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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.

CALIFORNIA STATE BOARD OF HEALTH.

MONTHLY BULLETIN.
Entered as second-class matter August 15, 1905, at the post office at
Sacramento, California, under the Act of Congress of July 16, 1894.

Vol. I.

SACRAMENTO, DECEMBER, 1905.

No. 7.

STATE BOARD OF HEALTH. MARTIN REGENSBURGER, M.D., President,

F. K. AINSWORTH, M.D.

San Francisco San Francisco A. C. HART, M.D.

Sacramento WALLACE A BRIGGS, M.D., Vice-President,

0, STANSBURY,
M.D...

Chico
Sacramento | W. LE MOYNE WILLS, M.D.

Los Angeles
N. K. FOSTER, M.D., Secretary Sacramento
Hon. W. I. FOLEY, Altorney..

Los Angeles

STATE BUREAU OF VITAL STATISTICS. N. K. FOSTER, M.D., State Registrar..Sacramento | GEORGE D. LESLIE, Statistician.. Sacramento

STATE HYGIENIC LABORATORY. ARCHIBALD R. WARD, D.V.M., Director.

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:

Number.

Proportion per 1,000.

Class.

December

November. December. November.

ALL CAUSES.
General Diseases

Epidemic diseases
Other general diseases
Nervous System
Circulatory System
Respiratory System.
Digestive System
Genito-Urinary System
Violence
All Others.

2,498

741
125
616
255
342
388
188
169
198
217

2,153
630
106
524
236
281
249
212
127
196
222

1,000.0
296.6

50.0
246.6
102.1
136.9
155.3
75.3
67.6
79.3
86.9

1,000.0 292.6

49.2 243.4 109.6 130.5 115.7 98.5 59.0 91.0 103.1

The most notable contrast between the proportions for the two months is the rise from 115.7 for November to 155.3 for December in the proportion of deaths caused by diseases of the respiratory system, which includes pneumonia and bronchitis.

The table below gives for California, in December, the number of deaths from the leading specific causes, together with the proportion per 1,000 from all causes :

Disease.

ALL CAUSES
Tuberculosis
Pneumonia.
Heart disease
Cancer
Bright's disease
Apoplexy
Accidental injuries.
Diarrhea and enteritis
Bronchitis
Meningitis
Suicides.
Typhoid fever.
All others

Number. Proportion. 2,498 1,000.0 392

156.9 288

115.3 275

110.1 135

54.1 124

49.7 107

42.8 89

35.6 57

22.8 49

19.6 49

19.6 36

14.4 36

14.4 861

344.7

The leading specific disease, as usual, was tuberculosis, which caused over one seventh of all deaths. Next in order were pneumonia and heart disease, each of which caused about one ninth of the total deaths.

NOTES TO REGISTRARS. New Numbers for Certificates.- The attention of Local Registrars is again drawn to the requirement of the registration law that new series of numbers be started for the certificates of births, marriages, and deaths filed with them each calendar year. The Local Registrar, having transmitted to the State Registrar the certificates for December, 1905, should begin with the number 1 for the certificates of births, marriages, and deaths, respectively, filed with him in January, 1906. Correct numbering of all certificates by calendar years facilitates the tabulations in the State Bureau of Vital Statistics and also expedites the approving of Local Registrars' quarterly accounts for fees.

Pre-Addressed Envelopes for Certificates.-County Recorders J. F. Johnson, Jr., of San Bernardino and I. S. Logan of Riverside have prepared pre-addressed envelopes for distribution to physicians, clergymen, subregistrars, and others required to mail them certificates of births, marriages, and deaths. Other County Recorders and City Health Officers should consider the advisability of supplying similar pre-addressed envelopes to physicians and others in their registration districts. The use of such envelopes prevents certificates from being missent in the mails and, especially by freeing physicians from all confusion regarding the person with whom they should register births, insures a complete registration of births in each district.

Printing Name of County and City on Certificates.- In some instances the certificates printed for certain counties and cities, instead of reading “County of ..

and “City of .. " have had printed on them the name of the county or of both the county and city. This has been done, for example, on the certificates for the counties of Contra Costa, San Bernardino, and San Diego, and for the cities of Los Angeles, Pasadena, Pomona, Santa Monica, Vallejo, and Woodland. The printing of the name of the county or of the county and city on the certificates saves individuals the trouble of writing the same name over and over again or of putting it on certificates with a rubber stamp, and also prevents the filing of incomplete certificates with the place of birth, marriage, or death carelessly left blank. Local Registrars, in ordering new supplies of certificates, would therefore do well to direct that the name of the county or in some cases of both the city and county be printed on each certificate under the heading Place of Birth, Place of Marriage, or Place of Death.

Here's to the stork,

A most valuable bird,
That inhabits the residence districts.

He doesn't sing tunes,

Nor yield any plumes,
But he helps out the vital statistics.

-Portland Oregoniun.
Here's to the stork,

A benevolent bird,
Who would bless every home in each district,

But he's sad and forlorn

From evening till morn,
If unable to help with the vital statistics.

-Iowa Health Bulletin.
Here's to the stork,

Good, industrious bird,
Who increases birth-rates for all districts,

But works without avail

When bad physicians fail
To register all these vital statistics.

STATE CONTROL OF TUBERCULOSIS.

CONTRIBUTED BY A. B. NYE.

Looming up before the State of California, and but a very short distance ahead in the natural line of advance, is the momentous question of a right public policy in relation to tuberculosis. It does not appear that it will be possible to avoid meeting it, nor should we desire to do so when we stop to consider all that is at stake. Our only solicitude should be to meet it right, which means in the manner that will produce the largest results in proportion to the effort expended. The question of ways and means is one to interest every citizen and every taxpayer, because the battle for the extirpation of consumption will be a long one and the expense will be very great. On its medical side a question for physicians alone, tuberculosis also presents social, industrial, and financial aspects which are quite as well worthy of attention, and these must appeal to all classes of intelligent persons.

Without sufficient preliminary discussion, and in a state of the public mind altogether unpropitious for satisfactory decision of so large a question, the attempt was made at the last session of the Legislature to

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