Bulletin of the North Carolina Board of Health

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LUNC-I8M F 40
IBTTIL.X-.EI'X'Il^T
OF THE
NORTH CAROLINA BOARD OF HEALTH
Publislied Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington.
S. Westray Battle, M. D.--Asheville.
Henry W. Lewis, M. D Jackson.
W. P. IVEY. M. D. Lenoir.
T. E. Anderson, M. D.--Statesville.
J. Howell Way, M. D Waynesville.
W. O. Spencer, M. D Winston-Salem.
J. L. Ludlow, G. E. Winston-Salem.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XXII. APRIL, 1907. No. 1.
GROUND AND DEEP WATERS OF NORTH CAROLINA.
By Gerald McCarthy, Biologist, N. C. Laboratory of Hygiene.
Fig. 1.—Typical arrang^ement of stratified beds in Atlantic coast region. B shows a
successful well drawing water from a gravel bed just above the crystalline rock.
More or less water is contained in all layers of the earth's crust
to a depth of about five miles; but it is abundant enough to be of
practical importance only in the upper 5,000 feet. According to the
estimate of T. C. Chamberlin of the United States Geological Survey,
were all the water contained in the earth's crust brought to the surface,
it would form a uniform layer covering the entire earth to the depth
of about 800 feet.
In crystalline rock, like granite, porphyry, and marble, and also in
shales and stiff clays, water in usable quantities occurs, if at all, only
in cracks and pot holes. In sands, sandstones, and loose strata gen-erally,
water percolates freely under the force of gravitation, saturating
the stratum, and flovidng towards its lowermost end. Percolating soil-water
usually flows very slowly, rarely exceeding 6 feet in 24 hours.
I BULLETIN N. C. BOARD OF HEALTH.
Jn fine-grained beds the flow is often less than 12 inches in 24 hours.
The rate of flow depends mainly upon the slope, porosity of strata and
hydrostatic pressure.
All waters yielded by wells and springs are in a sense "ground
waters," but for convenience water analysts designate by this name
only water from ordinary wells, or wells less than 200 feet deep.
Waters from ordinary gushing springs, artesian wells, and non-flowing
wells over 200 feet are properly called deep waters. The water which
collects in shallow pools under the roots of trees or at base of large
rocks, often miscalled "spring water," is merely ordinary surface-water.
In regions underlaid by a thick limestone bed the lime is often
dissolved in spots, forming "sinks," or "pot holes." The water which
fills these sinks may eventually force an underground passage by dis-solving
the lime rock along a fissure. The underground stream thus
formed may come to the surface at some point more or less distant,
forming a so-called "big spring." These underground streams are
never very long.
Ground and deep waters have a common source—the rainfall. When
rain falls upon the ground, a part—ordinarily about 40 per cent.—runs
off at once into streams; from 25 per cent, to 40 per cent, percolates
into the ground and this portion forms the source of all ground and
deep waters.
The term "artesian" is properly applied only to deep water under
hydrostatic pressure, usually producing flowing wells. Many properly
called artesian wells, however, do not actually flow because of leakage
of water into dry beds, or similar preventable causes. The name is
derived from the district of Artois in France, where flowing wells were
first drilled in the twelfth century.
The outcrop of a stratum supplying artesian wells is usually at a
considerable distance from the locality where the water is tapped by the
well. (See Fig. 1 at A. The well is sho\vn at B.) The essentials for
an abundant artesian flow are as follows:
1. A continuous porous bed to carry water.
2. A rainfall adequate to supply water enough to keep this bed
continually saturated.
3. Exposure of the outcrop sufficient to catch rain enough to satur-ate
the bed.
4. Eelatively imperviovis beds below and above to enclose the water-bed.
5. An inclination of all these beds suflScient to furnish a fall and
head.
6. An absence of escape outlets for water at a lower level than the
well. (See Fig. 6.)
In North Carolina the region of sedimentary or stratifled beds has a
maximum width of only about 140 miles, and the outcrop of water-bearing
stratum is nowhere over 600 feet above sea-level. Therefore,
BULLETIN N. C. BOARD OF HEALTH. 6
except in low spots, the water in deep wells does not rise or overflow
above the surrounding surface.
It is sometimes imagined that large-flowing artesian wells must tap
a subterranean lake which is under heavy pressure by the superim-posed
strata, and that it is this pressure which forces the water out
of the well tiibe. In fact, nO' such compressed subterranean lakes are
known, nor is one likely to be found. The real reservoir which sup-plies
an artesian well may be likened to a tilted tube, filled with sand,
pebbles, and clay. If water be poured in at the higher end of tube
—representing the "outcrop" of a' water-bearing layer—it will perco-late
downward until the entire enclosed mass is saturated. Now if the
lower end of the tube be plugged so no water can escape and a small
hole bored through the wall of the tube, the water will spurt out of
this hole with a force proportionate to the porosity and saturation of
enclosed soil, and the height of head. (See Figs. 1 and 6.) "Artesian
pressure" is ordinary hydrostatic pressure. It is not caused by the
weight of superimposed strata.
The actual quantity of water held in a stratiun and available for
tapping by wells obviously depends largely upon the character of the
water-bearing bed. The following table shows the percentage of water
by weight which some common layers of the earth's crust hold when
saturated:
Per Cent.
Humus 180.
Clay 6.5 to 75.
Loam 50.
Micaceous quartz sand .32.
Loose limestone 31.
Coarse or gi-anular sandstone 29.
Pure quartz sand 26.
Fine or clayey sandstone 4.3
Conglomerate 3.70
Shale 0.1 to 3.8
Basalt 0.85
Compact limestone 0.63
Gneiss 0.19
Granite 0.06 to .12
The Atlantic slope of the United States is underlaid at no great
depth by solid crystalline rock, sloping rapidly from the crest of
the Appalachian mountain chain to and beneath the ocean. (See
Q Fig. 1.) In the South Atlantic States, the western and higher part of
jj» this slope has the crystalline rock within less than 30 feet of the sur-
(P face. The loose overlying soil is usually formed from the weathered
*J* or decomposed bed-rock. A line draAvn from Weldon, X. C, to Smith-
^ field, X. C, from Smithfield to Cary, and from Gary, X. C, to Wades-
4 BULLETIN N. C. BOARD OF HEALTH.
boro, X. C, marks approximately the boundary between the weathered
rock region and the sedimentary or stratified region of the State.
Along the we.stern border of the coastal plain, extending in a
northeast and southwest direction, there lies a belt of coarse Triassic
sandstone and conglomerate from five to ten miles wide. This belt
enters the State from the south a little southwest of Wadesl>oro and
pinches out a little south of Oxford. Durham, Haywood, and Sanford
are situated on this belt. A considerable supply of pure, soft water
can be gotten anywhere on this belt at a depth of from 250 to 500
feet. A 6 14 -inch well at Sanford, about 500 feet deep, yields 45 gallons
per minute.
West of the sandstone belt and having the same trend is a belt of
Huronian slates interspersed with seams of conglomerate. This belt is
from 20 to 30 miles ^-ide. The seams and laminsB dip at a nearly verti-cal
angle. On this belt are situated the cities of Monroe, Albemtirle,
Pittsboro, and Hillsboro. At the present time the slate belt yields the
State's largest supplies of deep water. Tlie wat«r is of good quality.
(See analyses of Monroe and Albemarle waters further on.) It is quite
likely that this belt holds water enough to supply for many decades the
ordinary demands of the towns situated upon it. Probably the best
way to secure large supplies of water from the slate is by means of
gang-wells, 200 to 400 feet deep.
The bed-rock of the region west of the last-named belt is, except a
narrow bed of slate on the French Broad, granite and gneiss. In the
granite region, however, the upper face of the rock is eveiywhere more
or less fissured and in spots is decayed to considerable depths. In these
fissures and pot holes the water from rain collects and flo'vvs along the
fissures or joints. A moderate supply of usually soft wat-er can be had
where a deep well is sunk in crystalline rock at the converging point
of several fissures. But water from wells sunk in granite is simply
local surface-water. It is water which has fallen upon the ground
within a few miles at farthest. Such water is but slightly, if at all,
purified by its short sojourn in the ground. If the surface soil upon
which the water originally fell as rain was contaminated by filth, the
water yielded by the wells will be more or less polluted. Towns in the
granite region having deep water supplies should be very careful to
protect their collecting grounds from pollution. Wells in ciystalline
rock should as a rule be not over four inches in diameter. If more
water than a 4-inch well yields is needed, additional wells should be
sunk. Tlie wells should be aligned so as to cross the general direction
of the cracks and flow of water and should not be closer than 20 feet.
Obviously such wells should not be sunk near or on the lower side of
a cemetery, slaughter-house, or place where the ground is known to be
saturated with decaying organic m.atter. Fissures, joints, and decayed
spots in the granite are always supei-ficial. If satisfactory water is
not obtained by boring into the granite for 250 feet, it is very unlikely
BULLETIN N. C. BOARD OF HEALTH. 5
tO' be found at a lower depth. Before abandoning a dry or small-yielding
well, however, whether it be in rock or in a loose stratum,
the bottom of the hole shovild be torpedoed. (See Fig. 2.) The shat-tering
of the rock or clay around the base of the hole will often tap a
nearby water-bearing crevice or joint. Fully 90 per cent, of the deep
wells in granite have secured water at less than 250 feet. The average
yield of a 4-inch well in granite is about 20 gallons per minute.
Fig. 2.—a common arrangement of pockets or seams of porous nature interspersed
with impervious clay. A, A show successful wells: B, B are unsuccessful, but might
be made to yield water by exploding torpedoes at bottom, causing seams to open to
the gravel pockets.
True artesian water can be reasonably looked for only in a region of
stratified beds. In North Carolina, as a rule, a considerable supply of
such water will be found only within 100 miles of the coast. The
stratified beds of this region were deposited from the waters of the
receding ocean as the mountain^ ridge was gradually pushed up in
geological ages long distant. These beds dip eastward or southeast, fol-lowing
the slope of the underlying rock. The lowermost stratum is
known as the Potomac formation, consisting mainly of sand, kaolin,
and gravel. This stratum is in all the Atlantic States the chief and
best source of deep waters. Next above the Potomac, we usually find
a layer of marl or shell rock A^^th beds of sand and clay, referred to the
Pamunkey or Eocene fornnation. Upon the latter lies a compact blue
clay mixed with layers of marl and sand—the Chesapeake formation.
Upon this in turn we find the reddish, gravelly loams of the Lafayette
and the paler loamy Columbia formations, forming the surface or
agricultural soils of this region.
Fig. 3.—Arrangement of stratified beds in eastern North Carolina. A, crystalline
rock; B, Potomac formation: C, Cretaceous or Pamunkey formation: D, Eocene or
Chesapeake formation; E, Lafayette formation.
In North Carolina, the Potomac formation outcrops in the sand-hill
regions of Moore and Harnett counties, and in the region north of
the Neuse River. The Potomac layer dips steeply to the southeastward.
The upper limit of the Potomac formation, roughly speaking, in North
6 BULLETIN N. C. BOARD OF HKALTH.
Carolina is even with the level of the sea, about 80 miles inland. The
average depth below the surface of the ground of upper limit of the
Potomac formation 100 miles inland from the sea is 200 to 300 feet.
-At Wilmington it i-i more than 1,000 feet below the surface and is there
probably 300 feet or more thick. More or less water is found in all
parts of the Potomac formation. But the securing of large and perma-nent
supplies of good drinking-water from any but the basal horizon is
a doubtful proposition. Most of the wells sunk east of Goldsboro have
not gone deep enough to secure the best quality and largest yield of
water. Unless satisfactory water is encountered sooner well bores in
this region should be drilled to the granite, but should not penetrate
the granite.
Fig. 4.—Arrangement of stratified beds from which no artesian water can be
obtained. The porus stratum is overlaid by impervious clay and has no outcrop.
Most deep wells A\ithin 100 miles of the sea yield water which is at
first excessively hard and salty. But well improves with age, especially
when others are sunk nearby. This improvement is probably due to
the fact that the well at first draws upon water which has long stag-nated
and become saturated \AVa. mineral matter. The continued draft
of the well eventually exhausts the surrounding saturated supply and
fresh wat*r from the head of the bed flows in. Therefore, no well yield-ing
a plentiful supply should he abandoned merely on account of salti-ness
or mineral contents. Most highly mineralized ground waters can
be easily and cheaply improved by softening.
Deep or artesian wells forming a series should be aligned approxi-mately
at right angles to line of flow or dip of strata. Tlie wells
should not be less than 50 feet apart. In artesian wells lateral leakage
into drier strata must be carefully guarded against by means of tight
packing or plugs around well casing. These joints ire made of seed
bags or iiibber discs. The packing of well joints tends to wear out
and becomes inefficient in the course of years and must be renewed.
To determine the approximate height of flow of an artesian well, a
spring pressure gauge may be used. Each pound of pressure per
square inch of piston is equivalent to 2.3 feet rise of water above gauge.
Tlieoretically, water should rise in the well tube to the height of its
fountain-head. But lateral leakage and friction always cause more or
less loss of hydrostatic pressure. In average sand or sandstone an
artesian flow will usually lose from friction alone one foot of head
for each mile of distance from outcrop of the stratum.
BULLETIN N. C. BOARD OF HEALTH.
'Z'-r.
^rROCK 'C'/ ! v:/> C "^V vr?t7;r>tv':'7y;r-f:^g^^^^^^^s::z- 1
Fig. 5.—a common arrangement of stratified beds. Porous stratum yields water at
C, but pinches out further down. Well at D, unsuccessful.
In sinking a deep well, each water horizon encountered should be
carefully tested for amount and quality of its yield. Well drillers,
being paid by the foot,, often pass by good water horizons to finally
accept worse^ or even abandon the well as a failure.
A careful and permanent record or log of the well, with samples of
the material brought up, should be .preserved for future reference.
This record may prove of great value when repairing the well or dupli-cating
it.
The cost of drilling a 6-inch well is usually about $3 per foot.
The proper storage of deep and artesian waters is a matter of great
practical importance. Tliese waters as they come from the wells should
be nearly or quite germ free and sterile. Deep waters, however, always
contain in comparatively large quantities nitrogenous and mineral
matters suitable for food for bacteria and green and blue algae. Tlie
spores or reproductive lx)dies of these organisms are blown about by the
wind everywhere. When water reservoirs are open to the air the water
quickly becomes contaminated by these growths. Tastes and odors of
a peculiarly disagreeable character are produced in water by many
species of algae. The development of such growths in reservoirs can be
prevented by treating the water with copper sulphate—one part to one
million parts water. But the better way is to store deep waters only in
covered reservoirs. Deep waters and surface waters should never be
mixed or stored in same reservoir.
Artesian wells flowing satisfactorily at first, decline from various
causes. Some of these causes, according to T. C. Chamberlin of the
United States Geological Survey, are as follows:
1. Insufficient casing or packing. Insufficient length of pipe will per-mit
the Avater of the bed tapped by the well to leak into another
stratum. Packing around the pipe may also be insufficient to prevent
such leaks, or pressure may be so great as to cause the water to force
its way around or through packing. The greater the hydrostatic pres-sure,
the greater will be the loss of water by leakage. ( See Fig. 6.
)
Remedy.—Sink the pipe into the water-bearing bed. Pack sufficiently
just above this bed and renew packing whenever needed.
2. Filling Up of Bore.—The bore below the well casing may grad-ually
close by lateral pressure or 1)y the disintegi-ation of the surround-ing
stratum.
8 BULLETIN N. C. BOARD OF HEALTH.
Remedy.—Bore through the obstruction without removing casing.
This trouble comes on gradually and is usually found only in a loose
stratum.
3. Decay of Casi)ig.—This may cause waste of water by lateral leak-age.
The usual life of pipe in an artesian well is very brief—nirely
more than seven years. In many cases the jjipe becomes perforated in
two years. As a rule, the more highly mineralized the water is, the
more, rapid will be the decay of the pipe. Trouble of this kind increases
rapidly after starting. Remedy, renew casing.
4. Exhaustion of Supply.—The source of artesian water is the rain-fall.
In the eastern United States the water-bearing strata are fed by
an abundant and fairly uniform rainfall. Exhaustion of the supply is
therefore not likely to happen as regards any particular bed unless
carrying capacity of bed lias been overworked. When exhaustion not
due to waste really occurs, there is no remedy.
Fig. 6.—a typical artesian basin. A. water-bearing, porous bed. B, dry, porous bed.
E, outlet of dry bed. F, level of outcrop of A. Well I shows result of insufficient cas-ing
and lack of plugging between the two porous beds. The water from A escapes into
B and issues as a spring at E. Well II shows the good bed A passed and cased off and
well sunk into dry bed. Water from A escapes from outside of pipe at surface of ground.
Well III shows a properly plugged and cased bore.
ANALYSES OF NORTH CAROLINA DEEP WATERS.
The following analyses of samples from North Carolina public water
supplies derived from deep wells were made in the State Lalx)ratory of
Hygiene during the months of Jaauary and February, 1907. Complete
data as to depth of many of these wells and the nature of water-bearing
beds are unattainable. In most eases no records were made or they
have not been preser\'ed.
The comments on character of the different waters are by the author
of the present paper. The numerical determinations are in all cases
parts per million.
ALBEMARLE.
filiate rcyioii, 'i2 miles icest of eoasfal plain).
Odor » none.
Color 10.
Turbidity 1-6
Sediment none.
BULLETIN N. C. BOARD OF HEALTH. 9
Total solids 210.
Alkalinity 100.
Temporary hardness 100.
Permanent hardness 15.8
Total hardness 115.8
Incrustants • • 15.8
Iron trace.
Phosphates trace.
Chlorine 12.
Nitrates 90
Nitrites trace.
Ammonia, free .027
Ammonia, albmninoid .010
Algae none.
Infusoria none.
Organic detritus none.
Bacillus Coli- communis in 5 c.c none.
Other bacteria Harmless saprophytes.
Remarks.—Good but hard. Well 2.37 feet deep in hard blue slate.
Pumps 25 gallons per minute.
EDENTON.
(Coastal plain, 50 miles from sea).
Odor none.
Color 12.
Turbidity 2..J
Sediment none.
Total solids 610.
Alkalinity 400.
Temporary hardness 246.
Permanent hardness 0.
Total hardness 246.
Incrustants 0.
Iron .15
Phosphates trace.
Chlorine 61.
Nitrates 17
Nitrites considerable.
Ammonia, free .385
Ammonia, albuminoid .093
Algae none.
Infusoria none.
Organic detritus none.
10 BULLETIN N. C. BOARD OF HP:ALTH.
Bacillus Coli-coramunis in 5 c.c none.
Other bacteria Harmless saprophytes.
Kemauks.—Water contains an excessive quantity of lime and dis-solved
minerals. Can be very greatly improved by softening. Water-bed
is cretaceous marl.
KINSTOX.
(Coastal plain, 110 miles from sea).
Odor none.
Color 12.5
Turbidity 2.5
Sediment none.
Total solids 150.
Alkalinity 91.
Temporary hardness 78.75
Permanent hardness 7.8
Total hardness '. 92.8
Incrustants none.
Iron trace.
Phosphates trace.
Chlorine 9.
Nitrates . 20
Nitrites , trace.
Ammonia, free .015
Ammonia, albuminoid .063
Algae none.
Infusoria none.
Organic detritus '. none.
Bacillus Coli-communis in 5 c.c none.
Other bacteria Harmless saprophytes.
Remarks.—Pure, soft water, suitable for all uses. Water from sandy
cretaceous bed. Was formerly much harder than at present.
LEXINGTON.
(Oramte region, 10 miles west of coastal plain).
Odor n6ne.
Color 12.5
Turbidity 2.6
Sediment none.
Total solids 350.
Alkalinity 76.50-
Temporary hardness 76.50
Permanent hardness 171.
Total hardness 247.50
Incrustants •. . . 171.
BULLETIN N. C. BOARD OF HEALTH. 11
Iron .15
Phosphates trace.
Chlorine 12.
Nitrates 4.2.5
Nitrites trace.
Ammonia, free .010
Ammonia, albuminoid .030
Algae none.
Infusoria none.
Organic detritus none.
Bacillus Coli-eommunis in 5 c.c none.
Other bacteria Harmless saprophytes.
Remarks.—Pure water. Very hard and contains an excessive quan-tity
of dissolved mineral matter. The water can be greatly improved
by softening. Well 826 feet deep. Pumps about 80 gallons per minute.
LIXCOLNTON.
(Piedmont granite region).
Odor none.
Color 5.8
Turbidity 0.6
Sediment none.
Total solids 110.
Alkalinity 31.62
Temporary hardness 31.62
Permanent hardness . ; 21.25
Total hardness .52.87
Incrustants 21.25
Phosphates . trace.
Iron 08
Chlorine 3.8
Nitrates .13
Nitrites none.
Ammonia, free .035
Ammonia, albuminoid 4 .045
AlgiB none.
Infusoria none.
Organic detritus none.
Bacillus Coli-eommunis in 5 c.c none.
Other bacteria Harmless saprophytes.
Eemarks.—Pure, soft water. Suitable for all uses. Water from
fissures in granite. Depth of wells about 150 feet.
12 BULLETIN N. C. BOARD OF HEALTH.
MONROE.
(i^'lutv rcf/ioii, ,i(l miles iccst of coastal pl'iin).
Odor none.
Color 8.
Turbidity " 2.
Sediment none.
Total solids . 250.
Alkalinity 148.9
Temporary hardness 148.
Permanent hardness 15.
Total hardness 163.
Incrustants 15.
Iron trace.
Phosphates trace.
Chlorine » 18.4
Xitrates .15
Nitrites trace.
Ammonia, free .030
Ammonia, albuminoid .035
Algae none.
Infusoria none.
Organic detritus none.
Bacillus Coli-communis in 5 c.c none.
Other bacteria Harmless saprophytes.
Remarks.—Pure, but hard water. Well 1.000 feet deep, in compact
blue slate. Pumps 55 gallons per minute.
MORGAXTON.
(Piedmont granite region).
Odor none.
Color 12.5
Turbidity 1.4
Sediment none.
Total solids . .
.^ 44.
Alkalinity . . .
.' 26.
Temporary hardness 26.
Permanent hardness 17.
Total hardness 43.
Incrustants •. 17.
Iron trace.
Phosphates trace.
Chlorine 6.
Nitrates .32
Nitrites none.
Ammonia, free .041
BULLETIN N. C. BOARD OF HEALTH. 13
Ammonia, albuminoid .055
Algie none.
Infusoria none.
Organic detritus none.
Bacillus Coli-communis in 5 c.c none.
Other bacteria Harmless saprophytes.
Remarks.—Very pure, soft water. Suitable for all uses. Water
from fissures in granite.
NEW BEEN.
(Coastal plain, 4? miles from sea).
Odor none.
Color 10.
Turbidity 2.5
Sediment none.
Total solids .' 290.
Alkalinity 14.3.8
Temporary hardness 14-3.8
Permanent hardness 46.25
Total hardness 190.
Incrustants 46.25
Iron trace.
Phosphates trace.
Chlorine 27.
Nitrates 18
Nitrites trace.
Ammonia , free .052
Ammonia, albuminoid .042
Algse none.
Infusoria none.
Organic detritus none.
Bacillus Coli-communis in 5 c.c none.
Other bacteria Harmless saprophytes.
Remarks.—Pure, but A-eiy hard water. From cretaceous marl bed.
Can be improved for all purposes by softening.
SPENCER.
(Granite region, 10 miles west of coastal phiin).
Odor none.
Color 10.
Turbidity 2.5
Sediment none.
Total solids 150.
Alkalinity 84.6
Temporary hardness 67.50
14 BULLETIN N. C. BOARD OF HEALTH.
Permanent hardness 3.75
Total hardness 7L25
Incrustants trace.
Iron trace.
Phosphates trace.
Chlorine 4.
Nitrates 16
Nitrites trace.
Ammonia, free .018
Ammonia, albuminoid .048
Algae none.
Infusoria none.
Organic detritus none.
Bacillus Coli-communis in 5 e.e none.
Other bacteria Harmless saprophytes.
liEMARKS.—Good, soft Water. Suitable for all uses. Well 6 inches
in diameter, 200 feet deep. Pumps 67 gallons per minute. Water from
crevices in granite.
TARBORO.
(Coastal plain, 112 miles from sea).
Odor none.
Color 15.5
Turbidity 5.
Sediment none.
Total solids 120.
Alkalinity 53.
Temporary hardness 53.
Permanent hardness .• 6.25
Total hardness 59.25
Incrustants 6.25
Iron 60
Phosphates trace.
Chlorine 8.
Nitrates 18
Nitrites trace.
Ammonia, free .015
Ammonia, albuminoid .060
Algae none.
Infusoria • none.
Organic detritus none.
Bacillus Coli-communis in 5 c.c none.
Other bacteria Harmless saprophytes.
Remarks.—Pure, soft water. The iron content is persistently above
permissible limit. Water from drilled well 80 feet deep. Water-bed in
sandv cretaceous marl.
BULLETIN N. C. BOARD OF HEALTH. 15
REVIEW OF DISEASES FOR MARCH, 1907.
SE\'EXTY-XIXE COUXTIES REPORTING.
Ninety-three counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases, the
Superintendent has, as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-coii-tagious
diseases to him.
Where the number of cases is not given, or the prevalence of a disease
otherwise indicated, its mere presence in the county is to be understood
as leported.
For the month of March the following diseases have been reported
from the counties named:
Measles.—Alamance, some cases; Alexander, 150; Beaufort; Bladen,
a few; Cabarrus, 23; Camden, epidemic; Caswell, several; Cherokee, 3;
Chowan, several; Cleveland, many; Cumberland; Currituck, a few;
Davidson; Davie, several; Durham, many; Edgecombe, a great many;
Franklin, many; Gaston, 15; Graham, 3; Granville, 40; Guilford, 7;
Halifax; Harnett, 28; Haywood, several; Henderson, 3; Hertford,
many; Iredell, 8; Johnston, several; Lincoln, several; McDowell, 1;
Macon, in all parts; Mecklenburg; Nash, many; Northampton, a great
many; Orange, 1; Pasquotank, many; Pender, a few; Randolph, 8;
Richmond, 2; Robeson, several; Rowan, many; Rutherford, 50; Surry,
25; Transylvania, 1; Wake, 10; Warren, a few; Washington, many;
Watauga, 10; Wilkes, 5; Yadkin, several—50 counties.
Whooping-cough.—Alexander, 4: Bladen, a few; Cabarrus, 3; Cas-well,
several; Chowan, several; Cleveland, many; Craven, several;
Cumberland; Davie, many; Durham, a few; Edgecombe, a great many;
Forsyth, a few; Franklin, in all parts; Granville, 4; Halifax, epidemic;
Harnett, 24; Hertford, several; Lincoln, several; Mecklenburg; Nash,
3; Northampton; Randolph, 1; Rutherford, 80; Sampson, a few;
Transylvania, a few; Warren, a few—26 coimties.
Scarlatina.—Alexander. 2; Buncombe, 3; Catawba, 8; Ga,stfcn, 2;
Guilford, 1; Pitt, 1; Wake, 1—7 counties.
Diphtheria.—Alexander, 1; Cabarrus, 1; Cleveland, 1; Craven, 2;
Duplin, 1 ; Edgecombe, 1 ; Gaston, 1 ; Guilford, 3 ; Halifax, 1 ; Harnett,
2; Iredell, 1; Mecklenburg; Nash, 3; New Hanover, 2;" Suriy, 2;
Vance, 1 ; Watauga, 2—17 counties.
Typhoid Fe'V^r.—Alamance; Alexander. 1; Caldwell, 1; Caswell, 1;
Chatham, 1; Cleveland, 1; Cumberland; Edgecombe, several; Franklin,
2; Gaston, 1; Granville, 1; Haywood. 2; McDowell, 1; Mecklenburg;
New Hanover, 6; Onslow, 2; Pender, 1: Randolph, 1; Watauga, 1
—
19 counties.
16 BULLETIN N. C. BOARD OF HEALTH.
jVLiLAKiAL Fever.—Craven; Hyde.
Malarial Fever, Pernicious.—Hyde, 8.
Malarial Fever, Hemorrhagic.—Craven, 1 ; Hyde, 2.
Meningitis, Cerebrospinal.—Caswell, 2; Martin, 1; Richmond, 1.
Influenza.—Alamance; Bertie, general; Brnnswick; Burke, Cas-well,
Cherokee, general; Currituck; Edgecombe, general; Gaston, a
severe type; Graham, Halifax, Henderson, Hertford, Hyde, Lincoln,
McDowell, Montgomery, general; jSTorthampton ; Pender, general; Per-son;
Robeson; Rowan, in nearly all parts; Sampson, general; Sfotland;
Stanly, general ; Surry, Transylvania, Warren, Washington, Watauga,
Wilkes, general; Yadkin; Yancey—33 counties.
Pneumonia.—Alamance; Alexander, 45; Bladen, 3; Brunswick, 6;
Cabarrus, 2; Caldwell, 3; Camden, 3; Caswell, several; Catawba, 6;
Cherokee, 10; Chowan, scA'eral; Cleveland, several; Cumberland; David-son;
Davie, a few; Durham, a few; Forsyth; Franklin, many; Gaston,
12; Graham, 1; Greene, G; Halifax, many; Harnett, 23; Haywood,
several; Henderson, 6; Hertford, 10; Hyde, 6; Iredell, 5; Johnston, a
few; Lincoln, several; Macon, in all parts; Martin, a few; Mecklenbvirg
;
Montgomery, 6; Nash, 12; New Hanover, a few; Northampton, many;
Onslow; Person; Randolph. 3; Richmond, several; Rowan, several;
Rutherford, 3; Sampson, a few; Scotland; Stanly, a few; Surry;
Transylvania, several; Union, a few; Wake, 43; Warren, many;
Watauga, 3; Wilkes, 5; Yadkin, 1—54 counties.
Mumps.—Yancey.
Varicella.—New Hanover, in all parts; Union.
Small-pox—Alamance, 12; Bertie, 4; Chatham, 12; Cherokee, 1
Chowan, several ; Cleveland, 4 ; Currituck, 1 ; Davidson ; Duplin, 3
Durham, 35; Forsyth, 13; Franklin, 10; Gaston, 6; Granville, 5
Guilford, 4; Halifax, 1; Harnett, 2; Hertford. 8; Hyde. 1; Lincoln, 4
Mecklenburg, 1; Nash, 1; New Hanover, 1; Orange, 13; Pitt, 8; Rich-mond,
3; Robeson, 8; Vance, 6; Wake, 27; Warren, 4; Washington, a
few mild cases, next to Tyrrell County, which has no County Superin-tendent
of Health and in which the small-pox situation is neglected
—
31 counties.
Cholera, in Hogs.—Harnett, Sampson.
Distemper, in Horses.—Burke.
No diseases reported from Alleghany, Anson, Polk, Wayne, and
Wilson.
No reports received from Ashe, Carteret, Clay, Columbus, Dare, Gates,
Jackson, Jones, Lenoir, Macon, Mitchell, Moore, Pamlico, Perquimans,
Rockingham, and Swain.
BULLETIN N. C. BOARD OF HEALTH. 17
SUMMARY OF MORTUARY REPORTS FOR MARCH, 1907.
T^\^EXTY-OXE TOWNS.
White.
Aggregate popiijation 116,450
Aggregate deaths 136
Representing temporary annual death rate
per 1,000 14.0
Causes of Death—
Mahirial fever , 1
Whooping-cough 1
Measles 2
Pneumonia 32
Consumption 15
Brain diseases 7
Heart diseases 5
Xeurotic diseases 6
Diarrhoea! diseases , 7
All other diseases 55
Accident 2
Violence 3
136
Deaths under five years 28
Still-born 8
CoPd.
76.650
163
25.6
Total
193,100
299
18.6
18 BULLETIN N. C. BOARD OF HEALTH.
Mortuary Report for Marcb, 1907.
Towns
AND Reporters.
Charlotte |
Dr. F. O. Hawley. f
Durliani j
Dr. N. M. Johnson. f
Edeiitou \
Dr. Thomas J. Hoskins j
Elizabeth City 1
Dr. H. D. Walker. (
Fayettevllle )
Dr. A. S. Rose. J
Goldsboro /
Robt. A. Creech, Esq. f
Greensboro I
Dr. Edmund Harrison, f
High Point I
Dr. C. E. Reitzel. f
Marloii i
Dr. B. L. Ashworth. '"
)
Oxford 1
Dr. S. D. Booth. f
Raleigh. I
T. P. Sale, Clerk B. H. I
Rocky Moiiut I
Dr. L. C. Covington. I
Salem )
S. E. Butner, Supt. H. f
Salisbury )
Dr. H. T. Trantham. (
Sonth]>ort I
Dr. J. A. Dosher. (
Tarboro |
Dr. S. N. Harrell. i
Wadesl>oro )
Dr. J. H. Bennett. (
"Washiugtou )
Dr. John G. Blount. f
AVeldon I
J. T. Gooch, Mayor. (
Wiliniiigtou I
Dr. Charles T. Harper, j"
Wilson I
Dr. W. S. Anderson, f
Popula-tion.
Tem-porary
Annual
Death-rate
PER
1,000.
18,000 00 ooQ
12, OOOi "'"""'
10,000, J, f.J 8,000^*^'""":
1,400
2,600
6,000
4,000
3,500
2,500
5,000
3,000
10,000
5,000
7,500
1,900
1,400
100
1,700
1,500
9,000
7,000,
4,000
10,000,
6,000
8,000
15.000
9,400
1,500
3,200
16,000
3,000
5 000
2,000,
°'"""
3,400^
400
3.800
7-400! , 3,600,^^'0"0"0"
1,400
3,500
2,000
900
500
2.500l
1,000
1,200
800
4,000
3,000
750
750
16,000
14,000
3,800
3,000
7,000
1,500
30,000
6,800
9.3
11.0
13.2
30.0
8.6
13.8
14.0
48.0
37.7
28.8
9.6
36.0
10.8
60.0
14.4
31.6
8.6
0-0
21.2
16.0
18.7
29.1
16.0
24.0
10.6
30.0
13.0
13.3
13.3
0.0
9.6
12.0
0.0
0.0
18.0
40.0
32.0
0.0
16.5
20.5
12.6
20.0
•ill 5 11
52
EOQ-^ s. £ a
Eh Mi§iQ|^iSiai|o[P3:K
C 5 Ka)^.2= ug
10.
20.
12.
27.
34.
18.
27.
17.
8.
18.
23.
19.
12.6
13.1
8.6
10.3
0.0
27.4
16.0
18.4
13.0
Z'Q\< <!iW|>
J Si -
si I'll g
!>it >.' ID'S MM OlM
4
1
2
1
6
10
2
0|
22
-|24j
-I 4!
...; 5
6 5
3i 1
2...
7! 2
2...
6 2
1 1
3 1
2\...
3 2
2 1
2...
2i-
41 1
Ij...
'il'.'.
3.
3-
2—
6' 1
7j 7
1...
3...
N. B.���The reporters for the cities and towns printed in Blacfe Type have signed this certificate :
"I hereby certify that this report gives the whole number of deaths occurring within the corporate
limits during the above month."
BULLETIN N. C. BOARD OF HEALTH. 19
County Superintendents of Healtli.
Alamance Dr. George W. Long.
Alexander Dr. O. L. Hollar.
Alleghany Dr. B. E. Reeves.
Anson Dr. J. H. Bennett.
Ashe Dr. Manley Blevins.
Beaufort Dr. John G. Blount.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C. G. Ferebee.
Carteret Dr. F. M. Clarke.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. J. H. Taylor.
Cherokee Dr. J. A. Abernathy.
Chowan Dr. T. J. Hoskins.
Clay Dr. J. M.Sullivan.
Cleveland Dr. B. H. Palmer.
Columbus Dr. H. B. Maxwell.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare Dr. W. B. Fearing.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. J. Gerald Murphy.
Durham Dr. T. A. Mann.
Edgecombe Dr. S. N. Harrell.
Forsyth Dr. S. F. Pfohl.
Franklin Dr. R. F. Yarborough.
Gaston Dr. L. N. Glenn.
Gates Dr. W. O. P. Lee.
Graham Dr. M. T. Maxwell.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy.
Guilford Dr. Edmund Harrison.
Halifax Dr. L E. Green.
Harnett Dr. J. W. Halford.
Haywood Dr. J. R. McCracken.
Henderson Dr. J. G. Waldrop.
Hertford Dr. C. F. Griffin.
Hyde Dr. R. E. Wlndley.
Iredell Dr. M. R. Adams.
Jackson Dr. William Self.
Johnston Dr. Thel Hooks.
Jones
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. R. W. Petrie.
McDowell Dr. B. L. Ashworth.
Macon Dr. F. L. Siler.
Madison Dr. W. J. Weaver.
Martin Dr. W. E. Warren.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell.. Dr. Virgil R. Butt.
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod.
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico Dr. H. P. Underbill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. Robt. H Bradford.
Perquimans Dr. C. C. Winslow.
Person Dr. J. A. Wise.
Pitt Dr. Joseph E. Nobles.
Polk Dr. C. J. Kenworthy.
Randolph Dr. A. M. Bulla.
Richmond Dr. L. D. McPhail.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. I. H. Foust.
Rutherford Dr. E. B. Harris.
Sampson Dr. J. O. Matthews.
Scotland Dr. A. W. Hamer.
Stanly Dr. J. N. Anderson.
Stokes
Surry Dr. John R. Woltz.
Swain Dr. R. L. Davis.
Transvlvania Dr. C. W. Hunt.
Tyrrell
Union Dr. Henry D. Stewart.
Vance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. P. J. Macon.
Washington Dr. W. H. AVard.
Watauga Dr. H. McD. Little.
Wayne Dr. J B. Outlaw.
Wilkes Dr. John Q. Myers.
Wilson..'. Dr. W. S. Anderson.
Yadkin Dr. M. A. Rovall.
Yancey Dr. J. B. Gibbs.
OHAPEL HILL N C
Dr I H Manning
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh. N. C.
Geo. G. Thomas, M. D., Pres., Wilmington, i T. E. Anderson. M. D.--Statesville.
S. Westray Battle, M. D.- Asheville. J. Howell Way, M. D Waynesville.
Henry W. Lewis, M. D Jackson. W. O. Spencer. M. D Winston-Salem.
W. P. IVEY, M. D. Lenoir. J. L. Ludlow, C. E. Winston-Salem.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XXII. MAY, 1907. No. 2.
LEGISLATION RELATING TO THE PUBLIC HEALTH BY THE
GENERAL ASSEMBLY OF 1907.
The last Legislature showed more interest in the subject of the public
liealth than any of its predecessors. Tliis is encouraging, especially
as every act passed is helpful to the cause.
We cannot say as much, however, for the legislation bearing on the
practice of medicine. A bill requiring a preliminary education on the
part of applicants for license to practise medicine equal to the entrance
examinations of the State University and our leading colleges was so
sliarply attacked in the Senate that its author was only too glad to
have it re-referred, that it might die a peaceful death in committee.
Special acts were passed "for the relief of certain physicians of Cherokee,
Clay, and Graham counties," and "for the relief of certain physicians
in Chatham County." The former allows physicians having diplomas
from reputable medical colleges until May 1, 1909, to obtain license from
the Board of Medical Examiners and gives them the right to practise
until that date without the regular license. Tlie Chatham County
act simply allows physicians having no diploma the pri\nlege of stand-ing
the examinationi for license. Those advocating the above claimed
that unless the "relief" sought was granted they would be, to a large
extent, without physicians of any kind; that licensed physicians with
rare exceptions could not be induced to settle in their rough mountain
country sparsely settled with a population not overly rich in this
22 BULLETIN X. C. BOAED OF HEAI.TH.
r
world's goods. An act was also passed allowing an old doctor of 80,
who had returned to the State, to practise without license. While not
serious, perhaps, this is the first legislation in the least impairing our
medical license law that we remember. Everything heretofore has
been progressive, but this tends to retrogression. The sentiment in
favor of the license law is. however, so strong that we do not anticipate
any material damage to it.
We give below the other acts of a general character in full, except
that, to save space, we have omitted the enacting and ratification clauses.
When not otherwise stated, they go into effect immediately.
AN ACT TO AilEND SECTIOX 3057 OF THE REVISAL OF 1905,
IX RELATION TO THE STATE LABORATORY OF HYGIENE.
Section 1. That section 3057 of the Revisal of 1905 be amended by
striking out in line eighteen the words "twelve hundred dollars" and
inserting in lieu thereof the words "two thousand dollars annually,"
and by inserting after the words "sixty," in line nineteen, the word
"four."
[The effect of the above is to add two thousand dollars from the
general treasury to the annual income of the laboratory, heretofore
derived solely from the sixty-dollar tax on water companies. The
$1,200 stricken out was a single and not a continuing appropriation.
The four dollars were added to cover expressage on samples, as some
of the companies refused to pay it. The income of the laboratory now,
while not large, will, we think, be sufficient to enable it to adequately
fulfil its mission.]
AN ACT TO AMEND SECTION 3052 OF THE REVISAL OF 1905,
IN RELATION TO WATER SUPPLIES.
Section 1. That section 3052 of the Revisal of 1905 be amended by
striking out all after the word "maintain," in line five, and inserting
in lieu thereof the following: "A system for collecting and disposing
of all accumulations of human excrement within their respective juris-dictions,
or control, at least once each week, by burning, by burial, or
by some other method approved by the State Board of Health."
[The original act to protect water supplies required tlic removal of
human excrement from the water-shed, which was impracticable and
unnecessary.]
BULLETIN N. C. BOARD OF HEALTH. 23
AX ACT TO AMEND SECTION 3056 OF THE REVISAL OF 1905,
IN RELATION TO WATER SUPPLIES.
Sectiox 1. Tliat section 3056 of the Revisal of 1905 be amended by
adding at the end thereof the following: "And if at the end of ninety
days more, or four months from the time of the first service of said
notice of dangerous conditions and demand for their removal, the said
removal has not been accomplished, the firm, individual, or corporation
selling -svater to the public shall be guilty of a misdemeanor, and shall
upon conviction thereof be fined in the sum of five hundred dollars; and
a continuance of the said conditions dangerous to the public health for
thirty days thereafter shall constitute a new offense and be punishable
by a fine of the same amount: Provided, that the time limit above set
may be extended by a committee of three members of the State Board
of Health, of which committee the secretary and the engineer shall be
two, to such extent as the facts and conditions in the case may in
their judgment warrant."
AN ACT AUTHORIZING THE STATE BOARD OF HEALTH TO
PROVIDE FOR THE PREVENTIVE TREATMENT OF HYDRO-PHOBIA.
Sectiox I. That the State Board of Health is hereby authorized and
empowered to provide for and have conducted under its direction the
preventive treatment of hydrophobia or rabies, whenever in its judgment
circumstances, financial and other, will justify it. To meet the expenses
of this treatment the said board is hereby given authority to supple-ment
the revenue derived from fees for the treatment by such sums
from the treasury of the State Laboratory of Hygiene as may be
necessary: Provided, that the usefulness and efficiency of the said
laboratory is not thereby impaired.
Sec. 2. "That the benefits of said treatment shall be given free of
charge to all residents of the State who shall present to the Secretary
of the State Board of Health, or its representative having in charge
the management of this special work, an affidavit of inability to pay,
duly sworn to and subscribed before a justice of the peace, or, if the
case be a minor, such an affidavit by the parent or guardian. To meet
as far as may be the expenses of this special work, the said State
Board of Health is hereby authorized and directed to 'demand from
those able to do so the pajanent in advance of a reasonable fee, not to
exceed in any case the usual charge made by the reputable Pasteur
institutes of this covmtry.
24 BULLETIN :X. C. BOARD OF HEALTH.
AN ACT TO ESTABLISH A SAXATOEIUJNI FOR THE TREATMENT
OF TUBERCULOSIS.
Section 1. That there shall be appi'opriated the sum of fifteen thou-sand
dollars from the general fimds in the State Treasiuy for the
establishment of a sanatorium for the treatment of persons afflicted
with tuberculosis.
Sec. 2. That the control of the said sanatorium shall be vested in a
board of directors composed of twelve members, to be elected by the
General Assembly of North Carolina.
Sec. 3. Tliat the said board of directors shall be appointed in four
classes of three directors each : the first class to serve for a period of
two years; the second class for a period of four years; the third class
for a period of six years, and the fourth class for a period of eight
years. The following members shall constitute the first board of
directors, to-wit: First class, I. E. Green, Y. T. Ormand and W. H.
Whitehead, who shall serve for a period of two years from the date
of their election and until their successors are elected and qualified;
second class, to be composed of John D. Dawes, W. E. Breese and Walter
Murphy, who shall serve for a period of four years from the date of
their election and until their siiccessors are duly elected and qualified;
the third class shall be composed of N. A. McLean, M. Eugene Street
and Dr. J. R. Gordon, who shall serve for a period of six years from
the date of their election and imtil their successors are duly elected
and qualified; the fourth class shall be composed of Dr. J. E. Brooks,
J. Reese Blair and L. S. Blades, who shall serve for a period of eight
years from the date of their election and until their successors are
duly elected and qualified. The Secretary of the North Carolina State
Board of Health shall be ex officio a member of the board of directors.
Sec. 4. In case any vacancy or vacancies shall occur in either of the
said classes by deathi or removal from the State of any member of the
said board of directors as hereinbefore composed, or for any other
leason, such A-acancy or vacancies shall be filled by the board, the
person or persons thus chosen to serve until the next succeeding session
of the General Assembly of North Carolina, when a successor or succes-sors
shall be elected by the General Assembly to fill out the unexpired
term of the class or classes in which said vacancy or vacancies occur.
Sec. 5. That said board of directors shall be and are hereby consti-tuted
a body politic and corporate, imder the name and style of "North
Carolina Sanatorium for the Treatment of Tuberculosis," and upon
them, as such, are hereby conferred all the duties, powers, privileges
and obligations incident to bodies corporate.
Sec. 6. Tliat said board of directors are hereby given full power and
authority to meet and organize themselves, from their own numbers to
elect a chairman, to purchase sites, to erect buildings and to provide
such apparatus and equipment as may be necessary to establish such
BULLETI^"^ X. C. BOAKD OF HEALTH. 2o
a sanatorium and prepare it for the reception of patients: Provided,
such expenditures do not exceed the amount appropriated by section
one of this act; v.ith power in ths board to elect a superintendent, fix
his compensation, and do every other act or thing reasonably necessary
and incident to carrying out the provisions of this act.
Sec. 7. The board of directors shall prescribe the duties of the
superintendent, who shall be a skilled physician of good character and
good business habits and otherwise qualified to discharge the duties of
his oftice. He shall hold office for a period of two years from and after
the date of his election, unless sooner removed therefrom by the board
for incompetency or misconduct in office, and shall keep a record of his
transactions and duly enter the same in a book or books for the
piupose.
Sec. 8. ITiat said superintendent shall employ such subordinate
officers and employees of said sanatorium as may be necessary and fix
their compensation, subject to the approval of the board, and said
superintendent shall have the power to discharge the same for incom-petency
or misconduct in office, and the proceedings in regard to such
shall be reported to the said board of directors.
Sec. 9. The superintendent shall make monthly reports to the chair-man
of the board of directors, clearly setting forth the conditions and
workings of the institution, and upon the receipt of such report said
chairman shall have authority to convene said board, if in his discre-tion
it is necessary to do so. Said superintendent shall make a detailed
report of the conditions and workings of the institution every three (3)
months 'to the board of directors, and he shall also make a detailed
report to the Governor and the General Assembly. The directors shall
be required to hold meetings of their board every three (3) months, or
oftener, if the chairman of said board shall call them together, and
said board shall be required to make annual reports of the conditions
and workings of the hospital herein provided for to the Governor and
General Assembly.
Sec. 10. The board of directors shall at their first meeting select from
their number an executive committee, composed of the chairman of
said board and two of their members, who, in the absence of the board
of directors, shall have the direction of the affairs of the said hospital.
Sec. 11. Tlie board of directors shall make all such by-laws and regu-lations
for the government of the hospital as shall be necessary, among
which >ihall be such as shall make the said sanatorium as nearly self-supporting
as shall be consistent with the purpose of its creation.
Sec. 12. The Treasurer of the State of North Carolina shall be the
treasurer of the said corporation. The said treasurer shall keep all
accounts of the said sanatorium and pay out all moneys, upon a
warrant of the superintendent of said sanatorium, countersigned by two
members of the board of directors, under such rules and regulations as
said board mav establish.
26 BULLETIN N. C. BOARD OF HEALTH.
Sec. 13. For the purpose of maintaining and defraying the running
; expenses of said sanatorium there shall be appi'opriated annually the
! sum of five thousand dollars ($5,000) from the general funds of the
State Treasury in addition to the appropriation provided for in section
one of this act, which shall be deposited with the treasurer of the corpo-ration
and shall be subject to the orders of the said board.
Sec. 14. Said board of directors shall be empowered to receive or
accept gifts or donations for the benefit of the said sanatorium, and
said board shall, in their discretion, use the same for carrying out the
purposes for which the said sanatorium is established.
Sec. 15. Each member of the board of directors shall be entitled to
receive as compensation the sum of two dollars ($2) per day while
exclusively engaged in conducting the affairs of the said sanatorium.
in addition to his necessary traveling expenses and hotel bills.
AN ACT PROVIDING FOR THE SEPARATION OF PRISONERS
SUFFERING WITH TUBERCULOSIS FROM OTHER PRISON-ERS.
Section 1. That the Board of County Commissioners of the respective
counties of North Carolina shall provide in the jail-house or in any
camp or place where prisoners are committed for keeping or sentenced
to a term of imprisonment in any county in the State of North Caro-lina,
separate cells or rooms or a place in which shall be confined any
prisoner or prisoners who may be committed for keeping or sentenced
to said prison or place of confinement for a term of imprisonment, who
has been examined by the County Superintendent of Health and pro-nounced
by the said County Superintendent of Health as being affected
witli tuberculosis.
Sec. 2. That it sliall be the duty of any Sheriff of any county when a
prisoner is phiced in his custody for the purjwse of being committed to
jail or any place of confinement mentioned in this act, who said Sheriff
has been informed or has any reason to believe or suspect is suffering
with tuberculosis, to have any such prisoner examined by the County
Superintendent of Health, and if said prisoner shall be pronounced by
said County Superintendent of Health as a tuberculous prisoner, then
said prisoner shall be separated from the other prisoners and confined
in a separate cell or place provided for by this act.
Sec. 3. That it shall be the duty of the Board of Directors of the
State's Prison to provide separate cells or apartments in the said
State's Prison in which shall be l-cept any prisoner or prisoners wlio
may be sentenced to tliat institution for a term of imprisonment, who
after being examined and pronounced by the physician in charge as
being affected with tuberculosis.
BULLETIN X. C. BOARD OF HEALTH. 27
Sec. 4. Tliat the cells and places of confinement provided for in this
act for prisoners affected with tuberculosis shall be kept exclusively for
said tuberculous prisoners, and under no circumstances or conditions
shall any other prisoner be committed or sentenced to the institutions
and places of imprisonment mentioned in this act, who is well and not
affected with tuberculosis, be confined in. the cells or places of confine-ment
therein provided for tuberculous prisoners: Provided further,
that when said cells or places of confinement provided for in this act,
either in the county jail or camps or the State's Prison, have been used
and occupied by any prisoners affected with tuberculosis, the said cells
or places of confinement shall not be used for any other prisoners until
the County Superintendent of Health or the physician in charge and
health authorities of the State's Prison have been notified, and the said
cells or places of confinement have been thoroughly* fumigated and disin-fected
under the supervision of the said County Superintendent of
Health or the physician in charge and the health authorities of said
State's Prison, in the manner prescribed and required by the State
Board of Health.
Sec. 5. Whenever any prisoner or prisoners shall be committed to any
of the prisons or places of confinement designated in this act, it shall
be the duty of the Sheriff of the county or the warden of the State's
Prison, as the case may be, in the event any such prisoner or prisoners
be known or suspected by said authorities to be suffering with tubercu-losis,
to have any such prisoner or prisoners examined by the County
Superintendent of Health or the physician in charge within five days
after they have been committed or sentenced to said prison.
Sec. 6. That nothing contained in this act shall be construed as to
interfere with or prevent the county or State authorities from working
together all prisoners on public works as now provided for by law.
Sec. 7. Tliat any person or persons \aolating any of the terms or
pro\asiOns of this act shall be guilty of a misdemeanor and upon con-viction
shall be punished in the discretion of the Court.
Sec. 8. This act shall be in force from and after August first, one
thousand nine hundred and seven.
In the General Assembly read three times, and ratified this the 4th
day of March, A. D. 1907.
AN ACT REQUIRING RAILROAD COMPANIES TO KEEP THEIR
PASSENGER-CARS AND TOILET-ROOMS CLEAN AND DECENT.
Section 1. That every person or railroad company, whether incorpo-rated
or not. engaging in the regular business of carrying passengers on
its railroad ears in this State, shall have the passenger-cars on their
roads cleaned, brushed and dusted and the windows washed, if needed,
28 BULLETI^r N. C. BOAED OF HEALTH.
at least once each day, and have in each car, in which male and female
passengers are carried therein, a toilet-room for each sex, and have the
same kept clean.
Sec. 2. Any person or corporation engaged in the business described
in section one of this act, who shall wilfully or negligently fail or
refuse to give orders to their agent or agents in charge of such cars
and comply with the requirements of this act shall forfeit twenty
dollars ($20) for each day that it refuses, to be recovered by any person
suing for said penalty.
Sec. 3. That the wilful or negligent refusal or the failure on the part
of the conductor or manager of any such passenger-car as named in
section one to comply with said section one shall be received as evidence
of such failure or refusal of such person or railroad company to give
such orders, and, mereover, such conductor or manager shall be guilty
of a misdemeanor if he fails or refuses to carry out said orders of the
person or company mentioned in section one of this act.
Sec. 4. That this act shall take effect from and after the first day of
May, one thousand nine hundred and seven.
AN ACT TO AMEND SECTION 4498 OF THE RPVISAL OF 1905,
BY ADDING A SUBSECTION MARKED (A) THERETO FOR EN-LARGING
THE POWERS OF THE BOARD OF MEDICAL EXAM-INERS
IN GRANTING A LICENSE TO APPLICANTS TO PRAC-TISE
MEDICINE.
Section 1. That section four thousand four hundred and ninety-eight
of the Revisal of one thousand nine hundred apd five be amended
by adding a subsection marked (a) "Tliat tlie Board of Medical Exam-iners
shall in their discretion issue a license to any applicant to practise
medicine and surgeiy in this State without examination, if said appli-cant
exhibits a diploma or satisfactory proof of graduating from a
medical college in good standing, requiring an attendance of not less
tlian three years and a license issued to him to practise medicine and
surgery by the Board of Medical Examiners of another State."
[The saving feature in the above is that it is left to tlie discretion of
the Board of Examiners as to what States they shall reciprocate with.
We can trust them to see to it that our standard is not lowered.]
BULLETIN X. C. BOAKD OF HEALTH. 29
REVIEW OF DISEASES FOR APRIL. 1907.
EIGHTY COUNTIES REPORTIXG.
Ninety-three counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases, the
Superintendent has, as a rule, to rely upon his o^^-n information alone,
since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a disease
othenvise indicated, its mere presence in the county is to be understood
as reported.
For the month of April the following diseases have been reported
from the counties named:
MEA.SLES.—Alexander, 75 cases; Ashe, a few; Brimswick, several;
Burke. 10; Cabarrus, 17; Caldwell, 2; Camden, epidemic; Caswell, 200;
Catawba, 8; Chatham, 10; Cherokee, 1; Chowan, several; Clevel-and,
a few; Columbus, 2; Craven, several; Cumberland; Davidson; Durham,
many; Edgecombe, a great many; Forsyth, a few; Franklin, many;
Granville, 25; Guilford, 2; Halifax, many; Harnett, 50; Haywood,
many; Hertford, 50; Iredell, 4; Lincoln, a few; McDowell, 6; Madi-son,
30; Martin, 10; Mecklenburg; Xash, many; ISTorthampton ; Onslow,
many; Pasquotank; Perquimans, 30; Person, a few; Robeson, epi-demic;
Rowan, a few; Sampson, many; Stanly, several; Surry, 16;
Union, many; Vance, many; Wake, 45; Warren, a few; Yancey, a
few—49 counties.
Whooping-cough.—Alexander, 4; Ashe, several; Bladen, a few; Cas-well,
75 ; Chowan, several; Cleveland, a great many; Cumberland;
Davidson; Davie, many; Durham, a few; Edgecombe, a great many;
Forsyth, a few; Franklin, general; Granville, 10; Halifax, many; Hen-derson,
many; Hertford, 50; Martin, 12; Mecklenburg; Xorthampton;
Pasquotank, several; Perquimans. 10; Randolph, 2; Sampson, a few;
Surry, 10; Vance, a few; Wake, 7; Warren, a few; Washington, 20
—
29 counties.
Scarlatina.—Anson, several; Ashe, several; Catawba, 3; Ran-dolph,
1.
DlPHTHERiA.^Alexander, 1; Bladen, 1; Craven. 1; Duplin, 1; Dur-ham,
1: Gaston, 1; Harnett, 2; Lenoir, 1; Mecklenburg; Nash, 1: New
Hanover, 1; Pitt, 1; Randolph, 1; Union, 1—14 counties.
Ti-PHOiD Fever.—Alexander, 3; Ashe. 3; Cabarrus, 2; Caldwell, 2;
Chatham, 2; Columbus, 1; Craven, 1; Ciunberland; Durham, 1; Edge-combe,
a few; Franklin, several; Granville, 1; Haywood, 1; Madison,
a few; :Martin, a few; Mecklenburg; New Hanover, 4; Onslow; Pas-quotank,
several; Person, 3; Randolph, 3; Robeson, a few; Scotland, 2;
Wake, 1 ; Washington. 1—25 counties.
30 BULLETIN N. C. BOARD OF HEALTH.
Malaeial Fever.—Brunswick, Columbus, Granville, Halifax, Harnett,
Hertford, Hyde, Martin, Northampton, and Pender—10 counties.
Malarial FteVER, Pernicious.—Granville, 1; Hyde, several; North-ampton,
1.
Malarial Fever, Hemorrhagic.—Hyde, a few; Martin, 1.
Bowel Diseases.—Brunswick, Gaston, Halifax, Lincoln, Rowan.
CfcREBRO- SPINAL MENINGITIS.—Caswell, 2; Columbus, 1; Gates, a few;
Haywood, 1; Richmond, 1.
Infll^nza.—Alamance; Alleghany; Ashe, in all pai-ts; Caswell, in
all parts; Currituck, a few; Graham, in all parts; Henderson; Hert-ford,
in all parts; Iredell; Lincoln, in all parts; Northampton; Person,
in all parts; Sampson; Watauga; Wilkes, in all parts—15 counties.
Pneumonia.—Alexander, 12; Alleghany, a few; Ashe, many; Bladen,
3; Brun3\vick, 4; Burke, 8; Cabarrus, 6; Camden, 10; Carteret, a
few; Caswell, several ; Catawba, 2; Chowan, 10 or 12; Cleveland,
a few; Columbus, 2; Cumberland; Davie, a few; Durham, a few;
Edgecombe, many; Forsyth, a few; Franlilin, several; Gates, a few;
Greene, 2; Haywood, a few; Henderson, 2; Hertford, 4; Hyde, 2;
Iredell, 7; Lincoln, a few; Madison, 6; Martin, 3; Mecklenburg; Nash,
5; Northampton, a few; Onslow; Orange, several; Pender, 2; Person,
a few; Randolph, 2; Richmond, 4; Robeson, a few; Rowan, a few;
Scotland, a few; Union, 2; Wake, 25; Warren, a few; Washington. 8;
Watauga, 2—47 counties.
Mumps.—Northampton.
Varicella.—Gaston, a few.
Smat.l-pox.—Alamance, 17; Chatham, 2; Cherokee, 2; Chowan, sev-eral;
Cumberland, 3; Davidson; Durham, 15; Forsyth, 9; Franklin, 8
Gaston, a few; Granville, 5; Guilford, 8; Halifax, 1; Harnett, 5
Lincoln, 13; Nash, 8; Orange, 20; Pitt, 3; Rowan, 5; Vance, 11
Wake, 74, in eastern part; Warren, 4-—22 counties.
Cholera, in Hogs.—Onslow.
Distemper, in Horses.—Burke, Watauga.
Hydrophobia, in Dogs.—Stanly; several bitten children were sent to
Richmond.
No diseases reported from Bertie, Brunswick, Polk, Wayne, Wilson,
and Yadkin.
No reports received from Beaufort, Clay, Jackson, Johnston, Macon,
Mitchell, Montgomery, Moore, Pamlico, Rockingham, Rutherford, Swain,
and Transvlvania.
BULLETIN N. C. BOARD OF HEALTH. 31
SUMMARY OF MORTUARY REPORTS FOR APRIL, 1907.
TWENTY-FOXIB COUXTIES REPORTIXG.
White.
Aggregate population 131,750
Aggregate deaths 138
Eepresenting temporary annual death-rate per
1,000 12.6
Causes of Death.
Tj-phoid fever 2
Malarial fever
Diphtheria 1
Whooping-cough 2
Measles 5
Pneumonia 21
Consumption 15
Brain diseases '. 8
Heart diseases 8
Neurotic diseases 1
Diarrhceal diseases 10
All other diseases 61
Accident 3
Suicide
Violence 1
138
Deaths under five years 37
Still-born 8
CoVd.
87,750
151
20.6
Total.
219,500
289
15.8
1
32 BULLETIN N. C. BOARD OF HEALTH.
mortuary Report for April, i907'
Towns
AND Reporters.
Popula-tion.
Charlotte I
Dr. F. O. Hawley. f
Durliam I
Dr. N. M. Johnson. I
Edeiitoii
I
Dr. Thomas J. Hoskins j
Eliziiltetli City 1
Dr. H. D. Walker. (
Fayettevllle I
Dr. A. S. Rose. I
Goldsboro I
Robt. A. Creech, H. O. f
©reeiiHboro (
Dr. Edmund Harrison, f
Henderson )
Dr. J. H. Tucker. !
High Point (
Dr. C. E. Reitzel. (
Ijexlngtou 1
J. H. Moyer. Mayor. i
Marion I
Dr. B. L. Ashworth. f
Oxford I
Dr. S. D. Booth.
Raleigli. I
T. P. Sale, Clerk B. H. j
Rocfey Mount I
Dr. L. C. Covington. (
Salem I
S. E. Butner, Mayor. I
Sallsbwry I
Dr. H. T. Trantham. f
Sontliport )
Dr. J. A. Dosher. f
Tarhoro I
Dr. S. N. Harrell. (
Wadesboro I
Dr. J. H. Bennett. f
"Watiliiugton I
Dr. John G. Blount. f
Weldon I
J. T. Gooch, Mayor. f
Wllnilngton I
Dr. Charles T. Harper, i
AVllson I
Dr. W. S. Anderson, f
fViiiston I
Dr. E. A. Lockett. f
W. 18,000
C. 12,000j
10,000
8,000
1,400
2,600
6,000
4,000
Tem-porary
Annual
Death-rate
per
1,000.
30,000
13.3
18.0
18,000
12-0
3,500
2,500
6,000
4,000
10,000
5,000
2,000
2,300
4,000
10,000
6,000
8.6
4.6
12.0
45.0
31.9
14.4
10,000 J;°
15,000
4,300
9,200 II pnn
2,000, '''""
3,000 „ finn
600
^'^^
1,400
100
2,200
1,800
10.8
21.6
12.0
15.6
14.1
18.0
0.0
0.0
1,500 ^20:0
4,000
5.4
20.0
9<000,R nnn 20-0
•7 nnn lb' ^^^ 7,000 Q3f0i.9Q
3,000 , am 20.0
1,900
*'^°^ " "
3,400 o son
400
^•**""
7,400'
3.600
900!
500
2,500
1,000
1,200
800
11,000
1,400
3,500
0.0
3.2
30.0
4.8
23.3
0.0
24.0
14.4
48.0
2 000' °-° '^'""" 30.0
3,500 -. n;nn 24.0
3,000 '*'°"" ^^ "
750i
750:
16,000
14,000
3,800
3,000
7,600
6,900
1,500
16.0
32.0
64.0
30,000 Ifl
6'80o| leio
11.0
14,500 7.0
•S t: j3 -5 o
ft _0 £
J- <l>
ft .5
.2 Q
rt ;-
o = =' »^^
2 -4 >
O H «
-. ro
I ^1 mi _
ft .s g =; 5
«
^,(g§5;^,s£r
5 °
-S
^ I o
,^|Q|<<!|<J,aj|> m m,0|M
15.2
18.0
6.0
25.2
24.0
9.6
14.4
13.9
13.9
0.0
8.0
12.0
24.7
12.2
6.3
10.9
8.6
24.0
12.0
20.3
48.0
17.6
14.1
9.4
3
2
1 2
2
1 1
3
*1 8
4* *
9
9
2
9' 6
7 4
2 1
5: 2
1...
3...
6...
4 1
33 3! 1
4 2
N B -The reporters for the cities and towns printed in Black Type have signed this certificate :
"I hereby certify that this report gives the whole number of deaths occurrmg withm the corporate
limits during the above month."
BULLETIN X. C. BOARD OF HEALTH. 33
County Superiutendeiits of Health.
Alamance Dr. George W. Long.
Alexander Dr. O. L. Hollar.
Alleghany Dr. Robert Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. B. O. Edwards.
Beaufort .Dr. John G. Blount.
Bertie Dr. H. V. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C. G. Ferebee.
Carteret Dr. W. E. Headen.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. J. H. Taylor.
Cherokee Dr. J. F. Abernethy.
Chowan Dr. T. J. Hoskins.
Clay Dr. J. M. Sullivan.
Cleveland Dr. T. E. McBrayer.
Columbus Dr. H. B. Maxwell.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare ,.
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. J. Gerald Murphy.
Durham Dr. N. M. Johnson.
Edgecombe Dr. iS. N. Harrell.
Forsyth Dr. S. F. Pfohl.
Franklin Dr. R. F. Yarborough.
Gaston Dr. L. N. Glenn.
Gates Dr. Geo. D. Williams.
Graham Dr. M. T. Maxwell.
Granville Dr. S. D. Booth.
Greene.. Dr. W. B. Murphy.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. J. W. Halford.
Haywood Dr. J. R. McCracken.
Henderson Dr. J. G. Waldrop.
Hertford Dr. C. F. Griffin.
Hyde Dr. R. E. Windley.
Iredell Dr. M. R. Adams.
Jackson Dr. H. F. Burgin.
Johnston Dr. Thel Hooks.
Jones
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. R. W. Petrie.
McDowell Dr. B. L. Ashworth.
Macon Dr. F. L. Siler.
Madison Dr. W. J. Weaver.
Martin Dr. W. E. Warren.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Virgil R. Butt,
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod.
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico Dr. H. P. Underbill.
Pasquotank Dr. J. B. Griggs.
Pender Dr. Robt. H Bradford.
Perquimans Dr. C. C. Winslow.
Person Dr. W. A. Bradshaw.
Pitt Dr. Joseph E. Nobles.
Polk Dr. C. J. Kenworthy.
Randolph Dr. A. M. Bulla.
Richmond Dr. L. D. McPhaiL
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. I. H. Foust.
Rutherford Dr. E. B. Harris.
Sampson Dr. J. O. Matthews.
Scotland Dr. A. W. Hamer.
Stanly Dr. J. N. Anderson.
Stokes
Surry ....Dr. John R. Woltz.
Swain Dr. R. L. Davis.
Transylvania Dr. Goode Cheatham.
Tyrrell
Union Dr. Henry D. Stewart.
Vance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. M. P. Perry.
Washington Dr. W. H. Ward.
Watauga Dr. J. M. Hodges.
Wayne Dr. J B Outlaw.
Wilkes Dr. John Q. Myers.
Wilson Dr. W. S. Anderson,
Yadkin Dr. M. A. Rovall.
Yancey Dr. J. B. Gibbs.
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secfetary of the Board, Raleigh, N. C.
Geo. G.Thomas, M.D.,Pres., Wilmington. | T. E. Anderson. M. D.--Statesville.
S. Westray Battle, M. D.--Asheville.
Henry W. Lewis, M. D Jackson.
J. Howell Way, M. D Waynesville.
W. O. Spencer, M. D Winston- Salem.
W. P. IVEY, M. D. Lenoir. i J. L. Ludlow, C. E. Winston-Salero.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XXII. JUNE, 1907. . No. 3.
ANNUAL MEETING OF THE STATE BOARDOF HEALTH.
As the regular annual meeting of the State Board of Henlth is
always held at the same time and place as that of the State Medical
Society, it occurred this year June 11-12 at Morehead City.
All the members. ^Yith the exception of one detained by sickness,
were present.
The most important business of the meeting was the election of
a director of the State Laboratory of Hygiene to succeed Dr.
McCarthy, who goes abroad in the spring. Mr. C. A. Shore, of
Winston-Salem, who takes his degree of M. D. at .Johns Hopkins
University this year, was elected unanimously—thus early to secure
him and to save the expense of a special meeting for the purpose—
an item to be considered in view of our small appropriation. Mr.
Sliore, besides being a man of ability and integrity, is very well
educated academically and scientifically, being a graduate of our
University and having had much experience in laboratory work.
He was assistant in the department of biology at the University for
three years, and for three years after his graduation he was in-structor
in the same department. He has also worked in the Labora-toiy
of the United States Fisheries Connnission at Beaufort and in
the hygiene laboratory of Baltimore. During this summer. he will
do further work in the last named, will visit those of PhiladoIi)lHa
and New York, studying their methods, and will finish off in P.oston
38 BULLETIX X. C. BOAED. OF HEALTH.
with a special course under the general direction of Dr. Charles
Harrington, Professor of Plygiene in Harvard University and Secre-tary
of the State Board of Health of Massachusetts. We feel
entirely confident of his ability to take up and still further advance
and perjCect the work that has been developed by the earnest and
unflagging labors of Dr. McCarthy.
Doctors Way, Register, and Lewis, of the Board, and Messrs. .J. M.
Harry, of Charlotte, and H. W. Simpson, practical embalmers, were
elected on the State Board of Embalming—the last three to succeed
themselves. Colonel Ludlow and the Secretary were elected delegates
to the American Public Health Association which meets at Atlantic
City about October 1.
The present incumbent was re-elected Secretary and Treasurer.
The terms of Drs. Ivey and Lewis, R. H., appointees of the
Governor, and Battle and Lewis, H. W., elected by the State Medical
Society, expired at the present meeting, and the personnel of the
Board was materially changed. Governor Glenn appointed Dr. E. C.
Register, of Charlotte, to succeed Dr. Ivey, and the Society elected
Dr. D. T.. Tayloe. of Washington, and J. A. Burroughs, of Asheville,
to succeed Drs. Battle and H. W. Lewis, who were not candidates
for I'e-election.
It is with sincere regret that we part with the outgoing members,
who for so many years have held up our hands with unfailing sym-pathy
and support ; but at the same time we welcome the incoming
members, all of whom are of high professional standing in their
communities and in the Society, and upon whose assistance and
cooperation we count with confidence.
The usual conjoint session of the Board of Health with the Medical
Society was held on the second day of the meeting, at which the
Secretary read his report as follows
:
ANNUAL REUORT OF SECRETARY OF TFIE NORTH CAROLINA
BOARD OF HEALTH, MAY 1, 190G, TO MAY 1, 1907.
During the past year we have suffered no special outbreak of
disease and the health of our people in general has been about as
iisual. A detailed statement of the work of the Board will be found
in the Eleventh Biennial Report, which has been for months
and still is in the hands of the printer. A copy will be sent to
any one asking for it as soon as it is published.
The work of your Secretary has been for the most part of the
usual routine character, special attention having been paid to the
further distribution of the pamphlets on the prevention of tuber-culosis.
The indications are that the wide circulation of this publi-cation
has made an impression upon our people and has been of real
assistance in the campaign against this most fatal of all our diseases..
BULLETIN ^'. C. BOAKD OF HEALTH. 39
I am satisfied that the plan adopted of sending tlie pamphlet direct
to the individual, with a letter urging him to read it and to assist
in its distribution, has added much to its efEectiveness. Over 100,000
copies have been mailed to date, and I am confident that no expendi-ture
of our meager appropriation has brought forth better results
than that paid out for the postage on this pamphlet.
With Januarj- came the meeting of the General Assembly, which
is always a period of mingled hopefulness and anxiety. While the
attitude of the last Legislature was, perhaps, less friendly to our
license law than has been the case for many sessions, its interest
in the public health was more pronounced than usual—an interest
that was not simply academic, but one that did something worth
while. In The Bulletin for April I printed all the acts of general
interest bearing on the public health, both directly and indirectly,
through our medical license law, but it may not be amiss to refer
again in this place to the more important.
The act creating the State Laboratory of Hygiene, which carried
no annual appropriation from the general fund for its support, was
so amended as to give it two thousand dollars annually ; at the same
time increasing the annual tax of sixty dollars upon water com-panies
by four dollars. This latter does not materially increase the
income of the Laboratory, but all the companies would not pay
expressage on water samples, and th6 four dollars were added to
cover that; With the tax from the water companies, now numbering
fifty-one and gradually increasing year bj* year, the income will be
sufficient, with the money on hand, to adequately equip dnd conduct
an excellent laboratory without outside help. In this connection it
is proper to call attention again to the fact that without the generous
aid given us by the Board of Agriculture we, in all probability,
would not have had any laboratory at all. It should be remembered
tliat at first the Board of Agriculture had biological analyses of
drinking-water made for us in their laboratory free of charge
—
until the water tax was obtained four years ago—and that since
that time it has, in addition to furnishing the Laboratory with
gas and water, paid $750 a year towards the salary of the Director.
I hope suitable acknowledgment of the enlightened liberality of the
Board will be made by the con.ioint session. The report of the
Director for the past year is appended.
In order to extend the benefits of the Laboratory as far as possible
to the people, an act was passed authorizing the preventive treat-ment
of rabies by the Director—who, in. the reorganization, will
doubtless be a thoroughly trained medical man—when it can be
done without interfering with the legitimate work of the Laboratory
in'opfr.
A decided advance in State medicine was marked by the enact-ment
of the bill establishing a sanatorium for tuberculous patients.
40 BULLETIN N. C. BOAED OF HEALTH.
appropriating $15,000 for a plant and $5,000 annually for support.
The chief credit of this particular legislation is due to Dr. J. E.
Brooks, of Greensboro, who was "the man behind the guns," and the
Hon. J. R. Gordon, M. D., member from Guilford of the House of
Representatives, who was mainly instrumental in securing its pas-sage.
Acknowledgment of this was made by the Board of Directors,
of which the Secretary of the Board of Health is ex officio a member.
at their first meeting, in the election of Dr. Gordon Chairman of the
Board and Dr. Brooks Superintendent of the Sanatorium. While
the appropriation is very small, it will provide for a beginning, and
as the Superintendent is not only an intelligent and capable physician,
but an enthusiast on the subject, I feel confident that it will succeed.
As the competency of our physicians is of the highest importance
to the public health, anything bearing upon our medical license
law is of importance to us. During the session of the Legislature
bills for the relief of physicians in Cherokee, Clay, and Graham
counties and in Chatham County were enacted into laws. In the
one case physicians having diplomas were allowed to practise without
license until May 1, 1909, and in the other simply to stand the
examination for license without exhibiting a diploma. The reason
given for this legislation was the same in both cases—that in
the remote, sparsely-settled, and physically rough regions physicians
so well educated as to meet the requirements of our very high
standard had' not settled, and that unless such action was taken
the people in the affected regions would be without medical aid.
While actively opposing the first-named bill for fear it might be an
entering wedge threatening the integrity of our license law, I could
not deny the fact, nor in my own mind deny the inherent reasonable-ness
of the contention in the light of those facts. It was indeed the
realization of what we have been anticipating, and I was thoroughly
impressed with the importance of devising some means of practically
lowering the standard to meet such conditions lest our license law
should be emasculated 'in the near future. As a means to this eild
I approved, as Chairman of the Societj^'s Committee on Legislation,
the passage of a bill authorizing the Board of Medical Examiners
to reciprocate with other States in their discretion. I welcomed this
bill the more gladly because it enabled me to secure the voluntary
suppression by its author of another bill requiring the Board of
Examiners to grant licenses to any one presenting a diploma from
the American Association of Medical Colleges and a license from any
State. As the standard of some States is extremely low, and in
nearly all lower than in ours, the passage of this bill would have
practically repealed our license law and have undone the work of
fifty years for the elevation of our profession and the protection of
the people against incompetent physicians. Before the present
meeting of the Board of Medical Examiners I addressed a circular-letter
to each member of the same, calling attention to the conditions
BULLETIX X. C. BOAED OF HEALTH. 41
above set fortli and to the importance of action on their part to meet
them as far as possible, suggesting reciprocation with the low-standard
States when the conditions for this concession demanded
it. and also that it would probably be well to lessen the rigor of the
examination somewhat by granting certificates on the branches
pas,sed. and thereby encourage men to come a second time and
finish up successfully rather than give up in despair and take the
chances of practising illegally. I was. therefore, much gratified to
learn from Tresident Kent, who stopped over in Raleigh on his way
to the meeting for the purpose, that he had secured from the Assistant
Attorney-Ueneral an opinion to the effect that it would be legal for
his Board to grant a license and to require the recipient to sign a
contract to restrict his practise to a certain county or section, the
Assistaiit Attorney-General writing out the form of the said contract.
The judicious use of this privilege will, I think, solve the problem.
SMALLPOX.
I am very glad to state that smallpox has been very much less
prevalent. In 1905 tlie total number of cases was 7,375 with .31
deaths : in 1906, 6,049 cases and 17 deaths, while during the year
ending May 1, 1907, the total number of cases was only 1,897 with
6 deaths. The following is a tabulated statement of the disease by
counties
:
Counties.
Alamance --
Anson
Ashe*
Bertie
Bladen* —
-
Brunswick -
Cabarrus—
Carteret
Catawba
Chatham —
Cherokee—
Chowan* —
Cleveland
—
Columbus --
Cumberland
Currituck --
Number of Cases.
White.
42 BULLETIiS^ X. C. BOARD OF HEALTH,
Counties.
Davidson
Duplin
Durham
Forsyth
Franklin*
Gaston
Granville
Guilford
Halifax --
Harnett
Hertford
Lincoln
Martin
Mecklenburg
Moore
Nash
New Hanover
Northampton
Orange
Person
Pitt —
Randolph
Richmond*
Robeson
Rowan
Rutherford
Stanly
Vance
Wake*
Warren
Washington*
Wayne
Total in forty-eight counties -
Death rate, per cent
Number of Cases.
White. Colored, Total
25
*91
4
5
94
1
4
30
100
4
23
1
5
272
2
20
190
6
12
114
24
*100
14
7
99
3
22
45
17
120
8
27
10
1
3
25
1
13
91
13
10
5
4
1
13
339
6
28
190
Number of Deaths.
White. Colored. Total
1,348 ; 1,968 2
.003-1- .002-1
'Estimated.
BULLETIN :N". C. board OF HEALTH. 43
WANTED: A PHYSICIAN.
The Bulletin never accepts advertisements, but we always take
pleasure in doing everything we can to protect the public health. A
good physician is certainly a powerful agency in this cause, and we
are glad to print the letter given below. We would call the reader's
attention to its confirmation of the statements made in the Secre-tary's
report.
Secretary N. C. Board of Health,
Raleigh, N. C.
Dear Sir :—We greatly need a physician at this place. We have
to draw on a Virginia town fifteen miles distant for a doctor, and
keep one busy most of the time; the demand in the country around
is greater than the supply of M. Ds., hence we cannot hope to get
one from any near-by point.
Will you please insert an "ad" in your next issue of The Bulletin
for us? This is a thickly-settled section of mountain couutiy, north-western
part of Surry County, and a splendid opening for a good
physician ; a large territory. Those wishing to investigate can
write to me.
Have heard that you insert such "ads" for points desiring it, hence
this letter.
Thanking you in advance for the favor, I am,
Very truly,
Lowgap. y. C. T. X. Woodruff.
44 BULLETIX X. C. BOAED OF HEALTH.
REVIEW OF DISEASES FOR MAY, 1907.
SEVEXTY-THREE COUNTIES REPORTING;
Ninety-two counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases, the
Superintendent has, as a rule, to rely upon his own information alone,
since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a disease
otherwise indicated, its mere presence in the county is to be understood
as reported.
For the month of May the following diseases have been reported
from the cormties named:
Measles.—Alexander, 5 cases; Ashe, a few; Beaufort. 14; Bladen,
a few; Burke, 20; Caldwell, 18; Camden, epidemic; Caswell; Chatham,
3; Cherokee, in all parts; Chowan, many; Cleveland, a few; Craven,
a few; Cumberland, several; Davidson; Durham, many; Edgecombe,
several; Forsyth, a few; Franklin, several; Granville, 40; Guilford, 3;
Harnett, 9; Haywood, in all parts; Henderson, many; Hertford, 20;
Jackson, 20 ; Johnston, in all parts ; Lincoln, several ; Mecklenburg
;
Montgomery, 31; Onslow; Randolph, many; Robeson, a few; Rowan, a
few; Rutherford, 75; Swain, 50; Transylvania, a few; Union, many;
Vance, many; Wake, 80, in western part; Warren, a few; Washington,
10: Yancey, several—43 counties.
WiiooPiXG-coUGH—Ashe, several: Beaufort, 8: Bladen, many; Cas-well;
Cherokee, a few; Chowan, many; Clay, several; Cleveland, many;
Ciuuberland ; Currituck, a- few ; Davie, many ; Durham ; Edgecombe,
many ; Forsyth, a few; Franklin, epidemic; Gates, in all parts; Gran-ville,
8; Harnett, 12; Henderson, many; Hertford, 25; Hyde, a few
Lincoln, several; Martin, a few; Mecklenburg; Pasquotank, several
Randolph, in all parts; Richmond, many; Rutherford, 20; Union
several; Wake, 1; Warren, several: Washington, 30; Wilkes, 5—33
counties.
Scarlatina—Alamance, 7; Alexander, 1; Caldwell, 2; Union, several;
Wake, 1—5 counties.
Diphtheria—Davie, 2; Granville, many; Lincoln, in all parts; Meck-lenburg;
Nash, 2; Wake, 2—6 coimties.
Typhoid Fever.—Alexander, 10; Ashe, 6: Beaufort, 2; Burke, 1
Caldwell, 14; Chatham, 4; Clay, 2; Cleveland, 1 or 2; Cumberland
Edgecombe. 8; Forsyth, a few; Franklin, several; Gates, 5; Granville
3; Guilford, 1; Harnett, 2; Henderson, 1; Jackson, 3; Lincoln, 2
Madison, in all parts; Martin, a few; ^lecklenburg; Montgomery, 2
New Hanover, 4; Randolph, 2; Robeson, a few; Rvitherford, 5; Wake, 4
Yancev, 1 or 2—29 counties.
BULLETIX X. C. BOARD OF HEALTH. -i"5
AL\LARiAL Fever.—Caswell, in all parts; Currituck, a few; Harnett,
in all i>arts; Hyde; Johnston; Wake, 1—^G counties.
IMalarial Fe\'er, Pernicious.—Granville, 1 ; Hyde, a few.
Bowel Disbiase.—Alamance; Alleghany, general; Beaufort; Bruns-wick;
Burke, general, in children; Camden: Clay; Cleveland, mild;
Harnett; Henderson, general; Hertford, 30; Iredell, general; Johnston;
Maccn, a mild form epidemic ; Onslow ; Rowan; Stanly, epidemic;
Washington, general ; Wilkes, general—19 counties.
Ixfluexza.—Ashe, in all parts; Caswell, in all parts; Currituck;
•Macon, in all parts.
Mexixgitis. Cerebro-.spi-XAL.—Ashe, a few; Davie. 1: Harnett. 2;
Martin, 1; Kutherford. 1; ^^'ake, 2—G counties.
Mumps.—Onslow.
PxeuMoxia.—Alexander. 2: Alleghany, in all parts; Ashe, several;
Beaufort. 4; Camden, 6; Caswell, several; Chatham. 1; Cherokee,
several; Chowan, 1; Cleveland, a few; Duplin, 3; Durham, a few;
Edgecombe, 2 ; Forsjiih, a few ; Gates, 6 ; Graham, 2 ; Harnett, 3 ; Hert-ford.
2; Iredell, 3; Jackson, 3; Lincoln, a few; Madison, in all jiarts;
Martin, a few; Mecklenburg; Montgomery, 2; Pitt. 4: Randolph, 10;
Ptobeson, a few; Rowan, a few; Rutherford, 10; Union, 3; Wake. 11;
Warren, 2; Washington, 4; Watauga, 1—35 counties.
Smallpox.—Alamance. 5; Alexander, 1; Beaufort, 1; Bladen, 1;
Burke, 2; Cabarrvis, 1; Chatham, 1; Chowan, 27; Davidson, 12; Davie,
1; Edgecombe, 1; Forsyth, S; Franklin. 7; Guilford. 2.i : Harnett. 12;
Johnston, G; Lincoln. 1; Xash, 2; Xew Hanover. 0: Robeson. .5;
Rowan. !) : \^'ake. .59—22 counties.
Cholera, ix Chickexs.—Davie.
Xo diseases reported from Bertie, Buncombe, Carteret. Catawba,
McDowell, and \A'ilson,
Xo reports received from Anson, Columbus, Gaston, Greene, Halifax,
Lenoir. ^litchell, ]\Ioore, Xorthampton, Orange, Perquimans, Person,
Polk, Rockingham, Sampson, Scotland, Surry, Wayne, and Yadkin.
46 BULLETIN N. C. BOAKD OF HEALTH.
SUMMARY OF MORTUARY REPORTS FOR MAY, 1907.
NINETEEN TOWNS.
White.
Aggregate population 117,050
Aggregate deaths 183
Eepresenting temporary annual, death rate
per 1,000 18.8
Causes of Death.
Typhoid fever -
Malarial fever 1
Whooping-cougli 1
Measles 4
Pneumonia 9
Consumption 17
Brain diseases 19
Heart diseases 10
Neurotic diseases -4
Diarrha?al diseases 39
All other diseases .' 70
Accident 4
Suicide . -
Violence 1
183
Deaths under five years 72
Still-born H
CoVd.
72.250
152
25.2
Total.
189,300
335
21.2
1
BULLETIN N. C. BOARD OF HEALTH. 47
mortuary Report for May, I907'
Towns
AND Reporters.
Popula-tion.
Tem-porary
Annual
Death-rate
per
1,000. 5 a)
•S Q -i:
§|Q:^lSfcolmiWte,Pj<!<!,M>
2 •<< >
HQ Si
W r — »-l
y| ^ «3 o
>. >.. 41, '43 n PQ Q ca
Cliarlotte I
Dr. F. O. Hawley. f
Diirliani (
Dr. N. M. Johnson. !
Elizabeth City 1
Dr. H. D. Walker. I
Payettevllle I
Dr. A. S. Rose. J
Greensboro I
Dr. Edmund Harrison. (
HigU Point I
Dr. C. E. Reitzel. f
Lexington I
J. H. Moyer. Mayor. J
Marlon I
M. L. Justice, H. O. (
Oxford {
Dr. S. D. Booth. )
RaleigU j
T. P. Sale, Clerk B. H. i
Reldsvllle 1
R.S.MontKomery,H.O. I
Rocky Monut I
Dr. L. C. Covington. f
Saleni \
S. E. Butner, Mayor, f
Salisbury j
Dr. H. T. Trantham. (
Sontliport I
Dr. J. A. Dosher. )
Tarboro I
Dr. W. J. Thigpen. f
Wailetiboro I
Dr. J. H. Bennett. (
Weldon |
J. T. Gooch, Mayor. I
VCIInilugtou I
Dr. Charles T. Harper. (
Wilson I
Dr. W. S. Anderson. S
18,000
12,000
30,000
10, 000, J, 000
1
8,000^'''"""
I
10,000,
6,000'
4,000
liw 6'000
10,000
5,000
9,200
2,000
3,000
600
1,400
100
2,000
\ 2,000
i
9,000
7,000
15,000
11,200;
3,600i
1,500
4.000
16,000
4,000 f. nnn
2,000,
^'°"°
5,000
3,000
3,400;
400
j
7,400
3,600
900
500
2,500:
1,0001
8,000
3,800
11,000
1,400
3,500
1,200 2 000
800,
^'"""
1,500
750
! 750:
16,000
14.000
30,000,
I'ooS 6'800,
17.3
27.0
26.4
35.7
12.0
21.0
6.8
38.4
24.0
36.0
20.8
18.0
4.0
0.0
25.7
0.0
12.0.
24.0
29.3
18.9
24.0
18.0
28.8
12.0
10.6
90.0
4.9
20.0
13.3
0.0
19.2
0.0
0.0
0.0
16.0
32.0
14.2
21.4
15.8
20.0
21.2
30.0
15.6
20.0
28.0
20.4
3.3
24.0
18.0
24.7
22.0
22.5
18.9
9.8
8.6
13.7
0.0
24.0
17.6
17.7
8 3
63
26
27
22LclO
23j 10
6L 2.
2
1
2
2
1
68
N. B.—The reporters for the cities and towns printed in BlacU Type have signed this certificate :
"I hereby certify that this report gives the whole number of deaths occurring within the corporate
limits during the above month."
48 BULLETIN N. C. BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. H. M. Montgomery.
Alexander Dr. O. L. Hollar.
Alleghany Dr. Robert Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. B. O. Edwards.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. -V. Dunstan.
Bladen .....Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C G. Ferebee. .
Carteret Dr. W. E. Headen.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. J. H. Taylor.
Cherokee Dr. W. A. Graham.
Chowan Dr. H. M. S. Cason.
Clay Dr. P. B. Killian.
Cleveland Dr. T. E. McBrayer.
Columbus Dr. H. B. Maxwell.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimhrough.
Duplin Dr. J. Gerald Murphy.
Durham Dr. N. M. Johnson.
Edgecombe Dr. W. J. Thigpen.
Forsyth Dr. S. F. Pfohl.
Franklin Dr. R. F. Yarborough.
Gaston Dr. L. N. Glenn.
Gates ; Dr. Geo. D. Williams.
Graham Dr. M. T. Maxwell.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. J. W. Halford.
Haywood Dr. J. R. McCracken.
Henderson Dr. J. G. Waldrop.
Hertford Dr. J. H. Mitchell.
Hyde Dr. R. E. Windley.
Iredell Dr. M. R. Adams.
Jackson Dr. H. F. Burgin.
Johnston Dr. L. D. Wharton.
Jones
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. R. W. Petrie.
McDowell Dr. M. L. Justice.
Macon Dr. S. H. Lyle.
Madison Dr. W. J. Weaver.
Martin Dr. W. E. Warren.
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Virgil R. Butt.
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico
Pasquotank Dr. J. B. Griggs.
Pender Dr. Robt. H Bradford.
Perquimans Dr. C. C. Winslow
Person Dr. W. A. Bradshaw.
Pitt Dr. Joseph E. Nobles.
Polk Dr. C. J. Kenworthy.
Randolph Dr. S. A. Henley.
Richmond Dr. N. C. Hunter.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. I. H. Foust.
Rutherford Dr. E. B. Harris.
Sampson Dr. J. O. Matthews.
Scotland Dr. K. A. Blue.
Stanly Dr. J. N. Anderson.
Stokes
Surry Dr. John R. Woltz,
Swain Dr. J. A. Cooper.
Transvlvania Dr. Goode Cheatham.
Tyrrell -.
Union Dr. Henry D. Stewart.
Vance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. M. P. Perry.
Washington Dr. W. H. Ward.
Watauga Dr. J. M. Hodges.
Wayne^ Dr. T. L. Ginn.
Wilkes Dr. .John Q. Myers.
Wilson Dr. W. S. Anderson.
Yadkin Dr. S. L. Russell.
Yancey Dr. J. B. Gibbs.
I
i
OHAPEL HILL ,y n
^'- I H Manning
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board. Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington. T. E. Anderson, M. D.--Statesville.
S. Westray Battle, M. D.--Asheville. J. Howell Way, M. D Waynesville.
Henry W. Lewis, M. D Jackson. W. O. Spencer, M. D Winston- Salem.
W. P. Ivey, M. D. Lenoir. J. L. LuDLOW, C. E. Winston-Salem.
Richard H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XXII. JULY, 1907. No. 4.
COMPULSORY VACCINATION.
Without the power to order and enforce compulsory vaccination it
would be impossible to secure the vaccination of all the people—the
only really effective preventive of smallpox. We are very glad,
therefore, to chronicle another decision by our Supreme Court sus-taining
the right of the proper authorities to initiate and carry out
such regulations. A decision of similar effect was State v. Hay,
from Alamance, in 1900. We take much pleasure in- giving below
the able opinion of Justice Hoke. We are specially glad that Super-intendent
of Health Stewart was sustained, for he showed an earnest
devotion to duty that desen-es the highest praise
:
MORGAN V. STEWART.
(Supreme Court of North Carolina, April 24, 1907).
Malicious Prosecution—^Vant of Probable Cause—Criminal
Prosecution.
Revisal 1905. sec. 44.j1, provides that on the appearance of small-pox
in a neighborhood, the sanitary coinniittee of any county can
make such regulations for the vacciniition of its inhabitants and
impose such penalties as they may deem necessary to protect the
public health. Section 3455 provides that if any person shall violate
any of the regulations of the sanitary authorities of any county as to
vaccination he shall be guilty of a misdemeanor. Smallpox having
50 BULLETIN K'. C. BOARD OF HEALTH.
become prevalent in a county, and an epidemic being threatened, the
sanitai-y committee passed a resolution that any person within a
radius of three miles of any school-house who wilfully refused to be
vaccinated or to allow any one in his charge to be vaccinated should
be guilty of a misdemeanor, and the county superintendent of health
was directed to enforce compulsory vaccination as necessary. Small-pox
having developed within three miles of the plaintiff's school-house,
the county superintendent requested that he be allowed to
vaccinate plaintiff and his scholars, which request was refused, and
the county superintendent instituted a prosecution against plaintiff
Avhich resulted in his acquittal: Held, in an action for malicious
prosecution by plaintiff against the county superintendent, that there
was probable cause for the prosecution of plaintiff by the county
superintendent.
Appeal from Superior Court, Anson County. Justice, Judge.
Action by C. H. Morgan against Henry D. Stewart. From a judg-ment
for plaintiff, defendant appeals. Reversed.
There ^as evidence to the effect that in February, 1906, the present
defendant, who was at that time superintendent of health for Union
County, had caused the arrest and trial before two justices of the
peace of said county of the present plaintiff, who was then teaching a
public school in Union, on a charge of wrongfully refusing to be
vaccinated and to permit the vaccination of the pupils of his school,
pursuant to regulations of the sanitary committee of that county.
That on trial, had on March 10, 1906, the present plaintiff was
acquitted, and thereupon instituted the action against defendant for
malicious prosecution. At the close of the plaintiff's testimony, and
again at the close of the entire testimony, there was motion on the
part of the defendant to dismiss the action as on judgment of nonsuit,
in that there was no testimony to sustain or justify a finding for the
plaintiff on the issue as to want of probable cause for the prosecution
complained of. The motion was denied, and defendant excepted.
Verdict and judgment for plaintiff, and defendant excepted and
appealed.
R. B. Red ir hie for appellant.
Hoke, .J. It is accepted doctrine with us that on facts admitted
and established the question of probable cause is • one of law for
the Court. Jones v. Railroad, 12.5, N. C, 229, .34 S. E. 398 ; Bradley
V. Morris, 44 N. C, 395 ; Swain v. Stafford. 26 N. C, 392. And it is
further held that the acquittal by a court which has jurisdiction to
try and determine the question does not make out a prima facie
case of want of probable cause. Bell v. Pearcy, 33 N. C, 233. Apply-ing
these principles, a careful examination of the record leads us to
the conclusion that in no aspect of the testimony has the plaintiff
made out his allegation of a want of probable cause for the prosecu-
BULLETIN X. C. BOARD OF HEALTH. 51
tiou. and there was err<u' in refusing the defendant's motion to non-suit.
There is no substantial divergence in the testimony presented, and
it tends to show that for eighteen mouths prior to the occurrence
smallpox had been prevalent in Union County, there having been as
many as 572 cases in the year previous and 200 cases already devel-oped
in the current year : that one case existed one-half mile from the
school-house in question and several others at a distance not much
greater, and that at Waxhaw, within three miles, thei'e were quite a
number of cases. In the presence of these conditions, the sanitary
committee of Union County met at Monroe, N. C, and, having been
called to order by the chairman, passed a resolution looking to com-pulsory
vaccination, as follows : "Any person or persons within a
radius of three miles of any school-house who wilfully I'efuses to
be vaccinated or to allow any one in his charge to be vaccinated
shall be guilty of a misdemeanor." The committee, having fixed a
fee for vaccination, allowed the superintendent of health to call in
any doctor of the county to help him ; and it was further ordered
that the county superintendent of health proceed to enforce compul-sory
vaccination to such an extent as he might consider necessary.
The substance of these proceedings was duly published in the county
paper, and the plaintiff testified that he had been made aware of
some such proceedings, but was not informed of their precise nature.
The defendant, who was then superintendent of health in Union
County, having heard that there were several cases of smallpox near
the plaintiff's school, one within a half mile, and in sight, calls at
the school-house, explains the conditions and the law, as he under-stands
it. and requests that he be allowed to vaccinate the plaintiff
and his scholars, and the request is refused. The plaintiff and
defendant differ somewhat as to the precise terms; but, taking either
version to be true, there was a refusal both as to the plaintiff and
the scholars, or certainly as to some of them. Having referred the
matter to the Secretary of the State Medical Board at l^aleigh, and
having been advised that the teacher was indictable and should be
proceeded against, and. furthermore, having been shown a letter
from the Attorney-General of the State to the Superintendent of
Public Instruction, in which the Attorney-General advised that regu-lations
similar to those of Union County could be lawfully enforced,
the superintendent instituted the prosecution complained of and on
which the present plaintiff was tried and acquitted.
Our statute law provides, in substance (Rev. 100.5, sec. 4451), that
on the appearance of smallpox in a neighborhood the authorities of
any city or town or the sanitary committee of any county may make
such regulations and prnvisions for the vaccination of its inhabitants,
and impose such fines, as they may deem necessary to protect the
public health. And section ?Aoo provides that "if any person shall
52 BULLETIX X. C. BOARD OF HEALTH.
violate any of the rules and regulations of the sanitary authorities
of any county in regard to vaccination he shall be guilty of a mis-demeanor,
and fined, not exceeding fifty dollars, or imprisoned, not
exceeding thirty days." We find no precise form in which the resolu-tions
of the county sanitary board should be couched, nor any speci-fied
or stated order of proceedings where such matters are to be con-sidered
or determined, and we see no reason why the order of the
sanitary committee should not be upheld as a valid exercise of the
authority conferred upon them by the statute. They could not
declare the prohibited act a misdemeanor, because its status had.
already been so fixed by public law, but their resolution could still be
received and construed as a regulation requiring parties within the
prescribed territory to submit to vaccination ; and the statute makes
the refusal a misdemeanor within the jurisdiction of the Justice of
the peace. Legislation of this character has been upheld by well-considered
decisions in this and other jurisdictions. Hutchins v.
Durham. 137 N. C. 68, 49 S. E.. 4G : State v. Hay, 126 N. C, 999, 35
S. E., 459, 49 L. R. A., 588, 78 Am. St. Rep., 691 ; Morris v. Columbus,
102 Ga., 7-92, 30 S.. E., 850, 42 L. R. A., 175, 66 Am. St. Rep., 243.
And it is also well established that the Legislature can confer on
local boards, certainly those clothed with government functions,
the power to make reasonable regulations to protect the public health
and to fix and establish facts or conditions on which a statute makes
its own action depend. State v. Raitroad, 141 N. C, 852, 54 S. E..
294, 8 Cyc, 830; Freund on Police Power, sec. 34. And while the
local regulations are required to be reasonable, and are, to some
extent, subject to judicial control, both as to the existence of an
apprehended danger and the reasonableness of the relief (Freund
on Police Powers, supra), we have held that "'where a statute of this
kind has been passed and the conditions established which call it
into operation, it thus becomes a law binding on each and all alike,
and it is optional to no one's private judgment whether to render
compliance or not. If there ai-e exceptional cases, where, owing to
the peculiar state of the health or system, vaccination would be
dangerous, that would be a matter of defense the burden of which
would be on the defendant." State v. Hay, supra. In holding that
there was probable cause for prosecuting the plaintiff, we intend to
make no comment, certainly no adverse comment, either on the
justices who tried and acquitted the plaintiff nor on the plaintiff
himself. Both, no doubt, acted according to their best judgment and
sense of duty, and there is much to be said in justification of the
plaintiff's conduct. But the plaintiff's conduct here is not the impor-tant
or controlling question. We are considering chiefly the conduct
of the defendant and how the matter reasonably appeared to him.
He was at that time superintendent of health of Union County,
whose sworn duty it was to see that laws addressed to the subject
BULI.ETIX N. C. BOARD OF HEALTH. .)'o
involved were enfoix-ed, and to carry out, as far as possible, the work
as directed by the sanitary committee of his county and by the
State Board of Health. Revisal 1905, sec. 4451. He notes that the
county is threatened with an epidemic of sma.llpox. and the sanitary
board has passed a resolution I'equesting each and every one within
a radius of three miles of any case of smallpox to be vaccinated, and
on the statute books is a law which makes it a misdemeanor to
refuse to comply with this regulation : that this school is within such
a radius and is in great danger of exposure, and under such condi-tions
he applies to the plaintiff for permission to vaccinate both
plaintiff and his scholars, and the application is refused.
There is also evidence tending to show that there was a disposi-tion
in many localities to obstruct the enforcement of these regula-tions,
and. under such circumstances, the defendant consults with
the Secretary of the State Board of Health as to the proper course
to be pursued. That officer, who deservedly holds the confidence of
every well-informed and patriotic citizen of the State by reason of
his faithful and intelligent devotion to his duties and to the State's
best interest, advises, upon all the facts, that the law has been
broken, and that the public good requires that the prosecution should
be instituted. The defendant then swears out the warrant and
causes the plaintiff to be put on trial. Probable cause, in cases of
this kind, has been properly defined as the existence of such facts
and circumstances, known to him at the time, as would induce a
reasonable man to commence a prosecution. Cabiness v. Martin. 14
X. C, 454; Bell v. Pearcy. supra.
It seems clear to us that in no aspect of the testimony, as the same
i>< presented in this record, has there been a want of probable cause
shown, and the Court beloAv should have decided the case as on judg-ment
of nonsuit.
Reversed.
54 bulleti:n" m". c. board of health.
THE ANTISEPTIC BABY.
The antiseptic baby aud the prophylactic pup
Were playing in the garden when the bunny gamboled up
;
They looked upon the creature with loathing undisguised
—
He wasn't disinfected, he wasn't sterilized.
They said he was a microbe, a hot-bed of disease.
And they boiled him in a vapor of a thousand-odd degrees
;
They froze him in a freezer as cold as banished hope,
They washed him in permanganate with carbolated soap.
In sulphurated hydrogen they soaked his wiggly ears,
And trimmed his frisky whiskers with a pair of hard-boiled shears.
Then they donned their rubber mittens and took him by the hand.
And elected him a member of the fumigated band.
There isn't now a microbe in the garden where they play.
They swim in pure iodoform a dozen times a day
;
And each imbibes his rations from a hygienic cup.
The bunny and the baby and the prophylactic pup.
BULLETIX X. C. BOARD OF HEALTH.
REVIEW OF DISEASES FOR JUNE, 1907.
SEVENTY-NINE COUNTIES REPORTING.
Ninety-two counties biive Superintendents of Healtli.
Except in the case of tlie more contagious and dangerous diseases,
the Superintendent has, as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a
disease otherwise indicated, its mere presence in the county is to be
understood as reported.
For the month of June the following diseases have been reported
froni the counties named
:
Measles.—Alamance, 6 ; Ashe, several ; Bladen, a few ; Burke, 20
;
Cabarrus, 7 ; Caswell ; Chatham, 1 ; Cherokee, in all parts ; Chowan,
several ; Cleveland, a few ; Columbus, 2 ; Cumberland ; Davie, many ;
Forsyth, a few ; Gaston, many ; Granville, 20 ; Harnett, 66 ; Hender-son,
a few ; Hertford, 20 ; Jackson, 00 ; Johnston, many ; Lincoln,
several ; Mecklenburg ; Montgomery, 20 ; Onslow ; Person, 3 ; Ran-dolph,
20 ; Rutherford, 40 ; Sampson, a few ; Swain, 50 ; Wake, 12
Washington, many ; Yadkin, a few—33 counties.
Whooping-cough.—Alamance, several ; Ashe, a few ; Bladen, many ;
Caswell, 50; Cherokee, a few; Chowan, several; Clay, a few; Cleve-land,
many ; Currituck, a few ; Davie, many ; Edgecombe, several
Forsyth, a few ; Gaston, 9 ; Gates, in all parts ; Granville, 12 ; Harnett,
60 ; Henderson, several ; Hertford, 5 ; Martin, several ; Mecklenburg
;
Northampton ; Randolph, in all parts ; Richmond, 2 ; Rutherford, 40 ;
Sampson, a few; Swain, 50; Wake, 10; Washington, many; Yadkin,
a few—29 counties.
Scarlatina.—Alamance, 1 ; Alexander, 1 ; Cleveland, a few ; Gas-ton,
1 ; Mecklenburg : New Hanover. 1 ; Rutherford, 10 : Union, epi-demic.
Wake, 1—9 counties.
Diphtheria.—Ashe, a few; Davie, 2; Franklin, 2; Greene. 1;
JNIacon, 1; New Hanover, 1; Orange, 1; Richmond, 1; Rowan, 1;
Wake. 2—10 counties.
Typhoid Fever.—Alamance, 5 ; Alexander, 20 ; Ashe, 25 ; Bertie, 1
;
Bladen, 3 ; Brunswick, several ; Burke, 18 ; Cabarrus, 30 ; Camden, 2
;
Caswell. 4 ; Catawba, 3 ; Chatham, 15 ; Cherokee, several ; Chowan. 1
Clay, 7 ; Cleveland, many ; Columbus, 4 ; Craven, 3 ; Cumberland
Davidson; Davie, a few; Edgecombe, 25; Forsyth, a few: Franklin,
several ; Gaston. 8 ; Gates, 12 ; Graham, 2 ; Granville, 2 ; Guilford. 9 ;
Harnett, 26; Hertford, 10; Iredell, 30; Jackson, 4; Johnston, a few;
Lincoln, several; Lenoir. 1; Macon, 8; Mecklenburg; Montgomery,
10: New Hanover, 3; Northampton, many; Orange, 1; Pender. 7;
56 BULLETI2T IS'. C. BOAED OF HEALTH.
Perquimans, a few ; Person, 9 ; Randolph, 100 ; Richmond, 1 ; Rowan,
2; Rutherford, 10; Sampson, a few; Scotland, 15; Surry. 4; Swain,
1 ; Union, a few ; Yance, a few ; Wake. 14 : Warren, 1 ; Washington, 2
;
Watauga, 1 ; Wayne : Wilson, a few ; Yadkin, several—62 counties.
Malarial Fever.—Alamance; Camden, in all parts; Currituck;
Harnett ; Hertford ; Hyde ; Northampton ; Pender, Perquimans ; Rich-mond
; Rowan ; Union ; Wake ; Wayne, in all parts—14 counties.
Malarial Fever. Perxicious.—Alamance, 1 ; Harnett, 11 ; Hyde,
several ; Wake, 1—1 counties.
Meningitis., Cerebro-spinal.—Alamance, several ; Camden, 1 ; Cas-well,
5 ; Columbus, 1 ; Gaston, 1 ; Greene, 1 ; Wake, 1 ; Watauga, 1—
S counties.
Mumps.—Richmond.
Bowel Diseases.—Alleghany, Burke, Chowan, Currituck, Graham,
Lincoln, Onslow, Person, Surry, Yadkin—10 counties.
Pneumonia.—Alexander, 1; Alleghany, 1; Ashe, a few; Chat-'
ham, 1; Clay, 2; Davie, a few; Durham, 2 or 3; Gaston, a few;
Harnett, 12 ; Henderson, 1 ; Iredell, 1 ; Jackson, 4 ; Lincoln, a few
;
Macon, 3; Martin, a few; Mecklenburg: Northampton, 2; Perqui-mans
; Person, 1 ; Randolph, 2 ; Rowan, 1 ; Rutherford, 3 ; Wake, 6
Washington, 2 ; Watauga, 2—25 counties.
Smallpox.—Alamance, 4 ; Burke, 1 ; Chowan, 4 ; Columbus, 1
;
Durham, 3 ; Franklin, 4 ; Gaston. 3 ; Guilford, 12 ; Harnett, 1 ; Johns-ton,
24; Mecklenburg. 1; Nash. 1: Rutherford, 2; Wake, 1—14
counties.
Cholera, in Chickens.—Davie.
Cholera, in Hogs.—Harnett, Hertford.
Ticks, in Cattle.—Union.
No diseases reported from Buncombe, .Carteret, Duplin, Pasquo-tank,
Pitt, Polk. No reports received from Anson. Beaufort, Cald-well,
Halifax, Haywood, Madison, Mitchell, Moore, Robeson, Rocking-ham,
Stanly, Transylvania and Yancey.
BULLETI>' ^''. C. BOARD OF HEALTH.
SUMMARY OF MORTUARY REPORTS FOR JUNE, 1907.
T\VE>'TY-OXE TOWXS.
White.
Aggregate ijopulation 12!i.St)0
Aggregate deaths 153
Representing temporary annual death-rate
per -1.000 14.1
Causes of Death
.
Typhoid fever ». 7
Malarial fever
Whooping-cough 2
Measle.s 1
Pneumonia 7
Consumption 11
Brain diseases 5
Heart diseases .' 13
Neurotic diseases 1
Diarrhoeal diseases 34
All other diseases. 67
Accident -
Suicide 2
Tiolence 1
153
Deaths under five yeai-s 64
Stillborn S
CoViJ.
84,0t II
I
160
22.S
Total.
213,800
313
17.6
10
o
58 BULLETIN N. C. BOARD OF HEALTH.
Mortuary Report for June, 1907.
Towns
AND Reporters.
Popula-tion.
Tem-porary
Annual
Death-rate
PER
1,000.
o:fe -gibo
BULLETIN N. C. BOARD OF HEALTH. 59
CountJ Superinteiideuts of Health.
Alamance Dr. H. NI. Montgomery.
Alexander Dr. O. L. Hollar.
Alleghany Dr. Robert Thompson.
Anson Dr. J. H. Bennett.
Ashe Dr. B. O. Edwards.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. Y. Dunstan.
Bladen Dr. L. B. Evans.
Brunswick Dr. J. Arthur Dosher.
Buncombe Dr. D. E. Sevier.
Burke Dr. J. L. Laxton.
Cabarrus Dr. R. S. Young.
Caldwell Dr. C. L. Wilson.
Camden Dr. C. G. Ferebee.
Carteret Dr. ^V. E. Headen.
Caswell Dr. S. A. Malloy.
Catawba Dr. Geo. H. West.
Chatham Dr. J. H. Taylor.
Cherokee Dr. W. A. Graham.
Chowan Dr. H. M. S. Cason.
Clay Dr. P. B. Killian.
Cleveland Dr. T. E. McBrayer.
Columbus Dr. H. B. Maxwell.
Craven Dr. Joseph F. Rhem.
Cumberland Dr. A. S. Rose.
Currituck Dr. H. M. Shaw.
Dare
Davidson Dr. Joel Hill.
Davie Dr. M. D. Kimbrough.
Duplin Dr. John A. Ferrell.
Durham Dr. N. M. Johnson.
Edgecombe Dr. W. J. Thigpen.
Forsyth Dr. S. F. Pfohl.
Franklin Dr. R. F. Yarborough.
Gaston Dr. L. N. Glenn.
Gates Dr. Geo. D. Williams.
Graham.* Dr. M. T. Maxwell.
Granville Dr. S. D. Booth.
Greene Dr. W. B. Murphy.
Guilford Dr. Edmund Harrison.
Halifax Dr. I. E. Green.
Harnett Dr. J. W. Halford.
Haywood Dr. J. F. Abel.
Henderson Dr. J. G. Waldrop.
Hertford Dr. J. H. Mitchell.
Hvde Dr. R. E. Windley.
Iredell Dr. M. R. Adams.
Jackson Dr. H. F. Burgin.
Johnston Dr. L. D. Wharton.
Jones
Lenoir Dr. C. L. Pridgen.
Lincoln Dr. R. W. Petrie.
McDowell Dr. M. L. Justice.
Macon, Dr. S. H. Lyle.
ISIadison Dr. W. J. Weaver.
Martin Dr. W. E. Warren,
Mecklenburg Dr. C. S. McLaughlin.
Mitchell Dr. Yirgil R. Butt.
Montgomery Dr. J. B. Shamburger.
Moore Dr. Gilbert McLeod.
Nash Dr. J. P. Battle.
New Hanover Dr. W. D. McMillan.
Northampton Dr. H. W. Lewis.
Onslow Dr. Cyrus Thompson.
Orange Dr. C. D. Jones.
Pamlico
Pasquotank Dr. J. B. Griggs.
Pender Dr. Robt. H Bradford.
Perquimans..'. Dr. T. P. McMullen.
Person Dr. W. A. Bradsher.
Pitt Dr. Joseph E. Nobles.
Polk
Randolph Dr. S. A. Henley.
Richmond Dr. N. C. Hunter.
Robeson Dr. H. T. Pope.
Rockingham Dr. Sam Ellington.
Rowan Dr. I. H. Foust.
Rutherford Dr. E. B. Harris.
Sampson Dr. Frank H. Holmes.
Scotland Dr. K. A. Blue.
Stanly Dr. J. N. Anderson.
Stokes
Surry Dr. John R. Woltz.
Swain Dr. J. A. Cooper.
Transvlvania Dr. Goode Cheatham.
Tyrrell
Union Dr. Henry D. Stewart.
Yance Dr. John Hill Tucker.
Wake Dr. J. W. McGee, Jr.
Warren Dr. M. P. Perry.
Washington Dr. W. H. Ward.
Watauga Dr. J. M. Hodges.
Wavne Dr. T. L. Ginn.
Wilkes Dr. John Q. Myers.
Wilson Dr. W. S. Anderson.
Yadkin Dr. S. L. Russell.
Yancey Dr. J. B. Gibbs.
OHAPEL HILL N
Or I H .Afiinnin-
OF THE
NORTH CAROLINA BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh. N. C.
Geo. G.Thomas, M.D.,Pres., Wilmington. ; T. E. Anderson, M. D.--Statesvine.
S. Westray Battle, M. D.--Asheville. J. Howell Way, M. D Waynesville.
Henry W. Lewis, M. D Jackson.
j W. O. Spencer, M. D Winston-Salem.
W. P. IVEY, M. D. Lenoir. i J. L. LuDLOW, C. E. Winston-Salem.
Richard H. Lewis, M. p.. Secretary and Treasurer, Raleigh.
Vol. XXII. AUGUST, 1907. No.
WANTED—A PHYSICIAN.
We have just received a letter from Mr. Alplionso White of Wiu-fall,
Perquimans County, in wliioli Lie says : "We need a good doctor
to locate in Wiufall. Our town has three hundred inhabitants and
is on the 'X. and S. R. R.—a good place to live. There is a scope of
country tAventy miles long where he can get practice. A good doctor
can get all the practice he can do." Those interested will please
address Mr. White.
FLIES AND DISEASE.
At this season of the j'ear typhoid fever is especially prevalent.
While most frequently transmitted by infected drinking water, the fact
that Lt is carried by flies has been demonstrated and it is now held
that this is a very common method of transmission. It is a very rea-sonable
theory. Tj^phoid fever germs must be swallowed to cause the
disease, therefore infection of food and drink with them renders this
not only .easy but certain. The bacilli are found in the body dis-charges,
chiefly in those of active cases of the disease, but also for
weeks after convalescence has been established, and likewise in those
of some persons who are apparently healthy. This means that all
surface privies not properly cared for are a menace to health,
whether there l)e a case of typhoid fever in the ramily or not. Of
62 BULLETIN ]Sr, C. BOAED OF HEALTH.
course the greatest danger lies Id the discharges of a typhoid patient,
and we wish to emphasize again the extreme importance of the
'immediate disinfection of all typhoid stools, or, at least, their protec-tion
against the access of flies until this can be done, as well as the
importance of keeping flies out of the sick-room.
As being exactly in line with what we have said above, we give
below a very interesting and instructive article copied in the Bulletin
of the New York State Board of Health from the Boston Medical
and Surgical Journal:
"Tolerance of Typhoid.—The 'carrier' of infectious germs has intro-duced
a problem, hitherto unrecognized, into the sanitarian's work.
Apparently healthy people are found who are the 'hosts' of bacilli
which may be released from time to time, to find lodgment and cause
disease in a susceptible individual. The tolerance of the bacilli car-rier
has possibly been acquired by the repeated invasion of attenuated
organisms. With regard to typhoid, it is well to bear in mind that
all the members of a farmer's family may have acquired this toler-ance,
if their water supply is infected, and be 'carriers' ; the summer
visitor on "the farm, not being immune, jnay acquire the disease.
Again, milk may be infected by a dairyman "carrier,' although there
may be no clinical evidence of disease to which a resulting epidemic
can be ti'aced.
''Flies as Carriers of Disease.—Health oflicers and physicians gen-erally
need to dwell heavily upon the part played by the common
house fly in the transmission of disease. The fly is much more to be
dreaded from this point of view than the mosquito, which is responsi-ble
for the propagation of two diseases only—malaria and yellow
fever. On the other hand, it has been shown that the house fly can
be the medium of transmission for anthrax, cholera, tuberculosis,
fllariasis, certain inflammatory eye affections, plague, typhoid fever,
intestinal parasites, and wound infections. It has been suggested
that the fly is also a factor in the spread of gonorrhea, smallpox and
various skin affections.
"Flies, then, are neither harmless nor necessary, and public opin-ion
should be educated to be intolerant of them. The control of the
situation is within the province of the health oQicer as a sanitary
official. The breeding ground of the fly is the manure pile, and every
community should have its ordinance cohtroling this nuisance. Ma-nure
should not be allowed to stand in heaps, either on the street
or in the stable-yard ; it should be collected into closed vaults or cov-ered
metal receptacles as soon as possible after it is dropped, and at
least once a day it should be covered with chloride of lime or
sprinliled with a solution of sulphate of iron. Careful inspection of
stables and a proper administration of the street cleaning department
will diminish the possibility of transmitting disease to a very great
extent. "With regard to the spread of typhoid fever by flies, if this
BULLETIN X. C. BOAIID OF HEALTH. 63
takes place it is. in nine eases out of ten. the fault of the medical
attendant and the health officer. Prompt disinfection and burial or
other proper disposition of the excreta, and the absolute exclusion of
flies from the sick-room should be insisted upon.
•'Contact Infection and Typlwid Carriers.—lt is asserted by Kutscher
that in southwestern Germany direct contact is a more important
factor in the spread of typhoid fever than polluted water, and that
about 4 per cent, of typhoid patients become chronic carriers of
the specific bacilli, which they excrete in both urine and feces, some-times
for long periods. Doerr, for example, cites cases reported by
Drober and Hunner, in which the bacilli were isolated from the gall
bladder seventeen and twenty years after recoveiy, and Lentz asserts
that if after ten weeks from convalescence the excretion of the bacilli
has not ceased, it will most likely continue permanently and uninter-ruptedly,
in spite of medication. He cites a number of cases in
which after ten, thirtj- and even forty-two years after recovery the
excretion continued. Levy and Kayser report that in the autumn of
1905 a number of cases of typhoid fever occurred in an insane asylum,
in which two years previously an inmate had had the disease and
had recovered. On the appearance of these later cases, this person
was examined and was found to be excreting the bacilli in her feces.
Further examinations were made at intervals of several weeks, and
the bacilli were found ten times. In October, 1906, she died of a
typhoid bacillary septicemia, due to auto-infection from the gall
bladder; and on autopsy the bacilli were isolated from the spleen,
liver, bile, wall of the gall bladder and from the interior of a large
gallstone.
"A somewhat similar case is reported by Nieter and Liefmarm,
also from an insane asylum in which the disease had been endemic
for many months. A, patient dead of chronic dysentery was exam-ined
and typhoid bacilli were found in the intestines and in pure
culture in the gall bladder, in which were gallstones. Among 250
inmates were found 7 typhoid carriers.
"Klinger found among 1.700 persons 23 typhoid carriers, ranging
in age from eighteen months to sixty years, 11 of whom had no
typhoid history. Of 842 convalescents from the disease, 63, or 13.1
per cent, were found to be excreting the bacilli, and S were still doing
so six weeks after recovery.
"Kayser, tracing outbreaks to their sources, found a boy of twelve
years, a member of a milkman's family, to be a chronic carrier and
the probable source of infection in a number of cases. Another out-break,
in which 17 persons were seized (2 deaths), was traced to a
woman who had no typhoid history, but was excreting the specific
bacilli. She was employed in the dairy from which the persons
seized had obtained their milk. Of 260 cases of typhoid fever investi-gated
60 were traced to infected milk. Among the 60 victims were
64 BULLETIN" K. C. BOAED OF HEALTH.
30 maids and kitchen girls, 12 baliers, and 44 persons engaged more
or less in kitchen work. In all, 28 cases were traced directly to
apparently healthy typhoid carriers.
"Minelli examined 250 prisoners who had not been in contact with
typhoid cases, and found but one who had the specific organism
constantly in the feces. The agglutinative test was positive.
"Etienne and Thiry report the case of a man, sixty-four years of
age, who, after four years in a hospital, under treatment for tabes
and hemiplegia, had two attacks of jaundice, and on examination
was found to be excreting typhoid bacilli in the feces.
'���A series of 26 cases of the disease in fifteen families of a village
in Lorraine is described by Seige, who states that diligent investiga-tion
by the district physician, the village authorities and the Bac-teriological
Institute of Saar-louis placed the I'esponsibility upon a
woman who was a chronic typhoid carrier.
"An interesting case of infection from direct contact is reported by
Dr. H. MacKenzie and Mr. W. H. Battle. More than two years after
a severe attack of typhoid fever, a man had an attack of femoral
osteomyelitis, caused by B. typhosus. After operation the patient was
discharged, but some time afterwards a sinus formed, the purulent
discharge from which contained typhoid bacilli. The patient's wife
had not been in contact with any other case, but frequently removed
and burned the dressings. After a time she fell sick with typhoid
fever, and died.
"In a letter to the writer, under date of April 3, 1907, in response
to a I'equest for information concerning a woman described in the
press as a 'typhoid factory' and held under detention by the Depart-ment
of Health of the City of New York, Dr. Walter Bensel says
:
'The woman of whom you write has given a history of a probable
mild attack of typhoid fever about six years ago. Since that time
there have been undoubtedly twenty-eight cases of typhoid fever in
the families in which she woi'ked. The number of cases occurring
in a family within a few weeks of her advent varied from one or
two up to six out of seven members. The evidence seemed so strong
that she was a carrier of typhoid fever that she was removed to
Reception Hospital by force. Examinations of her feces and urine
were made, and the typhoid bacilli found in her feces confirmed posi-tively
our suspicions with regard to the possibility of her conveying
typhoid fever."
BULLETIN' jST. C. BOAKD OF HEALTH. 65
REVIEW OF DISEASES FOR JULY, 1907.
EIGHTY COUXTIES EEPORTIXG.
Ninety-two counties have Superintendents of Health.
Except in the case of the more contagious and dangerous diseases,
the Superintendent has, as a rule, to rely upon his own information
alone, since few physicians can be induced to report cases of non-contagious
diseases to him.
Where the number of cases is not given, or the prevalence of a dis-ease
otherwise indicated, its mere presence in the county is to be
understood as reported.
For the month of .July the following diseases have been reix)rted
from tlie counties named :
Measles.—Ashe, a few cases ; Burke, 5 ; Chatham, several ; Chero-kee,
several ; Cleveland, a few ; Davie, a few ; Forsyth, a few ; Gaston,
many ; Gates, 15 ; Graham, .3 ; Granville ; Harnett. 21 ; Jackson, 40
;
Lincoln, several ; Mitchell, 13 ; Randolph, in all parts ; Rutherford. 15 ;
Sampson, a few ; Swain, 50 ; Union many ; Wake, 4 : Watauga, many ;
Yadkin, several ; Yancey, several^24 counties.
Whoopittg-cough.—-Ashe, many ; Caswell, 15 ; Cherokee, several
Chowan, several ; Cleveland, a few ; Davie, many ; Edgecombe, sev-eral
; Forsyth, a few : Gates, 10 ; Guilford, 3 ; Harnett, 14 ; Henderson,
several ; Lincoln, several ; Macon, 4 ; ^Martin, several ; Nash ; Orange,
3 ; Pasquotank ; Perquimans, 2 ; Randolph, in all parts ; Rowan, many ;
Sampson, a few; Scotland, 24; LTnion, many; Wake, 4; Washington,
many ; Yadkin, several—27 counties.
ScARLATiKA.—Ahimance, 2 ; Buncombe, 2 ; Catawba, 4 ; Davie, 3
;
Gaston. 6 ; Macon, 1 ; Orange. 1 ; Surry, 2 ; Union, epidemic—
6
counties.
DiPHTHEKiA.—Beaufort, 1 ; Buncombe, 1 ; Catawba, 5 ; Cumberland,
1 ; Davidson. 1 ; Duplin, 1 ; Durham, 1 ; Edgecombe, 1 ; Gaston, 2
Guilford, 1 ; Henderson, 1 ; Macon, 2 ; Orange. 4 ; Randolph. 1 ; Union,
1 ; Warren, 1 : Yancey, 1 or 2—17 counties.
Typhoid Feat:r.—Alamance, a few ; Alleghany ; Ashe, many ; Beau-fort,
4 ; Bladen, 6 ; Brunswick, several ; Burke, 25 ; Cabarrus, 9
Caldwell, 20: Camden, 1; Caswell, 3; Catawba. S; Chatham, 17;
Cherokee, several ; Chowan, 3 ; Clay, several ; Cleveland, many ; Co-lumbus,
10 ; Craven, 4 ; Cumberland ; Davidson, many ; Davie, a few ;
Duplin, about 40; Durham, a few; Edgecombe, about 20; Forsyth;
Gaston, many ; Gates, 15 ; Graham, 1 ; Greene, 6 ; Guilford, about 20
;
Harnett, 29: Haywood, 4: Henderson. 2; Hertford, 20; Iredell. 10;
Jackson. 6: Johnston. G; Lincoln, several: McDowell, 8; Macon. 8;
Madison; Martin, several: Meeklonlnug; Mitchell. 12: Montgomery,
37; Nash; New Hanover, 6: Northampton, many; Orange, 1; Pasquo-
66 BULLETIX :S'. C. BOARD OF HEALTH.
tank; Pender, 8: Perquimans. 8; Person, 20; Pitt 12; Randolph. 15;
Rielimond, a few ; Rowan, a few ; Rutherford, 10 ; Sampson, several
;
Scotland, 12 ; Stanly, many ; Surry, 12 ; Swain, 12 ; Union, many
Wake, 25 ; Warren, several ; Washington, 1 ; Watauga, 3 ; Wilkes, 10
Yadkin, 10 or 12; Yancey, a few—72 counties.
Maiaeial Feveb.—Alamance, in all parts ; Bertie ; Caswell ; Chowan
;
Columbus ; Currituck : Davidson, in all parts ; Edgecombe ; Harnett,
in all parts; Hertford, in all parts; Johnston; Lincoln, in all parts;
Martin ; Montgomery ; Northampton, many ; Onslow ; Perquimans, in
all parts ; Randolph ; Richmond ; Stanly, in all parts ; Washington—21
counties.
Malarial Fever, PEEificious.—Bertie, 2 : Harnett, 1 ; Martin, 1.
MALABL4X, Fever, Hemorbhagic.—Edgecombe, 1 ; Martin, 2 ; Ran-dolph,
2 ; Washington, 1—4 counties.
Meningitis, Ceeebro-spinal.—Caswell, 4 ; Chatham, 1 ; Cherokee, a
few ; Durham, 1 ; Graham, 1