Aside from the special investigations of Dr. H. G. Lampson and Mr. A. R. Blakey, some routine work has been done in tuberculosis. Summaries Nos. 98-XIII., 106-XIII and 154-XIII, give instances of home care of “open” cases under conditions detrimental to the patients's welfare and dangerous to the community, while Summary No. 138-XIII illustrates the proper care of an "open" case of tuberculosis in the home. (Index No. 98-XIII.) SUMMARY Tuberculosis, Eden Lake Township, Stearns County, September 9, 1913 Reason-To investigate a case of tuberculosis. History-Mrs. M. K., 60, "open" pulmonary case, lives in a two-room shack with her sixteenyear-old daughter. Husband died eleven years ago from pulmonary tuberculosis. Mrs. M. K. began coughing in March, 1913; is in last stages now. Town Board provides for her keep. The physician desired to have her removed to an institution where proper attention could be given, but she refused to go. Inspector, with attending physician, visited the home Sept. 9. House unscreened; patient burns her sputum, but crowded quarters make it impossible to be clean. Daughter has slept with mother during her illness and apparently is infected now. Nearest neighbor lives 200 yards away. Results Mrs. M. K. promised to properly care for sputum, to screen doors and windows; to keep windows open; to have her daughter sleep alone and avoid intimate association with her as far as possible. Advised Mrs. K. that thorough scrubbing of walls and floors, removal of unnecessary accumulation of rags and clothing would make the rooms more habitable. Advised the Health Officer that Dr. H. M. Bracken would instruct him in regard to the management of the case. (Index No. 154-XIII.) SUMMARY Tuberculosis, Eden Lake Township, Stearns County, November 24, 25, 26, 1913 By Order of the Executive Officer, State Board of Health. Reason-To supervise removal of tuberculosis cases. History-See Summary No. 98 and Executive Officer's Memorandum re his conference at St. Cloud with Board of Supervisors and Stearns County officials. Inspectors met Town Board at Eden Valley, discussed the expenses and method of procedure re transference of Mrs. M. K., age 60 (in last stages of consumption) and Miss A. K., age 16, town charges, to Otter Tail County Tuberculosis Sanatorium. Visited home of patients with C. B. S. and Dr. D. C. O'Connor, Township Health Officer; examined A. K. and investigated situation Nov. 24. Nov. 25 moved cases by wagon to Eden Valley; by rail to Otter Tail; by auto to Otter Tail County Sanatorium. Results Board of Supervisors of Eden Lake Township appointed Dr. D. C. O'Connor Township Health Officer; signed an agreement re expenses of cases at Sanatorium and provided necessary supplies and transportation. Mr. Lloyd Scott was authorized to accompany patients by Health Officer, who was called to an emergency case and could not go. Dr. Greene took charge and went with cases to Sanatorium, since Mrs. K. was too sick to be left without medical aid en route. Note The K.'s lived in an old dilapidated shack on the shore of Rice Lake and had been town charges for several years. Owing to Mrs. K.'s opposition and her daughter's absolute lack of training as housekeeper or nurse, the place was in a most filthy condition. Neighbors had done what they could to assist and the Board of Supervisors had provided food, fuel, etc., but all efforts toward cleanliness and sanitary precautions were fruitless, the patient refusing to be moved to a Sanatorium and the daughter neglecting all measures for her mother's comfort and her own safety. The patient, being too weak to spit over her chin would remove the tenacious sputum by hand and throw it on the floor (sometimes hitting the newspaper laid there to receive it) or would wipe it on the bedding or on her clothing, which had not been changed in months. The floor, bedding, and in fact everything within reach, was smeared with sputum. Mrs. K.'s waist and undershirt were stiff, as if starched, from old dried sputum. She had not had a bath for months. It is recommended that the shack and all its contents be burned, since it is impossible to properly clean it, and it is unfit for human habitation. (Index No. 106-XIII.) Reason SUMMARY Tuberculosis, Marshall City, Lyon County, September 15, 1913 BY DR. H. A. BURNS To investigate the conditions in the home of Mr. J. D. where one child has recently died from pulmonary tuberculosis and another is now an "open" case. History-Mr. J. D. has lived in Lake Marshall Township for 30 years. Sixteen years ago his first wife died from pulmo nary tuberculosis, leaving three children. At the present time, he has a family of 13 children by a second wife. E. D., 15, died in Aug., '13; S. D., 19, is at present an "open" case. Mrs. J. D. has a cough and is emaciated and ill. The children' attend school, to which the neighbors object. Inspector, with Dr. W. A., the attending physician, and Mr. A. F., C. B. S., Lake Marshal township, visited the home of J. D. at 7 p. m., Sept. 15; found the family intimately associated, S. D. living with the others. The mother alone, with two infants, one newly born and the other too young to walk, was responsible for the care of the 14 living children. Mr. J. D. was absent, running his threshing machine. He is a breeder of imported horses and has a number of registered hogs. His hogs were among the first in the community to get the serum during the recent hog-cholera epidemic. Inspector, with Mr. A. F., found Mr. J. D. in Marshall at 8:30 p. m. Explained the law regarding the treatment and care of tuberculosis to him. J. D. does not believe in tuberculosis as relating to human beings. Results Advised Mr. A. F. to call a meeting of the Town Board and appoint a medical Health Officer, so that a legally constituted Board of Health could take the matter up. Talked with Dr. C. G. Bacon and Father Jordan relative to the removal of S. D. to a sanatorium where he could be properly cared for. They agreed to assist in every way possible to protect the remainder of the family from infection. Note-Case S. D., m., 19, died of tuberculosis a few months later. Tuberculosis, Providence Township, Lac qui Parle County, November 2, 3, 4, 1913 BY DR. W. P. GREENE (All investigations are made upon order from, or with the approval of the Executive Officer of the State Board of Health.) Reason To investigate complaint made to Executive Officer that pupils of a district school were endangered by a teacher living at home where her brother is sick with tuberculosis and by use of school books by the brother. History-Teacher's mother died of consumption March 28, 1913. Her brother developed the disease very rapidly. Inspector, with Dr. A. A. Stemsrud, of Dawson, examined the family. 1. Patient, m., 30, sick since spring, 1911; now in advanced stage of pulmonary tuberculosis, complicated with ulcers of intestines. 2. 3. 4. 5. Teacher, f., 21, "Negative" for tuberculosis. Sister, “A," 26, “Negative" for tuberculosis; nursed mother and patient when necessary. Brother, 34, "Negative" for tuberculosis; has chronic hoarseness; during rainy weather 6. Father, 64, "Negative" for tuberculosis. Family lives in six-room frame house, walls papered, no carpets, no draperies, everything orderly and exceptionally clean. Sputum is received in cloths and burned, or disinfected in vessel same as stools, with 5% phenol. Patient's dishes are kept separate and boiled after each meal. Nurse uses 5% phenol on hands after waiting on patient. Patient lives outdoors in a tent except in severe weather. Two of his sisters are trained nurses and have instructed the family. Results-Conditions favor protection of family. Although case is advanced, sputum. is scanty. Family seems to be well informed and cautious. Advised frequent examinations of family for early signs of disease and laryngeal examination of patient's brother. Asked that sputum be sent to Laboratory Division. Mr. Wm. B. and the C. B. S. of Providence Township, who is also on the School Board, understand conditions and make no objections to teacher boarding at home while employed at school. Books should not be carried from the home to the school, even though patient does not use them. LIST OF INVESTIGATIONS. Trachoma. Three routine investigations and two special investigations of trachoma were made in twenty-two different counties during the period Aug. 1, 1912 to Jan. 1, 1914. The special investigations of trachoma among Indians required thirty days. The special investigations of trachoma among whites required forty days. *Note-Special examinations made by Dr. Taliaferro Clark, Surgeon, United States Public Health Service. The investigation among the Indians was made in compliance with an Act of Congress, approved Aug. 24, 1912. The investigation among whites was made by order of Surgeon General Blue, upon request of the Minnesota State Board of Health. C-Dr. A. J. Chesley. G-Dr. W. P. Greene. B-Dr. H. A. Burns. L-Dr. A. V. Leonard. |