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nofter the treldtield, Nevada, where * . caps 16v one was buried

in on * silment to be a bad form of diphtheria,

Hur phrsicians are

The city

• the phrsicians. The house is not that the public schools will be closed."

and other organs. The proportion
were each higher than in thr
before, are diseases of the
352 deaths, or 14.2

Typhoid fever, 46 deaths agains

health officer has been influenza, and 2 cent of all deat 3.5 for Decem! Detailed fi

*** W tenor that it is that dreaded disease. Other called into consultation, and they agree that it is

quarantined, and if it should below, whic) in January

The case, is a very serious one, on account of the disagreedeaths for

Apo ndiphtheria the town has a good chance for an epidemic. It is thought Hrgienio Laboratory can and should be put. Lodi is within one imately true. It is quoted to demonstrate the use to which the State

The above is taken from a daily paper and is supposed to be approx.

hundred and ten miles of the laboratory, with quick and frequent conTyph nection, and a swab from the child's throat could be in the laboratory

reply no Mala

in a few hours. Taken in the morning, it could be sent to the laboraSma Мек Sca

erpense to the patient or health officer except postage and the telegram. espe reply was by mail, the postage on the package would be the only

examination would clear up a doubtful diagnosis, W D: I

and should always be made when that condition exists.

It is often impossible for a physician to be sure of a diagnosis from established a laboratory for just this purpose. has come to his relief in the bacterial examination, and the State has

the appearance of the throat, or from general symptoms, but science plenty of antitoxin in the early stage of the disease will save nearly

An early diagnosis means everything in diphtheria, for the use of all, if not all, cases. Every health officer should write to Dr. A. R. Ward, Director of the State Hygienic Laboratory, Berkeley, and secure properly used will lessen in a great degree the death-rate of diphtheria. a supply of mailing cases and directions. They are sent free, and if

In the last Bulletin we published a report of the work which was Berkeley. That work has gone steadily on, not, however, without some being done by the State Laboratory in connection with diphtheria in opposition from those whose children were being saved, and now the disease is practically stamped out. Two thousand five hundred separate

Some parents certainly have reason to offer thanks for the salvation of their little ones. is of interest:

tory, a culture made and a

expense. Such an

examinations have been made, but no one can tell the number of lives

sa ved,

The following report from Dr. A. R. Ward, Director of the Laboratory,

Diphtheria in Berkeley.---The work on diphtheria in the Lincoln School in Berkeley, as reported in the last issue of the Bulletin, has been continued vigorously. On January 10th cultures were made from the throat and nose of all of the pupils in the school-some five hundred and seventy-five. Twelve per cent of them showed diphtheria bacilli. Each of these children, together with all the other school children in the family, were excluded from school and placed under quarantine.

A corps of student inspectors has made it possible to take cultures from each family once a week. When a negative report has been obtained twice in succession from the person positive originally, and

once from the other children and the mother, quarantine has been terminated and a permit to attend school has been issued. Thirty-eight families have been released and thirty-seven remain under quarantine. Of these thirty-seven families, fourteen have refused to allow examinations, leaving twenty-three families under observation.

Two cases of diptheria have been reported among those excluded after the examination of January 10th. One of these cases passed the school examination successfully two days before the attack, but had been excluded because a brother had shown diphtheria bacilli at the school.

With the exception of the two cases among those excluded on January 10th, no diphtheria has occurred among the children attending the school in question up to the present date, February 11th. During the same period, five cases only of diphtheria have been reported from families in Berkeley having no relation to the school.

The relation of the preventive measures enforced at the school, to the prevalence of diphtheria among the children of the schools and others, is presented in the table below:

Cases in Families Cases in Families Period

Connected with Not Connected with
School,

School.
October 1 to 31

5 November 1 to 19.

9

1
November 19th. First school examination.
November 19 to 30
December 1 to 31

12

2 January 1 to 10

6 January 10th. Second school examination. January 10 to 31.

2* February 1 to 11.

It will be seen that the first examination of the school produced practically no effect as compared with the second. It should be noted that the first examination, in which the culture was taken from the throat only, showed but five per cent positive and no quarantine was placed upon those excluded. The second time, cultures were made from both nostrils as well as the tonsils, and all those excluded from school were quarantined.

DANGERS OF SWEAT-SHOPS AND TENEMENT HOUSES. “In England, in the early nineteenth century, a jet of poison spurted up out of a dingy Whitechapel sweat-shop into the splendid drawingrooms of St. James. Heavenly powers! Here was something to astound a nation. Disease and poverty were nothing to our bewigged and gartered parliaments, so long as they stayed pent up in the corrals and warrens of the disinherited poor. But when disease, fathered by poverty, showed its horrible face on polished floors, amazement stared, alarum sounded, England was on guard.

“What caused this cry at the gates, this rush to rescue ? The daughter of Sir Robert Peel was mysteriously stricken with ty is. The infection was traced to a stylish riding-habit ordered and fitted at a correct Regent Street shop, but finished in the tenement of a starving tailor with two children lying ill of fever. When their shivering spells were on, the destitute tailor had flung the heavy robe over his feverstricken little ones. It was not the first time that the plague of the toiling poor invaded the sanctuary of the mighty. It was not the last time. Hundreds of our own epidemics, emptying our schools and desoin number, were taken ill last week, and a few days ago one was buried privately, after the arrival of the father from Goldfield, Nevada, where he has been engaged in mining. Four physicians are in attendance on the children, two declaring the ailment to be a bad form of diphtheria, while the other two claim it is not. The city health officer has been notified, and even he cannot agree that it is that dreaded disease. Other physicians have been called into consultation, and they agree that it is diphtheria. The case is a very serious one, on account of the disagreement of the physicians. The house is not quarantined, and if it should be diphtheria the town has a good chance for an epidemic. It is thought that the public schools will be closed."

* These had both been excluded from the school on January 10.

The above is taken from a daily paper and is supposed to be approximately true. It is quoted to demonstrate the use to which the State Hygienic Laboratory can and should be put. Lodi is within one hundred and ten miles of the laboratory, with quick and frequent connection, and a swab from the child's throat could be in the laboratory in a few hours. Taken in the morning, it could be sent to the laboratory, a culture made and a reply could be returned the next, with no expense to the patient or health officer except postage and the telegram. If the reply was by mail, the postage on the package would be the only expense. Such an examination would clear up a doubtful diagnosis, and should always be made when that condition exists.

It is often impossible for a physician to be sure of a diagnosis from the appearance of the throat, or from general symptoms, but science has come to his relief in the bacterial examination, and the State has established a laboratory for just this purpose.

An early diagnosis means everything in diphtheria, for the use of plenty of antitoxin in the early stage of the disease will save nearly all, if not all, cases. Every health officer should write to Dr. A. R. Ward, Director of the State Hygienic Laboratory, Berkeley, and secure a supply of mailing cases and directions. They are sent free, and if properly used will lessen in a great degree the death-rate of diphtheria.

In the last Bulletin we published a report of the work which was being done by the State Laboratory in connection with diphtheria in Berkeley. That work has gone steadily on, not, however, without some opposition from those whose children were being saved, and now the disease is practically stamped out. Two thousand five hundred separate examinations have been made, but no one can tell the number of lives saved. Some parents certainly have reason to offer thanks for the salvation of their little ones.

The following report from Dr. A. R. Ward, Director of the Laboratory, is of interest:

Diphtheria in Berkeley.—The work on diphtheria in the Lincoln School in Berkeley, as reported in the last issue of the Bulletin, has been continued vigorously. On January 10th cultures were made from the throat and nose of all of the pupils in the school—some five hundred and seventy-five. Twelve per cent of them showed diphtheria bacilli. Each of these children, together with all the other school children in the family, were excluded from school and placed under quarantine.

A corps of student inspectors has made it possible to take cultures from each family once a week. When a negative report has been obtained twice in succession from the person positive originally, and

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once from the other children and the mother, quarantine has been terminated and a permit to attend school has been issued. Thirty-eight families have been released and thirty-seven remain under quarantine. Of these thirty-seven families, fourteen have refused to allow examinations, leaving twenty-three families under observation.

Two cases of diptheria have been reported among those excluded after the examination of January 10th. One of these cases passed the school examination successfully two days before the attack, but had been excluded because a brother had shown diphtheria bacilli at the school.

With the exception of the two cases among those excluded on January 10th, no diphtheria has occurred among the children attending the school in question up to the present date, February 11th. During the same period, five cases only of diphtheria have been reported from families in Berkeley having no relation to the school.

The relation of the preventive measures enforced at the school, to the prevalence of diphtheria among the children of the schools and others, is presented in the table below:

Cases in Families Cases in Families Period.

Connected with Not Connected with
School.

School.
October 1 to 31...

5

1 November 1 to 19.

1 November 19th. First school examination. November 19 to 30

4 December 1 to 31.

12 January 1 to 10

January 10th. Second school examination. January 10 to 31.

0 February 1 to 11.

0

2*

It will be seen that the first examination of the school produced practically no effect as compared with the second. It should be noted that the first examination, in which the culture was taken from the throat only, showed but five per cent positive and no quarantine was placed upon those excluded. The second time, cultures were made from both nostrils as well as the tonsils, and all those excluded from school were quarantined.

DANGERS OF SWEAT-SHOPS AND TENEMENT HOUSES. “In England, in the early nineteenth century, a jet of poison spurted up out of a dingy Whitechapel sweat-shop into the splendid drawingrooms of St. James. Heavenly powers! Here was something to astound a nation. Disease and poverty were nothing to our bewigged and gartered parliaments, so long as they stayed pent up in the corrals and warrens of the disinherited poor. But when disease, fathered by poverty, showed its horrible face on polished floors, amazement stared, alarum sounded, England was on guard.

“What caused this cry at the gates, this rush to rescue ? The daughter of Sir Robert Peel was mysteriously stricken with typhus. The infection was traced to a stylish riding-habit ordered and fitted at a correct Regent Street shop, but finished in the tenement of a starving tailor with two children lying ill of fever. When their shivering spells were on, the destitute tailor had flung the heavy robe over his feverstricken little ones. It was not the first time that the plague of the toiling poor invaded the sanctuary of the mighty. It was not the last time. Hundreds of our own epidemics, emptying our schools and deso

* These had both been excluded from the school on January 10.

lating our homes, are due to the desperate conditions under which many of our workers are forced to do their work. And of the nearly two hundred million dollars' worth of garments manufactured yearly in New York City, nine-tenths goes to the wardrobes of our citizens, wholly or partly, by the weary and pestilent way of the sweat-shop."

The above burning words from Edwin Markham's article on "The Sweat-Shop Inferno as clearly points to the danger of concealed diseases as the wretched condition of the "sweat-shops.” That disease is spread from clothes infected in the process of manufacture there is little doubt, for the conditions are all favorable to such results. Physicians who have practiced in the tenement-house districts have many times seen the beds in which were children sick with contagious disease covered with garments being finished for the market.

It requires no great stretch of imagination to see a garment which is being made by a man or woman in the last stages of consumption become grossly infected with the secretions from the patient's diseased lungs.

Wouldn't it be cheaper to support that sick person at a public sanitarium than to let him infect the clothing which will possibly, yes probably, infect and kill some useful citizen?

This is looking from a mercenary point of view, but we have to look from all sides.

It is no fancy picture that Markham drew, and the same conditions pertain now as when Sir Robert Peel's daughter was stricken with typhus. You that are well fed, well housed, and enjoy all the comforts of life must not think you are not exposed to the contaminating conditions of sweat-shop and tenement house. They reach you constantly in the shape of physical as well as moral disease, and will continue to claim you and yours as long as they are allowed to exist.

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. It is perhaps difficult for those who have not carefully studied the matter to realize the danger from the dust swept into the streets from houses, halls, hospitals, stores, and saloons. It is hardly possible to walk a few blocks along a city street any pleasant morning without encountering a storm of dust raised by some energetic servant beating a rug or sweeping the dirt from the house out across the sidewalk into the street. This dust may, and oftentimes does, contain the dried sputum of consumptives or diphtheria patients, or the discharge from a syphilitic sore mouth. Filth indescribable is represented in it, and the combination without selection is breathed into the lungs. Is it any wonder we get sick !

No dirt should be allowed to be swept from the house, but it should be taken up and burned. The time is not far off, we hope, when houses will be cleaned by the suction method. It will then be possible to unscrew the electric light bulb and screw on the cleaning machine and quickly remove all dust. The broom and feather duster will then be doomed as household utensils.

That time hasn't yet arrived, and we are dying from consumption at the rate of four hundred per month. One in every seven of us are doomed to travel that road unless we think best to close it up. We can not do it all at once, but we can begin.

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