Causes of Death.—The table below shows the number of deaths reported for November, by principal classes, for the State as a whole and also for Northern or Superior California in contrast with the seven counties of Southern California. For convenience in comparison, the proportion of deaths from each class per 10,000 from all causes is likewise given:

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There is little difference between Northern and Southern California in the proportion of deaths caused by diseases of the circulatory system, of the genito-urinary system, and violence. However, Northern California exceeds in the proportion of deaths caused by diseases of the nervous and respiratory systems, in which the principal specific diseases are respectively apoplexy and pneumonia. On the other hand, Southern California exceeds in the proportions for general diseases, especially tuberculosis and diseases of the digestive system, including diarrhea and enteritis. The contrast between Northern and Southern California is particularly great for other than epidemic general diseases, the class in which the principal specific disease is tuberculosis. The proportion of all deaths from diseases of this class was 2,316 for Northern California against 2,802 for Southern California, an excess of 486 in the proportion for the latter.

The following table gives for California as a whole the number of deaths from the leading specific diseases, together with the proportion per 10,000 from all causes: Disease.

Number. Proportion. ALL CAUSES

2,153 10,000 Tuberculosis


,1,528 Heart disease


980 Pneumonia


859 Cancer


544 Apoplexy.


455 Bright's disease


399 Diarrhea and enteritis.


381 Accidental injuries

334 Suicides.

242 All others.


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The main cause of death, as usual, was tuberculosis, with heart disease and pneumonia next in order. Tuberculosis is especially prevalent in Southern California, as appears from the following figures:

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No less than 32.8 per cent of the deaths from tuberculosis occurred in Southern California against only 24.4 per cent of the total deaths, an excess of 8.6 in the per cent for tuberculosis. In this connection, however, it should be noted that deaths of recent residents from tuberculosis are particularly frequent in Southern California. This is shown by the table below giving the number and per cent of tuberculosis victims by length of residence in California for both parts of the State:

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The table shows that of those who died of tuberculosis in Southern California 19.5 per cent had lived in the State less than a year and altogether 53.7 per cent had lived here less than 10 years.

The corresponding per cents for Northern California were 3.2 and 17.7 and for the entire State were 8.5 and 29.5, respectively. The great bulk of those who died of tuberculosis in Northern California were natives of the State or others of long-standing residence, 34.8 per cent being native Californians and 38.0 per cent others who had lived here at least 10 years. For Southern California the corresponding per cents were only 14.8 and 19.5, respectively.

CLEAN CAMPS FOR CALIFORNIA. The State Board of Health is, as fast and as thoroughly as possible, making an investigation of the sanitary conditions of the different streams and summer resorts of the State. It recognizes in these streams and resorts California's greatest health-giving asset, and that a summer spent in them will do more to restore health and prolong life than any other way it could possibly be spent.

In order that the maximum good can be secured with the minimum danger, the streams must be kept clean and the camps in perfect sanitary condition. This, however, is not always the case. Indeed, many of the streams are polluted to a superlative degree and the camps along them are reeking with filth. This is often the result of conditions growing so gradually as hardly to be noticed by the proprietor or those using the camp. The results of polluted water and bad sanitary conditions are the same whether the conditions arise from ignorance, carelessness, or greed, and these results are frequently a siege of typhoid fever.

The Board desires to encourage life in the open air, firmly believing that such a life will do more for the general health of the people than any other thing; but it believes it to be its duty to warn against such resorts and localities as persistently refuse to better their sanitary conditions and hence endanger life. It is not our intention to publicly denounce any place until it has been investigated and notified and then refuses or neglects to remedy the defect.

It is encouraging to notice that most proprietors are willing and anxious to adopt any proposition that will better the condition of their resort. Some are rebellious and bluntly refuse to do anything.

The policy of the Board will be to thoroughly inform itself as to the facts, notify the parties in charge of any needed sanitary improvements, and wait a reasonable time for an effort at compliance. If not made in good, faith publicity will be made of the conditions and where necessary the laws will be enforced. The Board is frequently consulted by parties desiring to know the healthfulness of the different localities, and it will strive to be posted and give reliable information.

It is interesting to know that the necessity of keeping our streams clean and pure has strong advocates outside the health departments. The following from Josephine Kinney Walker, chairman of the Purity of Streams Committee of the California Club of San Francisco, should be read by everybody, and no one can tell how many lives would be saved if its warnings were heeded:



Notice the beauty of the flowing streams; think well about their uses. Cultivate a respect for them; they are nature's irrigation plants, homes of the fish, delight of the birds, water-carriers for man and beast, singing as they serve.

Running waters are life-savers. Throw nothing into them to contaminate, poison, and make them life-destroyers. It is selfish, vulgar, even criminal. Picknickers:

Your enjoyment is lacking without the streams; why destroy their fringed edges, spoil their shade, or render water unsightly with trash? Campers :

Dig holes to receive all rubbish; neutralize and bury, or burn refuse. Do not burden the streams with it. The birds may claim a share of broken food. Leave no fires unattended. Housekeepers:

Empty no tubs, cleanings of either fish, fowl, animal, fruit, vegetable, or dairy into your adjacent stream, even though dry. It is not dry in winter. Farmers:

Do not use arroyos or dry chasms for vaults, looking to storms to cleanse them. Think of your neighbor below. Consider the milk supply and the poisoned water for the stock. Resolve or burn, and fertilize. Try changing stable waste heap and corral yearly and absorb drainage into rank growth of field corn or pumpkins. These will pay you, besides protecting the streams. Study the Pasadena sewer-farm methods. Change and growth purify, and nothing is lost. Farms, Schools, Summer Resorts, Camp Grounds, Logging and Mining Camps, Villages :

Allow no drains to reach your streams. India gives us warning. Surface sewage, unresolved, has poisoned her soil and her waters.

The early inhabitants of America gave to the waters due respect. Indian shellmounds and bone heaps stand as monuments to their care of the streams.

From dripping spring or mountain glacier to the sea, our streams call for protection.


Apropos of the question of pure milk, the following quotation from an article by Prof. A. R. Ward, in the “Occidental Medical Times” of May, 1902, will be of interest:

“There is objection to feeding infants on pasteurized milk which was originally contaminated with bacteria and their products. It is said with truth that such milk contains the dead bodies of the bacteria, together with their products, both of which have been found injurious to infants. There is considerable divergence of opinion among the medical profession concerning the comparative digestibility of raw and pasteurized milk. Sterilized or boiled milk is so profoundly altered in its constitution and nutritive properties that it can not be fairly compared with raw milk. It is generally conceded that the proper natural food for infants is milk as free from bacteria as possible, and that measures designed to exclude bacteria must be relied upon to accomplish this result. Dairies conducted with a view to excluding bacteria from milk are not easily put into successful operation, chiefly because of the competition in the milk business. Few men possess the technical knowledge necessary to direct such a business, and even if such an undertaking were inaugurated under private control, it would not succeed in the face of competition. We need in California a limited amount of milk produced under irreproachable conditions, to be sold at a price commensurate with the care bestowed upon its production. In several of the larger cities of the East, dairies are in operation under the direction of an expert commission responsible to some body of men enjoying the respect and confidence of the community. For instance, the Philadelphia Pediatric Society undertakes to furnish a certificate of approval to all dairymen complying with its requirements concerning the precautions essential to the production of good milk. The society appoints a commission consisting of a bacteriologist, chemist, and veterinarian, all men of recognized standing. These three specialists report to the society at regular intervals upon the condition of the dairies and the character of the product. The expense of inspection is borne by the dealer, and indirectly by the consumer. Compliance with the requirements of the society necessitates a greater cost to the consumer, but the justice of the increased charge is not seriously questioned by those familiar with the conditions. The indorsement of the society has a distinct commercial value to the dealers, and is highly prized. Similar commissions are improving the milk supply of New York and Boston.

“The model dairy indorsed by an authoritative society has several commendable features that warrant its introduction in any large city. Physicians are enabled to recommend to their patients a milk produced under the most favorable conditions for insuring a healthful product. To the specialist in pediatrics, such an opportunity is of great importance. But the greatest value of the model dairy is in its power of quietly educating the consumers and milk-dealers. The writer believes that the scheme offers a peaceful means for accomplishing desirable reforms. The amelioration of our city milk supplies can be best accomplished by encouraging the establishment of a few model dairies, as object lessons for the other dealers and the public. As soon as the public learns to appreciate good milk, it will be willing to pay for it and dealers will be ready to supply the demand."


MUNICIPAL SANITARY IMPROVEMENTS. Sacramento has just installed a garbage crematory, and the garbage dump which has been so unsightly and unhealthful will be known no

This is an evidence that Sacramento is awakening to the fact that as the Capital City she should lead in sanitary matters. This she can easily do, for nature has endowed her with all the advantages. She has that greatest of all blessings, an unlimited supply of soft water along the city front. This was as pure as water could be until polluted by the washings of camp, ranch, and town. All that is needed to restore that purity is to filter it through sand. This would add something to the cost of the water, but it would save more in avoiding sickness. The sewage of the city should not be put into the river to further pollute it, but be pumped into the country where a sewage farm could be instituted, and, without producing any nuisance, used to advantage. These things will surely come, for the women of the city are awakening to its need and agitating the subject.

Fresno has voted almost unanimously to issue bonds to improve the sewer, to put in a septic-tank system of sewage destruction, and to buy a ranch on which to use the effluent. With good management the ranch will pay interest on the investment.

Selma, not intending to be left in the march for sanitary improvements, is agitating a new sewer system. In no other way could it invest money where such returns are assured—better health, longer life, fewer deaths.

Sacramento is to be congratulated that its Board of Health has taken the progressive stand to eliminate undrawn refrigerated food from the market. There can be no doubt that it is a source of great danger, as the dead tissues of the intestines offer no great degree of obstruction to the absorption by the flesh of the poisonous gases generated from the excrementitious matter in them. It is sincerely to be hoped that the trustees will stand with the Board of Health.


Dr. W. R. Batt, of Philadelphia, quarantine officer at large of the Pennsylvania State Board of Health, has opened "a twelve weeks' correspondence course, giving instruction in sanitary science for members of boards of health, health officers, physicians, and nurses." Judging from the first lecture this will be a valuable course of instruction and one that will repay any health officer to take, as it is progressive and

up to date.


Although as far as we are informed no severe epidemic exists, diphtheria is reported quite extensively throughout the State. This is eminently a contagious disease, and one easily carried by an intermediary. Two cases have been recently reported where the disease was given by pet rabbits. In every case the utmost care should be exercised to prevent anything from leaving the sick room that can possibly carry disease. All pets should be excluded from the house.

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