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the reporting of contagious and infectious diseases. Diphtheria is reported from the largest number of places, 14; next in order comes influenza, 12; pneumonia and typhoid, 10 each; scarlet fever, 9; croup, 6; whooping-cough, 5; measles, 4. In the number of cases reported diphtheria is second only to influenza and exists in all parts of the State. A close watch should be kept by all health officers and all cases carefully isolated and thorough disinfection practiced.

PROTECT THE MILK.

The Board of Health of Fresno is taking a step in advance in urging the passage of an ordinance requiring all milk sold in that city in quantities of less than one gallon shall be in sealed bottles. We often see the milkman take from the seat beside him the measure, where it has been exposed since his last customer was served, and in the face of a strong wind which has filled the air with all conceivable filth, pour out the milk that is to be used perhaps by a sickly baby. Few of us fully appreciate the dangers of dust, but the light is breaking in, and some time we will refuse to drink milk or eat food that has been unnecessarily exposed to it.

AN ACTIVE HEALTH OFFICER.

Dr. Clark, the health officer of the progressive and prosperous town of Willits, is urging an extension of the sewer system and the installation of a septic tank. There is nothing that adds so much to the desirability of a town as a place of residence as a perfect sewer system, including the destruction of the sewage matter. Every one prefers to live where health conditions are good, and this can not be where the waste from toilets, sinks, or stables is allowed to spread uncared for on the surface or to collect in pools. A town can make no better investment than in a thoroughly up-to-date sewer system.

WOMEN AS MILK INSPECTORS.

The latest thing in dairy inspection in California is that started by the club women of Los Angeles. The proposition is for the women to inspect the dairies which furnish them milk, and insist that they be kept up to the standard. If they will do this, making their requirements within the bounds of reason, and refuse the milk if they are not complied with, we shall see a great cleaning up, and better milk.

A SUBSTITUTE FOR THE OYSTER.

"The importance of the oyster as a food and as a factor in the etiology of typhoid fever renders a possible substitute for it of medical interest. The abalone is a giant snail, weighing from one to two pounds, living in practically unlimited quantities in the deep waters of the ocean, and easily gathered along the entire coast of central and lower California. The flesh is a nutritious and wholesome article of food, highly esteemed by the Chinese and Japanese, but as yet very little used in the United States outside of California. The drying process and the original canning method yield a tough product, but a process has recently been discovered by which these giant snails can be canned and made as delicate as the oyster. They are used in a similar way for food, but have the decided advantage over the oyster that when gathered

the viscera can be detached from the muscular parts by the single stroke of a knife. The source being on less populated coasts, offers less danger of typhoid contamination than does that of the oyster, and, further, we understand that there is no necessity for fattening the abalone in creeks, as is the case with the oyster. The points are in favor of the new mollusk and seem to give it large possibilities as a food product."-The Journal of the American Medical Association.

The continued and increased pollution with sewage of the waters in which the oysters grow in California is a source of constant danger, and will, in the near future, cause that mollusk to be looked upon with much suspicion, if it does not drive it from the market. The condition is as bad, or possibly worse, in the East, and numerous epidemics of typhoid fever have been traced to this source. While in California no epidemic has resulted from the shell fish, no doubt many cases scattered throughout the State have come from them. If the abalone can be prepared so as to take the place of the oyster and clam, it may be the means of saving many lives.

Vol. I.

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.

SACRAMENTO, JANÚARY, 1906.

No. 8.

STATE BOARD OF HEALTH.

San Francisco
Sacramento

MARTIN REGENSBURGER, M.D., President,
F. K. AINSWORTH, M.D.
San Francisco A. C. HART, M.D.
WALLACE A BRIGGS, M.D., Vice-President,
O. STANSBURY, M.D..
Sacramento W. LE MOYNE WILLS, M.D.
N. K. FOSTER, M.D., Secretary - Sacramento
HON. W. I. FOLEY, Attorney..
Los Angeles

STATE BUREAU OF VITAL STATISTICS.

N. K. FOSTER, M.D., State Registrar..Sacramento | GEORGE D. LESLIE, Statistician....

Chico

Los Angeles

Sacramento

STATE HYGIENIC LABORATORY.

University of California, Berkeley

ARCHIBALD R. WARD, D.V.M., Director.

PUBLIC HEALTH ASSOCIATION.

The annual meeting of the California Public Health Association will be held at San Francisco, at the time of the meeting of the California State Medical Society-probably the day before. Watch the next issue for full account. This Association is for all health officers and others interested in sanitation, and all are urged to come. No dues.

STATISTICS OF DEATHS IN 1905.

Summary. Under the law for the registration of vital statistics which took effect in May, 1905, returns of varying completeness were received from all the fifty-seven counties in the State except only Humboldt. Estimated conservatively by the Census Bureau method with slight modifications, the population of the fifty-six counties in 1905 is 1,755,599. For the last six months of the year, including scattering returns for earlier months, there were reported altogether 12,236 deaths, exclusive of stillbirths not tabulated, giving an annual death-rate of only 13.9 per 1,000 population.

For Northern California, where, however, the returns were not particularly complete, the death-rate was 10.1 as compared with 14.3 for Central California and 15.2 for Southern California.

Of the minor geographic divisions into which the several counties have been grouped for convenience in tabulation, the six counties of Southern California other than Los Angeles (i. e., Santa Barbara, Ventura, San Bernardino, Orange, Riverside, and San Diego) show the highest death-rate, 16.1 per 1,000 population, followed by 15.1 for San Francisco, 14.9 for the coast counties from Santa Clara and Santa Cruz to San Luis Obispo, inclusive, 14.6 for Los Angeles, and 14.2 for the interior counties from Yolo, Sacramento, and El Dorado to and including Kern. The bay counties other than San Francisco (Alameda, Contra Costa, Marin, and San Mateo), for which the death-rate is 12.4, constitute the only

division besides the coast and interior counties of Northern California with a rate below the State average of 13.9, but in all these, geographic divisions there are counties for which the returns seem incomplete.

The relatively high death-rates for Southern California are due largely to 'deaths of newly arrived consumptives, and partly also to the "Bennington" disaster. If these exceptional deaths were excluded, the death-rate for Southern California would be reduced from 15.2 to 14.1, for Los Angeles from 14.6 to 13.8, and for the other counties from 16.1 to 14.6 per 1,000 population.

The death-rate for Northern and Central California together is 13.6, or somewhat less than the corrected rate for Southern California. The rate for the coast counties is 13.9 against 12.8 for the interior counties, the rate being higher for the coast counties mainly because of the relatively great mortality usual in a metropolis like San Francisco.

Analysis of causes of death in different localities reveals interesting contrasts between the several main and minor geographic divisions in the relative prevalence of different classes of diseases. The proportion of all deaths due to epidemic diseases is decidedly highest for the interior counties of Northern California, but is also considerably above the State average for the interior counties of Central California and for the coast counties of Northern and Central California, exclusive of San Francisco and the other bay counties. The proportions of total deaths caused by diseases of the circulatory system-heart disease and kindred complaints are considerably above the average for the State for San Francisco and the other bay counties, particularly for the metropolis itself. In Southern California, especially in Los Angeles, the proportion of deaths from all causes due to other than epidemic general diseases, the class which includes tuberculosis, is very much higher than the average proportion for all California.

Tuberculosis caused 1,813 deaths, or 14.8 per cent of the total 12,236 reported. The corresponding per cent is 21.4 for Los Angeles, 17.0 for the other six counties of Southern California, and 15.0 for San Francisco, the per cent for every other geographic division being below the State average. The per cent was 19.7 for the seven counties south of Tehachapi, against only 13.2 for the rest of the State.

However, deaths from tuberculosis in Southern California occur largely among newly arrived consumptives, while in Northern and Central California considerable numbers of native Californians and oldtime residents fall victims to the "great white plague." Thus, 25.8 per cent of the tuberculosis victims in Southern California had lived in the State less than a year, and altogether 55.7 per cent had lived here less than 10 years, the corresponding per cents for the entire State being 11.9 and 31.9 and for Northern and Central California together being 4.3 and 19.2 respectively. In fact, of all who died of tuberculosis in Southern California, 4.1 per cent had been in the State less than a month, altogether 12.7 per cent less than 3 months, and altogether 17.3 per cent less than 6 months. On the other hand, the per cent of native Californians among tuberculosis victims is 35.7 for Northern and Central California together, against 28.2 for the State as a whole and merely 13.4 for Southern California. Similarly, 35.5 per cent of all tuberculosis victims in Northern and Central California had lived in the State at least 10 years, in contrast with 30.0 for the entire State and only 19.5 for the seven counties south of Tehachapi.

Geographic Divisions.-For convenience in tabulation, the fifty-seven. counties of California have been grouped in three main and eight minor geographic divisions, as follows, the counties in each group being arranged alphabetically for the sake of ready reference:

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Death-rates. Returns of varying completeness were received under the new law for the registration of vital statistics from all the fiftyseven counties in the State except only Humboldt, the population of which has of course been excluded in the calculation of all death-rates. Though the present registration law took effect in May, comparatively few returns were received for May and June, as the law was not in operation generally throughout the State before July 1.

In the last six months of 1905, including scattering returns for earlier months, there were reported altogether 12,236 deaths, exclusive of stillbirths not tabulated. The population of California in 1905 has been estimated conservatively according to the Census Bureau method by adding to the population in 1900 five tenths of the increase between 1890 and 1900, except that for the few counties showing decreases between the last two Federal censuses the population in 1900 has been taken for 1905, and for the three principal cities arbitrary estimates have been made because of their exceptionally rapid growth. The estimate for San Francisco in 1905 is 450,000, for Los Angeles, 180,000, and for Oakland, 90,000.

The following table shows for each geographic division indicated above the population as enumerated in 1900 and as estimated for 1905,

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