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In case one member of a family is ill, all other members are required to come to the Station for examination. In this way as many as seven different individuals in a single family have been found afflicted. This careful work, this early finding out of the presence of the disease, and this watchfulness will eventually do more to root out the disease than any other measures imaginable. It is storming the disease in its stronghold; attacking it at its source. In my entire trip in Europe, I had nothing impress me so much as this rational plan of stamping out tuberculosis. Potter, Kayserling and their helpers are certainly heroes. Their names may not be written on the scroll of fame as they would be if they had slain their fellowmen in battle, but they will be indelibly stamped in the hearts of thousands of the poor, whose homes they have blessed by relieving the great white plague of much of its terror.

I do not wish to belittle any work that has been done anywhere in combating this dread disease, yet I believe that this work in the "Fuersorgstelle" in Berlin is the most comprehensive and most practical of all the measures heretofore inaugurated for combating tuberculosis. I should like to see such organizations in every city in our country. We can stamp out tuberculosis in a reasonable time, if we go at it right. We can let it continue its ravages, if we let it alone.

The foregoing article should be read and re-read and studied by every one interested in the extermination of tuberculosis, for it strikes at the root. If we can ever expect to limit to any great degree the ravages of tuberculosis we must strive to prevent people from contracting it. Taken in the incipient stage many can be cured, in the later stages some, but by no means all, and many who contract the disease, under whatever conditions they live, will die from it. By prevention all can be saved and cures will be unnecessary, but until that time comes the two must go hand in hand. Sanatoria should exist in every county and city, where incipient cases can be cared for and taught how to care for themselves. For those far advanced, where a cure is improbable, a hospital should be provided. There would be no need of extensive buildings, but a colony at the county or city hospital, distinct and separate from the main institution, but under the same management. This would reduce the expense to a minimum. Societies should be organized and the aid of philanthropic citizens secured to build sanatoria, where a reasonable charge could be made to those who do not need or will not accept public aid. But with these the "helping stations" should also be established, for in searching out the cases early and in helping and protecting the families lies the greatest good. The county and city authorities should take up and push this work to its full fruition, for there is nothing in the whole domain of social or political activity that can compare with it, for our annual death-rate from tuberculosis is tremendous, but it is a death-rate which can easily be lowered materially each year until it shall nearly cease.

IMPROVED SANITARY CONDITIONS.

The determination of the State Board of Health to enforce the law and prevent the unnecessary pollution of streams used for domestic purposes is bearing fruit, as shown by a general awakening of the

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people to the necessity of such a reform-a voluntary action on their part in some instances, and general acquiescence in a request from the Board in others.

In February, a representative of the Board, at the request of citizens, visited the San Lorenzo River in the Santa Cruz Mountains to make suggestions that would aid them in keeping that beautiful stream in its native purity. As a result of this interest the Board has already received plans of sewage-disposal plants from the trustees of Boulder Creek, and from Hon. A. H. Breed of Brookdale, a rapidly growing town two miles below. As soon as the other towns and summer resorts along the river have followed these excellent examples there will be no more beautiful or health-giving resort in the world than the Santa Cruz Mountains, and the good results will be felt in the healthfulness of the charming city at the mouth of the river, Santa Cruz.

Seabright is also discussing the question of sewage destruction, and will no doubt in a short time have a complete system.

Susanville has awakened to the knowledge that she has outgrown the cesspool period and is looking ahead for a greater growth which she is sure to get if she perseveres and puts in an up-to-date sewer system, with a proper disposal of the sewage. There is no question but what a good sewer system is second only to pure water, the most valuable asset of a city, and with the two, as Susanville can have, she can justly claim to be a gem of the mountains.

Lodi, stimulated by her rapid growth, also feels the need of a new and complete sewer system, and judging from the usual energy of her citizens, will accomplish this much desired improvement.

Lincoln, not to be outdone by any of her neighbors, even though larger, has just held a large and enthusiastic meeting in the interest of sewer bonds. A representative of the Board had the pleasure of being present, and the interest shown was most gratifying. The citizens of Lincoln evidently see that in order to get their share of the rapid development of the Sacramento Valley they must offer a clean, attractive town. The bonds should pass without opposition.

Oxnard is installing a septic-tank system of sewage disposal, with an outlet in the ocean. Why not use it for irrigation and save the valuable fertilizing properties in solution, and at the same time completely purify the water? The combination of the septic tank and irrigation seems the most rational, cheap, and effective system for this State.

These are not, by any means, the only cities and towns improving their sewer systems and means of disposal, but as the health officers have not reported particulars we can not record them.

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

STATE HYGIENIC LABORATORY.

University of California, Berkeley

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

VITAL STATISTICS FOR MARCH.

Summary. The vital statistics reported for March are as follows: Living births, 1,950; deaths, exclusive of stillbirths, 2,523; and marriages, 1,471, or 2,942 persons married. On the basis of an estimated population of 1,882,483 for the fifty-seven counties of the State, the returns for March give the following rates: Births, 12.4; deaths, 16.1; and marriages, 9.4, or 18.8 persons married, per 1,000 inhabitants.

Tuberculosis, as usual, was the principal cause of death, tuberculosis of the lungs causing 416 deaths and tuberculosis of other organs 58. The next highest number, 330, is for diseases of the circulatory system, heart disease, etc., followed closely by 307 for diseases of the respiratory system, 231 deaths being due to pneumonia or broncho-pneumonia, and 76 to other diseases of the respiratory system.

The epidemic diseases causing most deaths in March were measles and influenza, each 32, typhoid fever, 19, and diphtheria and croup, 17. There were 9 deaths from smallpox-6 in San Francisco, 1 in Alameda County and 2 in Merced County. Meningitis caused 37 deaths in the month.

Causes of Death.-The following table shows for the State in March the number and proportion of deaths due to certain important causes arranged according to the International Classification:

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As usual, tuberculosis was the leading cause of death. Altogether 474 deaths were due to this cause, 416 being from tuberculosis of the lungs and 58 from tuberculosis of other organs. The number of deaths next highest, 330, was for diseases of the circulatory system, heart disease, etc. There were 307 deaths from diseases of the respiratory system, 231 being due to pneumonia or broncho-pneumonia, and 76 to other diseases of this system.

There were 191 deaths from diseases of the nervous system other than meningitis, 157 from cancer, 154 from Bright's disease and nephritis, 146 from violence other than suicide, and 114 from diseases of the digestive system other than diarrhea and enteritis. The suicides in

March numbered 43.

Some 28 women died in childbirth or from other puerperal diseases, while 76 children died in early infancy from premature birth, congenital debility, etc. Diarrhea and enteritis caused 37 deaths of children under two years of age and 26 deaths of those above that age. The deaths from meningitis also numbered 37.

The epidemic diseases which caused the greatest number of deaths reported for the month were: measles and influenza, each 32; typhoid fever, 19; and diphtheria and croup, 17. There were 9 deaths from smallpox, 6 being in San Francisco, 1 in Alameda County, and 2 in Merced County.

A CASE OF BUBONIC PLAGUE.

After a lapse of two years California has another case of plague. The patient, a young Italian, worked in a sash and door factory and lived with his parents in fairly good sanitary surroundings. At present the source of infection is unknown, but every effort is being made by the United States and local health authorities to discover it and prevent any further occurrence of the disease. The latest investigations lead to the conclusion that rodents-rats, mice, squirrels, rabbits, etc.are the great source of dissemination; not the only one, but by far the greatest. The disease is at present scattered largely over the whole world, but is not in epidemic form except in those countries where poverty and filth prevail, and it is entirely in the hands of the people f a community where it may occur to prevent any great extension

of the trouble. The rodents should all be destroyed and the premises kept clean. Each family should take it upon themselves to trap or poison all rats and mice about their place. Squirrels and rabbits should be destroyed in all possible ways, and in all cases care should be exercised in handling all rodents found dead. They should not be taken in the hand, but lifted with tongs or a stick, put in a paper sack and burned at once, or put into a 10 per cent solution of carbolic acid.

Bubonic plague is not easily communicated from one person to another, requiring an intermediary, as the flea, bedbug, or other vermin, and these are generally the means by which it passes from the animal to the human. Although there is no occasion for alarm, still all health officers should be on their guard. If a case is in doubt before death, a bacteriological examination of serum from bubo should be made. After death an autopsy should be held in all cases where there is doubt, or if a suspicion exists that there might be a desire to conceal the cause. Always destroy all excreta from the patient.

DESTRUCTION OF MOSQUITOES.

The time of year is fast approaching when the mosquito will begin her annual campaign against life, health, and the pursuit of happiness. That discomfort attended her attacks we always knew, but fearing nothing worse than the annoyance, we endured the nuisance with what patience we could command; but now that it is proven that death follows in her track, we have additional reasons for a crusade against this insect pest. Knowing that her presence is a direct menace to health, shall we endure it longer? Shall we consent to be annoyed by the buzzing, biting furies and also stand the chance of contracting disease? Their destruction is simple and not surrounded by the difficulties that many suppose. They breed almost entirely in stagnant water, very little in running water, and never in the grass, as is sometimes claimed; grass and weeds are an excellent protection for them, but the breeding place is always water. Rain-barrels, wateringtroughs, old pails or cans, tubs in which plants stand, stagnant pools, vaults, or indeed any place where water remains for a considerable period of time, is a breeding place for mosquitoes. To rid ourselves of them we have simply to destroy their breeding places. In localities where there is much marsh land, this entails no little work and expense; but as the mosquito does not, as a rule, travel very far from its breeding place, the problem is not as difficult as at first appears.

Every city and town where mosquitoes are in the least troublesome should have an anti-mosquito society for the purpose of a systematic warfare against them. No barrels or vessels of any kind should be allowed to stand with water in them, unless screened. Often a discarded tin can in the back yard or alley contains water and is, therefore, a breeding place. These should be sought out and destroyed. All vaults should be closed or kept well covered with kerosene; swamps and pools should be drained, and watering-troughs emptied and washed twice a week. To accomplish this, unity of action is necessary and a society in each town, awake to the health and comfort of the people, could do much good if backed by a city and county ordinance somewhat

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