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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, 18944.

Vol. I.

SACRAMENTO, MARCH, 1906.

No. 10.

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 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.

Deaths.

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:

Proportion per

1,000 Total Cause of Death.

Number.
ALL CAUSES

2,523 1,000.0
Typhoid fever.

7.5 Malarial fever.

1.2 Smallpox

3.6 Measles

12.7 Scarlet fever.

2.4 Whooping-cough

3.2 Diphtheria and croup

17

6.7 Influenza

12.7 Other epidemic diseases..

16

6.3

19

32

Cause of Death.
Tuberculosis of lungs..
Tuberculosis of other organs.
Cancer
Other general diseases.
Meningitis
Other diseases of nervous system.
Diseases of circulatory system
Pneumonia and broncho-pneumonia
Other diseases of respiratory system.
Diarrhea and enteritis, under 2 years.
Diarrhea and enteritis, 2 years and over
Other diseases of digestive system
Bright's disease and nephritis
Childbirth
Early infancy
Suicide..
Other violence
All other causes.

Number.

416

58 157 103

37 191 330 231 76 37 26 114 154 28 76 43 146 158

Proportion per
1,000 Total
Deaths.
164.9
23.0
62.2
40.8
14.7
75.7
130.8
91.6
30.1
14.7
10.3
45.2
61.0
11.1
30.1
17.0
57.9
62.6

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 of 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 ynother, 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 similar to the one adopted by the Board of Supervisors of San Mateo County, which is in part as follows:

SECTION 1. All pools of water or other places in which mosquitoes are being bred are hereby declared to be public nuisances. All health officers of the county, and the boards of health of all cities and towns in the county, are hereby given authority, and it is made their duty, upon the complaint, in writing, of any resident of the county, or city or town, to condemn as nuisances all such pools of water or other places in which mosquitoes are being bred, and order the summary abatement thereof.

SEC. 2. Upon being notified by such health officers or boards of health of the existence of such pools of water or other places in which mosquitoes are bred, and that the same has been declared a public nuisance by said health officers or said boards of health, it shall be the duty of the person or persons responsible for the maintenance thereof to forthwith abate such nuisance, and all persons refusing or neglecting to forthwith abate such nuisance, as directed by said health officers or boards of health, shall be deemed guilty of a misdemeanor, and upon conviction thereof shall be fined not more than fifty ($50) dollars or be imprisoned in the county jail not more than twenty-five (25) days, or by both such fine and imprisonment.

As the mosquito which invades the house seldom flies far, individual action would do much good, and if all persons keep their own premises free from breeding places they will materially lessen the supply. Since ranchmen have complete control of their surroundings, and can generally, with very little trouble, prevent accumulations of water, they should never have mosquitoes to trouble them. If they have a water tank it should be screened with wire cloth of fine mesh; all wateringtroughs for stock should be carefully cleaned twice a week; no cans, barrels, or pails of water should be allowed to stand; all pools should be drained, even the tracks of stock in the ground, being breeding places for the pest when filled with water, should not be allowed. Where it is impossible to drain or protect, coal oil on the water will kill the wigglers, which would later develop into mosquitoes.

Every person interested in the destruction of mosquitoes should keep in mind the following points:

First - The wigglers seen in stagnant water become mosquitoes.

Second-They breed only in water, generally stagnant; never in grass or weeds.

Third— The wiggler has to breathe in order to live, and comes to the top of the water for that purpose.

Fourth— The ordinary fresh-water mosquito does not fly far from its breeding place, seldom exceeding six hundred yards.

Fifth - Besides being a decided nuisance, mosquitoes carry disease, especially yellow fever and malaria.

Sixth - To be rid of them we have simply to destroy their breeding places. This can be done by allowing no stagnant water to remain uncovered. In case pools can not be drained, coal oil on the water will prevent the wigglers breathing, and will therefore destroy them.

Seventh-Goldfish in small ponds of water will destroy the wigglers.

SUMMER SCHOOL OF SANITARY SCIENCE AND HYGIENE. The following course in Sanitary Science and Hygiene has been laid out for the Summer Session at the State University in Berkeley, from June 25 to August 4, 1906. This is the best opportunity ever offered in the State for health officers and others to get up-to-date instruction in these important subjects. If every health officer and teacher in the State could attend these lectures, a vast amount of good would be done:

SANITARY SCIENCE.

CHARLES GILMAN HYDE, C.E., Assistant Professor of Sanitary Engineering. 1. Sanitary Science, Municipal and State Sanitation. Assistant Professor HYDE.

A series of popular lectures, many of them richly illustrated with lantern slides, giving an outline of the most recent developments of knowledge concerning the relations of Sanitary Science to the public health; the sanitary aspect of the problems of cleanness, of pure air, pure water, and pure food; other important problems of the municipality and state; health laws and the organization, powers, and duties of boards of health.

This course is intended primarily for teachers, health officers, members of health and other municipal boards, and for all persons interested in the development of better sanitary standards and who are aware of the importance of public education in sanitation 2 units.

Monday, Tuesday, Wednesday, Thursday, Friday, 10 A. M. Room 2, Agricultural Building.

2. Potability of Water, Water Purification and Sanitation: Character of Sewage

and Refuse, and Their Disposal. Assistant Professor HYDE. The pure-water problem ; a discussion of the quality of water from the diathetic, enumerical, and sanitary points of view; methods of conserving the purity of public water supplies ; systems of water purification.

Study of the character of sewage, garbage, and other municipal wastes; of the principles underlying their treatment and proper disposal; systems in use. 2 units.

Monday, Tuesday, Wednesday, Thursday, Friday, 11 A. M. Room 2, Agricultural Building

HYGIENE.

ARCHIBALD ROBINSON WARD, B.S.A., D.V.M., Assistant Professor of Bacteriology

and Director of the State Hygienic Laboratory. 1. Bacteriology of Food Products. Assistant Professor WARD.

Popular lectures on bacteria and their relation to the health of the home. The course will include a discussion of the pure-milk problem. 1 unit.

Monday, Wednesday, Friday, 9 A. M. Room 2, Agricultural Building. 2. Bacteriology of the Infectious Diseases. Assistant Professor WARD.

Designed primarily for physicians and students of medicine. Lectures and laboratory work, which latter will be adapted to the needs of the individual.

Lectures Tuesday and Thursday, 9 A. M. Room 2, Agricultural Building. Laboratory work at hours to be arranged, to occupy at least three half-days a week.

BOVINE TUBERCULOSIS IN ITS RELATION TO PUBLIC HEALTH.

By ARCHIBALD R. WARD, D.V.M. In 1901, at the International Tuberculosis Congress in London, Dr. Robert Koch promulgated a theory that checked, for about five years, the efforts of health officers to protect the public from tuberculosis of bovine origin. His views presented at that meeting cast a cloud of uncertainty over the matter of the communicability of tuberculosis from cattle to man. The immediate result was a marked stimulation of research on the subject, for the conclusions of Koch were received with incredulity by most men who had investigated the problem. There has been a lull in the battle against bovine tuberculosis, because the immense financial interests involved warranted delay until further evidence could be obtained by research. None of the work recently reported strengthens Koch's conclusions; on the contrary, his position has been shown to be untenable. The idea predominating among writers on the subject now is that Koch was wrong and that there is ample justification for protecting infants against milk of tubercular cows. The following report is not without interest in showing how completely the work of Koch has been discredited.

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