department of internal
medicine and the Rackham Arthritis
Research Unit of the University of
Michigan. His report appeared in the
Journal of the A.M.A.
TWO-MONTH-OLD BABIES
NEED POLIO SHOTS
Polio shots for infants as young as
two months were recommended recently
in a guest editorial in the Journal of
the American Medical Association.
At present shots are generally begun
at six months of age. However, several
groups of researchers have fovmd that
many infants lose the immunity with
which they are born before they reach
six months.
Dr. Lam-i D. Thrupp, chief of the
poliomyelitis surveillance imit of the
U. S. Public Health Service's Com-municable
Disease Center, Atlanta, Ga.,
said the American Academy of Pedi-atrics
has recommended beginning the
shots at two months. The third shot
should follow the first two by at least
six or seven months.
During 1956, attack rates of paralytic
polio were highest in one-year-old
children and the largest proportion
of cases occurred in the under-five-year
age group, Dr. Thrupp said.
Preliminary data for 1957 indicate that
a comparably high proportion of para-lytic
cases is occurring in pre-school-age
children.
LIBRARIAN
DIVISION OF HEALTH AFFAIRS LIBRA
N.C. MEM, HOSP, U. N. C.
CHAPEL HILL, N.C.
I TKis Bulletin will be seni^jf^ to dniiciiizen of tKe 5kite upon request \
Entered as second-class mayi^ at Postoffice at Raleigh, N. C. under Act of August 24, 1912
Published monprfy at the office of the Secretary of the Board, Raleigh, N. C.
Vol. 73 APRIL, 1958 No. 4
Rtct-.'
^,.,^^-
m'i
o 105^9
ASHE COUNTY HEALTH DEPARTMENT
JEFFERSON, NORTH CAROLINA
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
G. Grady Dixon, M. D., President Ayden
John R. Bender, M. D., Vice-President Wlnston-Salem
Charles R. Bugg, M. D. Raleigh
Lenox D. Baker, M. D. Diirham
H. C. Lutz, Ph.G. Hickory
Mrs. J. E. Latta Hlllsboro, Rt. 1
John P. Henderson, Jr., M. D. Sneads Ferry
Roger W. Morrison, M. D. Ashevllle
Z. L. Edwards, D.D.S. Washington
EXECUTIVE STAFF
J. W. R. Norton, M.D., M.P.H., State Health Director
John H. Hamilton, M.D., Assistant State Health Director, Director
State Laboratory of Hygiene, and Editor Health Bulletin
Robert D. Hlgglns, M.D., M.P.H., Director Local Health Division
Ernest A. Branch, D.D.S., Director Oral Hygiene Division
A. H. Elliot, M.D., Director Personal Health Division
J. M. Jarrett, B.S., Director Sanitary Engineering Division
Fred T. Foard, M.D., Director Epidemiology Division
E. C. Hubbard, B.S., M.P.H., Director Division of Water Pollution Control
List of free health literature will be supplied by local Health Departments
or on written request.
CONTENTS Page
Nursing Homes and Homes for the Aged—The Heart of the Matter 2
Notes and Comment 9
Nursing Homes and Homes for the Aged — The
Heart of the Matter*
By L. E. Burney, M. D.
Surgeon General, Public Health Service
U. S. Department of Health, Education, and Welfare
First let me express my sincere ap- pose, a wider vision of otir individual !
preciation to every individual who has and collective responsibilities for the i
a part in this Conference. I am especi- patients in nursing homes, the resi-ally
grateful to the Planning Commit- dents of homes for the aged. They are
tee, the section chairmen, and all the ones who must reap the rewards of
others who have worked hard these this Conference. They are the sole rea-past
few months so that nothing shall son for our being here together this .
be lacking to make this Conference a morning. I
rewarding experience. Today, in a niursing home not far
'
It is my earnest hope that after these from here there is a little old lady aged ,
four days of working together, each of 90 years, a former schoolteacher. She
|
us will return to our usual tasks with a is happy, active, comiortable, busy
clearer understanding, a firmer pur- with her crossword puzzles, books, and
•National Conference on Nursing Homes and Homes for the Aged, Washington,