Health bulletin

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jOSfePH RUZtGR*
BOOHBIMO€RS
This booh must not
be taken from the
Library building.
LUNC-15M N.36
OP-13370
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BETTER BABIES SPEC
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Putli5\edb4 TnZ./^°KjnCAR9LI/^A STATE. D°ARDs^AE^LTA
I This Bullelirv will be 5er\t free to arwj citizeiA of the State upo:\reque5t. |
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Entered as second-class matter at Post Office at Raleigh, N. C, under Act of July 16, 1891/.
Vol. XXVIII. SEPTEMBER, 1913. No. 6.
COLORADO PRIZE WINNERS, 1912.
Watch this page for the North Carolina Champions, after the State Fair.
CONTENTS
Health axd Public Health Brevities 99
Better Babies ix Xorth Carolina 100
Watch Your Nursemaids 104
We Want to Help You 104
Feeding Sick Babies 105
How ASHEVILLE DoES It 106
Good Well Water 107
Mosquito Warfare in Panama 109
The Care of Milk in the Home Ill
AVhat Berlin Did, We Can Do 112
The Last Word 112
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 post-card will bring it by return
mail.
Medical Inspection of Schools and School Children.
Care and Feeding of Babies.
The Plague of Flies and Mosquitoes.
Residential Sewage Disposal Plants.
Sanitary Privy.
Hookworm Disease.
Malaria.
Tuberculosis Leaflet.
Compilation of Public Health Laws of North Caro-lina.
20. Tuberculosis Bulletin.
Fly Leaflet.
Baby Leaflet.
The Vital Statistics Law.
The Whole-time County Health Officer.
Anti-Spitting Placards ( ii inches by 9 inches).
Anti-Fly Placards ( ii inches iw lo'^inches).
No.
l-£j| | PUBLI5AE:D BYTML HOR-TM CAIgOLIhA 5TATL BQAI^D °^M&ALTM I El
J. Howell Way, M.D., President, Waynesville.
Richard H. Lewis, M.D., Raleigh.
J. L. Ludlow, C.E., Winston-Salem.
W. O. Spencer, M.D., Winston-Salem.
Thom.\s E. Ander.son, M.D., Statesville.
Charles O'H. Laughinghocse, M.D.
Greenville.
Edward J. Wood, M.D., Wilmington.
A. A. Kent, M.D., Lenoir.
Cyrus Thompson, M.D., Jacksonville.
W. S. Rankin, M.D., Secretary and Treasurer, Raleigii.
Vol. xxvm. SEPTEMBER, 1913. No. 6.
HEALTH AND PUBLIC HEALTH BREVITIES.
Dou"t miss the Better Babies Cox-test
at the State Fair. — —
To get some good, first-class health
literature free, see the opposite page.
—o
—
Over .$300 iu prizes for the best North
Carolina babies at the Fair. Enter
your baby. There are no entry fees.
For the elementary principles of
healtli and sanitation on the farm, see
the public health exhibit at the State
Fair. October 20th to 2.jth.
—o^
Th^> Better Babies Contest and the
PrBLic Health Exhibit will be two of
the biggest features of the State Fair
this year. —o
Thirty-three states make tuberculosis
a reportable disease. I.sn't it about
time for North Carolina to join the riro-cession?
—o
—
The liveliest thing at the State Fair
—the Better Babies Contest. Don't
miss it. It will beat the Midway any
day—and it's free.
August and September form low
water-mark for pneumonia. From Sep-tember
on to February the pneumonia
death rate goes up—because our win-dows
go down. Live, work, and sleep
in the fresh air. and avoid pneiiraonia,
colds, grip, and tuberculosis.
On dressing for hot weather, the
Chicago Health Department says
"Wear as little clothing as the law of
the land will permit—that's mighty
little these days. 'Equal rights for
men.' " _^_
Would you like to know if your child
has hookworms? The State Board of
Health will tell you free. Write them,
stating that you want a specimen con-tainer
for hookworm examination.
— —
Any one suspecting tuberculosis
should consult his family doctor at once.
If thought necessary, the doctor can
have a sample of sputum examined for
tuberculosis germs at the State Lab-oratory
of Hygiene free of charge.
—o
—
True civilization and refinement in a
town, community, or individual family
can be judged very closely by the way
they handle their own filth. If they
have the antiquated, open, insanitary
privies, or no privies at all, and no
screen doors or windows, they are about
at the bottom of the scale. If they have
screen doors and windows, they have
movetl up quite a bit: and if they have
abolished privies altogether, or use san-itary
privies and screens at their doors,
they have passetl the selfish stage and
recognize that they are their brother's
keeper. Where are you on this scale?
BETTER BABIES IN NORTH CAROLINA.
Each Year the Old North State Raises Better Cotton, Better Tobacco, Better
Horses, and Better Cattle—and Why Not Better Babies?
Warren H. Booker, C.E., Assistant Secretary.
Koi-th Carolina neglects her best
crop. Yes, just that. Every year we
have our county and state fairs; we
have our Agricultural Department with
scores of experts, test farms and ex-periment
stations, and our agricultural
colleges filled to overflowing; we have
our farmers' institutes, and the best
farm paper in the United States. We
have all these, and why? In order to
make two bales of cotton grow on an
acre that formerly produced but one;
in order to produce good cattle instead
of scalawags, and thoroughbred Berk-shires
and Poland-Chinas instead of
razorbacks and elm peelers.
But North Carolina's best crop is
never mentioned. No one ever dreamed
of holding institutes to teach fathers
and mothers how to raise better,
healthier babies. We have no schools
or colleges teaching such subjects. We
have no papers or magazines on this
subject. In fact, all we have ever done
was to have an occasional beauty show
at the fair. That was a joke. No one
ever knew a thing more about how to
raise a better, healthier baby, or how
to improve those they already had.
after attending such a beauty .show,
than they did before.
Now, all this is going to be changed.
The North Carolina mothers have said
so ; the State Fair Association has said
A Sound Chest is a Valuable Asset.
Broad, Deep Chests Are Fine, But
—
so; and the State Board of Health is
going to back them up and cooperate
with the mothers of the State and with
the State Fair Association, and hold
North Carolina's first great Better
Babies Contest at the State Fair in
October.
OVER $300 IN CASH PRIZES.
The contest will be under the direct
management and control of the State
Board of Health. It will not be a
beauty show in any sense of the word.
It will be a health contest, out and
out. Neither grandfathers nor grand-mothers,
town mayors, congressmen
nor politicians will be allowed to pat
babies' dimples, kiss them on the mouth,
or vote for the prettiest child. On the
other hand, a corps of the best doctors
and children's specialists in the State
will be on hand to score the babies on
a score-card in much the same way as
the horsemen and cattle judges will
THE HEALTH BULLETIX. 101
GETTING THE CORRECT HEIGHT.
Height and Weight Should Conform With Age.
$50. It took quite a bit of work to
raise this $150 iu order to secure the
$100, but the State Board of Health
did not stop there. It went on, and is
still collecting funds for prizes, and be-fore
the contest is held it hopes to have
a considerably larger fund for tliis
purpose.
JUDGING THE BABIES.
Lots of interest centers around just
how the babies will be judged or scored.
Space will not permit us to explain the
whole matter in detail, but the general
plan will be as follows
The contest will be held October
20th to 25th. at the State Fair Grounds
at Raleigh, in the east wing of Floral
Hall. At the appointed day and hour
the mother will bring the baby to the
large, comfortable reception room,
where a reception committee of ladies
interested in the babies and their moth-ers
will meet the babies, learn the name,
age. and sex of each one. and fill out
They Must Not be Flat or Pigeon-breasted.
score the horses and cattle. The baby"s
age will be noted, then he will be
weighed, measured, and carefully ex-amined,
and, above all things else, these
doctors will point out to the mothers
and fathers just what goes to make
a perfect baby. They will show why
the baby scores high here and low there,
and just how to remedy any defects.
Then, best of all, there will be the
prizes. Of course, the prize for the
best baby will not be so large this year
as it will be for the best horse or cow
or hog. One could scarcely expect that
the first year ; but next year, when
North Carolinians begin to appreciate
that a third or fourth prize baby is
worth more than the best race-horse on
the track, the adjustment of prizes will
be different. This year the Woman's
Home Companion offered $100. provided
the State Fair Association would raise
$100, and provided further that the
women's clubs of the State would raise Surveying Osier's "Mason and Olxon
Line."
102 THE HEALTH BULLETIN,
A Perfect Baby Must be Well Proportioned
as to Height, Lengtii of Arms, and
Length of Legs.
the score-card sbowing these facts, also
tlie name and address of the father
and mother, whether the baby has been
breast-fed or bottle-fed, whether or not
it sleeps alone, whether or not it sleeps
in a room with windows open, etc.
From the reception room the baby
and mother will enter a quiet room
where a doctor will test the child men-tally
according to its age. For instance,
a child of six months should sit alone,
play with simple objects like a pencil
or spoon, look in the direction of unex-pected
noises, etc., while a child of two
years should run, join words to make
short sentences, be able to point to eyes,
nose, ears, etc.. and so on. If baby
meets all these conditions, he will be
scored 100. or perfect.
WEIGHTS AND MEASURES.
From the mental test room the mother
and baby will be conducted to a meas-uring
room. Here a doctor and a trained
nurse will carefully weigh and meas-ure
the baby. A table of standards
has already been provided for babies
of different ages. Baby's height will
be measure<l. and his chest measure-ments
and other measurements taken,
and he will be graded accordingly.
PHYSICAL EXAMINATION.
From the weighing and measuring
room the mother an<l child will be taken
to the last examination room. Here
trained specialists will make careful
physical examinations of the baby from
head to foot. They will examine his
teeth, his eyes, ears, nose, throat, and
every possible detail that goes to make
up a perfectly healthy, normal baby.
Furthermore, these meflical experts will
point out to fathers and mothers any
physical defects or tendencies, and in-form
them, free of charge, how to rera-etly
or overcome these defects by proper
care of the baby.
PUBLIC HEALTH EXHIBIT.
Nor is that all. For the first time
in its history, the State Board of Health
will hold a public health exhibit, show-ing
the most approved forms of sanita-tion
so far as the care of babies is con-cerned.
There will also be a general
exhibit on a lot of other public health
subjects, such as tuberculosis, typhoid,
malaria, hookworm disease, etc. The
Board will devote a considerable
amount of time, money, and energy to
getting up the best public health ex-hibit
ever shown in this State, if not
in the South. The opportunity of
studying the cheap, practical, home-made
models of every-day sanitation
will be well worth a trip to the Fair,
to say nothing of the other features.
The object of the exhibit will l;e to
Better Babies Must Have Good Under-pinning.
They Have a Long Road
to Travel.
THE HEALTH BULLETIX. 103
briug mcKleni sanitation down to prac-tical,
every-day life. Don't miss it. It
will be next to the Better Babies Con-test.
ABOUT THE PRIZES.
The matter of prizes has not been
fully decided as yet. There will be
classes for rural babies and city babies,
and these classes will probably also be
arranged according to ages, say from
six months to twenty-four months, and
from twenty-four months to thirty-six
months. The classes will probably also
be divided into classes for boys and
classes for girls. There will probably
also be sweepstakes and special prizes
for the best boy and the best girl of
any class. In each class there will
probably be a first, second, third, and
fourth prize. A special committee will
decide later in regard to the number
and value of the prizes, and due an-nouncement
will be made in the next
number of The Health Bllletix.
Every effort is being made to make
The Better Babies Contest as pleasant
and comfortable for the babies and
their parents as possible. Besides the
large reception room, the Board will
endeavor to have tents erected for rest
rooms for mothers and babies. Cots
Gocd Teeth, Good Tonsils, and a Clean
Tongue Make for Better Babies.
Sore or Swollen "Kernels" May indicate a
Disposition to Contract Disease.
will be provided for sleepy babies, and
trained nurses will be left in charge of
the babies while the mothers go about
seeing the rest of the Fair.
HOW TO ENTER.
Parents wishing to enter their babies
in the contest will file their application
with the State Board of Health before
October Irith—the earlier the better-
No charge or entry fee will be required.
The parents will also state the day on
which they expect to attend the Fair^
so that the Board can arrange a con-venient
hour for the judges and the
baby.
Kemember that Wed)iesday will prob-ably
be a better day than Thursday or
Friday, and Tuesday will probably Be
the best day of all. so far as conveni-ence
and the comfort of the baby is
concerned.
Apiilications for entry will be filed
in order, and iireference in regard to
time of examinations will be given early
npplicanrs. For this reason it is best
to make your entry application early^,.
even though you should later find it
impossible to have the baby there. Ap-plications
are already coming in, and
if you make your entry application at
once, so much the better.
Home^cJmpailon^^
°^ ^^'' ^''"'="''' ''"^' ^^^ ^"'« illustrating this article are used by courtesy Womar.
104 THE HEALTH BULLETIN.
WATCH YOUR NURSEMAIDS.
Warren H. Booker, C
Nursemaids are a very potent health
factor in child life. Children's dis-eases
are frequently conveyed by them,
and sometimes diseases more far-reach-ing
are directly chargeable to ignor-ant,
careless, or diseased nurses. This
is particularly true in the South, where
colored women do much of the nursing.
Perhaps the only reason we do not
have more crimes of preventable dis-eases
charged up to careless, ignorant.
or diseased nurses is that, as a rule.
it is very hard to determine the exact
source, cause, or occasion wherein a
case of preventable sickness was con-tracted.
In May, 1912, however, in a
large children's home, a nurse having
tuberculosis was given charge of a ward
of ten small infants ranging from two
to four years of age. All ten of these
children had been tested for tubercu-losis
the month before this nursemaid
took charge, and it was then found that
three out of the ten had been previously
infected with tuberculosis, but were not
in an active stage of the disease at that
time.
It was noticed within six weeks
after employing this nurse that she had
tuberculosis, and she was promptly re-moved
on the first of July, and the
children again examined, but only the
same three responded to the test.
Three months later, however, the chil-dren
were again examined, and it was
E., Assistant Secretary.
found at that time that tubercular in-fection
had developed sufficiently in
every case to be recognized by the tu-berculin
test. These children could not
have contracted tuberculosis from any
one else except the tuberculous nurse-maid,
as she was the only person that
came in contact with them. Even their
milk supply was Pasteurized by heating
to l-iS F. for 45 minutes to kill any
tubercular infection from the cows.
It should be noted that there were
nearly three hundred children in this
institution, and it was found that this
was the only tuberculous nurse present.
It was also found that the children
under this particular nurse were the
only ones to develop tubercular infec-tion
after coming to the institution.
All this goes to show the grave danger
of infecting our children by means of
nursemaids.
Fortunately, these early tubercular
infections are, as a rule, readily over-come
by children, but not always, as
is shown by the records of deaths from
tuberculosis among children. The les-son
to be borne in mind is the possi-bility
and the danger of having our
little ones and our loved ones infected
by a race of people having three times
the amount of tuberculosis that white
people have, as well as a great excess of
certain other preventable diseases, to
say nothing of the loathsome venereal
diseases.
WE WANT TO HELP YOU.
Warren H. Booker, C
Miss Teacher, Mrs. Club Woman.
Messrs. Preachers and all other Public-
Spirited Citizens, we want to help you.
Will you let us?
Here is one way in which the State
Board of Health can help you in your
school, church, and community work.
We have just secured two sets of lan-tern
slides, with lectures already writ-
E., Assistant Secretary.
ten out to accompany them. One of
the lectures is on tuberculosis and is
well adapted for any mixed audience,
while the other lecture is on the general
subject of health, the teeth, voice, hear-ing,
and sight. It is especially adapted
for schools, and for work on the medi-cal
inspection of school children.
Anv one can "deliver" or read one of
THE HEALTH BULLETI^'. 105
these stock lectures while some oue
else operates the slides in any ordinary
stereopticon lantern.
The State Board of Health offers to
loan these slides and lectures free of
charge to any school, church, club, or-ganization,
or public-spirited citizen
who will agree to give a lecture from
them, provided they pay the express
charges to their town. Then they may
hold the slides and lecture until we
send them an order requesting that
they be shipped to some one else.
Besides the slides and lectures, this
Board will also send you special bulle-tins
to help you get posted on the sub-ject
on which you expect to lecture, and
a limited quantity of various kinds of
public health leaflets which may be dis-tributed
among the audience after the
lecture.
Here is a golden opportunity for any
one at all interested in giving his club,
church, or community an entertaining
and instructive lecture.
Our church people are beginning to
have more compassion on their over-worked
preachers, and are giving them
more generous vacations. Laymen who
relieve the regular minister should find
these lectures an excellent method of
continuing the regular meetings.
Health work, after all, is only one
phase of Christian activity, and if the
lecturer wants to add more religion to
his lecture, let him draw lessons from
the life of the Great Physician, or let
him teach modern sanitation from the
Book of Deuteronomy.
Doctors usually make excellent peo-ple
to deliver such lectures. However,
on account of the delicacy of medical
ethics and on account of the difficulty
in getting a good audience to an ordi-nary
lecture, doctors thus far have
not, as a rule, volunteered to give
health lectures as freely as they might.
But if some church, school, or public-spirited
citizen will invite a doctor to
give one of these illustrated lectures
there will be little danger of his not
accepting the invitation. Try it once.
To secure these slides and lectures.
write the State Board of Health, Ra-leigh.
Do not announce the date for a
lecture until you find out when you
can get the slides.
If the idea proves popular, the Board
will be glad ro add several more sets of
slides and lectures on different sub-
.iects, and possibly for those communi-ties
not having ready access to stere-opticon
lanterns the Board may later
secure one or more traveling lanterns
to loan out with the slides. Let us
know how the idea appeals to you.
FEEDING SICK BABIES.
If it were possible to obtain an accu-rate
record of baby sickness, it would
be found that many babies get sick in
June and the early part of July, though
the baby death i-ate does not begin to
show much rise until after the middle
of the latter month.
The asylums, sanitaria, hospitals, and
baby tents find that the children who
are severely sick in midsummer give a
history of mild sickness in the early
summer. It is the old. old story of the
"stitch in time saving nine."
Loose bowels, green stools, mucus,
and blood cannot be neglected with any
degree of safety after June 15th in this
climate and June 1st in warmer cli-mates.
The child may seem to be happy,
not upset by the little indigestion, and
it may seem useless to worry about so
trifling a matter. But. unless these
trifles are attended to. things will get
worse as the weather gets hotter, and.
presently, the baby is in a condition
where no food seems to agree with it
and no doctor seems to help it. The
106 THE HEALTH BULLETIN.
mother must carry on her loug. weary
fight to keep the jioor, skinuy baby alive
until the nights get cool in October.
The first thing to do when the baby
gets sick is to stop feeding it. Trobably
The milk is bad anyhow. But. whether
it be good or bad, it will disagree with
a sick baby. In place of milk the baby
should take clean water from a clean
bottle or a clean cup. If the trouble
keeps up there are milk substitutes
which can be given until it is safe to
give milk again. The physician or nurse
will demonstrate how these are made.
The next step, after str>iiiiing the food,
is to empty the child's intestines of all
fermenting, decomposing food. The par-ent
is justified in going as far in this
line as the use of oil by the mouth and
of simple enemas by injection. If re-lief
does not come when these have
acted, the mother is not justified in go-ing
further. She should get help from
a physician or nurse. Caring for a sick
baby is so largely '"doing and showing,"
as contrasted with "telling," that a
nurse is needed more than would usu-ally
be the case.
As the child goes back on milk, let it
be watered milk or good buttermilk. If
the first feeding agrees, let the next be
slightly less watered, and the next still
less, until within a few days the diet is
one proper for the age and the season of
the year. Occasionally a mother contin-ues
to give watery milk after the acute
trouble has subsided and the baby in a
few weeks shows signs of starvation.
Remember—a baby with indigestion
can be starved by overfeeding. The in-digestion
passed, it may be starved by
underfeeding.
—
Dr. W. A. Evans in The
Chicafio Trihvne.
HOW ASHEVILLE DOES IT.
When a case of typhoid fever occurs
in Asheville. the dairyman delivering
milk to the afflictetl family is immedi-ately
notified of the fact. That is usu-ally
enough to make the dairyman feel
that to some extent his dairy is charged
up with the case, until it is proven that
no further cases occur on his route or
that the first case was due to something
else.
Furthermore, the dairyman is not
allowed to remove milk bottles from the
premises of the sick person until the
bottles have been sterilized by the
health department. This is a very wise
provision, because typhoid germs grow
very rapidly in milk, and if the milk
bottle should become accidentally con-taminated
with typhoid germs in the
typhoid-stricken home the dairyman
might contaminate his other bottles and
cans in the course of ordinary washing
and spread the disease to the rest of his
customers. This is a very good pre-caution.
What is the policy of your
town is this matter?—w. h. b.
.Jesus was rebuked in the elder day
for healing an infirm man on the Sab-bath.
And those who rebuked Him
thought it perfectly all right to save a
sheep on the Sabbath. The sheep was
a piece of property. It was money, it
was value. "How much better is a man
than a sheep?" He asked, and the doc-tors,
the reformers, the cranks, have
been thundering that to the multitude
ever since, and the multitude has begun
to listeii. Within our own day, we have
seen legislatures appropriate more for
hog serum than for tuberculosis, more
for the hog than for the human; but a
man is getting to be worth as much as
a hog in this State, and he is going to
be worth more.—ir. T. Bost in The
Xeics and Observer.
THE HEALTH BI'LLETIX. 107
GOOD WELL WATER.
Warren H. Booker, C
Good, wholesome driuking-water is a
fimdameutal of life aud liealth. Judg-ing
from analyses of private well water
at the State Laboratory of Hygiene, one
would think good well water was a lux-ury
in North Carolina. Only 17 per
cent, or one out of six. of all the huu-dretls
of ordinary, open-top bucket wells
were found to furnish water safe for
drinking. Of the wells with pumps it
was found that 63 per cent, or four
times as many, furnished water fit for
human use. Only about 36 per cent of
the private spring supplies are found
safe. All this is an unfortunate, dan-gerous,
and disgraceful condition, par-ticularly
among our rural folk. A
great deal of this trouble can be easily
avoided by observing the following pre-cautions.
The purity of a water is a very de-ceiving
thing. We can frequently tell
whether or not food is wholesome by
looking at it, by smelling it. or tasting
it; but not so with water. Looks, taste,
and smell count for little. Water laden
with germs of typhoid, cholera, or diar-rheal
diseases may be perfectly clear,
tasteless, and odorless. The only way to
tell bad water is to have a chemical
and bacterial examination made of it.
giving the person examining the water
all the information available as to how,
when, and where the sample was col-lected,
and a description of the sur-roundings
of the well or spring. The
distance from privies, stables, etc..
should be given, also the direction of
the surface drainage with reference to
the well, and the methorl of covering
and protecting the top of the well.
What most of us are interested in is
how to get a well of good, wholesome
water, and then l^eep it good. Be'-ause
a well water is wholesome to-day is no
reason why it may not be dangerously
polluted next month or next year. A
well once polluted is iilwa.vs uncertain.
The water may beronie pure or it may
'•niitinne impure. It is like a jierson
E., Assistant Secretary.
that steals. If he steals once, it is
doubtful if he ever jiermanently re-forms,
and we are always uneasy lest
he commit a robbery.
A GOOD WELL LOCATION.
In locating a well use common sense
and foresight. Don't rely on supersti-tions
; they may kill some one with bad
water. Ordinarily, the water in the
ground moves slowly in a direction from
higher ground toward lower ground ; so
be careful not to locate a well so that
the water coming to it will have soaked
through barnyard manure or privy filth
above the well. Wells should, whenever
possible, he located on high ground, well
away from privies, hogpens, and barn-yards.
Wells located on high ground
usually have to be put down somewhat
deeper than wells located on low ground,
but the quality of the water from the
wells on high ground will justify the
extra expense.
Lse foresight and do not locate a well
where it may later become polluted by
privies or other sources of pollution not
under your control.
Never locate a well where the heavi-est
kind of a rain or even a "cloud-burst"
can wash surface material from
the ground into the top of the well. If
there is any possibility of such a thing
hapiiening. grade around the top of the
well so that rain and surface water will
drain 20 or 30 feet away from the well
—the farther the better. This Is very
important.
Never use an open-top well. The.v
are many times moi'e liable to contami-nation
than wells with pumps. Pumps,
either wooden or iron, never injure the
quality of the water or the health of
the users. The more you protect the
top (if the well, the better. Note in the
accompanying illustration how the
walls are laid u]) with cement joints.
The toil of the well is carefully cov-eretl.
cement is jiacked around the toj)
of the well, a trdugh and drain pre-
108 THE HEALTH BULLETIN.
vents waste water from returniug to
the well, and all surface water is
drained away from the well by the
slope of the ground. This is an excel-lent
form of well, and if privies, hog-pens,
etc., are kept away from it and
on lower ground, it should give excel-lent
water.
IMPROVING BAD WELLS.
To make a good well out of a bad one
is a very hard and uncertain job. It is
usually cheaper to locate a new well and
begin all over. Sometimes, by making
the walls water-tight, grading the sur-face
of the ground away from the well,
placing a tight cover over the well,
using a pump, draining the waste
water away, and removing all sources
of pollution, the water may be im-proved
; but the results cannot be guar-anteed.
PROTECTING SPRINGS.
The same general principles apply to
springs that apply to wells, except that,
as a rule, springs are already located.
and we have to leave them where they
are and protect them as best we can.
An excellent way to protect a spring
is to surround it with a cement bowl
or basin and cover it with some close-fitting
lid. This will exclude frogs and
bugs, and also leaves and other debris
frequently blown into oiien springs.
If possible, the water from the spring
should be piped down to the house di-rect.
If this cannot be done, an iron
pipe or terra-cotta pipe should dis-charge
the overflow from the spring so
tnat it can be caught in pails, etc. In
this way promiscuous dipping of cups
and pails into the spring bowl itself
can be avoided.
To protect a spring from surface
drainage, it is an excellent plan to cut
a small ditch around the spring on its
upper side at a distance of some 20 or
30 feet, and drain the surface wash
away from the spring. Live stock
should not be iillowed to pasture for a
distance of at least 100 feet above the
spring, and privies should be kept en-tirely
off the catchment area of small
springs. In the case of large springs,
possible sources of pollution should, as
a general rule, not be allowed within
500 feet above the spring. Ground
above a spring or around a well, if
used for farming, should not be fer-tilized
with barnyard manure, etc.. if
for no other than esthetic reasons.
No definite rule can be laid down as
to a safe distance from a source of
pollution to a well or spring. In sandy
and clayey soils there is less danger
than where rocks, more or less crackel
and seamy, exist a few feet under the
surface. The safest rule is to keep
all sources of pollution as far away
as possible, the farther the better, and
under no circumstances permit them to
exist within one hundred feet of even
a carefully protected well such as
shown in the illustration.
A GOOD FORM FOR A DUG WELL.
Protected from Surface Pollution by a
Good Cover, Well Laid Wall, and a
Trough Which Drains the Waste Water
Away. Note Also the Concrete Around
the Top. and the Direction of Surface
Drainage.
THE HEALTH BULLETIN. 109
MOSQUITO WARFARE IN PANAMA.
How They Fight Mosquitoes to Save Human Lives.
Dr. W. S. Rankin, Secretary.
The Isthmus of I';inama has seen
two great battles. Thirty years ago,
when the French started the Canal, the
mosquitoes undertook to drive out the
invaders, and they did it. The death
rate among the French was 240 per
1,000 annually—a clear-cut victory for
the mosquito. To-day, while the Ameri-cans
are digging the Canal, they are
also making war on the mosquito, and
the mosquito is losing. The present
death rate is only 14 per 1.000. We can
appreciate this better when we remem-ber
that the death rate in North Caro-lina
is about 30 per cent higher, or
something over IS per 1.000.
Methods used in controlling the mos-quito
problem consist of filling and
draining collections of stagnant water
oiling and using larvacide where filling
and draining cannot be employed ; in
screening; in catching mosquitoes by
hand and by traps; and in persuading
people subjected to bites of mosquitoes
to use small doses of quinine daily.
Three to five grains daily will prevent
malaria in a malarial district.
The most permanent method of con-trolling
mosquitoes is the filling or
drainage of stagnant water. This
method attacks the problem from its
very source. It prevents the bree<ling
of the mosquito. To fill up a swamp
is better than to drain it, but much
more expensive. After drainage the
ditches must be kept open and free
from grasses, and oiled frequently.
The cutting and removal of grass from
the ditches in the tropics is no small
part of the mosquito problem.
Where filling in or drainage cannot
he employed, then the only thing to do
is to oil the surface of the water, or
to treat it with some chemical larva-cide
that will kill the young mosqui-toes.
In the tropics they use a cheap
crude oil, which is much better for this
purpose than ordinary kerosene oil.
METHODS OF OILING.
Many interesting ways of applying
oil to water have been devised in the
Canal Zone. It is applied in some
places by men with a spraying appara-tus
fastened on their backs, knapsack
fashion ; in other places, where the
ground is not too soft for the wheels
to leave a track in which stagnant
water could accumulate, it is applied
by an oil cart with a mule hitched to
it and a spraying arrangement at-tached
to the tank on the oil cart. Oil
is applied to the water in small streams
and ditches by placing barrels or gar-bage
cans along the course of the
stream, the number and distance apart
of the barrels and garbage cans de-pending
upon the volume of the stream.
By fixing a spigot in the barrels, the
oil is allowed to fall on the water drop
by drop in such quantities as needed.
Where the amount of water is very
small, as that coming from an ooze on
a hillside, they dip a small roll of cot-ton
waste in the oil and fasten it on
the ground over the ooze.
Where conditions of travel make it
difficult to carry the large amounts of
oil needed, a chemical composed of
crude, cheap, carbolic acid, rosin, and
caustic soda, mixed together, and known
as larvacide, is sprayed upon the stag-nant
water. The larvacide is very
fatal to the young forms of mosqui-toes,
and as it can be used in much
smaller quantities than the oil, it is
more convenient where conditions of
travel make the oiling inconvenient.
An important thing that impresses one
in studying the treatment of stagnant
110 THE HEALTH BULLETIN,
water in tbe tropics bj' the various
methods nientioueti is tbe fact that no
stagnant water, not even small collec-tions
on a hillside a fourth or an
eighth of an inch deep, nor even the
water in a sheep's track, is neglected.
Tbe treatment is complete, and this is
one of tbe important points that the
authorities in tbe Zone make in deal-ing
with tbe mosquito problem.
VALUE OF SCREENS.
If mo.squitoes are allowed to breed,
the malarial death rate can be held
down remarkably low by thoroughly
screening all bouses and by catching
mosquitoes by hand and by traps. The
occurrence of malaria in the screened
section and unscreened section of the
same settlement, both sections of which
are equally exposed to the mosquitoes,
has demonstrated that there is one-third
less malaria in screened than in
unscreened houses. The authorities of
the Zone stress the point that screening
should not be done unless it is done
thoroughly. An imperfectly screened
house frequently serves to admit and
retain the mosquitoes, acting as a trap.
In screening, an IS-mesh copper wire is
used ; a larger mesh will admit of tbe
entrance of certain varieties of mos-quitoes.
The authorities of tbe Canal Zone
think a great deal of catching the mos-quito.
Mosquitoes are caught in two
ways : Wire traps, very much like
some forms of fly traps, are fastened
over the transoms of the doors. To
catch the mosquitoes entering tbe
house, tbe convex part of the trap is
turned in: to catch the mosquitoes
leaving the house the position of tbe
trap is reversed. A still more impor-tant
way than trapping, in catching the
mosquitoes that reach a dwelling, is
by the "band catch." "Hand catching"
as carried out in the Canal Zone is
done by ordinary day laborers. Tbe
mosquitoes are looked for early in the
morning, when they are usually found
on the wire screens trying to get out, or
late in the day in the dark corners of
tbe rooms, under shelving, or behind
l>ictures. Tbe mosquito catcher car-ries
a little bicycle lamp and a cylindri-cal
bottle, about 4 inches deep by an
inch in diameter, with a little piece vf
cotton in the bottom soaked with chlo-roform.
With tbe rays of the light
thrown in tbe dark place he spies the
mosquito on the wall and gradually
slips the mouth of the bottle over the
insect, which soon becomes anesthe-tized
and falls into the bottle. In some
of the temporary camps, where filling
in and draining are too expensive, it
has been possible to bold tbe malarial
death rate down to tbe average preva-lence
in tbe Canal Zone by tbe "hand
catch" method. This demonstrates tbe
importance of this measure in controll-ing
the malarial problem. About ten
times as many mosquitoes are caught
by hand as by traps.
The effect of the mosquito work in
the Canal Zone has been to entirely
eradicate yellow fever, the last case of
which occurred in lOOG. and to reduce
malaria 00 per cent.
As will be apparent to our readers,
many of tbe methods used in the Canal
Zone are applicable to North Carolina,
and many of the methods used by tbe
Canal Zone can be used by the indi-vidual
for bis own and his family's
protection, independently of the iudif-ference
of the municipality in which
be lives to the importance of mosquito
eradication. There are over .oOO deaths
and G.'.OOO to 7.5,000 cases of malaria
every year in North Carolina, nine-tentbs
of which occur in the eastern
half of the State. It is evident that it
is time for our people to begin to take
an interest in tbe mosquito and ma-laria.
i
THE HEALTH BULLETIN. Ill
THE CARE OF MILK IN THE HOME.
Milk is a perishable food. The length
of time it remains sweet depends largely
upon the care it receives after delivery
to the consumer. Keep it clean, cool,
and covered, and it should remain
sweet during the 24 hours in which it
should be used.
Germs, to grow, require three im-portant
things, namely : food, moisture,
and moderate heat. Milk furnishes
footi nnd moisture and the room air
furnishes the necessary warmth. Milk
is therefore a very good medium for
the growth of germs, if not kept cold.
Dust, dirt, and flies are the carriers
through which germs get into milk.
Milk, therefore, should be protected
from dust, dirt, and flies.
Remember : the most important rule
about the care of milk is : keep the
milk clean, Keep it cold, and keep it
covered.
Do not allow milk to stand on the
dumbwaiter, stoop, window-sill, or
other place where the driver leaves it.
Place it promptly in the ice box.
Keep your ice box cold and well
stocked with ice. You cannot obtain
good refrigeration without a well-filled
ice compartment.
Keep your refrigerator clean and
free from disagreeable odors. Milk ab-sorbs
unpleasant odors very readily.
Strong smelling foods, such as onions,
garlic, and strong cheeses, should not be
kept in the same compartment with
milk, butter, or cream.
Where ice boxes are not available,
some makeshift arrangement should be
provided. The following has been rec-ommendetl
"An emergency ice box may lie con-structed
by placing a piece of ice in a
covered tin pail or bucket having a
hole in the bottom. An old leaky pail
will answer.
"Place the bottles of milk in direct
contact with the ice. and cover the
whole with a heavy cloth or blanket.
The pail may be kept in the sink."
Milk inirchased from stores should
be delivered in a clean condition and
at or below .30 degrees F.
Keep the milk prepared for infant
feeding in nursery bottles in the ice
box until just before using. The prac-tice
of heating the baby's milk at even-ing
and keeping it warm until the
night or early morning feeding is very
bad. The heat thus maintained is most
favorable to the growth of germs.
Return promptly to the ice box any
unused portion of milk. Standing in
the warm room will greatly hasten the
growth of germs. Keep the milk tightly
covered, so that dust, dirt, and flies
may not enter.
Wipe the mouth of the bottle care-fully
with a clean towel before re-moving
the cap. Replace the cap im-mediately
after pouring out what milk
is wanted.
Pour the milk into clean receptacles.
Dirty vessels will as readily contami-nate
the milk as will dust. dirt, and
flies.
Place milk dipped from cans or
tanks only in clean covered pails or
other covered receptacles.
Mix the milk well before using. In-verting
the bottle rapidly two or three
times will accomplish this. Cream sepa-rates
and rises to the top, making this
necessary.
Pour only enough milk from the
bottle for the specific use. Do not put
any unused portion back with the milk
from which it was taken, but place it
in the ice box in another covered ves-sel.
Do not keep more than one day's
supply of milk at a time. Order a
fresh supphj daili/.
As a matter of courtesy, at least,
consumers should wash the milk bot-tles
before returning them to the
dealer. In some towns this is required
by law. The proper way to wash a
milk bottle is to first rinse it thoroughly
with cold water. When all the milky
112 THE HEALTH BULLETIN.
film has been removed from the in-side,
then wash carefullj with very
hot water. All vessels used for hold-ing
milk or cream should be cleansed
in the same manner.
Do not use milk bottles for any other
purpose than the holding of milk or
cream.
Pdnse nursery bottles and nipples in
cold water and wash in boiling water
immediately after each feeding. Turn
the nipple inside out and thoroughly
cleanse. Rinse the bottles and nipples
again in boiling water before using.
Remember, above all things, to keep
the milk clean, keep it cold, and keep it
covered.
(From circular issued by the New
York Sanitary Milk Dealers' Associ-ation.)
WHAT BERLIN DID, WE CAN DO.
The death rate of the city of Berlin,
which has a population of over 2,000,-
000, was 17.95 per 1.000 for 1911. In
1877 it was 35 per 1.000, and for the
twenty years preceding that time it had
averaged about 36 or 37. It is apparent
from these figures that the death rate
of Berlin has been cut in half during
the last 34 years, the era coincident
with the development of preventive
medicine. And yet there are people
who are still talking about the "theory
of public health." What is more real,
more vital, than the facts which these
figures demonstrate?
THE LAST WORD.
Some one always has to "get in the
last word." In formal debates it is the
rebuttal speaker. In informal debates
it is usually "the woman in the case."
In this case it seems to devolve upon
the new editor of The Health Bulle-tin.
Next month we shall endeavor to
let some of our readers "have a say"
on this page.
The Secretary of the Board, the
former editor or The Bulletin, has
found that the executive duties of his
office and the demands on his time for
service outside of the office make it
well-nigh impossible for him to find
time to do justice to the work of edit-ing
this Bulletin. This duty has fal-len
to the lot of the Assistant Secre-tary,
who takes up the work with con-siderable
hesitancy and misgiving.
Several changes have been made in tliis
issue of The Bulletin, and of course
we are anxious to know just how our
40.000 readers will like them.
With the next issue we shall en-deavor
to reserve this or a similar
space for "Brickbats and Bouquets"
from our readers. We want to know
just what you want, how you like the
changes, and what your ideas are as
to the most helpful material to be run
in these columns. Of course, we have
some ideas of our own. but we want to
get in touch with your ideas and see
just where we can meet on some com-mon
ground and work together with
the most efficiency.
For this reason we especially invite
criticism of this issue. We want your
suggestions. We want to improve this
Bulletin and make it supply the latest
information on personal health and
public health in a simple, direct, popu-lar
form easily understood by the aver-age
person who has but little time or
inclination to plod through long. hard,
dry, technical articles.
In a nutshell, these are our ideas.
Now what are your views? Let us
hear from you.
^^ COLLECTiONL
ut)Ii5}Yedbij TR£.^°KJACAR9LI/^A 5TATLE)9AR.D s^AmLTA
BulleliiAwillbe -serxt free to arwj citizen of "the StcrteupoAreqaest I
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Entered as second-class matter at Postoffice at Raleigh, N. C, under Act of July 16, 1894.
Vol, XXVIII. OCTOBER, 1913. No. 7.
Better Babies
from other
Southern States
Watch this page for North Carolina Prize Winners after the State Fair. October 20-25
CONTENTS
Bbief a.vd to the Poixt 115
Thk Bettsb Babies Contest 116
NuEsix^G THE Baby 119
Why 1 Ail Down on- Patent Medicines 120
FsEiGHT Rates and the Real Issue 121
Chsonic Constipation 121
i."H?:^j»EB Sanitation 124
What is the Matter With Your Stomach 125
Bbk'kbats and Bouquets 128
FREE PUBLIC HEALTH LITERATURE
The State Board of Health has a limited quantity of health literature on
the eubiects 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 litera-ture,
or want some sent to a friend, just write to the State Board of Health,
at Raleigh. A post-card will bring it by return mail.
No. 9. Medical Inspection of Schools and School Children.
No. 10. Care and Feeding of Babies.
No. 11. The Plague of Flies and Mosquitoes.
No. 12. Residental Sewage Disposal Plants.
No. 13. Sanitary Privy.
No. 14. Hookworm Disease.
No. 15. Malaria.
No. 18. Tuberculosis Leaflet.
No. 19. Compilation of Public Health Laws of North Carolina.
No. 20. Tuberculosis Bulletin.
No. 21. Fly Leaflet.
No. 22. Baby Leaflet.
No. 23. The Vital Statistics Law.
No. 27. The Whole-time County Health Officer.
Anti-Spitting Placards (11 inches by 9 inches).
Anti-Fly Placards (11 inches by 19 inches).
^a^^oiiJMVi^:^^^^'
I PUBLI-SM^D 6YTML nPI^TM CAIgOLIhA 5TATL BOAIgD q^MLALTM i fTl
Vol. XXVIII, OCTOBER, 1913. No. 7.
BRIEF AND TO THE POINT
It is not the babies born, but the
babies saved that count.
—o
—
Good morning! Yes, sir, the big-gest
Better Babies Contest in the
State will be held at the State Fair,
October 20th to 25th. Be there.
— —
Babies from some of the best fam-ilies
in the State are being entered
at the Better Babies Contest—that's
one reason it is called a Better Ba-bies
Contest.
— —
It costs $1,700 to fire some of Secre-tary
Daniels' big guns. It's a pity
a lot of North Carolina counties can't
I
have the price of about two shots to
1 put in a county health officer.
—o
—
You don't need to wait for the new
law requiring the reporting of tuber-
1 culbsis to go into effect. If you have
tuberculosis or know of anyone that
has it, send the name of the patient
in to the State Board of Health, and
the Board will do all it can for you
i until the Bureau of Tuberculosis is
established.
—o—
The Boy Scouts will assist the Ra-leigh
Nurses' Society in rendering
first aid to the sick or injured at the
Fair. An army tent will be provided,
and the lives, health and comfort of
the people will be looked after as
never before.
Health is purchasable. Within nat-ural
limitations a community can
determine its own death rate. — —
Have you entered your baby in the
Better Babies contest? Better get
busy if you want to have any choice
in the matter of time to be judged.
The schedules are filling up rapidly.
—o
—
Right now is a bully good time to
start a campaign for a sanitary privy
ordinance in your town. Have it go
into effect January first, and have no
old, open privies in your town next
summer.
—o
Over .$400 in prizes for Better Ba-bies
at the State Fair, but that is
the least important feature. The in-formation
the children's specialists
v.'ill give the mothers will be worth
ten times the value of the prizes.
— —
If a murderer were slipping up be-nind
you, you would thank somt
friend for telling you in time to make
your escape and reporting the matter
to the police, or would you prefer not
to be told for fear it would scare you
to death? The same thing applies
with reference to tuberculosis. If
you have tuberculosis, the sooner you
are told and the sooner it is reported
to the State Board of Health, the
more chances you have to make your
'get away."
THE BETTER BABIES CONTEST
What it is, How it is Conducted, Prizes Offered, Results Expected
and How to Enter.
Last month we announced the Bet-ter
Babies Contest to be held at the
State Fair October 20th to 25th, under
the direction of the State Board of
Health. This announcement must
have been just what our readers were
looking for. As soon as the Bulletin
went out applications for entries and
inquiries liave poured in at an alarming
rate. They have been coming from
parents, rich and poor, in all stations
of life. We have had to make larger
arrangements at the fair grounds, ar-range
for more judges, provide rest
tents for tired mothers and sleepy ba-bies,
and arrange everything on a
larger scale than at first contempla-ted.
Many inquiries still come in re-garding
the details of scoring and how
the babies are graded. For the bene-fit
of our readers we here give a few
extracts from the score card just to
give an idea of the nature and scope
of the contest.
When the mother and child arrive
they will be received by a doctor and
a lady from the Reception Committee.
The doctor will examine the child for
indications of contagious or infectious
diseases while the lady will proceed
to enroll the child in the contest.
Should any babies be found with con-tagious
diseases it will be necessary
to exclude them from the contest.
The ladies will explain the object
of the contest and any details con-nected
with it. At the same time they
will record the child's name, age,
sex, weight at birth, whether it is
breast fed or bottle fed and on what
foods, frequency of feeding, number
of teeth, whether or not it sleeps
alone, or with the windows open, as
well as the name, age and occupation
of father and mother. All this gives
the physicians a better understanding
of each individual baby.
From the reception room the mother
and child pass to tlie mental test
room. In the accompanying cut is
shown a two-year-old b^'y taking a
Giving a two year old boy a mental test.
mental test. We cannot give all the tests
for the various ages, but as an example
of these tests it may be stated that
a baby twelve months old should be
able to sit alone, stand and walk with
a support, should play with toys, lis-ten
to the ticking of a watch, look in
the direction of unexpected noises,
follow moving objects with his eyes.
He should also speak a word or two,
recognize nis mother (shown by. cry-ing
or uneasiness when taken away
from her) play with other children
THE HEALTH BULLETIN. 117
and be interested in liis surroundings.
He sliould not be highly nervous, ir-ritable
or have an exceeding bad tem-per.
Of course the mental require-ments
will vary for different ages.
This mental test counts 100 points out
of a total of 1,000 for a perfect baby.
After the mental test the baby is
taken to the measurement room
where he is weighed and measured.
ftCNCE OF HEAD
TO -FRONTAL)
UMFEftlNCe
CHEST AT NIPPLt
NE
RCUMFERENCB
F ABDOMEN
AT NAVEL
OF LEG FROM
ROCHANTEI^
" OF FOOT
Where four important measurements are made.
The accompanying cut shows where
four important measurements are
taken. We quote here a few standards
for babies of 6 months, 12 months, 24
months and 36 months of age. The
other ages are in proportion.
The weights and measurements
also count 100 points out of the total
1,000.
From the weighing and measuring
room the baby and mother enter the
last room, where the physical exami-nation
is given. There the doctors
carefully examine baby's eyes, ears.
nose, teeth, throat, chest, abdomen
and in fact every part of the body.
This is by far the most important
examination and counts 800 points
118 THE HEALTH BULLETIN.
these prizes will range from about
$15.00 for the first prize in each class
to about $1.00 for the fourth prize.
Then besides the money prizes there
will be four championship prizes for
the four best babies in the State, boy or
girl any age. These State champion-ship
prizes consist of gold, silver and
bronze medals together with beautiful
certificates of reward. The Woman's
Home Companion is furnishing these
medals and certificates besides $100 in
cash for the other prizes.
Governor Craig has just promised
the managers of the contest that if
possible he will arrange to present the
prizes to the champion babies on Fri-day
afternoon at 4 o'clock, immedi-ately
after the close of the contest.
Entries are pouring in to the office
of the State Board of Health rapidly
and arrangements are being made to
accommodate about one baby every five
minutes. While it will take from 20
to 30 minutes to judge a baby enough
doctors will be provided so that a
baby will be judged every five min-utes.
Two large rest tents with cots
will be provided for the convenience
of the mothers and babies. These
tents will be in charge of trained
nurses and mothers may leave their
babies there in safety while they visit
the fair. Everything possible will be
dune to provide for the health, happi-ness
and comfort of the mothers and
babies.
Many mothers are entering their
babies not so much for the prospect
of winning prizes but as an endorse-ment
of the movement for the satis-faction
of knowing how their babies
compared with other North Carolina
babies and for the benefit of experts'
advice in regard to correcting any
slight defects which may be found.
It is already planned to offer a special
set of prizes next year for the babies
who were entered this year and show
the greatest improvement made dur-ing
the year. To be eligible to enter
that contest it will of course be nec-essary
to enter the present contest.
Entrance to the contest is easy.
All that is necessary is to write the
State Board of Health stating the day
you expect to attend the fair and the
most convenient hour to have the
baby judged. You will then be sent
an entrance card with an appoint-ment
as near the hour mentioned as
it is possible to make it. Then if
you will present the baby and card at
east wing of Floral Hall at the ap-pointed
hour, the baby will be judged
and scored on his physical merits.
"With their parents' consent, some
good, first class babies will be
weighed, measured and examined in
public at the State Fair in order
that the people may see how part
of a Better Babies Contest is held.
How do we get hookworms? Easily
enough. Somebody else who did not
use toilets and sewers or a sanitary
privy polluted the soil. Our barefoot
children soiled their feet in this ma-terial
and a case of "ground itch" de-veloped.
That meant that the little
hookworms from this filth were bur-rowing
their way into the child's sys-tem
at this point. After that, the child
gets tired easily, fails to grow right,
or, if a severe case, it becomes puny
and sickly. To cure and to prevent
hookworm, write the State Board of
Health. _q_
A Toast.
Heard at the Maggots' banquet in the
Manure-Box: Eat, drink and be
merry, for to-morrow we'll be files.
—
Ex.
THE HEALTH BULLETIN. 119
NURSING THE BABY
A baby should always be nursed by
Its mother, unless the mother has
tuberculosis or some other grave dis-ease.
The mother saves herself trou-ble
by nursing her baby. When she
figures up the saving from diminished
illness and adds to it the trouble
of fixing the baby's bottle during
the night as well as the day, she finds
that she nets a gain by nursing her
baby.
During the first two days the baby
should be nursed four times a day
and once at night. From the third
day to six weeks the baby should be
nursed every two hours during the
day and twice at night ; from six weeks
to six months every three hours and
once at night; from six months to a
year, six times between 6 o'clock a. m.
and 10 o'clock p. m., and not at all
during the night.
In addition to milk, babies require
water from the very first. The old
granny who gave the baby teas was
a pretty good scientiest, though she
did not know it. Of course, the herbs
which she used to make the tea had
no particular effect, but she was giv-ing
the baby sterilized, warmed water,
and that was as it should be.
After about the second month the
baby should have some orange juice
every day. The juice should be given
freed from pulp. The amount should
begin with two teaspoonfuls a day
and should be gradually increased to
four tablespoonfuls, especially where
there is a tendency to constipation.
It is much better to relieve constipa-tion
with orange juice than by ene-mas,
and certainly than by medicine,
since babies need a little fruit juice
to correct any tendency to scurvy
and rickets.
That the mother may give enough
milk to supply the baby, it is neces-sary
that she be free from worry and
not called upon to do a great
amount of physical labor. Emotion
has more effect on the secretion ct
milk than does the food taken. Oc-casionally
a woman will overeat un-til
she becomes obese trying to give
milk enough for her baby, and then
worry so, fearing her milk will fail,
that she gains nothing for her trou-ble.
There are no special foods which
make milk. Beer does not; neither
does milk. Some women have the
idea that milk taken as a food run»
without much change Into milk for
the baby. This is not correct. A
mother should eat good, nutritious,
simple, staple food containing a good
deal of fluids.
That which she eats does not go
directly to milk. It is digested and
changed chemically thereby. It Is ob-sorbed
and still further changed
Eventually it is changed Into milk.
She should increase the quantity of
food eaten, since, for her own use,,
she needs more than she usually
does, and, in addition, she is eating;
for the baby.
The average woman nursing out*
baby can supply the child with food
out of her surplus if she will keep
her mind calm, her rest unbroken,
and not have too much work to do.
The average woman who thinks she
cannot nurse her baby can do so if
she will try.—Dr. W. A. Evans, in
Chicago Tribune.
— —
Next year a special set of priaes
goes to those babies who make the
greatest improvement during the year.
Enter the baby this year to get In
on the improvement prizes next year.
A poor baby has the best chance to
win here.
k
120 THE HEALTH BULLETIN.
WHY I AM DOWN ON PATENT MEDICINES
Simply Because They are Expensive and More Likely to do
Harm Than Good.
Mr8. W. N. Hutt, in the Progressive Farmer.
Hardly a week passes that I do not
receive a letter giving simple home
recipes for ailments. I am always
glad to get them and expect to make
use of most of them, as I am filing
them for future reference. In sev-eral
letters I have received are ex-pressions
such as this: "I know of
some good patent medicines, but
since you are down on them you would
not want to hear about them."
Listen. Are you "down on" the
weeds in your garden? Are you "down
on" the lice on your chickens? Are
you "down on" the root-worm in your
corn? No, you are not "down on"
them. You have studied them and
their methods and you know that
they lower the vitality and useful-ness
of the crop. Just so, one of my
purposes in spending those years of
study of domestic science was to gain
a knowledge of the body and the
healthfulness or harmfulness of those
things which affect it, as the farmer
studies those things which affect his
crop. In advertising against the use
of them I am not "down on" them. I
simply recognize their harm as any-one
may do if she cares to read the
literature published by the United
State. Government and the American
Medical Association.
We all recognize the fact that there
is no known drug that will be "sooth-ing
syrup" to the baby except one
which temporarily paralyzes the
brain. We know that the headache
medicines are heart depressants, and
so on through the list. It does not
take much thought to realize that
with each succeeding dose the body
reacts less and less—but how many
have not taken the time to think?
Nor are the patent medicines the
only ones that harm. Turpentine and
sweet spirits of nitre are exceed-ingly
hard on the kidneys. A physi-cian
might have given them to Mrs.
Smith, who recommends them so
highly to you, but he who had made
medicine a study would never in the
world have though of letting you take
them, because your kidneys were not
strong enough for the extra strain.
"But," I hear someone say, "what is
in it is on the outside of the bottle."
Next time you go to town buy the
published ingredients instead of the
medicine and see the result. If by
any chance you should get a similar
result—which you will not—you will
find that paying retail prices, you can
make quarts for the price of a bottle
of the stuff. All the large patent med-icine
makers of whom I know have
grown exceedingly wealthy with dol-lars
from the pockets of country peo-ple.
The point is, let us pay our money
to the physician who knows us and
gives us the results of knowledge in
return for our dollars, but let us also
realize that God gave us the finest
medicines in the world free, air and
water and sunshine, and the oppor-tunity
to study foods, and the intelli-gence
to get them pure and whole-some,
well cooked and well balanced.
Hard work does not kill; hard living
does. Hard living means using the
body badly. Three meals of pig meat
or food cooked in it mean lessened
health and energy; three meals of
pure milk and fresh fruit are good
and medicine and mean increased
health and energy.
THE HEALTH BULLETIN. 121
FREIGHT RATES AND THE REAL ISSUE
On an average, for every death dur-ing
a year, there are two persons sick
throughout the year. Over 40 per
cent of all our deaths are either pre-ventable
or postponable. Therefore, of
our 40,000 North Carolinians who
were last year swept into the great
beyond, something like 16,000 should
be with us today.
No, it is not God's will that we
should let all these our brethren die
needless deaths. Don't blame it on
the Almighty. We are our brother's
keeper. He has given us ample
means of stamping out preventable
disease, but we don't use them. It is
up to us.
We might as well admit the facts.
Here they are: 16,000 North Carolin-ians
are being sacrificed annually on
the altar of ignorance and lethargy.
Within the memory of some of us,
common laborers were bought and
sold for from 750 to $1,500 apiece.
May we assume that the average value
of these 16,000 of our loved ones is
$1,700 each, or a total of over $27,-
000,000? That is a tremendous loss
to our State
—
a heavy drain on our
State's wealth.
We have 80,000 North Carolinians
sick the year around. Half of this
sickness is preventable. That leaves
our needless sick loss at 40,000 for
their entire time. Assuming that one-third
of our sick are in the earning or
productive period of life and earn on
an average only $700 a year, we have,
therefore, 13,300 times 700 or over $9,-
000,000. Add $9,000,000 more for med-icine,
nursing, and special fond, and
we have over $18,000,000 as our an-nual
loss from sickness. This makes
a total annual loss to North Carolina
of $18,000,000 plus $27,000,000, or over
$45,000,000 annually.
Talk about conservation of national
resources—here's the greatest oppor-tunity
open for us today. No other
opportunity will compare with it.
When it is estimated that our State
loses as much as $5,000,000 annually in
excessive freight rates, we hold con-ventions
and conferences, we organ-ize
and call extra sessions of the Legis-lature;
but when we lose $45,000,000
worth of our best North Carolina citi-zenship
no one gets excited, no one
talks of an extra session. Why? The
main trouble is that most of us don't
know that we are suffering a loss of
$45,000,000 annually. Many of us that
do know it don't know that the loss is
preventable. When we once recognize
that this $45,000,000 is a preventable
loss and can be stopped, we will take
up the main issue. We will begin
public health work in earnest. As
it is now, there is practically no public
health work done in over 85 per cent
of the counties. The only work done
there is what the State Board of
Health can do through its health liter-ature,
lectures, and various campaigns.
CHRONIC CONSTIPATION
What it Does, Hov^^ We Acquire it, and the Rational Way to Treat It
D. H. Kress, M.D., in October Life and Health.
Chronic constipation exists to an
alarming extent among all highly civ-ilized
peoples. It is, in fact, the prod-uct
of high civilization. It does not
prevail among animals or among sav-ages,
whose habits are natural.
122 THE HEALTH BULLETIN.
We have not appreciated in the past
the relation constipation sustains to
many of the diseases of a chronic
or constitutional nature. Diseases of
degeneracy, which have been ascribed
to various causes, we now know are
due chiefly to the toxins absorbed
from the colon as a result of consti-pation.
From cases which have come under
my observation during the past few
years, I have been led to recognize
constipation as the chief causative
factor where insomnia, thickly coated
tongue, bad breath and high blood
pressure are present, when a specific
origin is excluded, and when no his-tory
of the free use of tobacco or
other toxic substances exists. In fact,
I have concluded that it is not the
excessive use of meats, tea, coffee,
tobacco, etc., that is wholly responsi-ble
for arteriosclerosis, but toxins
of a more injurious and subtle na-ture
developed in the alimentary
canal, and especially in the colon.
These poisons are likely to be
formed as a result of the prolonged
retention of waste substances which
readily undergo decay. Not only do
meats, tea, coffee, pepper and mus-tard
tend to bring about these de-generative
changes by the toxins they
contain, but they favor constipation
and the formation of poisons even
more injurious. In chronic constipa-tion
we have probably the chief factor
of degenerate arteries, heart, liver,
kidneys, thyroid glands, and other
glands of the body. There is strong
reason to believe that it is largely
responsible for the rapid increase in
the mortality rate from heart failure,
apoplexy, diabetes, and Bright's dis-ease.
In diabetes and Bright's dis-ease
there practically always exists
a history of constipation.
There are many annoying disorder^
of every-day life, among which may
be mentioned dyspepsia,, i headaches,
drowsiness, melancholia, insanity,
which may be due to chronic consti-pation.
Appendicitis seldom occurs in
a person whose bowels are regular.
From the prolonged retention of the
easily putrefying wastes, a diseased
condition of the mucous membrane
of the cecum results. This latter ex-tends
into the mouth of the appendix,
and an inflammatory condition is es-tablished.
There is a probability that
cancer is in some cases traceable to
the toxins absorbed from a stagnant
colon.
It would be difficult to conceive of
anything more defiling to the body
than the decay within it of fish, oys-ters,
rabbits, cheese, and other pro-tein
foods, and the absorption of the
resulting impurities and poisons.
Cells bathed in such a liquid become
diseased.
A blocked-up city sewer is recog-ni
ed as a source of danger and is not
tolerated, but here we have a condi-tion
that is very much more offensive
and dangerous, and yet very little se-rious
thought is given to it.
Over thirty per cent of the pres-ent
mortality is ascribed to this
cause by Prof. Eli Metchnikoff, who
has made a careful study of the
influence of these poisons on the hu-man
body, and who believes this to
be the chief cause of early degener-acy
and premature old age. His con-tention
is that by preventing the form-ation
of these alimentary toxins, man
might be at his best at eighty years,
be still active at one hundred and
twenty, and live to the age of one
hundred and forty. He has been
driven to some conclusions which
r^ay seem almost absurd, and yet,
reasoning from his viewpoint, they
are logical and conclusive.
Chronic constipation is more com-mon
than is supposed. In extreme
THE HEALTH BULLETIN. 123
cases tht/e exists a movement once
in two or three days, and in excep-tional
cases evacuation of the bowels
occurs only once a week.
A natural evacuation of the bowels
once in twenty-four hours is consid-ered
a normal condition. This is a
misconception. One evacuation a
day is not sufficient. A bowel move-ment
should be secured at least twice
a day, or, better still, after each reg-ular
meal, in order to safeguard
against putrefaction, and the absorp-tion
of toxins from the colon.
It is surprising how easily this
habit may be established and main-tained.
When once established, the
desire naturally recurs after each
meal, for the ingestion of food into
the stomach sets up a peristaltic wave
which travels along the entire alimen-tary
tract. In fact, it is less difficult
to evacuate the bowels twice daily than
once daily. Where but one movement
occurs daily, the moisture is absorbed
from the feces, and a plug forms in
the rectum. The contact of this hard
mass benumbs and destroys the sen-sitiveness
of the parts. The rectum
having been restored to a normal con-dition
the desire to defecate occurs
as soon as feces reach it. The stools
are never hard, the consistency being
practically the same all the time.
The best time to evacuate the bow-els
is shortly after regular meals.
The taking of food on an empty stom-ach
is a most powerful stimulus to
the motor activity of the colon.
During meal-time the contents of the
colon make more progress than dur-ing
four hours preceding the meal.
It is quite important that the stomach
be empty before introducing food.
Frequent meals and eating between
meals do not impart this stimulus
and hence tend to cause constipation.
Regularity of meals, at all events, is
a necessity in overcoming this condi-tion.
The same regularity should be
established in securing bowel evacu-ations.
The establishment of a right habit
is as effective in getting rid of consti-pation
as the establishment of irregu-larity
is in its causation. It is neces-sary,
therefore, to have a stated time
to go to stool.
If success does not attend the ef-fort
the first week or even the first
two weeks, the thing to do is to keep
up the practice. A little assistance
may be given by the injection of a
cupful of cold water, or the introduc-tion
of a suppository; a soft prune
or a date, turned inside out, will
answer for this purpose. While I do
not as a rule recommend laxatives,
in order to establish regularity it
may be well to take a mild laxative
each night before retiring, for a week
or ten days.
Agar-agar is of value. About two
tablespoonfuls soaked in a little hot
water and eaten with apple sauce or
some other stewed or canned fruit
should be taken with the morning
and evening meal. This should be
kept up for at least a month. Agar-agar
may be secured in any drug store.
If the druggist does not have it, he
can procure it, as it is regularly used
in all bacteriological laboratories.
Liquid paraffin is also of value in
very obstinate cases. The dose is one
dessertspoonful twice daily at first.
These preparations can be gradually
given up. The purpose of their use
is to establish regularity and the
formation of a correct habit.
The food is of the greatest impor-tance.
Foods which tend to consti-pate
should be given up. Meats
should be used moderately, if at all;
it is better to give them up all to-gether.
Tea, coffee, cocoa, chocolate,
pepper, mustard, and other substances
which cause constipation, should be
124 THE HEALTH BULLETIN.
abandoned. The tannin extracted in
st3eping tea is especially bad.
Laxative foods are of value. Among
these may be mentioned bran crack-ers,
whole-wheat or Graham breads,
shredded wheat biscuits, whole-wheat
biscuits, puffed wheat, etc.
The following vegetables are valua-ble:
parsnips, carrots, turnips, spin-ach,
raw vegetable oysters, cabbage,
etc.
The sweet fruits are all laxative.
Prunes, figs, dates, etc., are of value.
In the use of the foregidng foods,
care must be exercised in their com-bination.
In cases where irritability of the
stomach exists, with an excess of gas-tric
juice, the above foods should be
used sparingly; and where the condi-tion
borders on ulceration, they
should be entirely avoided until im-provement
occurs.
The agar-agar and paraflBn are es-pecially
helpful in these cases. Agar-agar
supplies the bulk, but is nonirri-tating,
while the parafBn is a splendid
lubricant.
Where digestion is slow and the
gastric juice diminished, the foods
referred to are indicated.
There are local and general treat-ments
and exercises which are great
aids in overcoming constipation, but
diet alone will accomplish marvelous
results if persevered in.
CHEAPER SANITATION
One thing in North Carolina sani-tation
stands head and shoulders
above everything else when it comes
to getting the greatset results for the
least money. It is the entire solution
of the hookworm problem, the solu-tion
of over half the typhoid fever
problem, a great share of the problem
of so-called "summer complaint," and
a big factor in the fly problem. It is
nothing more or less than the adop-tion
of the sanitary privy everywhere,
where access cannot be had to sewers.
It is an easy thing to show any
intelligent person or board of alder-men
that the lack of sanitary privies
is the cause of the continuation of
all our hookworm disease, half our
typhoid, and much of our diarrhceal
diseases, to say nothing about flies.
However, when you tell such a per-son
or board that a sanitary privy
made of iron, wood and concrete
costs upwards of $25, you give them
cold feet, and of course no such privy
is built. We now know that it costs
no more to build a sanitary privy
than it formerly cost to build an in-sanitary
one. If the individual has
to furnish the cans it will cost him
some 50 cents or sixty cents extra
for each can, where he used to have
to pay $1 or more. For cities and
towns it is recommended that munic-ipalities
own and clean the cans.
The State Board of Health is now
securing proposals from several can
manufacturers for prices on stand-ard
privy cans. Of course, the Board
cannot advertise any one make of can
to the exclusion of others, but it ap-pears
that one or two manufacturers
are able to make standard cans meet-ing
the specifications laid down by
the State Board of Health for between
one-half and two-thirds the price for-merly
charged, when bought in lots
of 100 or more. By addressing the
Board interested parties may secure
the benefit of the best proposals re-ceived
by the Board for such cans.
THE HEALTH BULLETIN. 125
WHAT IS THE MATTER WITH YOUR STOMACH?
Samuel Hopkins Adams, in the Ladies' Home Journal.
The American stomach is a gener-ally
condemned organ. We tend to
hold it criminally responsible for all
our lesser ills. Nearly half of all
medical advertising is aimed at the
stomach. As a matter of fact our di-gestion
is as sound as any of our func-tions.
The trouble isn't with our
stomachs. It is with our heads. We
lack common sense about our proces-ses
of nourishment. Nine-tenths of
the digestive disorders which lead to
the doctor's office or to the hospital
are not only preventable and avoida-ble,
but, medically speaking, they are
inexcusable. In other words, almost
all of our troubles of this sort are due
to our own stupidity.
"The average man," says a noted
authority, "never considers his stom-ach
until it fairly yells for help."
Now the human stomach is a bag,
equipped with nerves and supplied
with gastric juice which serves to di-gest
food. It is not an absolutely es-sential
portion of the anatomy. Peo-ple
get on very well and comfortably
with half a stomach or a third, or
even a fourth; and, at a pinch may
live without any at all, the small in-testine
making shift to do the work
of digestion. But normally the stom-ach
is there to receive food, digest
it, extract from it the energy neces-sary
for the running of the human
machine, and pass the residue on to
the intestines for disposal. The pro-cesses
are highly intricate in detail
and, in some phases, still mysterious
(nobody can tell, for example, why
the stomach doesn't digest and de-stroy
itself) ; but, in normal condi-tions,
they are carried on so capably
and quietly that the body is no more
awara of them than of the circula-tion
of the blood. When we become
conscious of our digestion it is be-cause
something is wrong with it.
MIND WHAT YOUR STOMACH TELLS YOU ABOUT
FOOD
Every stomach has its little eccen-tricities
and inhibitions. This one
says: "I cannot digest salt fish."
Another warns: "Don't give me pre-served
strawberries, for I won't have
them." A third ordains: "Anything
but honey." Or bananas. Or smoked
meat. And so on. There is but one
rule to cover all these cases: Mind
what your stomach tells you; it
knows best.
In a broad general sense it may be
said that we pamper ourselves too
much in the matter of food. Over re-finement
is a prevalent fault. We eat
too much delicately prepared and
highly seasoned food and too little
coarse and simple food. Processes of
preparation sometimes devitalize our
viands. Certain nourishing qualities
are polished out of the shining white
rice which we get exclusively. Our
oatmeals are refined down to a point
where only half of their value is left.
And the white flour which is so gen-erally
used lacks certain essential at-tributes.
Whole-wheat bread is given
only medicinally nowadays, yet whole-wheat
flour is the natural flour, and
if it were in common use a majority
of those who depend upon laxatives
to aid their digestive processes could
cast away those noxious drugs.
The same is true of uncooked fruits
and vegetables. A considerable por-tion
of the virtue of our vegetable
foods goes up the kitchen chimney.
How many people come back from
a vacation in the wilds feeling as if
they had acquired a brand-new diges-tion
and talking enthusiastically
^
126 THE HEALTH BULLETIN.
about the tonic effect of mountain or
forest air! Doubtless the air helped
in the matter of general condition.
But as people don't feed on the atmos-phere
to any great extent it hasn't
much immediate effect upon the stom-ach.
What reconstitutes the camper's
interior is the fact that he eats plain
food, simply prepared, and gets exer-cise
enough to make him digest prop-erly.
It may sound like heresy, but
it Is a fact that it doesn't really mat-ter
greatly what we eat—in condi-tions
of sound health, that is. S -me
food is better than others, but most
of it is pretty good. The healthy
stomach is willing and able to take
care of any reasonable article which
is sent down to it. Only when it
is impaired does the owner need to
give much thought to diet. In fact,
to be continually worrying over the
stomach, to exclude this article of
food lest it be indigestible, and to
eschew that because it might "dis-agree,"
to be continually narrowing
down the appetite—all this worries
the stomach and makes it unhappy.
A specialist of wide experience and
a somewhat unconventional habit of
thought suggests the following rules
to be framed and hung in every din-ing
room:
Eat what you want, and all you
want of it, but not more.
Don't eat when you're not hungry,
just because it's meal-time.
Take your time over it.
Remember that enjoyment of food
is the best of known digestives.
WHAT IS INDIGESTION?
Most familiar to the physician of
all forms of complaining is this:
"Doctor, my digestion is bad." In
perhaps half the instances the re-verse
is true. The patient's digestion
is not bad; it is good. In fact, it is
too good. OverefBciency is what
causes the difficulty. The stomach,
stimulated into overwork, produces
too great a flow of gastric juice, and
a condition of hyperacidity results,
causing the familiar "sour stomach,"
with uneasiness, fullness* and some-times
pain. It may arise from causes
not connected with food, such as
overindulgence in smoking or alco-hol,
or continued nervousness. In
the early stages it is readily corrected
by adjustment of habit and diet, and
by rest, particularly after eating.
Once fixed it is ugly and obstinate.
But the stomach always gives warn-ing
of its onset, and the man who
allows himself to fall into this condi-tion
has only himself to blame for it.
One absolutely and universally in-digestible
thing there is. All author-ities
agree upon this. It is worry.
No stomach can do anything with
it. The stomach is simply incapaci-tated
from doing its work properly
when the mind is harassed. Far
more digestions are ruined by mental
than by physical causes.
"Hurry and worry are the twin
curses of the twentieth century
stomach," one physician put the mat-ter,
"and worry is the worse of the
two. Give me a man who has sys-tematically
lived on the poorest and
most indigestible food, but has eaten
it with a mind free of taint, and I'll
take his case with far more confi-dence
than that of the most carefully
nurtured person who regularly
brings a harassfccl spirit to the dinner-table.
There is a good deal of truth
in Stevenson's picturesque reference
to the dining-room as the battlefield
upon whi3h most of our ancestors
have left their bones; but it wasn't
the flesh that they ate, but the spirit
in which they ate it that killed them
before their time. The most difficult
lesson I have to teach my patients is
that the stomach is a highly imagina-tive
piece of mechanism; largely gov-
THE HEALTH BULLETIN. 127
erned by the mind. Under the wrong
nervous stimulus it will either quit
work entirely or race like the lifted
screw of an ocean liner. But the
typical patient declines to be im-pressed
by this, and demands drugs
and treatments and training to do the
work which his own mind could do
with a little determined effort."
Because of their specious prnmises
of immediate relief the "patent med-icines"
secure many patrons from
among the hopefully credulous. Usu-ally
these pills and powders are ca-thartics.
Their use, continued, soon
establishes a hold upon the trustful
believer in their virtues.
Probably the cathartic habit is the
most widely prevalent addiction in the
United States today. Comparatively
harmless in the early stages of use,
these drugs create a demand for a con-stantly
increased dosage, as the sys-tem
becomes habituated to them, un-til
at length the victim finds himself
a slave to them. The ordinary pro-cesses
of Nature become paralyzed
without them. Then, as he repeatedly
lashes his intestines into action by
this means, an irritation is set up
which has serious and far-reaching
results. Fully one-third of the cases
of obstinate constipation which come
to the specialist show a history of
cathartic habit.
"The worst of all common errors,"
says an expert, "is to overload the
stomach and then appeal to purging
drugs to carry off the surplus."
A certain "patent medicine" fosters
this serious error by advertising that
a person can digest anything by tak-ing
the pills regularly. This is the
kind of advice which makes dyspep-tics.
As a matter of fact not one per-son
out of a hundred would need lax-ative
medicines if ordinary care
were taught from childhood. The
stomach and bowels are very much
creatures of habit, and it is really
easier to maintain them in good hab-its,
which are natural to them, than
to teach them bad ones.
Torpid bowel action, the common-est
of complaints, is almost invari-ably
due to neglect and carelessness,
and to thac alone. Even when it be-comes
fixed it can generally be cured,
by patient attention, without recourse
to drugs.
Liberal amounts of water, either
hot or cold, immediately upon rising,
followed by a hearty breakfast in-cluding
stewed or raw fruits and
whole-wheat bread, will be found
more efficacious than any of the
widely advertised nostrums.
COMMON-SENSE RULES FOR DIGESTION
To set forth comprehensively rules
for restoring to health a deranged di-gestive
system would more than fill
this magazine. To set forth rules for
preserving in health a sound stom-ach
is a short and simple matter. The
following represents a concensus of
advice given by leading authorities
on gastric and intestinal ailments:
Eat well-selected, well-prepared
food, the simpler the better, chewed
thoroughly with sound and clean
teeth.
Eat it deliberately; never bolt
your good.
Don't be a faddist; whatever you
like is good for you in moderation.
Use tobacco and alcohol moderately
if at all, but remember that they are
irritants even in the smallest quan-tities.
Shun cathartics and laxative drugs.
Obey the natural orders of your
stomach and intestines.
Don't harry and shock your stom-ach
with iced concoctions.
Never eat when very tired or un-der
emotional or nervous stress.
Above all, don't mix work or worry
with your meals.
128 THE HEALTH BULLETIN.
The man or woman who follows time; but at least, for that one, death
these primary regulations will still will not be hastened nor life poisoned
have left a reasonable range of ills b/ the too common torments of indi-from
which to die in the fullness of gestion and dyspepsia.
BRICKBATS AND BOQUETS
Last month several changes were
made in the Health Bulletin. At
the same time we offered our readers
a "come back" in this issue of the
Bulletin in order to find out how
they liked the changes. It was
planned to head the department
"Brickbats and Bouquets," but so far
the department lacks the variety we
had hoped it would have. We are
anxious to have some good stiff con-structive
criticisms. It won't hurt
our feelings. We simply want to
know how to make the Bulletin more
valuable to our readers.
Here is what a few of our readers
said:
"I congratulate you on the "tiurrent
issue of the Bulletin. I wish you to
send me 200 copies if available and
place the following names on the
mailing list. * * *
"J. Howell Way,
''President State Board of Health."
"Many thanks for the Health Bul-letin.
It is fine.
"Anna Steese Richardson,
''Woman's Home Companion."
"1 have just run through the Sep-tember
Bulletin. I didn't know who
was editing it until I reached the
last word. If power to interest and
instruct makes good editing, my ex-perience
with this number is evi-dence
that you are a success from the
start.
"You and Rankin are engaged in
the most useful business that I know
of. J. W. Bailey,
"Collector Internal Revenue."
"The September issue of the Bulle-tin
is jusy 'bully.' Keep at it. You
are on the right track. The brevities
are fine; the 'Brickbats and Bouquets'
I am sure will be popular.
"Geo. a. Wood,
"Nazareth Catholic Orphanage."
"I think the September Bulletin
is excellent. I have enjoyed it thor-oughly.
Dr. Wm. S. Jordan."
"I am very much interested in your
monthly Health Bulletin. This
month's issue is very good. I have
often wished that everybody in the
State could read it each month.
"Geo. Y. Watson."
"I certainly did enjoy reading your
last Bulletin—the September num-ber.
B. F. Montague."
When a thing reaches the point of
becoming a problem, there is hope. It
is the utter indifference to the serious-ness
of the health situation that has
made the death rate so high and the
life interest so low. When men made
public the appalling waste of life, the
public made assault upon them for
their "unpatriotic" exposure of home
conditions. Health reformers have
to fight their way, as every other re-former
has had to do, and it is now ac-cepted
that the so-called "fancy dis-eases"
are not fanciful and that pre-vention
of more than half the deaths
should be easy.—W. T. Bost in The
News and Observer.
i/
SANATORIUM SPECIAL
1 This Bulklinwillbe -sent free to arxg citizerN of the Stcrte upoa request j
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Entered as second-class matter at Postoffice at Raleigh, N. C, under Act of July 16, 1894
ol. XXVIII. NOVEMBER, 1913. No 8.
"Public health is purchasable. Within natural limitations
a community can determine its own death rate.
"
CONTENTS
•'Mechanical Fakes": The Electropoise—Oxypathor 132
Yadkin County Decides to Spend $200 a Year on Health 134
A Girl's Encouragement 135
Typhoid Vaccine Free I35
Mental Hygiene Conference and Exhibit Coming 136
Charlotte's Campaign against Typhoid I37
The Death Rates of Wilmington I37
Mr. Mayor : This for You I39
The State Sanatorium 141
(a) State Tuberculosis Policy 141
(b) The Cost of This Policy I43
(c) Requirements for Admission I43
(d ) Location of Sanatorium I45
(e) Site of Sanatorium I45
(f) Equipment of Sanatorium I45
Sanatorium Staff -^M
(a) Dr. Wilson Pendleton I47
(b) What Others Say of Dr. Pendleton 147
(c) Business Management 151
>
>
m •
I PUBLI5ME-D BY TM^ noR.TA CAI^OLIMA 5TATL BOAgP °^MEALTM
J. Howell Wat, M.D., President, Waynesville
Richard H. Lewis, M.D., Raleigh.
J. L. Ludlow, C.E., Winston-Salem.
W. O. Spencer, M.D., Winston-Salem.
Thoma.s E. Anderson, M.D., Statesville.
Charles O'H. Laughinghodse , M.D.
Greenville.
Edward J. Wood, M.D., Wilmington.
A. A. Kent, M.D., Lenoir.
Cyrus Thomp.son, M.D., Jacksonville.
W. S. Rankin, M.D., Secretary and Treasurer, Raleigh.
Vol. XXVIII. NOVEMBER, 1913. No. 8.
"MECHANICAL FAKES *'
The Electropoise -- Oxydonor -- Oxygenor -- Oxygenator
Oxypathor -- Oxytonor.
"It is sometimes hard to decide
wtiich. is the greater—the impudence
of the quack or the credulity of his
victims. The comparative ease with
which the medical faker is able, by
the most preposterous claims, to sep-arate
the trusting from their money
indicates the enormous potentialities
in advertising. It might be supposed
that an individual who set out to sell,
as a panacea for all the ills of the flesh,
a piece of brass pipe with one or two
wires attached to it, would, commer-cially
speaking, have a hard and rocky
road before him. But such a suppo-sition
would be incorrect. Not only
would the enterprising faker find cus-tomers
for his gas pipe, but there
would be such a demand for this most
inane of 'therapeutic' devices that two
or three imitators would immediately
enter the market."
Sanche's Inventions.
The American Medical Association's
expose tells how one Hercules Sanche,
self-styled "Discoverer of the Laws of
Spontaneous Cure of Disease," became
the original exploiter of mechanical
fakes. "Sanche's first and simplest
gas pipe cure device he called the Elec-tropoise."
The shrewd Sanche realized that, in
order to patent his device and at the
same time prevent physicists and
chemists and other scientists apply-ing
laboratory tests to the device and
exposing it as without any known
physical, chemical or other influence,
it would be necessary for him to
"discover" and attribute to his gas pipe
cure some hitherto and thereafter un-recognizable
power; so he said that
the instrument rendered the body oxy-gen
positive; that is, that it made the
body absorb larger quantities of oxy-gen.
He later named this newly "dis-covered"
power "Diaduction." Oh,
you needn't look in the dictionary;
the word isn't in it. No one, Sanche
argued, "had ever realized before that
by attaching a piece of nickel-plated
brass tubing to the body by means of a
flexible cord the system could be made
to absorb oxygen."
Of Diaduction Mr. Justice Shiras, of
the United States Supreme Court, says:
"I am entirely certain that I do not
understand the working of this so-called
force, if any such exists, and I
THE HEALTH BULLETIN. 133
greatly doubt whether Dr. Sanche has
any clear conception of the force or
principle which he seeks to describe
under the name of 'Diaduction.' "
Other judges have said: "From the
record evidence we have tried to get
some intelligent idea of 'diaduction.'
We have failed utterly."
And again: [The theory] "is a mere
pretense, that is to say, a theory not
entertained by the inventor in good
faith, but put forward as an imaginary
hypothesis merely for the purpose of
obtaining a patent on a very simple
contrivance, which was not patentable
unless the claim was reinforced by
some such pretended discovery."
The Progeny of the Electropoise.
From Sanche's original idea, em-bodied
in the Electropoise, there de-scended
the whole family of "Mechani-cal
Fakes," to wit: The Oxydonor,
Oxygenor, Oxygenator, Oxypathor, and
Oxytonor.
The members of this family bear well
marked family resemblances. They all
consist of nickel-plated metal tubes
with closed ends. To this tube is at-tached
one or more flexible cords,
which end in a strap to be buckled or
attached to some part of the body. The
Electropoise was empty ; the Oxydonor
contained a stick of carbon; the Oxy-genor
contained sulphur, sand, and
charcoal; the sulphur and sand to-gether
comprising 97 per cent of the
whole. The Oxygenator also called
the Oxypathor, according to the Lab-oratory
of the University of Vermont,
"is filled with a black powder, which
analysis disclosed to be a crude mix-ture
of inert substances, apparently
the waste or by-product of a manufac-turing
plant. * * * The powder is
a rough mixture of iron filings, clayey
material, and a dark-colored carbon-aceous
mass, * * * apparently nothing
more than coke dust or carbon-black."
The family resemblance is again ap-parent
in the claims as to their mode
of action. They are all claimed to act
by "diaduction," or by causing the body
to absorb oxygen. They claim also
to cure practically all diseases, with
the exception of cancer and tumor and
far advanced consumption. The ex-ception
made is probably for the pur-pose
of avoiding prosecution under the
federal law that prohibits a consider-able
amount of fake cancer cure ad-vertisements.
The Oxypathor.
According to "Nostrums and Quack-ery"
it would seem that the Oxypathor
is the youngest member of the family
group or the last alias adopted by
Sanche's original idea.
"In many ways," says Nostrums and
Quackery, "this last type of gas-pipe
cure is the worst, inasmuch as claims
are made for it that are not only ab-surd
but dangerous. For instance:
'Diphtheria: This overwhelming
child's disease finds its supreme master
in the Oxygenator. No earthly power
except the Oxygenator can take the
slowly choking child and with speed,
simplicity and safety bring it back to
health.
'Don't jeopardize the health and life
of your children by allowing to be in-jected
into their veins and blood the
often fearfully contaminated and death-dealing
serum of an animal, otherwise
known as antitoxin.'
"It is difficult to restrain one's indig-nation
at the thought that such vici-ously
cruel lies as these are permitted
to be scajttered broadcast. Let the
neurotic and neurasthenic adult, if he
can convince himself that a nickel-plated
piece of gas-pipe possesses
curative properties, experiment with it
on his own person if he wishes. But
that a helpless child in the throes of a
fearfully dangerous—and yet, rightly
134 THE HEALTH BULLETIN.
treated, curable—disease, should l:e al-lowed
to suffer and die because ig-norant
parents have been persuaded
to reiy on these mechanical frauds, is
no less than criminal. As for the
miserable harpies who for a few filthy
dollars will write such cold-blooded
untruths as those quoted above, the
safety of society demands that they
be put where they can do no further
harm."
"The State Board of Health of Ver-mont
declared the Oxygenator to be
'physically and therapeutically inert'
and prohibited the sale of the fraud."
Summary.
"To sum up: The 'Electropoise,' the
'Oxydonor,' the 'Oxygenor,' the 'Oxy-genator
(or 'Oxypathor') and the 'Oxy-tonor'
are utterly worthless except as
a means of enriching their exploiters.
Their therapeutic value, aside from
the element of suggestion that may be
induced in those who are willing to
pay from ten to thirty dollars for a
piece of nickel-plated tubing, is abso-lutely
nil. As already said, if adults
wish to squander their money on such
foolishness and are content to con-fine
the 'treatment' to their own per-sons,
well and good. If they have noth-ing
much the matter with them they
may believe they have received benefit;
if they are dangerously ill, Nature will
probably exterminate them as unfit.
But let no person try to 'cure' the
helpless child with such frauds; as
soon as that is attempted, such an in-dividual
ceases to be a harn?less idiot
and becomes a dangerous one."
YADKIN COUNTY DECIDES TO SPEND
$200 A YEAR ON HEALTH.
This is going some, isn't it? A phy-sician
of that county writes: "Our
Board of Health lets everything take
care of itself. We are now having
scarlet fever in several portions of the
county and 'not a one' has been quar-antined.
Our Board of Health met
the first Monday in October and elected
Dr. S. L. Russell for one year at the
extravagant salary of $200. So you
see we will have everything quaran-tined
and fumigated. (He is to fur-nish
all disinfectants)."
In Yadkin County there are 16,000
people—men, women and little chil-dren.
Assuming that the average death
rate of the United States t»revails in
that county, there are 250 of these
people who die every year. There is
an amount of sickness equivalent to
750 of the Yadkin folk being in bed the
entire year. 100 of these deaths are
from preventable diseases, and 250 of
the bedridden sick people ought to be
on their feet earning a living for them-selves
and others. 35 of the 100 deaths
are from consumption; there are 100
other active cases of consumption in
the county. There are 8 deaths from
typhoid fever; there are between 80
and 90 other cases of fever every year.
There are 8 or 10 deaths from con-tagions.
20 babies under two years of
age die in that county every year from
diarrheal diseases, and about 150
other babies are sick from that disease.
Now, evidently these diseases, that
most of the civilized world has re-garded
of a preventable nature, acquire
very peculiar properties when they
break out in Yadkin; they become
wholly unpreventable. Up there man
has no control whatever over these
diseases and therefore no responsi-,,
bility for their occurrence. All thatf
the rest of us can do when the tolkf
die in Yadkin is to extend our sympa-thy,
and let the preacher say, "the
Lord giveth and the Lord taketh"; the
county commissioners can't help it.
THE HEALTH BULLETIN. 135
A GIRL'S ENCOURAGEMENT.
Some days ago the State Board of
Health received a letter asking for an
investigation and an opinion as to the
influence of a swamp on the com-munit}-
in which the writer of the let-ter
lived. The letter indicated such
mature and intelligent interest in
health matters that in our reply we
stated that we would try to make the
investigation at an early date, and at
that time to meet and advise with the
writer and other authorities of
in regard to the proper treatment of
the ponds. In reply to our letter the
writer of the initial letter among other
things said: "I am only a girl. Dr.
Rankin, and I don't know that I would
be of any help to your representative."
This letter is one of the most encour-aging
that we have received in some
time; it indicates the interest of the
younger generation, and what they are
going to do when a few more years
give them some control in civic mat-ters.
It has been a long time since
the State Board of Health received a
request that it will more gladly com-ply
with than this one from "only a
girl."
TYPHOID VACCINE FREE.
The State Laboratory of Hygiene an-nounces
that it is now ready to dis-tribute,
on request, typhoid vaccine
free to the citizens of North Carolina.
The Laboratory trusts that only those
citizens who expect to use it will re-quest
the vaccine, but the Laboratory
is very anxious that as many of our
citizens be persuaded to take advantage
of the State free vaccine as it is pos-sible
for our influence to reach.
Now do not get the idea, because we
are giving the vaccine away, because
it will cost you nothing, my fellow
citizen, that it is without value. Vac-cination
against typhoid fever has
passed all the tests of science and prac-tice
and has won as permanent a place
among sanitarians as vaccination
against smallpox.
In a very thorough review of the re-sults
of anti-typhoid vaccination in the
Journal of the American Medical As-sociation,
under date of August 30,
1913, Major Frederick F. Russell, of
the medical corps of the United States
Army, presents such convincing facts
and figures as to leave this question
of vaccination against typhoid fever no
longer a matter of opinion. In the
last four years over 200,000 people have
been vaccinated against typhoid fever;
no bad effects from the vaccination
have occurred. Among the 85,000 vac-cinated
men in the United States Army,
located at different posts in the United
States and her colonies, there has not
been a single case of typhoid fever
since December 6th, of last year.
There have been fewer cases of typhoid
fever among the vaccinated soldiers
than cases of smallpox among the sol-diers
vaccinated against smallpox. The
opinion among sanitarians at present
is that typhoid vaccination is as effec-tive
as smallpox vaccination.
The vaccine is in liquid form and is
administered hypodermically, being in-jected
either into the outer side of the
arm or into the tissues of the breast.
The discomfort—because we can not
call it pain—of the injection is prac-tically
the same as the injection of
various forms of medicine. Any doc-
136 THE HEALTH BULLETIN.
tor can administer the vaccine. The
vaccine is in three doses, which have
to be given on three separate days, five
daj^s apart. In from ten to fifteen per
cent of the cases there is slight swell-ing
and redness, and a little pain about
the Injection lasting for a day or so;
associated with these local symptoms
is usually a slight feeling of indisposi-tion,
vague, dull aches similar to the
preliminary symptoms of a cold, and,
maybe, from a half to a degree of fever.
The second injection is not nearly so
likely to be followed with these sensa-tions
as the first, and the third injec-tion
still less likely than the second
to be associated with unpleasant sensa-tions.
The protective power of typhoid
vaccine lasts for four years. The pro-tective
power not only protects against
the contraction of the disease but, in
those exceptional cases where the dis-ease
is contracted, protects to a con-siderable
extent against a fatal out-come,
a kind of double protection.
The State Board of Health enter-tains
the hope that those counties em-ploying
whole time health officers will
have their officer arrange certain
dates in the county, town or other con-venient
places for citizens to visit,
where any citizen in the county can
be vaccinated, without cost, either for
typhoid fever or for smallpox. If the
health of the human animals of the
counties are worth anything from a
purely economical standpoint in the
production of cotton and corn and
wheat and meat, thereby increasing
the value of land, and by all this add-ing
to the wealth of the county treas-ury
through the taxes that are levied,
it would seem to be a very fine piece
of business for the owners of this pro-ductive
source of wealth, for the county
government, particularly the county
commissioners, to spend the small sum
necessary for this free public vaccina-tion
in the maintenance of their human
machinery.
MENTAL HYGIENE CONFERENCE AND EXHIBIT COMING
A great treat is in store for North
Carolina teachers and others inter-ested
in Mental Hygiene and the bet-terment
of the race. Through the ini-tiative,
generosity, energy, and fore-thought
of Dr. Albert Anderson, Super-intendent
of the State Hospital at Ral-eigh,
arrangements have been made to
have a Mental Hygiene exhibit and
conference at the Raleigh Auditorium
from November 28 to December 5th.
This is the same exhibit which attract-ed
so much attention at the Interna-tional
Congress on Hygiene and De-mography
at Washington last year.
The exhibit is free and the public is
cordially invited. Demonstrators and
attendants will be on hand to expL-iin
everything connected with it. It will
undoubtedly be one of the best exhibits
ever given in North Carolina. It will
mean a tremendous uplift all over the
State if several thousands of our teach-ers
and public spirited citizens will
learn the great lesson taught by this
exhibit.
Besides the exhibit, there will be
held North Carolina's first conference
on Mental Hygiene. A program is be-ing
arranged for two sessions daily,
afternoon and evening. Some of the
foremost specialists in the country will
lecture on various phases of mental
health. Among others will be Dr.
Adolph Meyers, of Johns Hopkins Uni-versity;
Dr. Wm. A. White, of Wash-ington,
D. C; Dr. James Parrott, of
Kinston, President of North Carolina
Medical Society, and many others of
equal calibre. The daily press will »
make full announcement of the pro
gram later.
THE HEALTH BULLETIN. 137
CHARLOTTE'S CAMPAIGN AGAINST TYPHOID.
Several weeks ago the City of Char-lotte
elected Dr. R. F. Linebach Assist-ant
Superintendent of Health, and dele-gated
to him the work of preventing
disease. Doctor Linebach seems to
have definite Ideas as to his work; his
campaign in attacking preventable dis-eases
suggests the idea of selecting
one specific thing and going after that,
and then taking something else. We
like this. There is entirely too much
diffusion in planning health work, and
we sometimes think the plans of health
officers might be made a little less
vague and a little more definite.
Doctor Linebach has selected typhoid
fever as the first disease with which
he will deal; he has made an interest-ing
study of the typhoid problem of
Charlotte; his investigation has shown
that 74 per cent of the typhoid fever
occurring in Charlotte occurs in fam-ilies
using wells, and 90 per cent of the
wells used by these families have been
found polluted. His investigation has
been in line with all other investiga-tions
in finding that the frequency of
typhoid fever is greatest in those wards
with open privies, and less in the
wards that are thoroughly sewered.
Based upon his investigation and find-ings,
considerable pressure is being
brought to bear on the city fathers to
extend their water and sewer mains.
Another important point still under
consideration in the fight against ty-phoid
in Charlotte is the proposition
to close all polluted wells as soon as
their pollution is shown by laboratory
examination.
THE DEATH RATES OF WILMINGTON.
We have been taken to task for never
having referred in the Bulletin to the
death rates of Wilmington. We do not
recall having referred in the Bulletin
to the death rates of any particular
town under the name of the town; we
have used, however, in our effort to
educate public opinion to the point of
enacting a vital statistics law, the
death rates of several towns and cities
in North Carolina under fictitious
names. We have not thought it fair
to call attention in the Bulletin to the
comparative death rates of different
towns and cities when we have felt
reasonably sure that some of the
towns and cities with low rates were
negligent in the complete registration
of their deaths.
This office has been without means
of verifying local death rates until
within the last two months, since
which time we have had an inspector
on the road. We trust that this ex-planation
will satisfy those who seem
to think that we have been negligent
in not having given space already to
the Wilmington death rates.
The death rates of Wilmington are
very interesting and the following
charts are worthy of careful study.
The figures of the charts up to and
including the year 1910 are taken from
the Mortality Statistics, United States
Bureau of the Census, and the figures
since 1910 from the records in the
State Registrar's office.
There is no witness so trustworthy
in the study of the quality of health
work as vital statistics. This witness,
however, must be made to testify in
strict accordance with the prescribed
oath, "to tell the truth, the whole
truth, and nothing but the truth." The
138 THE HEALTH BULLETIN.
Year.
1911
1912
1913 (estimated
WILMINGTON. N. C.
General
Diarrheal
^ , . J j _ , , Diseases
Typhoid
I
Tuberculosis
^ Under Two
Years
Combined
Contagions
The general death rates are per 1,000; the special disease rates per 100,000.
THE HEALTH BULLETIN. 139
great trouble with the statistical' wit-ness
is not that the witness fails to
tell the truth and nothing but the truth
(this witness never lies), but that fre-quently
the witness is not given a fair
chance to tell the whole truth.
Attention has been specifically di-rected
to the reduction in Wilmington's
death rates since 1911. Now the charts
show that 1911 was an exceptional
year and not an average year in the
health record of Wilmington. This
question, then, becomes pertinent right
here: Should exceptional years be
used as the standard by which to meas-ure
the efficiency of health work?
Should a health officer, whose admin-istration
began in a year characterized
by exceptionally low rates, rates lower
than for ten years, be discredited be-cause
he gets no reduction or only a
very slight reduction in his rates dur-ing
the first and second years of his
work? Likewise, should a health offi-cer
be credited with the full reduction
of death rates coincident with an ad-ministration
which started during a
year with exceptionally high or epi-demic
rates?
We believe that an average year
should be used as a standard of meas-urement,
and that such a standard is
the only fair measure to be adopted in
judging the quality of health work on
a death rate basis.
If we study the death rate of Wil-mington
from this standpoint, it would
appear that the health work coincident
with the half decade from 1906 to 1910
inclusive, expresses itself in a statisti-cal
drop from a death rate of 25.3,
which was even less than the average
in the preceding five years, to a death
rate in 1910 of 20.8. I submit that this
decline, considered in accordance with
the principles of statistical practice, as
above suggested, is even more credit-able
than the decline since 1911, which
was an exceptional year.
Now, in conclusion, I wish to say
that, notwithstanding that the rates
most frequently quoted in regard to
Wilmington go back only to 1911, and
start, therefore, from an exceptional or
epidemic year as a basis of measure-ment,
we think the decline in death
rates, even during the last few years,
is very satisfactory. We might point
out, however, in this connection, that
there is still much to be accomplished.
The typhoid rates are still three
times the average for the United States.
The diarrheal diseases of children
under two years of age are two and
one-half times the average, and tuber-culosis
is 50 per cent higher than the
average, and finally, the general death
rate for this year, 21.6, is 20 per cent
above the average urban death rate in
the United States.
MR. MAYOR, THIS FOR YOU.
"It is in health that cities grow; in
sunshine that their monuments are
builded. It is in disease that they are
wrecked; in pestilence that effort
ceases and hope dies.
"Therefore, in the not very long ago,
you created a department. You bade it
guard the public health. You gave it
a trust that may not be broken. You
charged it with a vigil that is sacred.
"And you assumed a duty. You
tendered fealty to this, your greatest
department; for had you not bade it
watch over the lives of men and wo-men
and little children.
"Nor creed, nor faith, nor party may
forget."
—
The Healthologist.
THE STATE SANATORIUM
Under the Management of the State Board of Health—Board
Announces Definite and Comprehensive State PoHcy
for DeaHn^ with Tuberculosis
The management of the State Sana-torium
has been transferred, by legis-lative
enactment of the Special Ses-sion
of the General Assembly, to the
State Board of Health. The transfer
was initiated and engineered by the
former Board of Directors of the In-stitution.
While the State Board of
Health had not asked for the Institu-tion,
the Board very cheerfully accepts
the responsibility of management. We
believe the Institution to be capable
of filling a very real need in the life
of the State, and that it has a very
bright future. The State Sanatorium
will represent a part of a general
policy of the State Board of Health
for dealing with the problem of tuber-culosis.
State Boards of Health should look
upon tuberculosis as something dis-tinctive
from the general run of pre-ventable
diseases. One-fourth of ca.11
preventable deaths is due to tubercu-losis.
That means that one-fourth of
the opportunity of State Boards of
Health, and other health boards, for
that matter, is tied up in the manage-ment
of the tuberculosis problem.
These considerations are responsible
for the adoption by the State Board of
Health of the following
State Tuberculosis Policy.
The central idea of this policy is
one of education. The educational
scheme will embrace the Sanatorium
as a sort of central school, and a
Bureau of Tuberculosis, to be estab-lished
in connection with the general
health work, as a correspondence
school. The State Sanatorium, by the
first of January, will have a capacity
for 125 patients, which will be suffi-cient
for the treatment of 250 patients
a year, assuming the stay of the aver-age
patient to be six months. In the
Institution these people will be taught
by personal contact, by illustrated lec-tures,
and by the rules of the Institu-tion
how to readjust their lives to
Nature's laws and so secure a new
lease on life, and how to live with
others without infecting them. This
training will be carried back by these
250 patients a year into their communi-ties
and counties, and its influence will
be of great benefit to their fellow suf-ferers
at home who have been unable
to attend the training school.
The Bureau of Tuberculosis will have
reported to it, under the requirements
of a recent enactment, seventy-five or
eighty per cent of all recognizable
cases of tuberculosis in this State.
These people, from 8,000 to 10,000 vic-tims
of the disease, will be matricu-lated
as members of a correspondence
school for tuberculosis. At the head
of this Bureau will be a man who
knows how to write a strong, personal,
appealing letter,—a man of great re-sourcefulness
and tact, and a man
above all with a deep, sincere, altruis-tic
nature. In an unofficious way and
THE HEALTH BULLETIN. 143
in a verj' personal way he will seek,
by correspondence, to make the eight
or ten thousand people reported to
the Bureau feel his interest in them;
hy correspondence and by a leaflet or
pamphlet from time to time he will
endeavor to encourage his scattered
school in their work for life, to teach
them how they may regain their
strength and teach them their obliga-tion
in protecting others, with whom
they may be associated, from tubercu-losis.
Another function of the correspond-ence
school that will call for a high
degree of resourcefulness is for the
Bureau of Tuberculosis to investigate
the claims of deserving indigents, and
through boards of county commis-sioners,
churches, lodges, or other or-ganizations
to which the indigent, or
the person upon whom the indigent is
dependent, belongs, secure the neces-sary
funds to take care of those who
would die unless supported from out-side
sources. One of the principal
measures of success by which the Bu-reau
of Tuberculosis will be judged
will be its ability to keep the Sana-torium
filled with patients who could
not themselves pay for their treat-ment,
but whose treatment is paid for
by interested organizations—political,
social, or fraternal—and philanthropic
individuals.
This combination of the Central
Training School, as an educational
nucleus, with a correspondence school
of eight or ten thousand consump-tives,
is suggestive of the educational
scheme in practice in the State of Wis-consin
by the University of that State,
which is rapidly and deservedly be-coming
a model to other state univer-sities.
The Cost of This Folicj.
The State of North Carolina has in-vested
in its present plant something
like $50,000. The interest on that in-vestment
amounts to $3,000 a year.
The State appropriates for the main-tenance
of this Institution and for the
maintenance of the correspondence
school idea, $20,000 a year; so that we
might say that this state tuberculosis
policy will cost the State, in round
numbers, about $25,000 a year. It will
be necessary in our State Institution,
as it is in practically all state sana-toria,
that the patients pay $1.00 a day
for treatment. This will seem to some
rather expensive. On investigation,
however, it will be found that this is
the general practice of state sanatoria;
that in different state institutions the
per capita charge is from four to ten
dollars a week. On the other hand,
when one recalls the fact that it now
costs one to get sanatorium treatment
or to be treated by a specialist, from
sixty to one hundred dollars a month,
the State's charity at once becomes
evident. While it is necessary to
maintain the Institution to charge each
patient one dollar a day, it should be
remembered that, under the policies
above outlined, many of the patients,
we hope most of them, will be pa-tients
who themselves are paying noth-ing,
but whose expenses are paid by
their friends and the organized inter-ests—
political, social, and fraternal
—
of which they are a part.
Requirements for Admission.
Patients, before being given a card
of admission, will be required to have
filled out by their physician a blank
form furnished by the Medical Direc-tor
of the Sanatorium, and return the
information contained on this form to
the Sanatorium in order that the man-agement
may know their condition.
Incipient patients will be given pref-erence
over moderately advanced
cases, and advanced cases will not be
admitted. Patients and physicians are
warned against going to the Sana-torium
without first communicating
THE HEALTH BULLETIN". 145
with the Medical Director and ascer-taining
whether the capacity of the
Institution and the condition of the
patient will permit the admission of
the patient. The fatality of incipient
tuberculosis under average treatment
is not more than 10 or 15 per cent;
the fatality of moderately advanced
tuberculosis is 40, 50, or 60 per cent;
and the fatality of advanced tubercu-losis
is 90, 95, or even a higher per
cent. It is, therefore, as evident as it
is reasonable, that as long as the
State's capacity to take care of her
consumptives is as limited as at pres-ent,
advanced consumptives, bedridden
consumptives, who have already prac-tically
lost their chance to live should
not be allowed to occupy the few beds
that the State now has, and that would
otherwise be used for consumptives
in the incipient stage of the disease
with 85 or 90 chances in a hundred to
get well. The reasonableness and the
economic considerations, as well as the
humanitarian considerations underly-ing
this fundamental principle in the
future management of the Institution
are too evident for argument.
location of Sanatorium.
The Sanatorium is located at Mont-rose,
in Hoke County, on the Rockfish
and Aberdeen Railroad, nine miles
southeast of Aberdeen. The Sanato-rium
is about twelve miles from Pine-hurst
and about the same distance
from Southern Pines. In this region
of these well known winter resorts
the Institution has an ideal location.
The warmer and more uniform temper-ature
of this region gives the Mont-rose
Institution a natural asset which
very probably more than makes up
for the better equipped and larger en-dowment
of the more widely known in-stitutions
of our northern, colder cli-mate.
Here the air is dried by its
course across the white sand and is
filtered pure and healthful through the
needles of the long leaf pine.
Site of Sanatorium.
When one alights from the train at
the little station of Montrose, after
having passed through a flat country,
rather desolate looking, with sandy
soil and blackjack and pine growth,
and ascends a gentle slope, a most
surprising view opens up before him.
So suddenly and distinctly different is
the scenery from that of the surround-ing
country, that its very unexpected-ness
adds interest to its beauty. In-deed,
Nature seems to have prepared
and set apart this spot for the very
purpose to which it is now dedicated.
Standing on a plateau about six hun-dred
feet above sea level, one can see
from ten to fifteen miles in almost any
direction. The view invariably makes
one think of the mountains of Western
North Carolina. In one direction a
sand road eight or ten miles away can
be seen easily.
Equipment of Sanatorium.
The Sanatorium is situated on a
farm of about 1,300 acres. There are
about 700 or SOO acres of this land
suitable for farming; there is also
much valuable timber on the land. A
creek passes through the farm which,
after it is dammed, will furnish the
necessaiT power for electric lights and
light machinery needed in an institu-tion
of this kind.
At present there are three buildings
for patients, with capacities of 15, 35,
and 75 patients each; there is a dining
room sufficiently large to seat 100 peo-ple.
A refrigerating plant will be in-stalled
beneath the kitchen some time
before next spring. There is a nurses'
building for the nurses, a small cot-tage
for the physician, and a pavilion
which will be immediately equipped
and hereafter used as a library and
THE HEALTH BULLETIN. 147
club room. This building will be
equipped with such games as patients
with incipient and moderately ad-vanced
tuberculosis may engage in;
a good Victrola with suitable records
will add to the attraction of the pa-vilion.
On the grounds there will be
such light outdoor games as croquet,
and other games that tuberculous pa-tients
may enjoy. The new Medical
Director, who is familiar with the con-struction
of sanatoria, is delighted
with the construction of the buildings.
The buildings are lighted by electric-ity,
heated by open fires, and supplied
with warm water and shower baths.
There is also a good two-story farm
house and a well constructed dairy
with capacious silos.
SANATORIUM STAFF.
Dr. Wilson Pendleton.
Dr. Pendleton is the man to whom
the State Board of Health pins its faith
in taking over the Sanatorium. Dr.
Chas. L. Minor, so well known as a
tuberculosis authority, not only in this
State, but in the nation, in writing to
the Board strongly recommending Dr.
Pendleton and urging the Board to
elect him as Medical Director of the
Sanatorium, says: "I am sure you will
agree with mo that the first thing is a
man. With a strong, competent man
at the head of affairs, the simplest
building makes a strong sanatorium;
without it, the most elaborate is use-less."
We thoroughly agree with Dr.
Minor's reasoning, and because we do,
we know that the absolute success of
the State Sanatorium is henceforth as-sured.
We have the man.
Allow me just a few words to in-troduce
Dr. Pendleton, and then, I
shall let those who speak with au-thority
tell you how well qualified he
is to take care of our patients. Dr.
Pendleton is a Southern man and was
educated at the University of Virginia.
He looks to be about twenty-eight or
thirty years old. After graduating at
the University of Virginia in medicine,
he was assistant to Dr. Watts, Pro-fessor
of Surgery in the hospital con-nected
with that Institution. Serving
under Dr. Watts, he contracted tuber-culosis,
went to Saranac Lake and was
cured. Like most specialists in tuber-culosis,
he became interested in and
took tuberculosis as his specialty as a
result of his personal experience with
the disease. After regaining his health
at Saranac Lake, and incidentally after
learning the methods of cure prac-ticed
in that well known Institution,
he accepted an assistantship with Dr.
David R. Lyman, of the Gay lord Farm
Sanatorium, the State Institution at
Wallingford, Connecticut, where he
served three years, for five months
of the time having absolute charge of
that Institution. From the Gaylord
Farm Sanatorium, he went to the Hope
Farm Sanatorium, Marshallton, Dela-ware,
to take charge of that Institu-tion.
What Others Say of Dr. Pendleton.
Dr. Livingston Farrand, Executive
Secretary of the National Association
for the Study and Prevention of Tu-berculosis,
who is qualified to take a
comprehensive view of the tuberculosis
problem as a national problem, writes
concerning Dr. Pendleton: "I have
made further inquiries concerning Dr.
Wilson Pendleton, * * * with refer-ence
to his administrative capacity and
general availability for the position
you have in mind with your depart-ment.
I have this morning received a
letter from Dr. David R. Lyman, of
Gaylord Farm Sanatorium, Walling-ford,
Conn., who says that Pendleton
had entire charge of that sanatorium
during an absence of Dr. Lyman's
lasting for five months, and in addition
to that he was with him as an assist-
THE HEALTH BULLETIN. 149
ant for two and a half years. He says
he is an excellent discip