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C6e Librarp of m einitiersitp of Bonb Carolina CndobJtD bp 'E^e SDialectic ano pfiilant^ropic &ocietie0 6)4. 06 NB6h i9i5-ie Med. Ii^. jOSfePH RUZtGR* BOOHBIMO€RS This booh must not be taken from the Library building. LUNC-15M N.36 OP-13370 -^ 3 BETTER BABIES SPEC irrr Putli5\edb4 TnZ./^°KjnCAR9LI/^A STATE. D°ARDs^AE^LTA I This Bullelirv will be 5er\t free to arwj citizeiA of the State upo:\reque5t. | Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C. Entered as second-class matter at Post Office at Raleigh, N. C, under Act of July 16, 1891/. Vol. XXVIII. SEPTEMBER, 1913. No. 6. COLORADO PRIZE WINNERS, 1912. Watch this page for the North Carolina Champions, after the State Fair. CONTENTS Health axd Public Health Brevities 99 Better Babies ix Xorth Carolina 100 Watch Your Nursemaids 104 We Want to Help You 104 Feeding Sick Babies 105 How ASHEVILLE DoES It 106 Good Well Water 107 Mosquito Warfare in Panama 109 The Care of Milk in the Home Ill AVhat Berlin Did, We Can Do 112 The Last Word 112 FREE PUBLIC HEALTH LITERATURE The State Board of Health has a limited quantity of health literature on the subjects listed below, which will be sent out, free of charge, to any citizen of the State as long as the supply lasts. If you care for any of this literature, or want some sent to a friend, just write to the State Board of Health, at Raleigh. A post-card will bring it by return mail. Medical Inspection of Schools and School Children. Care and Feeding of Babies. The Plague of Flies and Mosquitoes. Residential Sewage Disposal Plants. Sanitary Privy. Hookworm Disease. Malaria. Tuberculosis Leaflet. Compilation of Public Health Laws of North Caro-lina. 20. Tuberculosis Bulletin. Fly Leaflet. Baby Leaflet. The Vital Statistics Law. The Whole-time County Health Officer. Anti-Spitting Placards ( ii inches by 9 inches). Anti-Fly Placards ( ii inches iw lo'^inches). No. l-£j| | PUBLI5AE:D BYTML HOR-TM CAIgOLIhA 5TATL BQAI^D °^M&ALTM I El J. Howell Way, M.D., President, Waynesville. Richard H. Lewis, M.D., Raleigh. J. L. Ludlow, C.E., Winston-Salem. W. O. Spencer, M.D., Winston-Salem. Thom.\s E. Ander.son, M.D., Statesville. Charles O'H. Laughinghocse, M.D. Greenville. Edward J. Wood, M.D., Wilmington. A. A. Kent, M.D., Lenoir. Cyrus Thompson, M.D., Jacksonville. W. S. Rankin, M.D., Secretary and Treasurer, Raleigii. Vol. xxvm. SEPTEMBER, 1913. No. 6. HEALTH AND PUBLIC HEALTH BREVITIES. Dou"t miss the Better Babies Cox-test at the State Fair. — — To get some good, first-class health literature free, see the opposite page. —o — Over .$300 iu prizes for the best North Carolina babies at the Fair. Enter your baby. There are no entry fees. For the elementary principles of healtli and sanitation on the farm, see the public health exhibit at the State Fair. October 20th to 2.jth. —o^ Th^> Better Babies Contest and the PrBLic Health Exhibit will be two of the biggest features of the State Fair this year. —o Thirty-three states make tuberculosis a reportable disease. I.sn't it about time for North Carolina to join the riro-cession? —o — The liveliest thing at the State Fair —the Better Babies Contest. Don't miss it. It will beat the Midway any day—and it's free. August and September form low water-mark for pneumonia. From Sep-tember on to February the pneumonia death rate goes up—because our win-dows go down. Live, work, and sleep in the fresh air. and avoid pneiiraonia, colds, grip, and tuberculosis. On dressing for hot weather, the Chicago Health Department says "Wear as little clothing as the law of the land will permit—that's mighty little these days. 'Equal rights for men.' " _^_ Would you like to know if your child has hookworms? The State Board of Health will tell you free. Write them, stating that you want a specimen con-tainer for hookworm examination. — — Any one suspecting tuberculosis should consult his family doctor at once. If thought necessary, the doctor can have a sample of sputum examined for tuberculosis germs at the State Lab-oratory of Hygiene free of charge. —o — True civilization and refinement in a town, community, or individual family can be judged very closely by the way they handle their own filth. If they have the antiquated, open, insanitary privies, or no privies at all, and no screen doors or windows, they are about at the bottom of the scale. If they have screen doors and windows, they have movetl up quite a bit: and if they have abolished privies altogether, or use san-itary privies and screens at their doors, they have passetl the selfish stage and recognize that they are their brother's keeper. Where are you on this scale? BETTER BABIES IN NORTH CAROLINA. Each Year the Old North State Raises Better Cotton, Better Tobacco, Better Horses, and Better Cattle—and Why Not Better Babies? Warren H. Booker, C.E., Assistant Secretary. Koi-th Carolina neglects her best crop. Yes, just that. Every year we have our county and state fairs; we have our Agricultural Department with scores of experts, test farms and ex-periment stations, and our agricultural colleges filled to overflowing; we have our farmers' institutes, and the best farm paper in the United States. We have all these, and why? In order to make two bales of cotton grow on an acre that formerly produced but one; in order to produce good cattle instead of scalawags, and thoroughbred Berk-shires and Poland-Chinas instead of razorbacks and elm peelers. But North Carolina's best crop is never mentioned. No one ever dreamed of holding institutes to teach fathers and mothers how to raise better, healthier babies. We have no schools or colleges teaching such subjects. We have no papers or magazines on this subject. In fact, all we have ever done was to have an occasional beauty show at the fair. That was a joke. No one ever knew a thing more about how to raise a better, healthier baby, or how to improve those they already had. after attending such a beauty .show, than they did before. Now, all this is going to be changed. The North Carolina mothers have said so ; the State Fair Association has said A Sound Chest is a Valuable Asset. Broad, Deep Chests Are Fine, But — so; and the State Board of Health is going to back them up and cooperate with the mothers of the State and with the State Fair Association, and hold North Carolina's first great Better Babies Contest at the State Fair in October. OVER $300 IN CASH PRIZES. The contest will be under the direct management and control of the State Board of Health. It will not be a beauty show in any sense of the word. It will be a health contest, out and out. Neither grandfathers nor grand-mothers, town mayors, congressmen nor politicians will be allowed to pat babies' dimples, kiss them on the mouth, or vote for the prettiest child. On the other hand, a corps of the best doctors and children's specialists in the State will be on hand to score the babies on a score-card in much the same way as the horsemen and cattle judges will THE HEALTH BULLETIX. 101 GETTING THE CORRECT HEIGHT. Height and Weight Should Conform With Age. $50. It took quite a bit of work to raise this $150 iu order to secure the $100, but the State Board of Health did not stop there. It went on, and is still collecting funds for prizes, and be-fore the contest is held it hopes to have a considerably larger fund for tliis purpose. JUDGING THE BABIES. Lots of interest centers around just how the babies will be judged or scored. Space will not permit us to explain the whole matter in detail, but the general plan will be as follows The contest will be held October 20th to 25th. at the State Fair Grounds at Raleigh, in the east wing of Floral Hall. At the appointed day and hour the mother will bring the baby to the large, comfortable reception room, where a reception committee of ladies interested in the babies and their moth-ers will meet the babies, learn the name, age. and sex of each one. and fill out They Must Not be Flat or Pigeon-breasted. score the horses and cattle. The baby"s age will be noted, then he will be weighed, measured, and carefully ex-amined, and, above all things else, these doctors will point out to the mothers and fathers just what goes to make a perfect baby. They will show why the baby scores high here and low there, and just how to remedy any defects. Then, best of all, there will be the prizes. Of course, the prize for the best baby will not be so large this year as it will be for the best horse or cow or hog. One could scarcely expect that the first year ; but next year, when North Carolinians begin to appreciate that a third or fourth prize baby is worth more than the best race-horse on the track, the adjustment of prizes will be different. This year the Woman's Home Companion offered $100. provided the State Fair Association would raise $100, and provided further that the women's clubs of the State would raise Surveying Osier's "Mason and Olxon Line." 102 THE HEALTH BULLETIN, A Perfect Baby Must be Well Proportioned as to Height, Lengtii of Arms, and Length of Legs. the score-card sbowing these facts, also tlie name and address of the father and mother, whether the baby has been breast-fed or bottle-fed, whether or not it sleeps alone, whether or not it sleeps in a room with windows open, etc. From the reception room the baby and mother will enter a quiet room where a doctor will test the child men-tally according to its age. For instance, a child of six months should sit alone, play with simple objects like a pencil or spoon, look in the direction of unex-pected noises, etc., while a child of two years should run, join words to make short sentences, be able to point to eyes, nose, ears, etc.. and so on. If baby meets all these conditions, he will be scored 100. or perfect. WEIGHTS AND MEASURES. From the mental test room the mother and baby will be conducted to a meas-uring room. Here a doctor and a trained nurse will carefully weigh and meas-ure the baby. A table of standards has already been provided for babies of different ages. Baby's height will be measure<l. and his chest measure-ments and other measurements taken, and he will be graded accordingly. PHYSICAL EXAMINATION. From the weighing and measuring room the mother an<l child will be taken to the last examination room. Here trained specialists will make careful physical examinations of the baby from head to foot. They will examine his teeth, his eyes, ears, nose, throat, and every possible detail that goes to make up a perfectly healthy, normal baby. Furthermore, these meflical experts will point out to fathers and mothers any physical defects or tendencies, and in-form them, free of charge, how to rera-etly or overcome these defects by proper care of the baby. PUBLIC HEALTH EXHIBIT. Nor is that all. For the first time in its history, the State Board of Health will hold a public health exhibit, show-ing the most approved forms of sanita-tion so far as the care of babies is con-cerned. There will also be a general exhibit on a lot of other public health subjects, such as tuberculosis, typhoid, malaria, hookworm disease, etc. The Board will devote a considerable amount of time, money, and energy to getting up the best public health ex-hibit ever shown in this State, if not in the South. The opportunity of studying the cheap, practical, home-made models of every-day sanitation will be well worth a trip to the Fair, to say nothing of the other features. The object of the exhibit will l;e to Better Babies Must Have Good Under-pinning. They Have a Long Road to Travel. THE HEALTH BULLETIX. 103 briug mcKleni sanitation down to prac-tical, every-day life. Don't miss it. It will be next to the Better Babies Con-test. ABOUT THE PRIZES. The matter of prizes has not been fully decided as yet. There will be classes for rural babies and city babies, and these classes will probably also be arranged according to ages, say from six months to twenty-four months, and from twenty-four months to thirty-six months. The classes will probably also be divided into classes for boys and classes for girls. There will probably also be sweepstakes and special prizes for the best boy and the best girl of any class. In each class there will probably be a first, second, third, and fourth prize. A special committee will decide later in regard to the number and value of the prizes, and due an-nouncement will be made in the next number of The Health Bllletix. Every effort is being made to make The Better Babies Contest as pleasant and comfortable for the babies and their parents as possible. Besides the large reception room, the Board will endeavor to have tents erected for rest rooms for mothers and babies. Cots Gocd Teeth, Good Tonsils, and a Clean Tongue Make for Better Babies. Sore or Swollen "Kernels" May indicate a Disposition to Contract Disease. will be provided for sleepy babies, and trained nurses will be left in charge of the babies while the mothers go about seeing the rest of the Fair. HOW TO ENTER. Parents wishing to enter their babies in the contest will file their application with the State Board of Health before October Irith—the earlier the better- No charge or entry fee will be required. The parents will also state the day on which they expect to attend the Fair^ so that the Board can arrange a con-venient hour for the judges and the baby. Kemember that Wed)iesday will prob-ably be a better day than Thursday or Friday, and Tuesday will probably Be the best day of all. so far as conveni-ence and the comfort of the baby is concerned. Apiilications for entry will be filed in order, and iireference in regard to time of examinations will be given early npplicanrs. For this reason it is best to make your entry application early^,. even though you should later find it impossible to have the baby there. Ap-plications are already coming in, and if you make your entry application at once, so much the better. Home^cJmpailon^^ °^ ^^'' ^''"'="''' ''"^' ^^^ ^"'« illustrating this article are used by courtesy Womar. 104 THE HEALTH BULLETIN. WATCH YOUR NURSEMAIDS. Warren H. Booker, C Nursemaids are a very potent health factor in child life. Children's dis-eases are frequently conveyed by them, and sometimes diseases more far-reach-ing are directly chargeable to ignor-ant, careless, or diseased nurses. This is particularly true in the South, where colored women do much of the nursing. Perhaps the only reason we do not have more crimes of preventable dis-eases charged up to careless, ignorant. or diseased nurses is that, as a rule. it is very hard to determine the exact source, cause, or occasion wherein a case of preventable sickness was con-tracted. In May, 1912, however, in a large children's home, a nurse having tuberculosis was given charge of a ward of ten small infants ranging from two to four years of age. All ten of these children had been tested for tubercu-losis the month before this nursemaid took charge, and it was then found that three out of the ten had been previously infected with tuberculosis, but were not in an active stage of the disease at that time. It was noticed within six weeks after employing this nurse that she had tuberculosis, and she was promptly re-moved on the first of July, and the children again examined, but only the same three responded to the test. Three months later, however, the chil-dren were again examined, and it was E., Assistant Secretary. found at that time that tubercular in-fection had developed sufficiently in every case to be recognized by the tu-berculin test. These children could not have contracted tuberculosis from any one else except the tuberculous nurse-maid, as she was the only person that came in contact with them. Even their milk supply was Pasteurized by heating to l-iS F. for 45 minutes to kill any tubercular infection from the cows. It should be noted that there were nearly three hundred children in this institution, and it was found that this was the only tuberculous nurse present. It was also found that the children under this particular nurse were the only ones to develop tubercular infec-tion after coming to the institution. All this goes to show the grave danger of infecting our children by means of nursemaids. Fortunately, these early tubercular infections are, as a rule, readily over-come by children, but not always, as is shown by the records of deaths from tuberculosis among children. The les-son to be borne in mind is the possi-bility and the danger of having our little ones and our loved ones infected by a race of people having three times the amount of tuberculosis that white people have, as well as a great excess of certain other preventable diseases, to say nothing of the loathsome venereal diseases. WE WANT TO HELP YOU. Warren H. Booker, C Miss Teacher, Mrs. Club Woman. Messrs. Preachers and all other Public- Spirited Citizens, we want to help you. Will you let us? Here is one way in which the State Board of Health can help you in your school, church, and community work. We have just secured two sets of lan-tern slides, with lectures already writ- E., Assistant Secretary. ten out to accompany them. One of the lectures is on tuberculosis and is well adapted for any mixed audience, while the other lecture is on the general subject of health, the teeth, voice, hear-ing, and sight. It is especially adapted for schools, and for work on the medi-cal inspection of school children. Anv one can "deliver" or read one of THE HEALTH BULLETI^'. 105 these stock lectures while some oue else operates the slides in any ordinary stereopticon lantern. The State Board of Health offers to loan these slides and lectures free of charge to any school, church, club, or-ganization, or public-spirited citizen who will agree to give a lecture from them, provided they pay the express charges to their town. Then they may hold the slides and lecture until we send them an order requesting that they be shipped to some one else. Besides the slides and lectures, this Board will also send you special bulle-tins to help you get posted on the sub-ject on which you expect to lecture, and a limited quantity of various kinds of public health leaflets which may be dis-tributed among the audience after the lecture. Here is a golden opportunity for any one at all interested in giving his club, church, or community an entertaining and instructive lecture. Our church people are beginning to have more compassion on their over-worked preachers, and are giving them more generous vacations. Laymen who relieve the regular minister should find these lectures an excellent method of continuing the regular meetings. Health work, after all, is only one phase of Christian activity, and if the lecturer wants to add more religion to his lecture, let him draw lessons from the life of the Great Physician, or let him teach modern sanitation from the Book of Deuteronomy. Doctors usually make excellent peo-ple to deliver such lectures. However, on account of the delicacy of medical ethics and on account of the difficulty in getting a good audience to an ordi-nary lecture, doctors thus far have not, as a rule, volunteered to give health lectures as freely as they might. But if some church, school, or public-spirited citizen will invite a doctor to give one of these illustrated lectures there will be little danger of his not accepting the invitation. Try it once. To secure these slides and lectures. write the State Board of Health, Ra-leigh. Do not announce the date for a lecture until you find out when you can get the slides. If the idea proves popular, the Board will be glad ro add several more sets of slides and lectures on different sub- .iects, and possibly for those communi-ties not having ready access to stere-opticon lanterns the Board may later secure one or more traveling lanterns to loan out with the slides. Let us know how the idea appeals to you. FEEDING SICK BABIES. If it were possible to obtain an accu-rate record of baby sickness, it would be found that many babies get sick in June and the early part of July, though the baby death i-ate does not begin to show much rise until after the middle of the latter month. The asylums, sanitaria, hospitals, and baby tents find that the children who are severely sick in midsummer give a history of mild sickness in the early summer. It is the old. old story of the "stitch in time saving nine." Loose bowels, green stools, mucus, and blood cannot be neglected with any degree of safety after June 15th in this climate and June 1st in warmer cli-mates. The child may seem to be happy, not upset by the little indigestion, and it may seem useless to worry about so trifling a matter. But. unless these trifles are attended to. things will get worse as the weather gets hotter, and. presently, the baby is in a condition where no food seems to agree with it and no doctor seems to help it. The 106 THE HEALTH BULLETIN. mother must carry on her loug. weary fight to keep the jioor, skinuy baby alive until the nights get cool in October. The first thing to do when the baby gets sick is to stop feeding it. Trobably The milk is bad anyhow. But. whether it be good or bad, it will disagree with a sick baby. In place of milk the baby should take clean water from a clean bottle or a clean cup. If the trouble keeps up there are milk substitutes which can be given until it is safe to give milk again. The physician or nurse will demonstrate how these are made. The next step, after str>iiiiing the food, is to empty the child's intestines of all fermenting, decomposing food. The par-ent is justified in going as far in this line as the use of oil by the mouth and of simple enemas by injection. If re-lief does not come when these have acted, the mother is not justified in go-ing further. She should get help from a physician or nurse. Caring for a sick baby is so largely '"doing and showing," as contrasted with "telling," that a nurse is needed more than would usu-ally be the case. As the child goes back on milk, let it be watered milk or good buttermilk. If the first feeding agrees, let the next be slightly less watered, and the next still less, until within a few days the diet is one proper for the age and the season of the year. Occasionally a mother contin-ues to give watery milk after the acute trouble has subsided and the baby in a few weeks shows signs of starvation. Remember—a baby with indigestion can be starved by overfeeding. The in-digestion passed, it may be starved by underfeeding. — Dr. W. A. Evans in The Chicafio Trihvne. HOW ASHEVILLE DOES IT. When a case of typhoid fever occurs in Asheville. the dairyman delivering milk to the afflictetl family is immedi-ately notified of the fact. That is usu-ally enough to make the dairyman feel that to some extent his dairy is charged up with the case, until it is proven that no further cases occur on his route or that the first case was due to something else. Furthermore, the dairyman is not allowed to remove milk bottles from the premises of the sick person until the bottles have been sterilized by the health department. This is a very wise provision, because typhoid germs grow very rapidly in milk, and if the milk bottle should become accidentally con-taminated with typhoid germs in the typhoid-stricken home the dairyman might contaminate his other bottles and cans in the course of ordinary washing and spread the disease to the rest of his customers. This is a very good pre-caution. What is the policy of your town is this matter?—w. h. b. .Jesus was rebuked in the elder day for healing an infirm man on the Sab-bath. And those who rebuked Him thought it perfectly all right to save a sheep on the Sabbath. The sheep was a piece of property. It was money, it was value. "How much better is a man than a sheep?" He asked, and the doc-tors, the reformers, the cranks, have been thundering that to the multitude ever since, and the multitude has begun to listeii. Within our own day, we have seen legislatures appropriate more for hog serum than for tuberculosis, more for the hog than for the human; but a man is getting to be worth as much as a hog in this State, and he is going to be worth more.—ir. T. Bost in The Xeics and Observer. THE HEALTH BI'LLETIX. 107 GOOD WELL WATER. Warren H. Booker, C Good, wholesome driuking-water is a fimdameutal of life aud liealth. Judg-ing from analyses of private well water at the State Laboratory of Hygiene, one would think good well water was a lux-ury in North Carolina. Only 17 per cent, or one out of six. of all the huu-dretls of ordinary, open-top bucket wells were found to furnish water safe for drinking. Of the wells with pumps it was found that 63 per cent, or four times as many, furnished water fit for human use. Only about 36 per cent of the private spring supplies are found safe. All this is an unfortunate, dan-gerous, and disgraceful condition, par-ticularly among our rural folk. A great deal of this trouble can be easily avoided by observing the following pre-cautions. The purity of a water is a very de-ceiving thing. We can frequently tell whether or not food is wholesome by looking at it, by smelling it. or tasting it; but not so with water. Looks, taste, and smell count for little. Water laden with germs of typhoid, cholera, or diar-rheal diseases may be perfectly clear, tasteless, and odorless. The only way to tell bad water is to have a chemical and bacterial examination made of it. giving the person examining the water all the information available as to how, when, and where the sample was col-lected, and a description of the sur-roundings of the well or spring. The distance from privies, stables, etc.. should be given, also the direction of the surface drainage with reference to the well, and the methorl of covering and protecting the top of the well. What most of us are interested in is how to get a well of good, wholesome water, and then l^eep it good. Be'-ause a well water is wholesome to-day is no reason why it may not be dangerously polluted next month or next year. A well once polluted is iilwa.vs uncertain. The water may beronie pure or it may '•niitinne impure. It is like a jierson E., Assistant Secretary. that steals. If he steals once, it is doubtful if he ever jiermanently re-forms, and we are always uneasy lest he commit a robbery. A GOOD WELL LOCATION. In locating a well use common sense and foresight. Don't rely on supersti-tions ; they may kill some one with bad water. Ordinarily, the water in the ground moves slowly in a direction from higher ground toward lower ground ; so be careful not to locate a well so that the water coming to it will have soaked through barnyard manure or privy filth above the well. Wells should, whenever possible, he located on high ground, well away from privies, hogpens, and barn-yards. Wells located on high ground usually have to be put down somewhat deeper than wells located on low ground, but the quality of the water from the wells on high ground will justify the extra expense. Lse foresight and do not locate a well where it may later become polluted by privies or other sources of pollution not under your control. Never locate a well where the heavi-est kind of a rain or even a "cloud-burst" can wash surface material from the ground into the top of the well. If there is any possibility of such a thing hapiiening. grade around the top of the well so that rain and surface water will drain 20 or 30 feet away from the well —the farther the better. This Is very important. Never use an open-top well. The.v are many times moi'e liable to contami-nation than wells with pumps. Pumps, either wooden or iron, never injure the quality of the water or the health of the users. The more you protect the top (if the well, the better. Note in the accompanying illustration how the walls are laid u]) with cement joints. The toil of the well is carefully cov-eretl. cement is jiacked around the toj) of the well, a trdugh and drain pre- 108 THE HEALTH BULLETIN. vents waste water from returniug to the well, and all surface water is drained away from the well by the slope of the ground. This is an excel-lent form of well, and if privies, hog-pens, etc., are kept away from it and on lower ground, it should give excel-lent water. IMPROVING BAD WELLS. To make a good well out of a bad one is a very hard and uncertain job. It is usually cheaper to locate a new well and begin all over. Sometimes, by making the walls water-tight, grading the sur-face of the ground away from the well, placing a tight cover over the well, using a pump, draining the waste water away, and removing all sources of pollution, the water may be im-proved ; but the results cannot be guar-anteed. PROTECTING SPRINGS. The same general principles apply to springs that apply to wells, except that, as a rule, springs are already located. and we have to leave them where they are and protect them as best we can. An excellent way to protect a spring is to surround it with a cement bowl or basin and cover it with some close-fitting lid. This will exclude frogs and bugs, and also leaves and other debris frequently blown into oiien springs. If possible, the water from the spring should be piped down to the house di-rect. If this cannot be done, an iron pipe or terra-cotta pipe should dis-charge the overflow from the spring so tnat it can be caught in pails, etc. In this way promiscuous dipping of cups and pails into the spring bowl itself can be avoided. To protect a spring from surface drainage, it is an excellent plan to cut a small ditch around the spring on its upper side at a distance of some 20 or 30 feet, and drain the surface wash away from the spring. Live stock should not be iillowed to pasture for a distance of at least 100 feet above the spring, and privies should be kept en-tirely off the catchment area of small springs. In the case of large springs, possible sources of pollution should, as a general rule, not be allowed within 500 feet above the spring. Ground above a spring or around a well, if used for farming, should not be fer-tilized with barnyard manure, etc.. if for no other than esthetic reasons. No definite rule can be laid down as to a safe distance from a source of pollution to a well or spring. In sandy and clayey soils there is less danger than where rocks, more or less crackel and seamy, exist a few feet under the surface. The safest rule is to keep all sources of pollution as far away as possible, the farther the better, and under no circumstances permit them to exist within one hundred feet of even a carefully protected well such as shown in the illustration. A GOOD FORM FOR A DUG WELL. Protected from Surface Pollution by a Good Cover, Well Laid Wall, and a Trough Which Drains the Waste Water Away. Note Also the Concrete Around the Top. and the Direction of Surface Drainage. THE HEALTH BULLETIN. 109 MOSQUITO WARFARE IN PANAMA. How They Fight Mosquitoes to Save Human Lives. Dr. W. S. Rankin, Secretary. The Isthmus of I';inama has seen two great battles. Thirty years ago, when the French started the Canal, the mosquitoes undertook to drive out the invaders, and they did it. The death rate among the French was 240 per 1,000 annually—a clear-cut victory for the mosquito. To-day, while the Ameri-cans are digging the Canal, they are also making war on the mosquito, and the mosquito is losing. The present death rate is only 14 per 1.000. We can appreciate this better when we remem-ber that the death rate in North Caro-lina is about 30 per cent higher, or something over IS per 1.000. Methods used in controlling the mos-quito problem consist of filling and draining collections of stagnant water oiling and using larvacide where filling and draining cannot be employed ; in screening; in catching mosquitoes by hand and by traps; and in persuading people subjected to bites of mosquitoes to use small doses of quinine daily. Three to five grains daily will prevent malaria in a malarial district. The most permanent method of con-trolling mosquitoes is the filling or drainage of stagnant water. This method attacks the problem from its very source. It prevents the bree<ling of the mosquito. To fill up a swamp is better than to drain it, but much more expensive. After drainage the ditches must be kept open and free from grasses, and oiled frequently. The cutting and removal of grass from the ditches in the tropics is no small part of the mosquito problem. Where filling in or drainage cannot he employed, then the only thing to do is to oil the surface of the water, or to treat it with some chemical larva-cide that will kill the young mosqui-toes. In the tropics they use a cheap crude oil, which is much better for this purpose than ordinary kerosene oil. METHODS OF OILING. Many interesting ways of applying oil to water have been devised in the Canal Zone. It is applied in some places by men with a spraying appara-tus fastened on their backs, knapsack fashion ; in other places, where the ground is not too soft for the wheels to leave a track in which stagnant water could accumulate, it is applied by an oil cart with a mule hitched to it and a spraying arrangement at-tached to the tank on the oil cart. Oil is applied to the water in small streams and ditches by placing barrels or gar-bage cans along the course of the stream, the number and distance apart of the barrels and garbage cans de-pending upon the volume of the stream. By fixing a spigot in the barrels, the oil is allowed to fall on the water drop by drop in such quantities as needed. Where the amount of water is very small, as that coming from an ooze on a hillside, they dip a small roll of cot-ton waste in the oil and fasten it on the ground over the ooze. Where conditions of travel make it difficult to carry the large amounts of oil needed, a chemical composed of crude, cheap, carbolic acid, rosin, and caustic soda, mixed together, and known as larvacide, is sprayed upon the stag-nant water. The larvacide is very fatal to the young forms of mosqui-toes, and as it can be used in much smaller quantities than the oil, it is more convenient where conditions of travel make the oiling inconvenient. An important thing that impresses one in studying the treatment of stagnant 110 THE HEALTH BULLETIN, water in tbe tropics bj' the various methods nientioueti is tbe fact that no stagnant water, not even small collec-tions on a hillside a fourth or an eighth of an inch deep, nor even the water in a sheep's track, is neglected. Tbe treatment is complete, and this is one of tbe important points that the authorities in tbe Zone make in deal-ing with tbe mosquito problem. VALUE OF SCREENS. If mo.squitoes are allowed to breed, the malarial death rate can be held down remarkably low by thoroughly screening all bouses and by catching mosquitoes by hand and by traps. The occurrence of malaria in the screened section and unscreened section of the same settlement, both sections of which are equally exposed to the mosquitoes, has demonstrated that there is one-third less malaria in screened than in unscreened houses. The authorities of the Zone stress the point that screening should not be done unless it is done thoroughly. An imperfectly screened house frequently serves to admit and retain the mosquitoes, acting as a trap. In screening, an IS-mesh copper wire is used ; a larger mesh will admit of tbe entrance of certain varieties of mos-quitoes. The authorities of tbe Canal Zone think a great deal of catching the mos-quito. Mosquitoes are caught in two ways : Wire traps, very much like some forms of fly traps, are fastened over the transoms of the doors. To catch the mosquitoes entering tbe house, tbe convex part of the trap is turned in: to catch the mosquitoes leaving the house the position of tbe trap is reversed. A still more impor-tant way than trapping, in catching the mosquitoes that reach a dwelling, is by the "band catch." "Hand catching" as carried out in the Canal Zone is done by ordinary day laborers. Tbe mosquitoes are looked for early in the morning, when they are usually found on the wire screens trying to get out, or late in the day in the dark corners of tbe rooms, under shelving, or behind l>ictures. Tbe mosquito catcher car-ries a little bicycle lamp and a cylindri-cal bottle, about 4 inches deep by an inch in diameter, with a little piece vf cotton in the bottom soaked with chlo-roform. With tbe rays of the light thrown in tbe dark place he spies the mosquito on the wall and gradually slips the mouth of the bottle over the insect, which soon becomes anesthe-tized and falls into the bottle. In some of the temporary camps, where filling in and draining are too expensive, it has been possible to bold tbe malarial death rate down to tbe average preva-lence in tbe Canal Zone by tbe "hand catch" method. This demonstrates tbe importance of this measure in controll-ing the malarial problem. About ten times as many mosquitoes are caught by hand as by traps. The effect of the mosquito work in the Canal Zone has been to entirely eradicate yellow fever, the last case of which occurred in lOOG. and to reduce malaria 00 per cent. As will be apparent to our readers, many of tbe methods used in the Canal Zone are applicable to North Carolina, and many of the methods used by tbe Canal Zone can be used by the indi-vidual for bis own and his family's protection, independently of the iudif-ference of the municipality in which be lives to the importance of mosquito eradication. There are over .oOO deaths and G.'.OOO to 7.5,000 cases of malaria every year in North Carolina, nine-tentbs of which occur in the eastern half of the State. It is evident that it is time for our people to begin to take an interest in tbe mosquito and ma-laria. i THE HEALTH BULLETIN. Ill THE CARE OF MILK IN THE HOME. Milk is a perishable food. The length of time it remains sweet depends largely upon the care it receives after delivery to the consumer. Keep it clean, cool, and covered, and it should remain sweet during the 24 hours in which it should be used. Germs, to grow, require three im-portant things, namely : food, moisture, and moderate heat. Milk furnishes footi nnd moisture and the room air furnishes the necessary warmth. Milk is therefore a very good medium for the growth of germs, if not kept cold. Dust, dirt, and flies are the carriers through which germs get into milk. Milk, therefore, should be protected from dust, dirt, and flies. Remember : the most important rule about the care of milk is : keep the milk clean, Keep it cold, and keep it covered. Do not allow milk to stand on the dumbwaiter, stoop, window-sill, or other place where the driver leaves it. Place it promptly in the ice box. Keep your ice box cold and well stocked with ice. You cannot obtain good refrigeration without a well-filled ice compartment. Keep your refrigerator clean and free from disagreeable odors. Milk ab-sorbs unpleasant odors very readily. Strong smelling foods, such as onions, garlic, and strong cheeses, should not be kept in the same compartment with milk, butter, or cream. Where ice boxes are not available, some makeshift arrangement should be provided. The following has been rec-ommendetl "An emergency ice box may lie con-structed by placing a piece of ice in a covered tin pail or bucket having a hole in the bottom. An old leaky pail will answer. "Place the bottles of milk in direct contact with the ice. and cover the whole with a heavy cloth or blanket. The pail may be kept in the sink." Milk inirchased from stores should be delivered in a clean condition and at or below .30 degrees F. Keep the milk prepared for infant feeding in nursery bottles in the ice box until just before using. The prac-tice of heating the baby's milk at even-ing and keeping it warm until the night or early morning feeding is very bad. The heat thus maintained is most favorable to the growth of germs. Return promptly to the ice box any unused portion of milk. Standing in the warm room will greatly hasten the growth of germs. Keep the milk tightly covered, so that dust, dirt, and flies may not enter. Wipe the mouth of the bottle care-fully with a clean towel before re-moving the cap. Replace the cap im-mediately after pouring out what milk is wanted. Pour the milk into clean receptacles. Dirty vessels will as readily contami-nate the milk as will dust. dirt, and flies. Place milk dipped from cans or tanks only in clean covered pails or other covered receptacles. Mix the milk well before using. In-verting the bottle rapidly two or three times will accomplish this. Cream sepa-rates and rises to the top, making this necessary. Pour only enough milk from the bottle for the specific use. Do not put any unused portion back with the milk from which it was taken, but place it in the ice box in another covered ves-sel. Do not keep more than one day's supply of milk at a time. Order a fresh supphj daili/. As a matter of courtesy, at least, consumers should wash the milk bot-tles before returning them to the dealer. In some towns this is required by law. The proper way to wash a milk bottle is to first rinse it thoroughly with cold water. When all the milky 112 THE HEALTH BULLETIN. film has been removed from the in-side, then wash carefullj with very hot water. All vessels used for hold-ing milk or cream should be cleansed in the same manner. Do not use milk bottles for any other purpose than the holding of milk or cream. Pdnse nursery bottles and nipples in cold water and wash in boiling water immediately after each feeding. Turn the nipple inside out and thoroughly cleanse. Rinse the bottles and nipples again in boiling water before using. Remember, above all things, to keep the milk clean, keep it cold, and keep it covered. (From circular issued by the New York Sanitary Milk Dealers' Associ-ation.) WHAT BERLIN DID, WE CAN DO. The death rate of the city of Berlin, which has a population of over 2,000,- 000, was 17.95 per 1.000 for 1911. In 1877 it was 35 per 1.000, and for the twenty years preceding that time it had averaged about 36 or 37. It is apparent from these figures that the death rate of Berlin has been cut in half during the last 34 years, the era coincident with the development of preventive medicine. And yet there are people who are still talking about the "theory of public health." What is more real, more vital, than the facts which these figures demonstrate? THE LAST WORD. Some one always has to "get in the last word." In formal debates it is the rebuttal speaker. In informal debates it is usually "the woman in the case." In this case it seems to devolve upon the new editor of The Health Bulle-tin. Next month we shall endeavor to let some of our readers "have a say" on this page. The Secretary of the Board, the former editor or The Bulletin, has found that the executive duties of his office and the demands on his time for service outside of the office make it well-nigh impossible for him to find time to do justice to the work of edit-ing this Bulletin. This duty has fal-len to the lot of the Assistant Secre-tary, who takes up the work with con-siderable hesitancy and misgiving. Several changes have been made in tliis issue of The Bulletin, and of course we are anxious to know just how our 40.000 readers will like them. With the next issue we shall en-deavor to reserve this or a similar space for "Brickbats and Bouquets" from our readers. We want to know just what you want, how you like the changes, and what your ideas are as to the most helpful material to be run in these columns. Of course, we have some ideas of our own. but we want to get in touch with your ideas and see just where we can meet on some com-mon ground and work together with the most efficiency. For this reason we especially invite criticism of this issue. We want your suggestions. We want to improve this Bulletin and make it supply the latest information on personal health and public health in a simple, direct, popu-lar form easily understood by the aver-age person who has but little time or inclination to plod through long. hard, dry, technical articles. In a nutshell, these are our ideas. Now what are your views? Let us hear from you. ^^ COLLECTiONL ut)Ii5}Yedbij TR£.^°KJACAR9LI/^A 5TATLE)9AR.D s^AmLTA BulleliiAwillbe -serxt free to arwj citizen of "the StcrteupoAreqaest I Published monthly at the office of the Secretary of the Board, Raleigh, N. C. Entered as second-class matter at Postoffice at Raleigh, N. C, under Act of July 16, 1894. Vol, XXVIII. OCTOBER, 1913. No. 7. Better Babies from other Southern States Watch this page for North Carolina Prize Winners after the State Fair. October 20-25 CONTENTS Bbief a.vd to the Poixt 115 Thk Bettsb Babies Contest 116 NuEsix^G THE Baby 119 Why 1 Ail Down on- Patent Medicines 120 FsEiGHT Rates and the Real Issue 121 Chsonic Constipation 121 i."H?:^j»EB Sanitation 124 What is the Matter With Your Stomach 125 Bbk'kbats and Bouquets 128 FREE PUBLIC HEALTH LITERATURE The State Board of Health has a limited quantity of health literature on the eubiects listed below, which will be sent out, free of charge to any citizen of the State as long as the supply lasts. If you care for any of this litera-ture, or want some sent to a friend, just write to the State Board of Health, at Raleigh. A post-card will bring it by return mail. No. 9. Medical Inspection of Schools and School Children. No. 10. Care and Feeding of Babies. No. 11. The Plague of Flies and Mosquitoes. No. 12. Residental Sewage Disposal Plants. No. 13. Sanitary Privy. No. 14. Hookworm Disease. No. 15. Malaria. No. 18. Tuberculosis Leaflet. No. 19. Compilation of Public Health Laws of North Carolina. No. 20. Tuberculosis Bulletin. No. 21. Fly Leaflet. No. 22. Baby Leaflet. No. 23. The Vital Statistics Law. No. 27. The Whole-time County Health Officer. Anti-Spitting Placards (11 inches by 9 inches). Anti-Fly Placards (11 inches by 19 inches). ^a^^oiiJMVi^:^^^^' I PUBLI-SM^D 6YTML nPI^TM CAIgOLIhA 5TATL BOAIgD q^MLALTM i fTl Vol. XXVIII, OCTOBER, 1913. No. 7. BRIEF AND TO THE POINT It is not the babies born, but the babies saved that count. —o — Good morning! Yes, sir, the big-gest Better Babies Contest in the State will be held at the State Fair, October 20th to 25th. Be there. — — Babies from some of the best fam-ilies in the State are being entered at the Better Babies Contest—that's one reason it is called a Better Ba-bies Contest. — — It costs $1,700 to fire some of Secre-tary Daniels' big guns. It's a pity a lot of North Carolina counties can't I have the price of about two shots to 1 put in a county health officer. —o — You don't need to wait for the new law requiring the reporting of tuber- 1 culbsis to go into effect. If you have tuberculosis or know of anyone that has it, send the name of the patient in to the State Board of Health, and the Board will do all it can for you i until the Bureau of Tuberculosis is established. —o— The Boy Scouts will assist the Ra-leigh Nurses' Society in rendering first aid to the sick or injured at the Fair. An army tent will be provided, and the lives, health and comfort of the people will be looked after as never before. Health is purchasable. Within nat-ural limitations a community can determine its own death rate. — — Have you entered your baby in the Better Babies contest? Better get busy if you want to have any choice in the matter of time to be judged. The schedules are filling up rapidly. —o — Right now is a bully good time to start a campaign for a sanitary privy ordinance in your town. Have it go into effect January first, and have no old, open privies in your town next summer. —o Over .$400 in prizes for Better Ba-bies at the State Fair, but that is the least important feature. The in-formation the children's specialists v.'ill give the mothers will be worth ten times the value of the prizes. — — If a murderer were slipping up be-nind you, you would thank somt friend for telling you in time to make your escape and reporting the matter to the police, or would you prefer not to be told for fear it would scare you to death? The same thing applies with reference to tuberculosis. If you have tuberculosis, the sooner you are told and the sooner it is reported to the State Board of Health, the more chances you have to make your 'get away." THE BETTER BABIES CONTEST What it is, How it is Conducted, Prizes Offered, Results Expected and How to Enter. Last month we announced the Bet-ter Babies Contest to be held at the State Fair October 20th to 25th, under the direction of the State Board of Health. This announcement must have been just what our readers were looking for. As soon as the Bulletin went out applications for entries and inquiries liave poured in at an alarming rate. They have been coming from parents, rich and poor, in all stations of life. We have had to make larger arrangements at the fair grounds, ar-range for more judges, provide rest tents for tired mothers and sleepy ba-bies, and arrange everything on a larger scale than at first contempla-ted. Many inquiries still come in re-garding the details of scoring and how the babies are graded. For the bene-fit of our readers we here give a few extracts from the score card just to give an idea of the nature and scope of the contest. When the mother and child arrive they will be received by a doctor and a lady from the Reception Committee. The doctor will examine the child for indications of contagious or infectious diseases while the lady will proceed to enroll the child in the contest. Should any babies be found with con-tagious diseases it will be necessary to exclude them from the contest. The ladies will explain the object of the contest and any details con-nected with it. At the same time they will record the child's name, age, sex, weight at birth, whether it is breast fed or bottle fed and on what foods, frequency of feeding, number of teeth, whether or not it sleeps alone, or with the windows open, as well as the name, age and occupation of father and mother. All this gives the physicians a better understanding of each individual baby. From the reception room the mother and child pass to tlie mental test room. In the accompanying cut is shown a two-year-old b^'y taking a Giving a two year old boy a mental test. mental test. We cannot give all the tests for the various ages, but as an example of these tests it may be stated that a baby twelve months old should be able to sit alone, stand and walk with a support, should play with toys, lis-ten to the ticking of a watch, look in the direction of unexpected noises, follow moving objects with his eyes. He should also speak a word or two, recognize nis mother (shown by. cry-ing or uneasiness when taken away from her) play with other children THE HEALTH BULLETIN. 117 and be interested in liis surroundings. He sliould not be highly nervous, ir-ritable or have an exceeding bad tem-per. Of course the mental require-ments will vary for different ages. This mental test counts 100 points out of a total of 1,000 for a perfect baby. After the mental test the baby is taken to the measurement room where he is weighed and measured. ftCNCE OF HEAD TO -FRONTAL) UMFEftlNCe CHEST AT NIPPLt NE RCUMFERENCB F ABDOMEN AT NAVEL OF LEG FROM ROCHANTEI^ " OF FOOT Where four important measurements are made. The accompanying cut shows where four important measurements are taken. We quote here a few standards for babies of 6 months, 12 months, 24 months and 36 months of age. The other ages are in proportion. The weights and measurements also count 100 points out of the total 1,000. From the weighing and measuring room the baby and mother enter the last room, where the physical exami-nation is given. There the doctors carefully examine baby's eyes, ears. nose, teeth, throat, chest, abdomen and in fact every part of the body. This is by far the most important examination and counts 800 points 118 THE HEALTH BULLETIN. these prizes will range from about $15.00 for the first prize in each class to about $1.00 for the fourth prize. Then besides the money prizes there will be four championship prizes for the four best babies in the State, boy or girl any age. These State champion-ship prizes consist of gold, silver and bronze medals together with beautiful certificates of reward. The Woman's Home Companion is furnishing these medals and certificates besides $100 in cash for the other prizes. Governor Craig has just promised the managers of the contest that if possible he will arrange to present the prizes to the champion babies on Fri-day afternoon at 4 o'clock, immedi-ately after the close of the contest. Entries are pouring in to the office of the State Board of Health rapidly and arrangements are being made to accommodate about one baby every five minutes. While it will take from 20 to 30 minutes to judge a baby enough doctors will be provided so that a baby will be judged every five min-utes. Two large rest tents with cots will be provided for the convenience of the mothers and babies. These tents will be in charge of trained nurses and mothers may leave their babies there in safety while they visit the fair. Everything possible will be dune to provide for the health, happi-ness and comfort of the mothers and babies. Many mothers are entering their babies not so much for the prospect of winning prizes but as an endorse-ment of the movement for the satis-faction of knowing how their babies compared with other North Carolina babies and for the benefit of experts' advice in regard to correcting any slight defects which may be found. It is already planned to offer a special set of prizes next year for the babies who were entered this year and show the greatest improvement made dur-ing the year. To be eligible to enter that contest it will of course be nec-essary to enter the present contest. Entrance to the contest is easy. All that is necessary is to write the State Board of Health stating the day you expect to attend the fair and the most convenient hour to have the baby judged. You will then be sent an entrance card with an appoint-ment as near the hour mentioned as it is possible to make it. Then if you will present the baby and card at east wing of Floral Hall at the ap-pointed hour, the baby will be judged and scored on his physical merits. "With their parents' consent, some good, first class babies will be weighed, measured and examined in public at the State Fair in order that the people may see how part of a Better Babies Contest is held. How do we get hookworms? Easily enough. Somebody else who did not use toilets and sewers or a sanitary privy polluted the soil. Our barefoot children soiled their feet in this ma-terial and a case of "ground itch" de-veloped. That meant that the little hookworms from this filth were bur-rowing their way into the child's sys-tem at this point. After that, the child gets tired easily, fails to grow right, or, if a severe case, it becomes puny and sickly. To cure and to prevent hookworm, write the State Board of Health. _q_ A Toast. Heard at the Maggots' banquet in the Manure-Box: Eat, drink and be merry, for to-morrow we'll be files. — Ex. THE HEALTH BULLETIN. 119 NURSING THE BABY A baby should always be nursed by Its mother, unless the mother has tuberculosis or some other grave dis-ease. The mother saves herself trou-ble by nursing her baby. When she figures up the saving from diminished illness and adds to it the trouble of fixing the baby's bottle during the night as well as the day, she finds that she nets a gain by nursing her baby. During the first two days the baby should be nursed four times a day and once at night. From the third day to six weeks the baby should be nursed every two hours during the day and twice at night ; from six weeks to six months every three hours and once at night; from six months to a year, six times between 6 o'clock a. m. and 10 o'clock p. m., and not at all during the night. In addition to milk, babies require water from the very first. The old granny who gave the baby teas was a pretty good scientiest, though she did not know it. Of course, the herbs which she used to make the tea had no particular effect, but she was giv-ing the baby sterilized, warmed water, and that was as it should be. After about the second month the baby should have some orange juice every day. The juice should be given freed from pulp. The amount should begin with two teaspoonfuls a day and should be gradually increased to four tablespoonfuls, especially where there is a tendency to constipation. It is much better to relieve constipa-tion with orange juice than by ene-mas, and certainly than by medicine, since babies need a little fruit juice to correct any tendency to scurvy and rickets. That the mother may give enough milk to supply the baby, it is neces-sary that she be free from worry and not called upon to do a great amount of physical labor. Emotion has more effect on the secretion ct milk than does the food taken. Oc-casionally a woman will overeat un-til she becomes obese trying to give milk enough for her baby, and then worry so, fearing her milk will fail, that she gains nothing for her trou-ble. There are no special foods which make milk. Beer does not; neither does milk. Some women have the idea that milk taken as a food run» without much change Into milk for the baby. This is not correct. A mother should eat good, nutritious, simple, staple food containing a good deal of fluids. That which she eats does not go directly to milk. It is digested and changed chemically thereby. It Is ob-sorbed and still further changed Eventually it is changed Into milk. She should increase the quantity of food eaten, since, for her own use,, she needs more than she usually does, and, in addition, she is eating; for the baby. The average woman nursing out* baby can supply the child with food out of her surplus if she will keep her mind calm, her rest unbroken, and not have too much work to do. The average woman who thinks she cannot nurse her baby can do so if she will try.—Dr. W. A. Evans, in Chicago Tribune. — — Next year a special set of priaes goes to those babies who make the greatest improvement during the year. Enter the baby this year to get In on the improvement prizes next year. A poor baby has the best chance to win here. k 120 THE HEALTH BULLETIN. WHY I AM DOWN ON PATENT MEDICINES Simply Because They are Expensive and More Likely to do Harm Than Good. Mr8. W. N. Hutt, in the Progressive Farmer. Hardly a week passes that I do not receive a letter giving simple home recipes for ailments. I am always glad to get them and expect to make use of most of them, as I am filing them for future reference. In sev-eral letters I have received are ex-pressions such as this: "I know of some good patent medicines, but since you are down on them you would not want to hear about them." Listen. Are you "down on" the weeds in your garden? Are you "down on" the lice on your chickens? Are you "down on" the root-worm in your corn? No, you are not "down on" them. You have studied them and their methods and you know that they lower the vitality and useful-ness of the crop. Just so, one of my purposes in spending those years of study of domestic science was to gain a knowledge of the body and the healthfulness or harmfulness of those things which affect it, as the farmer studies those things which affect his crop. In advertising against the use of them I am not "down on" them. I simply recognize their harm as any-one may do if she cares to read the literature published by the United State. Government and the American Medical Association. We all recognize the fact that there is no known drug that will be "sooth-ing syrup" to the baby except one which temporarily paralyzes the brain. We know that the headache medicines are heart depressants, and so on through the list. It does not take much thought to realize that with each succeeding dose the body reacts less and less—but how many have not taken the time to think? Nor are the patent medicines the only ones that harm. Turpentine and sweet spirits of nitre are exceed-ingly hard on the kidneys. A physi-cian might have given them to Mrs. Smith, who recommends them so highly to you, but he who had made medicine a study would never in the world have though of letting you take them, because your kidneys were not strong enough for the extra strain. "But," I hear someone say, "what is in it is on the outside of the bottle." Next time you go to town buy the published ingredients instead of the medicine and see the result. If by any chance you should get a similar result—which you will not—you will find that paying retail prices, you can make quarts for the price of a bottle of the stuff. All the large patent med-icine makers of whom I know have grown exceedingly wealthy with dol-lars from the pockets of country peo-ple. The point is, let us pay our money to the physician who knows us and gives us the results of knowledge in return for our dollars, but let us also realize that God gave us the finest medicines in the world free, air and water and sunshine, and the oppor-tunity to study foods, and the intelli-gence to get them pure and whole-some, well cooked and well balanced. Hard work does not kill; hard living does. Hard living means using the body badly. Three meals of pig meat or food cooked in it mean lessened health and energy; three meals of pure milk and fresh fruit are good and medicine and mean increased health and energy. THE HEALTH BULLETIN. 121 FREIGHT RATES AND THE REAL ISSUE On an average, for every death dur-ing a year, there are two persons sick throughout the year. Over 40 per cent of all our deaths are either pre-ventable or postponable. Therefore, of our 40,000 North Carolinians who were last year swept into the great beyond, something like 16,000 should be with us today. No, it is not God's will that we should let all these our brethren die needless deaths. Don't blame it on the Almighty. We are our brother's keeper. He has given us ample means of stamping out preventable disease, but we don't use them. It is up to us. We might as well admit the facts. Here they are: 16,000 North Carolin-ians are being sacrificed annually on the altar of ignorance and lethargy. Within the memory of some of us, common laborers were bought and sold for from 750 to $1,500 apiece. May we assume that the average value of these 16,000 of our loved ones is $1,700 each, or a total of over $27,- 000,000? That is a tremendous loss to our State — a heavy drain on our State's wealth. We have 80,000 North Carolinians sick the year around. Half of this sickness is preventable. That leaves our needless sick loss at 40,000 for their entire time. Assuming that one-third of our sick are in the earning or productive period of life and earn on an average only $700 a year, we have, therefore, 13,300 times 700 or over $9,- 000,000. Add $9,000,000 more for med-icine, nursing, and special fond, and we have over $18,000,000 as our an-nual loss from sickness. This makes a total annual loss to North Carolina of $18,000,000 plus $27,000,000, or over $45,000,000 annually. Talk about conservation of national resources—here's the greatest oppor-tunity open for us today. No other opportunity will compare with it. When it is estimated that our State loses as much as $5,000,000 annually in excessive freight rates, we hold con-ventions and conferences, we organ-ize and call extra sessions of the Legis-lature; but when we lose $45,000,000 worth of our best North Carolina citi-zenship no one gets excited, no one talks of an extra session. Why? The main trouble is that most of us don't know that we are suffering a loss of $45,000,000 annually. Many of us that do know it don't know that the loss is preventable. When we once recognize that this $45,000,000 is a preventable loss and can be stopped, we will take up the main issue. We will begin public health work in earnest. As it is now, there is practically no public health work done in over 85 per cent of the counties. The only work done there is what the State Board of Health can do through its health liter-ature, lectures, and various campaigns. CHRONIC CONSTIPATION What it Does, Hov^^ We Acquire it, and the Rational Way to Treat It D. H. Kress, M.D., in October Life and Health. Chronic constipation exists to an alarming extent among all highly civ-ilized peoples. It is, in fact, the prod-uct of high civilization. It does not prevail among animals or among sav-ages, whose habits are natural. 122 THE HEALTH BULLETIN. We have not appreciated in the past the relation constipation sustains to many of the diseases of a chronic or constitutional nature. Diseases of degeneracy, which have been ascribed to various causes, we now know are due chiefly to the toxins absorbed from the colon as a result of consti-pation. From cases which have come under my observation during the past few years, I have been led to recognize constipation as the chief causative factor where insomnia, thickly coated tongue, bad breath and high blood pressure are present, when a specific origin is excluded, and when no his-tory of the free use of tobacco or other toxic substances exists. In fact, I have concluded that it is not the excessive use of meats, tea, coffee, tobacco, etc., that is wholly responsi-ble for arteriosclerosis, but toxins of a more injurious and subtle na-ture developed in the alimentary canal, and especially in the colon. These poisons are likely to be formed as a result of the prolonged retention of waste substances which readily undergo decay. Not only do meats, tea, coffee, pepper and mus-tard tend to bring about these de-generative changes by the toxins they contain, but they favor constipation and the formation of poisons even more injurious. In chronic constipa-tion we have probably the chief factor of degenerate arteries, heart, liver, kidneys, thyroid glands, and other glands of the body. There is strong reason to believe that it is largely responsible for the rapid increase in the mortality rate from heart failure, apoplexy, diabetes, and Bright's dis-ease. In diabetes and Bright's dis-ease there practically always exists a history of constipation. There are many annoying disorder^ of every-day life, among which may be mentioned dyspepsia,, i headaches, drowsiness, melancholia, insanity, which may be due to chronic consti-pation. Appendicitis seldom occurs in a person whose bowels are regular. From the prolonged retention of the easily putrefying wastes, a diseased condition of the mucous membrane of the cecum results. This latter ex-tends into the mouth of the appendix, and an inflammatory condition is es-tablished. There is a probability that cancer is in some cases traceable to the toxins absorbed from a stagnant colon. It would be difficult to conceive of anything more defiling to the body than the decay within it of fish, oys-ters, rabbits, cheese, and other pro-tein foods, and the absorption of the resulting impurities and poisons. Cells bathed in such a liquid become diseased. A blocked-up city sewer is recog-ni ed as a source of danger and is not tolerated, but here we have a condi-tion that is very much more offensive and dangerous, and yet very little se-rious thought is given to it. Over thirty per cent of the pres-ent mortality is ascribed to this cause by Prof. Eli Metchnikoff, who has made a careful study of the influence of these poisons on the hu-man body, and who believes this to be the chief cause of early degener-acy and premature old age. His con-tention is that by preventing the form-ation of these alimentary toxins, man might be at his best at eighty years, be still active at one hundred and twenty, and live to the age of one hundred and forty. He has been driven to some conclusions which r^ay seem almost absurd, and yet, reasoning from his viewpoint, they are logical and conclusive. Chronic constipation is more com-mon than is supposed. In extreme THE HEALTH BULLETIN. 123 cases tht/e exists a movement once in two or three days, and in excep-tional cases evacuation of the bowels occurs only once a week. A natural evacuation of the bowels once in twenty-four hours is consid-ered a normal condition. This is a misconception. One evacuation a day is not sufficient. A bowel move-ment should be secured at least twice a day, or, better still, after each reg-ular meal, in order to safeguard against putrefaction, and the absorp-tion of toxins from the colon. It is surprising how easily this habit may be established and main-tained. When once established, the desire naturally recurs after each meal, for the ingestion of food into the stomach sets up a peristaltic wave which travels along the entire alimen-tary tract. In fact, it is less difficult to evacuate the bowels twice daily than once daily. Where but one movement occurs daily, the moisture is absorbed from the feces, and a plug forms in the rectum. The contact of this hard mass benumbs and destroys the sen-sitiveness of the parts. The rectum having been restored to a normal con-dition the desire to defecate occurs as soon as feces reach it. The stools are never hard, the consistency being practically the same all the time. The best time to evacuate the bow-els is shortly after regular meals. The taking of food on an empty stom-ach is a most powerful stimulus to the motor activity of the colon. During meal-time the contents of the colon make more progress than dur-ing four hours preceding the meal. It is quite important that the stomach be empty before introducing food. Frequent meals and eating between meals do not impart this stimulus and hence tend to cause constipation. Regularity of meals, at all events, is a necessity in overcoming this condi-tion. The same regularity should be established in securing bowel evacu-ations. The establishment of a right habit is as effective in getting rid of consti-pation as the establishment of irregu-larity is in its causation. It is neces-sary, therefore, to have a stated time to go to stool. If success does not attend the ef-fort the first week or even the first two weeks, the thing to do is to keep up the practice. A little assistance may be given by the injection of a cupful of cold water, or the introduc-tion of a suppository; a soft prune or a date, turned inside out, will answer for this purpose. While I do not as a rule recommend laxatives, in order to establish regularity it may be well to take a mild laxative each night before retiring, for a week or ten days. Agar-agar is of value. About two tablespoonfuls soaked in a little hot water and eaten with apple sauce or some other stewed or canned fruit should be taken with the morning and evening meal. This should be kept up for at least a month. Agar-agar may be secured in any drug store. If the druggist does not have it, he can procure it, as it is regularly used in all bacteriological laboratories. Liquid paraffin is also of value in very obstinate cases. The dose is one dessertspoonful twice daily at first. These preparations can be gradually given up. The purpose of their use is to establish regularity and the formation of a correct habit. The food is of the greatest impor-tance. Foods which tend to consti-pate should be given up. Meats should be used moderately, if at all; it is better to give them up all to-gether. Tea, coffee, cocoa, chocolate, pepper, mustard, and other substances which cause constipation, should be 124 THE HEALTH BULLETIN. abandoned. The tannin extracted in st3eping tea is especially bad. Laxative foods are of value. Among these may be mentioned bran crack-ers, whole-wheat or Graham breads, shredded wheat biscuits, whole-wheat biscuits, puffed wheat, etc. The following vegetables are valua-ble: parsnips, carrots, turnips, spin-ach, raw vegetable oysters, cabbage, etc. The sweet fruits are all laxative. Prunes, figs, dates, etc., are of value. In the use of the foregidng foods, care must be exercised in their com-bination. In cases where irritability of the stomach exists, with an excess of gas-tric juice, the above foods should be used sparingly; and where the condi-tion borders on ulceration, they should be entirely avoided until im-provement occurs. The agar-agar and paraflBn are es-pecially helpful in these cases. Agar-agar supplies the bulk, but is nonirri-tating, while the parafBn is a splendid lubricant. Where digestion is slow and the gastric juice diminished, the foods referred to are indicated. There are local and general treat-ments and exercises which are great aids in overcoming constipation, but diet alone will accomplish marvelous results if persevered in. CHEAPER SANITATION One thing in North Carolina sani-tation stands head and shoulders above everything else when it comes to getting the greatset results for the least money. It is the entire solution of the hookworm problem, the solu-tion of over half the typhoid fever problem, a great share of the problem of so-called "summer complaint," and a big factor in the fly problem. It is nothing more or less than the adop-tion of the sanitary privy everywhere, where access cannot be had to sewers. It is an easy thing to show any intelligent person or board of alder-men that the lack of sanitary privies is the cause of the continuation of all our hookworm disease, half our typhoid, and much of our diarrhceal diseases, to say nothing about flies. However, when you tell such a per-son or board that a sanitary privy made of iron, wood and concrete costs upwards of $25, you give them cold feet, and of course no such privy is built. We now know that it costs no more to build a sanitary privy than it formerly cost to build an in-sanitary one. If the individual has to furnish the cans it will cost him some 50 cents or sixty cents extra for each can, where he used to have to pay $1 or more. For cities and towns it is recommended that munic-ipalities own and clean the cans. The State Board of Health is now securing proposals from several can manufacturers for prices on stand-ard privy cans. Of course, the Board cannot advertise any one make of can to the exclusion of others, but it ap-pears that one or two manufacturers are able to make standard cans meet-ing the specifications laid down by the State Board of Health for between one-half and two-thirds the price for-merly charged, when bought in lots of 100 or more. By addressing the Board interested parties may secure the benefit of the best proposals re-ceived by the Board for such cans. THE HEALTH BULLETIN. 125 WHAT IS THE MATTER WITH YOUR STOMACH? Samuel Hopkins Adams, in the Ladies' Home Journal. The American stomach is a gener-ally condemned organ. We tend to hold it criminally responsible for all our lesser ills. Nearly half of all medical advertising is aimed at the stomach. As a matter of fact our di-gestion is as sound as any of our func-tions. The trouble isn't with our stomachs. It is with our heads. We lack common sense about our proces-ses of nourishment. Nine-tenths of the digestive disorders which lead to the doctor's office or to the hospital are not only preventable and avoida-ble, but, medically speaking, they are inexcusable. In other words, almost all of our troubles of this sort are due to our own stupidity. "The average man," says a noted authority, "never considers his stom-ach until it fairly yells for help." Now the human stomach is a bag, equipped with nerves and supplied with gastric juice which serves to di-gest food. It is not an absolutely es-sential portion of the anatomy. Peo-ple get on very well and comfortably with half a stomach or a third, or even a fourth; and, at a pinch may live without any at all, the small in-testine making shift to do the work of digestion. But normally the stom-ach is there to receive food, digest it, extract from it the energy neces-sary for the running of the human machine, and pass the residue on to the intestines for disposal. The pro-cesses are highly intricate in detail and, in some phases, still mysterious (nobody can tell, for example, why the stomach doesn't digest and de-stroy itself) ; but, in normal condi-tions, they are carried on so capably and quietly that the body is no more awara of them than of the circula-tion of the blood. When we become conscious of our digestion it is be-cause something is wrong with it. MIND WHAT YOUR STOMACH TELLS YOU ABOUT FOOD Every stomach has its little eccen-tricities and inhibitions. This one says: "I cannot digest salt fish." Another warns: "Don't give me pre-served strawberries, for I won't have them." A third ordains: "Anything but honey." Or bananas. Or smoked meat. And so on. There is but one rule to cover all these cases: Mind what your stomach tells you; it knows best. In a broad general sense it may be said that we pamper ourselves too much in the matter of food. Over re-finement is a prevalent fault. We eat too much delicately prepared and highly seasoned food and too little coarse and simple food. Processes of preparation sometimes devitalize our viands. Certain nourishing qualities are polished out of the shining white rice which we get exclusively. Our oatmeals are refined down to a point where only half of their value is left. And the white flour which is so gen-erally used lacks certain essential at-tributes. Whole-wheat bread is given only medicinally nowadays, yet whole-wheat flour is the natural flour, and if it were in common use a majority of those who depend upon laxatives to aid their digestive processes could cast away those noxious drugs. The same is true of uncooked fruits and vegetables. A considerable por-tion of the virtue of our vegetable foods goes up the kitchen chimney. How many people come back from a vacation in the wilds feeling as if they had acquired a brand-new diges-tion and talking enthusiastically ^ 126 THE HEALTH BULLETIN. about the tonic effect of mountain or forest air! Doubtless the air helped in the matter of general condition. But as people don't feed on the atmos-phere to any great extent it hasn't much immediate effect upon the stom-ach. What reconstitutes the camper's interior is the fact that he eats plain food, simply prepared, and gets exer-cise enough to make him digest prop-erly. It may sound like heresy, but it Is a fact that it doesn't really mat-ter greatly what we eat—in condi-tions of sound health, that is. S -me food is better than others, but most of it is pretty good. The healthy stomach is willing and able to take care of any reasonable article which is sent down to it. Only when it is impaired does the owner need to give much thought to diet. In fact, to be continually worrying over the stomach, to exclude this article of food lest it be indigestible, and to eschew that because it might "dis-agree," to be continually narrowing down the appetite—all this worries the stomach and makes it unhappy. A specialist of wide experience and a somewhat unconventional habit of thought suggests the following rules to be framed and hung in every din-ing room: Eat what you want, and all you want of it, but not more. Don't eat when you're not hungry, just because it's meal-time. Take your time over it. Remember that enjoyment of food is the best of known digestives. WHAT IS INDIGESTION? Most familiar to the physician of all forms of complaining is this: "Doctor, my digestion is bad." In perhaps half the instances the re-verse is true. The patient's digestion is not bad; it is good. In fact, it is too good. OverefBciency is what causes the difficulty. The stomach, stimulated into overwork, produces too great a flow of gastric juice, and a condition of hyperacidity results, causing the familiar "sour stomach," with uneasiness, fullness* and some-times pain. It may arise from causes not connected with food, such as overindulgence in smoking or alco-hol, or continued nervousness. In the early stages it is readily corrected by adjustment of habit and diet, and by rest, particularly after eating. Once fixed it is ugly and obstinate. But the stomach always gives warn-ing of its onset, and the man who allows himself to fall into this condi-tion has only himself to blame for it. One absolutely and universally in-digestible thing there is. All author-ities agree upon this. It is worry. No stomach can do anything with it. The stomach is simply incapaci-tated from doing its work properly when the mind is harassed. Far more digestions are ruined by mental than by physical causes. "Hurry and worry are the twin curses of the twentieth century stomach," one physician put the mat-ter, "and worry is the worse of the two. Give me a man who has sys-tematically lived on the poorest and most indigestible food, but has eaten it with a mind free of taint, and I'll take his case with far more confi-dence than that of the most carefully nurtured person who regularly brings a harassfccl spirit to the dinner-table. There is a good deal of truth in Stevenson's picturesque reference to the dining-room as the battlefield upon whi3h most of our ancestors have left their bones; but it wasn't the flesh that they ate, but the spirit in which they ate it that killed them before their time. The most difficult lesson I have to teach my patients is that the stomach is a highly imagina-tive piece of mechanism; largely gov- THE HEALTH BULLETIN. 127 erned by the mind. Under the wrong nervous stimulus it will either quit work entirely or race like the lifted screw of an ocean liner. But the typical patient declines to be im-pressed by this, and demands drugs and treatments and training to do the work which his own mind could do with a little determined effort." Because of their specious prnmises of immediate relief the "patent med-icines" secure many patrons from among the hopefully credulous. Usu-ally these pills and powders are ca-thartics. Their use, continued, soon establishes a hold upon the trustful believer in their virtues. Probably the cathartic habit is the most widely prevalent addiction in the United States today. Comparatively harmless in the early stages of use, these drugs create a demand for a con-stantly increased dosage, as the sys-tem becomes habituated to them, un-til at length the victim finds himself a slave to them. The ordinary pro-cesses of Nature become paralyzed without them. Then, as he repeatedly lashes his intestines into action by this means, an irritation is set up which has serious and far-reaching results. Fully one-third of the cases of obstinate constipation which come to the specialist show a history of cathartic habit. "The worst of all common errors," says an expert, "is to overload the stomach and then appeal to purging drugs to carry off the surplus." A certain "patent medicine" fosters this serious error by advertising that a person can digest anything by tak-ing the pills regularly. This is the kind of advice which makes dyspep-tics. As a matter of fact not one per-son out of a hundred would need lax-ative medicines if ordinary care were taught from childhood. The stomach and bowels are very much creatures of habit, and it is really easier to maintain them in good hab-its, which are natural to them, than to teach them bad ones. Torpid bowel action, the common-est of complaints, is almost invari-ably due to neglect and carelessness, and to thac alone. Even when it be-comes fixed it can generally be cured, by patient attention, without recourse to drugs. Liberal amounts of water, either hot or cold, immediately upon rising, followed by a hearty breakfast in-cluding stewed or raw fruits and whole-wheat bread, will be found more efficacious than any of the widely advertised nostrums. COMMON-SENSE RULES FOR DIGESTION To set forth comprehensively rules for restoring to health a deranged di-gestive system would more than fill this magazine. To set forth rules for preserving in health a sound stom-ach is a short and simple matter. The following represents a concensus of advice given by leading authorities on gastric and intestinal ailments: Eat well-selected, well-prepared food, the simpler the better, chewed thoroughly with sound and clean teeth. Eat it deliberately; never bolt your good. Don't be a faddist; whatever you like is good for you in moderation. Use tobacco and alcohol moderately if at all, but remember that they are irritants even in the smallest quan-tities. Shun cathartics and laxative drugs. Obey the natural orders of your stomach and intestines. Don't harry and shock your stom-ach with iced concoctions. Never eat when very tired or un-der emotional or nervous stress. Above all, don't mix work or worry with your meals. 128 THE HEALTH BULLETIN. The man or woman who follows time; but at least, for that one, death these primary regulations will still will not be hastened nor life poisoned have left a reasonable range of ills b/ the too common torments of indi-from which to die in the fullness of gestion and dyspepsia. BRICKBATS AND BOQUETS Last month several changes were made in the Health Bulletin. At the same time we offered our readers a "come back" in this issue of the Bulletin in order to find out how they liked the changes. It was planned to head the department "Brickbats and Bouquets," but so far the department lacks the variety we had hoped it would have. We are anxious to have some good stiff con-structive criticisms. It won't hurt our feelings. We simply want to know how to make the Bulletin more valuable to our readers. Here is what a few of our readers said: "I congratulate you on the "tiurrent issue of the Bulletin. I wish you to send me 200 copies if available and place the following names on the mailing list. * * * "J. Howell Way, ''President State Board of Health." "Many thanks for the Health Bul-letin. It is fine. "Anna Steese Richardson, ''Woman's Home Companion." "1 have just run through the Sep-tember Bulletin. I didn't know who was editing it until I reached the last word. If power to interest and instruct makes good editing, my ex-perience with this number is evi-dence that you are a success from the start. "You and Rankin are engaged in the most useful business that I know of. J. W. Bailey, "Collector Internal Revenue." "The September issue of the Bulle-tin is jusy 'bully.' Keep at it. You are on the right track. The brevities are fine; the 'Brickbats and Bouquets' I am sure will be popular. "Geo. a. Wood, "Nazareth Catholic Orphanage." "I think the September Bulletin is excellent. I have enjoyed it thor-oughly. Dr. Wm. S. Jordan." "I am very much interested in your monthly Health Bulletin. This month's issue is very good. I have often wished that everybody in the State could read it each month. "Geo. Y. Watson." "I certainly did enjoy reading your last Bulletin—the September num-ber. B. F. Montague." When a thing reaches the point of becoming a problem, there is hope. It is the utter indifference to the serious-ness of the health situation that has made the death rate so high and the life interest so low. When men made public the appalling waste of life, the public made assault upon them for their "unpatriotic" exposure of home conditions. Health reformers have to fight their way, as every other re-former has had to do, and it is now ac-cepted that the so-called "fancy dis-eases" are not fanciful and that pre-vention of more than half the deaths should be easy.—W. T. Bost in The News and Observer. i/ SANATORIUM SPECIAL 1 This Bulklinwillbe -sent free to arxg citizerN of the Stcrte upoa request j Published monthly at the office of the Secretary of the Board, Raleigh, N. C. Entered as second-class matter at Postoffice at Raleigh, N. C, under Act of July 16, 1894 ol. XXVIII. NOVEMBER, 1913. No 8. "Public health is purchasable. Within natural limitations a community can determine its own death rate. " CONTENTS •'Mechanical Fakes": The Electropoise—Oxypathor 132 Yadkin County Decides to Spend $200 a Year on Health 134 A Girl's Encouragement 135 Typhoid Vaccine Free I35 Mental Hygiene Conference and Exhibit Coming 136 Charlotte's Campaign against Typhoid I37 The Death Rates of Wilmington I37 Mr. Mayor : This for You I39 The State Sanatorium 141 (a) State Tuberculosis Policy 141 (b) The Cost of This Policy I43 (c) Requirements for Admission I43 (d ) Location of Sanatorium I45 (e) Site of Sanatorium I45 (f) Equipment of Sanatorium I45 Sanatorium Staff -^M (a) Dr. Wilson Pendleton I47 (b) What Others Say of Dr. Pendleton 147 (c) Business Management 151 > > m • I PUBLI5ME-D BY TM^ noR.TA CAI^OLIMA 5TATL BOAgP °^MEALTM J. Howell Wat, M.D., President, Waynesville Richard H. Lewis, M.D., Raleigh. J. L. Ludlow, C.E., Winston-Salem. W. O. Spencer, M.D., Winston-Salem. Thoma.s E. Anderson, M.D., Statesville. Charles O'H. Laughinghodse , M.D. Greenville. Edward J. Wood, M.D., Wilmington. A. A. Kent, M.D., Lenoir. Cyrus Thomp.son, M.D., Jacksonville. W. S. Rankin, M.D., Secretary and Treasurer, Raleigh. Vol. XXVIII. NOVEMBER, 1913. No. 8. "MECHANICAL FAKES *' The Electropoise -- Oxydonor -- Oxygenor -- Oxygenator Oxypathor -- Oxytonor. "It is sometimes hard to decide wtiich. is the greater—the impudence of the quack or the credulity of his victims. The comparative ease with which the medical faker is able, by the most preposterous claims, to sep-arate the trusting from their money indicates the enormous potentialities in advertising. It might be supposed that an individual who set out to sell, as a panacea for all the ills of the flesh, a piece of brass pipe with one or two wires attached to it, would, commer-cially speaking, have a hard and rocky road before him. But such a suppo-sition would be incorrect. Not only would the enterprising faker find cus-tomers for his gas pipe, but there would be such a demand for this most inane of 'therapeutic' devices that two or three imitators would immediately enter the market." Sanche's Inventions. The American Medical Association's expose tells how one Hercules Sanche, self-styled "Discoverer of the Laws of Spontaneous Cure of Disease," became the original exploiter of mechanical fakes. "Sanche's first and simplest gas pipe cure device he called the Elec-tropoise." The shrewd Sanche realized that, in order to patent his device and at the same time prevent physicists and chemists and other scientists apply-ing laboratory tests to the device and exposing it as without any known physical, chemical or other influence, it would be necessary for him to "discover" and attribute to his gas pipe cure some hitherto and thereafter un-recognizable power; so he said that the instrument rendered the body oxy-gen positive; that is, that it made the body absorb larger quantities of oxy-gen. He later named this newly "dis-covered" power "Diaduction." Oh, you needn't look in the dictionary; the word isn't in it. No one, Sanche argued, "had ever realized before that by attaching a piece of nickel-plated brass tubing to the body by means of a flexible cord the system could be made to absorb oxygen." Of Diaduction Mr. Justice Shiras, of the United States Supreme Court, says: "I am entirely certain that I do not understand the working of this so-called force, if any such exists, and I THE HEALTH BULLETIN. 133 greatly doubt whether Dr. Sanche has any clear conception of the force or principle which he seeks to describe under the name of 'Diaduction.' " Other judges have said: "From the record evidence we have tried to get some intelligent idea of 'diaduction.' We have failed utterly." And again: [The theory] "is a mere pretense, that is to say, a theory not entertained by the inventor in good faith, but put forward as an imaginary hypothesis merely for the purpose of obtaining a patent on a very simple contrivance, which was not patentable unless the claim was reinforced by some such pretended discovery." The Progeny of the Electropoise. From Sanche's original idea, em-bodied in the Electropoise, there de-scended the whole family of "Mechani-cal Fakes," to wit: The Oxydonor, Oxygenor, Oxygenator, Oxypathor, and Oxytonor. The members of this family bear well marked family resemblances. They all consist of nickel-plated metal tubes with closed ends. To this tube is at-tached one or more flexible cords, which end in a strap to be buckled or attached to some part of the body. The Electropoise was empty ; the Oxydonor contained a stick of carbon; the Oxy-genor contained sulphur, sand, and charcoal; the sulphur and sand to-gether comprising 97 per cent of the whole. The Oxygenator also called the Oxypathor, according to the Lab-oratory of the University of Vermont, "is filled with a black powder, which analysis disclosed to be a crude mix-ture of inert substances, apparently the waste or by-product of a manufac-turing plant. * * * The powder is a rough mixture of iron filings, clayey material, and a dark-colored carbon-aceous mass, * * * apparently nothing more than coke dust or carbon-black." The family resemblance is again ap-parent in the claims as to their mode of action. They are all claimed to act by "diaduction," or by causing the body to absorb oxygen. They claim also to cure practically all diseases, with the exception of cancer and tumor and far advanced consumption. The ex-ception made is probably for the pur-pose of avoiding prosecution under the federal law that prohibits a consider-able amount of fake cancer cure ad-vertisements. The Oxypathor. According to "Nostrums and Quack-ery" it would seem that the Oxypathor is the youngest member of the family group or the last alias adopted by Sanche's original idea. "In many ways," says Nostrums and Quackery, "this last type of gas-pipe cure is the worst, inasmuch as claims are made for it that are not only ab-surd but dangerous. For instance: 'Diphtheria: This overwhelming child's disease finds its supreme master in the Oxygenator. No earthly power except the Oxygenator can take the slowly choking child and with speed, simplicity and safety bring it back to health. 'Don't jeopardize the health and life of your children by allowing to be in-jected into their veins and blood the often fearfully contaminated and death-dealing serum of an animal, otherwise known as antitoxin.' "It is difficult to restrain one's indig-nation at the thought that such vici-ously cruel lies as these are permitted to be scajttered broadcast. Let the neurotic and neurasthenic adult, if he can convince himself that a nickel-plated piece of gas-pipe possesses curative properties, experiment with it on his own person if he wishes. But that a helpless child in the throes of a fearfully dangerous—and yet, rightly 134 THE HEALTH BULLETIN. treated, curable—disease, should l:e al-lowed to suffer and die because ig-norant parents have been persuaded to reiy on these mechanical frauds, is no less than criminal. As for the miserable harpies who for a few filthy dollars will write such cold-blooded untruths as those quoted above, the safety of society demands that they be put where they can do no further harm." "The State Board of Health of Ver-mont declared the Oxygenator to be 'physically and therapeutically inert' and prohibited the sale of the fraud." Summary. "To sum up: The 'Electropoise,' the 'Oxydonor,' the 'Oxygenor,' the 'Oxy-genator (or 'Oxypathor') and the 'Oxy-tonor' are utterly worthless except as a means of enriching their exploiters. Their therapeutic value, aside from the element of suggestion that may be induced in those who are willing to pay from ten to thirty dollars for a piece of nickel-plated tubing, is abso-lutely nil. As already said, if adults wish to squander their money on such foolishness and are content to con-fine the 'treatment' to their own per-sons, well and good. If they have noth-ing much the matter with them they may believe they have received benefit; if they are dangerously ill, Nature will probably exterminate them as unfit. But let no person try to 'cure' the helpless child with such frauds; as soon as that is attempted, such an in-dividual ceases to be a harn?less idiot and becomes a dangerous one." YADKIN COUNTY DECIDES TO SPEND $200 A YEAR ON HEALTH. This is going some, isn't it? A phy-sician of that county writes: "Our Board of Health lets everything take care of itself. We are now having scarlet fever in several portions of the county and 'not a one' has been quar-antined. Our Board of Health met the first Monday in October and elected Dr. S. L. Russell for one year at the extravagant salary of $200. So you see we will have everything quaran-tined and fumigated. (He is to fur-nish all disinfectants)." In Yadkin County there are 16,000 people—men, women and little chil-dren. Assuming that the average death rate of the United States t»revails in that county, there are 250 of these people who die every year. There is an amount of sickness equivalent to 750 of the Yadkin folk being in bed the entire year. 100 of these deaths are from preventable diseases, and 250 of the bedridden sick people ought to be on their feet earning a living for them-selves and others. 35 of the 100 deaths are from consumption; there are 100 other active cases of consumption in the county. There are 8 deaths from typhoid fever; there are between 80 and 90 other cases of fever every year. There are 8 or 10 deaths from con-tagions. 20 babies under two years of age die in that county every year from diarrheal diseases, and about 150 other babies are sick from that disease. Now, evidently these diseases, that most of the civilized world has re-garded of a preventable nature, acquire very peculiar properties when they break out in Yadkin; they become wholly unpreventable. Up there man has no control whatever over these diseases and therefore no responsi-,, bility for their occurrence. All thatf the rest of us can do when the tolkf die in Yadkin is to extend our sympa-thy, and let the preacher say, "the Lord giveth and the Lord taketh"; the county commissioners can't help it. THE HEALTH BULLETIN. 135 A GIRL'S ENCOURAGEMENT. Some days ago the State Board of Health received a letter asking for an investigation and an opinion as to the influence of a swamp on the com-munit}- in which the writer of the let-ter lived. The letter indicated such mature and intelligent interest in health matters that in our reply we stated that we would try to make the investigation at an early date, and at that time to meet and advise with the writer and other authorities of in regard to the proper treatment of the ponds. In reply to our letter the writer of the initial letter among other things said: "I am only a girl. Dr. Rankin, and I don't know that I would be of any help to your representative." This letter is one of the most encour-aging that we have received in some time; it indicates the interest of the younger generation, and what they are going to do when a few more years give them some control in civic mat-ters. It has been a long time since the State Board of Health received a request that it will more gladly com-ply with than this one from "only a girl." TYPHOID VACCINE FREE. The State Laboratory of Hygiene an-nounces that it is now ready to dis-tribute, on request, typhoid vaccine free to the citizens of North Carolina. The Laboratory trusts that only those citizens who expect to use it will re-quest the vaccine, but the Laboratory is very anxious that as many of our citizens be persuaded to take advantage of the State free vaccine as it is pos-sible for our influence to reach. Now do not get the idea, because we are giving the vaccine away, because it will cost you nothing, my fellow citizen, that it is without value. Vac-cination against typhoid fever has passed all the tests of science and prac-tice and has won as permanent a place among sanitarians as vaccination against smallpox. In a very thorough review of the re-sults of anti-typhoid vaccination in the Journal of the American Medical As-sociation, under date of August 30, 1913, Major Frederick F. Russell, of the medical corps of the United States Army, presents such convincing facts and figures as to leave this question of vaccination against typhoid fever no longer a matter of opinion. In the last four years over 200,000 people have been vaccinated against typhoid fever; no bad effects from the vaccination have occurred. Among the 85,000 vac-cinated men in the United States Army, located at different posts in the United States and her colonies, there has not been a single case of typhoid fever since December 6th, of last year. There have been fewer cases of typhoid fever among the vaccinated soldiers than cases of smallpox among the sol-diers vaccinated against smallpox. The opinion among sanitarians at present is that typhoid vaccination is as effec-tive as smallpox vaccination. The vaccine is in liquid form and is administered hypodermically, being in-jected either into the outer side of the arm or into the tissues of the breast. The discomfort—because we can not call it pain—of the injection is prac-tically the same as the injection of various forms of medicine. Any doc- 136 THE HEALTH BULLETIN. tor can administer the vaccine. The vaccine is in three doses, which have to be given on three separate days, five daj^s apart. In from ten to fifteen per cent of the cases there is slight swell-ing and redness, and a little pain about the Injection lasting for a day or so; associated with these local symptoms is usually a slight feeling of indisposi-tion, vague, dull aches similar to the preliminary symptoms of a cold, and, maybe, from a half to a degree of fever. The second injection is not nearly so likely to be followed with these sensa-tions as the first, and the third injec-tion still less likely than the second to be associated with unpleasant sensa-tions. The protective power of typhoid vaccine lasts for four years. The pro-tective power not only protects against the contraction of the disease but, in those exceptional cases where the dis-ease is contracted, protects to a con-siderable extent against a fatal out-come, a kind of double protection. The State Board of Health enter-tains the hope that those counties em-ploying whole time health officers will have their officer arrange certain dates in the county, town or other con-venient places for citizens to visit, where any citizen in the county can be vaccinated, without cost, either for typhoid fever or for smallpox. If the health of the human animals of the counties are worth anything from a purely economical standpoint in the production of cotton and corn and wheat and meat, thereby increasing the value of land, and by all this add-ing to the wealth of the county treas-ury through the taxes that are levied, it would seem to be a very fine piece of business for the owners of this pro-ductive source of wealth, for the county government, particularly the county commissioners, to spend the small sum necessary for this free public vaccina-tion in the maintenance of their human machinery. MENTAL HYGIENE CONFERENCE AND EXHIBIT COMING A great treat is in store for North Carolina teachers and others inter-ested in Mental Hygiene and the bet-terment of the race. Through the ini-tiative, generosity, energy, and fore-thought of Dr. Albert Anderson, Super-intendent of the State Hospital at Ral-eigh, arrangements have been made to have a Mental Hygiene exhibit and conference at the Raleigh Auditorium from November 28 to December 5th. This is the same exhibit which attract-ed so much attention at the Interna-tional Congress on Hygiene and De-mography at Washington last year. The exhibit is free and the public is cordially invited. Demonstrators and attendants will be on hand to expL-iin everything connected with it. It will undoubtedly be one of the best exhibits ever given in North Carolina. It will mean a tremendous uplift all over the State if several thousands of our teach-ers and public spirited citizens will learn the great lesson taught by this exhibit. Besides the exhibit, there will be held North Carolina's first conference on Mental Hygiene. A program is be-ing arranged for two sessions daily, afternoon and evening. Some of the foremost specialists in the country will lecture on various phases of mental health. Among others will be Dr. Adolph Meyers, of Johns Hopkins Uni-versity; Dr. Wm. A. White, of Wash-ington, D. C; Dr. James Parrott, of Kinston, President of North Carolina Medical Society, and many others of equal calibre. The daily press will » make full announcement of the pro gram later. THE HEALTH BULLETIN. 137 CHARLOTTE'S CAMPAIGN AGAINST TYPHOID. Several weeks ago the City of Char-lotte elected Dr. R. F. Linebach Assist-ant Superintendent of Health, and dele-gated to him the work of preventing disease. Doctor Linebach seems to have definite Ideas as to his work; his campaign in attacking preventable dis-eases suggests the idea of selecting one specific thing and going after that, and then taking something else. We like this. There is entirely too much diffusion in planning health work, and we sometimes think the plans of health officers might be made a little less vague and a little more definite. Doctor Linebach has selected typhoid fever as the first disease with which he will deal; he has made an interest-ing study of the typhoid problem of Charlotte; his investigation has shown that 74 per cent of the typhoid fever occurring in Charlotte occurs in fam-ilies using wells, and 90 per cent of the wells used by these families have been found polluted. His investigation has been in line with all other investiga-tions in finding that the frequency of typhoid fever is greatest in those wards with open privies, and less in the wards that are thoroughly sewered. Based upon his investigation and find-ings, considerable pressure is being brought to bear on the city fathers to extend their water and sewer mains. Another important point still under consideration in the fight against ty-phoid in Charlotte is the proposition to close all polluted wells as soon as their pollution is shown by laboratory examination. THE DEATH RATES OF WILMINGTON. We have been taken to task for never having referred in the Bulletin to the death rates of Wilmington. We do not recall having referred in the Bulletin to the death rates of any particular town under the name of the town; we have used, however, in our effort to educate public opinion to the point of enacting a vital statistics law, the death rates of several towns and cities in North Carolina under fictitious names. We have not thought it fair to call attention in the Bulletin to the comparative death rates of different towns and cities when we have felt reasonably sure that some of the towns and cities with low rates were negligent in the complete registration of their deaths. This office has been without means of verifying local death rates until within the last two months, since which time we have had an inspector on the road. We trust that this ex-planation will satisfy those who seem to think that we have been negligent in not having given space already to the Wilmington death rates. The death rates of Wilmington are very interesting and the following charts are worthy of careful study. The figures of the charts up to and including the year 1910 are taken from the Mortality Statistics, United States Bureau of the Census, and the figures since 1910 from the records in the State Registrar's office. There is no witness so trustworthy in the study of the quality of health work as vital statistics. This witness, however, must be made to testify in strict accordance with the prescribed oath, "to tell the truth, the whole truth, and nothing but the truth." The 138 THE HEALTH BULLETIN. Year. 1911 1912 1913 (estimated WILMINGTON. N. C. General Diarrheal ^ , . J j _ , , Diseases Typhoid I Tuberculosis ^ Under Two Years Combined Contagions The general death rates are per 1,000; the special disease rates per 100,000. THE HEALTH BULLETIN. 139 great trouble with the statistical' wit-ness is not that the witness fails to tell the truth and nothing but the truth (this witness never lies), but that fre-quently the witness is not given a fair chance to tell the whole truth. Attention has been specifically di-rected to the reduction in Wilmington's death rates since 1911. Now the charts show that 1911 was an exceptional year and not an average year in the health record of Wilmington. This question, then, becomes pertinent right here: Should exceptional years be used as the standard by which to meas-ure the efficiency of health work? Should a health officer, whose admin-istration began in a year characterized by exceptionally low rates, rates lower than for ten years, be discredited be-cause he gets no reduction or only a very slight reduction in his rates dur-ing the first and second years of his work? Likewise, should a health offi-cer be credited with the full reduction of death rates coincident with an ad-ministration which started during a year with exceptionally high or epi-demic rates? We believe that an average year should be used as a standard of meas-urement, and that such a standard is the only fair measure to be adopted in judging the quality of health work on a death rate basis. If we study the death rate of Wil-mington from this standpoint, it would appear that the health work coincident with the half decade from 1906 to 1910 inclusive, expresses itself in a statisti-cal drop from a death rate of 25.3, which was even less than the average in the preceding five years, to a death rate in 1910 of 20.8. I submit that this decline, considered in accordance with the principles of statistical practice, as above suggested, is even more credit-able than the decline since 1911, which was an exceptional year. Now, in conclusion, I wish to say that, notwithstanding that the rates most frequently quoted in regard to Wilmington go back only to 1911, and start, therefore, from an exceptional or epidemic year as a basis of measure-ment, we think the decline in death rates, even during the last few years, is very satisfactory. We might point out, however, in this connection, that there is still much to be accomplished. The typhoid rates are still three times the average for the United States. The diarrheal diseases of children under two years of age are two and one-half times the average, and tuber-culosis is 50 per cent higher than the average, and finally, the general death rate for this year, 21.6, is 20 per cent above the average urban death rate in the United States. MR. MAYOR, THIS FOR YOU. "It is in health that cities grow; in sunshine that their monuments are builded. It is in disease that they are wrecked; in pestilence that effort ceases and hope dies. "Therefore, in the not very long ago, you created a department. You bade it guard the public health. You gave it a trust that may not be broken. You charged it with a vigil that is sacred. "And you assumed a duty. You tendered fealty to this, your greatest department; for had you not bade it watch over the lives of men and wo-men and little children. "Nor creed, nor faith, nor party may forget." — The Healthologist. THE STATE SANATORIUM Under the Management of the State Board of Health—Board Announces Definite and Comprehensive State PoHcy for DeaHn^ with Tuberculosis The management of the State Sana-torium has been transferred, by legis-lative enactment of the Special Ses-sion of the General Assembly, to the State Board of Health. The transfer was initiated and engineered by the former Board of Directors of the In-stitution. While the State Board of Health had not asked for the Institu-tion, the Board very cheerfully accepts the responsibility of management. We believe the Institution to be capable of filling a very real need in the life of the State, and that it has a very bright future. The State Sanatorium will represent a part of a general policy of the State Board of Health for dealing with the problem of tuber-culosis. State Boards of Health should look upon tuberculosis as something dis-tinctive from the general run of pre-ventable diseases. One-fourth of ca.11 preventable deaths is due to tubercu-losis. That means that one-fourth of the opportunity of State Boards of Health, and other health boards, for that matter, is tied up in the manage-ment of the tuberculosis problem. These considerations are responsible for the adoption by the State Board of Health of the following State Tuberculosis Policy. The central idea of this policy is one of education. The educational scheme will embrace the Sanatorium as a sort of central school, and a Bureau of Tuberculosis, to be estab-lished in connection with the general health work, as a correspondence school. The State Sanatorium, by the first of January, will have a capacity for 125 patients, which will be suffi-cient for the treatment of 250 patients a year, assuming the stay of the aver-age patient to be six months. In the Institution these people will be taught by personal contact, by illustrated lec-tures, and by the rules of the Institu-tion how to readjust their lives to Nature's laws and so secure a new lease on life, and how to live with others without infecting them. This training will be carried back by these 250 patients a year into their communi-ties and counties, and its influence will be of great benefit to their fellow suf-ferers at home who have been unable to attend the training school. The Bureau of Tuberculosis will have reported to it, under the requirements of a recent enactment, seventy-five or eighty per cent of all recognizable cases of tuberculosis in this State. These people, from 8,000 to 10,000 vic-tims of the disease, will be matricu-lated as members of a correspondence school for tuberculosis. At the head of this Bureau will be a man who knows how to write a strong, personal, appealing letter,—a man of great re-sourcefulness and tact, and a man above all with a deep, sincere, altruis-tic nature. In an unofficious way and THE HEALTH BULLETIN. 143 in a verj' personal way he will seek, by correspondence, to make the eight or ten thousand people reported to the Bureau feel his interest in them; hy correspondence and by a leaflet or pamphlet from time to time he will endeavor to encourage his scattered school in their work for life, to teach them how they may regain their strength and teach them their obliga-tion in protecting others, with whom they may be associated, from tubercu-losis. Another function of the correspond-ence school that will call for a high degree of resourcefulness is for the Bureau of Tuberculosis to investigate the claims of deserving indigents, and through boards of county commis-sioners, churches, lodges, or other or-ganizations to which the indigent, or the person upon whom the indigent is dependent, belongs, secure the neces-sary funds to take care of those who would die unless supported from out-side sources. One of the principal measures of success by which the Bu-reau of Tuberculosis will be judged will be its ability to keep the Sana-torium filled with patients who could not themselves pay for their treat-ment, but whose treatment is paid for by interested organizations—political, social, or fraternal—and philanthropic individuals. This combination of the Central Training School, as an educational nucleus, with a correspondence school of eight or ten thousand consump-tives, is suggestive of the educational scheme in practice in the State of Wis-consin by the University of that State, which is rapidly and deservedly be-coming a model to other state univer-sities. The Cost of This Folicj. The State of North Carolina has in-vested in its present plant something like $50,000. The interest on that in-vestment amounts to $3,000 a year. The State appropriates for the main-tenance of this Institution and for the maintenance of the correspondence school idea, $20,000 a year; so that we might say that this state tuberculosis policy will cost the State, in round numbers, about $25,000 a year. It will be necessary in our State Institution, as it is in practically all state sana-toria, that the patients pay $1.00 a day for treatment. This will seem to some rather expensive. On investigation, however, it will be found that this is the general practice of state sanatoria; that in different state institutions the per capita charge is from four to ten dollars a week. On the other hand, when one recalls the fact that it now costs one to get sanatorium treatment or to be treated by a specialist, from sixty to one hundred dollars a month, the State's charity at once becomes evident. While it is necessary to maintain the Institution to charge each patient one dollar a day, it should be remembered that, under the policies above outlined, many of the patients, we hope most of them, will be pa-tients who themselves are paying noth-ing, but whose expenses are paid by their friends and the organized inter-ests— political, social, and fraternal — of which they are a part. Requirements for Admission. Patients, before being given a card of admission, will be required to have filled out by their physician a blank form furnished by the Medical Direc-tor of the Sanatorium, and return the information contained on this form to the Sanatorium in order that the man-agement may know their condition. Incipient patients will be given pref-erence over moderately advanced cases, and advanced cases will not be admitted. Patients and physicians are warned against going to the Sana-torium without first communicating THE HEALTH BULLETIN". 145 with the Medical Director and ascer-taining whether the capacity of the Institution and the condition of the patient will permit the admission of the patient. The fatality of incipient tuberculosis under average treatment is not more than 10 or 15 per cent; the fatality of moderately advanced tuberculosis is 40, 50, or 60 per cent; and the fatality of advanced tubercu-losis is 90, 95, or even a higher per cent. It is, therefore, as evident as it is reasonable, that as long as the State's capacity to take care of her consumptives is as limited as at pres-ent, advanced consumptives, bedridden consumptives, who have already prac-tically lost their chance to live should not be allowed to occupy the few beds that the State now has, and that would otherwise be used for consumptives in the incipient stage of the disease with 85 or 90 chances in a hundred to get well. The reasonableness and the economic considerations, as well as the humanitarian considerations underly-ing this fundamental principle in the future management of the Institution are too evident for argument. location of Sanatorium. The Sanatorium is located at Mont-rose, in Hoke County, on the Rockfish and Aberdeen Railroad, nine miles southeast of Aberdeen. The Sanato-rium is about twelve miles from Pine-hurst and about the same distance from Southern Pines. In this region of these well known winter resorts the Institution has an ideal location. The warmer and more uniform temper-ature of this region gives the Mont-rose Institution a natural asset which very probably more than makes up for the better equipped and larger en-dowment of the more widely known in-stitutions of our northern, colder cli-mate. Here the air is dried by its course across the white sand and is filtered pure and healthful through the needles of the long leaf pine. Site of Sanatorium. When one alights from the train at the little station of Montrose, after having passed through a flat country, rather desolate looking, with sandy soil and blackjack and pine growth, and ascends a gentle slope, a most surprising view opens up before him. So suddenly and distinctly different is the scenery from that of the surround-ing country, that its very unexpected-ness adds interest to its beauty. In-deed, Nature seems to have prepared and set apart this spot for the very purpose to which it is now dedicated. Standing on a plateau about six hun-dred feet above sea level, one can see from ten to fifteen miles in almost any direction. The view invariably makes one think of the mountains of Western North Carolina. In one direction a sand road eight or ten miles away can be seen easily. Equipment of Sanatorium. The Sanatorium is situated on a farm of about 1,300 acres. There are about 700 or SOO acres of this land suitable for farming; there is also much valuable timber on the land. A creek passes through the farm which, after it is dammed, will furnish the necessaiT power for electric lights and light machinery needed in an institu-tion of this kind. At present there are three buildings for patients, with capacities of 15, 35, and 75 patients each; there is a dining room sufficiently large to seat 100 peo-ple. A refrigerating plant will be in-stalled beneath the kitchen some time before next spring. There is a nurses' building for the nurses, a small cot-tage for the physician, and a pavilion which will be immediately equipped and hereafter used as a library and THE HEALTH BULLETIN. 147 club room. This building will be equipped with such games as patients with incipient and moderately ad-vanced tuberculosis may engage in; a good Victrola with suitable records will add to the attraction of the pa-vilion. On the grounds there will be such light outdoor games as croquet, and other games that tuberculous pa-tients may enjoy. The new Medical Director, who is familiar with the con-struction of sanatoria, is delighted with the construction of the buildings. The buildings are lighted by electric-ity, heated by open fires, and supplied with warm water and shower baths. There is also a good two-story farm house and a well constructed dairy with capacious silos. SANATORIUM STAFF. Dr. Wilson Pendleton. Dr. Pendleton is the man to whom the State Board of Health pins its faith in taking over the Sanatorium. Dr. Chas. L. Minor, so well known as a tuberculosis authority, not only in this State, but in the nation, in writing to the Board strongly recommending Dr. Pendleton and urging the Board to elect him as Medical Director of the Sanatorium, says: "I am sure you will agree with mo that the first thing is a man. With a strong, competent man at the head of affairs, the simplest building makes a strong sanatorium; without it, the most elaborate is use-less." We thoroughly agree with Dr. Minor's reasoning, and because we do, we know that the absolute success of the State Sanatorium is henceforth as-sured. We have the man. Allow me just a few words to in-troduce Dr. Pendleton, and then, I shall let those who speak with au-thority tell you how well qualified he is to take care of our patients. Dr. Pendleton is a Southern man and was educated at the University of Virginia. He looks to be about twenty-eight or thirty years old. After graduating at the University of Virginia in medicine, he was assistant to Dr. Watts, Pro-fessor of Surgery in the hospital con-nected with that Institution. Serving under Dr. Watts, he contracted tuber-culosis, went to Saranac Lake and was cured. Like most specialists in tuber-culosis, he became interested in and took tuberculosis as his specialty as a result of his personal experience with the disease. After regaining his health at Saranac Lake, and incidentally after learning the methods of cure prac-ticed in that well known Institution, he accepted an assistantship with Dr. David R. Lyman, of the Gay lord Farm Sanatorium, the State Institution at Wallingford, Connecticut, where he served three years, for five months of the time having absolute charge of that Institution. From the Gaylord Farm Sanatorium, he went to the Hope Farm Sanatorium, Marshallton, Dela-ware, to take charge of that Institu-tion. What Others Say of Dr. Pendleton. Dr. Livingston Farrand, Executive Secretary of the National Association for the Study and Prevention of Tu-berculosis, who is qualified to take a comprehensive view of the tuberculosis problem as a national problem, writes concerning Dr. Pendleton: "I have made further inquiries concerning Dr. Wilson Pendleton, * * * with refer-ence to his administrative capacity and general availability for the position you have in mind with your depart-ment. I have this morning received a letter from Dr. David R. Lyman, of Gaylord Farm Sanatorium, Walling-ford, Conn., who says that Pendleton had entire charge of that sanatorium during an absence of Dr. Lyman's lasting for five months, and in addition to that he was with him as an assist- THE HEALTH BULLETIN. 149 ant for two and a half years. He says he is an excellent discip
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|Other Title||Bulletin of the North Carolina State Board of Health; Bulletin of the North Carolina Board of Health|
|Creator||North Carolina. State Board of Health.|
Children--Health and hygiene
Public Health--North Carolina--Periodicals
|Place||North Carolina, United States|
|Time Period||(1900-1929) North Carolina's industrial revolution and World War One|
|Description||Volume 28, Issues 6-12. Issues for Feb.-May 1917 and for Jan.-July 1918 not published.|
|Publisher||Raleigh,North Carolina State Board of Health.|
|Agency-Current||North Carolina Department of Health and Human Services|
|Rights||State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754|
|Physical Characteristics||61 v. :ill. ;23 cm.|
Health Sciences Library. University of North Carolina at Chapel Hill
Health Sciences Library, University of North Carolina at Chapel Hill
|Digital Characteristics-A||13,219 KB; 192 p.|
Ensuring Democracy through Digital Access, a North Carolina LSTA-funded grant project
North Carolina Digital State Documents Collection
|Related Items||Imprint varies: published later at Raleigh, N.C.|
|Title Replaces||Bulletin of the North Carolina Board of Health**|
|Pres File Name-M||pubs_edp_healthbulletin191314.pdf|
|Pres Local File Path-M||\Preservation_content\StatePubs\pubs_edp\images_master\|
einitiersitp of Bonb Carolina
CndobJtD bp 'E^e SDialectic
This booh must not
be taken from the
BETTER BABIES SPEC
Putli5\edb4 TnZ./^°KjnCAR9LI/^A STATE. D°ARDs^AE^LTA
I This Bullelirv will be 5er\t free to arwj citizeiA of the State upo:\reque5t. |
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. C.
Entered as second-class matter at Post Office at Raleigh, N. C, under Act of July 16, 1891/.
Vol. XXVIII. SEPTEMBER, 1913. No. 6.
COLORADO PRIZE WINNERS, 1912.
Watch this page for the North Carolina Champions, after the State Fair.
Health axd Public Health Brevities 99
Better Babies ix Xorth Carolina 100
Watch Your Nursemaids 104
We Want to Help You 104
Feeding Sick Babies 105
How ASHEVILLE DoES It 106
Good Well Water 107
Mosquito Warfare in Panama 109
The Care of Milk in the Home Ill
AVhat Berlin Did, We Can Do 112
The Last Word 112
FREE PUBLIC HEALTH LITERATURE
The State Board of Health has a limited quantity of health literature
on the subjects listed below, which will be sent out, free of charge, to
any citizen of the State as long as the supply lasts. If you care for
any of this literature, or want some sent to a friend, just write to the
State Board of Health, at Raleigh. A post-card will bring it by return
Medical Inspection of Schools and School Children.
Care and Feeding of Babies.
The Plague of Flies and Mosquitoes.
Residential Sewage Disposal Plants.
Compilation of Public Health Laws of North Caro-lina.
20. Tuberculosis Bulletin.
The Vital Statistics Law.
The Whole-time County Health Officer.
Anti-Spitting Placards ( ii inches by 9 inches).
Anti-Fly Placards ( ii inches iw lo'^inches).
l-£j| | PUBLI5AE:D BYTML HOR-TM CAIgOLIhA 5TATL BQAI^D °^M&ALTM I El
J. Howell Way, M.D., President, Waynesville.
Richard H. Lewis, M.D., Raleigh.
J. L. Ludlow, C.E., Winston-Salem.
W. O. Spencer, M.D., Winston-Salem.
Thom.\s E. Ander.son, M.D., Statesville.
Charles O'H. Laughinghocse, M.D.
Edward J. Wood, M.D., Wilmington.
A. A. Kent, M.D., Lenoir.
Cyrus Thompson, M.D., Jacksonville.
W. S. Rankin, M.D., Secretary and Treasurer, Raleigii.
Vol. xxvm. SEPTEMBER, 1913. No. 6.
HEALTH AND PUBLIC HEALTH BREVITIES.
Dou"t miss the Better Babies Cox-test
at the State Fair. — —
To get some good, first-class health
literature free, see the opposite page.
Over .$300 iu prizes for the best North
Carolina babies at the Fair. Enter
your baby. There are no entry fees.
For the elementary principles of
healtli and sanitation on the farm, see
the public health exhibit at the State
Fair. October 20th to 2.jth.
Th^> Better Babies Contest and the
PrBLic Health Exhibit will be two of
the biggest features of the State Fair
this year. —o
Thirty-three states make tuberculosis
a reportable disease. I.sn't it about
time for North Carolina to join the riro-cession?
The liveliest thing at the State Fair
—the Better Babies Contest. Don't
miss it. It will beat the Midway any
day—and it's free.
August and September form low
water-mark for pneumonia. From Sep-tember
on to February the pneumonia
death rate goes up—because our win-dows
go down. Live, work, and sleep
in the fresh air. and avoid pneiiraonia,
colds, grip, and tuberculosis.
On dressing for hot weather, the
Chicago Health Department says
"Wear as little clothing as the law of
the land will permit—that's mighty
little these days. 'Equal rights for
men.' " _^_
Would you like to know if your child
has hookworms? The State Board of
Health will tell you free. Write them,
stating that you want a specimen con-tainer
for hookworm examination.
Any one suspecting tuberculosis
should consult his family doctor at once.
If thought necessary, the doctor can
have a sample of sputum examined for
tuberculosis germs at the State Lab-oratory
of Hygiene free of charge.
True civilization and refinement in a
town, community, or individual family
can be judged very closely by the way
they handle their own filth. If they
have the antiquated, open, insanitary
privies, or no privies at all, and no
screen doors or windows, they are about
at the bottom of the scale. If they have
screen doors and windows, they have
movetl up quite a bit: and if they have
abolished privies altogether, or use san-itary
privies and screens at their doors,
they have passetl the selfish stage and
recognize that they are their brother's
keeper. Where are you on this scale?
BETTER BABIES IN NORTH CAROLINA.
Each Year the Old North State Raises Better Cotton, Better Tobacco, Better
Horses, and Better Cattle—and Why Not Better Babies?
Warren H. Booker, C.E., Assistant Secretary.
Koi-th Carolina neglects her best
crop. Yes, just that. Every year we
have our county and state fairs; we
have our Agricultural Department with
scores of experts, test farms and ex-periment
stations, and our agricultural
colleges filled to overflowing; we have
our farmers' institutes, and the best
farm paper in the United States. We
have all these, and why? In order to
make two bales of cotton grow on an
acre that formerly produced but one;
in order to produce good cattle instead
of scalawags, and thoroughbred Berk-shires
and Poland-Chinas instead of
razorbacks and elm peelers.
But North Carolina's best crop is
never mentioned. No one ever dreamed
of holding institutes to teach fathers
and mothers how to raise better,
healthier babies. We have no schools
or colleges teaching such subjects. We
have no papers or magazines on this
subject. In fact, all we have ever done
was to have an occasional beauty show
at the fair. That was a joke. No one
ever knew a thing more about how to
raise a better, healthier baby, or how
to improve those they already had.
after attending such a beauty .show,
than they did before.
Now, all this is going to be changed.
The North Carolina mothers have said
so ; the State Fair Association has said
A Sound Chest is a Valuable Asset.
Broad, Deep Chests Are Fine, But
so; and the State Board of Health is
going to back them up and cooperate
with the mothers of the State and with
the State Fair Association, and hold
North Carolina's first great Better
Babies Contest at the State Fair in
OVER $300 IN CASH PRIZES.
The contest will be under the direct
management and control of the State
Board of Health. It will not be a
beauty show in any sense of the word.
It will be a health contest, out and
out. Neither grandfathers nor grand-mothers,
town mayors, congressmen
nor politicians will be allowed to pat
babies' dimples, kiss them on the mouth,
or vote for the prettiest child. On the
other hand, a corps of the best doctors
and children's specialists in the State
will be on hand to score the babies on
a score-card in much the same way as
the horsemen and cattle judges will
THE HEALTH BULLETIX. 101
GETTING THE CORRECT HEIGHT.
Height and Weight Should Conform With Age.
$50. It took quite a bit of work to
raise this $150 iu order to secure the
$100, but the State Board of Health
did not stop there. It went on, and is
still collecting funds for prizes, and be-fore
the contest is held it hopes to have
a considerably larger fund for tliis
JUDGING THE BABIES.
Lots of interest centers around just
how the babies will be judged or scored.
Space will not permit us to explain the
whole matter in detail, but the general
plan will be as follows
The contest will be held October
20th to 25th. at the State Fair Grounds
at Raleigh, in the east wing of Floral
Hall. At the appointed day and hour
the mother will bring the baby to the
large, comfortable reception room,
where a reception committee of ladies
interested in the babies and their moth-ers
will meet the babies, learn the name,
age. and sex of each one. and fill out
They Must Not be Flat or Pigeon-breasted.
score the horses and cattle. The baby"s
age will be noted, then he will be
weighed, measured, and carefully ex-amined,
and, above all things else, these
doctors will point out to the mothers
and fathers just what goes to make
a perfect baby. They will show why
the baby scores high here and low there,
and just how to remedy any defects.
Then, best of all, there will be the
prizes. Of course, the prize for the
best baby will not be so large this year
as it will be for the best horse or cow
or hog. One could scarcely expect that
the first year ; but next year, when
North Carolinians begin to appreciate
that a third or fourth prize baby is
worth more than the best race-horse on
the track, the adjustment of prizes will
be different. This year the Woman's
Home Companion offered $100. provided
the State Fair Association would raise
$100, and provided further that the
women's clubs of the State would raise Surveying Osier's "Mason and Olxon
102 THE HEALTH BULLETIN,
A Perfect Baby Must be Well Proportioned
as to Height, Lengtii of Arms, and
Length of Legs.
the score-card sbowing these facts, also
tlie name and address of the father
and mother, whether the baby has been
breast-fed or bottle-fed, whether or not
it sleeps alone, whether or not it sleeps
in a room with windows open, etc.
From the reception room the baby
and mother will enter a quiet room
where a doctor will test the child men-tally
according to its age. For instance,
a child of six months should sit alone,
play with simple objects like a pencil
or spoon, look in the direction of unex-pected
noises, etc., while a child of two
years should run, join words to make
short sentences, be able to point to eyes,
nose, ears, etc.. and so on. If baby
meets all these conditions, he will be
scored 100. or perfect.
WEIGHTS AND MEASURES.
From the mental test room the mother
and baby will be conducted to a meas-uring
room. Here a doctor and a trained
nurse will carefully weigh and meas-ure
the baby. A table of standards
has already been provided for babies
of different ages. Baby's height will