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proposes to vaccinate the whole town, and if he succeeds he will have no more trouble until the inflow of population gives him more nonimmunes.
Dr. S. H. Rantz, Placerville, reports a few cases of malaria.
Have the Trustees pass an ordinance making the breeding place of mosquitoes a public nuisance, and then enforce it, and malaria will leave with the pests.
Dr. W. H. Cope, Pleasanton, Alameda County, who reported a case of smallpox last month, reports no cases coming from it.
The case was handled admirably, and no chance given for infection to spread.
Dr. J. M. Wheat, Redlands, reports smallpox contracted in Los Angeles, and typhoid fever from Arizona. Also three cases of diphtheria, the first of which was not reported. If all cases of communicable diseases were promptly reported to the health officers such an unnecessary spread of disease would be avoided.
Dr. T. P. Peery, Sutter County, reports scarlet fever stamped out by strict quarantine.
Dr. H. G. Plymire, San Mateo County, has numerous cases of typhoid, the cause of which he is investigating. Water is reported safe, and milk is from different sources. tch out for the flies and personal contact. We give these sources of spread too little attention.
Dr. S. F. Priestley, San Joaquin County, has numerous cases of smallpox on hand, but prompt and thorough work with vaccine and quarantining is checking its spread.
Dr. H. G. McGill, Livermore, says: "Physicians evidently do not understand their duty in regard to reportable diseases.' ” This is probably so, although the State laws and regulations have been sent to them. If the County Medical Societies would devote an hour at some meeting discussing this subject they would surely see the use of such reports. The municipal and county authorities should furnish the health officer with printed postal cards to be distributed to each physician. This was urged in last month's Bulletin.
Dr. A. P. Tarter, Tehama County, has perhaps had the hardest task of any in the State dealing with smallpox. It came from chicken pox, and spread extensively in the mountains, and also at Corning, before the health officer was informed of the true nature of the disease; but with characteristic energy and skill he has circumscribed the disease, and has it under control.
Dr. A. B. Gilliland, Cottonwood, Shasta County, and J. A. Young, health officer, Wilmington, report localities free from contagious disease and very healthy.
Dr. N. E. Richardson, Salinas City, sends card showing no reportable sickness, and promising a copy of semi-annual report to this board. As the doctor has been very active in sanitary matters we expect an interesting report.
Dr. Theo. Snypp, Placer County, has been battling with smallpox in two or three localities in the county. Owing to the difficulty of enforcing quarantine on the ranches, the disease spread quite extensively.
Dr. R. B. Davy, Downieville, has no communicable diseases to report, neither has Dr. Charles F. Miller of Gardena.
Dr. Wm. Thurston, Orland, reports malaria and chicken pox. We sincerely hope the latter is not what it has proved to be in several other cases-smallpox.
J. W. Sumner, Kernville, has no reportable diseases.
Dr. Ralph W. Avery, South Pasadena : Croup 2, measles 6, smallpox 2, erysipelas 1, chicken pox 2. No new foci of smallpox. All quarantines raised. Only personal cases; many not reported.
Dr. F. W. Coleman, Lodi: 11 cases of malaria, 1 of measles, and 2 of pneumonia.
Dr. S. W. R. Langdon, Stockton: Tuberculosis 4, pneumonia 1, diphtheria 1, smallpox 1.
Dr. C. D. Watson, Ontario District : No contagious diseases.
Dr. W. W. Roblee, Riverside: Tuberculosis 14, pneumonia 3, scarlet fever 1, typhoid fever 2, diphtheria 4, influenza 13, erysipelas 2, chicken
Dr. T. L. Magee, San Diego : Typhoid 2, measles 19.
Dr. J. Jones, Nevada County: Tuberculosis 9, pneumonia 4, typhoid fever 1, diphtheria 2, croup 1, measles 1, whooping-cough 2, malaria 10, smallpox 3, influenza 6, erysipelas 3, trachoma 1.
Dr. James A. Young, Wilmington: No infectious or contagious diseases. Conditions of health excellent.
Dr. B. Woodbridge, Rocklin: Reports that there have been no more cases of typhoid fever since the pollution of the water was stopped. Wherever typhoid exists the water should be closely watched, for it is one great source of dissemination.
Dr. T. M. Hayden, Fresno, has succeeded in getting a pretty complete report from the physicians. With no epidemic, but a few cases of scarlet fever, measles, malaria, typhoid and one of diphtheria. Tuberculosis 12, pneumonia 1, scarlet fever 4, typhoid fever 3, diphtheria 1, measles 2, malaria 15, influenza 10, erysipelas 5, cerebro spinal meningitis 1, trachoma 5, chicken pox 1.
Fred T. Bond, M. D., Vallejo, reports: Tuberculosis 2, diphtheria 1, measles 10, and cerebro spinal meningitis 1.
Dr. J. I. Clark, Santa Ana, has had a case of leprosy to deal with, and no doubt feels the need of a national institute where lepers can be sent. Typhoid fever 1.
Dr. William F. Freeman, Needles : Tuberculosis 6, measles 2; all imported.
Dr. E. C. Houston, Bieber, reports 10 cases of whooping-cough and 3 of malaria.
Dr. Wm. Simpson, Santa Clara County: No epidemics. being made to keep streams from pollution.
Dr. J. E. Taylor, Trinity County : Smallpox cases well, with no new
Dr. Frances L. Newton, Woodland: One case of diphtheria.
Dr. O. W. Steinwand, Selma: One case typhoid. General health good.
The above comprises the reports from health officers throughout the State for the month of June. It is a distinct advance over former months, and is, therefore, encouraging, but it is far below what it should be in numbers. These reports do not show the exact condition in any place, nor are they all of equal reliability. In some towns all physicians report, in others part of them, and in too many none. This makes it impossible for the health officer to make reliable reports to this office, and we, in turn, are deprived of needed information.
There is a noticeable absence of reports from the large cities. The delay in printing their report is no doubt caused by tardy reports to them.
In the interest of the State and the people, who look to us to guard their sanitary and health conditions, we urge physicians to report promptly all cases of communicable disease to the health officer, and for him to be equally prompt in reporting to the State board.
It is a satisfaction to record the fact that we have no epidemics at present. By active work and vaccination smallpox is rapidly dying out. Measles and scarlet fever are prevalent in some parts, but not to the extent of being epidemic, and are generally being well handled. Typhoid is also less prevalent, but is still too broadly scattered.
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.
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. Not 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 mouch.
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.