This disease is always present in the State, but prevails mostly in towns furnished with water from mountain streams. This water is pure as water can be in nature, when it starts on its course, but is sadly polluted long before it reaches its destination. A stream flowing through a farming or stock country will naturally gather a certain amount of pollution, but this is not what does the most harm. It is the drainage from the concentration of animals in corrals or from human habitations that causes trouble, and which should be excluded. Every water supply should be inspected from source to faucet frequently, and all means of contamination eliminated. If it can not be kept in a reasonable degree of purity, it should be filtered. This, however, is quite expensive, and for the small mountain towns impossible. The protection of the streams, however, is neither expensive nor impossible. There is not an individual house or a town in the State but what can, at a reasonable expense, dispose of its sewage in other ways. The laws are ample to protect the people, and the local authorities are there to enforce the laws. The law requires that every town have a health board, and assigns certain sanitary work to it. This board should in all cases be in existence and do its duty. The State Board of Health stands ready at all times to help, but it can not possibly, in such an immense State, visit and inspect all water supplies and sewerage systems. That must be done primarily by the local board, but where trouble is found that can not be readily adjusted, the State board will gladly help. Typhoid can, and should, be reduced to a minimum in our State. It needs only the active coöperation of the physicians and health officers; the former to see that all discharges from typhoid fever are disinfected and destroyed, the latter to keep pure the water supply. CLEANLINESS SHOULD BE TAUGHT IN SCHOOLS. The biennial report of the Department of Health of Chicago publishes the following from the Massachusetts Association of Boards of Health. It is as good and useful in California as in Massachusetts or Illinois, and we reproduce it in full, hoping it will be seen and heeded by every teacher in the State. It is impossible to estimate the amount of sickness or the number of deaths resulting from the uncleanly habits of children-habits that can and should be checked. Children, however, are not the only ones at fault, for the parents retain the habits of their childhood and by example teach them to the children, and so the endless chain of unclean habits linked with disease runs on for generations, gaining strength as it goes and dragging down to the grave many bright hopes: The poisons of some of the common and also of the most loathsome diseases are frequently contained in the mouth. In such cases anything which is moistened by the saliva of the infected person may, if it touches the lips of another, convey disease. The more direct the contact the greater the danger. It is the purpose of health officials to keep in isolation all persons having communicable diseases during the time that they are infectious. But in many cases this is impossible. Little restraint is put on certain mild diseases, as measles, whoopingcough, chicken pox, and mumps, and even such diseases as diphtheria, scarlet fever, and tuberculosis are frequently so mild as to be unnoticed, and children affected with them mingle freely with others. It is probable that in such cases one of the chief vehicles of contagion is the secretion of the mouth and nose. It is believed that much can be done to prevent contagion by teaching habits of cleanliness. But if such instruction is to be effectual it must be continuous. The teacher should notice and correct violations of these rules as habitually as violations of the more formal school rules are corrected. Even if the question of disease and contagion did not enter into the matter at all, the subject ought to be given more attention by teachers. Our schools should not only teach reading, writing, and arithmetc, but it is, perhaps, quite as important that they should inculcate cleanliness, decency, refinement, and manners. Cleanliness should be taught for its own sake, even if it had no relation whatever to health. Not Children should be taught: Not to spit; it is rarely necessary.. To spit on a slate, floor or sidewalk is an abomination. Not to put the fingers into the mouth. to pick the nose. Not to wet the fingers with saliva in turning the leaves of books. Not to put pencils into the mouth or moisten them with the lips. Not to put money into the mouth. Not to put pins into the mouth. Not to put anything into the mouth except food and drink and the tooth brush. Not to swap apple cores, candy, chewing gum, "all-day slickers," half-eaten food, whistles or bean blowers, or anything that is habitually put into the mouth. Teach the children to wash the hands and face often. See that they keep them clean. If a child is coming down with a communicable disease it is reasonable to believe that there is less chance of infecting persons and things if the hands and face are washed clean and not daubed with the secretions of the nose and mouth. Teach the children to turn the face aside when coughing and sneezing-especially if they are facing another person, or when at table. Children should be taught that their bodies are their own private possessions; that personal cleanliness is a duty; that the mouth is for eating and speaking, and should not be used as a pocket, and that the lips should not take the place of fingers. Vol. 2. MONTHLY BULLETIN. Entered as second-class matter August 15, 1905, at the post office at SACRAMENTO, JULY, 1906. No. 2. STATE BOARD OF HEALTH. 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. STATISTICS OF BIRTHS: 1905-1906. Summary.-For 1905-1906, the first year covered by the new birth registration law in California, there were reported a total of 20,909 living births. San Francisco reported 5,250 births, or 25.1 per cent of all, followed by Los Angeles city, 3,128, and Oakland, 1,397; the cities with the next highest totals being Fresno, Sacramento, San José, Berkeley, Pasadena, and San Diego. Among the counties, exclusive of freeholders' charter cities, the highest totals are for Santa Clara, 688; Los Angeles, 529, and Fresno, 429; followed by San Bernardino, Riverside, Orange, Tulare, Alameda, Butte, and San Joaquin. For a State population of 1,784,521 in 1905, estimated conservatively by the Census Bureau method with slight modifications, the 20,909 births in 1905-1906 give a rate of 11.7 per 1,000 population. The birth-rates are highest for the following cities: Fresno, 29.3; Santa Barbara, 26.9; Pasadena, 25.5; Santa Cruz, 25.0; Grass Valley, 23.7; Berkeley, 19.9, and San Bernardino, 18.6. The rates are also above 15.0 for the cities of Los Angeles, Napa, Watsonville, San José, Vallejo, and Oakland, as well as for the counties of Del Norte, Alpine, Riverside, Modoc, Tulare, Santa Clara, and Stanislaus. The birth-rate is 14.1 for the twenty cities having freeholders' charters, against only 9.2 for all the rest of the State. Outside these eities where health officers are the registrars it is difficult to make physi cians register births, but, nevertheless, several County Recorders as registrars for rural communities have secured complete returns. The 20,909 babies included 10,835 boys and 10,074 girls, the per cent male being 51.8 and female 48.2. The white babies numbered 20,537, or 98.2 per cent of all, while there were 156 Japanese, 141 Chinese, 70 negroes, and 5 Indians. No marked differences appear between localities, either in the proportion of the sexes or in the race distribution, though there are great Jifferences in the nativity of the white mothers, especially between sections north and south of Tehachapi, and also between the metropolitan area and the rural counties. The nativity of the 20,537 white mothers is as follows: Born in California, 7,683, or 37.4 per cent; born in other states (including 172, or 0.8 per cent, of unknown nativity), 7,478, or 36.4 per cent; and foreign born, 5,376, or 26.2 per cent. South of Tehachapi the great bulk of the white mothers, 59.6 per cent of all, were born elsewhere in the United States than California. But north of Tehachapi, especially far north, the bulk were natives of the Golden State, the per cent born here being 54.7 for Northern California and 43.2 for Central California. In Northern and Central California, except in San Francisco and the other bay counties (Alameda, Contra Costa, Marin, and San Mateo), the per cent of white mothers born elsewhere in the United States than California is much greater than the per cent foreign born. For the metropolitan area, comprising San Francisco and the other bay counties, the per cents born in the Golden State and in other States are lower than for the rural counties of Northern and Central California. Conversely, the per cent foreign born among the white mothers is much higher for the metropolitan area than for the rural counties. City and County Totals.-In accordance with the law of 1905, requiring all County Recorders and the Health Officers of the twenty cities having freeholders' charters, as ex officio local registrars, to transmit monthly to the State Registrar the original birth certificates filed with them, there have been registered in the State Bureau of Vital Statistics a total of 20,909 living births, 10,652 for the last half of 1905 and 10,257 for the first half of 1906. The destruction of over half a month's records for San Francisco in the fire of April 18-20, and the incomplete registration of births in the confused times succeeding this calamity caused the half-year total for that city to fall from 3,309 in 1905 to 1,941 in 1906, and also explains the slight falling off in the State total, the number of births registered outside the metropolis being considerably greater for the first six months of 1906 than for the last six months of 1905. For births, the registration districts are cities having freeholders' charters, the rural portions of counties containing these cities, and rural counties without any such cities. Of the total 20,909 living births reported for the fiscal year 1905-1906, as many as 5,250, or 25.1 per cent of all, were registered in the City and County of San Francisco, notwithstanding the effects of the great fire in April. Among the freeholders' charter cities Los Angeles is second, with 3,128 living births for the year, and Oakland is third with 1,397. The next highest city totals reported to the State Bureau are: Fresno, 390; Sacramento, 389; San José, 379; Berkeley, 370; Pasadena, 287, and San Diego, 238. Between 100 and 200 living births were registered in Grass Valley, San Bernardino, Santa Barbara, Santa Cruz, Stockton, and Vallejo, and less than 100 for the year in Napa, Salinas, Santa Rosa, and Watsonville. Eureka is the only city having a freeholders' charter for which no vital statistics at all were reported in 1905-1906. The highest totals for rural counties or the rural portions of counties. with freeholders' charter cities are as follows: Santa Clara (outside San José), 688; Los Angeles (outside Los Angeles city and Pasadena), 529; Fresno (outside Fresno city), 429; San Bernardino (outside San Bernardino city), 349; Riverside, 341; Orange, 327; Tulare, 297; Alameda (outside Berkeley and Oakland), 288; Butte, 244, and San Joaquin (outside Stockton), 227. Between 100 and 200 living births were registered in the following rural counties or portions of counties: Calaveras, Contra Costa, El Dorado, Kern, Madera, Marin, Mendocino, Monterey (outside Salinas), Nevada (outside Grass Valley), Sacramento (outside Sacramento city), San Luis Obispo, San Mateo, Santa Barbara (outside Santa Barbara city), Shasta, Siskiyou, Solano (outside Vallejo), Sonoma (outside Santa Rosa), Stanislaus, and Ventura. In considering the rank of cities and counties in births reported, it should be understood that the returns are affected not only by the number of living births which actually occurred, but also by the proportion of those which occurred that have been duly registered as required by law. Comparison of the returns for various registration districts indicates that there are marked differences between the districts in the extent to which local registrars have secured a thorough enforcement of the registration law or in the extent to which physicians and midwives have obeyed the law by promptly registering all births. Birth-rates. This appears clearly when birth-rates are considered. In order to calculate rates 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. For the three principal cities arbitrary estimates have been made because of their exceptionally rapid growth, the estimate for San Francisco in 1905 being 450,000, for Los Angeles 180,000, and for Oakland 90,000. The variations from the standard method made by the Census Bureau in published estimates for Berkeley and San Diego have also been followed, while for other cities the same method of estimating population has been applied as explained above for counties. For a State population, thus estimated, of 1,784,521 in 1905, the 20,909 living births reported for 1905-1906 give a birth-rate of 11.7 per 1,000 inhabitants. This is surpassed or equaled by the birth-rates for the thirty-one registration districts shown in the table below, the districts being arranged in descending order of birth-rates. The word "rural" after a county indicates that the figures relate to the county exclusive of its freeholders' charter city or cities. For the information of those interested in comparing birth-rates, or checking the calcula tions, the table gives the estimated population, 1905, and the living births, 1905-1906, as well as the birth-rate per 1,000 population. |