Discussion of Paper Read by Dr. W. F. Southard.

DR. J. T. MCLEAN (of Alameda): At the risk of occupying the time of the convention too frequently, I would say that the importance of this subject which Dr. Southard has brought before us cannot be overestimated or overstated. The idea of thousands and thousands of children becoming blind, and totally blind, by reason of the negligence or ignorance of people who are treating those children, or under whose care they have been brought into the world, is really a very alarming and frightful thing, and if this result can be stopped, by all means it ought to be brought about. That is one of the matters that we ought to take in charge and work out-the salvation of the children of the State from this most serious and dreadful affliction of blindness. And so I hope that our State Board of Health will take this matter also into serious consideration, and in regard to this matter formulate some recommendations which shall be printed and spread broadcast through this State. While I am on the floor I want to call attention to another matter in this same connection. I think there is a great deal of work for the State Board of Health to do, and they ought to go about and do it, or else get out of their places and let somebody else take them and go to work. This is plain talk, but it is all in good part, and it is serious, too. I have here in my hand, which I took out of my office to-day, the last three monthly reports of the State Board of Health of the deaths in the State of California. From these three reports I have found that these facts exist: that from communicable, and so preventable, diseases, as Dr. Ruggles states it, which is correct-of this class of diseases there occurred in January in this State, according to this report, three hundred and fifty-eight deaths. In February of this year there occurred three hundred and fifty deaths, and in March four hundred and fifty deaths from preventable diseases. Now, I say these diseases ought to be prevented, and consequently the deaths that have occurred from them; and that it is the business of the State Board of Health to go to work and spread broadcast over the State circulars which shall help the people to information in order to bring about this most beneficent result. I do not say this in any fault-finding spirit; I say it because I am shocked at this statement, that more than one third of the deaths that occurred in the last three months in this State were from preventable diseases. Those diseases ought to be prevented. Whose business is it to prevent them? These gentlemen whom we select and honor with this position, the executive officer of whom we pay a salary to do this very work. Now, I say that if the salary is not enough to induce the State Board of Health to undertake this work, let us give the executive officer who does the work more salary, and let us pay him properly. And just see the executive officer of the Board of Health of the City of San Francisco! There is an immense amount of work for that gentleman, and if he don't get salary enough to do it give him more salary and have it done, and save the lives of the people who are dying in this city from communicable diseases. But to come back to the State Board of Health. That is the point. We can talk about the State Board of Health, because they are our officers. And now, as I say, this data must be correct. It is the publication of our own Board, and it is a most lamentable statement that we get from that, that one third of all the diseases from which all the deaths in the State occur, are communi

cable, and therefore preventable, diseases. I do not know of any single publication made by our State Board of Health in regard to these preventable diseases, except that in regard to diphtheria. Now, diphtheria is a frightful disease, and a good many people who get it die from it, and it is very appropriate that the Board of Health has made that excellent publication, and whenever I have reported to me a case of diphtheria in our town, which is very seldom, I load myself up right away with several copies of this publication of our State Board of Health, and go and see the diphtheritic family, and I give them a copy of that, and I also give some to neighbors around there. Now, if we were enabled to do this in regard to all other communicable and so preventable diseases, what a world of good we could do, and how simple it is for our State Board of Health to provide us with this sort of literature, which is so necessary for us in doing our work, and I now make a motion, as the end of my statement in this regard, that it is the sense of this State Sanitary Convention that our Board of Health prepare, without unnecessary delay, circulars for widespread distribution over the State concerning all these communicable and so preventable diseases, and supply Boards of Health and health officers everywhere with this sort of literature, in order that they may carry it with them to families that are afflicted with these diseases, and to the neighbors where these diseases exist. I know that a great many medical men who attend these diseases, and the most experienced of them, do not take the pains they ought to take. I know it from my own experience. DR. BERT ELLIS: I rise to a point of order. This is not pertinent to the subject under discussion.

DR. J. T. MCLEAN: I know that physicians do not properly educate the families that they are treating where there are these diseases, and the Health Officer cannot do this always. If an intelligent communication were prepared in regard to each one of these communicable diseases, and given to the Boards of Health and to the communities generally, they would work out a world of good.

DR. M. REGENSBURGER: There is a motion before the house.
THE CHAIRMAN: It has not been seconded.

DR. M. REGENSBURGER: I seconded it.

THE CHAIRMAN: If that motion is to be put, I would request that it be in writing, because the Chair could not catch the drift of the motion. It seems to me the convention is degenerating into rather an attack and defense of Boards of Health, and as I understand it, that will not forward in any way sanitary ideas or the sanitary condition of the people of this State, and the Chair will decide that all this matter and this motion of Dr. McLean are out of order.

DR. M. REGENSBURGER: I think the Chair misunderstands that motion. The motion is a very simple one. There is no censorship regarding the State Board of Health. It is simply a motion that the State Board of Health instruct people regarding communicable diseases and how to prevent them. That is a very simple thing to do. As I understand the doctor, his idea was that a great many people are ignorant regarding communicable diseases. You take ophthalmia in new-born children. Here is a disease that we have all noticed, where the people are ignorant regarding the danger of this disease, and if people were instructed in a matter of that kind they would probably act, and a great deal of trouble would be prevented. As I understand it, that is the object of the

doctor's motion. It is in regard to instruction about some of these diseases, and I think the State Board of Health, which has done the same thing before they have instructed people in regard to diphtheria and its prevention-should continue the issuance of preventive disease circulars, and there is no reason in the world why this Sanitary Convention should not recommend that the Board notify the people and instruct them in regard to prevention of disease.

THE CHAIRMAN: The Chair will state this: that we have simply gotten away from the subject under discussion, which was a paper by Dr. Southard, and after that is disposed of, the Chair will entertain the motion of Dr. McLean. Is there any further discussion on the subject of Dr. Southard's paper? I hope the gentlemen will confine themselves to remarks on the paper.

DR. M. REGENSBURGER: I move that the paper be referred to the Committee on Publication.

(Carried.)

DR. J. T. MCLEAN: I disclaim, in the start, any disposition to reflect upon the State Board of Health. I do not want to attack them. I have no such idea in my thoughts. I am as peaceable as a lamb. I am only positive in regard to a thing that is, from my experience, very necessary and important to be done, and these are the gentlemen to do it; and so I make a motion that the State Board of Health be instructed or requested by this Sanitary Convention to prepare papers upon this subject of purulent ophthalmia, and upon all other subjects relating to communicable diseases, with a view to the spreading of the information which should be contained in their circulars throughout the State for the benefit of the sick.

(Motion seconded.)

DR. J. R. LAINE: Will you kindly enumerate the headings-the different subjects-whether measles, scarlet fever, or what?

DR. J. T. McLEAN: I will read from the State report the diseases that I have classified: Consumption, pneumonia, bronchitis, diarrhoea, dysentery, diphtheria, croup, scarlet fever, measles, whooping-cough, typhoid fever, remittent and intermittent fevers.

DR. J. R. LAINE: I would like to ask if you think there is weight enough in the Board to get through the subject and produce a work that will be commendable and a credit to the State on these various subjects.

DR. J. T. MCLEAN: I simply state that the State Boards of Health of a large number of the States of the United States do this very thing; and why our State Board of Health should be behind other State Boards of Health, I don't know. The State should certainly supply them with all the means necessary to publish these reports, and they have the ability to formulate them. If they are not paid enough to do it, let the State give them more pay.

DR. WINSLOW ANDERSON: Mr. President, if I may be permitted to say, this is not a political convention. There seems to be a disposition on the part of some of the speakers, year by year, to find fault with the State Board of Health and to desire to instruct the Board as to its duties and the salaries the State shall pay the Secretary. Now, the organic law creating the Board defines its duties and fixes the appropriations and salaries. The State Board of Health is not under the direction of this convention, nor can it become subservient to resolu

tions here presented. The members of the State Board are always thankful for any suggestions that might be offered, but they will act according to their own conclusions and established precedents. My worthy friend from Alameda believes that bronchitis and diarrhoea are contagious diseases, and places malarial fevers and pneumonia in the same category with tuberculosis, diphtheria, and scarlet fever. This classification I cannot accept as the opinion of the scientific world of to-day. Bronchitis is most frequently caused by sudden changes in temperature or by "catching cold." It frequently is a sequela of influenza or the result of irritating gases, but not a communicable disease. Ordinary diarrhoea is mostly caused by impure or improper food. Malaria depends upon impure water or impure air, and cannot be classed with diphtheria, which infects from person to person. In regard to sending out circulars, I wish to say that the present Board has sent out five or six upon various subjects. The last one was written by myself and contains simple tests for drinking water. The reports of these sanitary conventions, inaugurated by the present Board, are printed by the State and sent out to every physician and all the boards of health in the State and country. Nothing could have more general circulation than is given by the Board to these reports of our deliberations. All these excellent papers are published, and Alameda shall have one thousand copies if she so desires. I do not see the necessity of preparing voluminous articles on all these diseases, because it is probable that the State Board of Examiners will not have them printed.

DR. M. REGENSBURGER: Now, gentlemen, this is a very important matter. I don't wish to impose any extra duty on the State Board of Health. We cannot force them to do this thing. If they do not wish they need not do it, but there should be a way of instructing the people regarding this very disease of ophthalmia. This is a very important matter, as I see it, and a great many see it every day, and see that the trouble does arise from the ignorance of the people. There is a happy medium to bring this before the public. The State Board of Health does not have to publish any works. If the Secretary of the State Board of Health will formulate a small recommendation and forward it to the different daily papers, they will only be too glad to publish it, and that will be the best way out of it; and I second Dr. McLean's motion to recommend to these gentlemen to take this matter up. I do not wish to prescribe what preventable diseases they should take up, but I would ask that they take up the more important ones.

DR. J. R. LAINE: I wish to state that the duties of the State Board of Health are very clearly stated in the Political Code of the State of California, and among those duties it states that the Secretary, particularly, shall perform such duties as are imposed upon him by the State Board of Health. A great deal of it is discretionary with himself. I believe that the members of the Board understand that I have not shirked much duty. I have done a great deal, and if I have enjoyed a private practice outside of my duties, that is a matter, perhaps, for self-congratulation, the appreciation of my friends, and my good luck. do not object at all to formulating and causing to be printed (providing the State will print them) circulars on any of these subjects; in fact, I have published some, and the reason that I have not published more was because the publication of one circular on diphtheria would cover perhaps all the needs and requirements in cases, for

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instance, of scarlatina. The precautions necessary in the one case are almost sufficient for the other. With reference to smallpox, I do not regard it as necessary to publish one. Still I am willing to concede the point, and I confess, possibly, to a fair amount of ability, sufficient perhaps to write the circulars and cause them to be printed. I had at one time prepared a large amount of matter that. I submitted to the Board of Examiners. One of the members was Secretary of State, E. G. Waite, a friend of Dr. McLean. If I remember rightly, he advised it should not be printed. I have sometimes prepared other matter for print and was advised not to have it printed. It was not because it was inexpedient, or that it would be an injury, but it was too expensive. They wanted to confine the printing to the essential necessaries. So far as I am personally concerned, I believe in the kind of circulars that Dr. McLean speaks of. I have prepared a number, five or six, I think, but have not extended them for the reasons given. I do not think it is because I am lazy. I am willing to make all those recommendations officially, and hope they will be accepted.

(The Chairman put the motion of Dr. McLean, which was carried unanimously.)

THE CHECK-REIN; ITS USES AND ABUSES.

By CEPHAS L. BARD, M.D., of Ventura, California.

The check-rein now commonly in use, at least that form known as the side check-rein, originated many centuries before the era which we regard as that of a Christian civilization, boastful of its accomplishments for the amelioration of the condition of mankind, and of its humane and merciful treatment of its beasts of burden. It is shown without a doubt, by reference to the ancient Egyptian monuments, that the chariots of Pharaoh's time were drawn by horses furnished with checkreins attached to the pad, just as they are to-day. We have in the Scriptures, also, inferential mention made of its use. Thus in Job, thirtieth chapter, second verse, appears the following: "They have also let loose the bridle before me.'

The persistence in such a custom can only be explained by attributing it to the belief, on the part of many, that the use of the device in some form, if not indispensable, is at least desirable. For, in spite of the able, intelligent, and forcible arguments and appeals of humane people organized into societies for the special purpose of preventing cruelty to animals, and who favor the absolute disuse of the check-rein, as set forth in tracts and other literature scattered gratuitously broadcast o'er the land, it is absolutely true that public opinion has not conceded to these reformers that the check-rein is destitute of all merit, and resists the ultra prohibitive measures which they advocate.

Never since his subjugation has so much been done for the alleviation of the horse's condition of servitude as now. Never has he been exposed to such a close scrutiny and critical study as he is in these times, when, with an ever-increasing lowered record, he exacts more homage from fair lady and brave man than did the knights of old. As he speeds along the crowded track, the shadow of his stride is caught on the artist's plate; the pen of the bard immortalizes him in verse; and the