Health bulletin

              HEALTH SCIENCES LIBRARY
OF THE
UNIVERSITY OF NORTH CAROLINA
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be token from the
Library building.
Form No. 471
mm Publi5\edb4 TAZ>^9RmCAK9LI/^A 5TXrL5?AKDs^Am.Un
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Entered as second-class matter at Postofflce at Raleigh, N. C, under Act of July 16, 1891}.
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. XXXIV JULY, 1919 No. 7
A Law of Moses, Judge of Israel;
About 1491 B. C.
"Thou shalt have a place also with-out
the camp, whither thou shalt go
forth abroad:
"And thou shalt have a paddle upon
thy weapon; and it shall be, when
thou wilt ease thyself abroad, thou
shalt dig therewith, and shalt turn
back and cover that which cometh
from thee."—Deut. 23: 12-13.
A Law of the State of North Caro-lina,
Enacted A. D. 1919.
1. "Every residence located within
three hundred yards of another resi-dence
must have an improved privy
of a type approved by the State Board
of Health."
TABLE OF CONTENTS
Page
Introduction 2
The State-wide Privy Law Explained 3
Sanitary Principles of the Construction of Privies 5
Types of Improved Privies 8
Plans and Specifications for Approved Privies 15
Summary of Rules for Maintenance of Different Types of Privies 26
Economics of Privy Construction and Maintenance 31
Machinery and Methods for Enforcing the Law 31
INTRODUCTION
By A. J. AVabben,
Assistant Secretary, State Board of Health
This July issue of the Health Bulletin covers in the most
practical manner the largest single factor that is impeding the
progress of health work in N'orth Carolina and that confronts
her citizens today—the disposal of human excreta.
Kealizing this fact and being willing to meet, like true men
should, their responsibility, the last General Assembly passed
an act requiring every home within three hundred yards of
another home to have an improved type of privy that the State
Board of Health would approve. The questions immediately
arise, "What type will the State Board of Health approve, and
what type shall I install?" This Bulletin answers both ques-tions.
The information set forth in this Bulletin is not influ-enced
by a prejudice against nor preference for any particular
type of privy, but each type is dealt with in detail and both the
advantages and disadvantages, together with the comparative
costs given, as each particular type warrants.
The substance of this Bulletin was not compiled until an ex-haustive
study of the various types of privies in use in the
various sections of the country had been made. Each type
was studied not from its theoretical application alone, but in
actual use as well.
We present this Bulletin as the most complete study that has
yet been made public relative to the practical application of
the various types of privies now in use.
The technical matter in this Bulletin was prepared by H. E.
Miller, C.E., Director of the Bureau of Engineering and Inspec-tion
of the State Board of Health, and past assistant surgeon
K. E. Miller of the United States Public Health Service.
irmm D)M
[£j| | PUBLI5AE.D BY TMEL HPR-TM CAgQUhA 5TATL BQMgP 6>^MEALTM I B
VOL. XXXIV JULY, 1919 No. 7
THE STATE-WIDE PRIVY LAW EXPLAINED
1. Object
The Governor of the State, in his
message to the last General Assem-bly,
said, "A general law should be
enacted making it compulsory for the
owner of property on which a privy
is located within three hundred yards
of the dwelling house of any other
person, to maintain a sanitary privy
in accordance with plans and specifi-cations
approved by the State Board
of Health."
The State Board of Health drafted
and recommended to the General As-sembly
the passage of such an act,
which is explained in this article.
In advocating such a course, both
the highest executive official of the
State and the State Board of Health
had but one object in view—the pre-vention
of human suffering and dis-tress
from preventable diseases, and
the saving of human lives.
2. Meaning and Scope
When reduced from legal terms to
plain English, the law simply means
that the open back surface privy will
no longer meet the requirements and
demands of modern civilization; and
it must be remodeled and converted
into a sanitary type that the State
Board of Health approves. The
term "privy" as used in the act in-cludes
every type of disposal system,
except sewer connections and septic
tanks of a type approved by the State
Board of Health, that is located with-in
three hundred yards of another
residence.
The danger of any open, insanitary
privy is in proportion to the size of
the population to which it is related
by either the fly or water route. An
open back privy in a town or city
block is within fly range, that is,
three hundred yards, of from sixteen
to twenty homes with a total popula-tion
of from ninety to one hundred
and twenty people. An open back
privy in the average rural district is
in three hundred yards of one home
of from five to seven people. The
open privy in the country districts
usually affects only the owner, who is
responsible for his own surroundings,
whereas the open privy in the city
or town affects other people who are
in no way responsible for it and have
no control over it. The enforcement
of the act will protect these defense-less
homes against typhoid fever, dys-entery,
and other "privy-filth" dis-eases.
In the strictly rural districts
of North Carolina, there is one case
of typhoid fever per thousand per
year, whereas in the unsewered city,
town, village or suburban section
there are from five to six cases of
typhoid per thousand population
yearly.
The responsibility for the sanitary
maintenance of the privy is definitely
fixed as falling upon the head of a
family or household, the proprietor
of a boarding-house, hotel, restaurant,
or store, the principal or superintend-ent
of a school, the agent or station-master
of a railroad station or depot,
or the person in charge of an office
The Health Bulletin
building, establishment, or institution.
Any of the above named parties who
permits a privy other than a sani-tary
privy to be used by his or her
household, guests, customers, pupils,
passengers, occupants, employees,
workers, or other persons, will be
guilty of a misdemeanor and subject
to prosecution.
The North Carolina State Board of
Health, through its officers and in-spectors,
will supervise the construc-tion
and maintenance of all privies
coming under the jurisdiction of this
act. This will be done by dividing
the State into ten sanitary districts of
ten counties each, and a sanitary in-spector
will be placed in charge of
each district. These ten sanitary in-spectors
will be under the direct su-pervision
of an experienced sanitary
engineer, the chief of the Bureau of
Sanitary Engineering and Inspection.
All types of privies built must be ap-proved
by this bureau.
Whenever an inspector of the State
Board of Health shall find a privy lo-cated
within three hundred yards of
the residence of a person other than
that of the owner or tenant thereof,
which is not constructed according to
the specifications of the Bureau of
Sanitary Engineering and Inspection,
he shall fasten on such privy a notice
reading "Insanitary; unlawful to
use," and the use of a privy so pla-carded
will be a misdemeanor. Or if
a privy be constructed according to
specifications, but is not being prop-erly
maintained, it will be placarded
the same as one not properly con-structed.
When a privy is found to
be properly consti'ucted and main-tained,
the inspector will attach there-on
a license tag permitting its use, and
also instructions for the proper main-tenance
of the privy.
At the time of the inspection, the
owner of each privy shall pay to the
officer or inspector a license fee of
forty cents, for which the inspector is
required to issue a receipt. This li-cense
fee is to be used to defray the
expenses incurred by the State in the
enforcement of this act.
Cities that have a population in
excess of twenty thousand will be ex-empted
from the requirements of the
act if the city officially requests the
State Board of Health to exempt it
from its provisions before the first of
October, 1919.
The Necessity for Such An Act
The swallowing of human excre-ment
causes 2,000 deaths and 34,000
cases of sickness in North Carolina
every year, as is shown by the follow-ing
figures:
Deaths from
—
Typhoid 502
Dysentery 604
Diarrheal diseases of infants .
.
875
Total 1,981
Cases of sickness
—
Typhoid 5,020
Dysentery 12,080
Diarrheal diseases of infants.. 17,350
Total 34,450
It is true that all of the above list
of diseases did not have their sole
origin from the open privy. And it is
also true that after the State has
been sanitated there will continue to
be sporadic cases of diseases of fecal
origin. But it is quite certain that
the open back privy is the chief source
of propagation for the fecal-borne dis-eases
in North Carolina. It is also
quite certain that the enforcement of
this sanitary law will greatly reduce
this number of both deaths and cases
of sickness. And it is a singular fact
noted by sanitarians that wherever
the sanitary conditions are so im-proved
as to render the fecal-borne
diseases of minor consequence, the
general health of the community rela-tive
to the other diseases improves
also, and the total death rate is ma-terially
lowered.
The Health Bulletin
Let us assume that we prevent
only 18 per cent of deaths and sick-ness
now due to fecal-borne diseases
(an extremely conservative estimate)
by enforcing the sanitary privy law.
We would then prevent 365 deaths,
one for each day in the year, and the
occurrence of 63,000 cases of sickness.
If the 365 lives saved are worth $1,-
000 each, we shall have saved $365,-
000 worth of human economic value.
And if the 63,000 cases of sickness
cost in doctors' bills, druggists' bills,
nurses, time lost from labor, etc., $30
apiece, we shall have saved an addi-tional
$189,000; a total saving of
$554,000 for the State. The question
is simply this: Shall you pay to the
State an annual inspection tax of 40c,
or shair the State lose annually in hu-man
economic values $554,000?
A copy of the law will be sent to
any person desiring it, upon request.
(Signed) A. J. W.
SANITARY PRINCIPLES OF THE CONSTRUCTION OF PRIVIES
It is only in recent years that we
have come to a truer and more
thorough understanding of the mean-ing
of sanitation and its life-saving
principles. More recent still is the
application of these principles in a
wholesale manner to the daily life of
the citizens of a community, to pre-vent
the spread of disease.
Typhoid fever, dysentery, diar-rhea,
summer complaint, and certain
other diseases have been proven to
have their origin in human filth. That
is, in plain English, any person who
contracts one of these diseases has
either eaten or drunk the body waste
of some one else who had the disease.
Repulsive as this may seem, it is
nevertheless a daily occurrence in the
majority of our homes, especially
during the warm months, and it must
be so as long as the insanitary privy
remains in any community, as will be
shown below. There is, therefore, no
more simple and far reaching phase
of sanitation than that dealing with
the reduction of disease by means of
sanitary construction and mainte-
FiG. 1. North Carolina's battlefield. A battery of the enemy's automatic rapid-firing guns
Their firing range is at least 300 yards, and they are a particularly deadly weapon tor the
reason that they shoot in all directions with equal effectiveness.
6 The Health Bulletin
nance of the privy, from which, or the
lack of which, practically all fecal
borne disease has its origin. It was
with a full realization of this fact
that the people of North Carolina,
through their representatives, the
members of the General Assembly,
put themselves on record as desirous
of protecting themselves and their
neighbors from the ravages of fecal
borne diseases, by passing a law in
February, 1919, entitled, "An Act to
and dysentery, when we eat vege-tables
contaminated with human
filth, when our wells and springs are
polluted with it, and when the food
upon our tables is accessible to flies
that were bred and bathed in the hu-man
excreta of our own family or of
diseased neighbors. Therefore, the
open surface privy, which violates
every law of sanitation, is a nefarious
institution in any community, and
must be entirely eliminated.
Fig. 2. A backyard "bum" planted and ready for destruction of the occupants of the
home.' This open surface privy is less than 10 feet from a surface drinking-water supply.
It is perhaps the source of constant pollution of the drinking-water in this case.
Prevent the Spread of Disease from
Insanitary Privies."
What constitutes an insanitary
privy ? It is best exemplified by the
open surface privy, which is very
commonly used in our State. In this
type of privy, which is usually open
in back from the seat to the ground,
the excreta is deposited upon the sur-face
of the ground, where it can be
reached and scattered about by flies,
birds, domestic fowls and animals,
and with every rain may be washed
into the open well or spring, or into
the adjoining garden, where vege-tables
become contaminated with the
human filth. It is little wonder, then,
that we have typhoid fever, diarrhea
On the other hand, a properly con-structed
privy is one in which there
is a vault, pail, or tank which re-ceives
and retains the excreta until
properly disposed of. This receptacle
should be surrounded and protected
by fly-tight walls. Self-closing lids
should always be provided, and kept
closed, in order to keep the flies en-tirely
away from the filth. In addi-tion,
due regard must be paid to the
protection of drinking water supplies
from contamination, either by water-proof
receptacles, or by locating at
such distance from the water supply,
and down slope from the same, so
that the dangers from seepage and
drainage will be done away with.
The Health Bulletin
oo'^/t?-"
3-, -Cause and effect—the open surface privy and near-by cemetery. Disreputable
A discussion of each individual type
of privy will be entered into in the
succeeding articles.
From the foregoing, one is prompt-ly
convinced of the simplicity of the
principles involved in sanitary privy
construction. But, while simple, they
admit of no compromise. In addition,
another factor quite as important as
construction is that of proper main-tenance,
without which no privy will
pass the inspection of the State Board
of Health. Specific directions will be
given along v/ith the discussion of the
various types of privies that may be
used.
fr.I-^S'J',-'^^^-
effect of winds, etc., on open surface privy filtli. Soiled found toilet paper was floating in this tank, having been blown in from the near-by privies.
The Health Bulletin
TYPES OF IMPROVED PRIVIES
Advantages and Disadvantages of
Each
In order to assist the individual in
the choice of the privy which he shall
install, a discussion is here givlen
covering each of the several types of
improved privies. It will be seen
that no one of them has a field of
universal application. Each type has
its limitations, and likewise each type
has features which would especially
recommend it, all depending upon the
conditions existing in each case where
the installation is to be made. But,
by virtue of the several types of im-proved
privies from which one has to
chose, there is no condition that may
arise, so far as we can see, that can-not
be satisfactorily met and disposed
of.
The types of improved privies are
as follows:
1. Earth pit.
2. The box and can,
3. Tank construction employing the
L. R. S, principle,
4. Chemical privies.
5. The double compartment con-crete
vault.
6. Miscellaneous.
The Earth Pit
By all means, the simplest of all
improved privy types is that of the
dry earth pit. Humble as it is, the
principle upon which it is operated
enjoys the distinction of being in-cluded
among the rules laid down by
Moses, the great giver of the law.
The reference is found in Deuter-onomy,
chapter 23, verses 12 and 13,
which is here quoted as follows:
"Thou shalt have a place also with-out
the camp, whither thou shalt go
forth abroad: And thou shalt have a
paddle upon thy weapon; and it shall
be, when thou wilt ease thyself
abroad, thou shalt dig therewith, and
shalt turn back and cover that which
Cometh from thee."
The principle here involved is the
immediate burial of the waste mat-ter
from the human body, which is in
effect what is accomplished in a prop-erly
constructed and properly oper-ated
earth pit privy.
Advantages
1. It is the cheapest of all types.
When the task in hand is merely one
of reconstruction of an existing in-sanitary
privy to make it correspond
to the specifications for an approved
pit privy, the expense for materials is
small.
2. It possesses many of the quali-ties
of a fool-proof privy. It cannot
be too often reiterated that the con-struction
of a privy is no more than
half the task to be performed. The
other half is maintenance. Certain
types require very intelligent super-vision,
and lots of it, and without this
their purpose may not only be de-feated,
but they may become public
nuisances. This is particularly true
of the box and can privy. When once
properly located and constructed, the
earth pit requires little attention be-yond
occasional removals to new pits,
and it will give effective service even
among ignorant and careless classes.
3. It may be quickly installed, and
is frequently used in cases of emer-gency,
or during the interim while
higher types of waste disposal sys-tems
are under contemplation or un-der
construction. In fact, this is the
chief purpose for which they can
properly be considered in towns and
villages.
Disadvantages
1. The earth pit privy is the only
type particularly influenced by geolo-gical
conditions. In most places in
the State of North Carolina the pit
may be used with safety, but there
are some places where it may be
used only with caution or not at all.
(a) In limestone regions where the
stratified rock comes as close as ten
feet from the surface. The danger
is particularly great in cases where
The Health Bulletin 9
the rock strata are tilted. Due to
this fact, one is often deceived, and
in locating the privy down slope from
his well it sometimes happens that
an arrangement is effected by which
the privy filth may reach the well
directly by traveling along sheets of
rock that are tilted opposite to the
slope of the surface earth. It is,
therefore, essential to notice not only
the surface slope, but the slope of the
sub-surface rock strata as well, (b)
Another type of earth in which pit
privies may not be suitable is very
low, swampy lands where the ground
water level is very high. The danger
here is that of overflowing at certain
seasons of the year, due to an excess
of ground water. Bear in mind, how-ever,
that water in a pit is no great
disadvantage, so long as there is no
danger of overflowing. But, due to
the presence of water, there is fre-quently
copious mosquito breeding in
the earth pit. This may be the source
of considerable annoyance, but is of
no danger to health, as the malaria-bearing
mosquito rarely, if ever,
breeds in such a place. The difficulty
is easily remedied by pouring in a
half cupful of kerosene once each
week during the months from April
to October.
2. Judgment must be exercised in
the location of the earth pit with re-spect
to any well or spring. In no in-stance
is it permissible except when
located down slope from the water
supply. Although the limit of safety
will differ in different soils, the State
Board of Health will not approve any
earth pit privy that does not conform
to certain requirements as to loca-tion.
(See specifications.)
3. There is no provision for dis-posal
of filth except burial on the
spot where the building is located.
When the pit fills to its capacity, a
new pit must be dug and the building
moved and placed over it. The inter-vals
when this must be done vary in
such wide limits that no reliable
statement can be made on this point,
but it is safe to say that this is of-tener
than desirable.
In towns and villages there are
considerable disadvantages connected
with the use of the earth pit. (a)
There is great difficulty usually in
finding sufficient space to permit of
the location of the pit the required
distance from a water supply, (b)
It is more than possible that the con-gestion
of a great number of privies
into a small area will result in a su-persaturation
of the soil to a point
where the whole water table will be
endangered.
4. Although the pit privy is the
most primitive method of waste dis-posal,
it is likewise the crudest of all
allowable types. It is the first step
toward safe disposal of human waste
matter, but is not held up as the ulti-mate
and unqualified solution of the
problem.
The Box and Can Privy
The box and can privy collects all
the privy filth in a water-tight recep-tacle
which is inclosed inside a fly-tight
compartment. Thus it admir-ably
satisfies the two principles of
sanitary privy construction. But in
its practical operation it is found,
like all other types, to have its ad-vantages
and disadvantages.
Advantages.
Certain of these are similar to
those of the pit privy.
1. Next to the pit privy, it is the
cheapest to install, and as regards
rapidity of installation it excels all
others. When the boxes are supplied
ready for installation a carpenter can
install from 8 to 12 in a day.
2. This type is especially suitable
to towns and villages having as many
as 300 homes to serve. A community
of this kind can be quickly and cheap-ly
supplied with sanitary privies by
handling the job on a wholesale plan.
Some one takes the contract to build
2
10 The Health Bulletin
the required number of boxes at a
minimum figure. A carpenter is then
employed by the job or piece to do the
installations. In this way, uniform
work is accomplished throughout, and
the cost to the individual is reduced
to the lowest terms. (Illustration,
Quantity Production of Boxes.)
3. As with the pit privy, any build-ing
in good repair that will afford
adequate shelter from storms and
rain may be utilized in which to in-stall
it.
4. The box and can may be used in
all places without regard to geologi-week.
In practice, it is found that
where this duty is to be performed
by the user of the privy it is almost
al.,ays neglected, resulting in over-flowing
of the can and consequently
highly insanitary conditions. In gen-eral,
it may be said that a well organ-ized
and operated scavenger service is
absolutely essential to the success of
the box and can privy. For this rea-son,
the State Board of Health will
consider the box and can plus a satis-factory
scavenger service as an insep-arable
sanitary unit. The failure of
either portion of the unit will bring
Fig. 5. Quantity production of boxes for box and can privies
cal conditions or nearness to water
supplies, though, of course, one v/ould
naturally avoid any unnecessary near-ness
to the source of drinking water.
Disadvantages
1. Its capacity is very limited. The
can holds only about nine gallons, and
is therefore sufncient to serve the
average family only about one week.
On this account the box and can privy
is not advisable for general adoption,
since the average man does not like to
go to the trouble of removing the can
and burying the contents once each
condemnation upon the whole unit.
Those contemplating such installa-tions,
therefore, should do so with
great caution, as they will be under
the constant liability of having to
adopt some other more satisfactory
system. The box-and-can-scavenger
system, at best, is only a makeshift.
Such a scavenger service as men-tioned
above can hardly be expected
in a community of less than 300
homes. In order to be effective, the
scavenger service must visit each
px'ivy regularly once each week.
The Health Bulletin 11
Practice has shown that the only sat-isfactory
way to operate such a ser-vice
is by means of cans belonging,
not to the individual, but to the town
or village, as otherwise a hopeless
confusion would result from mis-placing
of cans. The scavenger man
starts out on his rounds with a load
of clean cans, which he exchanges as
he goes for those containing privy
filth. Having completed the exchange,
he hauls the load of filled cans to a
proper disposal station, where they
are emptied, washed, and treated
with a disinfectant solution, rendering
them ready for use again.
2. It will be seen from the above
description of the scavenger service
necessary to operate a box and can
system that it is a matter involving
a continuous expense. This item
varies greatly in different localities,
from $1.25 a quarter up to $3.00 a
quarter for each privy. At the pres-ent
cost of labor and equipment it is
very unlikely that the work could be
undertaken for less than $1.75 to
$2.00 a quarter in any locality in the
State.
3. The privy contents are more ac-cessible
to flies than in any other type
of privy. The scavenger men are
usually a careless class, and common-ly
leave the tops of the boxes improp-erly
adjusted after the weekly visits
for removal of the privy cans. Again,
the privy contents, being located in a
box having a fair amount of light in
it, are much more likely to attract
flies through small cracks, or seats in-advertently
left open, than similar
contents in the bottom of a deep, dark
pit or vault.
4. During the hot summer months
the privy filth in the cans is frequent-ly
subjected to considerable heat in
privies exposed to the sun, giving
rise to a high degree of putrefactive
fermentation, which will create very
foul odors unless great care is taken
to insure effective ventilation. Furth-ermore,
in mid-winter the privy ma-terial
sometimes freezes. This freez-ing
is not such as to burst the cans,
but adds to the difficulty of the scav-enger
in emptying them.
Tank Construction Employing the
L. R. S. Principle
The so-called L. R. S.* principle in
privy construction is based upon the
liquefying action of certain bacteria
in surroundings suitable for their
growth and activity. When fecal mat-ter
is deposited into water in certain
proportions and provision made for
suitable length of storage therein,
there is developed a growth of lique-fying
bacteria which convert the
major portion of the privy solids to
a liquid state. This principle is made
use of in various privy vault designs,
several of which are supplied to the
market by commercial concerns. As
good as any of the designs employing
this principle is . the North Carolina
privy, which is illustrated on page
23. Special mention is made of this
design for the reason that it is one
that can be duplicated by any one ex-perienced
with concrete construction,
at an expense somewhat less than re-quired
for the purchase of the com-mercial
products. The individual
should be warned, however, against
assuming that this is a trivial under-taking.
Until one is certain that he
can carry through all the details of
the work without making any mis-takes
it should best not be attempted.
The prime virtue arising from the
use of the L. R. S. or septic privies is
liquefaction of privy solids, thereby
rendering the ultimate disposal of the
privy contents much easier. All such
privy designs must provide for some
adequate drainage system to carry
the liquefied material away from the
privy and dispose of it in such a man-ner
that it will not become a nuisance
The term "L. R. S.", as here used, is
derived from the names of three U. S. Public
Health Service officers, Lumsden. Rucker,
and Stiles, who were the originators of this
type of privy construction.
12 The Health Bulletin
or in any way endanger public health
through contamination of food or
drinking water supplies. Privy filth
so treated is not purified to such an
extent that careful provisions for safe
disposal of the effluent can be over-looked.
The public should be guarded
against the arguments of ignorant or
unscrupulous salesmen who would
lead them to believe in the extreme
purifying power of privies of this
type.
The usual provisions for drainage
from septic privies consist of sub-surface
tiling with uncemented joints
to admit of underground distribution
and absorption of the liquefied mate-rial.
In soils where the absorption
is poor it may be necessary to pro-vide
a filter trench.
There is room for considerable
confusion as to the difference be-tween
a septic tank and a septic
privy. Indeed, the contention may
be raised by exponents of the septic
privy that the terms are identi-cal.
While the action is similar in
both cases, the practical operation of
them is essentially different. In the
meaning of the State Board of Health
any sewage liquefaction tank utiliz-ing
for this purpose bacterial action
and receiving its human waste mat-ter
by means of a water carriage sys-tem
will be considered a septic tank.
Such a liquefaction tank receiving
its human waste matter direct will be
considered a septic privy. It is obvi-ous
from this definition that the most
essential difference lies in the fact
that the septic tank receives an
abundance of water automatically
through flushing, while the septic
privy receives none except that which
is added at such intervals and in such
amounts as the user sees fit. Since
we have seen that certain propor-tions
of water to privy filth are neces-sary
to maintain this process in effec-tive
operation, it is plain that the
maintenance liabilities of the septic
privy are very great as compared to
the septic tank. It is for this rea-son
that this sharp distinction must
be drawn, so as to make clear the
reasons why it is imperative to in-clude
the septic privy within the pro-visions
of the state-wide privy law.
Advantages
1. All but a small portion of the
privy solids are reduced to a liquid
state, which admits of ultimate dis-posal
without handling in any way.
This is a great point in favor of this
type of construction, since no one
relishes the task of handling privy
filth. It must be remembered, how-ever,
that not all the privy solids are
eliminated. A certain small residue
remains, which settles to the bottom
and is called sludge. This gradually
collects to the point where the ef-fectiveness
of the privy is destroyed
unless the sludge be removed. Ordi-narily
this will have to be attended
to once in every three to five years.
2. The cost of maintenance is very
small, involving only the cost of toilet
paper, which is an essential, and the
cost of cleaning at long intervals.
3. It is a type of privy that can be
used in practically any soil or loca-tion,
though the location of the dis-posal
bed is governed by certain limi-tations.
(See specifications.)
4. It has the advantage of perma-nence.
It grows better with age,
rather than deteriorating.
5. In towns and villages where sew-erage
is not an economic possibility in
the near future the superiority of the
septic privy over other types can
hardly be questioned. Nowhere is
this more true than in industrial vil-lages.
Disadvantages.
1. The first cost is comparatively
large.
2. Intelligent care is required, (a)
Water must be added regularly in or-der
to maintain an approximately
constant water level. This will re-quire
from three to five bucketfuls
The Health Bulletin 13
of water each week, (b) Only toilet
paper may be used in the septic privy,
as other materials will clog it up.
Special care must be taken to prevent
children and irresponsible persons
from throwing rags, sticks, cotton
waste, etc., into the tank, (c) Should
a heavy mat of privy filth form on the
surface, this must be broken up and
allowed to settle.
3. For the reasons just stated, the
septic privy is not, as a rule, suitable
for use in public places, except where
constant and strict supervision is
maintained.
Chemical Privies
All types of chemical privies on the
market are patented commercial
products, none being home-made af-fairs.
Like the septic privies, their
object is liquefaction of fecal matter
so that it may be the more easily dis-posed
of. This object is accomplished,
however, through chemical instead of
bacterial action. Generally a special
iron tank of sufficient size to allow
for storage over a considerable length
of time, six months to a year, is pro-vided.
The tank is then charged with
a certain stated amount of caustic
substance which has the power of li-quefying
fecal matter. When the
tank is filled to its capacity the
liquefied matter is removed either by
pumping out into a tank wagon or by
underground drainage into a filter
bed or cesspool.
Advantages.
1. Like the septic privy, it has the
advantage of adaptability to any loca-tion.
2. Like the septic privy, also, it
makes ultimate disposal easy by
means of liquefaction. In this con-nection,
it has an added virtue by rea-son
of the fact that its liquefying
powers are greater than those of the
septic privy.
3. In addition to liquefaction, there
is a high degree of purification accom-plished
through the destruction of
bacteria and the eggs of intestinal
parasites.
4. A virtue possessed by this type
of privy in greater extent than in any
other type is that of deodorization.
5. The fly nuisance is reduced to a
minimum in this type of privy.
6. It seems to be particularly
adapted for use in schools, churches,
and other public places.
7. It is better suited to inside in-stallation
than any other type of
privy.
Disadvantages.
1. It is a commercial product which
cannot be home-made. This is nat-urally
a factor in increasing the first
cost.
2. In their present state, the life of
the chemical privy tanks is certainly
not' permanent.
3. The cost of maintenance is
greater than that of the septic privy,
but the trouble attached thereto is
considerably less, provided the con-tents
of the tank be carried off by
drainage.
The Double Compartment Concrete
Vault
A recent development in privy con-struction
is the double compartment
concrete vault. The principle herein
involved contemplates the action that
takes place in privy filth in the pres-ence
of some drying substance such as
dry earth or lime, when allowed to
stand for a period of three to six
months. When such drying substance
is used regularly and in sufficient
quantity, the product, after standing
for several months, is similar to well
rotted manure, and offers little or no
offensiveness in handling it. A vault
of suitable size is built (see specifica-tions)
with a partition wall dividing
it equally from front to back. Only
one compartment at a time is used,
the other being closed completely.
When one compartment becomes
filled it is closed up and the other
opened for use. The collection in the
14 The Health Bulletin
first is allowed to stand untouched
during the period that is consumed in
filling the second compartment. This
takes from three to six months, aver-aging
nearer three than six.
This type of construction has been
extensively employed in extra-canton-ment
zones, and while still in the ex-
•perimental stage to a certain extent,
some very good results are reported
from its use wherever it is properly
attended to. At the present time
there are studies in progress upon the
Disadvantages
These, likewise, are similar to those
of the septic privy. The first cost is
about the same as for the home-made
septic privy, but the cost of mainte-nance
is greater unless the cleaning is
done by the user, as it requires atten-tion
at rather frequent intervals. The
care to be exercised in its use must be
constant, as the object of the privy is
defeated unless a sufficient amount of
dry earth or lime be used to take up
Fig. 6. Excellent seats, but faulty seat covers. Always be on guard for warping such
as seen in this picture. This furnishes ample opportunity for flies to reach the privy
contents.
use of caustic soda in these vaults in-stead
of dry earth, the object being to
effect both liquefaction and steriliza-tion
of the contents. Inasmuch as
these experiments are unfinished, we
cannot give further information upon
them.
Advantages
The advantages in the use of this
type of privy are similar to those of
the septic privy. It is a permanent
construction; if properly cared for
will render the contents inoffensive to
handle; the privy can be used in any
location; and can be home-made.
the excess of moisture from the con-tents.
Miscellaneous
1. Chemical Commodes. These are
nothing more nor less than box and
can privies. A chemical substance is
used which generally gives them the
advantage of liquefaction, deodoriza-tion
and sterilization. These proper-ties
are relied upon to make the
chemical commode adaptable to use
inside the house. As compared to the
ordinary box and can privy, however,
they are much more expensive to in-stall,
and more expensive to maintain,
The Health Bulletin 15
the chemical alone costing about $7.00
a year for the average family. An-other
decided disadvantage connected
with them is that they are not capable
of being cared for by a systematized
scavenger service, as is the ordinary
box and can. The reason for this is
the fact that they are generally in-door
installations, and it would not be
at all practicable for a scavenger man
to have to go inside a house to re-move
privy cans. Thus, the chief ad-vantage
claimed for this type of privy
becomes at once its chief disadvan-tage.
However, an exception is made
with reference to the chemical com-mode
v.'hich will permit it to be used
without being served by a scavenger
system, as required for other box-and-ean
privies.
It is not the intention of the State
Board of Health to place an unquali-fied
disapproval upon this type of
privy, but it is the purpose of the
board to discourage the use of the
chemical commode, for the reason
that v.e know of but few instances
where some other type of privy would
not be more suitable.
2. Cesspools. A cesspool is a drain-age
basin, not having water-tight
walls, for the reception and disposal
of the effluent from a flush closet or
chemical privy. The cesspool is com-monly
made by digging a hole 8 to
10 feet deep in the earth, which is
usually walled up with stone or brick
to prevent caving. Its essential ob-ject
is to get rid of the fluid portion
of such effluents, in order to avoid
creation of a nuisance. In doing this,
the effluent is taken up by the deep
layers of the soil, thus subjecting the
water-bearing strata to great danger
of pollution.
The use of cesspools for disposal of
human filth is prohibited, except for
effluents from approved chemical
privy vaults.
3. Sewerage Systems. A discussion
of sewerage systems does not rightly
belong in this Bulletin, which is de-voted
to privies, except to stress the
fact that privies should be regarded
only as stepping stones to sewer sys-tems
as an ultimate goal. In all
to\\-ns v.here a sewer system is an
economic possibility, serious consid-eration
should be given to its instal-lation,
or to extension of the system
where one exists. This is also true
for isolated homes, but the case here
is net so urgent as it is in towns or
cities.
This matter will be taken up in
some detail in a succeeding bulletin.
PLANS AND SPECIFICATIONS
FOR APPROVED PRIVIES
In order that the work of remodel-ing
and construction of privies, to
meet with the requirements of the
new privy law, may proceed without
delay, plans and specifications, such
as will be approved by the State
Board of Health, are herein set forth.
I. General for All Types of Privies
1. Privy Building. (a) General.
While the specifications for building
Fig. 7. A good iirivy building which is
capable of reconstruction to meet the re-quirements
for improved privies.
16 The Health Bulletin
must of necessity be rather elastic in
order to provide for utilizing as many
as possible of the old buildings, it
must be borne in mind that no type of
privy can be maintained and operated
in a satisfactory manner unless it is
housed in a well constructed and
maintained building of sufficient size
and capacity. The building shall be
so constructed as to afford privacy to
the user in the acts of urination and
defecation and protection from in-clement
weather conditions. It must
be provided with a hinged door which
can be closed and fastened on the in-side.
Location. Location of the privy
within convenient reach of the house
is a matter of great hygienic impor-tance.
(1) A properly operated privy does
not have to be located in a remote
corner. Get it as near the residence
as is consistent with esthetic and
sanitary principles.
(2) "Provide a walk-way from back
door to privy, so that the privy may
be visited in bad weather or at night
with ease. Such a walk covered with
vines or lattice work is strongly
recommended.
Disregard of these suggestions in-terferes
with one's privy-going habit,
thereby giving rise to habitual consti-pation,
or aggravating it in those al-ready
affected in this way. It should
be emphasized that constipation is
perhaps the cause for more calls upon
the physician than any other physical
ailment.
(b) Utilization of Old Buildings.
In a great many instances the old
building may be repaired and used
to house a new or improved privy. In
Figure 7 there is shown an open sur-face
privy, with building well con-structed
and in a fair state of repair.
Such a privy, although the building
is in good condition, is insanitary and
dangerous to health, and would not be
approved by the State Board of
Health. Figure 8, however, shows
the same building repaired and placed
over a septic privy. With very little
expense this privy, originally a
menace to the community, was so im-proved
that it may be used without
danger of spreading disease, and will
therefore pass inspection and be ap-proved
by the State Board of Health,
(c) Old Buildings Condemned. In
Figure 9 there is shown a privy build-ing
v/hich is poorly constructed and in
such a deplorable state of repair as to
mMr'^..-idijSll^iiiliSS£iS
Fa.. S. '1 he same building as shown in
Fig. 7, after reconstruction, placed over
a North Carolina septic privy.
render it past redemption for use
with any type of privy. Such a build-ing
will in no case be approved by the
State Board of Health.
(d) Construction of New Buildings.
In case it is necessary to construct a
new privy building, such a building
as that shown in Figure 10 will be
found inexpensive and easy to con-struct.
Material required to construct
building shown in Figure 10, 4 feet
square, rear wall 6 feet high, front
wall 7% feet high, is tabulated in
Table 1.
The Health Bulletin 17
TABLE 1.
Similar to Fig.
18 The Health Bulletin
5"space between roofand
weafher boarding all around
for lighf and venfilafion.
'---Venfilafor pipe jiof /ess than
4"in diameter to extend at
least 2 feet above roof
Excavated earth drains '
water away from pit.---'
''5fnp prevents lid from
remaimtng open v^hen
not in use.
Former ground level
Sides ofexcavated pit
inclined to prevent caving.
''~/iii^^.'^'^hlly^-'^'Stable manure promotes de-
'^.^A^^^^ri^^tt^Jycomposition andprevents odor.
PIT PRIVY DESIGN
FOR USE IN
RURAL DISTRICTS
NORTH CAROLINA STATE BOARD OF HEALTH
Fig. 10
The Health Bulletin 19
a point below the seat to a point at
least 2 feet above the roof, as sho\vn
in Fig. 10. The cross-sectional open-ing
shall be screened to exclude flies,
and covered with a vent hood.
3. Seat Covers. All lids shall be
self closing, that is, so constructed
that the lid will automatically fall and
remain closed at all times when the
seat is not occupied.
4. Surface Drainage. The ground
surface adjacent to the privy walls
shall be graded up to an elevation at
least 6 inches higher than any point
within six feet in any direction there-from.
Excavated earth may be used
for this purpose, as in Fig. 10.
The following specifications are of
necessity highly technical, and there-fore
of special interest only to those
contemplating the installation of one
of the types of privies set forth
therein.
III. The Earth Pit Privy—Class 1
1. Location
(a) The earth pit privy shall be located
at least 100 feet if possible, but never less
than fifty feet, from any well, spring, or
other source of domestic water supply, and
upon ground sloping therefrom. Distances
less than 100 feet may be maintained only
with the approval of the State Board of
Health.
(b) The earth pit privy shall never be lo-cated
upon swampy ground. Exceptions to
Fig. 11. Two models of galvanized iron boxes for box-and-can privy.
II. Miscellaneous
1. Cesspools. Cesspools will in no
case be approved for the disposal of
human wastes, except in connection
with chemical privies.
2. Chemical Commodes, (a) Chemi-cal
commodes shall correspond to spe-cifications
of section IV, for box-and-can
privies.
(b) Chemical commodes will be ap-proved
only on condition that dry
caustic chemical substance, of a phe-nol
coeflTiciency of at least 15, be used.
this rule may be permitted, at the discretion
of the State Board of Health.
(c) The earth pit privy shall never be lo-cated
where formations of solid or fissured
rock lie closer than 10 feet below the ground
surface. Distances less than 10 feet may
be maintained only with the approval of the
State Board of Health.
2. The Pit
(a) Sfiripe. The pit shall be dug with sides
sloped, as shown in Fig. 10, to prevent
caving.
(b) Dimensions. The dimensions of the pit
shall conform to the following table :
20 The Health Bulletin
The Health Bulletin 31
tern shall be less than 25 feet, if possible,
from any well, spring, or other source of
domestic water supply.
2. Tank
(a) Form. The tank shall be of two or
more chambers, connected by baffled weir,
overflow pipe, or orifice properly located, as
shown in Figs. 14, 15 and 16, or two or more
tanks may be connected together in series by
means of overflow elbows and pipe, as shown
in Fig. 17.
IL All cement tanks with walls under 4"
in thickness shall be thoroughly water-proofed
inside and out, or constructed of
cement mixed with a standard waterproof-ing
element.
Warning : Beware, in making contracts
with commercial producers of concrete tanks,
to make sure that they include the following
specifications :
a. The richness of the concrete mixture.
The purchaser should be on guard against
inferior qualities of concrete construction, as
F0F?M5 IN RLACE: IN PIT
COhfCRtTL BOTTOM AND SIDDNALLS POUREC
Fig. 13
(b) Construction.
(1) The tank shall be so constructed as to
render it impervious to water and resistant
to oxidation and decay.
(2) Waterproofing Concrete or Cement
Tanks.
1. All concrete tanks with walls 4" and
over in thickness shall be thoroughly water-proofed
on the inside or constructfd of ce-ment
mixed with a standard waterproofing
element.
concrete constructions are by no means of
equal value. The best mixture is one to
one—that is, one part of cement to one of
clean, .=harp sand. Others used are one to
two and one to three. Each grade may be
used satisfactorily, but there is greater
danger of leakage and breakage in tanks
with the leaner mixtures.
b. All tanks should be guaranteed not to
leak when laid down at the point of installa-tion.
22 The Health Bulletin
c. Leakage may be determined by filling
tank with water before being placed in
ground. All leaky tanks should be replaced
or repaired before being accepted.
(c) Capacity. The minimum volumes and
dimensions shall conform to Table 5, which
is based upon the assumption that the aver-age
family consists of five persons.
3. Drainage System
(a) Methods. The effluent from the septic
privy may be discharged into a system of
tile or cement drains, laid as close to the sur-face
as is consistent with protection of
drains.
(b) Length of Drain. Where the efflu-ent
is disposed of through subsurface drain-age
lengths of drain lines in accordance
with Table 5 shall be provided.
walls, as shown in Fig. 13. Cleats B,
Fig. 13, are nailed to sides of forms, 16
inches from outlet end, to make grooves in
walls for placing of baffles, as shown in Fig.
14. Cleats A are nailed to the sides of
forms 12" from the outlet end to make
grooves for placing weir. Concrete should
be mixed in proportions of one part of ce-ment
to four parts of sand and gravel.
Make weir 24" high, make baffle 2'-ll"
high, extending from bottom of groove B to
top of tank, as shown in Fig. 14.
When bottom and walls are poured and
forms removed, plaster the entire inner sur-face
with 1 to 1 mixture of cement and sand.
Test tank for leaks, before placing cover.
Starting at the outlet elbow, dig trench
about 20' long. Beginning at and joining
with outlet elbow, lay 4" drain the full
TABLE 5.
Minimum Allowable Capacities and Dimensions of Septic Privy Tanks.
Sludge Chamber Effluent
j^Q Effective Distance Water Chamber Drain
Families Volume Depth Line to Cover Volume Length
1 100 gal. 30" 12" 45 gal. 20'
2 175 gal. 30" 12" 50 gal. 40'
3 250 gal. 36" 12" 55 gal. 50'
4 300 gal. 36" 12" 60 gal. 60'
(1) Joints. The drain lines shall be laid length of ditch, in accordance with specifi-with
abutting joints. cations for drains.
(2) Soil Distribution. In order to insure This privy tank has a capacity of 180 gal-distribution
and absorption, in clay and other Ions in the sludge chamber, and 60 gallons
non-porous soils the drains shall be laid on in the effluent chamber.
a bed of coarse gravel or cinders, 6" in In case one does not care to construct his
depth to the full width of the trench. In own septic privy, there are various commer-case
the drain is laid in sand, the gravel or cial types employing the same principle,
binder bed may be omitted. which may be purchased at reasonable prices.
Some general types are shown in Figs. 15,
North Carolina Privy le, and 17.
In Fig. 14 is shown the North Carolina L.
Chemical Privies—Class 4
R S. privy. This type of privy is designed
for home construction. The tank is simply All chemical privies of the vault type in-a
rectangular concrete box provided with stalled after July 31, 1919, shall correspond
baffleboard, weir and overflow, constructed to the following specifications
:
in a pit dug to the proper dimensions.
^ ^^^ Bowl
To build this tank, first dig a hole 5'-0"
long, 3' 8" wide, and 3' 9" deep. Then mix The bowl must be of good grade vitreous
and pour a 4" layer of concrete in bottom of china, or such material as may hereafter be
hole for the floor. After this concrete has approved, plain and sanitary, with connec-become
set, roughen a 4" strip all the way tion for vent pipe at the top, equipped with
around the' edge, to give bond between floor good grade of seat so constructed as to
and side walls. Place forms and pour side insure durability.
TABLE 6.
Materials Required to Construct North Carolina Septic Privy Estimated
Material ' Quantity Cost
Lumber for forms 64 bd. ft. $ 5.00
Board 2"xl2"xl6' for baffle and weir 32 bd. ft. 1.50
One 4" glazed elbow or quarter bend 1 •°"
4" drain 20 ft. 1.50
Sand and gravel 1 cu. yd. 2.00
• Cement "^ ^^^''^ ^-Q*^
Total $17.50
The Health Bulletin 23
S'-O'
^
SECTION- CC
i
S-O'
13
I
4;
-/Z' IZ •2*
^ -* N
NORTH CAROLINA SEPTIC PRIVY
Fig. 14
24 The Health Bulletin
2. Connecting Tube
(a) The connecting tube is to be made of
the best available material to withstand cor-rosion
and effect of urine, such as monel
metal or lead, each properly insulated from
iron, enameled iron, or a metal coated with
non-corrosive, non-absorbent material.
(b) The tube must extend into the tank
a sufficient distance to prevent urine from
coming into contact with the tank.
(c) The tank tube must not be less than
11 inches outside diameter.
3. Tank
(a) The tank must be made of iron or
copper bearing steel of the best grade, equal
to that made by the three leading American
manufacturers, and must be not less than
fourteen gauge thickness, or such material
as may hereafter be approved, and provided
with an agitator which will effectually mix
the entire contents. The capacity is to be not
less than 125 gallons per bowl. The shape
must be cylindrical or half-round. In steel
tanks all joints must be welded.
(b) Openings in the tanks for bowls are
to be spaced not less than thirty inches from
center to center.
(c) All steel tanks are either to be fur-nished
with sufficient burlap and tar or as-phaltum
paint free from acid or water to
cover the tank with two coats of the former
and three of the latter on installation, or be
thoroughly covered at the factory with some
approved coating that will unquestionably
furnish equal protection.
4. Ventilating Pipes
(a) Ventilating pipes must be so designed
and arranged as to give proper ventilation
regardless of atmospheric conditions. The
miuimum vent pipe to be used on single
bowls and urinals is four inches, and pipes
are to be made correspondingly larger as
bowls are added for multiple installations.
(b) All ventilating pipe is to run inside of
the building so far as possible and emerge at
the ridge of the roof. If impossible to
emerge at the ridge or in close proximity to
it so as to obtain unobstructed draft without
long extension of pipe above the point of
emergence from roof, a suitable ventilator is
to be provided to- insure good ventilation.
Ventilation into the smoke flue of a chimney
is not permitted.
(c) In placing pipes, right angled turns
must not be used, and an angle not exceed-ing
45 degrees is to be worked to wherever
possible.
(d) Neither horizontal runs nor square
pipes will be permitted.
CBPflCITY Z05
Qals uu^
Qci:::
Sub- SorfarcDrainTile-
Bedded in-Porou3
V\aTtr\a\
CH5T-Or-CEMf NT-^TFEL-RIINFOECEO-PlG.
15. Commercial septic privy, employing baffle and weir in its construction.
The Health Bulletin 25
5. Drain
The drain valve opening is to be not less
than three inches in diameter. The drain
pipe leading from the drain valve is to be
not less than four inches in diameter.
6. Installation
(a) The distance between the top of tank
and bottom of bowl must not be less than 18
inches or more than 48 inches.
(b) The opening for the clean-out and for
the manhole must be readily accessible either
inside or outside of building, outside when
ing thereto from the tank, the fall of which
must be at least one-half inch to the foot.
The construction of the cesspool or leaching
well and its distance from the tank must be
made to conform to the conditions that pre-vail
in the case. However, a cesspool or
leaching well is not to be used when there
is any possibility of contaminating drink-ing
water through its use.
8. Chemical
The chemical used shall be a dry caustic
chemical of standard commercial quality
with a phenol coefficiency of at least 15, and
Oeia// of Commode
Oel9i/ of
N/fr/f/caf/on Bed
Note. Beveled hole in baffle.
Two overflow openings flush with tank.
Fig. 16. Commercial septic privy, employing baffle and orifice in its construction.
I
the tank is to be cleaned by pumping or dip-ping.
(c) All joints leading to and from the
tank are to be made tight.
(d) The installation must be made so as
to insure the tank ample protection against
frost.
7. Drainage
Drainage may be provided as follows :
(a) Tile. When absorption tile drainage
is used, sufficient lengths of 4" abutted joint
tile lines shall be provided to receive and
readily dispose of the entire tank volume.
(b) Cesspool or leaching well. Whenever
the cesspool or leaching well is used, a ca-pacity
equal at least to the capacity of the
tank should be provided, with a drain lead-a
minimum amount of 25 pounds of chemi-cal
of this standard per bowl is to be used.
9. Service and Guarantee
(a) Each manufacturer is to guarantee his
equipment against defects in material and
workmanship for at least two years, and that
it will operate effectively provided it is in-stalled
and used in accordance with his di-rections.
(b) The manufacturer is to be notified of
defects, if any exist, and is to be given op-portunity
to make them good without charge
to the purchaser.
(c) In case difficulty arises which is clear-ly
due to the fault of the purchaser either In
installing or operating, he is chargeable for
tho service at regular rates.
26 The Health Bulletin
The general principles of construction of
the vault type chemical privy are shown in
Fig. 18.
All chemical privies installed prior to July
31, 1919, which do not correspond to the
above specifications will be allowed to remain
only with the approval of the State Board of
Health.
VII. Double Compartment Concrete
Vault—Class 5
The double compartment concrete vault, for
family installation, shall be constructed in
accordance with U. S. Public Health Service
plans shown in Fig. 19, of such dimensions
as shown therein.
Openinq Scr-<?enea
The double compartment concrete vault
may be constructed either with plank floor
and seat risers, as shown in Fig. 20, or with
concrete floor and seat risers, as shown in
Fig. 21.
SUMMARY OF RULES FOR MAIN-TENANCE
OF DIFFERENT
TYPES OF PRIVIES
Certain features of maintenance
are common to all types of improved
privies, and therefore need to be
stated only once.
! So//^ Sof^fTt
Sect/on
P/o n
Fig. 17. Commercial septic privy consist-ing
of two tanks connected by overflow pipe.
In Fig. 20 is shown a double compartment
concrete vault with concrete poured, forms
drawn, and anchor bolts in place. Note
grooves in top of center wall and inner sides
of side walls. These grooves are for the
purpose of making union of concrete floor
with walls.
In Fig. 21 is shown concrete work of vault
finished, with floor and risers for seats in
place.
General Rules
1. The State Board of Health will
not approve any type of privy unless
it is housed in a building that will af-ford
a reasonable degree of protection
from bad weather conditions.
2. The walls, floor, and seat of the
privy, and the ground immediately
The Health Bulletin 27
adjacent to the building, must be kept
in a clean and decent condition. The
sanitary inspector will not compro-mise
on these points.
3. Never allow chickens or other
animals to harbor in the building.
4. Privy seat covers shall be kept
closed at all times when the seat is
4in Veni
V
Z)ouhh Hinged
ny Tight Seat
Vitreous
China 3ow/
FJaor
fla'dProofedDrop Tube——
f
Nan Hole
.Opening
'PP^OX/MAT£i;r:aSGML^^^
- Drain Valve Opening 3 "
Fig. 18. Vault type cUemical privy.
unoccupied. This should be set down
as the golden rule, as all the objects
of fly-proof construction are fmis-trated
if this point is neglected. In
certain types of privies, of course,
this is decidedly more essential than
in others, but no exception can be
made in any case.
5. Make frequent inspection of
the seat and seat covers to be sure
that there is no warping or shrinking
of planks that would give access to
flies. (See fig. 6, Faulty Seat
Covers.)
6. Screen wire coverings of vent
holes shall be maintained in such a
state of repair as to exclude flies, at
all times.
7. That portion of the privy build-ing
which houses the privy filth shall
be maintained at all times in such
state of repair as to exclude flies.
The Earth Pit
1. When the privy contents reach
within 18 inches of the top of the pit
the building must be removed to a
new pit and the old pit completely
filled with earth.
2. The pit must never be allowed to
fill with water to overflowing.
3. If the pit should cave in at any
time it must be promptly repaired.
4. During months from April to
October, sprinkle cupful of kerosene
each week into the pit to prevent fly
and mosquito breeding.
The Box and Can Privy
1. The can must never be allowed to
become filled closer than within four
inches of the top. A routine practice
of removal and emptying of the can
regularly once each week should be
adopted, no matter whether or not
the can be filled to the limit.
2. The privy filth must be disposed
of in a sanitary manner (a) by
emptying into sewer main, or (b) by
shallow earth burial, 6 to 12 inches
below the surface.
3. Cans must be reasonably clean
before being replaced in the privy box.
28 The Health Bulletin
4. The can is for the reception of
nothing but human filth and the neces-sary
toilet paper. Newspapers, rags,
sticks, cotton waste, or any other
waste or offal must not be deposited
in cans, as they clog the sewer sys-tem
when emptied into the disposal
plant,
5. By all means avoid the use of
lime in the cans, as this destroys
them in a very short time. A good
can properly handled will last about
two years or more. If a deodorant is
desired, use some one of the coal tar
disinfectants.
6. See that the top of the box, after
each removal of the can, is properly
adjusted so as to exclude flies.
mm
\ Hoi'se F/oor
^Bacfi mffofHoi/se
ever W*//.
_ t~-l/ ' * '"'ber Dttfipecf
HKcttrpnef.
')fffrrf\im)w>
Vertical Section
Horizontal Section
Fig. 19. Double compartment concrete vault shown in sections.
The Health Bulletin 29
The L. R. S. or Septic Privy
1. The working
privy must not be
capacity of the
overloaded. The
minimum standard is an active ca-pacity
of 20 gallons per person in the
sedimentation chamber, provided the
total active capacity of the sedimen-tation
chamber be not less than 100
gallons.
2. A depth of liquid in sludge cham-ber
equal to the designed working
necessary toilet paper to be deposited
in the tank.
5. Use no disinfectants or deodor-ants,
as they will destroy the bacterial
action.
6. The collection of sludge must be
removed from the sedimentation or
sludge chamber whenever there is
reason to believe that it is hindering
the operation of the septic process.
This matter should be investigated at
Fig. 20. Double compartment concrete vault, with top open.
depth of said chamber shall be main-tained
at all times. That is, if the
tank is so designed and constructed
that when full the depth is 30", or
other measurement, as the case may
be, then that depth shall be maintained
at all times. This may be accom-plished
by adding water at regular
intervals, usually 3 to 5 bucketfuls a
week.
3. Encrusted collections of fecal
matter on the surface must be broken
up by addition of water.
4. The operation of the septic privy
can be totally destroyed in a very
short time unless the following cau-tion
is heeded: Allow nothing but
fecal mattei% clean water, and the
least once in every three or four
years.
The Chemical Privy (Vault Type)
1. This type of privy must not be
used without chemical substance of
proper quality and quantity.
2. The tank must be completely
emptied before each charge of chem-icals.
3. Each charge must consist of at
least 25 pounds of caustic chemical,
as described in the specifications, to
each 125 gallons capacity or approxi-mation
thereof.
4. The chemical must be completely
dissolved before placing in the tank.
5. The agitator must be woi'ked
after each time the privy is used.
30 The Health Bulletin
6. The contents of the tank must
never reach into the tube connecting
the bowl and the tank.
7. The inside of the bowl must be
kept free from fecal matter.
Caution: In handling the dry chem-ical
do not allow it to come in contact
with the skin. It is well to tie two
thicknesses of handkerchief over the
nose and mouth to prevent irritation
of the air passages from the caustic
Chemical Commodes
1. For each five gallons capacity in
the can or approximation thereof, one
pint of caustic chemical as described
in the specifications must be placed in
the can, after each emptying of the
contents.
2. The caustic chemical referred to
in Rule 1 is dry caustic and must be
completely dissolved in water before
placing in the privy can. About three
Fig. 21. Double compartment concrete vault, with top and seat risers in position.
dust. Should any of the chemical
come in contact with the skin or cloth-ing
through splashing after being dis-solved,
or otherwise, wash with water
and apply vinegar, lemon juice, or
some other mild acid.
The Double Compartment Concrete
Vault.
1. Always allow one compartment
to stand idle while the other is being
filled, allowing storage of privy con-tents
in one compartment through
the period of filling the other.
2. Use enough dry earth or other
substance to absorb the moisture from
the privy contents.
3. Remove stored privy substance
at intervals indicated by the filling of
the compartment in active use.
quarts of water to one pint of dry
caustic is required.
3. The can must never be allowed to
fill to within less than four inches
from the top.
4. The privy contents must be dis-posed
of in a sanitary manner, either
by emptying into a sewer or by shal-low
earth burial.
5. The can must be reasonably clean
before being replaced into the com-mode.
6. Do not use lime in the can.
7. See that the top of the commode,
after each removal of the can, is
properly adjusted so as to exclude
flies.
8. The presence of offensive fecal
odors and of fly breeding, or absence
The Health Bulletin 31
of liquefaction of fecal matter in the
can are evidences of improper main-tenance,
and of violation of the above
rules.
Caution: In case of splashing the
chemical upon the skin or clothing,
wash with water and apply vinegar or
lemon juice.
ECONOMICS OF PRIVY CON-STRUCTION
AND MAIN-TENANCE
In the following schedule the vari-ous
elements of cost for privy con-struction
and maintenance are esti-mated
as closely as possible and ex-tended
over a period of five years.
These figures will naturally vary
more or less widely on account of
differences in cost of material and
labor in different localities. This is
especially true of labor, inasmuch as
there is usually no well established
standard prices for this class of work.
The greatest factor of variation, how-ever,
is whether the work required for
construction or maintenance is done
by hired labor or by the owner of the
privy himself. The calculations that
have been made in the accompanying
table presuppose in each instance that
the labor necessary is to be hired.
Whenever the work is done by the
owner of the privy, labor deductions
may be made from the total five year
cost.
It will be further noted that the fig-ures
in the table make no provision
for the building itself, the privy filth
receptacle alone being considered. In
the majority of cases no extra cost for
this purpose will be necessary, as any
existing building in a good state of
repair will suffice. However, in case a
new building is desired or necessary,
the average cost, figured on the basis
of specifications given on page 17,
will amount to about $21.00, divided
as follows: Cost of material, $11.00;
cost of labor, $10.00.
MACHINERY AND METHODS FOR
ENFORCING THE LAW
In accordance with the provisions
of the law, the organization responsi-ble
for its enforcement consists of the
following:
1. The Secretary of the State Board
of Health.
2. Bureau of Engineering and In-spection:
(a) Chief of the bureau in charge
of the work, (b) A corps of sanitary
inspectors to carry out the details of
the law.
ANALYSIS OF COST
Type of privy
Earth pit $ 4.50
Box and can. . . 11.05
L. R. S., North
Carolina .... 7.70
to
L. R. S., com- 10.10
mereial 12.10
Chemical 28.00
Double compart-ment
concrete
vault 15.20
32 The Health Bulletin
It will be noted that the law became
effective upon the date of its passage,
namely, February 24, 1919. Its re-quirements,
therefore, are present as
well as future. But in order to give
every one ample opportunity to com-ply
with it, the State Board of Health
is deferring the date for insisting
upon compliance with the law to Oc-tober
1, 1919. Upon that date the in-spectors
will be put into the field.
The inspector, on visiting the home,
will find the privy either sanitary or
insanitary.
Privies Found Sanitary
The procedure is simple in such in-stances.
The inspector posts the
State privy license number upon such
privy, after having collected the li-cense
fee of forty cents.
Privies Found Insanitary
Such privies will be found insani-tary,
due either to faulty construction
or faulty maintenance. In such in-stances
the responsible parties will be
subject to immediate prosecution, but
it will be within the discretion of the
sanitary inspector to follow one of
two courses, as follows:
1. If reasonable evidence is fur-nished
to show that the responsible in-dividual
is acting in good faith, but
for some unavoidable reason has been
unable to meet the requirements, the
inspector will be given authority to
waive prosecution temporarily. In
this case the inspector will collect the
license fee as usual, and affix to the
privy a sign bearing the words, "Li-cense
pending." Upon the next visit
of the inspector he will naturally ex-pect
the requirements to have been
met, at which time few, if any, ex-cuses
for non-compliance will be con-sidered.
2. All other privies insanitary in
construction or maintenance will be
placarded with the sign, "Insanitary:
Unlawful to Use." The inspector will
specify the date after which this no-tice
becomes effective.
Procedure With Privies, "Insanitary:
Unlawful to Use"
1. Where condemnation is due to
defective construction, the owner will
be held legally liable.
2. Where condemnation is due to
defective maintenance, the user will
be held legally liable.
Procedure, Residence Without a Privy
1. The Owner. It is a misdemeanor
to maintain a residence coming within
the provisions of this law until such
time as it shall be provided with a
sanitary privy, of a type approved by
the State Board of Health.
Approved and Disapproved Privies
It is a responsibility upon the owner
of a residence coming under the re-quirements
of this law to satisfy him-self
that the type of privy which he
installs is one having the approval of
the State Board of Health. If it is
not, the requirements of this law are
not satisfied, and the case will be
handled as if there were no privy at
all.
It must be emphasized that the in-spector
will be a busy man. He will
have no time for parleys on points
either of construction or of mainte-nance.
The specifications on these
points, as set forth in this Bulletin,
are so clear that any one who reads
them can have no difficulty in settling
for himself the question of responsi-bility
in any case. The inspector will,
therefore, be charged by the State
Board of Health to apply the require-ments
of this law to the responsible
party or parties without argument or
hesitation.
DO IT NOW
This is the day to begin construction of a sanitary privy.
Read this Bulletin and learn how it is done
PubIi5}^^dbl^ T/\£./|OKinCAK9U/m STATL59ARD sTAEAHA
1 This Bulle-tinwillbe 3er\t free to oa\3 dfaen of the State xjpoATeguesti
Vol. XXXIV AUGUST, 1919 No. 8
I
I
AVOID TYPHOID-BE VACCINATED
Average Monthly Variation In Number
of Typhoid Deaths in North
CaroUna During the
Last Five Years.
Janfck01ar.^frMaijJvin,dulA\xg.Sc]^.0c\,C^ov,pcc,
IVIEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
J. Howell Way, M.D., President, Waynesville
Richard H. Lewis. M.D., Raleigh
J. L. Ludlow, C.E., Winston-Salem
Thomas E. Atsderson, M.D., Statesville
E. C. Register, M.D., Charlotte
Chas. O'H. Laughinghouse, M.D., Greenville
Cyrus Thompson, M.D., Jacksonville
F. R. H.ARRis, M.D., Henderson
E. J. Tucker, D.D.S., Roxboro
OFFICIAL STAFF
W. S. Rankin, M.D., Secretary State Board of Health and State Health Officer
A. J. Warren, M.D., Assistant State Health Officer
Ronald B. Wilson, Director PuUic Health Education
L. B. McBrayer. M.D., Superintendent of the State Sanatorium
J. R. Gordon, M.D., Deputy State Registrar
G. M. Cooper, M.D., Chief of the Bureau of Medical Inspection of Schools
H. E. Miller, C.E., Chief of the Bureau of Engineering and Inspection
James A. Keiger, M.D., Chief of the Bureau of Venereal Diseases
Mrs. Kate Brew Vaughn, Chief of the Bureau of Infant Hygiene
A. McR. Crouch, M.D., Epidemiologist
B. E. Washburn, M.D., Director County Health Work
FREE PUBLIC HEALTH LITERATURE
The State Board of Health has a limited quantity of literature on health subjects for
free distribution. If jou are interested in one or more of the following gubjects, or -want
same sent to a friend, write to the State Board of Health for free lit*r<vture on that par-ticular
rubject.
Sanitary Peivies
UEliii.'rsTiAi Sewage
Disposal Plants
I^;:s
Flies
Colds
Teeth
Cancer
Malaria
Smallpox
Adenoids
Measles
WHOOPINa-COUGH
Hookworm Disease
Public Health Laws
tubeboulosis laws
Tuberculosis
Scarlet Fever
Inpantilb Paralysis
Carb op the Baby
Fly Placards
Typhoid Placards
Tuberculosis Placards
Clean-up Placards
Spitting Placards
SEX HYGIENE BULLETINS
Set a—^FoB Young Men
A Reasonable Sex Life for Men.
Sexual Hyoriene for Young Men.
Vigorous Manhood.
Smash the Line. (The case against the re-
Btricted district.)
List of Reliable Pamphlets.
Set B—For Public Officials and
Business Men
Public Health Measures in Relation to Ve-nereal
Diseases.
Venereal Diseases—A Sociologic Study.
Smash the Line. (The case against the re-stricted
District.)
The Need for Sex Education.
A State-Wide Program for Sex Education.
List of Reliable Pamphlets.
Set C—For Boys
Vigorous Manhood. (Especially for boys 12
years of age and over.)
Note.—For boys under 12, see "When
and How to Tell the Children" (Set D) ;
portions of "Vigorous Manhood" also may
be read to younger boys. Boys 15 years
and over may be given Bulletin "A Rea-sonable
Sex Life for Men" (see Set A),
at the discretion of the parent.
Sexual Hygiene for Young Men.
List of Reliable Pamphlets.
Any of the above will be sent without charge
which you have definite use.
German Measles
Typhoid Fe\'ee
Diphtheria
Pellagra
Constipation
Indigestion
Infant Care
Child of Pre-School
Age
Corner Stone of
Child's Future
Prb-Natal Letters
Set D—Foe Parents
When and How to Tell the Children.
Venereal Diseases—A Sociologic Study.
The Need for Sex Education.
List of Reliable Pamphlets.
Set E—For Girls and Youno Women
Your Country Needs You. (Especially for
girls 11 years of age and over.)
Note.—For girls under 11, see "When
and How to Tell the Children" (Set D) ;
portions of "Your Country Needs You"
also may be read to younger girls. Girls
15 and over may be given "The Nation's
Call to Young Women" at the discretion
of the parent.
The Nation's Call to Young Women.
List of Reliable Pamphlets.
Set F—Foe Teachers
The School Teacher and Sex Education.
Sex Education in the Home and High
School.
Venereal Diseases—A Sociologic Study.
Smash the Line.
The Need for Sex Education.
List of Reliable Pamphlets.
Please send for only those bulletins for
IDWARDS t SROUGHTON PRINTINS CO.. RALtlSH. N. C.
IE .PUBU5MLb bY TAL HQI^TM CAIgQUhA 3TATL FyQ^fgD »^MEALJAl
[fol
Vol. XXXIV AUGUST, 1919 No. 8
EDITORIAL
POINT OF TIEW
"Point of view" according to the dic-tionary
means "tlie relative position
from which anything is seen or any
subject is considered." The definition,
however, does not tell how important
a thing point of view is: does not inti-mate
that a correct point of view
makes a man's work useful while a
false point of view may doom all his
efforts to failure. Public workers with
a broad and sympathetic point of view
do much to build up and improve liv-ing
conditions in the communities in
which they labor, while officials and
others who do not grasp the import-ance
of their positions may handicap
progressive movements which would
prove a blessing to mankind. It all
depends on the breadth of his point of
view whether a man is a help or a hin-drance
and whether his work is worth
while to himself and to his neighbors.
In North Carolina, point of view has
played an important part in our de-velopment
and we should all be thank-ful
that the majority of our leaders
have had humanitarian and broad, in-stead
of selfish and narrow, points of
view. Two little stories will illustrate
some of the meanings of point of view.
It was in front of the grocery store
in a small town. The story of a ser-ious
accident in which a boy had been
run over and killed by a train was be-ing
told. It seems that the boy was
carrying a large watermelon and had
stopped on the railroad track to plug
it, in order to find out whether or not
it was ripe. While he was doing this
the train came along and struck him.
The narrator had just finished telling
of the incident when a negro in the
crowd asked. "Boss, did yer happen
ter hear whedder 'er not dat water-melon
wuz ripe?"
A teachers' meeting was in progress
and a prominent school ofHcial was
complaining to the teachers that at
many schoolhouses the boys had
broken out window-panes. The county
is in a section of the state where mos-quitoes
and flies are found. The teach-ers
were advised to raise money or ob-tain
it from their school committees
in order to have the windows screened
so the boys could not throw rocks
through them. Flies or mosquitoes
were not worthy of consideration! Or,
at least, no mention was made of them.
The comfort and health of the pupils
seemed to be small matters and in-significant
when compared to damage
to school property.
It is point of view which makes com-mitteemen
and school patrons build
schoolhouses near the woods so that
they will not need to build privies. It
is no matter, of course, that the teach-ers
and children may contract hook-worm,
typhoid fever, tuberculosis, or
become victims of chronic constipation
which may handicap them for life.
These things are not considered of any
The Health Bulletin
value in many rural communities; but
to save a few dollars on the school
building and its up-keep is something
worth while! And, again, it is point
of view which causes a man to pay to
have his hogs vaccinated against
cholera while he can't be persuaded to
have his wife and children vaccinated
against typhoid fever even when the
health officer does it free of cost.
But, every day shows an increase in
the number of people who have or ac-quire
a good, wholesome point of view.
And for this we should all be thankful.
B. E. W.
OUR INTERDEPENDENCE IN
KEEPING WELL
"Now this is the law of the Jungle,
As old and as true as the sky;
And the wolf that shall keep it shall
prosper;
But the wolf that shall break it must
die.
As the creeper that circles the tree
trunk,
So the law runneth forward and
back;
For the strength of the pack is the
wolf.
And the strength of the wolf is the
pack."
The above lines by Kipling describe
in a very striking way the interde-pendence
of all citizens in keeping well
and in educating the community in
which they live and work regarding
infectious diseases. We have had an
excellent example in our army of what
cooperation under skilled supervision
means in keeping a group of men in
good health and "fit to fight." Our
soldiers are returning home in much
better physical condition than when
they entered the army. And if we do
not work together to better sanitary
conditions and promote health in our
families and communities we are going
to lose one of the most important and
most pronounced lessons of the war.
Right now is the time to urge our gov-erning
bodies to provide health de-partments
with trained health officers
in order that we may be kept well and
allowed to produce larger results from
the work we do; and this means that
we can make more money and be able
to save it.
You have probably heard the remark
from some diseased individual, in re-ply
to a question regarding his health:
"I am pretty well for me." This brings
up the question, how do you know you
are well? or how do you know that
you are sick? These things are deter-mined
by applying certain standards.
These standards come from the great
averages of experience of mankind.
For example, we know that the normal
temperature in the human being is
about 98.6 degrees. We know this
because the record of temperatures
taken of many thousands and perhaps
millions of people shows the average to
be 98.6. The same thing is true when
we speak of the normal blood pressure
or the normal diet or anything else
regarding health.
Before men are discharged from the
army they are required to stand a com-plete
physical examination in order to
determine whether or not they have
any hidden disease, or whether any
condition exists which might later on
produce ill health. A man who is
found defective, even in a small degree,
is given appropriate treatment and
made well before he is returned to civil
life. If this is important in the army
and for our soldiers, why isn't it im-portant
in our counties and for our
citizens?
You may be interested to know that
ten counties in the State are cooper-ating
with the State Board of Health
and have provided health departments
The Health Bulletii^^
under the supervision of trained medi-cal
men. As part of the program of
work in these counties any adult citi-zen
can go to the health officer and re-ceive
a complete physical examination
free of cost. This examination is not
for the purpose of making a diagnosis
or of giving treatments. The indi-vidual
is examined solely for the pur-pose
of finding any latent physical de-fect
which may exist so that he can
go to his family physician or a special-ist
and receive treatment before the
defect becomes serious or permanent.
The counties with such work are,
Davidson, Forsyth, Lenoir, Nash,
Northampton, Pitt, Robeson, Rowan,
Vance, and Wilson. Why can't other
counties follow the lead of the progres-sive
ten?
Many other, in fact any, phase of
public health work will show that an
individual is not independent in the
matter of keeping well. And it doesn't
require much study to readily see that
the responsibility for the health of the
citizens, whether they be rich or poor,
white or black, rests upon the com-munity
and upon the public health
officials. In North Carolina such re-sponsibility
is with the Board of
County Commissioners who by provid-ing
funds to the County Board of
Health can, in the words of chapter
62, section 9, of the Public Laws of
North Carolina of 1911, "make such
rules and regulations, pay such fees
and salary, and impose such penalties
as in their judgment may be necessary
to protect and advance the public
health." B. E. W.
AN APPRECIATION
The bravest battle that ever was
fought!
Shall I tell you where and when?
On the maps of the world you will
find it not—
'Ttvas fought by the mothers of
men.
Joaquin Miller.
In all the great social reforms that
have come as great blessings to our
country the women have always fur-nished
the initiative in thought, and
most times, in action. And in their
undertakings they have ever been
successful. They have been successful
because they were not inspired by
motives of personal gain, or desires to
play petty politics. Their motto has
been simply to do that which was
right for the great mass of humanity.
And the courage with which they have
diligently performed their tasks should
be an inspiration to us all.
The State Board of Health is duly
aware of and deeply appreciative of
the endorsement given to it and its
fight against disease and vice by the
Federation of North Carolina Woman's
Clubs in its recent session at Hender-sonville,
where they adopted a resolu-tion
pledging themselves to cooperate
with and be guided by the State Board
of Health in all health and anti-vice
plans and campaigns.
The club women of the State can
bring about any reform to which they
set their hands in earnest, and the
unqualified support of such an organi-zation
will certainly advance public
health work in North Carolina.
A. J. W.
The Health Bulletin
A CONVERSATION THAT
TOOK PLACE IN
YOUR TOWN
Typhoid: "Were you at the confer-ence
yesterday?"
Jonnie Fly: "What conference?"
Typhoid: "You don't know about
it? Well, there was a big conference
between the flies, the hookworms, the
typhoid bacilli and the dysentery
bacilli down at the mayor's open privy
yesterday, to formulate some plan to
retaliate against the State Board of
Health for passing a law that does
away with the open privy and thereby
depriving us of the homes of our child-hood.
It simply means that if this
act is enforced it will almost com-pletely
annihilate us in this State."
Jonnie Fly: "What decision did you
reach?"
Typhoid: "Mr. Hookworm sug-gested
that we boycott North Carolina
and all move into the neighboring
states. You know the hookworm
crowd is about done for in North
Carolina anyway, so they are willing
to give up, and then, too, they are not
willing to cooperate with us to any
great extent, because we carelessly
stood back and allowed the State
Board of Health to almost wipe them
out without even raising a protest."
Jonnie Fly: "It is true that no other
state has acted so drastically towards
wrecking our homes, and we could
easily boycott North Carolina, but if
we give up without a fight it will make
the enforcement of the act much easier,
and this would tend to influence
other states to pass similar acts and
we would then be continually on the
move, and some day we would realize
that our last move was close at hand.
This, of course, would not occur in our
lifetime, but we have to think of the
future of our race. I am not willing
to give up without a fight to the finish."
Typhoid: "Your position, though,
Mr. Fly, is different from mine. You
are not absolutely dependent upon the
human excrement and open back
privies for the propagation of your
species and for your life's vocation, as
we are. And I feel, my dear Mr. Fly,
that our race is going to be compelled
to follow Mr. Hookworm's suggestion.
I an indeed sad, because I feel that
our comradeship, the comradeship
between your people and my people
in this State, I\lr. Fly, will soon begin
to wane. And when I think of the
State Board of Health, my sorrow is
intensified, because I know that crowd.
I know they are fearless fighters for
that which they in their convictions
believe to be right. And I know that
they are going to enforce the privy
ordinance to the letter. My despond-ency
is great."
Jonnie Fly: "My dear friend and
comrade, Typhoid, your predicament
is indeed precarious; your future in
North Carolina looks extremely dis-appointing,
but remember 'A friend in
need is a friend indeed,' and I pledge
you and your allies, dysentery and
hookworm, the support of the flies."
A. J. AV.
THE VETERAN
From Bethel clean to Appomattox,
through four long years, I done my
turn of fightin'. I wa'n't but a strip
of a boy then. Mother said I shouldn't
go, but how did she know? She never
had seen a war before. Well, any-how,
I found out she knowed more
about it than I did. What I saw and
went through with wasn't fit for a
beast, much less a boy. But somehow
we got through with it, and I got back
home to find everything all gone but
the home folks. Me and dad and
brother Bill all come through pretty
well used up, but all whole. 'Course,
The Health Bulletin
the Yankees stole everything we had
and burnt the barn, but they didn't
do no harm to Mother and the kids.
In them days the Germans didn't have
nothin' to do with It, and* so they
played the game sorter fair, you know.
But say, do you know what happened
along in '75, when we had almost for-gotten
about the war? Well, sir, the
fever struck our house, and not one
escaped it. Brother Bill was first,
and him that had went through all
that war didn't last but about two
weeks. There was Bill, and me, and
Mother and Dad, and Sister Sue, and
Sister Jane and her two kids, and
Mary, the cook, all had the fever at
the same time. I ain't never seen the
war do nothin' like that to a family.
Well, as I was tellin' you, Bill was the
first one to go, and then Sister Jane,
and by and by her little girl. Even
old Phil Sheridan didn't kill women
and children. And me? Well, I ain't
never been no account since then.
Then comes on the fuss with Spain,
and my fightin' blood riz up agin,
and so I got my finger into that pie,
too. Tell you the truth about it, that
wa'n't no war at all. It was simply
a disgrace. Think of it—150 killed by
bullet wounds and over 2,000 by the
fever.
When this here fracus with the
Kaiser and his crowd come up. Uncle
Sam ruled me out, 'cause they said I
was no good. But my two boys, John
and Bill (that was named for Brother
Bill that died of the fever), they was
rarin' to go just like I did back in the
sixties. I didn't mind their goin',
so far as the fightin' was concerned,
'cause a man feels like he'd had a fair
chance if he gets killed while he's
tryin' to kill the other feller. But
thinkin' back to the days of '98, when
the fever hung around the camps like
the breath o' Hell, I don't mind tellin'
you it gave me a sinkin' feelin' in the
pit o' my stomach to think of my two
fine lads havin' to go into somethin'
like that.
But say, folks, I've found out that
it's all different now. There ain't as
many gets the fever in camps now as
if they'd stayed at home. John and
Bill writes me about all these things,
and besides I do a little thinkin' of my
own when nobody's lookin'. John he
tells me about gettin' vaxinated for
the fever the very first day he landed
in camp. 'Course, I didn't say nothin'
to nobody, but that struck me like a
funny way to start out fightin' Ger-mans.
Still, I knowed how vaxina-tion
keeps off smallpox, and I says
to myself that there might be some-thin'
in it after all. Bill writes me
about this, too, but tells me some other
things more in my line of thinkin'.
You see, I ain't never had much
schoolin', so I ain't in shape to know
much about such things as vaxination,
but some things I can understand as
well as them that's been to college.
When we all had the fever back in
'75, old Doc Jones said we got it from
an old pond with green scum on it.
He 'lowed that somehow it must have
traveled through the air. When the
boys all had it in the camps in '98,
they told us then it come from the
hot sun which we wasn't used to, and
from eatin' green cucumbers and such
like. Last summer, when they all had
the fever over at Amos Brown's, Doc
Wilkins said it come from their pig
pen, which had got into a pretty bad
shape, to be sure. Old Ty Fold, what's
Justice of the Peace, said he knowed
better. He 'lowed that the only place
they could have got it from was that
old pile of rotten wood that they had
in the back yard. He said he guessed
he had ought to know, 'cause he had
the fever three times hisself. I've
puzzled over the thing a heap. Sure
thing, they can't all be right. Fact is.
The Health Bulletin
none of these Ideers looks right to me.
You'll call me an old fool for settin'
up my opinion against Doc Jones, Doc
Wilkins and all them army doctors,
but I ain't hardly ever seen it fail that
when there's typhoid fever there's
plenty of flies around, and I just made
up my mind to it that them pesky
critters has somethin' to do with it.
Now, just as I was tellin' you, Bill
writes me how things is worked in
the camps. He says they fight flies
as if they was Germans, and says that
all the vittels is kept so that flies
can't get to 'em. And he was also
tellin' me about what they call latrines.
I reckon they must be what we call
privies, but he says they're fixed so
that flies can't get in and mess over
the privy stuff, like they do in these
here privies of ours.
Well, I know one thing for certain.
They ain't got no fever in the camps
now like they used to have. The boys
tells me it's due to vaxination and them
latrines, and I think they're both
worth tryin' at home. K. E. M.
A TWENTIETH CENTURY
FAIRY TALE
Once upon a time there was a
wicked, savage nation of Huns called
Disease. The Kaiser, whose name was
Typhoid, called together his lords and
generals, among them Diarrhea, Dy-sentery,
and Hookworm, and with
their assistance set about to conquer
the world. They speedily gathered
around them many lords and warriors,
who with their vassals eventually
formed a mighty army.
The conquering ariiiies of disease
and death penetrated all parts of the
world. Their spies and agents gained
entrance to all public gatherings and
to practically every home in the land.
It is possible that the world might
have been eventually defeated had not
the wicked Kaiser Typhoid and his
ministers made use of an infernal
engine of* warfare, a bombing machine
called the housefly, which flew into
the very kitchens, dining rooms, fruit
shops, and dairy houses, and dropped
deadly bombs of pestilence and disease
to kill neutrals, noncombatants, and
women and children.
The hearts of the noncombatant
nations, not only of the old world,
but also of the new world, sickened
at such infernal practices of warfare.
In the new world there was a nation of
lofty ideals. This nation, whose
name was Sanitation, dwelt upon the
continent of Education. They pro-tested
with the Kaiser against such
ruthless practices of warfare, but re-ceived
only insulting notes in reply.
The people of this nation then realized
that this was not and never had been
a restricted warfare, but that it was a
ruthless, savage warfare, waged with
the object of conquering the world.
Therefore the nation of Sanitation
declared war upon the wicked Hun,
in order to assist the harassed and
devastated peoples of the world.
On awakening to the emergency,
however, they found themselves beset
with spies, under the name of open
surface privies, who had long been
considered desirable citizens in every
community In which they were found.
The true character of the open surface
privy was first discovered and brought
to light by intelligence bureaus called
Health Departments. Their investiga-tions
revealed the open surface privies
to be spies of the most despicable
character. It was found that under
cover of what was supposed to be
legitimate business they had gained
entrance to practically every home in
the land and left unseen the deadly
germs of disease. It was learned also
that by virtue of their business
The Health Bulletin
standing they had obtained positions
of public trust, whereby they were
sufficiently removed from suspicion,
that they harbored, undetected, in
and about their premises, great multi-tudes
of marauders, and raiding par-ties,
which had been secretly sapping
the health and strength of the whole
world. They also furnished landing
places, food supplies and ammunition
for the enemy's bombing machines.
With systematic propaganda these
spies led the people to believe that the
tales of savagery and ruthlessness
from across the water were false, in
order to keep them from entering the
war against the Hun. When the
people of the nation of Sanitation
learned all these things, they rose up
in mighty anger, and cast the once
trusted enemy agents and spies out
from their midst to a death of disgrace.
At this time, however, the power of
the wicked enemy seemed to be at its
highest. The hordes of Huns had long
been coming on, in drive after drive.
It seemed that their enemies' resist-ance
would soon be broken, whereupon
they would be pushed into the sea.
A dark cloud of dejection hung over
the world. The new allies of the
harassed nations found themselves
unprepared for warfare, on acccount
of the propaganda of the open privy.
They speedily turned every effort to
making ammunition and war material
and training soldiers. Men, women
and children worked day and night,
hoping to get their armies into the
field before it was too late. Mean-while,
their allies held on, being
pushed steadily backward, clinging to
the hope that the new ally. Sanitation,
would enter the field before it was
too late. Finally the armies of Sani-tation,
under the leadership of Gen-eralissimo
Sanitary Privy, came, and
continued to come with ever increas-ing
numbers until they occupied all
parts of the field, whereupon the tide
of battle turned, until in February,
1919, after having encountered count-less
losses, the wicked enemy saw
that it was useless to resist longer,
and asked for an armistice, which was
granted by the General Assembly of
North Carolina in February, 1919.
Peace terms were formulated by the
State Board of Health and formally
presented to the enemy on July 1,
1919. The terms presented shattered
the power of the wicked enemy and
forever banished the Kaiser Typhoid
from the world as represented by the
portion of North Carolina's population
coming under the provisions of the
new law. They also provided for the
wholesale destruction of his infernal
machines of warfare, including the
deadly housefly. The provisions of
these peace terms demanded compli-ance
by October 1, 1919.
The following summer found Ty-phoid
and his chiefs shorn of their
homes and power. They had become
outcasts, never to be allowed upon the
face of the earth again.
Their wicked people are still paying
the debt of reconstruction and resti-tution,
while the world once so ruth-lessly
harassed and beset by spies,
traitors and savagery, lives in peace
and joy, protected by the league of
sanitation, which is presided over by
the sanitary privy. H. E. M.
CIVIC CONSCIENTIOUSNESS
BY REV. G. W. LAY.
Good health in a community does
not depend alone on physical condi-tions,
and cannot be controlled merely
by efforts to enact and enforce regu-lations
that deal with material things.
There must be, first, Civic Intelli-gence.
AH the people must be edu-cated
to know what to do and why to
10 The Health Bulletin
do it. But beyond and above all this
there musl be the cultivation of the
moral and spiritual qualities. The
right will not win in the Health War,
or in any war, unless each citizen,
not only knows and holds the right,
but also feels from the bottom of his
soul the moral obligation as an indi-vidual
to give all that he has and all
that he is in order that others may
live and live well.
There must be, second. Civic Con-sciousness,
that is, the feeling that we
are all members of a community and
that if one member suffers, all the
members suffer with it. One may
have this civic consciousness and only
be interested in what other people are
doing for the health of the community,
hoping to reap the benefit thereof.
It might exist where each man was
entirely selfish.
There must, then, be, third. Civic
Conscience, that is, a feeling of moral
responsibility for the welfare of others,
a high sense of the duty that each
owes to all the rest. A community
that has advanced thus far is doing
well. But this is not enough. I
may know what to do and my con-science
may tell me I ought to do it,
and yet I may lack the strength of
character to do as I know I ought.
There must, therefore, be, fourth.
Civic Conscientiousness. This is the
ultimate compelling force that drives
everything before it to success. The
conscientious man makes himself do
that which his intelligence tells his is
proper and his conscience tells him he
ought to do.
This quality cannot exist with
health and sanitation as its only
object. If it exists at all, it will show
itself in conscientious obedience to all
laws, whatever their object, and only
by the cultivation of a universal con-scientiousness
towards all duties will
it be possible to produce a body of
citizens devoted to the performance
of those particular duties that concern
the one object of the preservation of
life and health.
Here is a vast field for the teacher
and the writer. The schools and the
press can do a noble part. But above
all, it is the opportunity and the re-sponsibility
of the preacher. He who
has the care of souls must also have
a care for the body. To save the
bodies of his people, he must first
cleanse, instruct, and inspire their
souls, and then, ultimately, he will
save both soul and body. Health work
is based on a religious foundation
without which its efforts fail. When
completely carried out, it is the prac-tical
application of the whole scheme
of Christian doctrine and a demonstra-tion
of what follows from the Royal
law: "Thou shalt love thy neighbor
as thyself."
In the terrible influenza plague re-cently,
one of the difficulties was to
know what to do. There seemed little
connection between this plague and
material, sanitary conditions. And
yet, curiously enough, those commu-nities
which had already achieved
most success in health work and in
lowering their death rate seemed on
the whole to suffer least from this
plague. There was a remarkable cor-respondence
between the death rates
of different cities in recent normal
years and the rate of cases and deaths
from influenza. If this be so, and the
papers called attention to it, is it not
reasonable to conclude that the decid-ing
factor in both rates was the moral
character of the citizens? A commu-nity
that had been raised to a high
level of civic intelligence, civic con-ciousness,
and civic conscientiousness,
in order to lower the death rate, pos-sessed
the very qualities which alone
could be efficient in the struggle
against the influenza. The qualities
which made the influenza spread were
ignorance, selfishness, disobe Hence to
The Health Bulletin 11
laws and instructions, and other dis-regard
for the dangers to which one
might expose others. The production
of high moral character and of all
the Christian virtues, which is the
business of the church, will furnish
the basis on which alone every suc-cessful
campaign for health must be
waged.
A young Hebrew once told me that
his mother was so strict that she
would not even eat an apple without
first washing her hands and saying a
prayer. If everyone washed his hands
before every meal, it would be a great
step forward in the prevention of
disease. I thoroughly believe in the
efficacy of prayer, though I do not
know just how it works. But I am
very sure that the man who says grace
before meals, thereby acknowledging
his dependence upon God and his duty
towards him, is more likely than one
who neglects this to be conscious of
his true relation towards his fellow
men. Truly, cleanliness is next to
Godliness.
It takes good, conscientious men
to secure good health for a community.
There is no glory in it; you never
know what you have done except by
the bare figures of the annual death
record, and you get no credit for what
you have done. Besides, if ten men in
each thousand have been saved, no
one man feels that he was the par-ticular
one who was saved. No one
feels grateful, and if any one felt
grateful at all, he could only feel so
in a general way towards the commu-nity
as a whole. The man who
picks up a piece of glass from the road
does not know whose tire did not get
punctured, and those who follow him
are ignorant of the danger from which
they were saved. But if a doctor
saves a man's life by performing a
difficult operation or by carrying him
successfully through a dangerous ill-ness,
the doctor gets credit for what
he has done and has a right to feel
proud of it, while the patient will
always feel truly grateful to the man
who saved his life.
Prevention requires intelligence of
a docile and humble kind. The man
who holds tenaciously and expresses
vehemently half-baked opinions on
matters of which he is really ignorant,
is a danger to the health of a commu-nity.
He thinks he knows more than
the doctor who is a specialist, and he
feels that his empty utterances are
entitled to respect. He opposes good
doctors and is a follower of the latest
school f quackery, and does not be-lieve
in vaccination against smallpox
or typhoid, or that malaria is caused
by a mosquito and typhoid carried by
flies. He is a great clog against any
forward movement. He is a wicked
man. God has no use for a fool, and
it is made clear in the Bible that the
fool is a sinner just as plainly as that
the sinner is a fool.
Success in the prevention of disease
depends on that universal feeling of
moral responsibility that believes in
the necessity of obedience to every law
just because it is the law. There is
no direct connection between health
and cutting across the grass and spoil-ing
the neighbor's lawn, or dropping
paper on the sidewalk. But where
people perform these amiable tricks,
or leave the road and make ruts in
the lawn with their automobiles, or
try to beat the cop and evade the traffic
laws, the health record will probably
be poor.
To secure health every citizen must
feel that the town is his town and that
he has a duty towards every one in it
just as much as towards his own wife
and children. He must obey every
law himself and he must see that
every one else obeys the law and that
every law is enforced on everybody
all the time. If the best citizens play
cards for money or allow liquor to be
12 The Health Bulletin
sold in their clubs or match nickels
tor soda water, while the poor negro
is severely punished for shooting craps
or for getting a drink for a thirsty
stranger, it is not to be wondered at
if the average man concludes that no
moral principle is involved and that
law enforcement is a mere matter of
expediency and favoritism.
One of the greatest things that e\er
happened was when one of the highest
ecclesiastics in Havana was arrested
for not having a cover to his garbage
can. He proved that he had had a
cover and that he did not know
it had been taken. The answer was
that it was his duty and that of no
one else to see to that particular gar-bage
can; that Havana would not be
kept healthy with open garbage cans,
and that he must pay the fine. Unfor-tunately,
while we may ascertain who
breaks a specific law, we can seldom
tell who was the direct cause of a
particular case of contagious disease.
Someone has caused the sickness and
perhaps the death of a fellow-being,
usually an innocent child. No one
can be sued for damages or prosecuted
for man-slaughter. The guilty escape
punishment and even the conscious-ness
of guilt. In health matters,
there is no answer to the time-honored
questions: "Who killed Cock Robin?"
and "Who hit Billy Patterson?"
Behold on how high a plane stands
the campaign for health! It fails
unless conducted on the highest
grounds of Christian Charity for all
men. It is useless to appeal to merely
selfish motives. I cannot be safe un-less
I make my neighbor safe; his
health is necessary to my health. I
must work for the good of all, even
though there may be some slight
underlying selfish motive, and thus I
am compelled to live the Christian life.
I am foolish if I do not protect myself
absolutely against smallpox and
typhoid, and, when necessary, against
diphtheria; but for most communi-cable
diseases I must depend on the
condition of all in my community.
Complete success will only come with
entire unselfishness. I must be vac-cinated
against typhoid, not simply for
my own sake, but to support the right,
to set a good example and to prevent
the possibility of giving the disease
to others.
Finally, each man is personally re-sponsible
to God for his neighbor's
health. I cannot put it off on "they"
or "Put it up to God." That mysteri-ous
"they" is the bugbear of all re-form.
When a citizen says "They
ought to do something," we know we
have found some one who evades con-tentedly
his own moral responsibility.
"They" means "me." "They" to this
man means everyone except himself.
If everyone takes that ground, every-one
is exempt and no one is respon-sible.
God is all-powerful, but He has taken
each of us into partnership. It is His
will that all men, including you,
should be saved. But He is not going
to compel it. He has left you free.
You must even "work out your own
salvation with fear and trembling."
It is so with life and health. Do we
dare say that it is God's will that the
cruel murderer shot down the harm-less
man? Is it not then a profane
impertinence to say it is God's will
that a little child died of preventable
disease when it was given him by
another child whose parents deliber-ately
allowed him to> break quarantine
and give the disease to passers-by?
It is God's will that we should keep
His laws and obey religiously the laws
of man. If I live by the Christian
law, I am working for health; and I
cannot work successfully for health
unless I feel my full moral responsi-bility
to live in all ways by the Chris-tian
law.
The Health Bulletin l.*?
THE AIMS OF THE BUREAU
OF INFANT HYGIENE TO
BE ACCOMPLISHED
THROUGH COUNTY
NURSES
Bj' Mrs. Kate Brew Vaughan
Chief of Bureau
The most important aim of all pub-lic
health work is that of making
stronger, better citizens. Needless to
say that the great burden of this task
rests upon the mothers, and they are
showing continually their readiness
to assume the responsibility as rapid-ly
as they are prepared for it. The
first step, then, in this branch is edu-cation—
the instruction of the mother
in the care of herself during the ex-pectant
period, not only that the child
may be well nourished at birth, but
that the chances for maternal nursing
during the nine or twelve months
after birth will be enhanced.
The next step is the instruction in
the care of babies. The bureau of
Infant Hygiene of the State Board of
Health believes the best results are
obtained by personal advice given by
the county nurse in home demonstra-tions
or in small groups.
The way to accomplish this may
perhaps be best expressed in the fol-lowing
instructions, which it is hoped
every nurse will have in her posses-sion
and try to live up to.
We aim
—
1. To instruct expectant mothers in
the hygiene of pregnancy:
a. To encourage medical atten-tion;
b. Urine analysis; attention
called to danger signs of preg-nancy;
c. Proper feeding, rest, clothing,
exercise, etc., to insure normal
development of baby and safe
delivery and to make possible
maternal nursing.
2. To supervise and instruct mid-wives:
a. Precautions for septic condi-tions
— method of scrubbing
hands and using disinfectants.
b. In conducting a safe delivery
and advising regarding danger
points at which a physician
must be called.
c. Attention to cord dressing and
method of dressing the newborn
baby.
d. Introduction of two drops of
two per cent silver nitrate in
each eye. Furnished free by
State Board of Health.
e. Advise against castor oil or
teas for baby until mother's
milk is established.
f. Establishment of regular feed-ing
hours — 2% hours for a
newly born baby.
g. Separate sleeping quarters for
newly born baby. (Padded
basket will answer.)
h. Proper ventilation of the sick
room,
i. Proper care and bathing of
the mother first 5 days,
j. Advise against encouraging
mother to leave the bed before
the 10th day.
3. Encourage breast-feeding in every
case.
a. Teaching the mother the value
of diet, hygiene and exercise
which will enable her to nurse
her baby.
4. Where artificial food is necessary,
to impress the importance of mod-ified
cows' milk, the feeding to
be directed by a reputable physi-cian.
In case no physician is
employed, "The Cornerstone of a
Child's Future," by Dr. A. S.
Root, to be used as a guide.
a. To demonstrate preparation
of food, observing mother as she
prepares the food until she has
mastered the process.
b. To make sure that mother
understands how to care for the
milk after the initial prepara-tion
— sterilized bottles, cotton
stoppers, temperature below 50
degrees. Explain to mothers
why boiled milk allowed in
temperature above 50 degrees
may become infected.
c. Teach mother proper care of
nipples and bottles.
14 The Health Bulletin
d. To discourage use of pacifiers.
e. To insist upon regularity in
feeding.
f. To forbid the feeding of solid
food to children under 12
months.
5. Where artificial food is necessary,
cows' milk is unobtainable, or con-ditions
for preserving same are
inadequate, nurse v/ill advocate
the use of dry milk, advising 21/2
tablespoons per pound body
weight every 24 hours, diluted
with an ounce of water for each
tablespoon of milk, milk to be
prepared each feeding on this
basis:
a. The heating of milk (fresh
milk boiled or dry milk) has a
tendency to rob the food of the
vital principles or vitamines.
These are replaced by the use
of small quantities (continu-ously
increasing) of orange
juice, sweet lemonade, potato
water, cabbage water, or tomato
juice boiled and strained.
6. Demonstration of baby comfort:
a. Bath.
b. Making of bed.
c. Ventilation of room (impor-tance
of fresh air to baby).
d. Buying or making of suitable
clothing for baby.
7. Advice for the child of pre-school
age as to feeding, defects, cloth-ing
and habits.
a. Care should be taken to de-termine
tuberculosis or syph-ilis
in mother, baby or older
members of the family. Where
the fact is established, advice as
to precautions and care tact-fully
given.
8. A thorough knowledge of all
agencies in a county working for
Child Welfare—charitable, philan-thropic,
private institutions, hos-pitals,
dispensaries and doctors,
and cooperation with same offered.
9. Organization of mothers' clubs,
where none obtain, or regular
meetings with organized bodies
in a county.
10. Where no mothers' meetings ob-tain,
occasional demonstrations
—
preparation of milk, care and
washing of bottles, etc., in the
homes.
11. A simple exhibition of clothing
for different seasons should be
given in prenatal cases.
12. Mother should be encouraged to
regularly weigh and measure her
baby, keeping for comparison a
written report each week.
The order in which these things are
taken depends upon the needs and
condition of the mother and baby.
Great discretion on the part of the
nurse has to be used not to insist upon
more being done at a time than the
mother is able to understand and
carry out. The main object of the
work is the education of the mother
and her ability to carry out instruc-tions
depend^5 largely on her social
condition.
ECZEMA
Many mothers are writing to this
bureau for information regarding
eczema and most of those writing
seem to regard it as a trivial but irri-tating
ailment. Many others who do
not write are called upon to give it
attention.
Eczema is the commonest skin dis-ease
in babies under two years of age.
The skin of infants is extremely deli-cate
and more easily affected by exter-nal
irritants. While all children are
susceptible, there are some especially
sensitive to irritation and to digestive
disturbances. It is prevalent in some
families and often inherited with
other evidences of diathesis. It very
rarely occurs in poorly nourished chil-dren,
but is common in fat, healthy-looking
babies, breast-fed or bottle-fed,
and it is more often on the face
and scalp than upon the body, though
it appears often on other parts of the
body.
The face becomes raw and moist
and a sticky, watery fluid comes from
it. This dries and forms a thick,
dirty-looking crust over the sore
places. Itching is intense and causes
great suffering. The baby scratches
the sores and this makes them bleed.
The Health Bulletin 15
These children cannot sleep well at
night. They often have diarrhea,
lose weight, and their health becomes
affected.
It is often hard to say what causes
eczema; it is sometimes due to over-feeding,
sometimes to giving the child
too much sugar or fat, sometimes to
using too strong soap on the skin and
sometimes to uncleanliness.
Treatment: Cut down the food in a
breast-fed baby by not nursing so
often. In a bottle-fed baby cut down
the sugar and partly skim the milk.
See that the baby's bowels move
every day. Don't wash the sores with
plain tvater, or soap and water. Wash
them gently with equal parts of milk
and water, but not often. Anoint with
olive oil to soften crusts, so they may
be removed in order to reach the dis-eased
surface. Cut out some stiff
pasteboard slips and bandage them
around the elbow joints. This allows
free use of the hands but makes it
impossible for the child to reach the
sores. A soothing application is
composed of equal parts lime water
and sweet almond oil.
Salves recommended should be ap-plied
in this way:
Make a mask of muslin for the
face (if the eczema is on the face)
and smear the salve on the muslin
and tie it on. It should stay on day
and night for a few days, until the
sores are improved, and then put on
every few days until they get well.
Clean the parts gently with olive oil.
Holt advocates as a simple protec-tive
ointment, one containing starch,
zinc oxide, or bismuth, either alone
or in combination, may be used. An
excellent formula is zinc oxide oint-ment
with 2% of salicylic acid. Later
when inflammation is less acute and
the itching severe, tar in the strength
of ten to twenty per cent may be
substituted for the salicylic acid.
THE COST OF NEGLECT
Report of the Provost Marshal Gen-eral:
Total men called by draft... 3,802,946
Total examined by local
boards 2,510,706
Total rejected by local boards
for physical reasons 730,756
Pex'cefttage of those examined
rejected 29.11
Add 5.8 per cent rejected at
cantonments (estimated) . . 33.11
There is no disputing these figures.
There is no sentiment attached to
them. They are the cold facts ob-tained
by military machinery. If
one-third of American manhood be-tween
the ages of 21 and 31 is so
physically defective as to be rejected
for military srrvice, what is to be
expected of those under 21 and past
the age of 31?
The most superficial analysis of the
causes for which men are rejected
for service shows that more than 60
per cent of these defects are prevent-able;
that 30 per cent are due to poor
general physical condition, which can
be remedied by proper feeding, by
proper attention to personal hygiene
and physical training; that another
30 per cent are due to defective eyes
and teeth, including bad mouth con-ditions;
and that only 10 per cent are
due to neglected surgery.
An analysis of the purely prevent-able
defects for which these men have
been rejected shows that they are not
acute or of recent occurrence, but that
they are chronic conditions; that is,
they have existed for years, many of
them from early childhood. A little
more attention to the physical needs
of children, correction of their minor
defects while they are still easily
remedied, and proper health protec-tion
of the growing boys and girls
would result in a very different health
and efficiency analysis of the adult
population.
16 The Health Bulletin
The Percentage of Venereal Diseases Among
Approximately the Second Million Drafted Men
By States.
Examinations at Mobilization Camps showed that 5.4 per cent of these men had a venereal disease
at the time of examination upon arrival in camp. This percentage includes only obvious cases of syphilis
and gonorrhea and chancroid. Wassermann examinations were not given. Furthermore, this percentage
does not include those who had been previously cured or who may have become infected later. The
record for each State follows:
According to the statement of the Surgeon General of
the War Department, venereal diseases constituted the
greatest cause of disability in the army. For this con-dition,
civilian communities have been responsible.
Virtually all cases of venereal diseases were contracted
within communities ever which civil authorities have
control.
It will be noted that the percentages are much higher,
as a rule, than the percentages for the first million men.
This is due to the fact that, as a result of experience
gained by the Examining Medical Boards, the medical
officers in the Army were able to make more careful ex-aminations
of the second million men and to record more
carefully diseases detected than was possible at the time
of the sudden mob lization of the first million men.
The Army has done more than its part in combating
venereal disease. Civil communities must continue
the fight vtith vigor.
Reports from your State and city w\\\ be watched
with interest by the nation.
EXPLANATION OF GRAPH
Taking Mo
hundred draft
vhich they
enerral d>sea
33 who had
mple, out of every
t the various mobili-
!real disease.
The figures here
Medical Records Sec
OfSce of the Army.
ere furnished by the
the Surgeon CeneraTs
^V AY
AY
n^ mm
This BiJlelirvwillbe 3e?\1 free to oraj Q-tken of tha State upon"requesU
Vol. XXXIV SEPTEMBER, 1919 No. 9
GO TO IT!
Here is the ivay a prominent merchant in one North Carolina
town feels about the efforts of the State Board of Health to abolish
the insanitary, open-back privy in the State. For obvious reasons
his name and town are omitted. Writing straight from his heart
he says:
"Seems you are going to get busy about October 1st and
have some privies looked after.
"It should be DONE.
"Anything worth doing at all is worth doing WELL.
"DO IT WELL.
"My, you got a job!
"Suppose every landowner in North Carolina should see
your last Bulletin. Would it not wake them up?
"Wake 'em up!
"Sheriffs of the counties ought to distribute about one
hundred thousand copies at once. I will pay my part for such
work to be done—and I will get out cheap, if it does the work.
"I know a man worth $25,000, five in family, one a
teacher in graded school, owns a touring car, have no more
privy than a monkey in Africa. His flies eat dinner with
sanitary neighbors every chance.
"IS IT RIGHT
"Roll up your sleeves and,
"GO TO IT!"
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
J. HowEix Wat, M.D., President, Waynesville
Richard H. Lewis, M.D., Raleigh
J. L. Ludlow, C.E., Winston-Salem
Thomas B. Anderson, M.D., Statesville
E. C. Register, M.D., Charlotte
Chas. O'H. Lauqhinghouse, M.D., Greenville
Cyrus Thompson, M.D., Jacksonville
F. R. Harris, M.D., Henderson
E. J. Tucker, D.D.S., Roxboro
OFFICIAL STAFF
W. S. Rankin, M.D., Secretary State Board of Health and State Health Officer
A. J. Warren,' M.D., Assistant State Health Officer
RoNAXD B. Wilson, Director Public Health Education
L. B. McBrayer, M.D., Superintendent of the State Sanatorium
J. R. Gordon, M.D., Deputy State Registrar
G. M. Cooper, M.D., Chief of the Bureau of Medical Inspection of Schools
H. E. Miller, C.E., Chief of the Bureau of Engineering and Inspection
James A. Keigkr, M.D., Chief of the Bureau of Venereal Diseases
Mrs. ICate Bbew Vaughn, Chief of the Bureau of Infant Hygiene
F. M. Register, M.D., Chief of the Bureau of Infant Hygiene
B. E. Washburn, M.D., Director County Health Work
FREE PUBLIC HEALTH LITERATURE
The State Board of Health has a limited quantity of literature on health subjects for
free distribution. If vou are interested in one or more of the following subjects, or want
same sent to a friend," write to the State Board of Health for free literature on that par-ticular
subject. _ Sanitary Privies
Bb^idbktial Sew.\ge
Disposal PijAnts
Eyes
Flies
Colds
Teeth
Cancer
Malaria
Smallpox
Adenoids
Measles
Whooping-oouqh
Hookworm Diseash
PtTBLio Health Laws
tubbboulosis laws
Tuberculosis
Scarlet Fever
Infantile Paralysis
Care of the Baby
Fly Placards
Typhoid Placards
Tuberculosis Placards
Clean-up Placards
Spitting Placards
SEX HYGIENE BULLETINS
German Measles
Typhoid Fever
Diphtheria
Pellagra
Constipation
Indigestion
Infant Care
Child of Pre-School
Age
Corner Stone of
Child's Future
Pre-Natal Letters
Set a—For Young Men
A Reasonable Sex Life for Men.
Sexual Hygiene for Young Men.
Vigorous Manhood.
Smash the Line. (The case against the re-stricted
district.)
List of Reliable Pamphlets.
Set B—^FoR Public Officials and
Business Men
Public Health Measures in Relation to "Ve-nereal
Diseases.
Venereal Diseases—A Sociologic Study.
Smash the Line. (The case against the re-stricted
District.)
The Need for Sex Education.
A State-Wide Program for Sex Education.
List of Reliable Pamphlets.
Set C—For Boys
Vigorous Manhood. (Especially for boys 12
years of age and over.)
Note.—For boys under 12, see "When
and How to Tell the Children" (Set D) ;
portions of "Vigorous Manhood" also may
be read to younger boys. Boys 15 yeart
and OTer may be given Bulletin "A Rea-sonable
Sex Life for Men" (see Set A),
at the discretion of the parent.
Sexual Hygiene for Young Men.
Li«t of Reliable Pamphlets.
Any of the above will be sent without charge
which you have definite use.
Set D—For Parents
When and How to Tell the Children.
Venereal Diseases—A Sociologic Study.
The Need for Sex Education.
List of Reliable Pamphlets.
Set E—For Girls and Young Women
Your Country Needs You. (Especially for
girls 11 years of age and over.)
Note.—For girls under 11, see "When
and How to Tell the Children" (Set D) ;
portions of "Your Country Needs You"
also may be read to younger girls. Girls
15 and over may be given "The Nation's
Call to Young Women" at the discretion
of the parent.
The Nation's Call to Young Women.
List of Reliable Pamphlets.
Set F—For Teachers
The School Teacher and Sex Education.
Sex Education in the Home and High
School.
Venereal Diseases—A Sociologic Study.
Smash the Line.
The Need for Sex Education.
List of Reliable Pamphlets.
Please send for only those bulletins for
IDWAUBS t IROUSHTOM PKlNTmB CO.. RALtiaH. H. C.
&PUBU5AEJD 6YTME. HPRTM CAPQunA 5TATL PXy^D »^MEALXA iIR
Vol. XXXIV SEPTEMBER, 1919 No. 9
EDITORIAL
I
DID 3I0SES KNOW HIS BUSINESS?
Thirty-five hundred years ago Moses,
writing at the dictation of Omniscience,
prescribed in Deuteronomy 23:12-13,
a means and a manner for the sani-tary
disposal of human excreta. This
law, divine in its origin, was regarded
as necessary for a nomadic people liv-ing
in a wilderness with an abundance
of space and natural privacy. This
law provided a manner of excreta dis-posal
which prevented (1) through its
immediate burial, infestation with fly
eggs and the breeding of flies; (2) ac-cess
to and contamination with flies
and insects that would visit, contami-nate
and infest the food and drink of
the people; (3) the washing of the ex-cret