em be clear and so drawn up that the more important factors are phasized. Simplicity and concentration are important, but above all accuracy should be sought. A scorecard which gives a dairy ten points for odors in the barn and only one for small top pails is from the sanitary standpoint worse than useless. The card should generally be arranged in two parts, no matter what it is scoring, for these two main headings apply to anything. worth scoring. They are "Equipment" and "Methods". In some cases more divisions are used or indicate less directly these two points. Herewith are reproduced four original scorecards which are now in use and have proved satisfactory. DAIRY SCORECARD Name... Address. I. Stables (15) Number cows. Quarts of milk daily. EQUIPMENT (25) Score Possible Allowed a) Well lighted, 400 cu. ft. air per cow.. b) Floors, walls, ceilings, windows, clean, no dust, barn whitewashed c) Tight floor and gutter.. d) No contaminating surroundings. II. Milk House (10) . a) Concrete floor, light and well ventilated, screens. b) Floors, walls, ceilings, windows clean....... c) No contaminating surroundings..... III. Utensils (16) METHODS (75) a) Sterilized in steam, 5; scalded, 3.. c) Small top pail with strainer.. IV. Cows (17) a) Tuberculin tested b) Clean, free from dirt, dust, and manure. c) Udders washed before milking... d) Disposal of manure (at least 50 ft. from barn).... V. Employees (23) a) Free from disease, vaccinated for typhoid... b) Clean in person, clean milking suits.. c) Wash hands before milking.. d) Milk dry handed...... VI. Milk (19) a) Not poured in cow stable... b) Removed and cooled at once. Final score. Date... % Inspector Possible total score....... Total score allowed. .by Scoring the Dairy The first of these is for dairies and was devised by the author. It differs from that of the U. S. Bureau of Animal Industry in that equipment is given 25 instead of 40 and methods 75 instead of 60, and the number of items is also reduced and condensed. The experiments of Dr. C. E. North of New York City have proved con Inspector clusively that clean pure milk can be produced in an old wooden shack by means of proper sanitary methods, methods, while dirty milk can. come from a palatial, expensive stable. This has also been the experience of the writer, who has seen milk which gave a count of millions of bacteria per cubic centimeter come from a dairy that was in the certified class, while a small dealer with a tumble-down barn consistently produced milk with about three or four thousand bacteria per cubic centimeter. Dr. North's experiments have led him to recommend a dairy score in which equipment is given only ten and methods ninety, but while concurring in his conclusions, the writer believes that the change is too radical for the present. The ideas of farmers and the vast quantity of small producers must be somewhat more gradually changed. If we wipe out our previous teachings with one fell swoop, as it were, the farmer will distrust, what we give him now and say that we were wrong before and probably are now. There is also some psychological effect in good equipment, for a clean whitewashed barn induces a man to attempt to practice cleanliness. The Other Cards The second scorecard shown was devised for restaurants. It emphasizes the health of smployees, an item which should be backed up by requiring a medical certificate from every food handler. Protection of food, source and condition of same and garbage disposal are also given prominence. The third card is for barber shops devised when the author was health officer of West Orange, N. J. In these shops the relation of barber and customer is one of personal contact 10 8 3. Running water, hot and cold (allow 8 for heater). 1. Well lighted (natural) 2. Well lighted (artificial). 4. Basin for washing hands.. business 5. Unconnected by door or hall with room used for other 6. Sanitary toilet (proper plumbing) 7. Screens, free from flies..... Deduct for spitting on floor or other unclean action... 10 4 100 5508805 Equipment.. Methods... Inspector.. Total Score. Water tight floor..... 6. Water closet not opening into room where food is handled METHODS (66). 7. Floors, walls, ceilings, windows clean.... 8. Utensils, mixers, dough troughs, racks clean. 9. 10. 11. Protection of raw materials. Mechanical mixer Basin for washing hands, towels, sanitary plumbing... 12. Employees free from disease, clean in person, wear clean uniforms ... 5 10 10 3 4 6 10 5 7 6 5 100 Inspector and the opportunity for infection is great. They deserve more attention than is generally paid to them. The fourth card is for bakeries and is modified after that used in Monteclair, N. J. Other uses of scorecards are in inspecting groceries and markets, ice cream factories and laundries. CHILLICOTHE INSTALLS MORE RIGID CODE OF SANITARY REGULATIONS Additions to Chillicothe's sanitary code, growing out of the campaign of sanitation which has been waged by representatives of the United States Public Health Service in the Camp Sherman zone, have been approved by the board of health in that city. By the new regulations, restaurants and their employees are compelled to submit to inspections whenever the health authorities desire, and employees of restaurants must submit to vaccination in case it is deemed necessary. A fee of $1 will be charged for restaurant permits. Such inspections have been going on for some time as a measure of protection for the soldiers' health. Inspection of private as well as public wells is provided for, and any found unsanitary may be condemned. Manure bins must be elevated one foot, and must be emptied twice weekly from March to November and once weekly from November to March. Privies must be screened. Looking After Ohio Soldiers Discharged for Tuberculosis A SYSTEM of following up cases of tuberculosis in men discharged because of the disease from the military service, made possible by the co-operation of the military authorities in giving notifications of such discharges, was installed just before the beginning of the year by the. Division of Public Health Education and Tuberculosis of the State Department of Health. Notifications of tuberculosis discharges from Camp Sherman, Chillicothe, are received direct from the disability board at the camp. Reports from other camps. and posts reach the department through the National Association for the Prevention of Tuberculosis, which receives and classifies the army reports. Follow-Up Methods If a reported case is within the jurisdiction of a public health nursing center, a notice, with an investigation blank for each case in the district, is sent to the public health nurse or superior officer. If the case cannot be reached by a public health nurse, a letter is sent from the department direct to the discharged man, offering advice and assistance. It is hoped that the direct letter will elicit a reply from the subject and place the department in position to give such general advice as may be possible and to recommend consultation with a physician of known worth in tuberculosis cases. It is also desired that physicians, in case the discharged man is in poor circumstances, will agree to render free service. In some cases where it may appear advisable, representatives of the department's nursing service will probably visit the subjects. Investigation By Nurses Where cases are referred to public health nurses, it is presumed that their investigations and visits will obviate any further direct action in the case on the part of the department until the subject becomes a patient in an institution for the public care of tuberculosis. The investigation blank used in connection with this new branch of the department's work is the regular form used by the bureau of admissions and discharges, with the addition of questions bearing upon the industrial occupations of the subject, practically identical with the questions to be found on the certificate of industrial disease used by the department's Division of Industrial Hygiene. Replies Come In Several replies were received shortly after the first letters to discharged men were sent out. It is believed that the department's offers of assistance will in general meet with a cordial reception. Information regarding draft rejections on ground of tuberculosis infection was not at first available, an early order of Provost Marshal General Crowder making it available having been revoked. More |