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People Anxious to Read The demand for the three sex hygiene pamSex Hygiene Booklets phlets recently issued by the State Depart

ment of Health, as evidenced in individual calls for copies from various parts of the state, indicates a most encouraging interest in this subject among the people of Ohio.

The three pamphlets, as announced in last month's JOURNAL, are: "Instructing Your Child in the Facts of Sex" (for parents), "Some Things a Young Man Ought to Know About Sex and Sex Diseases" (for young men and older boys) and “How Any Boy Can Develop His Health and Strength" (for younger boys).

The Department will be glad to fill further calls for these pamphlets and will appreciate the efforts of any one who is willing to help in introducing them to the people of the state.

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Urban Hog-Keeping Again The State Department of Health has Calls Forth Protest

recently received two complaints regard

ing the keeping of hogs in municipalities. To both of these the reply was that the abatement of this or any other nuisance is a matter within the jurisdiction of the local health board only. The State Department of Health cannot legally take any action in such a matter.

This Department, however, is not bound to keep silent on the general question of hog-keeping in towns, and these letters impel it to register again an emphatic protest against the growing movement to relax the regulations against this practice on patriotic grounds.

To raise more food is indeed a patriotic purpose. This method of raising food, however, can not be carried out in an urban community without great danger to the public health. And no act which endangers the public health can be considered patriotic.

The average pigpen is an unexcelled breeder of Alies, and flies are carriers of typhoid fever and of babies' intestinal disorders. Moreover, the existence of filthy pigpens can not be expected to have any effect other than a damaging one upon a community's sanitary standards. These considerations are all aside from the very apparent unpleasantness of having pigpens crowded among human habitations, for odor and other unpleasant features are not in themselves dangerous to health. When such unpleasant features are accompanied by actually dangerous features, however, we fail to see much argument for permitting pigpens.

We must keep our food supply up to its maximum point, but pork can not be valued in terms of human lives, especially when there are so many places outside of town where hogs can be raised.

Three More Department The Department has lost the services of Men Enter War Service another Division head and of two members

of the staff of sanitary engineers, all of whom have gone into war service. Dr. Robert G. Paterson, director of the Division of Tuberculosis, will go to Italy with the Red Cross commission headed by Dr. R. H. Bishop, Jr., Cleveland health commissioner, to fight tuberculosis in that country. Assistant Engineers M. Z. Bair and Harry E. Miller have been granted commissions in the maintenance and repair branch of the construction division of the Quartermaster Corps of the Army --- the former as captain and the latter as first lieutenant. They will do sanitary engineering work.

Congratulations upon their opportunities to be of service and best wishes for success in their new work are offered by the members of the Department staff to these new members of the honor roll as they take their departure.

Municipal Public Health In this issue of the JOURNAL is reprinted an Organization in Ohio article on "Municipal Public Health Organ

ization," which appeared in the Monthly Bulletin of the California State Board of Health. Many of the comments made by the author with regard to the way California cities measure up to his ideal statement of health department activities would apply equally well to the situation in Ohio cities.

Here, too, part-time administration and inadequate appropriations cause many vital phases of public health work to be neglected. Quarantine, abatement of nuisances and registration of vital statistics in too many cities comprise practically all of the health department activities. In some cases there is in addition to these a limited amount of laboratory work, a limited amount of public health nursing service, a limited amount of food supervision and a limited amount of medical supervision of schools.

Nowhere except in a few of our largest cities will a well-rounded system of public health administration be found. Only in a few instances is there reasonably adequate epidemiological work, child hygiene work and sanitary supervision - three broad classes of health activity which must be carried on fully and intelligently if the highest degree of improvement in the public health is to be achieved.

Fifty cents per capita — the amount stated in this article as the ininimum expenditure necessary to provide a city with an adequate public health administration -- is certainly a sum which any community ought to be willing to spend to obtain the protection which such a health department would afford. The health officer who can educate his community up to this point of view will be doing his constituents a great service.

Now They Blame the Poor Why we need public health education is Horse for Typhoid Fever indicated by the following choice bits of

misinformation recently published: Arthur Brisbane, the country's highest salaried editorial writer, recently informed readers of the Hearst newspapers that "the civilized world as a whole opposes the use of horseflesh, and there is usually a substantial reason for a feeling so widespread. The typhoid germ develops in the horse, not elsewhere. Man can get typhoid only from the germ that has lived in the horse's body."

And from an Ohio newspaper is taken an item to the effect that a small boy in an Ohio town, upon seeing a friend run over by a horse, fell into convulsions, which developed into typhoid fever and caused the boy's death.

Perhaps the latter example indicates that the Brisbane theory ought to be extended so as to say that not only eating horseflesh, but even seeing a horse, may cause typhoid fever. For our part, however, we shall continue to inform the public from time to time, as has been our custom, that "the typhoid germ develops only in human filth and causes typhoid fever only when swallowed.”

SCARLET FEVER EPIDEMIC In two or three days after the

DUE TO MILK INFECTION' investigation and stoppage of sale, A typical milk-borne epidemic

numerous reports of scarlet fever

cases in Salem began to come in. of scarlet fever was that which

The epidemic reached its height beraged in Salem in February and

tween February 25 and March 1. March. The Salem health officials

From February 9 to March 18, learned February 10 that a case eighty-five cases were reported. of scarlet fever existed in the

Of these, sixty-five cases were in family of a dairyman in an adjoin- families supplied with milk by the ing township, who had been selling infected dairy. Thirty-five cases milk in Salem. It was found that were reported in three days, showthe dairyman's house had been ing that a common carrier was replacarded by the health authorities

sponsible for the infection. of his township, but that he had This is the first positively estabmeanwhile continued supplying lished milk-borne scarlet fever milk to his customers. The milk epidemic on record in Ohio. An sale was at once stopped, but the epidemic in 1911 in Portsmouth damage had been done during the was believed to be milk-borne, but preceding six or seven days. the evidence was not conclusive.

Ohio's Tuberculosis Hospital Equipment

T

HE present year has been

Whatever the cause of the presmarked in Ohio by a great ent favorable situation may be, the

growth of interest in tuber- fact of most practical importance culosis sanatoria as a necessary is that the situation exists and feature of the state's public health should be developed to the fullest equipment. Since the first of the possible extent at once. With this year, one new district tuberculosis idea in mind, a survey of the state's hospital has been opened, two addi- present hospital equipment and of tional districts have been organized desirable and probable extensions on a permanent basis and have ap- of that equipment ,during the next propriated money for hospitals and few years is seen to be quite timely. two other proposed districts have The sketch here undertaken is of effected temporary organizations necessity somewhat superficial: and seem about to make these many of the problems touched permanent. From 1909 (the year upon would require a separate the law permitting counties to join article each for complete treatin erecting district hospitals ment. passed) through 1917, only four Ohio has eleven public tubercusuch institutions were opened. losis sanatoria in operation, providThis sudden development of ac

ing accommodations for approxtivity may be to some extent at- imately 1,500 patients (see accomtributable to the growth of interest panying table for capacity of each in tuberculosis and its prevention institution). These eleven fall into which the war has produced. The four classes: one state, two munidraft examinations have brought to cipal, three county and five district light many previously unknown sanatoria. . cases of tuberculosis in this coun- The state sanatorium, located at try, and the magazines and news- Mt. Vernon, cares for incipient papers have devoted much space to cases only. It is under the superthe increase in the prevalence of vision of the state board of adthe disease in the warring nations ministration. Each county may - especially in France. It is have at least one patient in the natural that such warnings as this sanatorium at all times. Indigent should make Americans take heed patients may be sent to the institumore fully than before of the dan- tion at the expense of their home ger which they had previously been counties, and pay patients are also too willing to disregard. However, received. it is believed by students of Ohio's Municipal hospitals are maintuberculosis problem that the sud- tained by Cleveland and Cincinnati, den rush of interest in tuberculosis and county institutions by Lucas, hospital establishment in the state Franklin and Butler counties. Any this year is the result of several city may found a municipal tuberyears' steady, unceasing effort to culosis hospital but the law permitarouse such interest, as much as ting the establishment of county (if not more than) it is of war's hospitals was repealed in 1913, the warning.

county hospitals which had been established before the repeal being hospital. The choice of a site, the permitted to continue in operation plans of the hospital and the estiCounty and municipal hospitals mate of cost must be approved by provide for both advanced and in- the State Department of Health, cipient cases and receive both indi- The same law (Section 3139) forgent and self-supporting patients. bade the maintenance of any per

Since the repeal of the county son suffering from pulmonary hospital law in 1913, the only way tuberculosis in a county infirmary, open for a county to provide an in- giving the State Department of stitution for the care of its tuber- Health authority (Section 3140) culous citizens has been to join to remove any such inmate illegally with another county or other coun- kept in an infirmary and to place ties in forming a hospital district. him in a tuberculosis hospital to This course was provided for by be maintained at the expense of his a law passed in 1909 - and there- county. The district tuberculosis fore in operation concurrently hospital law, therefore, left open with the county law for four years. to the county commissioners only Under the district hospital law two courses for the care of indi(Sections 3139 to 3153-7, G. C., in- gent tuberculosis sufferers — to clusive), any group of from two to join a hospital district or to make ten counties may, by voluntary ac- contracts for such care with existtion of their respective boards of ing public or private hospitals. commissioners, approved by the The law also provides a convenient State Department of Health, or- means of caring for tuberculosis ganize a hospital district and pro- sufferers able to pay for treatment. ceed with the establishment of a In either case the public health is

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* There are 50 more beds available for public use in privately operated hospitals; there are also 212 tuberculosis beds in two state insane hospitals and the Soldiers' Home at Dayton.

* See discussion of these costs in body of article,

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