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The State hospitals were badly damaged, Agnews being almost entirely destroyed, and the Home for Feeble-Minded was injured to the extent of many thousand dollars. In this institution, however, no one was injured. There are lessons to be learned from the disaster, and if properly heeded, some time, after the personal sorrow and distress are passed, we will look upon it as a blessing.
Three-story brick buildings which are unsightly, unsafe, and expensive will give place in State hospitals to smaller buildings, where patients can be segregated and receive better care, and which are infinitely safer. More care will be given to construction, and poor work will not be accepted.
Sanitary laws should be strictly adhered to in rebuilding San Francisco. No unsanitary parts should be allowed. Chinatown was not the only filthy place; but they are all gone and must never be allowed again. All buildings should be made rat proof, especially in the business parts, by making basements, on bottom and sides, of cement or some other rat-proof material.
Sewers and sewer connections should be improved and tenement houses built so that sun and air can have free access to every room. Should this one thing be done the saving of life from tuberculosis alone, would soon far more than offset the loss by the earthquake and fire.
There is now every chance to make the city the most beautiful as well as the most healthful in the world. There is no city for which nature has done more, and with plenty of pure water, which can be easily secured, and rebuilt along sanitary as well as artistic and utilitarian lines, the new and greater San Francisco will far outshine the old.
A better supply of water in safer pipes is also an urgent necessity for the San Francisco which is to come.
The disaster in San Francisco gave occasion for a quick and effective sanitary organization and an exhibition of marked executive ability. The health authorities recognized the gravity of the situation and that the sanitary problem was of the utmost importance. With 300,000 people thrown out of home and business; with almost no water in the houses left unburned, and what there was of more than a doubtful nature; with the sick freely mingling with the well; with camps established everywhere, and all without sewer connections; and with irregular food and scanty covering, there was justification of the fear that much sickness would result. The day following the commencement of the fire, a thorough organization for the protection of health was formed. Col. George H. Torney, Deputy Surgeon-General and a thorough sanitarian and organizer, represented the U. S. Army ; Drs. James W. Ward (president), Simon, Harrison, Hassler, and Ragan, the City Health Commission; Drs. Martin Regensburger and N. K. Foster, the State Board of Health; and Dr. Sawtelle, the U. S. Public Health and Marine Hospital Service.
Dr. Ward, as President of the City Health Commission, was given full power to control sanitary measures, and the control could not have been put into abler or more willing hands. Long before the fire was out, headquarters were established in Golden Gate Park, hospitals started, the city districted and each put under a responsible chief, the camps were patroled and inspected, toilets were established, and plans formulated for concentration in a single camp. As rapidly as possible a house-to-house inspection was made, all garbage cleaned up, people removed from unhealthful localities to those better adapted to their needs, and instructions issued about how to protect the healthfulness of the individual and camp. Cleanliness was insisted on and an earnest effort made to prevent the pollution of the soil.
The Medical Department of the U. S. Army, the U. S. Public Health and Marine Hospital Service, and the State Board of Health all worked in harmony with the city authorities, and all have the satisfaction of knowing that the quick active work was effective, and now, after a month's time, there is no more than the normal amount of sickness in the city.
This exhibition of sanitary work-a work that is unparalleled in effectiveness-could not have been accomplished had it not been for the active coöperation and hard, earnest work of the doctors of the city. With their offices and contents burned, and oftentimes with all they had on earth except their courage gone, they gave their time and best endeavors to succor the stricken city. They toiled in whatever place or position it was necessary to relieve suffering, and no history of the great catastrophe will be complete that does not fully recognize their noble work.
In the last two issues of the Bulletin, we have called attention to the existence of smallpox in the different parts of the State, and to the necessity of prompt isolation and vaccination. The need of this is intensified by the fire in San Francisco. As reported last month, smallpox was quite extensive in that city. Owing to the dread of quarantine there is always a certain number of cases that are never reported to the health officers. Most of these are light cases and have no physicians. They are, however, as dangerous as a more severe case, and those contracting the disease from one of them is just as liable to have a severe attack. Some of the non-reported cases are attended by physicians, who, for reasons of their own, do not report them. Under normal conditions some of these take reasonable care, remain isolated until all danger of spreading the disease ceases, and are careful that proper disinfection is practiced. Many-yes, most-do not, and in this way the disease is kept alive.
In an accident like the recent burning of San Francisco they are all driven out and are mixed generally with the people. The sick and those who had been exposed have spread out over the surrounding country, and, as was to be expected, we have now many points of infection and undoubtedly more will appear. Under these conditions it is absolutely necessary for the local health departments to exercise the greatest care. Physicians should report all cases, even those in doubt. It is better to keep a few quarantined until the nature of the disease can be established than to let any be exposed unnecessarily. Vaccination should be urged in all cases, and the State law in regard to vaccination in schools should be enforced. To quarantine all those who have been exposed to smallpox oftentimes works a hardship, and is really unnecessary. Vaccination will stop the disease-nothing else will. All contacts should be vaccinated and disinfected, if it is possible that their clothing may have received the contagion, after which they can be allowed to go to their usual employment, provided they can be under inspection by the health department; should they become sick they can be isolated before there is danger to others.
While the greatest care and firmness must be exercised, we must remember that we are facing a condition in the State never before experienced in this country, and temper our acts accordingly. We must protect the health of the community, sometimes with what may seem arbitrary measures, but no unnecessary restraints should be imposed.
MEETING OF THE PUBLIC HEALTH ASSOCIATION. The sixth semi-annual session of the California Public Health Association was held in San Francisco, April 16th. Each session has increased in interest, and this was no exception. The day was given to papers and discussions on the water supplies of the State and on the disposal of sewage.
The first paper, "The Condition of California Water Supplies,” by Dr. N. K. Foster, was a description of the polluted condition of many of our streams, and also called attention to the danger of wells located so they could receive the drainage of toilet or corral.
Prof. Chas. G. Hyde, of the University of California, read a paper on “The Sanitary Quality and Purification of Public Water Supplies." He explained the needs of pure water for domestic and manufacturing purposes, and said that the clear, sparkling water was not always pure, nor the turbid one always unhealthful. He compared the typhoid ratio in Massachusetts and Pennsylvania, as showing the good results of carefully guarding the streams.
Mr. George L. Hoxie, City Engineer of Fresno, read a paper on "Sanitary Disposal of Sewage," advocating strongly the disposal of sewage on land, either direct or after treatment in the septic tank, and describing fully the new disposal system being installed in Fresno.
Dr. Charles F. Clark, of Willits, read the last paper, on “Sewage Disposal,” giving in detail the process of bacterial destruction and showing the dangers of sewage pollution of land and water.
The discussions that were brought out were of great interest, and an effort will be made to have the whole proceedings published.
The following officers were elected for the coming year: President, Wm. Simpson, M.D., San José; Vice-President, James W. Ward, M.D., San Francisco; Secretary and Treasurer, N. K. Foster, M.D., Sacramento.
The next meeting will be held in San José, at the call of the Executive Committee.
TYPHOID FEVER. 'Typhoid fever is reported from several parts of the State, and in some it is quite severe. In those parts where the disease is severe, the water supply is under suspicion and is doubtless the cause, as in most cases the pollution is plainly to be seen, and in all there is a possibility. Typhoid fever is a preventable disease and should not be allowed to exist; it is a disease of filth, for it is only communicated through the excreta of the diseased person. This excreta, being loaded with the germs of typhoid, and finding access to our food and drink, and there
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 watering troughs 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, Al unicipal 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.