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The malaria mosquito is found extensively throughout the State, and its destruction should be sought by all communities. All persons suffering from malaria should be protected from mosquitoes in order to prevent their becoming infected and carrying the disease to others. The following directions are from the Public Health Reports', and while given for yellow fever, are as applicable to malaria:

The infection of yellow fever is carried by mosquitoes, and by no other means is the infection spread.

Persons take the disease by being bitten by mosquitoes that have previously bitten a yellow-fever patient.

The mosquitoes to become infected must bite a yellow-fever patient during the first three days of his attack. These first three days, therefore, are the most important time for preventing the access of mosquitoes to a fever patient.

It is often difficult to decide during the first three days whether a patient has yellow fever; hence the necessity in threatened communities of placing a mosquito bar immediately around every patient who has fever of any kind, and for three days at least.

Facts about Screening.-1. The netting used should have meshes fine enough to prevent the passage of mosquitoes (at least 18 to 20 meshes to the inch).

2. It is important to screen the windows and doors of the house. It is doubly important to screen the beds of fever patients.

3. Mosquitoes can bite through mosquito nets when any part of the patient's body is in contact with the netting.

4. Frequent examinations should be made to see that there are no torn places in the netting, or that no mosquitoes have found a lodgment inside.

5. The netting should be well tucked in to keep mosquitoes from entering.

6. If mosquitoes are found within the netting they should be killed inside and not merely driven or shaken out.

7. All cases of fever should be promptly reported to the local health officer. Awaiting his arrival they should be covered with a mosquito bar.

Facts Bearing on Mosquito Destruction.-1. Mosquitoes live in the vicinity in which they breed. They do not often fly a long distance.

2. Mosquitoes breed only in water-usually in artificial collections of fresh water. 3. The young

squito, or wriggler, lives in water at least seven to twelve days. 4. Although the wrigglers live in water, they must come frequently to the surface to breathe.

5. Coal oil on the surface of the water prevents the wrigglers from breathing. 6. Destroy the breeding-places and you will destroy the mosquitoes.

7. Empty the water from all tubs, buckets, cans, flowerpots, and vases once every forty-eight hours.

8. Fill or drain all pools, ditches, unfilled postholes, and the like. 9. Change regularly every day all water needed in chicken-coops, kennels, etc. 10. Treat with coal oil all standing water which can not be screened or drained (1 ounce of oil will cover 15 square feet of surface). The oil does not affect the water for use if the water is drawn from below.

11. Where oil is applied to standing water it must be distributed evenly over the surface.

12. Put fine wire netting over cisterns, wells, and tanks of water in everyday use.

13. Places in which it is undesirable to put oil, such as watering-troughs for stock, lily ponds, and so forth, can be kept free from wrigglers by putting in gold fish or minnows.

14. Clean away all weeds, grass, and bushes about ditches, ponds, and other possible breeding-places, since these afford a hiding place for the mosquitoes.

15. Clean up vacant lots and back yards of all cans, tins, bottles, and rubbish.

16. First do away with, or treat, all places where mosquitoes are known to breed, and then begin to work on places where they might breed.

17. Inspect and treat with coal oil gutters, culverts, ditches, manholes, catching basins, etc., along the roadside. Manhole covers should be screened.

18. Houses should be cleared of mosquitoes by burning 1 pound of insect powder or 2 pounds of sulphur to 1,000 cubic feet of space. The mosquitoes will fall to the floor and should be collected and burned.

19. Success in mosquito destruction depends upon the coöperation of the members of the entire community.

20. While the infection of yellow fever is carried by a single species of mosquito (the Steqomyia), to insure its destruction it is necessary to destroy all mosquitoes.

In places liable to yellow fever both individuals and communities have an effective method of protecting themselves, as indicated above. Use the mosquito bar at once over all cases of fever until the danger from yellow fever has passed. Destroy all mosquitoes.

WALTER WYMAN, Surgeon-General.

1 U.S. Public Health and Marine Hospital Service. Public Health Reports, Vol. XX, No. 31, pages 1555-1557. (August 4, 1905.)

NOTIFICATION OF TUBERCULOSIS. The State Board of Health, in publishing a revised list of reportable diseases, included “tuberculosis of the respiratory tract," believing that the health department of every locality should know where every case of this disease is located. Otherwise they can do little to prevent its spread.

The September number of the California State Journal of Medicine contains the following, which so thoroughly voices our opinion that we reproduce it in full. It should be read by all those suffering with this dread, but preventable, disease, and actively supported by physicians. The italics are ours:

The committee on tuberculosis of the Medical Society of the State of California believes the following represents the most advanced thought upon the subject of notification in pulmonary tuberculosis:

First-Tuberculosis is a disease communicated from one individual to another because of the violation of simple rules of hygiene and sanitation, through either ignorance or willfulness, usually the former.

Second-In order to wage an effective warfare against this disease, the individual suffering from tuberculosis must know that he has the disease, must be instructed as to its nature and as to what measures are necessary to prevent its spread, and must carry them out with care. After removal or death, the apartments previously occupied must be thoroughly cleansed and disinfected.

Third- The supervision of such measures rightfully belongs to the department of health, and in order for this department to have such supervision, it must be able to locate those suffering from the disease, which can only come about by requiring all cases to be reported.

Fourth-The notification of tuberculosis should be especially safeguarded so as not to work unnecessary hardship upon those who are afflicted. Consequently the books containing the record of the names of those suffering from the disease should be open to the inspection of none but the health authorities. This protects not only the patient, but the physician as well, and removes the usual objection urged by physicians against notification. The purpose of notification is not for quarantine, nor for placarding the house occupied, but simply to insure that proper instructions are ai

r precautions taken. Fifth-Special instructions should be printed by the health board. These should be furnished to physicians, who should give them to all patients suffering from tuberculosis. When the physician notifies the department, he should signify whether he will instruct the patient and friends himself as to the methods of preventing the disease, or whether he wishes the department to do this. In this way there would be no meddling with private patients, unless at the physician's request, and consequently there would be no clash between physician and health board. When physicians learn that notification can be carried out without interfering with the liberty of their patients, they feel friendly to the plan. When the public learns that it is done for their protection, and that it entails no hardship, they, too, will take readily to it.

Notification is in harmony with the advanced thought on the prevention of tuberculosis, and will be adopted generally sooner or later, the time depending upon the importance given the subject in the various localities.

F. M. POTTENGER.
Jno. C. KING.
GEORGE L. COLE.
EDWARD VON ADELUNG.
GEORGE H. Evans.

ANSWER TO REQUEST FOR INFORMATION. Information has been sought from this office as to the safety of the process of removing, by means of caustic acid, the skin of peaches that were to be canned. It was stated that the California Fruit Canners' Association, at San José, was using this process, and fear expressed that it was deleterious to health. A representative of the State Board of Health visited the cannery and examined the methods used. The fruit is immersed in the hot lye and quickly passed into pure cold water, which is constantly changing, and quickly washes away any alkali. The process is entirely cleanly, the fruit not being handled as it must

1 California State Journal of Medicine, Vol. III, No. 9, page 294. (September, 1905.)

have been registered in each of the following twelve counties, arranged alphabetically: Calaveras, Kern, Monterey, Napa, Nevada, San Luis Obispo, Shasta, Solano, Stanislaus, Tulare, Ventura, and Yolo. In the period covered marriages have also been registered in the following twenty counties: Alpine, Butte, Del Norte, El Dorado, Glenn, Inyo, Kings, Lake, Lassen, Mariposa, Merced, Modoc, Plumas, San Benito, Sierra, Siskiyou, Sutter, Tehama, Trinity, and Yuba. Though the eleven counties from which the County Registrars have not yet forwarded certificates of marriages include one populous county, none of the others had over 40,000 inhabitants in 1900, and, in fact, all except three were of less than 20,000 population at the last Federal census.

A total of 1,811 deaths, exclusive of stillbirths not tabulated, were reported for September from forty-eight of the fifty-seven counties in the State, including seventy-four cities and incorporated towns. Reports that no deaths occurred in the month were received from three County and fourteen City or Town Registrars. The principal causes of death were general diseases (especially other than epidemic diseases), diseases of the nervous system, of the circulatory system, of the digestive system, and violence. About one eighth of the deaths were due to tuberculosis, and about one twelfth to heart disease. The next most important specific causes of death in September were cancer, pneumonia, Bright's disease, apoplexy, and diarrhea and enteritis.

Causes of Death.—The following table gives the number of deaths from the diseases included under each of the main headings of the International classification for California in September and August repectively. For convenience in comparison, the proportion of deaths from each class pėr 10,000 from all causes is likewise shown for both months:

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About one fourth of the deaths each month were caused by general diseases other than epidemic diseases, the class which includes tuberculosis and cancer. In August there were relatively more deaths from diseases of the circulatory system than from those of the nervous system, but in September the balance had shifted so that then the pro

of deaths from diseases of the nervous system was somewhat

greater than that from diseases of the circulatory system. Further, while in August more deaths were caused by violence than by diseases of the digestive system, in September there were more deaths from diseases of the digestive system than from the various forms of violence. In both months the next most important causes of death were diseases of the respiratory system and of the genito-urinary system.

The following table shows for September the number of deaths from the leading specific diseases, as well as the proportion per 10,000 from all causes:

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About one death in eight was caused by tuberculosis and one in twelve by heart disease. In round numbers about one death in twenty was due to cancer, pneumonia, Bright's disease, apoplexy, or diarrhea and enteritis, and, roughly speaking, about one in forty was due to old age, congenital debility, meningitis, or typhoid fever.

PUBLIC HEALTH ASSOCIATION. The California Public Health Association will hold its fifth session at the Board of Health room, City Hall, San Francisco, beginning at 10 A. M. October 28th. The following is the program: 10:00 A. M.-Greeting by the President, Dr. E. von Adelung, Oakland. 10:15 A. M.-“Sanitation of Stanford,” Dr. W. F. Snow, Stanford University. .

Discussion to be opened by Dr. R. L. Wilbur. 11:00 A. M.-" Contamination of Water Supplies,” Dr. N. K. Foster, Sacramento.

Discussion to be opened by Dr. F. G. Canney. 11:45 A. M.--Questions and general discussion on any desired subject. 12:00 m. --Noon recess.

1:30 P. M.-.

--Questions continued. 2:00 P. M.-"Disinfection,” Dr. J. A. Cobb, Passed Assistant Surgeon U. S. Public

Health and Marine Hospital Service, Los Angeles.

Discussion to be opened by Dr. W. C. Hassler. 2:45 P. M.—“Quarantine in Typhoid,” Dr. Woods Hutchinson, Arrowhead Sanatorium.

Discussion to be opened by Dr. Charles C. Browning. 3:30 P. M.--"Control of Contagious and Infectious Diseases of Aliens arriving in San

Francisco," Dr. H. S. Cumming, Passed Assistant Surgeon U. S.
Public Health and Marine Hospital Service, San Francisco.

Discussion to be opened by Dr. Trotter, 'U. S.

Public Health and Marine Hospital Service. 4:15 P. M.--"Undrawn Fish and Poultry," Dr. F. G. Fay, Sacramento.

Discussion to be opened by Prof. A. R. Ward. Discussion will follow each paper; speakers limited to five minutes. Evening session at pleasure of Association.

Every person interested in sanitation is cordially invited.

have been registered in each of the following twelve counties, arranged alphabetically: Calaveras, Kern, Monterey, Napa, Nevada, San Luis Obispo, Shasta, Solano, Stanislaus, Tulare, Ventura, and Yolo. In the period covered marriages have also been registered in the following twenty counties: Alpine, Butte, Del Norte, El Dorado, Glenn, Inyo, Kings, Lake, Lassen, Mariposa, Merced, Modoc, Plumas, San Benito, Sierra, Siskiyou, Sutter, Tehama, Trinity, and Yuba. Though the eleven counties from which the County Registrars have not yet forwarded certificates of marriages include one populous county, none of the others had over 40,000 inhabitants in 1900, and, in fact, all except three were of less than 20,000 population at the last Federal census.

A total of 1,811 deaths, exclusive of stillbirths not tabulated, were reported for September from forty-eight of the fifty-seven counties in the State, including seventy-four cities and incorporated towns. Reports that no deaths occurred in the month were received from three County and fourteen City or Town Registrars. The principal causes of death were general diseases (especially other than epidemic diseases), diseases of the nervous system, of the circulatory system, of the digestive system, and violence. About one eighth of the deaths were due to tuberculosis, and about one twelfth to heart disease. The next most important specific causes of death in September were cancer, pneumonia, Bright's disease, apoplexy, and diarrhea and enteritis.

Causes of Death.—The following table gives the number of deaths from the diseases included under each of the main headings of the International classification for California in September and August repectively. For convenience in comparison, the proportion of deaths from each class pėr 10,000 from all causes is likewise shown for both months:

[graphic][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][merged small][subsumed]

About one fourth of the deaths each month were caused by general diseases other than epidemic diseases, the class which includes tuberculosis and cancer. In August there were relatively more deaths from diseases of the circulatory system than from those of the nervous system, but in September the balance had shifted so that then the proportion of deaths from diseases of the nervous system was somewhat

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