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DEATHS OF CHILDREN UNDER 5 YEARS OF AGE IN OHIO, BY

COUNTIES, IN FIRST SEVEN MONTHS OF 1918, WITH 1916 TOTALS
OF SUCH DEATHS AND BABY-SAVING QUOTAS FOR 1918 BASED
ON THOSE TOTALS - Continued.

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Clermont
Clinton
Columbiana
Coshocton
Crawford
Cuyahoga
Darke
Defiance
Delaware
Erie
Fairfield
Fayette
Franklin
Fulton
Gallia
Geauga
Greene
Guernsey
Hamilton
Hancock
Hardin
Harrison
Henry
Highland
Hocking
Holmes
Huron
Jackson
Jefferson
Knox
Lake
Lawrence
Licking
Logan
Lorain
Lucas
Madison
Mahoning
Marion
Medina
Meigs
Mercer
Miami
Monroe
Montgomery
Morgan
Morrow

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DEATHS OF CHILDEN UNDER 5 YEARS OF AGE IN OHIO, BY

COUNTIES, IN FIRST SEVEN MONTHS OF 1918, WITH 1916 TOTALS OF SUCH DEATHS AND BABY-SAVING QUOTAS FOR 1918 BASED ON THOSE TOTALS – Concluded.

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Muskingum
Noble
Ottawa
Paulding
Perry
Pickaway
Pike
Portage
Preble
Putnam
Richland
Ross
Sandusky
Scioto
Seneca
Shelby
Stark
Summit
Trumbull
Tuscarawas
Union
Van Wert..
Vinton
Warren
Washington
Wayne
Williams
Wood
Wyandot

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CHILD PAMPHLET ISSUED nize symptoms which indicate the

The Federal Children's Bureau need of special care, and also to has just issued the third pamphlet give mothers the better underin its series on the care of children. standing of the simple laws of The new publication is entitled hygiene through which it may be “Child Care.” Earlier numbers in possible to prevent the developthe series are "Prenatal Care" and ment of such defects at all. It will “Infant Care. The third pam

be especially useful to thousands phlet deals with children from two of mothers who have learned by to six years old.

the weighing and measuring test “Child Care” has been prepared of defects and weaknesses in their in the hope that it would enable children which need particular atmothers to understand and recog- tention.

A Recent Word on Pneumonia

Prevention

D

ISCUSSING “Prevention of depend upon the answer to the

Pneumonia" in a recent question: Do persons acquire the

article*, Dr. Rufus Cole of disease because they receive these the Rockefeller Institute empha- bacteria into their mouths or upon sizes the new knowledge of the their respiratory mucous surfaces, subject which has been gained or do they acquire it because of from investigations brought about some earlier factor which has inby the serious epidemic of pneu- creased their susceptibility to the monia in the army camps last win- disease? If the former is the reater. He points out that an article son, then measures for preventing on this subject a year ago would the distribution of the bacteria have dealt with the prevention of must be employed; if the latter, acute lobar pneumonia only, but then the distribution of the bacthat more recent experience dem- teria is of slight importance and onstrates the need for considering attention must be given to the facbroncho or lobular pneumonia also. tors influencing resistance.

Lack of general recognition of The resistance factor was conthe fact that these two distinct dis- sidered the important one so long eases existed side by side in the as all pneumococci were considered camps, and inability to differen- identical, but recent demonstration tiate between the two diseases even of the existence of several types where their separate existence was of pneumococci and of the fact that recognized makes it impossible for the types causing two-thirds of the us to know the relative incidence cases are not found in the mouths of the two kinds of pneumonia last of well persons, other than carriers year. The hope is expressed, how- who have been in close association ever, that with the better labora- with patients, justifies measures to tory facilities and the more wide- restrict the distribution of these spread knowledge of the methods types of pneumococci. The experiof differential diagnosis which now ence of physicians who have obprevail, more accurate differentia

served many pneumonia tion will henceforth be made. bears out this justification, as all

Lobar and broncho pneumonia have seen examples of contact inare considered independently, as fection, and recent studies have they require different preventive demonstrated the not infrequent methods.

association of cases due to pneuLobar pneumonia is caused by mococci of the same type.

Similar the pneumococcus, which organism preventive measures in the case of is widely distributed in the mouths pneumonia of the less virulent of healthy individuals and survives

types are made advisable by the for considerable periods in dust. long recognized fact that the viruPreventive methods to be followed lence of any bacterium for a given

cases

* Journal of the American Medical Association, LXII, 8 (August 24, 1918).

seem

species of animal is increased by ever, that hemolytic streptococci repeatedly passing the bacterium are rare in normal throats, except through animals of that species. in the presence of streptococcus

Experience indicates that the sore throat, and that such organfactor of lowered resistance plays isms found in dairy products are a certain part in pneumonia infec- of a bovine type, harmless to mani. tion, so measures to prevent undue At present, therefore, we exposure and lowered resistance justified in considering persons are recommended for preventive who harbor large numbers of acpurposes, together with isolation of tively hemolytic streptococci in the patients to as great an extent as throat as potential carriers, and in possible. Experiments with vac- giving some attention to the possicination against Types I, II and III bility of infection through dust, last winter produced results which, dried sputum, etc., and through while not conclusive, are sufficiently

food. The disease is spread, it promising to justify more extended appears at present, by fairly direct tests during the coming winter. In

transfer of the infectious agent 12,000 men inoculated at Camp from the patient or a healthy carUpton last winter not one case of rier, either by droplet infection or pneumonia due to pneumococci of through dust. . The pathology 01 Types I, II or III occurred, ,

the disease suggests a relatively although there was a considerable high immunity in man, despite the number of such cases among unin- high fatality, and therefore a relaoculated men in the same camp.

tively large number of healthy car

riers. Broncho pneumonia, which received serious attention for the

The recent epidemic among the first time last winter, is believed soldiers started with infection of to have been due, so far as the patients suffering from, or convalcases in the camps are concerned, escent from, measles, none of the one organism, hemolytic

earlier attacks being upon healthy streptococcus. Whether all strains individuals. Later such primary of this organism which have been infections appeared, however, afisolated are identical has not been fording some basis for the theory. discovered. If they are found that the streptococci, first attacking identical, the problem of preven

persons whose resistance had been tion will be comparatively simple. weakened by measles infection, If they are not identical, the con- were by that fact rendered more clusion must be that the essential

virulent and enabled to attack perfactor causing the epidemic was

sons suffering from other respirasomething other than the organism, tory diseases, such as lobar pneuand the study of the spread of the

monia, and finally acquired such disease will be made more difficult.

virulence that they may now infect If it should be found that these healthy persons. streptococci are

with Measures probably advisable to streptococci which exist as harm- prevent and restrict broncho pneuless organisms widely distributed monia are: outside the human body and in the (1) Precautions to prevent the throats of healthy persons, then the infection of persons highly susdifficulties will be still greater. ceptible to the disease, especially Present knowledge indicates, how- patients with measles, lobar pneu

identical

to

a

monia and other respiratory infec- at present, but similar results can tions;

be obtained by avoiding crowding (2) Prompt diagnosis and as and by educating men to use more rigid isolation as possible in ail care in disposing of their oral and cases of the disease;

nasal secretions.

Knowledge by the surgeons of (3) Preventive inoculation

the early symptoms of the disease, impossible until methods have been discovered with further investiga

well equipped diagnostic labora

tories and properly organized intion;

fectious disease hospitals are essen(4) Detection and isolation of tial to the effective carrying out of the healthy carrier-impracticable these measures in the army.

FEDERAL FUNDS MAY

A subsidy of this kind is proAID STATES' CHILD vided by the British government HYGIENE ACTIVITIES

for local child welfare work. The Federal financial aid for child

British, however, are appropriating hygiene activities of the states will a larger sum, in proportion to inbe provided, if Congress passes fant population, than is proposed duplicate bills introduced by Repre- for the United States. The British sentative Jeanette Rankin of Mon- subsidy amounts to approximately tana, and Senator Robinson of

$1,100,000 per year for fewer than Arkansas with the aproval of the 709,000 babies under one year of Children's Bureau of the Depart- age, while the amount proposed ment of Labor.

for this country is $1,480,000 for The bill would grant Federal aid

more than 1,500,000 babies in the to state work for mothers and

rural districts. babies in rural districts, provided this work meets the general requirements of the bill and such detailed standards as may be fixed

T. B. CASE ESTIMATE by the Children's Bureau. The

MAY BE TOO SMALL amount allowed for the first year would be $1,480,000, including the

Statistics compiled as the result expenses of Federal administra- of community-wide medical extion. This amount would be in- aminations in connection with the creased each year, until in 1923-24

health demonstration at Framingit would be $2,480,000. Each state

ham, Mass., show that tuberculosis would, under certain conditions, exists there in the ratio of twentyreceive $10,000 annually. The re- one case to every death, if armainder would be divided among rested cases are included, or nine the states upon the basis of their cases to one death if only active rural population, but amounts be- cases are considered. The generyond the first $10,000 would be ally accepted estimate of this ratio available only after a state had ap- in the past has been five or six propriated an equal sum.

cases to one death.

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