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Cbe Librarp of tl)e Onjtiet0itp of Boitb Carolina CntiotoeD bp %^t SDialectic ano l^gilant^ropic &ocietie0 614^^06 JSfSSh 1526-30 Med. i;t>. JOSEPH RUZICKA BOOxetMOERS BALTIMORE.MO nl'lWf^'m 1 This hooh must not be taken from the Library building. ff- " "' .-I——r" t-'s, JUL 1 5 ]%] LUNC-15M N.36 OP-13370 Putlislyed h^ TAZ. N°KJI\ (M9Lm^ 5TATL D°ARD s^AE^LTA This BulkliAwillbe -serxt free to qu\3 ci"tizer\ of Ihe State upor\ request.! Entered as second-class matter at postoffice at Raleigh, N. C, under Act of July 16, 1S94. Published monthly at the office of the Secretary of the Board, Raleigh N. C. VOL. XLV JANUARY, 1930 NO. 1 The midwife class of Person County. These women have been taking a course of instruction provided by the county health department, spo7isored by Miss Ruth McCollum, the county nurse. It is a creditable looking group. They are putting into effect the practical idea of improving the status of all mid-wives as long as there remains a single woman needing their services. MEMBERS OF THE NORTH CAROLINA STATE BOARD OP HEALTH A. J. CROWELL, CTRUS M.D., President r>>,o^i^«.» THOMPSON, M.D._ tV.v^ ^m* THOMAS E. ANDERSON, M-DTI: «^t^f°°yH ' E. J. TUCKER, D.D.S._. I Statesville D. A. STANTON, M.D._r___ ' £rV u ?. • ° JAMES P. STOWE, Ph.G. ^^Mu ^^i?* JOHN B. WRIGHT, M.D Charlotte L. E. McDANIEL, M.D. __ Raleigh CHARLES C. ORR, M.D. 1- i"^t*^^?," Asneville EXECUTIVE STAFF ROnIld^ ^V^olEf^a^^^.^^; }^-^i: KONALDB. WILSON Secretary and State Health Officer. Assistant to the Secretary. ?< V; ^M93^ M.D., Director State Laboratory of Hyeiene H E- M?TI'^' ^^' ?i5*?'°^ g^^^*^ «' Health Educatfon. F m" REmf^R Mh^^A^^ "t Bureau of Engineering and Inspection. H A TAVTHT?^^ •i*-°/'^^^^°?'.B".^^,^^ °^ V"^l Statistics. t±. A. iAYLOR, M.D., State Epidemiologist. ^^g^Qf COLLINS M.D Director Bureau of Maternity and Infancy. iErR;>NTfEvS^^TriSK, M.D., Director of County Health Work A. BRANCH, D.D.S., Director of Oral Hygiene. FREE HEALTH LITERATURE whi-Jw^-lfhl^ ^^^'^ of Health publishes monthly The Health Bulletin, T^LSkT l^i-^r^-^""!? *° ^"7 "^'^^^ requesting it. The Board also has available for distribution without charge special literature on the follow-ing subjects. Ask for any in which you may be interested Adenoids and Tonsils Cancer Catarrh Care of the Baby Constipation Colds Clean-up Placards Chickenpox Diphtheria Don't Spit Placards Eyes Plies Fly Placards German Measles Hookworm Disease Infantile Paralysis Indigestion . Influenza Malaria Measles Pellagra Public Health Laws Prenatal Care Sanitary Privies Scarlet Fever Smallpox Teeth Tuberculosis Tuberculosis Placards Typhoid Fever Typhoid Placards Veneral Diseases Water Supplies Whooping Cough SPECIAL LITERATURE ON MATERNITY AND INFANCY .pnt'^f!^!/t"'''^'"^-'.?^"^^^'tf^i"'"^ °" ^^^ subjects listed below will be Health, RaleighfNlc.? ^^^^ °'' ''^"''* *° ^^" ^^^^^ ^°^^d °f Prenatal Care (by Mrs. Max West) Infant Care (by Mrs. Max West) Prenatal Letters (series of nine monthly letters) Minimum Standards of Prenatal Care What Builds Babies? Breast Feeding Sunlight for Babies Save Your Baby Hints to North Carolina Mothers Who Want Better Babies Table of Heights and Welgiits The Runabouts in the House of Health (pamphlet for children from 2 to 6 years of age) Baby's daily Time Cards: Under 5 months; 5 to 6 months; 7, 8, and 9 months. 10, 11, and 12 months; 1 year to 19 months; 19 months to 2 years. Diet Lists: 9 to 12 months; 12 to IS months; 15 to 24 months; 2 to 3 years; 3 to 6 years. CONTENTS PAGE North Carolina Health Prospects For 1930 ^^____ 3 Practical Health Teaching' In Wilk-inson School 4 Recalls Days of Embalmed Beef and Typhoid Fever 6 Vitamin Band Pellagra 7 Preventing Unnecessary Noises—1__ 8 Heart Disease and the Public Health 9 Who Is Educated? 10 Practice of Medicine Regarded as Public Utility 11 PAGE Driving On Left Side of Road 13 Broken Wings 14 Vaccination Pacts 21 College Blues 23 Our Lives Shorter, Not Longer 25 Common Sense and the Open Win-dow^ 26 Dosers 28 Our Back Cover Cartoon 29 How Very Few of Us Die 30 An Encouragement 31 VOL. XLV JANUARY, 1930 NO. 1 NORTH CAROLINA HEALTH PROSPECTUS FOR 1930 Facing a new year is an adventure for everj" living human being from the infant in its crib to the individual who has marked off three score and ten years. For many of the infants, too many of them, the journey will be perilous. For many of the aged it will mean embarkation on the "Third Puzzle" of human existence. Accidents and untimely deaths, most of which are preventable, will take heavy toll among the intervening ages. The same history is recorded year after year. It is the business of a health depart-ment to make the traveling of the in-fants less hazardous, to reduce the preventable toll taken from those of active age, and to defer the em-barkation of those of advanced years as long as possible. The practical question is, how may these things be done? The equally practical answer is, by efficiencj', honesty and industry on the part of health department personnel, county, city, and state, in vigorously teaching the people how to apply the scientific principles of disease and accident pre-vention. We herewith set forth some of the things that might be done. Every prospective bride and groom might be taught the dangers of ve-nereal disease with the disastrous consequences which so often follow such infection. Every prospective mother should receive expert care and adx-ice during the entire pre-natal period. She should have the proper kind of food in adequate quantity. Any abnormal condition manifesting itself should have immediate medical at-tention. During the birth process ev-ery needful attention should be avail-able. Thus the maternal dangers may be largely eliminated. The infant then, given a healthy heritage free from venereal infection, may have at least an even start. Every infant born should have right from its first hour the inalienable right of nourishment from its mother's breast, unless a com-petent physician certifies that breast feeding would be dangerous for the mother and disastrous for the infant. Soap is cheap and water, fresh air and sunlight in North Carolina is practic-ally unlimited the year round. The baby should, therefore, have a clean bed, regardless of rags or poverty (the rags can be clean ones), mother's milk, sunlight and clean air. The male relative with pipe or cigar, or the mother with cigarette, should be equal-ly barred from the baby's presence as the visitor with a cold. Give the baby air free from the germs of respira-tory infection, the irritating effects of nicotine loaded smoke, good breast milk, a clean bed, good heritage from healthy parents, let it alone and the chances are better than even the baby will do the rest for the first eight or nine months of life. Careful attention to the establishment of health habits with assurance of right kind of food, frequent inspection by the family phy-sician and dentist will take care of the pre-school period and ensure the pre-sentation of a healthy young animal to the school at the ripe and experienced age of six. These first six years are the important ones. Then is the pe-riod when the parents should know The Health Bulletin January, 1930 the water is pure, the milk safe and the food of the right kind, adequate and properly prepared. Two of the most important things to do during the first year is to see that the infant is successfully vaccinated against smallpox and that it has three ade-quate doses of a fresh product of toxin-antitoxin properly administered to guarantee against diphtheria. Measles, whooping cough, and scarlet fever should be guarded against with all possible care. Six years old and healthy when school troubles begin means power to win if the teacher is intelligent. There are so many aids to good health now available for the school children almost all over the State, that no pupil's health should be jeopardized during these years. Never-theless many thousands of them have their health seriously impaired in many ways which could be avoided. But we may take heart here for the teachers are learning. It is the solemn duty of every health officer to help teach them, and none the less the ob-ligation of every practicing physician to do the same thing. Shorter school hours for younger children, all those under twelve, and rigid supervision of school cafeterias may be regarded as the two most imperative demands for better health safeguards for school children. It ought not to be necessary to say that if any child is so unfor-tunate as to be admitted to school this year before receiving a successful vac-cination against smallpox and diph-theria this important deficiency should be remedied during the first thirty days of school. In all the foregoing the one respon-sible individual who is paid a salary from public moneys to do these things is the local health officer. It makes no difference whether he is a full time official or a part time one, the obliga-tion is equally binding. It is no use to say the fault is the parents, or the practicing physician's when failure to invoke protection is present. The health officer must secure the coopera-tion of parent and family physician. Details and methods by which things may be done are unimportant. Getting them done is the important point. Plans and programs should be made to fit the local needs. But the prin-ciples are fundamental and State-wide. For the general population atten-tion should be given to a more plenti-ful supply of fruits and vegetables and an increase in the consumption of dairy products, poultry, eggs, meat, and fish, by people who need to guard against the deficiency diseases. Pure water, whether it be for village or city dweller or on the farms, should be made available. Better safeguards to assure clean and safe milk. Adequate screening of all houses, the extension of sewage facilities and sanitary privies where needed are among some of the things to be looked after in our 1930 health prospectus. More humane and sympathetic care for the aged and the "down and out;" the better safeguarding of the health of working people in all kinds of in-dustry and agriculture are among our biggest needs. For the adult individual a health examination, a really truly health examination, not a pulse feeling and tongue inspecting enterprise, would if included in the year's pro-gram add much to the happiness of all such wise folk as well as possibly adding a little something to the span of life. May your New Year be what you try to make it. PRACTICAL HEALTH TEACHING IN THE WILKINSON SCHOOL OF ROCKY MOUNT Early in October the teachers of the Wilkinson school of Rocky Mount, North Carolina, wrote to the State Board of Health explaining a plan they had for the practical teaching of health matters in the school this January, 1930 The Health Bulletin year. They informed us that they had about three hundred and twenty-five pupils in this particular school. The plan that they proposed to put into effect is one that any wide-awake school of the State can also utilize. Briefly speaking, they propose to take up one phase of health teaching each month and study that exhaustively. They selected as their subject for the month of October the care of the teeth. They asked us to supply them with literature in the form of a short pamphlet on the care of the teeth, sufficient to supply each one of the pupils with a copy. It so happened that we have been distributing for ten years all throughout North Carolina a carefully written special pamphlet on the care of the teeth. This little pamphlet has two cuts, one a drawing of the temporary teeth and one that of the permanent teeth. The two are placed on the same page. Each tooth of each set has the proper name and the approximate date of eruption. The teachers of the Rocky Mount school proceeded to examine each child, writing his or her name on the pam-phlet to begin with. Whenever they found a child who had a particular tooth corresponding to the tooth on the plate, either temporary or perman-ent, which was decayed, they mark-ed this particular tooth "decayed" or "needed dental attention." Each child was then asked to take this pamphlet home and to show the parents the sit-uation that the teacher had found. This is certainly beginning at the beginning and is one of the most ef-fective methods of teaching practical care of the teeth we have ever seen. The method assures concentrated in-terest on the part of the parent at a time when it will probably do more good than it could ever do again. The information carried in the pamphlet is sufficient to explain to the parent the importance of taking action imme-diately. No dentist in the world could criticise this procedure. The examina-tion was not a dental examination, and if a tooth had a decay in it big enough for a teacher to see, it is a self-evident proposition that the dental services were needed; and, after all, the re-sponsibility of health departments and teachers is to get children who need dental or medical care into the hands of capable dentists and physicians. This procedure on the part of the Rocky Mount teachers strikes us as being the finest method yet devised to do that particular thing. To go a little farther along with the Rocky Mount program, another month, after they settle the teeth question, is to be devoted to the ques-tion of a study of the prevalence, dan-gers, and prevention of diphtheria. Here again we are able to provide them with literature which is to the point, sufficient for each child and its parents to have. In this way every parent who is patronizing the Wilkin-son school in Rocky Mount will have directly called to his attention the fact that diphtheria may be easily pre-vented through the administration of toxin-antitoxin to any young children in their families. If the parents do their part and act on the suggestions which will be brought directly to them, there should not be a single case of diphtheria developing m the Wilkinson school of Rocky Mount when the fall session of 1930 opens. This will give ample time for the immunization thi'ough the winter and spring of any children in homes patronizing that school for the immunization to take full effect before the school opens next September. And another item of vast import-ance to the health of the school chil-dren is the question of foods. The teachers propose to take one month for the study of the particular kind of food, the quantities, and so on that school children should have. These are only items illustrative of the fine and comprehensive program these teachers are carrying through. We take pleasure in departing from our usual custom in which we are The Health Bulletin January, 1930 treating all matters these days dis-cussed in the Bulletin in an imperson-al manner, by mentioning the names of the two teachers who have initiat-ed this program. Communication to the State Board of Health was made by Miss Charlie Westbrook, one of the teachers in the Wilkinson school, and Miss Bessie McDearman, principal of that school. We hope that other teach-ers, when engaged in their schools, will follow the example of these wide-awake teachers in this particular Rocky Mount school. The field is un-limited and the need is great for just such practical teaching. RECALLS THE DAYS OF EMBALMED BEEF AND TYPHOID FEVER Thirty-two years ago this month the battleship Maine was blown up in Ha-vanna Harbor, and very soon there-after the country was at war with Spain. Some few weeks ago the Mon-roe Journal published a rather poig-nant little story from a Monroe citi-zen who is a veteran of that war. The story recalls to mind so graphically the conditions in this country, and in the army where typhoid fever killed many more soldiers than Spanish bul-lets, that we herewith publish it in full. To a present-day health officer in North Carolina it will read like a story from some ancient and musty history. However, there are many of us who can remember only too well the conditions that existed in the civil-ian population in North Carolina just as well as obtained in the army. This man speaks from personal knowledge. He was a victim. The story has gone the round many times of a pompous major general of one of the camps walking up and tearing from a polluted well a notice from the med-ical department warning the soldiers not to drink the water from that par-ticular well. This old incarnation of political authority, and ignorant of things outside of his particular tech-nical training, proceeded to drink of the water and to remark that all this medical palaver was foolishness. At the time hundreds of his soldiers were sick from typhoid fever, and many of them were dying every day. We have certainly traveled some distance since that day. Read the story that this sol-dier tells, and take heart that in some things the world is not as bad as it was thirty-two years ago. "When Mr. John Holloway put on his uniform of a soldier of the Span-ish- American War, people said, "Hel-lo, Mr. Holloway, I didn't know you were a Boy Scout.' "That riled John, riled him to think that the war in which he had been a soldier and came very near losing his life, could be totally forgotten by the older people and wholly unknown to the young. "But that is about the truth of it. And the government takes the same attitude, says Mr. Holloway. It does just about half as much for a veteran of the Spanish-American War as it does for one of the World War for exactly the same disability. And though it paid him only fifteen dollars and sixty cents for soldiering, it mus-tered him out without any compensa-tion adjustment at all. "Dewey captured the Spanish fleet in Manila bay on May first, 1898, and Schley smacked the Cevera fleet on July fourth. At that time the Ameri-can soldiers, every last one of them volunteers, were being prepared to land in Cuba, but a lot of them never got there. They were already dead or dying of typhoid fever or starving on embalmed beef in the concentration camps. John Holloway was one who was laid up with typhoid fever and his leg was swollen as big as his body when his regiment embarked for Cuba. "There are a good many more Span-ish- American War veterans around here and there and no doubt they feel January, 1930 The Health Bulletin about like John of the hardships of that war and the scant attention they now receive, especially as John says, since what they underwent caused the revolution that swept away the men-ace of embalmed beef, cheating con-tractors and such like and started the war against typhoid and made army camps at last free from such dis-eases." VITAMIN B AND PELLAGRA In a letter to the Editor of the Bul-letin sometime ago a physician friend remarked that he could not see why pellagra should be regarded as a de-ficiency disease in view of the fact that the pellagra preventing principle in food known as vitamin B is the most widely disti'ibuted vitamin in nature, and so that practically the diet served on all tables in the homes of the peo-ple of this State therefore had an abundance of vitamin B, and that they could not help eating a considerable amount of food containing this vita-min. The fact that vitamin B is present in the leafy vegetables such as let-tuce, cabbage, spinach, turnips, in liv-er, kidneys, tomatoes, beans, peas, po-tatoes, eggs, milk, in addition to the large amount found in yeast and the basic foods of every family, cereals, would seem to afford a sufficiency of this necessary element. It is, of course, true that an abundance of this vitamin is available, provided we eat it. We have just called cereals the basic food of every family. This is true, be-cause, in North Carolina at least, corn bread, white store bread, or biscuit made from white flour, composes the bread diet for ninety-nine per cent or more of the people. In a thorough-go-ing study of this point the late Dr. Edward J. Wood made a special trip to some of the large flour mills in the Central West in order to see the pro-cess employed in making flour, a large quantity of which was shipped and is shipped to this State for consump-tion. He made the same investigation concerning the manufacture of the commercial corn meal handled in large quantities by the grocery stores of this section also. He learned that the germ of the wheat, and of the corn, was removed in the milling process, be-cause this portion of the grain, which contains the vitamin B, if retained, then the flour or the corn meal was many times more subject to mold and spoilation in shipping, and therefore to commercial loss. People who eat the native whole wheat bread from wheat made in this section, or at least milled in this sec-tion, and which contains all of the This little Youngaville girl weighed only two pounds when one ivcck old. She lay on a pillotv in a bassinet with hot water bottles around her for the first three months. During this time she teas fed lactic acid milk sweetened ivith corn syrup, and administered with a medicine dropper. She is a fine example of what may be done with patient and intelligent care, includ-ing parental, nurse and medical. 8 The Health Bulletin January, 1930 wheat kei-nel, including the germ, get the vitamin B in proper proportion. In the same way the many thousand families in the State who embrace the opportunity of getting their corn meal, from which they make their corn bread, from local grist mills, especial-ly from local mills in which the North Carolina corn is utilized fresh from the barns and fields of the local farm-ers, also get vitamin B in their corn bread, although in smaller proportions than in the whole wheat bread. Dr. Wood therefore held that the basic cause which made pellagra possible was that the people who had been de-pending upon a diet rich in the gei-ms of wheat and corn in their bread, when deprived of this through the commercial products utilized in recent years, failed to get enough of the pel-lagra preventing principles by eating it in other foods, sufficient to make up for the deficiency. We reiterate here the doctrine of Goldberger and Wood, that it is not only necessary to have an adequate diet on the table containing an abund-ance of vitamin B, called by Goldberg-er the pellagra preventing principle, but it is essential that this diet be consumed by the person who would avoid pellagra or other deficiency dis-eases of like character. PREVENTING UNNECESSARY NOISES Some of the health departments in the various cities of the country are very much concerned over the ques-tion of control of unnecessary noise. The city of London has had various commissions at work making surveys in their thorough-going style as a pre-liminary to city ordinances drastical-ly extending control in order to pre-vent these nuisances. In this State the city of Greensboro raises a big fuss about the blowing of train whistles and the exhaust racket kept up dur-ing the night by a surplus of motor cycles. In some of the cities of the North street cars are blamed for a great deal of the noise, the city of Dayton, Ohio, in its Health Bulletin declaring that there had been no im-provement from a noise standpoint in the operation of street cars of that city in a third of a century. Nearly all the cities and towns in our State find the unnecessary blow-ing of automobile horns nothing short of an unmitigated nuisance. The vi-bration caused by heavily loaded trucks running at rapid speed on the streets at all hours of the night is another cause for complaint. For the most part the latter are engaged in the work necessary to be done for the welfare of the people, and nothing we know could be done to prevent it ex-cept better training of the drivers as to how to reduce the racket to a min- I imum. In the case of blowing automo-bile horns, in our opinion about one toot every six months for the average car is sufficient. The fact is that the manufacturers ought to be prohibited by law from equipping cars with horns. If this nuisance were drastical-ly abated in the foregoing manner, and an ordinance strictly enforced, re-quiring all drivers to keep well to the right side of the road, there would not be any possible excuse for a horn on an automobile. Some critic might prob-ably say that it would still be neces-sary to warn pedestrians, but the fact is that a few sharp blasts from the automobile horn when a pedestrian is crossing the street only tends to con-fuse him and make bad matters worse. The pedestrian, of course, must be taught to look before he crosses the street, just as the automobile driver should be trained to stay on his side of the road. The ringing of the train bells and the blowing of locomotive whistles day and night in thickly populated resident portions of town certainly should be reduced in volume | and used only as a necessity in the safe operation of trains. For the rath- January, 1930 The Health Bulletin er large volume of sound as an inci-dent of making general "whoopee" in the residential sections of towns in all hours of the night, that is a matter for education and regulation by com-petent authorities. HEART DISEASE AND THE PUBLIC HEALTH It was not until about the beginning of the present century that tubercu-losis was definitely recognized as a public health responsibility. Only re-cently cancer has been placed in the category of diseases constituting a public health problem. The fact is that it is not even so recognized every-where now. The extremely communic-able diseases like smallpox have natur-ally been looked upon as public health problems all the time. We are glad to he able to record the fact that now heart disease is coming to be looked upon as just as definitely a public health problem as cancer is. Progress tov/ard the control of the spread of tuberculosis is much more satisfactory now that it is realized that the disease is almost always con-tracted in childhood through exposure of infants and very small children to contamination with the fresh sputum and other discharges coming from tu-berculous patients living in close con-tact with the infants. When it was learned that this infection was pres-ent in latent form in the children, to become manifest in later years, then it was that the most intelligent efforts could be directed against the eradica-tion of the disease. It is now realized that about seven-ty- five per cent of all cases of heart disease develop in children ten years of age or under, and that only about ten or twelve per cent develop in per-sons over forty years of age. Heart disease is one of the gi-eat killers of this country. More than twice as many people die each year from heart dis-ease as do from kidney disease or from cancer or from pneumonia; and these four diseases constitute the four chief causes of death. Another disturbing element is that the rate of death from heart disease is increasing about twice as rapidly as the rate of population increase. Often heart disease is congenital; that is, a child is born with the disease present, and in such cases nothing can be done to prevent its development and the probable early death of the child. The only thing in such possible cases that can be done is to pay more practical attention to the care necessary to safe-guard expectant mothers. The other form of heart disease; that is, the form that is acquired after the healthy birth of a baby, is nearly always due to complications resulting from com-municable disease, or to improper hab-its of living. The group of diseases known under the general term as rheumatism is notably large. Rheumatism is at this time believed to be a germ disease. For many years the doctors and den-tists have had a great deal to say about focal infections. In these condi-tions so-called rheumatism infection is frequently a result of diseased ton-sils or decayed teeth, the germ gain-ing entrance into the blood stream through such conditions in the body. The chief thing to emphasize in this connection is that the best method of prevention of such conditions is to pre-vent, when possible, decayed teeth, and also to preserve, if possible, norm-al tonsils, through care for the gen-eral health of the child before and after birth, the prenatal care, of course, directed to proper hygienic living, proper food, and the freedom from disease of the mother. The United States Public Health Service in a recent publication stated the tabulations of physical records of five thousand school children under their supervision showed that of the children whose tonsils had been remov-ed for serious tonsillar infection in 10 The Health Bulletin January, 19SO A fine pair of Jackson County twins. At present both are underweight, but we hope that handicap will be re-moved at an early date. the past, twenty out of every hundred had attacks of rheumatism, and of the children with defective tonsils which had not been removed, seven-teen out of every hundred had rheum-atism. With the former group, four had heart disease, and of the latter group, three out of each hundred had heart disease. The showing, however, for children who had normal tonsils which had not been removed and which were not diseased was much better, not more than one-third as many having indications of heart dis-ease. The use of the word "rheumatism" is somewhat misleading, because of the fact that in the past so many poorly classified conditions have been diagnosed as rheumatism. This has been done to the point where the average intelligent physician feels that when the word "rheumatism" is used, it is done so as a general term, and means very nearly nothing. Much experimental research work remains to be done in this group of diseases before an intelligent classification can be made. It is sufficient for our needs in this discussion, however, to recog-nize the fact that heart disease is an increasing menace, and that it results from many communicable diseases as well as from improper habits of liv-ing. In conclusion, we would like to em-phasize again the fact that to do any-thing much with heart disease requires an early beginning, and it is one con-dition in which prevention is about the only logical procedure toward which all efforts at eradication should be directed. WHO IS EDUCATED? September and October this year have been disappointing to the State Board of Health officials and to the public health workers in general in North Carolina because of the fact that the presence of diphtheria, judg-ing from cases reported throughout the State, has been just as serious, if not more so, than in previous years. We have said it several times be-fore orally and in print that there is today in North Carolina no excuse for a parent whose child has diphtheria. The reason for this statement is that toxin-anti-toxin properly administered to young children affords such a max-imum of protection that it is exceed-ingly rare for any child to have diph-theria after immunity is secured through the administration of toxin antitoxin. A short time ago a close personal friend of the writer, a university grad-uate and an important North Carolina educator, was detained at his home on account of an attack of diphtheria in his youngest child, a boy of six years of age. The child had started to school at the opening of schools in Septem-ber. Naturally being exposed, as so many other thousands of children are every fall, for the first time to diph- p January, 1930 The Health Bulletin 11 theria and other contagious diseases, not having had the protection afforded by toxin-antitoxin, and being suscep-tible to the disease, he promptly con-tracted diphtheria. The wife of this friend is an educated woman. Both of them have had access to the litera-ture and other channels of informa-tion concerning every protective de-vice available for the rearing of their children. Their home is located within four blocks of one of the four oldest whole-time health departments in North Carolina. The health officer in that county has been giving toxin-antitoxin at frequent intervals to the children of all parents who would take the trouble to bring them to the office or arrange the schedule in the differ-ent sections of that particular county. The same thing has been done in many other counties, and yet there are lit-erally thousands on thousands of chil-dren in North Carolina today who have not been given this protection by their parents. Our friends in response to the question as to why they had neglected to protect their child through toxin-antitoxin last spring and summer, knowing that their child would start to school this fall and be exposed to diphtheria, replied that they just simply had not done it. They were not indifferent to the value. They were not in ignorance of its protection, but they simply had not got around to it. A few days later we were in the of-fice of the health officer of Randolph County just preceeding a county-wide teachers' meeting in which the super-intendent of Randolph County schools was making a particular point to em-phasize the importance of public health protection at his very first county-wide teachers meeting held in the county. While we were sitting in the office conversing with the health officer, a nearby farmer came in with his two children, a little boy of four and a baby of fifteen months. They had been there for their first dose a week previous, and on entering the office the little four year old began pulling up his sleeve, and, with a broad grin on his face, told the health officer he was "ready for another one." In less than a half minute the health officer had administered the second dose of toxin-antitoxin to the fine little chap. There was just about as much pain as a mosquito bite, and if the reaction is no worse than the average, that was the last that the little fel-low would hear from that dose. Now our question is, so far as pub-lic health protection goes. Whose edu-cation in these cases proved to be the most practical? PRACTICE OF MEDICINE NOW REGARDED AS A PUBLIC UTILITY Doctor Henry G. Longworthy is the treasurer of an organization known as the Inter- State Post Graduate Med-ical Association of North America. He wrote an article which was published in the September issue of the Nation's Business Magazine. He begins his ar-ticle with the astounding statement that "The practice of medicine today may be regarded as a vital public util-ity function well regulated by law and well managed by physicians, hospit-als and social agencies." He pictures the physician of the present day who practices medicine in the city as a "bedside medical engi-neer." He says that as a medical ex-ecutive such a physician "engineers or calls to his aid at the bedside for the benefit of the patient, all necessary consultations, hospital facilities, nurs-ing, diet, and all the other sciences. In many cases for the diagnosis and treatment of a single patient, this medical executive will use the services, directly or indirectly, of a dozen to a hundred persons." The foregoing is true and it is what 12 The Health Bulletin January, 1930 is making the practice of medicine to-day one of the most complicated and costly of professions. It accounts for the enormous cost of hospital care. The sinister phase of it is that the successful physician can no more hope or expect to get back to old style economic individualistic methods than he can expect or desire to return to his saddle bags and home-made pills. The danger in the situation lies in the possibility of the physician (medical engineer) becoming of necessity a sim-ple cog in a vast machine whose final superior may be a political cabinet of-ficer. That is the spectre of State Medicine so many thoughtful physic-ians fear. In such an arrangement the individual patient would receive about as much personal and individual at-tention as one biddie in an incubator flock of ten thousand. This is the day of big business. All of us think and talk in terms of bil-lions, whether it be debts or folks. Mergers and combines are in complete and glorious control of everything. The pendulum has simply followed the law of averages and swung back from the period of thirty years ago when no corporation or combine was too small or too poor to be kicked. What more natural then, in the present mental state, than to regard the doc-tor along with the chain store opera-tor as a purveyor of a public utility because he has something to sell that most people have to have at one time or another. The writer in the aforementioned article quotes Homer Folks in a state-ment that the families of this country having illness in the course of a year pay out in actual cash on account of such illness the astounding total of two billion dollars. The same total amount is spent annually for public education—from kindergarten to post graduate universities. If cost in loss of time and other economic loss is in-cluded, sickness costs the American people every year about fifteen billion dollars. So, we see that in a way the practice of medicine and the conduct of hospitals for sick people constitute about the biggest public enterprise in the country. That being true it is in-evitable that business and medicine should form a new alliance, and the foundation stone of the enterprise must be preventive medicine. The pre-vention of disease is a public enter-prise. To achieve its finest results it must be organized like an army, and in the struggle for the ideal of longer life and sounder health, the army must be composed of individual physicians. No faculty ever educated a student. What the student gets is the sum total of efforts made in his behalf by indi-vidual instructors. No medical society ever cured a patient. Some individual member of the group must assume full responsibility and do the job if the pa-tient is to benefit. And that is what Dr. Longworthy meant by calling the physician a bedside engineer. If the mass of the people are to receive the benefits of this new alliance between business and medicine they that are well must be told how they may keep well. That is an individual problem. Each must read what some one per-son writes for him or he must be told by some individual. Who is better qualified than the physician? If the person who is sick is to benefit he must have the attention of an individ-ual physician. In the final analysis the things that must be done to reach the ideal may be summed up about as fol-lows: 1. Knowledge concerning the cause of disease and the prevention of its spread must be placed in the hands of every intelligent individual. This is a purely public health responsibility. 2. The services of a competent phy-sician must be available for every sick person regardless of where he lives or how poor he is, for so long a period as he needs such service. TTiis is ob-viously impossible at present. So the business part of this alliance be-tween medicine and business must see that: January, 1930 The Health Bulletin 13 3. Hospital facilities are placed within the reach of all. The physician must practice more and more in con-nection with hospital and medical cen-ters. These hospitals must be placed in the rural sections as well as larger towns. Under this arrangement the physicians will have available all mod-ern methods of aid in diagnosis. Such a system will result in 4. Better care for the patient at much lower cost than at present. A physician will be able to treat many more patients, and to treat them more competently. Having his office and home in such a center, even though it be in a small town, the of-fice or ambulatory patients may re-ceive assurance of more satisfactory care, and patients needing bed care can receive it easily. The cost must be many times less than at present, and the physician must receive much better compensation than he does now. Business methods can assure all this and the physician and patient will both retain forever the fine individual relationship that has obtained in the past, surely to the vast benefit of the patient. DRIVING ON THE LEFT SIDE OF THE ROAD Here we are again talking about traffic on the highways. However, in view of the fact that mortality due directly and indirectly to automobile accidents constitutes one of the major causes of preventable deaths in this State, we feel justified in continually writing something in the Bulletin about the matter. It has been neces-sary in the progress of the science of public health in driving away at the preventable causes of death to keep continually before the public these particular causes and how a dif-ferent public attitude might result in preventing death from unnecessary causes. There are not many rules for safety on the public highways, but the few rules that there are constitute some very important ones, the breach of which causes many deaths and much suffering among the people who are the victims. With the thousands of automobiles running along our main public highways every day at high speed, the least variation from the known methods of safety may at any time instantly result in death to one or more persons. It has been our observation in our journeys to and fro around over the highways that a frequent cause of traffic trouble, accidents and death, is the man who persists in driving along on the left side of the road. There seems to be a large percentage of such pests exercising the privilege of driving automobiles all the time. This particular insect seems to delight in getting on a crowded highway and piddling along at a low rate of speed on the extreme left-hand side of the highways in the country, and in the city or town he gets just as far over the middle of the driveway to the left as he can possibly get without having a collision with cars coming from the opposite direction. TTiey seem to think that the roadway is better on that side, or that the atmosphere is more rarefied and purer, or they may do it for just pure carelessness. The driver who wishes to pass, even on an open road, has to wear his horn out calling attention to his desires before any notice is taken. By the time he reluc-tantly and slowly begins to turn in, one or more cars heave in sight com-ing from the opposite direction, which makes it impossible to pass, often for a mile or more. The chief characteristic of the left side of the road driver seems to be his desire to drive along slowly. When coming meeting such a driver the le-gitimate, careful driver of an on-com-ing car almost has his hair standing on end before this pest seems to take notice and grudgingly turns back to- 14 The Health Bulletin January, 1930 ward the right, perhaps getting out of the line of traffic just about the time the driver meeting him has to slam on his brakes or leave the road-way entirely to avoid hitting him. Such a habit is dangerous for several rea-sons. One of the chief dangers, of course, is the impossibility of drivers of cars behind him being able to see an on-coming car, perhaps just be-fore a road intersection, or, in their efforts to pass him, the on-coming car is obstructed from view, and ac-cidents often result. Another thing, it is bad for the nervous system and therefore the safety of every driver of a car, and to the people he meets, to have his calmness or his equanimity upset from any cause. Such driving frequently results in fatal accidents to pedestrians also. After all, the question of driving comes back to the very old one of good manners. A polite, considerate, well-bred driver of an automobile will think of the convenience and safety of the drivers of other cars, as well as his own, and will therefore govern himself accordingly. We would suggest to all persons reading these lines, who are accus-tomed to driving an automobile that they ask themselves the question: "Am I a left-hand side of the road driver ? " If the answer is in the affirmative, our advice and request is to quit it. BROKEN WINGS By SuDiE E. Pyatt Paul was falling from a couple of thousand feet above the earth. His plane had gone bad, the left wing was broken. He was crashing toward the earth at terrific speed with no time to adjust his parachute. Just before he reached the earth that rose to meet his broke plane, he awoke swearing. "D—n!" He could hardly breathe. That left lung, the one the doctor had pumped gas into that day was pain-ing him as if a sharp knife had been driven through it. Pleurisy, and the spot still sore from the passage of the needle that had introduced the first shot of air into the pleural space be-tween his lungs and his ribs, caused the pain. No wonder he had dreamed he was crashing to earth with a broken airplane xwing. Bird with a broken wing he was, and birds with broken wings never could soar so high again. Paul groaned. The night nurse, a silent figure in white, a lantern bob-bing by her side like a huge firefly, laid her hand gently on his arm. "What is the trouble, Mr. Dun-bar?" "D d bird with a broken wing!" Paul sighed half asleep, but not for-getful of the pain in his left side — —broken wing. "Never fly again. No more stories from the pilot's seat of my plane—broken wings— " Paul's voice trailed off into silence under the nurse's ministrations. When she left him he was sleeping again, peacefully this time. Feature writer for one of his state's best daily newspapers, and airplane pilot good enough to have a transport license, Paul Dunbar had been sent three months before by physicians who would hear of no other course to the State Sanatorium suffering from a moderately advanced tuberculosis le-sion in his left lung. Paul should have responded to twen-ty- four hours a day rest in bed in a number of weeks, but he did not. The January, 1930 The Health Bulletin 15 lesion began to look as if it might be-come worse, and the physicians in the institution decided to administer pneu-mothorax. Far from being a model patient Paul had objected at first, but had finally acquiesced. He had received his first treatment the day before the night he had had his dream of dash-ing from a great heighth in an air-plane with a broken left wing. Eighteen months of the sanatorium and Paul was in the superintendent's office receiving his final examination and instructions before leaving the in-stitution to resume his life back in the world of men and women outside the san's wall. Paul was now what the doctors call-ed a quiescent case of tuberculosis. He would have to have the pneumothorax treatments continued, and he could work only a few hours a day. He sup-posed he should feel thankful that the "bugs" had not gotten him, but in Paul's breast there was a dull, glow-ering resentment.—"The bird with the broken wing never soars so high again." —And sitting in the superintend-ent's office listening to his final words of instruction, Paul was dully aware that back in the world again he would be a bird with a broken wing, who would never be able to soar so high again. For the doctor said emphatical-ly: "No flying for two years." It had been nearly two years now since he had flown, strong and well up there against the sun. Two more years, four years before he could fly again! Was it worth it? As Paul watched an army plane skimming over the hazy blue hills that surrounded the sanatorium he felt for a moment that he had fought in vain. But the doctor had said he might return to his work on the desk for part time. Part time on the desk, he who had been his paper's star report-er, free to go in his plane to the ends of the earth if he could find there a story for his paper, was to be a desk man, writing news that other report-ers gathered, and handling copy that the fellows who could get out on the streets were too busy to write. Not yet twenty-five, he had run his gamut, was played out before his time, and all because of that bad lung—d— n broken wing! The fellows on The Ashton News were nice to Paul. Nice because they were sorry for him, he thought, as deaf old Henry Clinard carefully wrote down for him the information about that Draketown Street robbery the reporter had brought in before he arrived, to make sure that he would understand everything connected with it. Watching "Old Henry" Paul won-dered how it would feel to never be able to hear a sound. "Not so bad," Henry had once vol-unteered the information, "if you don't get cross with people who holler at you. Deaf folks don't like to be On the Stump in Guilford. 16 The Health Bulletin January, 1930 bawled at any more than folks who can hear do." After that Paul was always very careful to write out his communica-tions with Henry, or to talk in a tone of voice that would make the old copy-reader feel that he was not bawl-ing him out. Henry appreciated Paul's thoughtfulness, and there were many times when Paul's work would not have been completed in the few short hours he was on the desk if it had not been for Henry's aid. Gradually there grew up between the deaf copy reader and the young re-write man with the broken wing the close bond of sympathy that always unites the incapacitated regardless of what the nature of the trouble is. The first day Paul was back at his old position he noticed a flower and gift shop that had been opened up in his absence in the little niche next door to the newspaper office. It was spring, early spring, and the first yellow jonquils were blooming. The little shop was filled with the bright, sunny beauty of the yellow flowers, and just behind them stood a girl, whose hair was as sunnily golden as were the delicate petals of the jon-quils, and the smile she gave Paul from dewy blue eyes, Paul was willing to swear, was made of pure gold it-self. "How much are they?" Paul found himself vaguely indicating the whole gorgeous display. Again Jonquil smiled, for Jonquil her name must be, she was so much like the flowers. "Twenty-five cents a dozen, or three dozen for fifty cents," and she had not finished speaking before Paul decided that her voice was as flowerlike as her face and her smile. "O, give me all of them," he said carelessly. "All of them?" A puzzled frown crossed the sweet, little face, some-thing like a brisk wind blowing across a bed of flowers. "All of them!" Paul repeated em-phatically after her. "That will be $10, sir." And Paul thought that her talking of prices was as if one of her yellow flowers had stepped out of its vase to do business. "Where shall I send them, or will you take them?" Paul looked puzzled for a moment. The jonquils would overflow his one room, bath and sleeping porch. "Send them out to the Bausman County Tu-berculosis Sanatorium," he said quick-ly. "To anyone in particular?" "No, to all of the patients." "What shall I put on the card?" "From a 'Broken Wing,' only." Paul did not realize that his voice was bit-ter. The girl smiled in quick sympathy, and for a moment Paul's black mood lifted. "Say, isn't your name Jonquil?" he asked impulsively. "No, it isn't, I'm sorry, but—" she stopped. "I'm going to call you Jonquil." "When?" "Now, and every time I see you — you see,—" Paul suddenly found he was floundering helplessly. "I work next door on the newspaper." "O, you're a reporter?" "Yeah, sort of." And with that Paul tipped his hat and went into the office. He had found suddenly that he would not like for this golden, blue-eyed Jonquil to think of him as a man with a broken wing. Paul had been back on the desk at The Ashton News for three months when Lon Dale, the greatest airplane stunt flyer in the United States came to Ashton. Paul had flown with Dale in the days before he had known that he had lungs. The stunt flyer's air antics and the reporter's ability at description had given The News many good stories. Dale and Paul, who were very fond January, 1930 The Health Bulletin 17 of each other, were delighted to meet again. It had been two and one-half years since they had pulled one of the hair raising airplane stunts. They had not been together fifteen minutes be-fore they were planning one of those thrilling flights of the old days, Paul forgetting once again that he had lungs—that he was a bird with a broken wing. They buttonholed Bill Lacates, the managing editor, as he came in. It did not take them long to tell him what they wanted. A story in The News that Dale was back, and that he and the reporter were going to give again some of the stunts that had given Ashton citizens such a thrill three years be-fore. Bill listened, chewing the end of a villainous black cigar. "Sounds fine, Dale," he disregarded Paul, "if you can get someone to go up with you to cover the flights, as Paul used to. Paul's not well, you know. It would never do for him to at-tempt it." Dale's face fell, and Paul grew pale, his eyes blazed. "Bill, you have no right to say I'm not well enough to get that story, any d—n story I want to." "Remember, Paul, you're a desk man now, and I'm the only one who can tell you to go outside, and I'm not going to tell you." With that Lacates walked into his office, and Paul was left facing Dale, white and shaken. "I'm just a bird with a broken wing. Dale. I can't even fly now by my doc-tor's orders. For a minute I forgot. Bill is right. That was his way of tell-ing me, 'I'm no good'." "Sorry, old boy," Dale rose and shook Paul's hand. "I was looking for-ward to some of our old stunts, but we won't now." Paul sat at the re-write desk, smouldering resentment in his eyes when Dale had gone. The managing editor had really been kind not to let him attempt the dangerous physical strain the gathering of the material for the air stories would entail, but Paul did not want kindness, sympathy. He wanted his old red-blooded strength back. He didn't want to be a bird with a broken wing. It was the night of the afternoon that Paul's managing editor had re-fused to let him take the air assign-ments that Paul learned that Jonquil was crippled, and that her beautiful, white-haired mother was blind. He left the newspaper office, walk-ing by the little flower shop with dragging footsteps. "Hello!" It was Jonquil, whose real name was Marta Sennett, the flower shop girl. Since the day in early spring when Paul had bought her total available supply of jonquils all at one time, the girl had not forgotten Paul, nor had Paul forgotten her. To speak to her every day, and to stop in the shop a few moments to talk to her was almost a ritual with Paul—and with Jonquil, too, if he had known. Further than the greetings and flower shop conversations the affair had never progressed. Whenever Paul thought of knowing her more inti-mately he immediately became hot, then cold. A fellow with a broken wing had no business being more than the most casual of friends to a girl like Jon-quil. But tonight things were different. Jonquil had invited him around to her home, because she told him her moth-er was celebrating her fiftieth birth-day, and she had been looking for him all day to invite him to the party. Mrs. Sennett was seated by a win-dow that looked down on the street when Paul let himself into the little apartment in response to her invita-tion to come in when he had knocked. She called cheerily to him to come across the room to her chair, telling him that she knew who he was. When Paul took the soft hand of 18 The Health Bulletin January, 1930 Jonquil's mother, and looked into the eager face raised to meet his, he real-ized with a start that she was blind. Reverently Paul took the white hand, and bending touched it with his lips. He wondered why Jonquil had not told him before that her mother was blind. Paul's surprises were not at an end. As Jonquil came from the kitchen of the little apartment, stripping off her work apron as she walked, he saw that she was crippled. Her left foot and leg to the knee was horribly de-formed. Looking at her Paul thought that he had never before seen Jonquil out from behind her flower counter. Crip-pled herself, her mother blind, she supported them both with the little flower shop. Brave, gallant girl! No wonder he had thought she was like a flower when he had first seen her. A wave of tenderness swept over him. He wanted to go to her, to lift her in his arms, and carry her so she would nev-er have to use the hurt limb again. TTien his high mood fell. Bird with a broken wing, he was not even able to lift her slender body once, much the less care for her all of his life as he wanted to. Paul touched Jonquil's slim, little hand softly. The blue eyes on his were questioning. "It has always been that way," she said in simple explanation, looking down at the deformed foot. "You do not mind that I did not tell you." She indicated her leg and foot, her moth-er's sightless eyes. "Mother and I don't like to talk about it. We play all of the time that we are both well and normal, and it makes everything much happier for us." Paul suddenly knew that her warm little hand was still in his. He pressed it quick and hard. "You wonderful girl. Jonquil." Paul was happy, happier than he had been in a long time when he left Jonquil and her mother that night. Though happier he left railing mental-ly against fate, life, whatever force it is, that sends young men out to fight life with broken wings, cripples beau-tiful young girls, makes blind lovely old women, and deaf good fellows like Henry Clinard. Passing by Dr. Herndon Benson's home, Paul saw a light burning in the doctor's office at the side of the house. Doc had been a good friend to him all along, even when he had in-sisted on his going down to the san-atorium. He would stop in and talk to the doctor, see if the physician's training, and the hard philosophy of a medical man could help him to solve some of his problems. It was late, but Dr. Benson received Paul with a smile. "My, you're looking fine, young fel-low. Weigh more than you did before going to the San, don't you? Not so bad this business of having one lung after all, is it?" Paul frowned. "Mighty tough, doc-tor, when you want to do something so bad you can taste it, and people tell you that you can't because of your lungs." The doctor looked thoughtfully down at a test tube in his hand. "Paul, to some degree almost every man, wo-man and child living is physically in-capacitated. It may be only a very, very slight trouble, but the physical-ly perfect man or woman hardly ex-ists at all, any doctor will tell you." "Guess that's true, doctor, but they don't have to go dragging around crip-pled wings like my lung, have deaf ears, sightless eyes and deformed limbs," Paul spoke bitterly. Dr. Benson carefully laid down the test tube. "You are right at that, Paul, but did you ever think of the large number of people who fight organic troubles? I myself have a bad heart. It has been bad since my high school days. My wife suffers from high blood pressure, and has to stay away from many social functions she would like to attend. My oldest son can't play high school football because of January, 1930 The Health Bulletin 19 chronic bronchitis. Loretha, my daugh-er, is underweight and everyday of her life the food she has to eat is a trial to her." "I know, doctor, but those are all disorders than can be cured." The doctor shook his head. "Some-times they can, sometimes not. We all have our lives to live, Paul, making them as worthwhile as possible, re-gardless of whether all of our phy-sical organs are in perfect order or not. Perhaps some day we will breed a perfect race, a race that will not have to be bound down to earth by the needs and the disabilities of our phy-sical bodies today. That time has not come yet, and those of us who are liv-ing now have to give our bodies the best care possible, paying particular attention to the weakest members. Then forget we have a body at all, and live our lives in spite of physical disabilities." Paul got slowly to his feet. "There's a lot in what you say, doctor. I haven't seen daylight yet, but I'm going to think things through. I hope 111 be able to see as clearly as you do, when I have thought them through." "You will, Paul," the doctor laid his hand fondly on the erect shoulders of the tall young man. "Best of luck!" As Paul walked homeward through the night the physician thought what a lucky chap Paul Dunbar was. Twen-ty- five years ago his disease rapidly advancing he would have probably died. Now, modern medical science had saved him, as firte a looking specimen of young manhood as could be seen on the streets. The broken wing, Paul so bitterly complained of, the doctor felt sure Paul would find less of a disability as time went on. He would learn to live his life despite the broken wing. In the gray dawn of the morning after Paul had been to Jonquil's moth-er's birthday party, and talked to Dr. Benson, he wrote the editorial "Brok-en Wings" that won for him that This distinguished Jackson county couple are 82 and 85 [icars <>/ <ii/e re-spectively. They have been inarried 57 years. They owned the second antomn-hile in Jackson County. They still drive their oivn car and travel irhere they please. The husband operates a large farm and store. They lire in their own home but drive down town every nice day for a hotel dinner. Roth of them read the newspapers and take a vital interest in all the affairs of the day. 20 The Health Bulletin January, 19SO year's prize for the best editorial writ-ten in the United States. Donald Heitman, editor of The News, found the editorial on his desk and blinked when he saw the name. Dunbar writing editorials? Well, he would read it, and if it was passable he would use it, give the boy a bit of encouragement. Heitman slowly read : Broken Wings "The bird with the broken wing nev-er soars so high again." The airplane up against the sun, a wing broken dives swiftly to de-struction for itself and its occupants. Human beings, blind, deaf, crippled, with bad lungs, hearts and defective bodily organs, armless, legless, or in some way incapacitated are birds with broken wings—birds that can never again soar up against the sun. To some degree all of us are in-capacitated. Physical perfection, one hundred per cent is rarely ever found. The wing broken, the machine dis-abled, shall the incapacitated give up, say life is over? No! Modern medical science has gone a long way toward mending the broken wings of the physically and mentally incapacitated. The church has always done its share in binding up spiritual wounds. The broken wing mended one must go on, forgetting—if he can—that it was ever broken. —But it is impossible to forget the broken wing. Its strength is gone. It is not the same wing—"The bird with the broken wing can never soar so high again!" True, he can not soar up against the sun, but what of the earth ! All of us are closely bound to earth. The air-plane gets only a very small portion of us away for a short time, from down there against the earth where we live. The broken winged must find interests upon which he can center his thoughts. Interests close to earth. He can not keep his thoughts bottled up, thinking of the wing that Is not work-ing just right. He must forget he has a broken wing in the joy of living, not because, but in spite of something gone wrong. Someone to love deeply, a hobby, mu-sic, reading, pets, flowers, a garden will all aid in throwing thoughts that might become morbid off their sinister trail. You are not a bird with a broken wing, but a normal, whole, happy in-dividual. Happy with one's work, and in one's home the morbid thoughts seldom find time to enter, and when they do they do not stay long, where the sun i;hat filters down to earth is allowed to come in. The broken winged bird may never fly again, but the memory of the days when soaring up against the blue the earth was green below, the sun gold on his wings can never be taken away. —And who knows, the bird with a broken wing may be able to soar up against the blue with the sun on his wings, again sometime! There was an offer of a job from several big city papers after Paul's editorial won the prize. When his home town paper offered him the place as city editor with a salary large enough to support a wife and family on, Paul refused the big city job, and stayed on in Ashton. Before he accepted the new position on The News he walked out to talk things over with Jonquil. "Must I take it?" he asked. "Take it? Why you know you'll take, Paul!" "If I accept the place will you give up your flower shop and marry me?" The dewy blue eyes had never been more flowerlike, as she raised them to Paul. "If you insisted long enough, and hard enough, I might." "Even if I am a bird with a broken wing?" "Hush!" Jonquil placed her fingers January, 1930 The Health Bulletin 21 lightly on his lips. "At our house we're going to play we're always well. I wouldn't marry a man with a broken wing, even if he were an angel, and I know you wouldn't think of even looking at a girl with a crippled foot," Jonquil teased brightly as Paul sil-enced her with a kiss. VACCINATION FACTS By Frederick R. Taylor, M. D. Vaccination against smallpox was the first great discovery of preventive medicine. In 1798 Dr. Edward Jenner, an English country doctor, after fif-teen years of painstaking observation and record keeping, published his epoch-making paper entitled "An In-quiry into the Causes and Effects of the Variolae Vaccinae, a Disease Dis-covered in Some of the Western Coun-ties of England, Particularly Glouches-tershire, and Known by the Name of the Cow-pox." The modesty of this great benefactor of mankind is shown most impressively in Jenner's reply to a Mr. Cline of London, who promised him the stupendous sum of 10,000 pounds a year income if Jenner would consent to settle in London. Jenner replied to this offer, "Shall I, who even in the morning of my days sought the lowly and sequestered paths of life, the valley, and not the mountain; shall I, now my evening is fast ap-proaching, hold myself up as an object for fortune and for fame? Admitting it as a certainty that I obtain both, what stock should I add to my little fund of happiness? My fortune, with what flows in from my profession, is sufficient to gratify my wishes; in-deed, so limited is my ambition, and that of my nearest connections, that were I precluded from future practice, I should be enabled to obtain all I want. And as for fame, what is it? a gilded butt, forever pierced with the arrows of malignancy . . . ." What has vaccination really accom-plished? The following data are copied from the article on Vaccination by Professor George Dock in the second edition of Osier and McCrae's "Mod-ern Medicine." He writes: "Coincident with the rapid spread of vaccination was a marked fall in the extent and mortality of smallpox all over the civilized world—. In Lon-don, in the years 1761-1800 the mor-tality in the successive decades was respectively 24,234, 20,923, 17,867, 18,477. In the first two decades of the 19th century it was 12,534 and 7,856. Toward the end of the second decade of the 19th century smallpox began to increase, and in some countries be-came almost as prevalent as it had been before. The causes of the recrud-escence are not difficult to understand. Many people had been vaccinated so long before that they had lost their immunity wholly or in pai-t. This was the time to settle the question as to the life-long protection which the early vaccinators so fondly believed in, but prejudices were still too strong. Many other people were not vaccinat-ed at all, because smallpox was so much less frequent that the operation seemed unnecessary, and there was a smaller proportion than before not protected by smallpox." (One attack of smallpox, when it does not kill, protects against subsequent attacks.) "Looking back, it is clear that cer-tain great changes had occurred in the smallpox situation since Jenner's dis-covery. The absolute mortality was less; the disease was not so frequent as before in the years following the usual age of vaccination; and these facts were most obvious in countries 22 The Health Bulletin January, 1930 that had the most thorough vaccina-tion. The change in the age-incidence is interesting. Smallpox was common-ly spoken of in Germany in the pre-vaccination days as "Kinder-pocken' (children's pox). Of 1252 cases of smallpox before vaccination 94% were in children less than 10 years of age, and no case above 20. Of 1677 cases after vaccination, only 18% were und-er 10 years of age, and 42% over 20. Epidemics were smaller, and mild cases, long known, but rarely men-tioned, became relatively more fre-quent "In this period revaccination be-gan. Suggested early in the century, it was long neglected. Certain German states first applied it to their arm-ies "The most striking test of the pos-sibilities of vaccination was made in the war of 1870-71, and depended largely upon the far-sighted care of the German military authorities. Smallpox became so prevalent in France in the pi'eceding winter, that effoi'ts were begun to combat it, but the outbreak of the war not only pre-vented such action, but as usual caus-ed a great increase of the disease which rapidly extended over Europe. In Germany, v/here many prisoners of war carried the infection, the disease was widespread; but it was a striking fact that the German soldiers were not only less frequently and less severely affected than the French, but that they were less affected than civilians of mil-itary age in the same towns. The only difference was that all the German sol-diers under arms at the outbreak of the war had been revaccinated within two years. The following figures show the mortality of different classes at that time: revaccinated 5%, once vac-cinated 14%, unvaccinated 45 7f. This object lesson was not lost on the newly formed German Empire. In 1874 the first law was passed providing for the vaccination of every child before the second year, and of all school children in the twelfth year. The result of the operation was to be a matter of record, and failure to produce a satisfactory vesicle necessitated a repetition. In the civil population the mortality sank rapidly, so that in 1910 the deaths in the whole empire was only 33 (15 being foreigners)." The woi'k from which the above is quoted was published in 1913. Cecil's Text-book of Medicine by 130 American authors, published in 1927, has a chapter on vaccination by Prof. D. Murray Cowie. The last two para-graphs of his chapter show how little smallpox can be influenced by the best methods of sanitation and quarantine, and how completely it can be con-trolled by vaccination. They read as follov/s : "In no country since the discovery of vaccination have as rigid sanitary measures been carried out as in Eng-land— notification, strict quarantine of patients and contacts, and careful dis-infection. On the other hand, in Ger-many where more attention has been paid to vaccination and revaccination, the death rate from smallpox has been much lower. From 1875 to 1905 England and Wales had 8,342 deaths compared vv'ith 1,115 in Germany (Schamberg). Vaccination and revac-cination became compulsory by law in Germany in 1874. Since that time smallpox has ceased to be an epidemic disease. Unquestionably, vaccination and revaccination is the most import-ant method of stamping out the dis-ease. "General Leonard Wood records the experience of two battalions (700 U. S. soldiers) in Holguin, Cuba, in 1898: 'A large number of American sol-diers under a fair state of discipline was sent into a country infected with the most virulent type of smallpox, where the death rate was heavy and all sanitary conditions were against them, and although living for months in towns infected with the most ma-lignant type of smallpox, to which they were constantly exposed, not a single case occurred in the regiment'." January, 1930 The Health Bulletin 23 Yet, there are still some people who oppose smallpox vaccination! It is very difficult to see why this should be so. Two arguments are advanced in objecting to vaccination that are thoroughly fallacious. These are: 1. That smallpox is now so mild that vaccination is unnecessary, 2. That vaccination itself is occa-sionally fatal. Let us consider these supposed ob-jections for a moment. 1. Any infectious disease that can-not spread fast usually becomes of a milder type. Smallpox is no exception to the rule. However, smallpox is get-ting milder only because vaccination prevents its rapid spread. Experience has shov/n repeatedly that where vac-cination is neglected, smallpox begins to spread more rapidly again and be-comes as deadly as ever. Moreover, even where it is usually mild, some severe and fatal cases are sure to ex-ist. 2. Vaccination is occasionally fatal, as is sewing with a needle, as prick-ing the finger may be fatal. The risk is, however, so nearly absolute zero as to be absolutely negligible—not for 01 e moment to be compared with the risk of riding in an automobile. It is not even to be compared to the risk of going down one's steps at home— a performance that kills or cripples some people every year. Smallpox is a serious risk, on the other hand. If everyone were simultaneously vaccinated, smallpox could be literal-ly wiped off the face of the earth, and the germ that causes it would be-come as extinct as the mastodon or the saber-toothed tiger, and would nev-er again plague mankind. Let's all get vaccinated! COLLEGE BLUES By Karl A. Menninger, M. D. Each year thousands of college stu-dents fall by the wayside. The wise-acres have many explanations and very little remedy. Too riiany stu-dents are going to college. The pace is too fast. The ideals are wrong. The faculties are incompetent. The curri-cula are inappropriate. Above all there is too much money and too much friv-olity and too much social life. College students have much too good a time. The mental hygienist is somewhat out of sympathy with these explana-tions. He does not deny that some of them may be true but his pragmatic sense is offended by the futility of generalization. His whole point of view is individualistic. Leaving prob-lems of curriculum and world politics aside, he is interested in what has put a particular John Smith and Mary Baker out of the running. The loss of John Smith may mean little to the college; the loss of Mai-y Baker may not greatly distress the world, but some of these Johns and Marys are worth saving if any one is. The boy or girl who gets to college is one in a hundred. He is engaged in a period of enormous importance to himself be-cause it is his preparation for a spe-cialized contribution to the world. For the same reason it is a period of enormous importance to the world. For the past ten years psychiatrists have been trying to make people un-derstand that mental hygiene is not a matter of preventing insanity. Psy-chiatrists are not particularly inter-ested in insanity any more. Of course the insane are numerous; in fact, they quite outnumber the college students. But far more numerous are the un-healthy minded. By the unhealthy 24 The Health Bulletin January, 1930 minded we mean the unadjusted, the unhappy. One of the Survey's contrib-utors some time ago wrote under the title, "The unhappy are always wrong." This is true. At any rate the unhappy are always in need of mental hygiene, whether their unhappiness is conscious or not. There are lots of mentally unhealthy people who are not unhappy but who ought to be. These too are included in the mental hygiene program of today. Mental hygiene aims at the preven-tion, the deflection one might say, of human failure. If it is to be effective its efforts must begin months, if not years, before the student flunks out of college, or has a nervous breakdown or shoots his room-mate or enters an asylum, or arrives at some other shocking and often irrevocable ex-tremity. Consider for a moment what the college freshman faces. He leaves the high school to enter a college. From being a senior with all that it means, he becomes a freshman with all that it in turn implies. From town or coun-try he may transport himself to a city, and to a very sophisticated and complex group within the city. From living at home, with all the protection and consideration which that includes he enters a rooming house or fratern-ity house. Meanwhile he (or she) is changing physically. The average col-lege freshman is almost, but not quite an adult physically. This state of al-most is very difficult, as every one knows except those who have never reached it. Then, too, there are ac-quaintances to make of the same and of the opposite sex, and there are cer-tain attitudes to be taken and certain gratifications to be sought and certain new lines of inhibitions to be set up and certain old ones to be broken down. There is practically a new spok-en language to learn and a new set of taboos and a more or less thorough-going revision of aims and ideals. In addition to these general prob-lems college students have a lot of specific problems about which the out-side world knows nothing or which it judges unsympathetically. There are problems of athletic ambition and dis-appointment: the world hears only of the successes. There are problems of Greek letter fraternities, both inside and out, which only one in close con-tact with students can fully realize. There are problems of love affairs dealt with in the immature fashion to be expected at this stage, but also with an intensity which the unsympathetic may easily underestimate. There are problems of jealousies and envies in-side and outside of the family, con-flicts with parents, special antipathies to subjects and instructors, religious problems, curricular problems, physic-al problems real and imaginary, life-work problems, racial problems, eco-nomic problems; in fact all the prob-lems the older people confront, plus a great many more. Think of all this faced by a freshman student of only average intelligence, of average emo- Folks, please meet the New Sister of oio- two old friends from Greens-boro. January, 1930 The Health Bulletin 25 tional control and average ability, at the average American college or uni-versity at the average age of eigh-teen. Surely it is not surprising that some of them have "adjustment diffi-culties" and are sent to the mental hygiene counsellor or seek his help voluntarily. — Survey Graphic. OUR LIVES SHORTER, NOT LONGER So at least concludes C. H. Forsyth of the Department of Mathematics at Dartmouth College, from recent sta-tistical studies, whose results he pre-sents in Science (New York). The average lives of the young have been increased, but the old die earlier. Un-less adults can manage to live more sanely, it will be a losing fight for the elderly, he concludes, at least for some time to come. Those who feel justified in predicting marvelous increases in the average length of life have failed to appreciate, says Mr. Forsyth, that practically all reductions in the death-rate have been in children's diseases, and that little or no attention has been given to ages beyond the prime of life. He finds that conditions in this country at advanced ages have long been on the down grade, and that the great gains at early ages are already more than offset by the losses at ad-vanced ages. In brief, the surprising conclusion is that the average length of life in this country is now actually decreasing. Writes Mr. Forsyth: "The main results were obtained from abridged mortality tables con-structed from the statistics of the males of the ten original registration States—the new England States and Indiana, New Jersey, and New York —the only States which have sup-plied satisfactory records since 1900 —and even 1890. The results for fe-males are not given here, but present the same picture—in somewhat less smooth form. "It will be understood, of course, that there is an average length of life corresponding to each age—the aver-age length from that age on—al-though it is usually called the expec-tation of life in that case. In working with abridged mortality tables it is necessary to omit the first few ages — say, before the age of ten—for well-known reasons, but the expectation at age ten is usually a rough approxi-mation of the average length of the whole of life. "During the thirty years from 1890 to 1920 the expectation of life at age ten—and therefore approximately the average length of life—increased markedly. The results for 1920 proved a little disconcerting for a time, for that year showed not only unexpected improvement at the early ages but also fairly satisfactory conditions at advanced ages. The abnormality of the year 1920 should have been appre-ciated at that time, however, because we were just recovering from the 'flu' of 1918, and the improvement could have been easily explained as a natural reaction. "Every one has been familiar with the consistent improvement of condi-tions at earlier ages, and some have been more or less aware of the situa-tion at advanced ages, but there is no printed evidence that any one was suf-ficiently aware of the seriousness of the latter situation to propose the pertinent question of whether the latter situation would ever develop to the point where it would dominate. In any case, the question is no longer per-tinent— the decline at advanced ages already dominates, and the average length of life—or at least the expec-tation from age ten—is already going down. The curves for the years 1921 to 1927 inclusive tell their own story. The expectation from age forty-five or fifty on is the lowest of which we have any record—far lower than it was even forty years ago—and it is still going down, not up. "The changes in death-rates previ- 26 The Health Bulletin January, 1930 ous to thirty are not significant, and although it might well be argued that little significant change could be ex-pected in a short period of only seven years, by the same logic the changes in the neighborhood of age seventy are tremendous. "It is well to recognize that im-provement at the early ages has a rather definite limit, and that the de-cline at advanced ages has no appreci-able limit. It follows naturally that with all the improvement in the world at the early ages the present down-ward trend at the advanced ages, if unchecked, will continue to dominate and produce a greater and greater net decline in the average length of life. "The great decline at advanced ages is remarkably concentrated about age seventy, although it extends as far back as age forty. To me, the whole picture, from our earliest records in 1890, to the present time, points con-sistently and inevitably to a future of a declining average length of life until the American adult wakes up to the fact that the odds are at present heav-ily against his living as long as his father or grandfather. Some will say —and no doubt truly—that it is all a natural consequence of the great drift to the cities. Others will go farther and say life has become too fast and strenuous, and that we do not know as yet how to adjust ourselves to such a life. "To the medical authorities the whole problem will loom as one of re-lieving the strain upon the heart. But little will be accomplished until the American adult himself is duly in-formed and made to realize that he is in the midst of a decidedly losing fight, and that the situation will continue unless he applies himself energetically to be superior to his environment. Moreover, each adult must fight his own individual battle, since he usually brooks no interference with his own individual mode of living. Medical au-thorities and scentists can be depend-ed upon to care for the children and their diseases, but they have little or no chance to interfere with the lives of adults. "It truly looks as if it is going to be a losing fight for some time to come, for although some adults are making a commendable effort to live sane lives, the vast majority seem very indifferent, and many give apparent-ly no thought whatever to habits which they clearly know are bad, and which they know they could easily discard. There is surely no worse in-fluence than that wielded by well-meaning authorities who go around airing their ill-founded beliefs that all is going fine and that before long everybody is going to be living seven-ty- five to a hundred years." — The Lit-erary Digest. COMMON SENSE AND THE OPEN WINDOW By Arnold H. Kegel, M. D. Commissioner of Health, Chicago Do you sleep with your window open? Recent discoveries in the science of ventilation throw interesting side-lights on the ventilation of sleeping rooms and tend to modify to a consid-erable extent previous opinions and practice. Less than a generation ago we heard a great deal about fresh air and foul air. All outdoor air was labeled "fresh," for want of a better term, and air indoors was supposed to be "foul." These terms are fast disap-pearing from our literature. Flugge January, 1930 The Health Bulletin 27 of Breslau, Germany, and Leonard Hill, of England, have shown conclu-sively that the bad effects in a poorly ventilated room, the headaches, and general feelings of discomfort, are not due to some ms^hical substance in the air that renders it foul, but to an excessive temperature, a high humid-ity or a combination of the two. Furth-ermore, we have learned that the air from out-of-doors is not always more desirable than the air indoors. This is particularly true in Chicago and other large cities where the outdoor air is constantly contaminated, par-ticularly during the winter months, with smoke, fog and dust from vari-ous sources. Do you sleep better with your win-dow open? Analyze and consider this question without prejudice or precon-ceived opinion. Suppose you have a north room provided with an ordinary wooden sash double-hung window without weather strips or a storm win-dow. The weather is cold; Jack Frost flirting with the zero mark on the thermometer, and a moderate wind, say ten miles per hour comes from the north. The leakage of air into the I . room between the sash and casement and between the upper and lower win- ; dows would be under these conditions j about 60 cubic feet per minute with the window closed. Now, an ordinary adult requires for respiration about one-third of a cubic foot of air per minute. So, for the purpose of re-spiration, the leakage around a closed window will supply him with about 180 times the amount of air necessary. But to promote circulation of air in the room, and to ventilate in a satis-factory manner hygienists have set a standard of from 25 to 30 cubic feet of air per minute for each person. This is a very liberal allowance. With a leakage of 60 cubic feet per minute around a closed window under the con-ditions mentioned, we still have twice the amount of air required to ven-tilate the room when occupied by one person, or an ample supply for two persons. Let it be clearly understood, how-ever, that we are not advocating as a general proposition that Chicago's cit-izens sleep with the windows closed. We are only pointing out that in cold weather there is no necessity for open-ing the windows to any considerable extent under the false impression that this practice is necessarily desirable or healthful. By all means, sleep with the win-dow open. Open it wide when the weather permits. But do not make a fetish or a fad of open window ven-tilation. Do not boast to your friends that your window is always wide open irrespective of weather conditions. This practice does not indicate the best of judgment on your part. Direct drafts, particularly when one is sleep-ing, are productive of colds and tend to increase rather than decrease our death rate during the winter season from influenza and other respiratory diseases. There is much the medical profes-sion does not know about colds, but there is ample evidence that a sim-ple cold is a local infection of the membrane lining the nose or throat. Quick changes in temperature, uncom-fortable drafts, or chilling of the body upset or disturb the control of blood flow to these parts and favors the spread of infection. In this way a simple cold becomes severe as the in-fected area increases. If the infec-tion invades the finer structure of the lungs, pneumonia may be the result. Rest in bed and a comfortable even temperature are the best ways to treat a cold and prevent serious complica-tions. Use common sense in opening your window. Young adults who are strong and robust may profit by the prac-tice. This, however, is not necessarily so of children, of the aged, and of many of all ages who are not particu-larly rugged or are susceptible to colds and drafts. And we strongly suspect 28 The Health Bulletin Janvury, 1980 that even the robust sometimes enjoy good health in spite of the wide open window in cold weather rather than because of it. Be comfortable with the window open. Physical comfort should invari-ably be your rule governing sleeping room ventilation. If you sleep better and awaken refreshed with the win-dow open a fraction of an inch, that is the best condition for your individ-ual requirements. If you sleep better with the window wide open and the chilling drafts are pleasant rather than disagreeable, by all means open your window wide. But do not throw open your window in cold and inclem-ent weather and retire with chatter-ing teeth and sleep with a blue nose and general discomfort under the mistaken idea that it is healthful. A person may sleep in cold and windy weather with the window closed without the slightest fear of bad re-sults from a deficient air supply. Leak-age about and between the sash will supply sufficient air for breathing purposes. It is usually desirable, how-ever, to have the window open to some extent; the reason for this is not to obtain more air, but rather to cool the sleeping room to a comfortable temperature and promote air circula-tion. This should be approximately 10° below that of the living rooms. I One should understand that the im-portant considerations in maintaining healthful conditions in the sleeping room are a comfortable temperature and clean air. In many parts of the city, the outside air contains an ex-cessive amount of soot and dust. It is advisable to use a cheese cloth screen beneath the lower sash of the win-dow. An ordinary fly screen can be easily adapted for this purpose. The wire screen is left in and covered with a piece of clean cheese cloth. This breaks up the strong currents of air that produce unwelcome direct drafts, and also filters out the greater portion j of the soot and dust. — Chicago Health Bulletin. DOSERS By D. E. Ford, M. D. He poked his head around the edge of the door and gazed hopefully into the office. A strange presence pervad-ed the room like a thin blue-green fog. "The Welfare Lady says will Dr. Ford cure me." "Working?" "The fertilizer man says to keep away 'till I'se cured." The pain is evident as he limps into the room. "Mah blood's bad," he explains as he begins to unwind oozy rags from his legs. The stenographer has vanished. With the loosening of the dripping bindings slices of side-meat slide to the floor revealing large and luscious ulcers up and down his shins. Perfect specimens of ulcers—beautiful ex-amples for a medical class. I don't blame the fish factory for casting him out. But why pick on me! "How long have you been like that?" "Three months—maybe four; but they want so bad then." "Three months ! You've let your legs rot like that for three months and done nothing?" Stronger words may have slipped out. He straightens up; the worm is turning, indignant at the false charge of neglect. "I've done everything every one told January, 1930 The Health Bulletin 29 me! I've put on collard leaves and vinegar, bread mash, fish meal, and kerosene oil. I got a black salve at a drug store, I've tried spider webs, turpentine and side meat. I've done everything anyone told me!" He leaves the horrid impression that —along with the side meat—someone told him to come to me. He did everything every one told him! While the janitor is called to do the proper things to doors and furniture, the right things are done for the pa-tient. He departs, leaving a specimen of blood and a lingering impression of a strong personality. He is to let the bandage alone and to return in two days—unless someone, meanwhile, tells him different. He did everything everyone told him to do! Better men than he—and women—do the same. Oh! how we abuse our bodies and those of our chil-dren, doing what well-meaning some-bodies advise! A tired feeling! A pain! Can't sleep! Sleepy all the time! The baby cries! The baby won't cry! Any con-dition of body or mind. Free advice gathers around. Friend or stranger — each has a sure-fire remedy. Free? Why they beg you to take it ! Read the glowing promises in the newspaper advertising. Read the wonderful tes-timonals on the colored wrappers of the big bottles—testimonials that are offered at so many dollars per hun-drd for any medicine manufacturer to buy. Free? The advice only is free. Who pays for the pages of advertising. for the quarts and pints in funny-shaped bottles on the druggist's shelves and in the parcel post? The dosers pay. The chronic dosers and home remedy folks pay more every year for useless or harmful stuff than all the hospitals in the country receive. Illness, simple and easily cured in the beginning, grow by ignorant neg-lect and harmful dosing to serious conditions. Finally someone trained to understand the body is called—a doc-tor's advice is sought. When you want a dress made do you patch it together on every neigh-bor's free advice? No, you go to a dressmaker, one whose business is to know dresses. When you want your house painted do you listen to the ad-vice of the colored delivery boy whose father used some paint once? No, you get a skilled painter. When you are in jail, you hire a man trained in the law. But when you run a fever for days or have a chronic headache or most anything—you follow the advice, first of anyone not trained to know the causes of illness. If one recommenda-tion doesn't work another may be tried until the sickness gets beyond endurance. Too often it is when strength is gone and pocket-book is flat, after everything freely advised—even to "side meat"—has failed, that skilled trained advice is hired. And too often an immediate miraculous cure is ex-pected for a condition which, though simple at first, has progressed too far for help. — New Bern Times. OUR BACK COVER CARTOON THIS MONTH We hear much discussion of the present tendency of the younger gen-eration to indulge to excess, or seem-ingly so to their parents, in the fast living incident to the present day. It is probable that just such apprehen-sions have been expressed ever since civilization appeared on this earth. Seriously speaking, it does seem to this writer that many of our finest young people are indulging to excess in such pleasures as dancing and ci-garette smoking, to mention no other excesses. Excessive smoking indulged in by boys and girls in their teens is unquestionably detrimental to their 30 The Health Bulletin January, 1930 health. Excessive indulgence in the pleasures of dancing, requiring much loss of sleep, irregularities of various sorts, to say nothing of the emotional excitement, means that young people indulging to excess are drawing from their bank of health, resources that they will need in later years. The foregoing is merely introduc-tory to the statement that our cartoon this month is drawTi by a talented young man who is at present serving a term in the State's Prison. We know nothing of his guilt or innocence, but we do know that he is in position at present to observe some of the dis-asters that overtake young people who lose their balance and embark on a course liable to end in disaster. HOW VERY TEW OF US DIE By WM. BRADY, M. D. Probably many readers know that when I think anybody or anything is wrong I like to say so in print. Not so many know that I apply this policy to myself when I happen to be the wrong one, for now and then I have been wrong and I have acknowledged it fi-eely and just as soon as I could. Met a man connected with the life insurance business, and he seemed surprised that I oppose a departure of certain insurance companies that is variously called health conservation, longevity service, and the like. I told him that primarily I objected, as a buyer of insurance, to paying the ad-ditional cost of such service; and sec-ondarily I do not believe all of this adventuring by insurance companies in other fields of work has any tan-gible effect on the health of their policyholders. My friend came right back there. He assured me that the statistics were available to prove that this health or medical work by the insurance cor-poration actually lowers the cost of insurance to the public, to the indi-vidual buyer. There he had me, for in all fairness I was compelled to reply that if I were convinced of that I should cease opposing these activities of insurance companies and become a booster for such practice. Insurance of all kinds is a great boon and for comfort and peace of mind while we live and the well being of our loved ones after we've passed along. I say with all fervor "God bless the life in-surance business." In the same spirit I maintain that the use or administra-tion of funds in the insurance com-pany's keeping is a matter that is your business and mine, and up to the pres-ent, or until I met this man I refer to, I have felt quite positive that this ad-venturing in health, in public health activities, in what should be private medical practice matters, is an un-justifiable diversion of funds, and ac-cordingly I have opposed this fad of certain insurance companies whenever my views or advice have been sought. Well my good friend saw to it that the cold figures were placed in my hands. They were impressive figures, too. The mortality rate, that is, the number of deaths, occurring among each thousand persons in the year, is given in a chart, first that of the pop-ulation of the country at large, and alongside it the rate among several million policyholders of this particular company. It shows that the death rate among the people at large was rather | lower than that of the policyholders i in every year from 1911 up to 1925. j In 1925 the insurance company's rate January, 1930 The Health Bulletin 31 finally got down to that of the whole country, and in the past three years the policyholders have been holding out a little better than the people at large. At first glance such figures might seem to justify the argument that this health work by the insurance com-pany lowers the cost of insurance to the buyer for of course the premium rate on your insurance is determined by the death claims the company has to pay. But the figures must be inter-preted with the fact in mind that the policyholders are selected risks, and the many applicants rejected as poor risks must figure in the mortality rate of the population at large. These con-siderations, it seems to me, invalidate the argument that this health adven-turing by the insurance corporation lowers the cost of life insurance. To draw that conclusion it would be necessary to ignore the effect of all public health and in fact all other ac-tivities or work than that done by the insurance corporation. — Ealeigh Times. AN ENCOURAGEMENT The deathrate for tuberculosis dur-ing the first half of 1929 was unpre-cedently low for this part of any year. The rate for white policyholders was only 73.6 per 100,000. This marks a decline of 3.3 per cent over the record for January-June, 1928. There was, also, a 7.8 per cent drop for the col-ored insured. These new declines have taken place despite the influenza out-break which was responsible, during the first quarter, for hastening the deaths of large numbers of tubercular patients. It is now assured, almost be-yond peradventure, that the end of 1929 will see another new minimum mortality figure for tuberculosis in the United States and Canada; and that this figure will be well below the form-er low point established only last year. Heart Disease Leads All The Rest The "Degenerative" Diseases The combined deathrate for the three principal "degenerative" condi-tions (heart disease, chronic nephritis and cerebral hemorrhage) rose slight-ly as compared with the first half of last year. This was due entirely to an increase for heart disease. Deathrates from Alcoholism, Cirrhosis of the Liver and Acute Alcoholic Poisoning Are All Increasing Alcoholism, exclusive of acute poi-soning by wood or denatured alcohol, was the reported cause of death of 321 Metropolitan Industrial policy-holders during the first six months of 1929. This number corresponds to a deathrate of 3.4 per 100,000, and marks an increase over the corre-sponding period of last year, when there were 284 deaths and a deathrate of 3.1. The deathrate from alcoholism con-tinues to run much higher in the in-dustrial population of the United States among Canadian wage-earners. This has always held true—both be-fore and since National Prohibition. Of the 321 deaths from alcoholism, so far this year, only six affected Can-adian policyholders, who number ap-proximately one and one-quarter mil-lions. Since January 1, 1922, a pe-riod of seven and one-half years, there occurred 3,818 deaths from alcoholism among Metropolitan Industrial policy-holders. Only 43 of these were deaths of Canadians. Six hundred and fifteen deaths were reported from cirrhosis of the liver, which is closely associated with alco-holism. The deathrate was 6.6 per 100,000. During the like period of 1928 there were 578 deaths, with a rate of 6.3. Deaths from acute poisoning by wood or denatured alcohol are of little importance numerically, but have late-ly been showing a tendency to in-crease.— Fro?H Statistical Bulletin, Metropolitan Life Ins. Co. 1929. ff ^HE. YOUNGER GENERATION ARE SWIFTLY SENDING THEMSELVES TO AN EARLY GRAVE BY THEIR RIOTOUS LIVING,'^ SAYS NEWS tTEM. • ^ ^'S^^p^sj^abq Tnn.^°RmCAR9LI^A SWE.DPARDs^^E^Cm 1 This Bunelir\wi];!be 5er\l free to arwj citizen of Ihe 5tcrteupoi\Teque5t. | Entered as second-class matter at postoffice at Raleigh, N. C, under Act of July 16, 1894. Published monthly at the office of the Secretary of the Board, Raleigh. N. C. VOL. XLV FEBRUARY, 1930 NO. 2 For a number of years we have been proclaiming the desir-ability of utilizing home-made equip^nent for playground exercises. Here at a two teacher school in Columbus county is a fine example of the practicability of such devices. This is called a walking ladder. Six year old girls as ivell as boys climb up these poles and wcilk bij their hands from one end to the other. As the photograph indicates, there is hardly any limit to the kind of exercises possible ivith such a device. MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH A. J. CROWELL, M.D., President CharlotU CYRUS THOMPSON, M.D Jacksonvllla THOMAS E. ANDERSON, M.D Statesville E. J. TUCKER, D.D.S Roxboro D. A. STANTON, M.D High Point JAMES P. STOWE, Ph.G Charlotte JOHN B. WRIGHT, M.D Raleigh L. E. McDANIEIj, M.D Jackson CHARLES C. ORR, M.D. Asheville EXECUTIVE STAFF CHAS. O'H. L.AUGHINGHOUSE, M.D., Secretary and State Health Officer. RONALD B. WILSON, Assistant to the Secretary. C. A. SHORE, M.D., Director State Laboratory of Hygiene. G. M. COOPER, M.D., Director Bureau of Health Education. H. E. MILLER, .C. E., Chief of Bureau of Engineering and Inspection. F. M. REGISTER, M.D., Director Bureau of Vital Statistics. H. A. TAYLOR, M.D., State Epidemiologist. GEORGE COLLINS, M.D., Director Bureau of Maternity and Infancy. C. N. SISK, M.D., Director of County Health Work. ERNEST A. BRANCH, D.D.S. , Director of Oral Hygiene. FREE HEALTH LITERATURE The State Board of Health publishes monthly The Health Bulletin, which will be sent free to any citizen requesting it. The Board also has available for distribution without charge special literature on the follow-ing subjects. Ask for any in which you may be interested. Adenoids and Tonsils Cancer Catarrh Care of the Baby Constipation Colds Clean-up Placards Chickenpox Diplithei-ia Don't Spit Placards Eyes Flies Fly Placards German Measles Hookworm Disease Infantile Paralysis Indigestion Influenza Malaria Measles Pellagra Public Health Laws Prenatal Care Sanitary Privies Scarlet Fever Smallpox Teeth Tuberculosis Tuberculosis Placards Typhoid Fever Typhoid Placards Veneral Diseases Water Supplies Whooping Cough SPECIAL LITERATURE ON MATERNITY AND INFANCY The following special literature on the subjects listed below will be sent free to any citizen of the State on request to the State Board of Health, Raleigh, N. C: Prenatal Care (by Mrs. Max West) Infant Care (by Mrs. Max West) Prenatal Letters (series of nine monthly letters) Minimum Standards of Prenatal Care What Builds Babies? Breast Feeding Sunlight for Babies Save Your Baby Hints to North Carolina Mothers Who Want Better Babies Table of Heights and Weiglits The Runabouts in the House of Health (pamphlet for children from 2 to 6 years of age) Baby's daily Time Cards: Under 6 months; 5 to 6 months; 7, 8, and 9 months. 10, 11, and 12 months; 1 year to 19 months; 19 months to 2 years. Diet Lists: 9 to 12 months; 12 to 15 months; 15 to 24 months; 2 to 3 years; 3 to 6 years. CONTENTS PAGE Health Calendar 3 An Old Story 4 A Disappointed Child 6 International Congress On Men-tal Hygiene 7 Asthma 8 Starving In A Land As Fertile As the Nile IC PAGE Pulling At Your Heartstrings 16 Preventive Medicine As Applied To The Individual 21 Out Of Date 23 The Venereal Menace 24 Immunization 28 The Cost of Sickness 31 How Is This For Milk Drinking.. 31 Project About Diphtheria 13 Property Against Human Life. 32 VOL. XLV FEBRUARY, 1930 NO. 2 HEALTH CALENDAR FEBRUARY As a rule, during nearly all the year the climate of North Carolina is seldom too cold in winter to pro-duce much discomfort or suffering, and it is infrequent that the weather in summer is too hot for a sufficient length of time to produce illness as a result. About the only month in the year which affords any exception to the foregoing statement might be said to be the month of February. In most years, although it is the shortest month, it generally has more dis-agreeable weather than any other month. For most of our people, who enjoy outdoor life, certainly to some extent, during most of the year, the cold, disagreeable days of February sometime cause more indoor crowding than any other period in the year. This results in an undue prevalence of the respiratory infeajtions. Peo-ple are crowded more in the stores, in street cars, and in their homes, and infection therefore is more eas-ily spread from person to person on account of the close contacts neces-sary. The records always result in a rather high death rate from pneu-monia during this month, and other diseases of like character. It is a month generally fraught with more danger than usual to old people, espe-cially those who suffer to some ex-tent from chronic ailments, such as bronchitis and so on. It is literally mid-winter for the children in the schools. Ventilation, and at the same time a comfortable atmosphere, is a little harder to maintain during this month than other months, thus mak-ing respiratorj? troubles more common in the schools. Another deficiency which everybody suffers is from the scarcity of fresh vegetables and fruits which are avail-able in more abundance during the other months. For those who are financially able to avail themselves of the abundance of fresh stuff, im-ported from Florida and other places in the far South, the deficiency is not so acute, but as about half the population of the State live on the farms and are dependent on the prod-ucts of their own gardens and fields for food, the deficiency is sufficient to result in temporary impairment of health at least. These handicaps may be overcome to a certain extent by concerted ef-fort on the part of every one respon-sible. A little more care may be di-rected toward the heating plants and the ventilation of school rooms. The same thing may be undertaken by the householders in the homes, no matter what kind of a heating plant there may be, whether open fire place or steam heat; and a satisfactory effort may be made to procure at least some fi-esh vegetables every day; and for the old people a little extra care as to food, sleeping and clothing require-ments may help considerably in coming through the month without any impairment of health. We cannot close this subject in The Health Bulletin February, 1930 any more satisfactory manner than to return to our old slogan, name-ly, "A Garden for Health" for every family in the State who can afford it. Doctor Henry Albert, State Health Commissioner of Iowa, sends out the following suggestions which he sug-gests might reduce the liability to pneumonia and other respiratory in-fections to a minimum: "1. Avoid persons who have coughs or colds and are sneezing, 2. Avoid use of glasses and dishes which are not properly washed. 3. Avoid visits to persons ill with colds, influenza and pneumonia. 4. Wash your hands before eating and after caring for the sick. 5. Dress warmly and avoid unneces-sary exposure. 6. Do not use towels or handker-chiefs used by others. 7. Avoid a starvation diet but do not over-eat. 8. Sleep with the window in your room open but be warm. 9. Keep the temperature of the house and office at not over 70°. 10. Cover mouth and nose when coughing or sneezing." AN OLD STORY In one of the weekly papers of North Carolina which comes to our desk we noticed the following item in one of them in its issue of the week preceding Christmas. Naturally we are not giving the name of the paper, the county, nor of the parents of the child, because such items are con-stantly occurring here and there in every county in the State. So there is no good service to be performed by calling out the names of delin-quents of this nature, and it would only serve to hurt the feelings of the parents. We would not mind hurting the feelings of the parents if we thought it would protect any of their remaining children. However, if the physician attending the sick child was worthy of the name physician, he has before now thoroughly impressed upon the parents in this particular instance the importance of protect-ing every remaining child against diphtheria. Following is the item: "The many friends of Mr. and Mrs. sympathize with them in their sad bereavement caused by the GAL TWO— death of , one of their twins, which occurred December 12th at their home in . When little was taken sick they supposed it was a deep cold, but it was dis-covered to be diphtheria. For nearly two weeks the doctor, the parents and friends watched and worked with anxiety, but Thursday morning about three o'clock she breathed her last. They dreaded to give up any one of their children, but it seemed to be more sad to part the twins. She was two years, four months and fifteen days old." The foregoing is a poignant story, but it is a story that should have a moral for every physician and health officer and parent in this State this coming year, and that moral is that every child under six years of age should be protected against diphtheria by being given three doses, hypo-dermically, of toxin-antitoxin, which is the preventive vaccine against diphtheria. All children over six years should have the Schick test, and if they are not immune to diphtheria, should receive three doses, which would be necessary to confer immun-ity. There is no longer any excuse for children having diphtheria in North Carolina. It does seem that the physi-cians, the health officers, and the par-ents, with the help of the newspap-ers in this State, could get this story Fehruary, 1930 The Health Bulletin across to all the people having small children who need this protection. This is the same old story that has adorned the pages of weekly newspa-pers of North Carolina for many, many years. They first thought an at-tack of diphtheria was a' 'cold," what-ever that meant. They therefore proceeded to rub on the neck and chest of the helpless little victim some dirty stinking salve, always kept in stock in the medicine closet, or on the mantelpiece of the poor folks, always purchased at the drug store or gro-cery store, and always recommended for colds, no matter what a cold might mean. We have no idea that the prac-tice will cease until the millennium is ushered in, and at that time the children will not need the assistance. As long as dividends must be forth-coming, and commercial interests mounting into millions of dollars are concerned, there will be plenty of salves of different kinds for sale for the treatment of colds. Be it said to the credit of some of these manufac-turers that they do have at the pres-ent time conscience enough to recom-mend on their package, their adver-tising matter, and on the labels of the bottle to send for a physician in cases of suspected diphtheria or pneumonia. The question is, however. How may an ignorant parent be able to distinguish the very early signs or dangers of diphtheria and pneu-monia? This is especially true in the country districts where so many chil-dren live a long distance from the nearest physician and where a visit of the physician costs money, and a lot of it. To these people it is only human for them to trust and hope that the application of the salve will save the child's life. Again the physicians have a more important duty to perform in this regard than any other class of peo-ple. The State laboratory and num-erous county laboratories are avail-able for the examination of swarbs taken from the throats in order to set up a definite diagnosis within a reasonable length of time, but, even at that, delay in the administration of antitoxin is dangerous. The labor-atory report only serves to confirm the diagnosis of diphtheria, which the doctor may only have reason to suspect, but the laboratory does furn-ish almost totally free of charge a fresh reliable product of diphtheria antitoxin available to every physi-cian in North Carolina. So there is no excuse for any delay in the ad-ministration of antitoxin. But far more important to physi-cian and parent, and certainly to the children, is the fact that toxin-anti-toxin, which is for practical purposes a preventive vaccine, and not to be confused with the antitoxin, which is a serum for the cure of the dis-ease, is available to anybody in the State, free of charge. So it is only necessary to have every child im-munized against diphtheria in order to protect from such tragedies as the foregoing item describes as occurring in a North Carolina county early in December. A -peanut ranch in the sontheastci-n part of the State. The stacks are pea-nut vines. It makes fine hay for cat-tle. The Health Bulletin February, 1930 A DISSAPOINTED CHILD Driving along a country road in eastern North Carolina the other day we were witness xto a little occurrence which may happen any time, any-where, and which, of course, in a way, was trivial but at the same time meant a great deal to this particular child. We were driving along some few hundred yards behind a rural mail carrier. He had stopped at two or three boxes and we were slowly ap-proaching him when he passed anoth-er small residence close to the road, but which bore every mark of neat-ness and stood out even to the cas-ual passer-by as an unusual little roadside home. The carrier, not hav-ing any mail for this particular box at this house, naturally went on by without stopping. Coming along be-hind we observed a little girl, some six or eight years of age, who was evidently watching with great an-ticipation for the approach of the mail carrier. After the carrier passed by, the child sorrowfully made her way to the mail box, and just as we approached, removed a beautiful bunch of fall flowers from the box which she had intended for the car-rier. The look of disappointment on the child's face and her very attitude caused us to involuntarily stop our car and make the acquaintance of the little girl. We found that the child's baby brother had been ill for quite a while and the carrier's services had been requisitioned quite a number of times to bring medicines and so on from town. The family were tenant farmers, living on a big farm belong-ing to an absentee landowner. The mother had been ill previously in the summer, the prospects for a crop re-turn were poor, the September storm had greatly damaged the cotton and ruined some of the later tobacco which had got wet, and altogether the While February may not he a good month to take an outdoor sun-hath like this Riitherfordton bahy is do-ing, it is a good time to try to get any hahy to practice this kind of ex-ercise. The pose is most unusual and indicates a hahy of splendid health and strong vitality. outlook was gloomy for the family the coming winter. The father's health was none too good, and the crop was fairly heavily mortgaged for fertilizer and supplies typical of the condition of so many tenant farm-ers throughout that particular sec-tion. The little girl reluctantly con-fided that the mail carrier had been so good, and that they were unable to repay his kindness, that she thought that as the hollyhocks and the half dozen or so of late dahlias, that the mother had put out in the yard early in the spring, looked so beautiful that she just knew the mail February, 1930 The Health Bulletin carrier would appreciate a bouquet to carry to his own family, which could be accepted as part pay for his kind-ness. Naturally the mail carrier was in blissful ignorance of any such inten-tion and cheerfully drove on, probably congratulating himself that he could pass one box without shifting his gears and stopping, and therefore getting back home just that many seconds earlier. There could have been no doubt but that if he had known the surprise for him in the mail box that morning that he would have been only too glad to have stop-ped, and there would have been a fine visit all around. To us, or as it would have been to any other observing traveler, it was only an incidence of the day's rou-tine; but the lesson it carries may be applied by any reader to suit his or her own philosophy of life as it exists INTERNATIONAL CONGRESS ON MENTAL HYGIENE First in the World to Be Held at Washington, May 5 to 10, 1930 On the above mentioned date there will be held in Washington, D. C, one of the most important interna-tional meetings to be held in the world during 1930. It has only been twenty-two years since Clifford W. Beers, who is the Secretary-General of this first great International Congress on Mental Hygiene, organized at New Haven, Connecticut, the first Mental Hygiene Society in the world. Mr. Beers some months later, early in 1909, organized the National Com-mittee for Mental Hygiene. Many of our readers will recall that Mr. Beers is the author of one of the most celebrated books ever pub-lished. The title of the book is "A Mind That Found Itself." This book has been run through more than fif-teen editions in the last twenty years. It is the most vivid example of constructive criticism the world has seen since the Sermon on the Mount. "During the twenty years that have since passed the peoples of the world have become increasing-ly conscious of the fundamental im-portance of mental health and of the fact that mental health, like physical health, may be preserved and enhanc-ed by the giving of attention to known procedures of prevention, cure and treatment." About twenty countries of the world will send delegates to this meeting, including such representative na-tions as England, Germany, France, Japan, and others. The range of top-ics to be discussed at this significant meeting are as wide as the field of human relations. The topics will range all the way from such subjects as the "magnitude of the mental hy-giene problem as a health problem" to such topics as "possibilities in the future of human rerlationships in the light of an increasing knowledge of those factors that help and hinder the emotional, physical and intellec-tual development of the individual." This meeting is sponsored by such people as the President of the United States, the Surgeon General of the United States Public Health Service, the Commissioner of the United States Bureau of Education, Har-vard, Yale, and Johns Hopkins Uni-versities, the United States Depart-ment of Interior, and many other in-stitutions and organizations, includ-ing a number of state boards of health. In the preliminary announcement concerning the meeting the following significant statement to public health officers everywhere is made: "Public Health Does, and Must, In. elude Mental Health. The public can-not be truly healthy unless and until 8 The Health Bulletin February, 1930 mental health and its conservation are given deserved attention by pub-lic health authorities, private health agencies, medical practitioners and private citizens. Man is more than a physical organism. Good Health in-cludes good mental and emotional habits no less than good digestion, sound teeth and healthy lungs. The partly figurative, partly matter-of-fact, popular slogan: 'Public Health Is Purchasable,' applies to mental health no less than to physical health." In conclusion, as an additional il-lustration of the importance of the meeting, it has been announced that the transactions will be published in full in English, French, and German, the official languages of the Con-gress. Membership in this association may be had for five dollars, which will entitle the holder to a copy of the proceedings. Further information may be had by writing Mr. John R. Shillady, Administrative Secretary, 370 Seventh Avenue, New York. ASTHMA It is seldom that a day passes but what some person writes to the State Board of Health requesting informa-tion on the subject of asthma. Not long ago a writer in one of the larger cities of eastern North Carolina wrote a letter making the usual re-quest and included some advertising matter sent out by a concern in New York state, which had free trial methods and so on, as they put it, for the control of asthma. As the questions of this writer included most of the questions usually asked with reference to this subject, we are herewith quoting some of them to-gether with the substance of the reply of the Editor of the Bulletin. Following are some of the questions: "Please advise me how I may be relieved, or preferably cured, of asthma. I have been troubled with it seriously for the past two years. I have been treated by a physician, but I do not get much relief. I seem to be getting worse as time goes on. The attacks are so severe that at times I have to stay in bed for two or three days. After the attacks I am so weak frequently that I cannot get out of bed. Some people tell me that a change of climate will cure it others tell me that a change of cli-mate will only give temporary relief. Should a change of climate in your estimation be advisable, please tell me what place or locality you v/ould recommend. Do you think I could ex-pect to be cured or only get tempo-rary relief?" The following embraces the sub-stance of the answer to the foregoing request: People generally associate the disease called asthma with various conditions which physicians term as asthmatic. The two terms naturally indicate different conditions. A per-son may be asthmatic from many different causes. The term asthma ought to be limited to the specific disease itself, which is a periodic at-tack of bronchial spasm. There are such variations as cardiac asthma, caused by disease of the heart; renal asthma, relating to kidney diseases; and so on. True asthma is sometimes due to ear, nose, or throat troubles, or chronic bronchitis. It frequently oc-curs with acute irritation of the mem-branes of the upper respiratory tract. This is the case when it is caused by irritation from pollen or dust parti-cles or drug irritants. Genuine as-thma gives more trouble to the pati-ent suffering from it at night than it does any other time. Sometimes the suffering continues all night, and occasionally an attack will last sever- Fehruary, 1930 The Health Bulletin al days, giving trouble day and night. Such is the case not infrequently in spite of all efforts at medical treat-ment. Even though the attack be controlled with powerful drugs, in such cases it recurs when
Object Description
Description
Title | Health bulletin |
Other Title | Bulletin of the North Carolina State Board of Health; Bulletin of the North Carolina Board of Health |
Creator | North Carolina. State Board of Health. |
Date | 1930 |
Subjects |
Children--Health and hygiene Diseases Hygiene Public Health--North Carolina--Periodicals Sanitation |
Place | North Carolina, United States |
Time Period | (1929-1945) Depression and World War Two |
Description | Volume 45, Issues 1-12. Issues for Feb.-May 1917 and for Jan.-July 1918 not published. |
Publisher | Raleigh,North Carolina State Board of Health. |
Agency-Current | North Carolina Department of Health and Human Services |
Rights | State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754 |
Physical Characteristics | 61 v. :ill. ;23 cm. |
Collection | Health Sciences Library, University of North Carolina at Chapel Hill |
Type | text |
Language | English |
Format | Bulletins |
Digital Characteristics-A | 23,717 KB; 342 p. |
Digital Collection |
Ensuring Democracy through Digital Access, a North Carolina LSTA-funded grant project North Carolina Digital State Documents Collection |
Digital Format | application/pdf |
Related Items | Imprint varies: published later at Raleigh, N.C. |
Title Replaces | Bulletin of the North Carolina Board of Health** |
Audience | All |
Pres File Name-M | pubs_edp_healthbulletin1930.pdf |
Pres Local File Path-M | \Preservation_content\StatePubs\pubs_edp\images_master\ |
Full Text |
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Entered as second-class matter at postoffice at Raleigh, N. C, under Act of July 16,
1S94. Published monthly at the office of the Secretary of the Board, Raleigh N. C.
VOL. XLV JANUARY, 1930 NO. 1
The midwife class of Person County. These women have been taking a
course of instruction provided by the county health department, spo7isored by
Miss Ruth McCollum, the county nurse. It is a creditable looking group. They
are putting into effect the practical idea of improving the status of all mid-wives
as long as there remains a single woman needing their services.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OP HEALTH
A. J. CROWELL, CTRUS M.D., President r>>,o^i^«.» THOMPSON, M.D._ tV.v^ ^m* THOMAS E. ANDERSON, M-DTI: «^t^f°°yH '
E. J. TUCKER, D.D.S._. I
Statesville
D. A. STANTON, M.D._r___ ' £rV u ?. •
°
JAMES P. STOWE, Ph.G. ^^Mu ^^i?* JOHN B. WRIGHT, M.D Charlotte
L. E. McDANIEL, M.D. __ Raleigh
CHARLES C. ORR, M.D. 1- i"^t*^^?," Asneville
EXECUTIVE STAFF
ROnIld^ ^V^olEf^a^^^.^^; }^-^i:
KONALDB. WILSON Secretary and State Health Officer. Assistant to the Secretary.
?< V; ^M93^ M.D., Director State Laboratory of Hyeiene
H E- M?TI'^' ^^' ?i5*?'°^ g^^^*^ «' Health Educatfon.
F m" REmf^R Mh^^A^^ "t
Bureau of Engineering and Inspection.
H A TAVTHT?^^ •i*-°/'^^^^°?'.B".^^,^^ °^ V"^l Statistics. t±. A. iAYLOR, M.D., State Epidemiologist.
^^g^Qf COLLINS M.D Director Bureau of Maternity and Infancy.
iErR;>NTfEvS^^TriSK, M.D., Director of County Health Work A. BRANCH, D.D.S., Director of Oral Hygiene.
FREE HEALTH LITERATURE
whi-Jw^-lfhl^ ^^^'^ of Health publishes monthly The Health Bulletin,
T^LSkT l^i-^r^-^""!? *° ^"7 "^'^^^ requesting it. The Board also has available for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested
Adenoids and Tonsils
Cancer
Catarrh
Care of the Baby
Constipation
Colds
Clean-up Placards
Chickenpox
Diphtheria
Don't Spit Placards
Eyes
Plies
Fly Placards
German Measles
Hookworm Disease
Infantile Paralysis
Indigestion
. Influenza
Malaria
Measles
Pellagra
Public Health Laws
Prenatal Care
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placards
Typhoid Fever
Typhoid Placards
Veneral Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY AND INFANCY
.pnt'^f!^!/t"'''^'"^-'.?^"^^^'tf^i"'"^ °" ^^^ subjects listed below will be
Health, RaleighfNlc.?
^^^^ °'' ''^"''* *° ^^" ^^^^^ ^°^^d °f
Prenatal Care (by Mrs. Max West)
Infant Care (by Mrs. Max West)
Prenatal Letters (series of nine
monthly letters)
Minimum Standards of Prenatal Care What Builds Babies?
Breast Feeding
Sunlight for Babies
Save Your Baby
Hints to North Carolina Mothers Who Want Better Babies
Table of Heights and Welgiits
The Runabouts in the House of Health
(pamphlet for children from 2 to 6 years of age)
Baby's daily Time Cards: Under 5 months; 5 to 6 months; 7, 8, and 9 months. 10, 11, and 12 months; 1 year to 19 months; 19 months to 2
years.
Diet Lists: 9 to 12 months; 12 to IS months; 15 to 24 months; 2 to 3
years; 3 to 6 years.
CONTENTS
PAGE
North Carolina Health Prospects
For 1930 ^^____ 3
Practical Health Teaching' In Wilk-inson
School 4
Recalls Days of Embalmed Beef and
Typhoid Fever 6 Vitamin Band Pellagra 7 Preventing Unnecessary Noises—1__ 8 Heart Disease and the Public Health 9 Who Is Educated? 10 Practice of Medicine Regarded as
Public Utility 11
PAGE
Driving On Left Side of Road 13 Broken Wings 14
Vaccination Pacts 21
College Blues 23 Our Lives Shorter, Not Longer 25
Common Sense and the Open Win-dow^
26
Dosers 28
Our Back Cover Cartoon 29 How Very Few of Us Die 30 An Encouragement 31
VOL. XLV JANUARY, 1930 NO. 1
NORTH CAROLINA HEALTH PROSPECTUS FOR 1930
Facing a new year is an adventure
for everj" living human being from the
infant in its crib to the individual
who has marked off three score and
ten years. For many of the infants,
too many of them, the journey will
be perilous. For many of the aged it
will mean embarkation on the "Third
Puzzle" of human existence. Accidents
and untimely deaths, most of which
are preventable, will take heavy toll
among the intervening ages. The same
history is recorded year after year.
It is the business of a health depart-ment
to make the traveling of the in-fants
less hazardous, to reduce the
preventable toll taken from those of
active age, and to defer the em-barkation
of those of advanced years
as long as possible.
The practical question is, how may
these things be done? The equally
practical answer is, by efficiencj',
honesty and industry on the part of
health department personnel, county,
city, and state, in vigorously teaching
the people how to apply the scientific
principles of disease and accident pre-vention.
We herewith set forth some of the
things that might be done.
Every prospective bride and groom
might be taught the dangers of ve-nereal
disease with the disastrous
consequences which so often follow
such infection. Every prospective
mother should receive expert care and
adx-ice during the entire pre-natal
period. She should have the proper
kind of food in adequate quantity. Any
abnormal condition manifesting itself
should have immediate medical at-tention.
During the birth process ev-ery
needful attention should be avail-able.
Thus the maternal dangers may
be largely eliminated. The infant then,
given a healthy heritage free from
venereal infection, may have at least
an even start. Every infant born
should have right from its first hour
the inalienable right of nourishment
from its mother's breast, unless a com-petent
physician certifies that breast
feeding would be dangerous for the
mother and disastrous for the infant.
Soap is cheap and water, fresh air and
sunlight in North Carolina is practic-ally
unlimited the year round. The
baby should, therefore, have a clean
bed, regardless of rags or poverty
(the rags can be clean ones), mother's
milk, sunlight and clean air. The male
relative with pipe or cigar, or the
mother with cigarette, should be equal-ly
barred from the baby's presence as
the visitor with a cold. Give the baby
air free from the germs of respira-tory
infection, the irritating effects of
nicotine loaded smoke, good breast
milk, a clean bed, good heritage from
healthy parents, let it alone and the
chances are better than even the baby
will do the rest for the first eight or
nine months of life. Careful attention
to the establishment of health habits
with assurance of right kind of food,
frequent inspection by the family phy-sician
and dentist will take care of the
pre-school period and ensure the pre-sentation
of a healthy young animal to
the school at the ripe and experienced
age of six. These first six years are
the important ones. Then is the pe-riod
when the parents should know
The Health Bulletin January, 1930
the water is pure, the milk safe and
the food of the right kind, adequate
and properly prepared. Two of the
most important things to do during
the first year is to see that the infant
is successfully vaccinated against
smallpox and that it has three ade-quate
doses of a fresh product of
toxin-antitoxin properly administered
to guarantee against diphtheria.
Measles, whooping cough, and scarlet
fever should be guarded against with
all possible care. Six years old and
healthy when school troubles begin
means power to win if the teacher is
intelligent. There are so many aids to
good health now available for the
school children almost all over the
State, that no pupil's health should be
jeopardized during these years. Never-theless
many thousands of them have
their health seriously impaired in
many ways which could be avoided.
But we may take heart here for the
teachers are learning. It is the solemn
duty of every health officer to help
teach them, and none the less the ob-ligation
of every practicing physician
to do the same thing. Shorter school
hours for younger children, all those
under twelve, and rigid supervision of
school cafeterias may be regarded as
the two most imperative demands for
better health safeguards for school
children. It ought not to be necessary
to say that if any child is so unfor-tunate
as to be admitted to school this
year before receiving a successful vac-cination
against smallpox and diph-theria
this important deficiency should
be remedied during the first thirty
days of school.
In all the foregoing the one respon-sible
individual who is paid a salary
from public moneys to do these things
is the local health officer. It makes no
difference whether he is a full time
official or a part time one, the obliga-tion
is equally binding. It is no use
to say the fault is the parents, or the
practicing physician's when failure to
invoke protection is present. The
health officer must secure the coopera-tion
of parent and family physician.
Details and methods by which things
may be done are unimportant. Getting
them done is the important point.
Plans and programs should be made
to fit the local needs. But the prin-ciples
are fundamental and State-wide.
For the general population atten-tion
should be given to a more plenti-ful
supply of fruits and vegetables
and an increase in the consumption of
dairy products, poultry, eggs, meat,
and fish, by people who need to guard
against the deficiency diseases. Pure
water, whether it be for village or city
dweller or on the farms, should be
made available. Better safeguards to
assure clean and safe milk. Adequate
screening of all houses, the extension
of sewage facilities and sanitary
privies where needed are among some
of the things to be looked after in our
1930 health prospectus.
More humane and sympathetic care
for the aged and the "down and out;"
the better safeguarding of the health
of working people in all kinds of in-dustry
and agriculture are among our
biggest needs. For the adult individual
a health examination, a really truly
health examination, not a pulse feeling
and tongue inspecting enterprise,
would if included in the year's pro-gram
add much to the happiness of
all such wise folk as well as possibly
adding a little something to the span
of life.
May your New Year be what you
try to make it.
PRACTICAL HEALTH TEACHING IN THE
WILKINSON SCHOOL OF ROCKY MOUNT
Early in October the teachers of the
Wilkinson school of Rocky Mount,
North Carolina, wrote to the State
Board of Health explaining a plan
they had for the practical teaching
of health matters in the school this
January, 1930 The Health Bulletin
year. They informed us that they had
about three hundred and twenty-five
pupils in this particular school.
The plan that they proposed to put
into effect is one that any wide-awake
school of the State can also utilize.
Briefly speaking, they propose to take
up one phase of health teaching each
month and study that exhaustively.
They selected as their subject for the
month of October the care of the teeth.
They asked us to supply them with
literature in the form of a short
pamphlet on the care of the teeth,
sufficient to supply each one of the
pupils with a copy. It so happened
that we have been distributing for ten
years all throughout North Carolina a
carefully written special pamphlet on
the care of the teeth. This little
pamphlet has two cuts, one a drawing
of the temporary teeth and one that
of the permanent teeth. The two are
placed on the same page. Each tooth
of each set has the proper name and
the approximate date of eruption.
The teachers of the Rocky Mount
school proceeded to examine each child,
writing his or her name on the pam-phlet
to begin with. Whenever they
found a child who had a particular
tooth corresponding to the tooth on
the plate, either temporary or perman-ent,
which was decayed, they mark-ed
this particular tooth "decayed" or
"needed dental attention." Each child
was then asked to take this pamphlet
home and to show the parents the sit-uation
that the teacher had found.
This is certainly beginning at the
beginning and is one of the most ef-fective
methods of teaching practical
care of the teeth we have ever seen.
The method assures concentrated in-terest
on the part of the parent at a
time when it will probably do more
good than it could ever do again. The
information carried in the pamphlet
is sufficient to explain to the parent
the importance of taking action imme-diately.
No dentist in the world could
criticise this procedure. The examina-tion
was not a dental examination, and
if a tooth had a decay in it big enough
for a teacher to see, it is a self-evident
proposition that the dental services
were needed; and, after all, the re-sponsibility
of health departments and
teachers is to get children who need
dental or medical care into the hands
of capable dentists and physicians.
This procedure on the part of the
Rocky Mount teachers strikes us as
being the finest method yet devised
to do that particular thing.
To go a little farther along with
the Rocky Mount program, another
month, after they settle the teeth
question, is to be devoted to the ques-tion
of a study of the prevalence, dan-gers,
and prevention of diphtheria.
Here again we are able to provide
them with literature which is to the
point, sufficient for each child and its
parents to have. In this way every
parent who is patronizing the Wilkin-son
school in Rocky Mount will have
directly called to his attention the fact
that diphtheria may be easily pre-vented
through the administration of
toxin-antitoxin to any young children
in their families. If the parents do
their part and act on the suggestions
which will be brought directly to them,
there should not be a single case of
diphtheria developing m the Wilkinson
school of Rocky Mount when the fall
session of 1930 opens. This will give
ample time for the immunization
thi'ough the winter and spring of any
children in homes patronizing that
school for the immunization to take
full effect before the school opens next
September.
And another item of vast import-ance
to the health of the school chil-dren
is the question of foods. The
teachers propose to take one month for
the study of the particular kind of
food, the quantities, and so on that
school children should have. These are
only items illustrative of the fine and
comprehensive program these teachers
are carrying through.
We take pleasure in departing from
our usual custom in which we are
The Health Bulletin January, 1930
treating all matters these days dis-cussed
in the Bulletin in an imperson-al
manner, by mentioning the names
of the two teachers who have initiat-ed
this program. Communication to
the State Board of Health was made
by Miss Charlie Westbrook, one of the
teachers in the Wilkinson school, and
Miss Bessie McDearman, principal of
that school. We hope that other teach-ers,
when engaged in their schools, will
follow the example of these wide-awake
teachers in this particular
Rocky Mount school. The field is un-limited
and the need is great for just
such practical teaching.
RECALLS THE DAYS OF EMBALMED BEEF AND
TYPHOID FEVER
Thirty-two years ago this month the
battleship Maine was blown up in Ha-vanna
Harbor, and very soon there-after
the country was at war with
Spain. Some few weeks ago the Mon-roe
Journal published a rather poig-nant
little story from a Monroe citi-zen
who is a veteran of that war. The
story recalls to mind so graphically
the conditions in this country, and in
the army where typhoid fever killed
many more soldiers than Spanish bul-lets,
that we herewith publish it in
full. To a present-day health officer
in North Carolina it will read like a
story from some ancient and musty
history. However, there are many of
us who can remember only too well
the conditions that existed in the civil-ian
population in North Carolina just
as well as obtained in the army.
This man speaks from personal
knowledge. He was a victim. The story
has gone the round many times of a
pompous major general of one of the
camps walking up and tearing from
a polluted well a notice from the med-ical
department warning the soldiers
not to drink the water from that par-ticular
well. This old incarnation of
political authority, and ignorant of
things outside of his particular tech-nical
training, proceeded to drink of
the water and to remark that all this
medical palaver was foolishness. At
the time hundreds of his soldiers were
sick from typhoid fever, and many of
them were dying every day. We have
certainly traveled some distance since
that day. Read the story that this sol-dier
tells, and take heart that in some
things the world is not as bad as it
was thirty-two years ago.
"When Mr. John Holloway put on
his uniform of a soldier of the Span-ish-
American War, people said, "Hel-lo,
Mr. Holloway, I didn't know you
were a Boy Scout.'
"That riled John, riled him to think
that the war in which he had been a
soldier and came very near losing his
life, could be totally forgotten by the
older people and wholly unknown to
the young.
"But that is about the truth of it.
And the government takes the same
attitude, says Mr. Holloway. It does
just about half as much for a veteran
of the Spanish-American War as it
does for one of the World War for
exactly the same disability. And
though it paid him only fifteen dollars
and sixty cents for soldiering, it mus-tered
him out without any compensa-tion
adjustment at all.
"Dewey captured the Spanish fleet
in Manila bay on May first, 1898, and
Schley smacked the Cevera fleet on
July fourth. At that time the Ameri-can
soldiers, every last one of them
volunteers, were being prepared to
land in Cuba, but a lot of them never
got there. They were already dead or
dying of typhoid fever or starving on
embalmed beef in the concentration
camps. John Holloway was one who
was laid up with typhoid fever and his
leg was swollen as big as his body
when his regiment embarked for Cuba.
"There are a good many more Span-ish-
American War veterans around
here and there and no doubt they feel
January, 1930 The Health Bulletin
about like John of the hardships of
that war and the scant attention they
now receive, especially as John says,
since what they underwent caused the
revolution that swept away the men-ace
of embalmed beef, cheating con-tractors
and such like and started the
war against typhoid and made army
camps at last free from such dis-eases."
VITAMIN B AND PELLAGRA
In a letter to the Editor of the Bul-letin
sometime ago a physician friend
remarked that he could not see why
pellagra should be regarded as a de-ficiency
disease in view of the fact that
the pellagra preventing principle in
food known as vitamin B is the most
widely disti'ibuted vitamin in nature,
and so that practically the diet served
on all tables in the homes of the peo-ple
of this State therefore had an
abundance of vitamin B, and that they
could not help eating a considerable
amount of food containing this vita-min.
The fact that vitamin B is present
in the leafy vegetables such as let-tuce,
cabbage, spinach, turnips, in liv-er,
kidneys, tomatoes, beans, peas, po-tatoes,
eggs, milk, in addition to the
large amount found in yeast and the
basic foods of every family, cereals,
would seem to afford a sufficiency of
this necessary element. It is, of course,
true that an abundance of this vitamin
is available, provided we eat it.
We have just called cereals the basic
food of every family. This is true, be-cause,
in North Carolina at least, corn
bread, white store bread, or biscuit
made from white flour, composes the
bread diet for ninety-nine per cent or
more of the people. In a thorough-go-ing
study of this point the late Dr.
Edward J. Wood made a special trip
to some of the large flour mills in the
Central West in order to see the pro-cess
employed in making flour, a large
quantity of which was shipped and is
shipped to this State for consump-tion.
He made the same investigation
concerning the manufacture of the
commercial corn meal handled in large
quantities by the grocery stores of this
section also. He learned that the germ
of the wheat, and of the corn, was
removed in the milling process, be-cause
this portion of the grain, which
contains the vitamin B, if retained,
then the flour or the corn meal was
many times more subject to mold and
spoilation in shipping, and therefore to
commercial loss.
People who eat the native whole
wheat bread from wheat made in this
section, or at least milled in this sec-tion,
and which contains all of the
This little Youngaville girl weighed
only two pounds when one ivcck old.
She lay on a pillotv in a bassinet with
hot water bottles around her for the
first three months. During this time
she teas fed lactic acid milk sweetened
ivith corn syrup, and administered
with a medicine dropper. She is a fine
example of what may be done with
patient and intelligent care, includ-ing
parental, nurse and medical.
8 The Health Bulletin January, 1930
wheat kei-nel, including the germ, get
the vitamin B in proper proportion.
In the same way the many thousand
families in the State who embrace the
opportunity of getting their corn meal,
from which they make their corn
bread, from local grist mills, especial-ly
from local mills in which the North
Carolina corn is utilized fresh from
the barns and fields of the local farm-ers,
also get vitamin B in their corn
bread, although in smaller proportions
than in the whole wheat bread. Dr.
Wood therefore held that the basic
cause which made pellagra possible
was that the people who had been de-pending
upon a diet rich in the gei-ms
of wheat and corn in their bread,
when deprived of this through the
commercial products utilized in recent
years, failed to get enough of the pel-lagra
preventing principles by eating
it in other foods, sufficient to make
up for the deficiency.
We reiterate here the doctrine of
Goldberger and Wood, that it is not
only necessary to have an adequate
diet on the table containing an abund-ance
of vitamin B, called by Goldberg-er
the pellagra preventing principle,
but it is essential that this diet be
consumed by the person who would
avoid pellagra or other deficiency dis-eases
of like character.
PREVENTING UNNECESSARY NOISES
Some of the health departments in
the various cities of the country are
very much concerned over the ques-tion
of control of unnecessary noise.
The city of London has had various
commissions at work making surveys
in their thorough-going style as a pre-liminary
to city ordinances drastical-ly
extending control in order to pre-vent
these nuisances. In this State the
city of Greensboro raises a big fuss
about the blowing of train whistles
and the exhaust racket kept up dur-ing
the night by a surplus of motor
cycles. In some of the cities of the
North street cars are blamed for a
great deal of the noise, the city of
Dayton, Ohio, in its Health Bulletin
declaring that there had been no im-provement
from a noise standpoint in
the operation of street cars of that
city in a third of a century.
Nearly all the cities and towns in
our State find the unnecessary blow-ing
of automobile horns nothing short
of an unmitigated nuisance. The vi-bration
caused by heavily loaded
trucks running at rapid speed on the
streets at all hours of the night is
another cause for complaint. For the
most part the latter are engaged in
the work necessary to be done for the
welfare of the people, and nothing we
know could be done to prevent it ex-cept
better training of the drivers as
to how to reduce the racket to a min- I
imum. In the case of blowing automo-bile
horns, in our opinion about one
toot every six months for the average
car is sufficient. The fact is that the
manufacturers ought to be prohibited
by law from equipping cars with
horns. If this nuisance were drastical-ly
abated in the foregoing manner,
and an ordinance strictly enforced, re-quiring
all drivers to keep well to the
right side of the road, there would not
be any possible excuse for a horn on
an automobile. Some critic might prob-ably
say that it would still be neces-sary
to warn pedestrians, but the fact
is that a few sharp blasts from the
automobile horn when a pedestrian is
crossing the street only tends to con-fuse
him and make bad matters worse.
The pedestrian, of course, must be
taught to look before he crosses the
street, just as the automobile driver
should be trained to stay on his side
of the road. The ringing of the train
bells and the blowing of locomotive
whistles day and night in thickly
populated resident portions of town
certainly should be reduced in volume
|
and used only as a necessity in the
safe operation of trains. For the rath-
January, 1930 The Health Bulletin
er large volume of sound as an inci-dent
of making general "whoopee" in
the residential sections of towns in all
hours of the night, that is a matter
for education and regulation by com-petent
authorities.
HEART DISEASE AND THE PUBLIC HEALTH
It was not until about the beginning
of the present century that tubercu-losis
was definitely recognized as a
public health responsibility. Only re-cently
cancer has been placed in the
category of diseases constituting a
public health problem. The fact is that
it is not even so recognized every-where
now. The extremely communic-able
diseases like smallpox have natur-ally
been looked upon as public health
problems all the time. We are glad to
he able to record the fact that now
heart disease is coming to be looked
upon as just as definitely a public
health problem as cancer is.
Progress tov/ard the control of the
spread of tuberculosis is much more
satisfactory now that it is realized
that the disease is almost always con-tracted
in childhood through exposure
of infants and very small children to
contamination with the fresh sputum
and other discharges coming from tu-berculous
patients living in close con-tact
with the infants. When it was
learned that this infection was pres-ent
in latent form in the children, to
become manifest in later years, then
it was that the most intelligent efforts
could be directed against the eradica-tion
of the disease.
It is now realized that about seven-ty-
five per cent of all cases of heart
disease develop in children ten years
of age or under, and that only about
ten or twelve per cent develop in per-sons
over forty years of age. Heart
disease is one of the gi-eat killers of
this country. More than twice as many
people die each year from heart dis-ease
as do from kidney disease or from
cancer or from pneumonia; and these
four diseases constitute the four chief
causes of death.
Another disturbing element is that
the rate of death from heart disease
is increasing about twice as rapidly as
the rate of population increase. Often
heart disease is congenital; that is, a
child is born with the disease present,
and in such cases nothing can be done
to prevent its development and the
probable early death of the child. The
only thing in such possible cases that
can be done is to pay more practical
attention to the care necessary to safe-guard
expectant mothers. The other
form of heart disease; that is, the
form that is acquired after the healthy
birth of a baby, is nearly always due
to complications resulting from com-municable
disease, or to improper hab-its
of living.
The group of diseases known under
the general term as rheumatism is
notably large. Rheumatism is at this
time believed to be a germ disease.
For many years the doctors and den-tists
have had a great deal to say
about focal infections. In these condi-tions
so-called rheumatism infection
is frequently a result of diseased ton-sils
or decayed teeth, the germ gain-ing
entrance into the blood stream
through such conditions in the body.
The chief thing to emphasize in this
connection is that the best method of
prevention of such conditions is to pre-vent,
when possible, decayed teeth,
and also to preserve, if possible, norm-al
tonsils, through care for the gen-eral
health of the child before and
after birth, the prenatal care, of
course, directed to proper hygienic
living, proper food, and the freedom
from disease of the mother.
The United States Public Health
Service in a recent publication stated
the tabulations of physical records of
five thousand school children under
their supervision showed that of the
children whose tonsils had been remov-ed
for serious tonsillar infection in
10 The Health Bulletin January, 19SO
A fine pair of Jackson County twins.
At present both are underweight, but
we hope that handicap will be re-moved
at an early date.
the past, twenty out of every hundred
had attacks of rheumatism, and of
the children with defective tonsils
which had not been removed, seven-teen
out of every hundred had rheum-atism.
With the former group, four
had heart disease, and of the latter
group, three out of each hundred had
heart disease. The showing, however,
for children who had normal tonsils
which had not been removed and
which were not diseased was much
better, not more than one-third as
many having indications of heart dis-ease.
The use of the word "rheumatism"
is somewhat misleading, because of
the fact that in the past so many
poorly classified conditions have been
diagnosed as rheumatism. This has
been done to the point where the
average intelligent physician feels
that when the word "rheumatism" is
used, it is done so as a general term,
and means very nearly nothing. Much
experimental research work remains
to be done in this group of diseases
before an intelligent classification can
be made. It is sufficient for our needs
in this discussion, however, to recog-nize
the fact that heart disease is an
increasing menace, and that it results
from many communicable diseases as
well as from improper habits of liv-ing.
In conclusion, we would like to em-phasize
again the fact that to do any-thing
much with heart disease requires
an early beginning, and it is one con-dition
in which prevention is about
the only logical procedure toward
which all efforts at eradication should
be directed.
WHO IS EDUCATED?
September and October this year
have been disappointing to the State
Board of Health officials and to the
public health workers in general in
North Carolina because of the fact
that the presence of diphtheria, judg-ing
from cases reported throughout
the State, has been just as serious, if
not more so, than in previous years.
We have said it several times be-fore
orally and in print that there is
today in North Carolina no excuse for
a parent whose child has diphtheria.
The reason for this statement is that
toxin-anti-toxin properly administered
to young children affords such a max-imum
of protection that it is exceed-ingly
rare for any child to have diph-theria
after immunity is secured
through the administration of toxin
antitoxin.
A short time ago a close personal
friend of the writer, a university grad-uate
and an important North Carolina
educator, was detained at his home on
account of an attack of diphtheria in
his youngest child, a boy of six years
of age. The child had started to school
at the opening of schools in Septem-ber.
Naturally being exposed, as so
many other thousands of children are
every fall, for the first time to diph-
p
January, 1930 The Health Bulletin 11
theria and other contagious diseases,
not having had the protection afforded
by toxin-antitoxin, and being suscep-tible
to the disease, he promptly con-tracted
diphtheria. The wife of this
friend is an educated woman. Both of
them have had access to the litera-ture
and other channels of informa-tion
concerning every protective de-vice
available for the rearing of their
children. Their home is located within
four blocks of one of the four oldest
whole-time health departments in
North Carolina. The health officer in
that county has been giving toxin-antitoxin
at frequent intervals to the
children of all parents who would take
the trouble to bring them to the office
or arrange the schedule in the differ-ent
sections of that particular county.
The same thing has been done in many
other counties, and yet there are lit-erally
thousands on thousands of chil-dren
in North Carolina today who
have not been given this protection by
their parents. Our friends in response
to the question as to why they had
neglected to protect their child
through toxin-antitoxin last spring
and summer, knowing that their child
would start to school this fall and be
exposed to diphtheria, replied that
they just simply had not done it. They
were not indifferent to the value. They
were not in ignorance of its protection,
but they simply had not got around to
it.
A few days later we were in the of-fice
of the health officer of Randolph
County just preceeding a county-wide
teachers' meeting in which the super-intendent
of Randolph County schools
was making a particular point to em-phasize
the importance of public
health protection at his very first
county-wide teachers meeting held in
the county. While we were sitting in
the office conversing with the health
officer, a nearby farmer came in with
his two children, a little boy of four
and a baby of fifteen months. They
had been there for their first dose a
week previous, and on entering the
office the little four year old began
pulling up his sleeve, and, with a
broad grin on his face, told the health
officer he was "ready for another one."
In less than a half minute the health
officer had administered the second
dose of toxin-antitoxin to the fine little
chap. There was just about as much
pain as a mosquito bite, and if the
reaction is no worse than the average,
that was the last that the little fel-low
would hear from that dose.
Now our question is, so far as pub-lic
health protection goes. Whose edu-cation
in these cases proved to be the
most practical?
PRACTICE OF MEDICINE NOW REGARDED AS A
PUBLIC UTILITY
Doctor Henry G. Longworthy is the
treasurer of an organization known
as the Inter- State Post Graduate Med-ical
Association of North America. He
wrote an article which was published
in the September issue of the Nation's
Business Magazine. He begins his ar-ticle
with the astounding statement
that "The practice of medicine today
may be regarded as a vital public util-ity
function well regulated by law and
well managed by physicians, hospit-als
and social agencies."
He pictures the physician of the
present day who practices medicine in
the city as a "bedside medical engi-neer."
He says that as a medical ex-ecutive
such a physician "engineers or
calls to his aid at the bedside for the
benefit of the patient, all necessary
consultations, hospital facilities, nurs-ing,
diet, and all the other sciences.
In many cases for the diagnosis and
treatment of a single patient, this
medical executive will use the services,
directly or indirectly, of a dozen to a
hundred persons."
The foregoing is true and it is what
12 The Health Bulletin January, 1930
is making the practice of medicine to-day
one of the most complicated and
costly of professions. It accounts for
the enormous cost of hospital care.
The sinister phase of it is that the
successful physician can no more hope
or expect to get back to old style
economic individualistic methods than
he can expect or desire to return to
his saddle bags and home-made pills.
The danger in the situation lies in the
possibility of the physician (medical
engineer) becoming of necessity a sim-ple
cog in a vast machine whose final
superior may be a political cabinet of-ficer.
That is the spectre of State
Medicine so many thoughtful physic-ians
fear. In such an arrangement the
individual patient would receive about
as much personal and individual at-tention
as one biddie in an incubator
flock of ten thousand.
This is the day of big business. All
of us think and talk in terms of bil-lions,
whether it be debts or folks.
Mergers and combines are in complete
and glorious control of everything. The
pendulum has simply followed the
law of averages and swung back from
the period of thirty years ago when
no corporation or combine was too
small or too poor to be kicked. What
more natural then, in the present
mental state, than to regard the doc-tor
along with the chain store opera-tor
as a purveyor of a public utility
because he has something to sell that
most people have to have at one time
or another.
The writer in the aforementioned
article quotes Homer Folks in a state-ment
that the families of this country
having illness in the course of a year
pay out in actual cash on account of
such illness the astounding total of
two billion dollars. The same total
amount is spent annually for public
education—from kindergarten to post
graduate universities. If cost in loss
of time and other economic loss is in-cluded,
sickness costs the American
people every year about fifteen billion
dollars. So, we see that in a way the
practice of medicine and the conduct
of hospitals for sick people constitute
about the biggest public enterprise in
the country. That being true it is in-evitable
that business and medicine
should form a new alliance, and the
foundation stone of the enterprise
must be preventive medicine. The pre-vention
of disease is a public enter-prise.
To achieve its finest results it
must be organized like an army, and
in the struggle for the ideal of longer
life and sounder health, the army must
be composed of individual physicians.
No faculty ever educated a student.
What the student gets is the sum total
of efforts made in his behalf by indi-vidual
instructors. No medical society
ever cured a patient. Some individual
member of the group must assume full
responsibility and do the job if the pa-tient
is to benefit. And that is what
Dr. Longworthy meant by calling the
physician a bedside engineer. If the
mass of the people are to receive the
benefits of this new alliance between
business and medicine they that are
well must be told how they may keep
well. That is an individual problem.
Each must read what some one per-son
writes for him or he must be told
by some individual. Who is better
qualified than the physician? If the
person who is sick is to benefit he
must have the attention of an individ-ual
physician. In the final analysis the
things that must be done to reach the
ideal may be summed up about as fol-lows:
1. Knowledge concerning the cause
of disease and the prevention of its
spread must be placed in the hands of
every intelligent individual. This is a
purely public health responsibility.
2. The services of a competent phy-sician
must be available for every sick
person regardless of where he lives or
how poor he is, for so long a period as
he needs such service. TTiis is ob-viously
impossible at present. So
the business part of this alliance be-tween
medicine and business must
see that:
January, 1930 The Health Bulletin 13
3. Hospital facilities are placed
within the reach of all. The physician
must practice more and more in con-nection
with hospital and medical cen-ters.
These hospitals must be placed
in the rural sections as well as larger
towns. Under this arrangement the
physicians will have available all mod-ern
methods of aid in diagnosis. Such
a system will result in
4. Better care for the patient at
much lower cost than at present. A
physician will be able to treat many
more patients, and to treat them
more competently. Having his office
and home in such a center, even
though it be in a small town, the of-fice
or ambulatory patients may re-ceive
assurance of more satisfactory
care, and patients needing bed care
can receive it easily. The cost must
be many times less than at present,
and the physician must receive much
better compensation than he does
now. Business methods can assure all
this and the physician and patient will
both retain forever the fine individual
relationship that has obtained in the
past, surely to the vast benefit of the
patient.
DRIVING ON THE LEFT SIDE OF THE ROAD
Here we are again talking about
traffic on the highways. However, in
view of the fact that mortality due
directly and indirectly to automobile
accidents constitutes one of the major
causes of preventable deaths in this
State, we feel justified in continually
writing something in the Bulletin
about the matter. It has been neces-sary
in the progress of the science
of public health in driving away at
the preventable causes of death to
keep continually before the public
these particular causes and how a dif-ferent
public attitude might result in
preventing death from unnecessary
causes.
There are not many rules for safety
on the public highways, but the few
rules that there are constitute some
very important ones, the breach of
which causes many deaths and much
suffering among the people who are
the victims. With the thousands of
automobiles running along our main
public highways every day at high
speed, the least variation from the
known methods of safety may at any
time instantly result in death to one
or more persons.
It has been our observation in our
journeys to and fro around over the
highways that a frequent cause of
traffic trouble, accidents and death, is
the man who persists in driving along
on the left side of the road. There
seems to be a large percentage of
such pests exercising the privilege of
driving automobiles all the time. This
particular insect seems to delight in
getting on a crowded highway and
piddling along at a low rate of speed
on the extreme left-hand side of the
highways in the country, and in the
city or town he gets just as far over
the middle of the driveway to the left
as he can possibly get without having
a collision with cars coming from the
opposite direction. TTiey seem to think
that the roadway is better on that
side, or that the atmosphere is more
rarefied and purer, or they may do it
for just pure carelessness. The driver
who wishes to pass, even on an open
road, has to wear his horn out calling
attention to his desires before any
notice is taken. By the time he reluc-tantly
and slowly begins to turn in,
one or more cars heave in sight com-ing
from the opposite direction, which
makes it impossible to pass, often for
a mile or more.
The chief characteristic of the left
side of the road driver seems to be his
desire to drive along slowly. When
coming meeting such a driver the le-gitimate,
careful driver of an on-com-ing
car almost has his hair standing
on end before this pest seems to take
notice and grudgingly turns back to-
14 The Health Bulletin January, 1930
ward the right, perhaps getting out
of the line of traffic just about the
time the driver meeting him has to
slam on his brakes or leave the road-way
entirely to avoid hitting him. Such
a habit is dangerous for several rea-sons.
One of the chief dangers, of
course, is the impossibility of drivers
of cars behind him being able to see
an on-coming car, perhaps just be-fore
a road intersection, or, in their
efforts to pass him, the on-coming
car is obstructed from view, and ac-cidents
often result. Another thing,
it is bad for the nervous system and
therefore the safety of every driver
of a car, and to the people he meets,
to have his calmness or his equanimity
upset from any cause. Such driving
frequently results in fatal accidents
to pedestrians also.
After all, the question of driving
comes back to the very old one of good
manners. A polite, considerate, well-bred
driver of an automobile will think
of the convenience and safety of the
drivers of other cars, as well as his
own, and will therefore govern himself
accordingly.
We would suggest to all persons
reading these lines, who are accus-tomed
to driving an automobile that
they ask themselves the question: "Am
I a left-hand side of the road driver ?
"
If the answer is in the affirmative,
our advice and request is to quit it.
BROKEN WINGS
By
SuDiE E. Pyatt
Paul was falling from a couple of
thousand feet above the earth. His
plane had gone bad, the left wing was
broken. He was crashing toward the
earth at terrific speed with no time
to adjust his parachute.
Just before he reached the earth
that rose to meet his broke plane,
he awoke swearing.
"D—n!" He could hardly breathe.
That left lung, the one the doctor had
pumped gas into that day was pain-ing
him as if a sharp knife had been
driven through it. Pleurisy, and the
spot still sore from the passage of the
needle that had introduced the first
shot of air into the pleural space be-tween
his lungs and his ribs, caused
the pain. No wonder he had dreamed
he was crashing to earth with a
broken airplane xwing.
Bird with a broken wing he was,
and birds with broken wings never
could soar so high again.
Paul groaned. The night nurse, a
silent figure in white, a lantern bob-bing
by her side like a huge firefly,
laid her hand gently on his arm.
"What is the trouble, Mr. Dun-bar?"
"D d bird with a broken wing!"
Paul sighed half asleep, but not for-getful
of the pain in his left side
—
—broken wing. "Never fly again.
No more stories from the pilot's seat
of my plane—broken wings—
"
Paul's voice trailed off into silence
under the nurse's ministrations. When
she left him he was sleeping again,
peacefully this time.
Feature writer for one of his state's
best daily newspapers, and airplane
pilot good enough to have a transport
license, Paul Dunbar had been sent
three months before by physicians who
would hear of no other course to the
State Sanatorium suffering from a
moderately advanced tuberculosis le-sion
in his left lung.
Paul should have responded to twen-ty-
four hours a day rest in bed in a
number of weeks, but he did not. The
January, 1930 The Health Bulletin 15
lesion began to look as if it might be-come
worse, and the physicians in the
institution decided to administer pneu-mothorax.
Far from being a model patient
Paul had objected at first, but had
finally acquiesced. He had received
his first treatment the day before the
night he had had his dream of dash-ing
from a great heighth in an air-plane
with a broken left wing.
Eighteen months of the sanatorium
and Paul was in the superintendent's
office receiving his final examination
and instructions before leaving the in-stitution
to resume his life back in
the world of men and women outside
the san's wall.
Paul was now what the doctors call-ed
a quiescent case of tuberculosis. He
would have to have the pneumothorax
treatments continued, and he could
work only a few hours a day. He sup-posed
he should feel thankful that the
"bugs" had not gotten him, but in
Paul's breast there was a dull, glow-ering
resentment.—"The bird with the
broken wing never soars so high
again."
—And sitting in the superintend-ent's
office listening to his final words
of instruction, Paul was dully aware
that back in the world again he would
be a bird with a broken wing, who
would never be able to soar so high
again. For the doctor said emphatical-ly:
"No flying for two years."
It had been nearly two years now
since he had flown, strong and well
up there against the sun. Two more
years, four years before he could fly
again! Was it worth it?
As Paul watched an army plane
skimming over the hazy blue hills
that surrounded the sanatorium he
felt for a moment that he had fought
in vain.
But the doctor had said he might
return to his work on the desk for
part time. Part time on the desk, he
who had been his paper's star report-er,
free to go in his plane to the ends
of the earth if he could find there a
story for his paper, was to be a desk
man, writing news that other report-ers
gathered, and handling copy that
the fellows who could get out on the
streets were too busy to write. Not
yet twenty-five, he had run his gamut,
was played out before his time, and
all because of that bad lung—d—
n
broken wing!
The fellows on The Ashton News
were nice to Paul. Nice because they
were sorry for him, he thought, as
deaf old Henry Clinard carefully
wrote down for him the information
about that Draketown Street robbery
the reporter had brought in before he
arrived, to make sure that he would
understand everything connected with
it.
Watching "Old Henry" Paul won-dered
how it would feel to never be
able to hear a sound.
"Not so bad," Henry had once vol-unteered
the information, "if you
don't get cross with people who holler
at you. Deaf folks don't like to be
On the Stump in Guilford.
16 The Health Bulletin January, 1930
bawled at any more than folks who
can hear do."
After that Paul was always very
careful to write out his communica-tions
with Henry, or to talk in a tone
of voice that would make the old
copy-reader feel that he was not bawl-ing
him out. Henry appreciated Paul's
thoughtfulness, and there were many
times when Paul's work would not
have been completed in the few short
hours he was on the desk if it had not
been for Henry's aid.
Gradually there grew up between
the deaf copy reader and the young
re-write man with the broken wing the
close bond of sympathy that always
unites the incapacitated regardless of
what the nature of the trouble is.
The first day Paul was back at his
old position he noticed a flower and
gift shop that had been opened up in
his absence in the little niche next
door to the newspaper office. It was
spring, early spring, and the first
yellow jonquils were blooming. The
little shop was filled with the bright,
sunny beauty of the yellow flowers,
and just behind them stood a girl,
whose hair was as sunnily golden as
were the delicate petals of the jon-quils,
and the smile she gave Paul
from dewy blue eyes, Paul was willing
to swear, was made of pure gold it-self.
"How much are they?" Paul found
himself vaguely indicating the whole
gorgeous display.
Again Jonquil smiled, for Jonquil
her name must be, she was so much
like the flowers.
"Twenty-five cents a dozen, or three
dozen for fifty cents," and she had not
finished speaking before Paul decided
that her voice was as flowerlike as her
face and her smile.
"O, give me all of them," he said
carelessly.
"All of them?" A puzzled frown
crossed the sweet, little face, some-thing
like a brisk wind blowing across
a bed of flowers.
"All of them!" Paul repeated em-phatically
after her.
"That will be $10, sir."
And Paul thought that her talking
of prices was as if one of her yellow
flowers had stepped out of its vase to
do business.
"Where shall I send them, or will
you take them?"
Paul looked puzzled for a moment.
The jonquils would overflow his one
room, bath and sleeping porch. "Send
them out to the Bausman County Tu-berculosis
Sanatorium," he said quick-ly.
"To anyone in particular?"
"No, to all of the patients."
"What shall I put on the card?"
"From a 'Broken Wing,' only." Paul
did not realize that his voice was bit-ter.
The girl smiled in quick sympathy,
and for a moment Paul's black mood
lifted.
"Say, isn't your name Jonquil?" he
asked impulsively.
"No, it isn't, I'm sorry, but—" she
stopped.
"I'm going to call you Jonquil."
"When?"
"Now, and every time I see you
—
you see,—" Paul suddenly found he
was floundering helplessly. "I work
next door on the newspaper."
"O, you're a reporter?"
"Yeah, sort of."
And with that Paul tipped his hat
and went into the office. He had found
suddenly that he would not like for
this golden, blue-eyed Jonquil to
think of him as a man with a broken
wing.
Paul had been back on the desk at
The Ashton News for three months
when Lon Dale, the greatest airplane
stunt flyer in the United States came
to Ashton. Paul had flown with Dale
in the days before he had known that
he had lungs.
The stunt flyer's air antics and the
reporter's ability at description had
given The News many good stories.
Dale and Paul, who were very fond
January, 1930 The Health Bulletin 17
of each other, were delighted to meet
again. It had been two and one-half
years since they had pulled one of the
hair raising airplane stunts. They had
not been together fifteen minutes be-fore
they were planning one of those
thrilling flights of the old days, Paul
forgetting once again that he had
lungs—that he was a bird with a
broken wing.
They buttonholed Bill Lacates, the
managing editor, as he came in. It did
not take them long to tell him what
they wanted. A story in The News that
Dale was back, and that he and the
reporter were going to give again some
of the stunts that had given Ashton
citizens such a thrill three years be-fore.
Bill listened, chewing the end of a
villainous black cigar.
"Sounds fine, Dale," he disregarded
Paul, "if you can get someone to go
up with you to cover the flights, as
Paul used to. Paul's not well, you
know. It would never do for him to at-tempt
it."
Dale's face fell, and Paul grew
pale, his eyes blazed. "Bill, you have
no right to say I'm not well enough
to get that story, any d—n story I
want to."
"Remember, Paul, you're a desk
man now, and I'm the only one who
can tell you to go outside, and I'm not
going to tell you."
With that Lacates walked into his
office, and Paul was left facing Dale,
white and shaken.
"I'm just a bird with a broken wing.
Dale. I can't even fly now by my doc-tor's
orders. For a minute I forgot.
Bill is right. That was his way of tell-ing
me, 'I'm no good'."
"Sorry, old boy," Dale rose and
shook Paul's hand. "I was looking for-ward
to some of our old stunts, but we
won't now."
Paul sat at the re-write desk,
smouldering resentment in his eyes
when Dale had gone. The managing
editor had really been kind not to let
him attempt the dangerous physical
strain the gathering of the material
for the air stories would entail, but
Paul did not want kindness, sympathy.
He wanted his old red-blooded strength
back. He didn't want to be a bird with
a broken wing.
It was the night of the afternoon
that Paul's managing editor had re-fused
to let him take the air assign-ments
that Paul learned that Jonquil
was crippled, and that her beautiful,
white-haired mother was blind.
He left the newspaper office, walk-ing
by the little flower shop with
dragging footsteps.
"Hello!" It was Jonquil, whose real
name was Marta Sennett, the flower
shop girl.
Since the day in early spring when
Paul had bought her total available
supply of jonquils all at one time,
the girl had not forgotten Paul, nor
had Paul forgotten her.
To speak to her every day, and to
stop in the shop a few moments to
talk to her was almost a ritual with
Paul—and with Jonquil, too, if he had
known.
Further than the greetings and
flower shop conversations the affair
had never progressed. Whenever Paul
thought of knowing her more inti-mately
he immediately became hot,
then cold.
A fellow with a broken wing had no
business being more than the most
casual of friends to a girl like Jon-quil.
But tonight things were different.
Jonquil had invited him around to her
home, because she told him her moth-er
was celebrating her fiftieth birth-day,
and she had been looking for him
all day to invite him to the party.
Mrs. Sennett was seated by a win-dow
that looked down on the street
when Paul let himself into the little
apartment in response to her invita-tion
to come in when he had knocked.
She called cheerily to him to come
across the room to her chair, telling
him that she knew who he was.
When Paul took the soft hand of
18 The Health Bulletin January, 1930
Jonquil's mother, and looked into the
eager face raised to meet his, he real-ized
with a start that she was blind.
Reverently Paul took the white
hand, and bending touched it with his
lips. He wondered why Jonquil had
not told him before that her mother
was blind.
Paul's surprises were not at an end.
As Jonquil came from the kitchen of
the little apartment, stripping off her
work apron as she walked, he saw
that she was crippled. Her left foot
and leg to the knee was horribly de-formed.
Looking at her Paul thought that
he had never before seen Jonquil out
from behind her flower counter. Crip-pled
herself, her mother blind, she
supported them both with the little
flower shop. Brave, gallant girl! No
wonder he had thought she was like a
flower when he had first seen her. A
wave of tenderness swept over him. He
wanted to go to her, to lift her in his
arms, and carry her so she would nev-er
have to use the hurt limb again.
TTien his high mood fell. Bird with
a broken wing, he was not even able
to lift her slender body once, much
the less care for her all of his life
as he wanted to.
Paul touched Jonquil's slim, little
hand softly. The blue eyes on his were
questioning.
"It has always been that way," she
said in simple explanation, looking
down at the deformed foot. "You do
not mind that I did not tell you." She
indicated her leg and foot, her moth-er's
sightless eyes. "Mother and I don't
like to talk about it. We play all of
the time that we are both well and
normal, and it makes everything much
happier for us."
Paul suddenly knew that her warm
little hand was still in his. He pressed
it quick and hard. "You wonderful
girl. Jonquil."
Paul was happy, happier than he
had been in a long time when he left
Jonquil and her mother that night.
Though happier he left railing mental-ly
against fate, life, whatever force it
is, that sends young men out to fight
life with broken wings, cripples beau-tiful
young girls, makes blind lovely
old women, and deaf good fellows like
Henry Clinard.
Passing by Dr. Herndon Benson's
home, Paul saw a light burning in the
doctor's office at the side of the
house. Doc had been a good friend to
him all along, even when he had in-sisted
on his going down to the san-atorium.
He would stop in and talk
to the doctor, see if the physician's
training, and the hard philosophy of a
medical man could help him to solve
some of his problems.
It was late, but Dr. Benson received
Paul with a smile.
"My, you're looking fine, young fel-low.
Weigh more than you did before
going to the San, don't you? Not so
bad this business of having one lung
after all, is it?"
Paul frowned. "Mighty tough, doc-tor,
when you want to do something
so bad you can taste it, and people
tell you that you can't because of your
lungs."
The doctor looked thoughtfully
down at a test tube in his hand. "Paul,
to some degree almost every man, wo-man
and child living is physically in-capacitated.
It may be only a very,
very slight trouble, but the physical-ly
perfect man or woman hardly ex-ists
at all, any doctor will tell you."
"Guess that's true, doctor, but they
don't have to go dragging around crip-pled
wings like my lung, have deaf
ears, sightless eyes and deformed
limbs," Paul spoke bitterly.
Dr. Benson carefully laid down the
test tube. "You are right at that, Paul,
but did you ever think of the large
number of people who fight organic
troubles? I myself have a bad heart. It
has been bad since my high school
days. My wife suffers from high blood
pressure, and has to stay away from
many social functions she would like
to attend. My oldest son can't play
high school football because of
January, 1930 The Health Bulletin 19
chronic bronchitis. Loretha, my daugh-er,
is underweight and everyday of
her life the food she has to eat is a
trial to her."
"I know, doctor, but those are all
disorders than can be cured."
The doctor shook his head. "Some-times
they can, sometimes not. We all
have our lives to live, Paul, making
them as worthwhile as possible, re-gardless
of whether all of our phy-sical
organs are in perfect order or
not. Perhaps some day we will breed
a perfect race, a race that will not
have to be bound down to earth by the
needs and the disabilities of our phy-sical
bodies today. That time has not
come yet, and those of us who are liv-ing
now have to give our bodies the
best care possible, paying particular
attention to the weakest members.
Then forget we have a body at all,
and live our lives in spite of physical
disabilities."
Paul got slowly to his feet. "There's
a lot in what you say, doctor. I haven't
seen daylight yet, but I'm going to
think things through. I hope 111 be
able to see as clearly as you do, when
I have thought them through."
"You will, Paul," the doctor laid
his hand fondly on the erect shoulders
of the tall young man. "Best of luck!"
As Paul walked homeward through
the night the physician thought what
a lucky chap Paul Dunbar was. Twen-ty-
five years ago his disease rapidly
advancing he would have probably
died. Now, modern medical science had
saved him, as firte a looking specimen
of young manhood as could be seen on
the streets.
The broken wing, Paul so bitterly
complained of, the doctor felt sure
Paul would find less of a disability as
time went on. He would learn to live
his life despite the broken wing.
In the gray dawn of the morning
after Paul had been to Jonquil's moth-er's
birthday party, and talked to Dr.
Benson, he wrote the editorial "Brok-en
Wings" that won for him that
This distinguished Jackson county couple are 82 and 85 [icars <>/ |