PURE MILK. 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 more. 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. SANITATION CORRESPONDENCE SCHOOL LECTURES. 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. DIPHTHERIA. 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. Thorough disinfection should be practiced. Too little of the chosen disinfectant is frequently used to be effective. Not less than 16 ounces of the forty per cent formalin solution to 1,000 cubic feet of space should be used, with a long exposure and under the immediate direction of the health officer. DANGER IN SHELL FISH. Dr. D. F. Ragan, the able and efficient Health Officer of San Francisco, in his September report, treats extensively of "Our Marine Products." He shows that the waters of San Francisco bay are polluted by the sewage of the numerous cities and counties surrounding it, and that in the mud "bacteria, protozoa, and various other forms of organic life, both animal and vegetable, thrive abundantly. Strict supervision should be maintained so that no fish, either the small fish, clams, crawfish, shrimps, or oysters, should come from such a bed of filth as I have described." The catching and handling of most of the clams and shrimps are done by the filthy Chinese, and “do not provide a pure or fit product for human consumption." There can be no doubt that much grave and often fatal illness is produced by eating these products, and the doctor rightfully recommends that a strict inspection be instituted and that all clams, shrimps, and small fish taken from near the mud banks be quarantined and not allowed to be brought to the markets of San Francisco. Other cities should follow this lead and exclude from their markets all shell and other fish coming from near the mud banks, which are largely an accumulation of filth. Some time the city will stop polluting and poisoning the waters of the bay. NOTICE TO HEALTH OFFICERS. There has been sent from the office of the State Board of Health, to each Health Officer in the State, as far as known, postal cards on which to report cases of contagious or infectious diseases. These reports should contain all cases reported by physicians to the Health Officer, or that are known to exist. Do not send them until the end of the month, unless an epidemic exists, in which case report weekly. The reports should be as correct as it is possible to make them, for from them alone can we know the location and extent of the different epidemic diseases. Be careful to fill blank for "place" and "date." There is room on the card for remarks or suggestions, both of which we gladly receive. TUBERCULOSIS. An average of almost one death a day occurred in November in California from tuberculosis, among those who had been here less than one year. What a price to pay for the reputation of California as a health resort! The slight increase of our death-rate is no factor. The pecuniary cost, great as it is, is of little account, as we can produce more wealth. The danger from the many extra sources of infection, though a grave thing, can be overcome by care and disinfection, but the untold sufferings of the poor victims, a needless and cruel thing, can never be properly atoned. Buoyed up by false hopes and anticipations, oftentimes given them by those who know better, many left their homes where there was plenty of fresh air, plenty of food, with friends to care for them, to go to a strange country without friends or funds, where fresh air and sunshine are free, but where it takes material wealth to get food and care. There is probably no class of patients that suffer more from homesickness or long for the tender ministrations of friends than these, and there certainly is none with whom the balance for life or death is more influenced by the surroundings and mental condition. California is hospitable and is willing that all should enjoy her health-giving climate who have the means to get good from it, but she objects to those who have not the means to live being sent to her. The objection is not on financial grounds alone, but on humanitarian, for it is cruel in the extreme to send patients suffering from tuberculosis, or any disease, among strangers to die. The following case recently occurred: A young lady eighteen or twenty years of age, from one of the States of the Middle West, was advised to go to California, where she would speedily get rid of her troublesome cough. It was represented to her that she could get work sufficient to pay all expenses. She arrived with but a few dollars, and of course in her enfeebled condition could not get employment. She hired a cheap room with little sunlight and poor ventilation, and lived on the least possible food. Her disease progressed rapidly, and had it not been for the charity of strangers who sent her home, she would have added one more victim to the list of "died inside one year." This is not an isolated case, but a sample of what is constantly occurring. The fact that life in the pure open air, with plenty of good food and rest, is the principal thing in the cure of tuberculosis is rapidly gaining ground. The advantage of the California climate is, that one can live out of doors with comfort the year round, but this is of no use where, as in the case of this poor girl, the patient could not get that life, nor the care and food that must go with it. Vol. I. MONTHLY BULLETIN. Entered as second-class matter August 15, 1905, at the post office at SACRAMENTO, DECEMBER, 1905. No. 7. STATE BOARD OF HEALTH. N. K. FOSTER, M.D., State Registrar..Sacramento | GEORGE D. LESLIE, Statistician ARCHIBALD R. WARD, D.V.M., Director. Sacramento University of California, Berkeley VITAL STATISTICS FOR DECEMBER. Summary.-For December, vital statistics were. reported from fiftythree counties with a population estimated very conservatively at 1,723,773. There were 1,788 living births, 2,498 deaths exclusive of stillbirths, and 1,576 marriages, or 3,152 persons married. These figures represent an annual birth-rate of 12.4, a death-rate of 17.4, and a marriage-rate of 11.0, or 22.0 persons married, per 1,000 population. The high death-rate reflects the great mortality in December from pneumonia and other diseases of the respiratory system, and also indicates that the population of California has increased more rapidly since than before 1900, the low estimate for the population found by the Census Bureau method necessarily making the death-rate too high. The proportion of deaths caused by diseases of the respiratory system (pneumonia, bronchitis, etc.) was considerably greater for December than for November. The leading specific cause of death, as usual, was tuberculosis, with pneumonia and heart disease next in order. Causes of Death.-The following table gives the number of deaths, by principal classes, reported for California in December and November respectively. For convenience in comparison, the proportion from each class per 1,000 from all causes is likewise shown: |