Health bulletin

              THE LIBRARY OF THE
UNIVERSITY OF
NORTH CAROLINA
AT CHAPEL HILL
THE COLLECTION OF
NORTH CAROLINIANA
C61U
N86
V.C31-32:
1916/18
FOR USE ONLY IN
THE NORTH CAROLINA COLLECTION
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Published b4 TfiL^m CAROLINA 5WE.B?ARDs>7\mLTA
? This Bulletin, will "be ser\t free to arxq citizen of the 5tateupor\ request !
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. G.
Vol. XXXII JUNE, 1917 No. 3
GOVERNOR BICKETT AND PUBLIC HEALTH
(EXTRACT FROM HIS INAUGURAL ADDRESS. JANUARY II, 1917)
The State Board of Health shall he given ample funds to continue and
enlarge its work. The law should require a careful examination of every
child who enters a puhlic school, at least twice a year. This can he done
by whole-time county health officers or by representatives of the State
Board, as the conditions may warrant; but the law should compel it to
be done. „m, . , .. _ ...
"The riches of a Commonwealth
Are free, strong minds, and hearts of health."
To insure such riches, intelligent examination of the children at stated
intervals is absolutely necessary.
The State Board deserves the unqualified support of the General As-sembly
in its campaign against quacks and quackery. The law requires
a man to have a diploma from a first-class medical college and to stand
a rigid examination before the North Carolina Board of Medical Exam-iners
before he is allowed to write a single prescription for a patient in
North Carolina. And yet we permit the sale of nostrums to our people
without any adequate knowledge of whether or not they are injurious to
health, or have any medicinal value whatever.
I am in favor of a law making it a felony for any man to sell, offer for
sale, or advertise for sale in North Carolina any proprietary or patent
medicine purporting to cure cancer, consumption, diabetes, paralysis,
epilepsy, Bright's disease, or any other disease for which the North Caro-lina
Medical Association and the American Medical Association declare
that no cure has been discovered.
I am earnestly in favor of a law requiring all vendors of proprietary
medicines to file with the State Board of Health a statement showing the
exact composition of such medicines, and that the State Board be empow-ered
to forbid the sale of such proprietary medicines in the State of North
Carolina if, in its opinion, it is without curative value in the treatment of
the disease it purports to cure.
TABLE OF CONTENTS
Editorial Brevities 75
New Health Laws 75
Medical Inspection of School
Children 77
The Bacxwaed Ch h.tj 78
Make a Date fob Free Examina-tion
79
The Common House 1'i.v 80
How Disease Germs Live anq Grow. 82
On Early Detection of Tuber-culosis
84
For Hoarding House* and Sana-toria
86
Dental Hygiene 87
Teach Our Children How Best to
Live 8!)
Weigh the Baby Once a Week. ... 90
The Prevention of Pellagra 91
Typhoid an Accident 93
Li\ ing Love and Well 15
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
J. Howell Wat, M.D., Pres., Waynesville
Richard H. Lewis, M.D., LL.D., Raleigh
J. L. Ludlow, C.E., . . Winston-Salem
Thomas E A vdkpshv. M.D.. . p*ito«-»-',ip
E C. Register, M.D., . . . Charlotte
Chas. O'H. Laughinghouse,
Edward J. Wood. M.D., . .
Cyrus Thompson, M.D., .
P. R. Harris, M.D., . .
M.D.,
Greenville
Wilmington
Jacksonville
Henderson
official Staff
W. S. Rankin, M.D., Secretary of the State Board of Health and State Health Officer.
C. A. Shore, M.D., Director of the State Laboratory of Hygiene.
Warren H. Booker, C.E., Chief of the Bureau of Engineering and Education.
L. B. McBrayer. M.D., Superintendent of the State Sanatorium.
J. R. Gordon, M.D., Deputy State Registrar.
G. M. Cooper, M.D.. Chief of the Bureau of Rural Sanitation.
A. M. Crouch, M.D., Epidemologist.
FREE PUBLIC HEALTH LITERATURE
The State Board of Health has a limited quantity of health literature on the subjects
listed below, which will be sent out, free of charge, to any citizen of the State as long as
the supply lasts. If you care for any of this literature, or want some sent to a friend, just
write to the State Board of Health, at Raleigh. A postcard will bring it by return mail.
No. 12.
No. 31.
No. 32.
No. 39.
No. 50.
No. 52.
No. 53.
No. 54.
No. 60.
No. 67.
No. 70.
No. 72.
No. 73.
No. 74.
No. 75.
No. 76.
No. 77.
No. 78.
No. 79.
No. 80.
No. 81.
No. 82.
No. 83.
Residential Sewage Disposal Plants.
Whooping Cough.
Diphtheria.
Tuberculosis Leaflet.
Baby Leaflet.
Malaria and What Everybody
Should Know About It.
Disinfection After Diphtheria,
Measles, or Whooping Cough.
Disinfection After Scarlet Fever.
Sanitary and Hygienic Care of
Prisoners.
Cancer Leaflet.
Adenoids.
Tuberculosis.
Smallpox.
Measles.
Scarlet Fevrr.
Baby Welfarp.
Rave the Rnbv.
Free medical examination, etc.
Care of the Mouth and Teeth.
Hygiene at Middle Life.
Prevention of Degenerative Dis-eases.
The Prevention of Colds.
Underweight.
( >\ (:••« eight.
No. 84. Indigestion.
No. 85. Constipation.
No. 86. Venereal Diseases.
No. 87. Sanitary Privies.
No. 88. Public Health Laws.
No. 89. The Common House Fly.
No. 90. Typhoid Fever.
No. 91. Tuberculosis Laws.
Teeth. Tou&ns. and Adenoids.*
How to Live Long.*
Hookworm Disease.*
A War on Consumption.*
Milk.* Periodic Medical Examina-tion.
Typhoid Fever and How to Prevent
It.*
Concrete Septic Tanks}.
Anti-Spitting Placards (5 inches by
7 inches).
Anti-Fly Placards (14 inches by 22
inches).
Anti-Typhoid Placards (14 inches
by 22 inches).
Anti - Tuberculosis Placards (14
inchpc hv °? irises'*
Clean Up Placards ('14 in. by
23 in )
Furnished by courtesy of the Metropolitan Life Insurance Company.
t Furnished by courtesy of Portland Cement Association.
COWARDS a BROU
jBI | PU5LI5ALD 5Y TAL HORXA CAROLINA 5TATL BQMgD s^MEALTM ||[gj.
Vol. XXXII JUNE, 1917 No. 3
EDITORIAL BREVITIES
To heal the sick was once the only
aim of the physician. Now his great-est
ambition is to prevent sickness.
Why not apply the same sane com-mon
sense to your health that you ap-ply
to your business? As far as you
yourself are concerned, and as far as
your family and business are con-cerned,
it is the most important thing
in the world.
Have you ever asked your doctor
what causes and what prevents
Bright's disease, heart failure, harden-ing
of the arteries, and apoplexy? And
have you ever asked him to look you
over to see if any of these diseases are
undermining your health, so that if
such were the case you could ward
them off?
The average person can eat good,
plain, wholesome food in moderation
all his life without ever being aware
that he has a digestive apparatus. It
is only when he overeats or is other-wise
indiscreet as to his meals that he
knows he has a stomach and one that
affects his whole being.
As important to the soldier as are
good feet, good eyesight, and good
brains, neither of these is considered
quite as important as good teeth. A
soldier may have good feet, good eyes
and brains, but if he hasn't good teeth
so that he may properly chew his
food and keep well and strong, of
what service will good feet, good eyes,
and good brains be to him? For the
reason that the soldier's health de-pends
so largely on the condition of
his teeth, good teeth are said to be a
soldier's first and most necessary
equipment.
NEW HEALTH LAWS
What the Legislature Did in the Inter-est
of Better Health in North
Carolina
v^jIHE last General Assembly, backed
!^L by Governor T. W. Bickett, en-a
™° acted probably more modern and
progressive health legislation than any
other General Assembly North Caro-lina
has ever seen. While there were
several pieees of valuable legislation
which failed of passage, there was
enough other good legislation enacted
to amply justify calling this a truly
public health Legislature.
Chief among the new health laws
enacted were a State-wide Quarantine
Law. a Medical Inspection of Schools
Law, a Rural Sanitation Law, a Law for
the Prevention of Blindness, a Hotel In-spection
Law, and a Law Requiring
the Inspection and Hygienic Care of
Prisons and Prisoners.
The Quarantine Law
Heretofore the individual towns, cit-ies,
and counties were left to their
own devices for dealing with or not
76 THE HEALTH BULLETIN
dealing with contagious and infectious
diseases. It is unnecessary to describe
the chaotic, inefficient methods that
obtained. The results are reflected in
our excessive death rates from con-tagious
and infectious diseases.
After July 1, 1917, all cases or sus-pected
cases of contagious or infec-tious
diseases will be reported by the
physicians in attendance or household-ers
to a county quarantine officer with-in
twenty-four hours, and each county
quarantine officer will report daily to
the State Board of Health. Rules and
regulations governing quarantine of
all cases of contagious diseases will
be promulgated. By the time this Bul-letin
reaches its readers copies of these
rules and regulations will probably be
ready for distribution.
Medical Inspection of Schools Law
Elsewhere in this issue of the Bulle-tin
will be found a complete resume
of this important law. Briefly, it pro-vides
for the physical examination of
every school child in the State every
third year, and it even goes so far as
to make a nominal appropriation as
the State's part to assist in defraying
the expenses of treating physical de-fects.
By virtue of this law every
school child may receive two physical
examinations during his school life,
and as a result thousands upon thou-sands
of school children will be re-lieved
of unnecessary physical handi-caps
of bad teeth, defective sight and
hearing, enlarged tonsils, adenoids,
hookworm disease, and other defects
which greatly reduce their physical
and mental growth and the efficiency
of our rising generations.
The Rural Sanitation Law
The cooperative rural sanitation law
makes an appropriation of $15,000 an-nually
to be expended in the ratio of
$1 for every $3 from other agencies.
As a result of this law, effective co-operative
health departments will be
established in a number of counties
and maintained in part from this fund,
in part from funds from the Interna-tional
Health Board, and in part from
the respective counties in which these
health departments are established. As
the work becomes more thoroughly
established, the support of the State
will be gradually withdrawn in order
to establish it in other counties. In
this way well organized county health
departments will ultimately be estab-lished
in every county in the State.
Prevention of Blindness
The Legislature also enacted a law
which provides for the proper treat-ment
of the eyes of all new-born
babies with a solution which effectu-ally
prevents infant blindness. To
make this law effective and to place
the proper solution in the hands of
every physician and midwife in the
State requires an appropriation of
$3,000. The net result will be the sav-ing
of the sight of from 25 to 35
babies every year. The wisdom of
this law is more apparent when it is
considered that by this means the State
converts a person, needlessly blind for
life and who is always more or less
of a charge upon the State and society
generally, into an active productive
person for life at an initial cost of only
about $100.
Hotel Inspection Law
Through the efforts of the traveling
men of the State a law was enacted
requiring the State Board of Health to
inspect and grade the sanitary condi-tions
of all the hotels and restaurants.
This is a very complete law, and it
deals with practically every phase of
the hotel question. It will do much
toward improving the safety and com-fort
of traveling, as well as to im-prove
the general sanitary tone of the
State.
THE HEALTH BULLETIN 77
Prison Reform Law
The new prison reform law is a
landmark in human progress in North
Carolina. It represents some of the
most important advances in the hu-mane
treatment of prisoners North
Carolina or any other State has ever
seen. It provides ample opportunity
for those in charge of prisoners, pris-ons,
jails, convict camps, and other
places of confinement to reform and
return true, valuable men and women
to take responsible places in society,
instead of grinding down the unfortu-nates
with endless hard work under
conditions anything but favorable to-ward
their reformation, uplift, and
proper training. While the State
Board of Health had nothing to do
with the promotion of this law, this
board is made responsible for the san-itary
and hygienic care of prisons and
prisoners, be they city, county, or
State institutions.
MEDICAL INSPECTION
OF SCHOOL CHILDREN
Law of State-wide Application Passed
by the Recent Legislature
ly^jjHANKS to the untiring efforts of
l ^^J Governor Thomas W. Bickett, the
GMM iast General Assembly enacted a
law providing for the medical inspec-tion
of all school children in North
Carolina every three years.
The State Board of Health and the
State Superintendent of Public In-struction
are charged with the respon-sibility
of executing this law. One-third
of the State's counties accord-ing
to population will be chosen this
summer for beginning this work. The
commissioners of each county will be
required to pay a physician for the
work. The physician must be selected
by the Board of Education of each
county. The State Board of Health
2
must be notified at once of the selec-tion
of such physician. The teachers
will be supplied with blanks by the
State Board of Health and a compe-tent
physician will instruct them how
to fill out these blanks, one for each
child in school. This work must be
done at the time specified by the State
Board of Health and the State Super-intendent
of Schools.
When the teacher completes his or
her part of the work, the information
contained in this record must be
placed in the hands of the official in-specting
physician. He in turn must
have brought to a central point, not
more than ten miles from each child's
home, on Saturdays, as many children
as he can carefully examine. The
physician will require something like
ten or twelve per cent of the total
enrollment, including the children most
in need of treatment, to be brought for
examination. At the time of such ex-amination
the physician must make
a record of his findings and send a
copy to the State Board of Health,
and also give the parent or guardian
specific advice as to the necessity for
correcting any physical defect within
the scope of this examination.
After all the children have been ex-amined
(one-third of the State each
year), the State Board of Health may
divide the sum of ten thousand dol-lars
pro rata, according to school en-rollment,
among the counties covered
in the work each year, provided the
county commissioners will provide an
equal amount and the total sum does
not exceed 40 per cent of the amount
needed for treating the defective chil-dren.
The balance of money neces-sary
for paying physicians, dentists,
specialists, etc., for this work at re-duced
rates must, of course, be fur-nished
by parents or from other pri-vate
sources.
This law provides for the careful
examination, by a good physician, of at
78 THE HEALTH BULLETIN
least twenty-five thousand defective
children each year, and enables the
State to put up one-fifth of the cash
in providing a fund of fifty thousand
dollars per year for getting these chil-dren
treated. Not much, it is true, but
just that much more than has ever
been done before; and with the cordial
and sympathetic cooperation of the
authorities and people of each county
it means the difference between misery
and suffering, and health and happi-ness
to twenty-five thousand children
each year.
The law makes no discrimination
between the poor and the well-to-do;
nor between the white and colored
races. All are treated alike.
THE BACKWARD CHILD
Medical School Inspection a Friend to
Backward Children
ijTl HAT is really meant by the back-
J^ ward child? It means a child
™™ who has begun to attend school,
who fails to learn as other children
do, and who, at the end of the term, is
turned back to repeat the course.
Backward children are usually regard-ed
as mentally deficient, but the fact
is they are usually either diseased or
physically deficient.
In this country there are said to be
20,000.000 children of school age, about
3,000,000 of whom are called "repeat-ers"
because they remain in one grade
at school more than one term.
These children, however, are not
"repeaters" by the will oc an inscruta-ble
Providence, but rather by the law
of cause and effect. Their physical
condition is at fault. It may be that
they have bad teeth and pus forming
gums that are filling their systems
with poisons that are diseasing, their
eyesight is at fault, or that their hear-ing
is bad, or perhaps they have dis-eased
tonsils, or adenoids. Dr. A. C.
Bulla, medical school inspector for the
State Board of Health of this State,
says that he finds at least 18 per cent
of all school children suffering from
defects of the eyes, ears, nose, and
throat.
Doctor Bulla believes that such de-fects
as any one of these not only hin-ders
a child in school, retarding his
education and causing him to be called
backward or a repeater, but that it
goes with him through life, severely
handicapping his efforts and crippling
his efficiency. Furthermore, Doctor
Bulla believes that the best time to
remedy such defects and diseases is
when the child is in the first, second,
or third grade at school, before these
defacing defects such as adenoids, bad
teeth, or defective eyes, have gotten in
their ugly work, and while they are
yet in the stage when removal or cor-rection
will be the most easy and ef-fective.
Medical school inspection work is a
feature of public health work done by
the State Board of Health just to this
end: to discover and remove these
handicaps to health and education at a
time when the results will be most
valuable and easily accomplished. Last
year three counties made provision for
this educational health work, with the
result that 10,000 children were ex-amined
for defects of the eyes, ears,
nose, throat, teeth, and for communi-cable
diseases. This year six more
counties, including a number of indi-vidual
schools and communities, have
made arrangements for this work, and
thousands of school children are being
benefited. Next year approximately
one-third of the State will have medi-cal
inspection of school children ac-cording
to the new law proposed by
Governor Bickett. Parents are coming
to know what health means to the
proper development of their children,
and how to proceed that their children
may have it.
THE HEALTH BULLETIN 79
MAKE A DATE FOR
FREE EXAMINATION
Sanatorium Will Charge Fee of $5 for
Tuberculosis Examination Unless
Patient Makes a Date
O HE State Sanatorium for the
Treatment of Tuberculosis will
continue to give examinations
tuberculosis free to the people,
ME
for
provided that physicians sending pa-tients
there or the patients themselves
write beforehand and make an en-gagement;
otherwise a fee of $5 will
be charged for such an examination.
Another requirement connected with
this free service is that patients pre-sent
themselves between the hours of
8 and 11 a. m. on the date set for them;
otherwise, they will not only have to
wait till the next day for an examina-tion,
but will also be charged the fee
of $5.
This ruling has been made necessary
for the reason that so many people
now demand this service, and at times
such large numbers present them-selves
for examination as to greatly
interfere with the regular medical
work of the institution. Besides, when
the examinations are made out of regu-lar
office hours or at any time the pa-tient
happens to arrive, it works ex-cessive
hardship on the medical staff
and demands a service which the in-stitution
is not able to meet. Last
year 411 such examinations were made,
and the indications are that a far
greater number will ask for the serv-ice
this year.
ONE FOR PREVENTION; ELEVEN
FOR CURE
The United States is at the present
time spending more than thirty-three
million dollars yearly for the cure and
care of patients afflicted with mental
disease, and comparatively nothing for
prevention. And yet the perusal of
the report of almost any State hospital
will show that in about 50 per cent of
the cases admitted the mental disorder
is due directly to definite causes which
are clearly preventable.
For instance, North Carolina expends
$650,000 annually for the care of her
insane and delinquents, and $55,500
annually for prevention. Where the
State spends $1 for the prevention of
disease it spends $11.60 for the care
of the insane and delinquent. Much
of insanity and delinquency has a
preventable basis. Sixteen per cent
of the insanity is due to syphilis.
This means that there are 500 in-sane
people in our asylums as the
result of syphilis alone. The annual
per capita cost of these 500 people is
$170. Therefore, for the care of the
syphilitic insane alone the State is
spending 500 x $170, a total of $85,000
a year. Twenty per cent of insanity
is traceable to alcohol. If this per-centage
holds good for North Carolina,
we have 600 insane in our asylums as
the result of alcohol, the annual per
capita cost being $170, making our bill
for taking care of our alcoholic insane
600 x $170, a total of $102,000 a year.
From 5 to 10 per cent more are func-tional
disorders which probably could
have been prevented by early treat-ment.
Proper posture and carriage, with
shoulders square, chest arched, head
erect, and body well stretched from
the waist up, will of its own account
contribute much toward relieving our
people of the many petty and not a
few of the serious ills from which they
are now suffering. It is the founda-tion
of robust health, and should be
insisted upon in children from the
very beginning until it becomes a habit,
and as such will displace the disease-breeding
"slouchy" habit now so prev-alent
among people of all ages and
stations.
i,.',i, i^r
PUBLIC HEALTH
and SANITATION
THE COMMON HOUSE FLY
The Best Way to Have a Flyless Home
j^lOUSE FLIES used to be one of
£~± the commonest things to be found
^™ in our kitchens and dining-rooms
in the summer time. While they are
not even now getting to be rare, they
are not quite so common as to quan-tity
or number but "exceedingly com-mon"
as to quality. Chief among the
reasons why the house fly is getting
into such bad repute is because we
are beginning to know him better. We
are learning about his nativity—his
ancestry and place of birth—the man-ner
and method of his bringing-up,
and, finally, about his every-day habits
and mode of life.
The Story of the Fly
Instead of considering him a nice,
clean, respectable little pet, as we
once did, we know that his mother laid
the eggs from which he and perhaps a
hundred or more of his companions
were hatched in some accumulation
of warm, moist manure, waste, or de-caying
filth. For fly eggs to hatch
they must be laid in some kind of de-caying
organic matter and supplied
with a certain amount of heat and
moisture. In from eight to ten hours
they hatch into tiny white, squirming,
wiggling maggots which burrow down
into the manure or filth in which the
eggs were laid. After from six to
eight days, these maggots grow a shell
or coating somewhat like a very small
wheat grain in appearance. In two or
three days more this shell opens and
a full-grown fly emerges. While the
fly is still wet and slippery, he bur-rows
and works his way up through
the manure to the open air.
The Danger of the Fly
The fly is no longer considered
harmless. Instead of thinking of him
as merely a tickling, crawling, both-ersome
pest, we know him to be a car-rier
of filth, a spewer and spreader of
the vilest and deadliest poisons and
disease germs. His daily habits of
life lead him to feast on almost any-thing
from manure, tuberculosis spu-tum,
pus, or typhoid dejecta to cake,
candy, pie, milk, sugar, or butter. The
cost of his maintenance for food, how-ever,
is trifling. We base one of our
main objections to him upon the fact
that his digestive tract is so simple
and his digestive liquids so weak that
typhoid, tuberculosis, or other germs
eaten by him pass out an hour or two
later unchanged and are deposited,
frequently in a liquid and invisible
form, on baby's face, lips, and hands,
or on our food, dishes, and furniture.
The common house fly, or typhoid
fly, has lost caste not only because we
know that over ninety per cent of his
kind were bred in manure piles and
open privies, or because he feasts on
the vilest filth and later deposits it on
our food, or because we know that he
vomits up such material to dissolve
such solids as sugar, and later eats
the entire mixture, but also because
we have found that the very hairy
nature of his body and legs enables
him to carry tiny quantities of nasty,
nauseating, and disease-laden material
to our food and drink.
THE HEALTH BULLETIN 81
Remedies
The question of prime importance is,
What are we going to do about it?
Theoretically, it is possible to clean
up and keep so clean that flies cannot
find sufficient decaying organic mat-ter
in which to breed. To a large meas-ure
this is practical in certain cities.
Unfortunately, it is not practical in
the country or in most of our villages
and small towns, though undoubtedly a
great deal can be done by proper
means of cleanliness around stables,
privies, hog pens, and other places
toward controlling and reducing the
number of flies. Ordinarily, it matters
little how clean certain farms, homes,
or premises are kept. Almost always
there will be some near-by slothful,
filthy neighbors who will breed enough
flies for an entire county. For these
reasons our present methods of ordi-nary
cleanliness are far from being
entirely successful in the fight against
flies.
Fly traps, particularly large fly
traps, around barns, stables, grocer-ies,
or placed on garbage cans, or
other places where flies breed or fre-quent
in large numbers, have been
found to greatly reduce the fly popu-lation.
Fly poisons, such as formaldehyde
in the proportion of two tablespoon-fuls
of formaldehyde to a mixture of
a half pint of water and a half pint of
milk, have been found to kill large
numbers of flies, but flies will not
drink such poison if other water or
drink is available. Furtherfore, there
is usually a certain element of danger
in having fly poisons around the home.
The Best Remedy
By all odds the cheapest and the
most effective means yet found for
successfully combating the fly evil is
THOROUGH SCREENING OF THE
HOME AND PLACES WHERE FOOD
IS HANDLED from April 1st to De-cember
1st, and swatting at least once
a day the few stray flies that dodge in
as the doors are opened. It is not
sufficient to screen the doors and win-dows
of the kitchen and dining room,
or of the downstairs only. The back
porch, where much of the food is pre-pared,
should by all means be screened.
Again, it is quite important that the
upstairs windows be screened, as in-coming
flies will follow the scent of
savory or cooking foods and come
down the stairway in discouraging
numbers.
Do not use cheap, ineffective exten-sion
screens. They rarely fit the win-
A Bad Type of Screen
Extension screens rarely fit fly-tight. Flies
get in between the screen and the lower sash,
as shown by the lower set of arrows. They
also work their way up between the upper
and lower sashes and enter, as shown by the
upper arrows.
dow and make it fly-tight, and they al-low
flies to come in between sashes.
Wire screens, particularly those pro-tecting
the entire window, are best. The
present retail market price (March,
1917) of black is about two cents per
square foot, and three cents per square
82 THE HEALTH BULLETIN
foot for galvanized wire. Such screens
will usually last from five to ten years,
or longer. Where the cost of good
wire screens seems prohibitive, excel-lent
results may be obtained by the
use of ordinary mosquito netting. Such
Window Effectively Scr;ened "With
Mosquito Netting
The mosquito netting is secured at the top
and sides by means of small three-quarter
round mouldings or by tacks. It is unfastened
at the bottom and left about eight inches too
long. This permits closing the shutters from
the inside. Such a screen costs about twenty
cents.
netting costs about 75 cents per bolt of
eight yards in length by fifty-eight
inches wide. A very effective and in-expensive
method of screening with
mosquito netting is to tack it on to
the outside of the window frame or by
tacking or fastening it with cleats or
what is called three-quarter round
moulding, to the outside window stop.
Such moulding costs about a quarter
of a cent a foot. Wherever it is de-sired
to open and close shutters from
the inside, cut the piece of mosquito
netting six or eight inches longer than
the window is high and leave it a bit
"full" or loose at the bottom, so that'
the shutter may be operated from the
inside at will, as is shown in the ac-companying
cut. Such mosquito net-ting
screens will last from one to
three years.
For the doors there is nothing bet-ter
than well fitting made-to-measure
or machine-made screen doors well
braced, carefully hung, and provided
with spring hinges. Very satisfactory
wire screen doors can be obtained for
as little as $1.25, while the spring
hinges and fasteners cost 25 cents
more.
The Finishing Touch—Swatting
With the back porch and every door
and window screened, the household
will be practically free from the dan-gers
and inconveniences of flies. What
few flies find their way in as the doors
are opened may be killed off once or
twice a day by swatting.
Thorough screening not only ex-cludes
flies, but it also excludes mos-quitoes
and prevents the danger of
malaria. Once a decent, self-respect-ing
North Carolina family enjoys the
benefits of screens in the home, there
will be no return to the dangerous,
disgusting condition of common house
flies.
HOW' DISEASE GERMS
LIVE AND GROW
Dr. Be.vj. K. Hays, Health Officer of Granville
County.
It was formerly believed that the
poison germs or virus which produce
disease would live for long periods of
time outside the body. It was believed
that this poison would attach itself to
furniture, books, and clothing, and
THE HEALTH BULLETIN 83
that it was possible to contract a dis-ease
by handling one of these articles
years afterward. We used to hear of
how people contracted yellow fever
by handling a lock of hair from a per-son
dead with the disease, and of how
children contracted diphtheria from
the toys of other children long since
dead of diphtheria. We heard of how
people contracted consumption from
books that a consumptive had handled
years before.
A more accurate knowledge of the
life history of disease-producing
germs has changed our ideas of such
things. So long as the old ideas con-tinue
to prevail the contagious dis-eases
will continue to claim our loved
ones. Just as soon as we learn the
truth about contagious diseases (pro-vided
we live up to our knowledge)
they will cease to appear in our midst.
When germs leave the human body
they tend to die. The life outside the
body depends upon three things, viz.,
light, air, and moisture. Light and
air tend to kill the germs. Moisture
helps to keep them alive. Germs with-out
moisture exposed to the direct
rays of the sun live only a few hours.
Germs without moisture in a well
lighted and ventilated room, but not
exposed to the direct rays of the sun,
live only a few days. Germs embed-ded
in sputum and deposited in the
direct rays of the sun may live for two
or three days. Germs imbedded in
sputum and deposited on the floor of a
well lighted and ventilated room, but
not exposed to the direct rays of the
sun, will live for two or three weeks.
Germs imbedded in sputum and de-posited
in a dark room, especially in
the cracks of a floor that holds the
moisture, may live for six months or
longer.
The poison (or germs) of diphtheria,"
measles, scarlet fever, whooping
cough, tuberculosis, and typhoid fever
do not grow outside the body except
in one place, and that is in milk. It
is well to remember that when disease-producing
germs find their way into
milk they will grow and reproduce
there. It is also well to remember
that horses and cats are sometimes
subject to diphtheria, while almost all
of the lower animals are subject to
tuberculosis.
From what has been said, it is clear
that the sick room is not a common
means of spreading disease. Let us
suppose that one of the above named
diseases has been present in a room.
The patient is now up and out. All
bedding, carpets, rugs, curtains, and
other articles which hold dust have
been taken out and boiled or sunned.
The furniture, floors, and walls have
been scoured with soap and water.
The room is then thrown open to air
and dry. Such a room may be con-sidered
perfectly safe after two days.
A moderately well cleaned room is
safe after two weeks, while a room
that is dark and without ventilation
is never safe.
How are contagious diseases spread?
In nine cases out of ten it is by the
passing of moisture directly from the
mouth of one individual to that of an-other.
This is done by coughing or
sneezing into the faces of others; by
the use of the common drinking cup
or dipper; by the damnable habit of
promiscuous spitting; by kissing upon
the lips; by the use of towels, hand-kerchiefs,
and napkins that have been
used by others; by flies; by saliva
upon the dirty hands of persons hand-ling
food; by children carrying mar-bles
and coins in their mouths, and
by the passing of any substance from
mouth to mouth.
It may seem a simple thing to stop
all of these things. When they are
stopped it will save more than five
thousand human lives in North Caro-lina
every year.
ffOBERCULOSlS
ON EARLY DETECTION
OF TUBERCULOSIS
Case History, Temperature Record,
Sputum Analysis, and Exami-nation
Necessary
<p\| OTHING aside from prevention
*j^l is so important in the fight ™" against tuberculosis as an early
diagnosis. But in spite of its impor-tance
only about fifteen or twenty per
cent of the one and a quarter million
cases in the United States are diag-nosed
in the incipient stage. This is
due not so much to the fact that pa-tients
don't apply for diagnosis and
treatment until the disease is past its
incipiency, as to the failure of the pro-fession
to make the diagnosis until
the patient is beyond the curable stage.
This statement is corroborated by the
experience of other sanatorium work-ers,
and it is all the more serious
when a close study of the situation
reveals the fact that this failure to
make an early diagnosis is due very
largely to carelessness, to a failure to
employ all the ordinary methods which
are within the reach of every physi-cian.
The four essentials in diagnos-ing
tuberculosis are a careful history
of the case, a proper temperature rec-ord,
a sputum analysis, and a physical
examination.
An accurate history is very impor-tant,
and a synopsis of the most prom-inent
symptoms and of the course of
the disease should always be recorded.
Some authorities claim that a good
history is of as much value as the
physical examination.
In early tuberculosis the sputum ex-amination
rarely reveals the tubercle
bacillus. Sanatorium records show
that from 70 to 80 per cent of incipi-ent
cases show negative finding. So
that unless it is positive, a single
sputum analysis is of little diagnostic
value. The physician who will rule
out tuberculosis because of one nega-tive
sputum examination is criminally
negligent of his patient's life. But it
is of extreme importance that when-ever
any expectoration is present that
it be examined, because a positive find-ing
will confirm the diagnosis. And
in case of a negative report, it cannot
be emphasized too strongly that at
least five or six examinations should
be made on successive days and the
procedure repeated every month as
long as the expectoration continues or
until the bacilli are found.
There is nothing in all the realm of
medicine more characteristic than the
subnormal or normal morning tem-perature
with the afternoon or eve-ning
rise in active tuberculosis. To
such an extent is this true that the
thermometer, properly used, is all that
is needed in the large majority of
cases to make a diagnosis. It is only
natural that tuberculosis should often
be confused with malaria and typhoid
fever when the physician has no rec-ord
of the temperature save at the
time of his daily afternoon visit. If he
would spend only a few minutes in
teaching some one in the home how to
take the temperature, and have it re-corded
every two hours, the character-istic
curve in tuberculosis would make
clear the true nature of the disease.
THE HEALTH BULLETIN 85
No chest examination is worthy of
the name unless the patient is stripped
to the skin above the waist line. The
examination should be systematic, and
the various methods of inspection,
palpation, percussion, and ausculta-tion
should be applied each in its turn
to the whole of the chest. One frequent
source of error consists in having the
patient only open his shirt instead of
removing it, and in limiting the exami-nation
to the front of the chest. If
there were a likelihood of one's house
being on fire, who would be satisfied
with anything short of a thorough
search of the whole house, that the
fire might be located and extinguished
before the flames should become un-controllable?
The victim of tubercu-losis
has not simply his property, but
his life at stake, and can we as guard-ians
of his health and of his life put
our consciences at rest until we have
made a careful search over the whole
of his chest, both front and back for
every possible focus of infection?
The most important feature of the
chest examination and the one most
frequently neglected is to have the
patient cough. It is during the deep
inspiration following the cough given
at the end of expiration that adventi-tious
sounds in tuberculosis are most
frequently elicited. Oftentimes this
cough will reveal rales in early tuber-culosis
when all the other findings
are normal.
Since tuberculosis is many times the
most common of all diseases, and since
it is responsible for one-tenth of all
the deaths and about one-third of all
the sickness in the human race, let me
urge, in conclusion, that the profes-sion
adopt an attitude toward the great
white plague of eternal vigilance and
suspicion, and always eliminate tuber-culosis
before making any other diag-nosis.—
Dr. P. P. McCain, Sanatorium,
N. C.
3%
8%
24%
34%
27%
17%
10%
5%
2y2%
%o%
TUBERCULOSIS CAUSES
of all deaths below the age of 5.
of all deaths ages 5 to 9.
of all deaths ages 10 to 19.
of all deaths ages 20 to 29.
of all deaths ages 30 to 39.
of all deaths ages 40 to 49.
of all deaths ages 50 to 59.
of all deaths ages 60 to 69.
of all deaths ages 70 to 79.
of all deaths ages 80 and over.
86 THE HEALTH BULLETIN
FOR BOARDING HOUSES
AND SANATORIA
Rules Governing' Boarding Houses and
Sanatoria for Tuberculous people.
As to the rules and regulations gov-erning
boarding houses and sanatoria
for tuberculous people, the following
requirements constitute the minimum
standards as prescribed by the Tuber-culosis
Directory, recently issued by the
National Association for the Study and
Prevention of Tuberculosis:
1. Provision for outdoor sleeping,
either on sleeping porches or other-wise.
2. Sputum cups or similar devices
must be used by patients and proper
disposal of such sputum containers
and sputum made.
3. The building or buildings must be
clean, sanitary and in good repair;
they must also have running water and
suitable means of sewage disposal
;
they must be adequately protected
against fire.
4. Each room must be thoroughly
cleaned and disinfected at regular in-tervals
and before being used by an-other
patient. The bedding must also
be disinfected and aired before being
used by a new patient.
5. Food must be of good quality, and
the diet must include fresh milk and
eggs.
6. Provision must be made for regu-lar
monthly visits of inspection by a
physician. All patients must be under
the care of a physician.
7. Provision must be made for nurs-ing
supervision of all patients, and for
nursing care of patients who are bed-fast.
Beware of pills and purgatives. They
are habit-forming drugs. They should
only be used like opium, or other habit-forming
drugs, under the direct guid-ance
and control of an intelligent and
conscientious physician.
FRESH AIR FOR SICK AND WELL
The open-air treatment has been 100
much confined to the sick. Why
should we force healthy, normal chil-dren,
by compulsory education laws,
into closed rooms, to breathe exhaled
air from the lungs of forty or fifty of
their fellows, and wait until the gen-eral
health is undermined before con-structing
open-air schools in which to
restore them to vigorous health? Na-ture
intends that children shall
breathe fresh air, with its natural
moisture content, not baked and pol-luted
air. A most ridiculous propo-sition
is the present-day method (in
vogue in many city school systems) of
pumping outside air over superheated
steam coils and forcing it, dried of all
natural, life-giving qualities, into the
classrooms of modern school build-ings.
And with what result? That
your child and your neighbor's child
sit for five hours a day in human dry-ing-
kilns, with the warm, dry, thirsty
air sapping most of the moisture from
their little bodies.
NECESSARIES FOR EFFICIENCY
AND HEALTH
The necessaries for the efficiency
and health of an ordinary agricultural
or of an unskilled town laborer and
his family in this generation may be
said to consist of a well-drained dwell-ing
with several rooms, warm cloth-ing,
with some changes of undercloth-ing,
pure water, a plentiful supply of
cereal food, with a moderate allow-ance
of meat and milk, and a little
tea, etc.; some education and some
recreation; and, lastly, sufficient free-dom
for his wife from other work to
perform properly her maternal and
her household duties. If in any dis-trict
unskilled labor is deprived of
any of these things, its efficiency will
suffer in the same way as that of a
horse that is not properly tended or a
steam engine that has an inadequate
supply of coal.
—
Alfred Marshall.
HILDJIYGIME
DENTAL HYGIENE
The Care of the Teeth
Iv^jIHE coming of baby's first tooth
l^jjL is heralded as a great event
—
GHEI which it really is; yet the mother
may be astonished when advised that
the day after this tooth makes its ap-pearance
is not too soon to commence
the regular cleaning, which she must
persistently continue until the child
itself is old enough to realize the
value of these "mouth jewels." If neg-
EVERY MEMBER OF THE FAMILY
^SHOULD FORM THE HABIT OF
BRUSHING THE TEETH THEFIRSl
THING IN THE MORNING AND
THE LAST THIN6 AT NIGHT.
lected, the temporary teeth may be
lost before the little jaw has grown
sufficiently to accommodate the larger
teeth of the permanent set, and crowd-ing
will result—a condition not only
unsightly, but also very conducive to
decay. Many lines and wrinkles de-tracting
from the beauty of the face
may be traced to toothache—which is
only another name for tooth-neglect.
When the toothache signal is sounded
it may be too late to save the tooth,
but you should consult the dentist im-mediately
and not decide to have your
child's tooth extracted until, with the
help of the dentist, you have taken
every means to save it.
Baby's first toothbrush is home-made.
It is the mother's finger wrap-ped
with soft linen and dipped in a
solution of bicarbonate of soda, a tea-spoonful
to a glass of water. It should
be very gently used in cleaning the
little tooth and gums.
When baby has two teeth, side by
side, a small, narrow, soft-bristle
brush should also be used to remove
the food particles which collect be-tween
the teeth.
See the Dentist Early
The crowns of the teeth, with their
beautiful enamel covering, are fully
Eormed when they appear in the gums.
It is very important that the mother
should have the molars examined by
the dentist as soon as they are fairly
in place. Sometimes there are minute
fissures in the enamel surfaces (es-pecially
with the six-year molars)
which require filling when the teeth
first appear, but generally a perfect
protection is given by keeping the
enamel clean.
At the Marion School in Cleveland,
Ohio, an experimental class was
formed of several backward or defi-cient
scholars. Tests, both as to phys-ical
and mental condition, were con-ducted
before and after the teaching
of tooth care was begun. So success-ful
were the results obtained with
this class in proving that the care of
the teeth is necessary to good school
work that particular attention is now
given to the condition of the mouths
of the pupils in the Cleveland schools.
That general health demands proper
tooth care is again forcibly expressed
88 THE HEALTH BULLETIN
by a noted U. S. Army surgeon who
states that "failure to care for the
teeth is the direct cause of more dis-ease
than any other single cause."
The behavior, too, of a child is nat-urally
affected by the condition of his
teeth. The President of the New York,
Juvenile Asylum is quoted as saying
that "more than 90 per cent of the
boys come to us with bad teeth"—in
brief, bad teeth make bad boys.
Proper Care of the Teetli
Decay of the teeth is due to the de-velopment
of bacilli in the human
mouth, producing an acid which grad-ually
eats away, first, the enamel, and
then, much more rapidly, the dentine
exposing the pulp, which speedily be-comes
inflamed. Decay thus once
started can never be stopped until it
is eradicated from the dentine and the
teeth are filled.
Since the tooth structure grows
denser with age, the ravages of decay
are greater in youth—all the more
reason for impressing young people
with the importance of the faithful use
of brush and dental cream. The bacilli
increase and do their work in direct
proportion to the neglect of thorough-ness
of cleaning—conditions being
more favorable for their development
in some individuals than in others;
but if all the cracks and fissures of
the enamel are properly filled and the
teeth are kept thoroughly cleaned there
will be no decay.
Brushing the Teeth
Do not brush the teeth straight
across. The outside of the upper teeth
should be brushed downward from the
gums; the lower teeth upward. Clean
the inside of your teeth—next to
your tongue—in the same way. The
part of the teeth used for chewing
food (the grinding surfaces) should
be brushed in all directions.
After each meal use a soft quill
toothpick or floss silk to remove bits
of food from between the teeth.
Decay causes the teeth to ache, so
by preventing decay you prevent pain.
The best way to stop decay is to keep
the teeth clean.
Twice a year is none too often to
see your dentist.
DON'T DOPE THE BABY WITH
PAREGORIC
Among the baby killers there is
nothing so deadly as dope. In some
households it is the custom to keep
paregoric on hand for an emergency.
Some mothers are thoughtless and
careless enough to dope their babies
with this drug whenever they cry.
Occasionally a mother is so heartless
and even criminal that she will dope
her baby to make it sleep while she
works or goes calling.
Paregoric contains opium, and ba-bies
are very susceptible to opium or
its alkaloids, the chief of which are
codein, heroin, and morphine. Careless
dosing with such drugs has sometimes
killed babies or led to other very seri-ous
consequences. Among other ill
effects, opiates profoundly affect the
digestive processes by retarding the
secretion of digestive fluids. A baby's
digestion is too important a function
to be tampered with in this fashion.
Perfect health, often even life itself,
depends upon an unimpaired digestion.
If cattle breeders believe that "scrub
stock" is unprofitable, certainly hu-manity
has a greater interest in hav-ing
every child well born, free from
hereditary diseases, and of parents
whose habits are and have been free
from drug, alcohol, tobacco, and other
harmful influences and agencies, as
far as possible insuring a sound mind
and a sound body to the little stranger.
THE HEALTH BULLETIN 89
TEACH OUR CHILDREN
HOW BEST TO LIVE
At college I saw fortunes spent every
autumn to teach football candidates
how to elude opposing tackles, but not
a cent to teach them how to elude
tuberculosis, typhoid, pneumonia, or
cancer. We were required to dig out
Latin roots and to unkink logarithmic
PVERY MEMBER OF THE
L, FAMILY SHOULD HAVE
/{ TOOTHBRUSH AND USE IT.
TEACH YOUR CHILDREN
7
THE TOOTHBRUSH
DRILL.
gnarls, but there was not required a
course in intelligent living.
There was a perennial, concerted,
rock-ribbed, steel-girt conspiracy of
silence against the human body. The
educational system frowned upon bad
taste in deportment, manners, lan-guage,
and literature, but bad taste in
life itself was quite the proper thing.
It was deemed more important to know
quadratic equations than the simple
fact that to sleep healthily in a room
where the sunbeams never enter is as
suicidal as a nibble of cyanide, albeit
somewhat slower.
Long before New York's public
school children of today learn how to
decline "amo" they are taught to de-cline
indiscriminate kisses. Long be-fore
they learn how Gettysburg was
fought, they learn how fire is fought.
The toothbrush drill precedes the first
spelling drill. They learn the intelli-gent
way to sneeze or cough. Long
before they take up the avenues of
Caesar's entrance into Gaul, they are
instructed in the avenue of entrance
of regiments of bacilli into the human
body. Gotham's tots learn the neces-sity
of frequent airing of bedding, the
proper cleaning of ice boxes, the cura-bility
of phthisis. No longer the pa-thetic
spectacle of Alice in Blunder-land.
When Alice reaches the age of
six and matriculates in New York's
public schools she is now ushered at
once into the wonderland of genuinely
useful knowledge of her wisp of a
body. And it begins to look as if the
public schools of the future were to be
a vast system of service stations on
the highway of human life.—Newton A.
Fuessle, in the Craftsman.
BETTER BABIES—BETTER TOWNS
The country-wide campaign for "bet-ter
babies" has taken a new twist.
Cities engaged in the work of lowering
the infant mortality rate are using the
results obtained to advertise the de-sirability
of the home town. It is
being pointed out that a city where the
infant mortality rate is low is a good
city to live in.
Local boards of trade and similar or-ganizations,
in conducting a campaign
to boost the home town, have hitherto
enlarged upon its broad avenues, its
schools, its churches, its hospitals, its
parks, but not a word has been said as
to its infant mortality rate.
This is a mistake. The best "talk-ing-
point" for any community is now
believed to be its infant mortality
rate. If the rate is low, the community
must be regarded as a healthful one.
If it is high, the community is a dan-gerous
one.
While all the inhabitants of a city,
old as well as young, are affected ad-versely
by insanitary conditions, they
react most severely and most notice-ably
among infants under one year of
age. That is why the infant mortality
rate of a city may be regarded as an
index to the community's sanitary
status.
—
Wisconsin Health Bulletin.
90 THE HEALTH BULLETIN
WEIGH THE BABY
ONCE A WEEK
Watch baby's weight carefully during
the warm weather. If he does not hold
his own or if he begins to lose weight
something is wrong and it is time to call
a doctor.
To keep accurate tab on baby's weight
the mother must weigh the child regu-larly.
By comparing results she can tell
if baby is thriving or losing weight and
health.
To weigh the baby, undress him and
put him on the pan of the scales, which
has first been covered with a clean light
cloth or sheet of paper.
After carefully weighing him make a
note of the result.
The weight of the average baby at birth
is about seven pounds, boys being slightly
heavier than girls. Still, a healthy baby
'may weigh as little as five or six pounds,
or, on the other hand, as much as ten or
twelve pounds at birth. These weights,
however, are the exception.
In the first few days after birth there
may be a slight falling off in weight, but
in four to ten days this loss is all re-gained
and from then on the baby should
show a constant gain.
But a baby that gains weight too rap-idly
is not always a healthy baby. The
ideal in baby feeding is not to produce a
fat baby, but a proportionately and well
nourished one. The aim is to grow mus-cle,
bone, blood and nerve tissue, not
merelv fat.
BABY SHOULD HAVE FRESH AIR
Let fresh air blow health blossoms into
the cheeks of your baby by keeping it in
the open air all day during the hot
weather.
If you can arrange it let baby sleep
out of doors on the porch, in the yard, or,
if nothing better affords itself, near an
open window.
But always be sure that baby is shaded
from hot, glaring sun, and protected from
dust, strong winds and flies.
A big clothes basket makes a splendid <
outdoors "bed" for baby. Cover it with
mosquito netting and place it in the yard
or on the porch.
Remember that babies must be kept
quiet and that they require lots of sleep. !
Up to three years of age a child should
sleep twelve hours at night and should
have naps, both morning and afternoon.
But baby should sleep alone and on a
bed and with bed clothes that are clean,
perfectly clean.
Whether sleeping indoors or out of
doors, cover the bed or crib with netting
to keep out flies and mosquitoes.
BATHE BABY EACH DAY OR OFTENER
IN WARM WEATHER
A bath every day for your baby will
help to keep the doctor away.
But on hot summer days a sponging off
with lukewarm water two or three times
a day is necessary to keep baby cool and
comfortable.
The water for baby's daily bath should
be about body temperature or a degree
or two higher. It is best to use a ther-mometer
to determine the temperature.
Always give the bath before baby's
feeding time—never immediately after.
When washing baby be especially care-ful
to cleanse the body creases. After
drying baby thoroughly, dust with talcum
powder, but be sure it is of good grade.
A city may be justly accused of criminal
neglect that does not, when it can, pro-vide
for a complete system of up-to-date
school inspection, and thus permits per-petually
in the schools, the existence of
diphtheria, scarlet fever, measles, whoop-ing
cough, mumps, chicken-pox, small-pox,
pneumonia, parasitic affections, etc.
Most of these are too frequently, alas,
followed by a trail of death and grief.
From the schools infected these diseases
scatter among the people.
THE PREVENTION
OF PELLAGRA
And How It May be Done by Decreas-ing
the Cost of Living
; W By Edward J. Wood, Wilmington, N. C.
^p]N former times in Italy, which
r~* was the home of pellagra, it was
*BBi gaj^ that pellagra and poverty
were interchangeable terms, and this
was certainly true there and else-where.
Today, in the light of recent
investigation, it can be shown that the
poor man can decrease the cost of his
food and insure protection of his fam-ily
against this scourge.
Dr. Goldberger, of the United States
Public Health Service, has proven that
pellagra is due to unsuitable food; that
it is not a poisoning, but a deficiency
of certain essential substances which
are normally present in our food.
Modern Milling Responsible
We have proven in North Carolina
that it is safe to go a step further in
these observations of Dr. Goldberger
and find that some of the errors of
modern civilization are really at fault.
The appearance of pellagra was
marked by numerous abuses in our
manner of living which did not occur
fifty years ago. Today our people
think too much of ease and appear-ances.
It is not always the pretty
food which is safest, nor is it always
the beautiful white flour of wheat or
corn which gives us what our bodies
demand if they are properly nour-ished.
Modern milling methods are
largely responsible for pellagra. If
the old-fashioned mill of fifty years
ago was now in use we would see
pellagra disappear as rapidly as does
ship scurvy when the sailors reach
port and fresh fruit. The milling of
today aims largely at a product which
by its appearance will tempt the buyer.
The dirty portion of the grain lies on
the outside and is dirty in color be-cause
of its composition. But this
cortical layer contains a complex body
or group of bodies which cannot be
dispensed with without the appearance
of certain disease conditions. This
body is known as vitamin. Little is
known of it except that it is one of
the most essential bodies to life. It
occurs in the outer layer of rice, and
when rice is polished it is rubbed off,
and as a result the consumer develops
beriberi. The reader will ask, why,
then, are there no more cases? The
answer is that by the conservation of
nature other foods make up the deficit.
In those who live on one grain, as do
the coolies of the East, beriberi re-sults
if that one grain is deficient' or
polished. In the South such condi-tions
as living on one food alone are
unknown, and so we do not have beri-beri,
but we do have pellagra, which,
in my opinion, is due to a partial in-sufficiency.
Our wheat is ground in such an ele-gant
way that the outside is discarded
because of its dingy color, and so the
cattle get what our children are dying
for because of appearances. In the
92 THE HEALTH BULLETIN
case of corn the matter is more exag-gerated.
We have proven that the
heart or germ of the corn contains
practically all of the vitamin. We have
produced experimentally in pigeons
and chickens beriberi by feeding corn
meal made after the plan of first re-moving
the germ or heart. We have
cured the condition by later feeding
the portion of the grain removed. We
know that this heart contains much
fat and that the process of manufac-ture
whereby this heart is removed
was introduced because the meal made
of the whole grain does not keep well
and the dealers had much loss from
rancid meal. When whole corn is
ground at the water mill and we eat
all of it we will never have pellagra,
no matter how hard the times become.
If we will buy from the grain dealers
this heart of the grain which is called
Corn Chops and make our bread of it,
or add half or even a third to our ordi-nary
corn meal, we will increase the
nutritive value tremendously and be
eating a much cheaper food. In the
same way, if we will buy wheat mid-dlings
or shorts and add a portion to
our flour there will result the same
protection. This decreases the cost
of living very materially. It must be
remembered that a clean mill can sup-ply
us with clean corn chops or wheat
middlings just as they supply clean
meal or flour. We must not buy the
sweepings of the floor, however.
Soda and Baking-Powder Factors
Another factor playing a most im-portant
part in the production of pel-lagra
in North Carolina is the use of
soda and baking powder. Much has
been done along this line by Professor
Voegtlin of the Public Health Service,
and it has been my privilege to confirm
on man many of his views which are
of the very first importance to the
people of the South. I spoke above of
ease, and I repeat that the love of ease
is the chief cause of this second error.
Bread can be made more rapidly and
with a small fraction of work if these
rising agents are used. When heat is
applied in this manner of cooking car-bon
dioxide is liberated, leaving be-hind
a strongly alkaline preparation
of soda which is very destructive to
the vitamin. If sour milk had been
used this danger would be largely off-set;
but our country people as a rule
do not use milk. Those who do are
protected from pellagra in so many
different ways that this article will
not interest them. We are told that
the alum baking powders have another
danger of the same sort which cannot
be dealt with here. The importance
of the subject is to warn our people
to eat yeast-raised bread, or kneaded
or beaten, or old-fashioned hoe-cake or
corn pone. Again, we see that a de-parture
from the primitive plan has
wrough great havoc. The cotton mill
people have, in many instances, fallen
into the pernicious habit of adding to
all sorts of food soda or baking powder
to hasten the cooking and to make the
vegetables more tender. It is this class
suffering most from pellagra today.
Another pernicious practice is the uni-versal
use of canned food. Vitamin
is destroyed by an excess of heat, and
these products are often exposed to
an excess of heat in order to prevent
any possibility of decomposition. One
of my gravest cases in recent years
was an old bachelor who had no serv-ant
but a room full of empty cans
was the silent witness to the source
of his disease. Of course, canning
done after the pasteurization plan is a
very different thing and is to be en-couraged
right now especially.
The evidence is growing day by day
in my work that the use of self-rising
flour is a large factor in the production
of pellagra. In the first place, the
flour used is too highly milled, being
thereby deprived of the essential sub-
THE HEALTH BULLETIN 93
stance of vitamin. In the second place,
the rising agents have a marked ten-dency
to destroy the little vitamin
which may have escaped the modern
miller. It is not inconceivable that a
self-rising product may be made which
will not have this harmful effect, but
it is much safer to avoid all such pro-ducts
and return to Nature.
Excessive Cooking Harmful
Our people overcook nearly every-thing
except those things needing
much cooking, as do cereals, and these
are universally undercooked. The
choicest cuts of almost priceless beef
and mutton are being cooked today in
North Carolina to the point where
every trace of vitamin is destroyed
and, in fact, all the nutritious element
is made worthless, leaving behind only
those harmful extractives which we
hear so much of in the causation of
high blood pressure conditions. Cook
your meats less, and then add to this
rule a strong resolve to throw the
frying pan out of the window. Apart
from injurious effect of cooked grease
on our digestive apparatus, an emi-nent
New York physician has recently
shown that the vehicle in which our
food is cooked may destroy the vita-min.
He found that by cooking orange
juice in oil it would not protect the
children from scurvy, while if the
orange juice were cooked in water
there was no loss of this power of
protection. Therefore, we cannot af-ford
to lessen the value of our precious
foods by the addition of costly grease
when we know that the grease in itself
will cause a double danger.
Nearly all the faulty methods of
cooking in the South have been intro-duced
to save trouble and work. It
is to be hoped that the next generation
of girls will be taught in the schools
how to cook and how not to cook, and
the reason why. An authority on this
matter of cooking has said that the
next best thing Mr. Rockefeller could
do after the eradication of the hook-worm
would be to send through the
South a force of authorities to teach
the people to discard the frying pan.
If, then, our people will grow their
own corn and wheat and take it in
small amounts to the local mill and
have it ground, and if our housewives
will learn again the art of making
yeast if too far away to get the manu-factured
product, and if the soda and
baking powder are thrown away, we
will see the rapid disappearance of
pellagra, our greatest scourge. It will
matter then very little what the price
of meat is, for we can do very well
without it. The high price of wheat
and corn will not affect us, and the
waste in this new-fangled milling will
not be charged up to us and our chil-dren.
In addition to pellagra, the evi-dence
is growing that many of our
nervous disturbances are caused di-rectly
by this faulty but beautiful food.
Let our slogan, then, be, Back to the
soil and the old water mill.
TYPHOID AN ACCIDENT
Court Ruling on Death From Typhoid
Fever Sets a Precedent
v^TlHE Supreme Court of the State of
^ Wisconsin has ruled that a victim
^**° of typhoid fever died an acciden-tal
death and has sustained a verdict in
his favor against the company that em-ployed
him.
The mere fact that the man took ty-phoid
fever while in the employ of the
company, would not constitute a
charge that he sustained an accidental
injury within tha meaning of the stat-ute.
Rut the allegation goes further;
it states that he contracted the dis-ease
through drinking polluted water
furnished by the defendant, and the
presence of bacteria in the water was
the undesigned and unexpected occur-rence.
The court holds this due to the
94 THE HEALTH BULLKTIX
negligence of the company that fur-nished
the water.
Scientists have proved long ago that
typhoid fever is not an act of God,
but on the contrary, an entirely hu-man
disgrace. Now if the courts go a
step further and decide that it is not
a disgrace only, but a prima facie evi-dence
of criminal negligence, another
long step will have been taken to-ward
the elimination of the disease.
City authorities who furnish water to
the public have a duty to know what
kind of water they are furnishing. As
soon as they assume public responsi-bility
of office in a city or town it be-comes
their duty to know that the
public water supply is safe, just as it
is their duty to know that their public
bridges are safe or that their public
schools are not fire traps. The sooner
officials appreciate the full significance
of this public health principle and
their responsibility, the better for them
and their constituents.
GUARDING TOUR HEALTH
We constantly read in the daily press
accounts of persons dying suddenly
who were not suspected of even being
in bad health, and also it frequently
happens that we are surprised to learn
that a friend that we had met within
a day or two apparently in perfect
health is suddenly found to be desper-ately
ill.
The reason for this is that many
diseases are so insidious that the dam-age
to vital organs goes on without
warning until the breaking point
comes and with it sudden death.
Knowing this to be true, would it
not be wise to have an examination
made of your physical condition, say
at least once a year, in order that you
may feel assured that you are not liv-ing
in a state of false security? If a
thorough examination reveals that you
are normal, that knowledge alone is
worth the trouble and small expense
involved, and if such an examination
should reveal that you have some ab-normal
condition, surely such knowl-edge
is vital to you, that you may have
the advantage of remedies applied
while there is yet time, to say nothing
of the saving in expense and lost time
that would inevitably come later.
(VISE AND PREVENTION OF DE-GENERATIVE
DISEASES
Many diseases are largely due to de-fective
elimination, or chronic accumu-lation
of toxics in our body, due to one
or more of the following causes:
1st—Overeating, especially of meat
and highly seasoned foods after middle
life. As some one has aptly expressed
it, we too often dig our graves with
our teeth.
2d—Insufficient exercise, or too much
or too strenuous exercise.
3d—Social diseases.
4th—The use of alcoholics and the
excessive use of tobacco. In fact, in-temperance
of any kind.
Probably the greatest determining
factor is "the strenuous life." The mad
rush for the almighty dollar, and un-due
worry and anxiety, interfere more
or less with all the normal functions of
the body. Worry is ten times more dis-astrous
than work.
THINK HEALTH!
"It is not a fear of illness or of
death that we should encourage, but a
love of health, a sense of responsibility
for the care of our bodies, a desire for
bodily endurance and efficiency and
full achievement,
"If the mind is fixed on these ideals,
and the already known means of ap-proaching
them are utilized, the need-less
miseries that embitter the lives of
so many may be left to take care o:
themselves.
"It is not so much necessary to
fight disease as to cultivate health for
the happiness, contentment and moral
gain that it brincis."
THE HEALTH BULLETIN 95
LIVING LONG AND WELL
In Every Case the Well Balanced Life
is the Longest and Best
frf\ HAT profiteth a man that he gain w the whole world yet lose his
^8 heaith?
In the race for power and place, for
ease of circumstance and relief from
the stimulus of hunger, the modern
man is apt to forget that unless he is
careful of his body he will soon be
made to suffer for the infraction of
Nature's inexorable physical law. With
the loss in body tone comes an equal
loss in mental acuity, and the brain
which for a time was able to operate
despite the complaints of an over-fed.
under-exercised, self-poisoned body,
stops working.
Statisticians have discovered that
the mortality rate of persons in the
United States over 45 years of age is
increasing. The strenuous life of to-day
is not alone responsible for this.
Lack of health-giving exercise, super-fluity
of diet, lack of restoring sleep,
over-stimulation, the high pressure of
the race for power, wealth, and posi-tion,
plus physical neglect—these
bring early decay. The goal is
reached—wealth is amassed—honor,
position, and power are just being
grasped, when the apple of accomplish-ment
turns to ashes of dissolution.
The brilliant mind becomes clouded,
the steady hand is no longer accurate,
the eye which once gazed fearlessly
on the whole world is dimmed, and it
is not long before the final break-up
occurs. All of this was entirely pre-ventable.
Other, things being equal, it is the
man who leads the well balanced life
who lasts the longest, whose work to
the end is uniformly the best—he who
neither overworks nor overplays,
neither overeats, overdrinks, nor over-sleeps,
he who maintains a standard
of simple, healthy diet in moderation,
who offsets mental work with physical
recreation, who is as honest with his
own body as he is with his own busi-ness.
When success comes to such an
one his physical and mental condition
is such that he can enjoy in peace of
mind and contentment of body the
fruits of his labors.
ON TAKING TABLETS FOR
INDIGESTION
"Do not diet. Eat what you please,
as much as you please, and then some.
After each meal take one of Slickem's
Mysteriosa Digestive Tablets. These
tablets are a scientific combination of
seventeen of the best flesh producing
chemicals known to medical science.
They will make you strong, healthy
and vigorous. If you are thin you
will get fat. If you are fat you will
get thin."
Evidently there must be millions
of fools who really believe that you
may safely outrage Nature and then
escape the consequences by means of
a tablet.
With a cocktail before a meal, and
a tablet after, you may worry along for
a few years. Then, if you continue to
suppress symptoms of an outraged
stomach—to sit on the safety valve and
turn a deaf ear to Nature's protests—
you will find yourself afflicted with a
more serious disease than dyspepsia—
perhaps Bright's disease, or rheuma-tism,
or hardening of the arteries—
and even the nature cure may not be
able to save you from suffering pre-mature
death.—Harry Ellington Brook.
Bright's disease is common in Amer-ica
because so many men work their
kidneys harder than they do their
heads or their hearts.—St. Louis Bul-letin.
CLEAN UP
!
Cleanliness Is Nex* lb Godliness
——S—ta—l—e Board of Health , Raleigh. N.C. —IBII lllllllllll I I IH II l«iMi| Ul> ——^M———f——
J
Large placards of this cut 14" x 22" may re obtained free of charge by addressing the
State Board of Health, Raleigh, N. C.
U^T
NOTiCE 10 READER- When you finish reading this', magazine
plffiL 1 place a one-cent stamp on this notice, hand same to any postal em-
*'/Sl7fl Mltftliyeefand it will be placed in the hands of our soldiers or sailors
Published b4 TATL^RTACARPLIrtA STATE. B?ARD s^ATiALTA
This Bulletin, will be seryt free to ar\u citizen of the 5tateupoa request !
Entered as second-class matter at Postoffi.ee at Raleigh, N. C, under Act of July 16, 1894.
Published monthly at the office of the Secretary of the Board, Raleigh, 2V. G.
Vol. XXXII JULY, 1917 No. 4
rE :ir=ir==ir=ir=ir=nr= ir==if=i r—ii ir=ir= n
CONSERVE LIFE AND HEALTH
GOVERNOR T. W. BICKETT .f^ZZZ^.'^*1 '
Y17E say that human life is priceless. Yet statistics
indicate that in North Carolina we are losing, yea
needlessly wasting, thousands of precious human lives
every year, together with the efficiency, the earning
capacity and the real joy of living for tens of thousands
of others. All this is preventable. Much of it is easily
preventable. When shall we awaken to the full gravity
of the situation? Now, if ever, in war times, every
North Carolinian should be at his maximum efficiency,
free from all preventable physical handicaps, and in the
best physical condition, ready to do a man's full part
in waging this world war to a speedy, successful
conclusion. To win this war we. must conserve our
health, vigor and efficiency; we must do health work,
U both personal and public, as never before.
!
—
ii ir===ir==^ r==^r=^r=^P==^ r==i r==^r==^r====ir===i r==n i nJ
TABLE OF CONTENTS
Editorial Brevities 99
Vital Conservation for War... 100
What is the Red Cross 101
President Wilson and the Red
Cross 102
Mason's Iron Cross 103
Protect Your Community From
Contagious Diseases 105
An Old Fable 106
Controlling the Midiwfe Prob-lem
108
Don't Let This Happen to You. 109
Hot Weather Health no
Rheumatism a Preventable Dis-ease
H2
The Teacher's Part in Medical
School Inspection 114
Chronic Constipation in Women. 115
Tuberculosis a County Problem 117
Symptoms of Tuberculosis 119
Tuberculosis a Most Curable
Disease 119
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
J. Howell Way, M.D., Pres., Waynesville
Richard H. Lewis, M.D., LL.D., Raleigh
J. L. Ludlow, C.E., . . Winston-Salem
Thomas E. Anderson, M.D., . Statesville
E. C. Register, M.D., . . . Charlotte
Chas. O'H. Laughinghousk, M.D.,
Greenville
Edward J. Wood, M.D., . . Wilmington
Cyrus Thompson, M.D., . . Jacksonville
P. R. Harris, M.D., . . . Henderson
Official Staff
W. S. Rankin, M.D., Secretary of the State Board of Health and State Health Officer.
O. A. Shore, M.D., Director of the State Laboratory of Hygiene.
Warren H. Booker, C.E., Chief of the Bureau of Engineering and Education.
L. B. McBrayer. M.D., Superintendent of the State Sanatorium.
J. R. Gordon, M.D., Deputy State Registrar.
G. M. Cooper, M.D., Chief of the Bureau of Medical Inspection of Schools.
A. McR. Crouch, M.D., Epidemiologist.
B. E. Washburn, M.D., Director of County Health Work.
FREE PUBLIC HEALTH LITERATURE
The State Board of Health has a limited quantity of health literature on the subjects
listed below, which will be sent out, free of charge, to any citizen of the State as long as
the supply lasts. If you care for any of this literature, or want some sent to a friend, just
write to the State Board of Health, at Raleigh. A postcard will bring it by return mail.
No. 107. Life Saving Facts About Diph-theria.
No. 116. Scarlet Fever.
No. 117. Tuberculosis.
No. 118. Measles.
No. 119. Whooping Cough.
No. 120. Hookworm Disease.
No. 121. Sanitary Management of Hotels.
No. 122. Poliomyelitis or Infantile Paral
vsis.
No. 123. Typhoid Fever.
No. 126. Indigestion.
Teeth, Tonsils, and Adenoids.*
How to Live Long.*
A War on Consumption.*
Milk.* Periodic Medical Examina-tion.
Typhoid Fever and How to Prevent
It*
Concrete Septic TanksJ
Anti-Spitting Placards (5 inches by
7 inches)
.
Anti-Fly Placards (14 inches by 22
inches).
Anti-Typhoid Placards (14 inches
by 22 inches).
Anti - Tuberculosis Placards (14
inches by 22 inches).
Clean Up Placards (14 in. by
23 in.)
•Furnished by courtesy of the Metropolitan Life Insurance Company.
t Furnished by courtesy of Portland Cement Association.
No. 12.
PUBLI5ALD ST TML mPRTM CARPUMA 5TATE. BQMgD s^MEALTH
Vol. XXXII JULY, 1917 No. 4
EDITORIAL BREVITIES
Keep well—the first service you owe
to your country.
Are you a member of the Red Cross?
Are you doing all that you can for the
health and comfort of those who are
fighting for you?
Do you have good, made-to-measure
wire screens, or at least mosquito net-ting
screens at every door and window
this summer? If you do not, you are
missing a lot of solid comfort, greatly
increasing an unnecessary summer an-noyance,
and needlessly exposing the
lives and health of yourself and family.
Screen the flies and mosquitoes out!
Every neighborhood, town, or com-munity,
especially every industrial
center, should have one or more
classes in First Aid. All that is nec-essary
to form such a class is to se-cure
not less than four nor more than
twenty-five members, the minimum
age limit being sixteen years, and the
consent of a qualified physician in act-ive
practice to act as instructor. The
name and qualification of the physician
and the number in the class are then
sent by the class secretary to the First
Aid Division, American Red Cross,
Washington, D. C, for approval, where-upon
a class roll, a catalogue of sup-plies,
and necessary information will
be forwarded to the secretary and the
class will be ready to begin work.
When you dream of your work and
worry over it, it is time for you to
take a vacation. Don't think you can't
afford it. It is cheaper and better for
you to take it now than to take a
longer enforced leave of absence later.
A crying shame it is that it takes
such an emergency as a great war to
drive us to the realization that an
appalling number of our young men
are not physically fit to cope in battle
with an enemy. If bad teeth, hook-worm
disease, malaria, constipation,
adenoids, defective eyes, ears, under-weight,
and other equally unnecessary,
sometimes disgraceful and nearly al-ways
easily preventable, defects can
so seriously affect our young manhood,
how about our young womanhood?
How about our middle-aged men and
women, those that should be the real
factors in the world's work? Let's
put an end to such inefficiency. Medi-cal
inspection of schools is the im-mediate
step in providing for the fu-ture,
while periodic medical examina-tions
for adults and sanitation and
public health work offer much hope
for us of today.
Don't get the idea that good health
is merely absence of disease or sick-ness.
It is far more. One may not
feel sick at all and still be only 60, 70,
or 75 per cent efficient. Good health
is 100 per cent of physical efficiency.
It is that physical state of being where
life is a joy, and plenty of hard work
is a pleasure.
LOO THE HEALTH BULLETIN
VITAL CONSERVATION
FOR WAR
Why and How We Should Conserve
Our Greatest Waste at This Time
W&a
AR, waste, and conservation ara
words that are kept ringing in
our ears these days. That we
are involved in the greatest war the
world has ever known, that our own
fate and future are absolutely and in-separably
dependent upon the outcome
of this war, is a certainty. If we win,
democracy and freedom of peoples win.
If we lose, democracy and freedom
lose, autocracy wins, and we stand
liable to pay tremendous indemnities
to our enemies that will make our
seven-billion-dollar Liberty Loan look
small. There is but one solution to
this situation: WE MUST WIN. But
to win is going to tax our resources
to the utmost. Already from far and
wide are going out appeals for larger
food crops and greater economy and
conservation along this line.
But we cannot afford to be short-sighted,
penny-wise or pound-foolish.
It takes more than food to win a war.
It takes men and women, and money
and resources of every kind to win a
war. Before we can have money and
resources we must have men and
women that are men and women to
produce and supply, and continue to
produce and supply, money and food
and resources of every kind. A nation
of weaklings will fail, just as Rome
failed, when her people, because of
drunkards and debauched victims of
disease, neglected to take proper care
of their physical machine. Similarly,
we cannot expect to win a war with a
nation of young men wno do not pass
even a moderately rigid physical ex-amination.
Nor can we expect the
physical culls and seconds left at home
to supply food, munitions, money, and
supplies almost without end to sustain
our own and other armies of fighting
men abroad. War requires men that
are all men, full of physical vitality
and working up to the fullest possible
efficiency. In such a gigantic strug-gle
as we now face, every weakling
and every sick and inefficient person in
our land who is not more than taking
care of himself, is just that much dead
weight. Similarly, every individual
who is pegging along at 60, 70, or 80
per cent of his possible physical ef-ficiency
lacks just that much of doing
"his bit."
War is a tremendous tax and ex-pense
in every way upon a nation. In
order to meet this tax, this terrific loss
of our best manhood, money and re-sources,
we must conserve, avoid every
possible waste, and make for efficiency
in a large way. From time imme-morial
we have continued to suffer a
tremendous and unnecessary loss of
life, health, happiness, and efficiency
from needless and easily preventable
disease. Now, if ever, we must "about
face" and stop this needless loss and
waste. While it is estimated that
North Carolina wastes annually per-haps
$20,000,000 worth of food, we are
at the same time wasting much more
in absolutely needless sickness and
loss of life, when figured in cold dol-lars
and cents. For instance, it is es-timated
that every year about 14,700
North Carolinians die from easily pre-ventable
or postponable diseases. If
we estimate a person's life to be
worth only $1,700, we have an annual
loss from this one item of over $24,-
000,000. It is estimated that over one
per cent of our population are need-lessly
sick at all times, and that their
annual earning capacity is only $700.
This gives us an annual time loss
from sickness of 23,000 times $700, or
$16,100,000. It is estimated that the
average family in North Carolina
THE HEALTH BULLETIN 101
spends $27 annually for medicines and
doctors' bills for needless sickness—
another loss for our 400,000 families
of $10,800,000. The total of these three
items of
$24,000,000 for needless deaths,
$16,100,000 for needless loss of time,
$10,800,000 for doctors' bills and
medicines for needless sickness, is over
$50,000,000 annual health loss for
North Carolina from these three items
alone. There are, of course, many
other items not included, such as loss
of efficiency when not sick enough to
stop work or call a doctor, and fur-thermore
this estimate does not take
into account intangible values such
as broken family ties, love, friendship,
or the value of pain and suffering.
Is it not time to set our house in
order, and not only stop this gigantic
loss, but place ourselves on an effi-cient
basis as never before? We can-not
put in our best efforts, either in
war or in civil life, while laboring
under such unnecessary vital losses.
To make real headway in this work
means better attention to child hy-giene,
the education of mothers in the
matter of raising healthier, stronger,
babies; it means better medical inspec-tion
of school children so that they
don't have to spend four years in
school doing three years' work; it
means better home sanitation so that
we are not cursed with malaria, ty-phoid,
tuberculosis, hookworm disease,
etc. It means at least annual, careful,
painstaking medical examinations of
every adult by a competent physician
to determine any oncoming diseases.
In brief, it means the establishment
of an active city or county health de-partment
in every city and county in
the State, such department to be armed
with nurses, sanitary inspectors, a
quarantine officer, medical inspectors,
lecturers, and a laboratory. With
such we will begin to see results with-in
a year or two. The death rate will
decline and the whole physical and
moral tone of the city, county, and
State will improve. Will we do it?
Will we take this step to win the war
and to make life fuller and richer
after the war? It is up to us now as
never before.
WHAT IS THE RED CROSS?
Good Samaritan to all People in
Trouble—Our Part in the
Great War
s^7|HE Red Cross is to the men of
^-^ the army what the "Good Sa-
**™° maritan" was to the man who
"fell among thieves, which stripped
him of his raiment and wounded him.
and departed, leaving him half dead."
The American Red Cross is a branch
of the great international organization
and has recognition from all for-eign
governments. It is chartered by
Congress, has the President of the
United States as its president, and
has its accounts audited by the United
States Treasury Department. It is
the only volunteer relief agency auth-orized
by the government to render
aid to its land and naval forces in time
of war. Its services are guaranteed to
reach the needy and render aid in the
most efficient way.
The Red Cross grew out of the
generous impulse of the human heart
to relieve human suffering met by war
or disaster. It has grown from a
lonely nurse dressing the wounds of
soldiers on the battlefield to the great-est
humanitarian society in the world.
It is altogether a philanthropic or-ganization,
is supported by voluntary
subscriptions, and is neutral in war,
knowing no race, sect, or religion.
It is indeed the Good Samaritan to
all folk in their darkest hour.
The work of the Red Cross in time
102 THE HEALTH BULLETIN
of war consists in all forms of relief
work, from administering to the
wounded and suffering of the army and
navy to taking care of the dependent
families of soldiers and sailors and se-curing
employment for men disabled
in the country's service. In time of
peace it not only prepares for war,
but maintains that state of prepared-ness
that enables it to relieve distress
caused by disaster in the quickest and
most efficient way possible.
Every chapter has its workrooms
and auxiliaries. It furnishes trained
instructors for the making of medical
and surgical supplies and gives
courses in accident and disease pre-vention,
as well as in rendering first
aid to the injured. It also provides
courses in home care of the sick,
home dietetics, and various means of
disease and accident prevention.
The purpose of what has above been
said concerning the Red Cross is to
commend it, its work and its support,
to the readers of the Health Bulletin,
as the Red Cross is the big brother to
the medical profession and all health
workers. We believe that every town
and community in the State should
form either a chapter or an auxiliary,
which is a branch of a chapter, and
should actively engage in this great
work of relief and mercy by making
medical and surgical supplies for hos-pitals,
by learning how to care for the
sick and wounded and by giving of
their means to support this work.
It is the only way those who do not
go to the front have of showing their
appreciation for, and giving aid to,
those who are doing the fighting. The
Government provides for their food,
clothing and ammunition, but it leaves
it to us to provide for their lives in
case they are wounded or sick, and
for their families in case they leavr
them dependent and helpless.
Information for forming a Red
Cross chapter, an auxiliary, or a class
in First Aid may be had by writing
to the American Red Cross at Wash-ington,
D. C.
Write for further information and
circulars today and proceed at once
with the work in your own community
among your neighbors and friends.
They will appreciate your taking the
lead. It is a small part of your pa-triotic
duty and theirs. Do it now.
PRESIDENT WILSON AND
THE RED CROSS
Earnestly Recommends it to the Con-fidence
and Support of
the People
j^lELIEF work is undoubtedly ahead
ffL of us," was asserted by President
Wilson in a letter sent to the
Washington branch of the American
Red Cross, saying that as the official
volunteer aid organization of the Uni-ted
States the society should receive
the generous support of the American
people.
"In order that the relief work, which
is undoubtedly ahead of us, should be
made thoroughly efficient," wrote the
President, "it is most desirable that it
should be coordinated and concen-trated
under one organization.
"Having been made the official vol-unteer
aid organization of the United
States, the American Red Cross comes
under the protection of the treaty of
Geneva and has received due recogni-tion
from all foreign governments.
Its status both at home and abroad is
thus definitely determined and assured.
"The surgeons general of the War
and Navy Departments are members of
the executive committee of the Amer-ican
Red Cross. By act of Congress
medical officers of both branches of the
service are detailed for service with it
in order that its military relief may be
so organized as best to supplement
THE HEALTH BULLETIN 103
the medical services of our fighting
forces.
"Until the civilian relief is under a
trained and experienced personnel es-pecially
fitted to care for soldiers'
families and other non-combatants, the
accounts of the association are audited
by the War Department in order
thoroughly to safeguard the funds con-tributed
by the public.
"Recent experience has made it
more clear than ever that a multi-plicity
of relief agencies tends to
bring about confusion, duplication, de-lay,
and waste. Moreover, it affords
temptations to dishonest persons to
take advantage of the general willing-ness
of the public to subscribe to
such agencies to defraud subscribers
and rob the soldier of the assistance
he so much needs. Wherever in the
present war sufficient volunteer aid
has been rendered either to soldiers
or to non-combatants it has been ren-dered
under a well organized central
body. Experience is certainly the
most convincing teacher, and we
should learn by these European ex-amples
how to conduct our own relief
work with the most thorough efficiency
and system. With its catholicity and
its democracy the Red Cross is broad
enough to embrace all efforts for the
relief of our soldiers and sailors, the
care of their families, and for the as-sistance
of any other non-combatants
who may require aid.
"As the president of the American
Red Cross, our branch of the great in-ternational
organization, I most earn-estly
commend it to your confidence
and your support. Upon your aid,
upon the amounts and promptness of
your gifts and cooperation must de-pend
the fulfillment of the duties that
are imposed upon it. It serves so
noble and beneficent a purpose that
it must appeal to all who love their
country and love humanity."
MASON'S IRON CROSS
Valerie D. Ohrenstein sends us this
poser from Chicago:
"Have we any right to expect any-thing
from Congress which is idealis-tic,
or for the good of the many, as
opposed to the immediate benefit of the
few, when we elect men of the type of
ex-Senator William E. Mason [now a
member of the House of Representa-tives
from Illinois], who is willing to
sell his title for the price of a patent-medicine
testimonial? The inclosed
advertisment appeared in the Chicago
'American.' . . ."
Miss Ohrenstein takes too blue a
view of the case. Chicago has, to be
sure, a Mason in Congress, a Thomp-son
in the mayor's chair, but there are
cities with better mayors, and Chicago
itself has better representatives than
Mason. Mason is a hold-over from the
patent-medicine school of American
politics, and as a young nation we
must not be too impatient with our
elders. Collier's Chicago friend in-closes
in her letter the "American's"
three-column advertisement, with its
far-flung headline telling how Mason
says
NUXATED IRON INCREASED HIS
POWER AND ENDURANCE SO MUCH
THAT IT OUGHT TO BE MADE
KNOWN TO EVERY NERVOUS, RUN-DOWN,
ANEMIC MAN, WOMAN AND
CHILD.
If that's so, it's a pity that the ex-senator
didn't take some "Nuxated
Iron before telling Congress, on the
eve of the war declaration, that "Ger-many
had given us no cause for war."
"Nuxated Iron," if it is much good,
ought to have kept him from saying:
"I am against this war because . . .
it is a dollar war." It might have
kept him, after the declaration, from
counseling delay in respect to war
measures: "Gentlemen, we have plenty
of time. . . ." Mason's tribute to
104 THE HEALTH BULLETIN
"Nuxated Iron" starts like this: "I
have often said I would never recom-mend
medicine of any kind—" and on
second thought he hasn't broken his
pledge, either. "Nuxated Iron" con-tains
only about a five-hundredth of a
grain of nux vomica alkaloids to a tab-let,
and a twenty-fifth of a grain of
iron—which is shown in an analysis
by the American Medical Association.
"Nuxated Iron" comes about as near
to being a medicine and to having
"valuable blood, nerve force, and tis-sue-
building properties" (see the wrap-per)
as Mason comes to being a pa-triot
and a statesman. The other day
Mason had an article by Mayor Thomp-son
of Chicago attacking the Govern-ment's
war loan and its food-regula-tion
plans printed as an "extension of
remarks" in the Congressional Record.
Only a few days later Mr. Hastings of
Oklahoma was reported to have
charged him with treason because of
certain remarks on our military law
and policies. (Later the word "trea-sonable"
was expunged from the Rec-ord.)
Chicago is not fortunate in all
its statesmen, but Chicago is a big
city after all, and we think Miss Ohren-stein
need not be much depressed just
because Herr Mason has earned
a "Nuxated" Iron Cross.— Collier's
Weekly.
PATRIOTISM AND YOUR HEALTH
Why not add at least 3 or 4 per
cent to your personal efficiency so as
to be better able to meet all coming
needs? The sanitary sharps agree
that the average citizen loses between
nine and twelve working days each
year because of preventable sickness.
Now, if this war is to mean anything
to the average man, it ought to mean
shaking off only semisensible habits
and living up to his best. No one is
even suggesting a tax on water; why
not drink it and have more money to
buy war loan securities? Air is as
free as ever—take your full share.
Fewer of us will be in danger of over-eating
these next few years, and there
will be work enough to make us all
sleep when bedtime comes. Now is a
good chance to get rid of any foolish-ness
about clothes; shoes that curse
the feet, collars that cut the wind, and
any other nonsensical items in be-tween.
This is a 100 per cent war,
and we can ill afford to carry the
burden of preventable sickness. Tak-ing
care of yourself is more than sense
now—it is a duty.—Collier's Weekly.
There never has been a time when
there were so many reasons why one
should keep well and do all in his
power to prevent disease as now. The
first and the last reason, perhaps, is
that sickness is expensive; it costs
both time and money, to say nothing
of the valuable human life that it
wastes annually; and if this country is
to win in this great war, it cannot
afford to have any of its resources
spent on anything so unnecessary as
disease. On the other hand, it would
be better to spend money to prevent
disease.
Disease is no respecter of persons.
There is not one kind of consumption
for the white people and another kind
for the black. A town is like the sky
at night: for as a flash of lightning in
one quarter of the heavens lights up
all the rest, so disease in the poorest
section of the town reaches out its
fingers and blights the remote home of
the wealthy.
As to pellagra, a safe conclusion of
the whole matter is that the farm that
has a good cow, a pea patch, and a hen
coop will not have pellagra on it.
:: : i
,
' :: ^
PUBLIC HEALTH
and SANITATION
PROTECT YOUR COMMUN-ITY
FROM CONTAGIOUS
DISEASES
Ten Righteous People Can Do It
I ND the Lord said, If I find in
^J Sodom fifty righteous within the
^ma city, then I will spare all the
place for their sakes."
"And he (Abraham) said, . . .
Peradventure ten shall be found."
"And He (the Lord) said, I will not
destroy it for ten's sake."
The salvation of communities still
and always, as in the days of Sodom,
depends upon a few righteous, respon-sive
individuals, and not upon the mul-titude,
the irresponsive herd—the
shepherd saves the flock.
To every township with from three
to five interested, responsive citizens
and to every town or city with one or
two interested, responsive citizens for
each thousand of the population, North
Carolina, under a law which went into
effect August 1st, can promise safety
from unnecessary contagion. This
does not mean all contagion, but it
does mean a very large proportion of
it. On the other hand, the State is
helpless to protect those communities
where nobody knows, or, which is
worse, where nobody cares. Won't
you, in this vital matter of protecting
the health and lives of your disinter-ested
neighbors and of their helpless
children, be one of the ten righteous?
Will you make and keep a trade with
your conscience, unconditioned on any
supplementary pay from the crowd?
If so, you can effectually assist our
State in protecting your community
from epidemics. But before you should
be expected to do this, the State and
county must make it possible, first, for
you to be able to recognize violations
of the State quarantine law, and, sec-ond,
for you to report such violations
without becoming involved in legal en-tanglements
or social embarrassments.
How You May Recognize Unmistaka-ble
Violations of the Quarantine Law
If you know of a home in which
there is a person sick with whooping
cough, measles, diphtheria, scarlet
fever, smallpox, infantile paralysis, ty-phoid
fever, or cerebro-spinal menin-gitis
and on the front of which there
is not fastened a large yellow placard
with the name of the disease printed
thereon, you may know positively that
the quarantine law is being violated.
When the law is violated, one of three
parties is guilty—the quarantine offi-cer,
the attending physician, or the
householder.
When the Quarantine Officer is
Guilty.—The quarantine officer has
sworn "that he will well and duly exe-cute
and perform all the duties as
county quarantine officer prescribed by
chapter 263 of the Public Laws of
1917, and such duties as are now or
may hereafter be prescribed in and
by the regulations promulgated by the
North Carolina State Board of Health
under the authority conferred by sec-tion
10, chapter 263, of the Public
Laws of 1917." Under this oath it is
the duty of the quarantine officer to
see that every home in which one of
the aforementioned diseases has been
reported to exist shall receive a yellow
placard with the name of the disease
printed thereon, and shall receive the
law and the rules and regulations re-quiring
the posting of the placard and
106 THE HEALTH BULLETIN
prescribing other necessary precau-tions
for public safety to be carried
out by the householder. It is hardly
conceivable that the quarantine officer,
under the obligation of a solemn oath
and with a full realization of the im-portance
of prompt and effective
quarantine, has failed to do his duty.
When the Attending Physician is
Guilty.—If the physician in attend-ance
upon a case of whooping cough,
measles, diphtheria, scarlet fever,
When the Householder is Guilty.—
First, if one of the above mentioned
diseases is so mild as not to have
necessitated the calling in of a physi-cian,
the householder, under the re-quirements
of the law, should have re-ported
the case of sickness to the
quarantine officer. If he has not done
so, he has, either ignorantly or know-ingly,
violated the law; and if he has
willfully violated the law, he is guilty
of a misdemeanor. Second, if the
AN OLD FABLE
/^VNCE UPON A TIME there was a city with a street
^-^ running along a cliff. In dark and stormy weather so
many people were injured by falling over the edge that
the citizens gathered together to see what they could do
about it. They decided to use their resources to build a
hospital at the foot of the cliff so that the injured might
receive immediate attention.
Now, it chanced that a great physician visited their land,
and the inhabitants showed him the hospital with great
pride. But he, looking up at the cliff, said : "Wouldn't it
have been cheaper in lives and money to build a wall of
protection along the cliff?"
smallpox, infantile paralysis, typhoid
fever, or cerebro-spinal meningitis
fails to report the case to the quaran-tine
officer, he has failed to perform
his duty and is guilty of a misde-meanor.
Practically all physicians are
interested to a sufficient extent in the
prevention of disease and realize suf-ficiently
the vital importance of well-enforced
quarantine laws to cause
them to report the "catching" diseases.
Occasionally, however, physicians are
careless or forgetful in performing
this their most important civic obli-gation.
householder has not posted the yellow
placard received from the quarantine
officer and has not complied with the
rules and regulations furnished him in
writing by the quarantine officer, he
is guilty of a misdemeanor.
How You Can, Without Expense, In-convenience,
or Embarrassment, See
That Violations Are Investigated and
Punished.
First, you can notify the quarantine
officer of your county, whose name
and address appear on page 107 of
this Bulletin, of probable violations of
the quarantine law. The quarantine
THE HEALTH BULLETIN 107
officer should regard the information
you supply him as strictly confiden-tial.
He should investigate the possi-ble
violation, and if he finds the law
has been violated he should, in accord-ance
with his oath, indict the guilty
parties. In investigating the complaint
and in bringing the indictment, the
quarantine officer can secure the nec-essary
evidence without involving his
assistant and informer in legal pro-ceedings
or social embarrassment.
The Control of Contagion Rests Pri-marily
on Complete Reporting of
Contagious Diseases
A fire department can't put out a
fire until it is notified. The State and
county machinery for restricting the
spread of contagion cannot be put into
operation until the disease is reported.
The reporting of contagious diseases,
every case, is the first and absolutely
necessary step in any system of con-trol.
After the disease is reported, the
BROUGHT UP TO DATE
ONCE UPON A TIME a great country went to war
and needed her strong men to fight her battles. But
when her sons were called together only half of them
were found fit to do battle, the others being deficient in
health and lacking in physical strength. What shall we
do?" said the people. "Unless our men are strong in body
they will lose in battle. Let us ask Congress to appropri-ate
a great sum and build hospitals where they may receive
treatment and be cured of their diseases." And this Con-cress
approved. ,
But some said: "A pity it is that great sums of money
should be spent for this purpose now, whereas small sums
spent a few years ago when these were boys would have
made this unnecessary and saved the country s manhood
from this blight of ill health and inefficiency.
And the people said, "Yea, truly ! A poorer nation, but
a wiser one, will we be when the war is over.
Second, if you do not care to report
direct to your county quarantine offi-cer,
you can report to the State Epi-demiologist,
Raleigh, North Carolina.
The State officer will regard your in-formation
as confidential, and will im-mediately
communicate with your
county quarantine officer in regard to
the probable violation of the law, and
in doing so will not use your name.
The State Board of Health would ad-vise,
however, that wherever possible
interested citizens cooperate directly
with their local authorities in the en-forcement
of the quarantine law.
responsibility for controlling its spread
rests largely with the State and coun-ty,
and in the order mentioned.
NAMES AND ADDRESSES OF QUARAN-TINE
OFFICERS.
Counties.
Alamance Dr.
Alexander Dr.
Alleghany Dr.
Anson ..Dr.
Ashe
Avery
Beaufort Dr.
Bertie
Bladen Dr.
Brunswick Dr.
Buncombe Dr.
Burke
Cabarrus Dr.
Caldwell Dr.
Camden Dr.
Carteret. Dr
Caswell Mr.
Catawba Dr.
Name. Address.
C. T. Vernon Burlington.
S. T. CrowBon—Taylorsville.
J. L. Doughton.. Sparta.
J. H. Bennett Wadesboro.
J. G. Blount Washington.
G. F. Bullard Elizabethtown.
J. A. Dosher Southport.
D. E. Sevier Asheville.
R. M. King Concord.
L. H. CofTev Lenoir.
C. G. Ferebee Camden.
P, B. Loftin Beaufort;
Henry S. Turn< r.Yaneeyville.
( ieoige W . Shipp.Newton.
108 THE HEALTH BULLETIN
Counties. Name. Address.
Chatham Dr. L. E. Farthing. ..Pittsboro.
Cherokee Dr. H. J. Tilson Murphy.
Chowan Dr. J. S. Mitchener ..Edenton.
Clay
Cleveland Dr. E. B. Lattimore.. Shelby.
Columbus Dr. R. C. Sadler Vineland.
Craven Dr. J. F. Rhem New Bern.
Cumberland .Dr. J. W. McXeilL—Fayetteville.
Currituck -
Daie ..Dr. Franklin P.Gates Manteo.
Davidson Dr. E. F. Long. Lexington.
Davie ..Dr. J. W. Rodwell Mocksville.
Duplin Dr. J. W. Fairior Kenansville.
Durham Dr. Arch Cheatham..Durham.
Edgecombe.. .Dr. K. E. Miller Tarboro
Forsyth Dr. A. C. Bulla Winston Salem.
Franklin Dr. J. E. Malone Louisburg.
Gaston Dr. L. N. Glenn Gastonia.
Gates
Graham
Granville Dr. B. K. Hays Oxford.
Greene ...Dr. W. B. Murphy.. .Snow Hill.
Guilford Dr. W. M.Jones Greensboro.
Halifax. Dr. I. E. Green Weldon.
Harnett Dr. J. W. Halford ...Chalybeate
Springs.
Haywood Dr. J. R. McCracken.Waynesville.
Henderson ...Dr. J. F. Cranford ...Hendersonville.
Hertford Dr. \V. B. Pollard.. ..Winton.
Hoke Dr. R. T. Wilkins ....Raeford.
Hyde. Dr. L. H. Swindell.. .Swanquarter.
Iredell Dr. R. S. McElwee...Statesville.
Jackson
Johnston .Dr. Thel. Hooks Smithfiend.
Jones..
Lee Dr. Lynn Mclver Sanford.
Lenoir Dr. G. S. Mitchener.. Kinston.
Lincoln Dr. J. W. Sain. Lincolnton.
Macon. ..Dr. H. T. Horsley ...Franklin.
Madison. Dr. Frank Roberts. ..Marshall.
Martin Dr. W. E. Warren Williamston.
McDowell Dr. J. F. Jones Marion.
Mecklenburg. Dr. C. S. McLaughlinCharlotte.
Mitchell Dr. C. C. Smith Toecane.
Montgomery. Dr. C. Daligny.. Troy.
Moore Dr. A. McN. Blue Carthage.
Nash Dr. Ambler Speight.. Nashville.
New HanoverDr. C. T. Nesbit Wilmington.
NorthamptonDr. F. M. Register Jackson.
Onslow Dr. R. H. Noell. Swansboro.
Orange Dr. A. J. Warren Hillsboro.
Pamlico Dr. G. S. Attimore... Stonewall.
Pasquotank.. Dr. Zenas Fearing ...Elizabeth City.
Pender Dr. P. E. Lucas Burgaw.
Perquimans. -Dr. F. S. McMillan. ..Hertford.
Person Dr. Arch Bradsher__.Roxboro.
Pitt. Di. M. T. Edger-ton,
Jr. Greenville.
Polk.. ..Dr. Earle Grady Tryon.
Randrlph Dr. L. M. Fox Asheboro.
Richmond Dr. J. M. Maness Ellerbe.
Robeson Dr. B. W. Page Lumberton.
Roc ki:igham
Rowan Dr. C. W. Woodson. .Salisbury
Rutherford
Sampson Dr. E. T. Hollings-worth
Clinton
.
Scotland Dr. Peter McLean Laurinburg.
Stanly Dr. J N. Anderson..Albemarle.
Stokes ..Dr. W. L. McCauless.Danbury.
Surry Dr. Ira S. Gambill.-.Dobson.
Swain. Dr. P. R. Bennett Bryson City.
Transylvania Dr. C. W. Hunt Brevard.
Tyrrell Dr. C. A. Flowers Columbia.
Union .Dr. S. A. Stevens Monroe.
Vance..
Wake Dr. Z. M. Caviness...Raleigh.
Warren Dr. Ghas. H. Peete...Warrenton.
Washington ..Dr. W. H. Ward Plymouth.
Watauga Dr. M. G. Anders Boone.
Wayne Dr. W. H. Smith Goldsboro.
Wilkes Dr. J. M. Turner No. Wilkesboro.
Wilson Dr. J. C. Braswell.Jr. .Wilson.
Yadkin Dr. V. F. Couch Yadkinville.
Yancey Dr. J. B. Gibbs Burnsville.
CONTROLLING THE MID-WIFE
PROBLEM
Rocky 3Iount Board of Health Re-quires
all Midlives to Pass
Satisfactory Examination
qjOCKY MOUNT has led all other
^^ towns in the State, and prob-ably
in the South, for all we
know, in conducting a school for mid-wives,
even to the extent of requiring
them to stand an examination and
make a satisfactory grade in order to
obtain a permit to practice their work.
The city board of health passed an
ordinance making it unlawful for any
midwife in the city to practice her
profession after January 1, 1917, with-out
having passed a satisfactory ex-amination
in the elementary principles
of midwifery. Free instructions were
given by the city health officer, no fee
being charged for the examination or
for issuing the permit.
The result has been, according to
the city health officer, a noticeable
falling off in the infant death rate,
while at the same time an increase in
the birth rate has been noticed, due to
complete birth registration, the im-.
portance of which was one essential
made known to the midwives.
The place filled by widwives in this
country, from a health standpoint, is
a big problem. The question is, how
shall the midwife be so trained and
controlled as to become of greatest
value, rather than a menace, to those
who from ignorance, traditions, en-vironment,
or for financial reasons,
still seek her services? This, it is
believed, can be achieved through
training, licensure, and control by
State and local boards of health, as
the city board of health of Rocky
Mount has recently found out.
The extent to which the midwife
problem affects North Carolina is seen
THE HEALTH BULLETIN 109
through the following figures: Last
year there were 55,512 white births
in North Carolina and 24,408 colored
births, a total of 79,920. Of the white
births, 80 per cent were attended by
physicians and 20 per cent by mid-wives,
while 80 per cent of the colored
births were attended by midwives and
only 20 per cent by physicians. That
almost twice as many colored babies
in North Carolina die during the first
\veek of life as white babies, accord-ing
to figures from the Vital Statistics
Department, is thought to be largely
due to the ignorant midwife. That
more women from fifteen to forty-four
years old die from conditions caused
by child-birth than from any disease
except tuberculosis is also thought to
be largely due to the ignorant mid-wife.
These facts point to the need of
stricter laws governing midwives, par-ticularly
as it affects their training
and ability.
D0>'T LET THIS HAPPE> TO YOU
OK TOUR HOUSEHOLD
The doctor said "TYPHOID!" How
you dread that word! It strikes ter-ror
to you now as you hear, in your
imagination, the muffled tread of foot-steps
and low voices near the bedside
of the stricken patient, and you ask
what cause has brought such sorrow to
your unsuspecting household!
Your own home had sanitary facil-ities,
sewers and screens, perhaps, and
clean, well-kept grounds, and yet
typhoid came unbidden—the unwel-come
guest.
WHY? you ask. Look about you for
the reason. Watch that little fly buzz-ing
harmlessly near the sick-room
door. Where does he come from and
what is his business here? Ah! You
have it!
Over in yonder hollow is a plain,
ordinary, outdoor privy. Nothing un-usual
about it. You have seen it be-fore.
Perhaps there are others nearer
or even farther away!
BUT THERE IS THE CAUSE! One
little fly regaled himself in yonder
closet, took his fill of filth and cov-ered
his body and legs with the deadly
typhoid germs, then came to your own
kitchen and dining-room to walk upon
the butter, feast upon the cake, or
scrape his feet on the rim of the
baby's bottle; and found you and your
family disarmed. But how?
You had promised yourself that
when this summer came, you and your
household would be vaccinated against
typhoid fever; but did you? You kept
putting it off till a more convenient
season, and already the doctor has
said "typhoid"!
What would you not give to have
that peace of mind that comes from
having done one's duty? You saw
yours, but you neglected it.
Oh, yes, you will never let it occur
again. You and the remainder of your
household will at once be vaccinated.
But it may be too late to save you.
It certainly will not save the stricken
patient from suffering weeks and per-haps
months of burning fever. It may
not save you of, perhaps, a funeral,
but it could have saved you all.
Talk Health. The dreary, never-changing
tale
Of mortal maladies is worn and stale.
You cannot charm or interest or
please
By harping on that minor chord
—
disease.
"Whatever the weather may be," says
he—
"Whatever the weather may be,
It's the songs you sing and the smiles
you wear,
That's a-making the sun shine every-where."
HOT WEATHER HEALTH
How to Keep Cool, Comfortable, and
Healthy During Hot Weather
OON'T dread or worry about the
__ hot weather. That makes its
"^ coming all the worse. Recognize
that it is coming, then get ready for it.
Much can be gained by really get-ting
ready for hot weather. For in-stance,
did it ever occur to you what a
tremendous drain it is on your nerve
force, in other words, your "pep," in
hot weather to be bothered with house
flies crawling over and tickling your
anatomy by day, to say nothing of the
mosquitoes by night? Without screens
flies materially disturb one's rest or
prevent us from getting our full eight
hours sleep each day. To successfully
battle against hot weather requires
that we get a full eight hours good
sleep out of every twenty-four, and if
this is shortened or disturbed by flies,
even this handicap may be enough to
spell the difference between health and
sickness during the hot weather. Good
screens or even mosquito netting at
every door and window would solve
this problem for the entire family all
summer long. Furthermore, if good
wire screens are installed they may
confidentally be expected to last for
five to ten years.
Now one more word about that "full
eight hours of good sleep." You can
hardly expect to be living, working,
and feeling at your best if you have to
retire to a hot, stuffy bedroom with one
or two small windows where it is so
hot you have to swelter for hours until
it cools off enough to permit you to
get to sleep, only to have to get up
before you have been fully refreshed.
The remedy is simple: Knock out one
or two sides of your old-fashioned
room and replace them with windows.
Then you'll have a modern sleeping-porch,
and then you will be able to
sleep in comfort and rise in the morn-
SCREENS WOULD SAVE ALL THIS, AND MORE.
ing feeling like the proverbial "two-year-
old." Just before retiring, a tem-perate
or cool bath about seventy-five
to eighty-five degrees forms a splendid
"night cap" after a hot day. It is a
splendid introduction to a good night's
sleep, although many find a cool bath,
plunge or dip in the morning as an
"eye-opener" even more to the point
to start the day off right. At all
events, get a bath every day at least
in summer.
What one eats and drinks has a lot
THE HEALTH BULLETIN 111
to do with the way one feels during
hot weather. Fat meats, concentrated
foods, and heat and energy producing
foods were certainly not intended for
summer use. This is the time to elimi-nate
meats and heat and energy foods,
or at least reduce them to a minimum
and live on fruits and vegetables.
Learn to eat "greens" and all kinds of
THE BEST KIND OF A
NIGHT-CAP
OR AN
EYE-OPENER
TOR HOT WEATHER
"garden sas." Keep the bowels moving
freely at least once or twice a day by
means of a fruit and vegetable diet,
lots of cool (not cold) drinking water,
and a little bran gruel, if necessary.
Avoid the ice-cold soft drinks of all
kinds. "Adam's ale," the pure, unadul-terated
kind and in large quantities, is
far better.
Don't overdress in summer. Save
your clothes for winter wear. A bit of
good summer advice along this line is
to wear as little as the law of the land
will allow, and that is mighty little
these days—equal rights for men.
Much of our summer discomfort may
be avoided by the proper planning of
our work. By a little forethought house-wives
can arrange to minimize the
time spent over a hot kitchen stove,
and do much of the ironing, preparing
of vegetables, sewing, etc., on a shady
porch or in the breezy, fresh air. Work
that has to be done in hot places can
usually be done during the coolest
parts of the day.
Finally, one should not try to go
through a summer physically handi-capped
in any way, unless absolutely
necessary. Life is rough enough and
hard enough in places, anyway, with-out
having to bear any unnecessary
physical ills. For any person to ex-pect
to keep up, to say nothing of win-ning,
in this fierce race of life while
handicapped by some physical dis-order,
is the height of folly. It is just
as impossible and as ridiculous for a
man or woman to try to live up to his
rated efficiency while handicapped by
bad teeth, constipation, or any one or
more of a score of needless ailments,
as it is to expect a horse to win a
race on three legs or an automobile
"hitting on three cylinders." Get fixed
up. Go to the best doctor you can find,
put your case entirely in his hands.
Have him find out what is wrong with
you. In the vast majority of cases it
will probably be some simple living
habit. Correct that habit, hit on all
four cylinders, and you will be sur-prised
to see how work and difficulties
disappear before you and how much
real comfort and joy there is in life in
the Good Old Summer Time.
A healthful, well balanced diet calls
for a liberal allowance of vegetables.
This is why, both for health and
economy's sake, we should plant gar-dens.
If people all over the country
will only plant gardens and not be
so largely dependent on city markets
for their table vegetables, not only will
there be a big reduction in prices, but
a correspondingly big increase in the
good health and happiness of the peo-ple
generally.
112 THE HEALTH BULLETIN
RHEUMATISM A PREVENT-ABLE
DISEASE
Pus Poisoning From Teeth, Gums or
Tonsils Often the Source
of Infection
By EDWARD J. WOOD, M.D., Wilmington
Y focal infection is meant an ac-cumulation
of pus somewhere in
the body which is discharged into
the circulation, producing certain
damaging changes to vulnerable parts.
All tissues of the body are not equally
resistant to this pus poisoning. The
parts which are more apt to suffer are
the lining membrane of the heart, in-cluding
the valves, the kidneys, and
the joints. Recently it has been found
that the heart muscle is often danger-ously
affected by infections of this
kind without producing any visible
signs for the doctor to observe until
the damage is beyond repair.
One Cure for Rheumatism
Dr. Osier said only a few years ago
that rheumatism was a reproach to
the medical profession because no
progress had been made in the dis-covery
of its cause; hence, no remedy
could be intelligently applied. But
today any case of rheumatism calls for
a searching investigation on the part
of the physician, for there is locked up
somewhere in the body one or more
pockets of pus which must be removed
to prevent a further rheumatic in-volvement
and also to cure the present
trouble. All of the hitherto used rem-edies
for rheumatism only relieved ant"
never cured. There can be only one
cure, and that calls possibly for the
combined attack of a good nose ant"
throat specialist, a modern dentist who
works for a higher purpose than the
outward appearance of the teeth and
who will intelligently use the help of
the X-ray when needed, and a con-scientious
physician who is not content
to have as the rule of professional ac-tivity,
"What is to be must be." If the
physician does his part the patient will
be directed to the proper dentist and
the proper nose and throat man,
their findings will be brought together
in an intelligent manner and the pa-tient
will find relief.
The reader will be impressed with
the expensive nature of this investi-gation.
If the patient lives in the
country, it becomes necessary to gc
to the city for the X-ray part of the
work, at least. While it is costly, it is
much cheaper than the numerous se-cret
remedies advertised, and which
will only relieve pain at best, and that
often at the expense of kidney irrita-tion
or heart depression
Toothbrush and Dentist Best
Preventives
It would be far better to prevent all
of this trouble, and it can be in the
next generation, by a little education,
which had better be done in the public
schools. The one preventive measure
above all others is the use of the tooth-brush.
Like all other things, the use
of the toothbrush must be made care-fully
and thoroughly and the child
must not be expected to have been
born with a knowledge of its use.
Many people think that the use of a
toothbrush is a part of respectability.
While this may be true, from a med-ical
point of view, the average tooth-brush
used in my practice is almost
worse than nothing at all. The tooth-brush
has only a limited life, and it is
worse than useless after it is worn out.
Again, a toothbrush to retain its stiff-ness
must be dried out between usings,
and should, therefore, not be kept in
a toothbrush container. Each indi-vidual
should have two or more of
these useful articles in constant use
and should be careful to use them in
rotation in order to favor drying and
a return of the normal stiffness of the
THE HEALTH BULLETIN 113
bristles. But, in spite of all this, the
individual must not expect to keep
the mouth normal without the help of
a competent, conscientious, patient
dentist, who is not too busy or too
prosperous to have time to practice
preventive dentistry. Everyone should
visit such a dentist every three or six
months and have him carefully ex-amine
every tooth. If there are no
cavities, he will, at least, clean the
teeth of the deposit known commonly
as tartar, which cannot be removed
except with a sharp instrument, which
must be applied skilfully even below
the gum. This is sometimes called
scaling. If the teeth are kept dentally
clean by this scaling process, as deep
down as the dentist finds necessary,
pyorrhea or Rigg's disease will soon
become a negligible factor. The idea
in the minds of the laity that the use
of the ipecac preparations, as emetine,
by the mouth or hypodermically will
prevent and cure this gum condition
is very fallacious. Without the dental
cleaning of the teeth such a drug is
entirely wasted and should never be
used except by the dentist's advice as
an aid to what he will do with his
instruments.
As a physician it is now my custom
to begin all examinations with an ex-amination
of the teeth. It is often a
very embarrassing duty to have to tell
intelligent patients that their mouths
are dirty, uncared for by themselves,
and needing dental treatment. It is
surprising to find how few well
dressed people are acquainted with the
personal touch of the toothbrush.
Tonsils Often Source of Infection
The next important focus of this
kind of infection is the tonsils. Many
tonsils that apparently are normal or
that cannot be seen on the ordinary
examination are "submerged," and
when drawn out by the throat spec-ialist's
instrument are found to be
exuding pus. Such tonsils probably
cause more trouble than the large
tonsils, which are usually removed.
A case recently under my care was
strongly suspected of tuberculosis, but
after the removal of the tonsils the
little fever immediately ceased and
the patient is now well. Tonsils are
•very important in any study of the
source of rheumatism, heart disease,
or kidney disease. I recently had
under my care two young women with
acute Bright's disease which had its
origin in infection of the tonsils.
There are other cavities in the head
which become infected, especially after
colds, which may be the sources ol
focal infections and require expert
attention. Anything but the best at-tention
in such cases is worse than
useless. Fortunately for most of us
this is the least common source of
trouble. It emphasizes the real need
for a more thoughtful consideration of
the danger of colds. Colds lower the
resistance and prepare the way for
many infections. Many focal infec-tions
would be prevented if we would
protect ourselves from colds.
There are other sources of focal in-fection
to be found in certain cases,
but these cannot concern us here ex-cept
in a general way. The public
must learn that rheumatism is a pre-ventable
disease; that the doctor must
find the focus or direct them to some
place where the investigation can be
made; that the charge so often made
that this new teaching is a fad had
better be suspended until a fair trial
is made.
In conclusion, let me say that no sin-gle
development in medicine and hy-giene
can rank in importance with
this. It opens up a new field which
will almost immediately increase the
normal expectation of life. By this
means it is reasonable to expect a
marked decrease in rheumatism, in
heart disease, in Bright's disease, and
in other conditions. Many cases of
114 THE HEALTH BULLETIN
neurasthenia or nervous prostration
are curable by this means and still
more cases of neuralgia and eye strain
cease to exist after the patient has
been conscientiously studied in this
way.
THE TEACHER'S PART IN MEDI-CAL
INSPECTION OF SCHOOLS
Sometime ago when a physician was
explaining the few simple but im-portant
items which relate to the
teacher's part in the medical inspec-tion
of schools under the law enacted
by the General Assembly of 1917, a
teacher was overheard to remark in a
loud whisper, "Who is going to pay
the teacher for this?" That teacher
has been teaching for twenty-two
years, and has never taught more than
five months in any one year, and her
highest salary at any time has been
forty dollars per month. She has prob-ably
been paid entirely too much for
the service rendered, if that sp