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For centuries the practice of medicine was simply a game of follow my leader," and the dogmatic assertion of the leader of the period was as final in medicine as a papal bull in theology. From this the pendulum has perhaps swung to the other extreme, until any person who has kissed the blarney stone or read some forgotten story of the days of Mesmer or Cagliostro may propound a new system of medicine or theology with the assurance of finding followers a-plenty.

For these conditions the medical profession are alone to blame, in that they, in the beginning, and even to this day, too much neglect the psychological side of the profession, emphasizing so strenuously the physiological side that it leaves room for the faddist to successfully foist upon humanity the rankest fallacy. From this contemplation it is a pleasure to turn to a society like the Public Health Association, which has no theories to advance, no selfish ends to gain, can not be suspicioned of self-seeking or self-interest, but preaches and practices the gospel of cleanliness, of self-help, of prevention-which seeks no honor for itself, no emoluments for its officers or members, but simply and solely the greatest good of the greatest number.

The interest in this organization, instead of being limited to the faithful few who have from its organization been devoted to its interests, should include every educator, every head of every public institution, every trustee or worker in or manager of every private institution, no matter what its character, in the State; for there is not one of these which does not have questions of sanitation constantly thrusting themselves on their attention, and to help in the answering of these is the province of this organization, and to this end we ask and believe we are entitled to recognition of our work by the Ştate in the publication of our papers.

Those who have followed the meetings of this organization know that much valuable material has been lost for lack of funds to print our proceedings. Pope's couplet-,

“Reason's whole pleasure, all the joys of sense,

Lie in three words: health, peace and competence,” are as true to-day as when written, and we who are the conservers of the first are contributors to the other two; for without health peace is impossible and competence worthless.

That the calamity which followed so speedily our last annual session caused no serious epidemic we are all sure is due to the sanitary precepts enforced by our secretary and by the Board of Health of San Francisco under the able leadership of our vicepresident and with the assistance of one of our charter members, Dr. Rupert Blue, of the United States Public Health Service.

In behalf of the California Public Health Association, I, as president, welcome you to our eighth meeting and thank you for the interest expressed by your presence.

Prof. Henry Johnson, of Stanford University, delivered from notes illustrated by drawings a very interesting and instructive lecture on “Geology of Underground Waters and Mineral Springs." His lecture related especially to the formation of the Santa Clara Valley, and showed very clearly the source of the artesian water supply to be in the surrounding mountains, where the strata which underlie the valley come to the surface with a very steep dip, thus allowing the water which falls thereon, to rapidly flow into the underground reservoir. There was no discussion of the possibility of this water becoming polluted, and in this case being on high hills that are sparsely settled the danger is small, but under less favorable circumstances this might result, and all artesian supplies should be mapped out and studied by some one thoroughly capable of making a scientific report.

Dr. Chas. F. Clark, of Woodland, read a paper on "Effect of School Life on Children's Health,” which was both interesting and instructive. The writer believes that the steady raising of standards in the schools, and the consequent tax upon the vital energy of the students, are responsible for much of the nervous trouble which they certainly have. In support of this he refers to school statistics taken by competent examiners. Headache from whatever cause increases day by day and grade by grade as the student advances in his course. Investigations made in St. Petersburg and London prove the gradual increase of nervous troubles as the time in school advances. In Cleveland seventy-five per cent of the girls and thirty per cent of the boys who left school during the

year did so from ill health. In Waltham a class of seventeen was

decreased by nine from ill health during the graduating year. The writer believes that the school is not the cause of this ill health; "heredity, home environment, and an endless number of conditions foreign to school" are factors, but that the continued mental effort superimposed on these factors is what breaks the health. Medical supervision of schools in a broad sense is demanded, a supervision that can guide the weakened mentalities and those physically frail to the best that can possibly be attained.

The discussion of the paper was very ably and interestingly opened by Prof. Job Wood, of the State Department of Public Instruction, who, while enthusiastic for the good work our public schools are doing, sees plainly the hardship they impose on the weaker' scholars, and the mental and physical breakdowns which result.

The discussion was quite general, and the following resolution offered and adopted:

Resolved, That the California Public Health Association, recognizing the many cases of eye, ear, and throat troubles, as well as many other ills among the children in both public and private schools, earnestly urges that boards of education and superintendents of private schools shall appoint medical inspectors for the purpose of ascertaining and correcting these evils as they may be found to exist.

Dr. A. E. Osborne, of Santa Clara, read a paper on "The SocioEconomic Status of the Feeble-Minded.” The paper was scholarly and full of good thoughts, but the lateness of the hour prevented discussion.

An effort will be made to have the papers published so that the State may benefit by the labor spent upon them.

The Association adjourned to meet in its Fall session at Woodland, Yolo County.

*

Dr. E. E. Stone, President of the Northern District Medical Society, has arranged for a section of "Public Health" at the next meeting, with one or more papers pertaining to that subject. All health officers will be welcome, and should avail themselves of this opportunity to discuss questions of vital interest to the public and themselves.

WILL THE LAW BE ENFORCED?

During the month of February there died in California 384 persons from tuberculosis, and 282 from pneumonia, both of them communicable and consequently preventable diseases. Six hundred and sixtysix out of twenty-three hundred and ten, or almost 29 per cent of all deaths, died in this one month from these two causes. What an awful sacrifice of life to ignorance and carelessness! A larger share of these were in the prime of life, and useful, productive members of society, and the economic loss to the State was immense, to say nothing of the sorrow and broken home circles.

The last Legislature, fully appreciating this loss, passed a law with the aim to check this wholesale murder, for murder it morally is for one person to kill another, whether it is done with a quick method like a shot or a slow one of infection with disease.

This law is as follows: “It shall be a misdemeanor for any person to discharge mucus from the nose or mouth, or spit upon any sidewalk of any public street or highway, or upon any part of any public building or railroad train, street car, stage, ferryboat, steamer, boat or other vessel or vehicle used for the transportation of the public.”

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Another law requires physicians and others to report all communi cable diseases, among which are enumerated pulmonary tuberculosis and pneumonia. Had these laws been in effect and carefully observed, many of the 666 who died of these two diseases the month the law was enacted, would now be alive and productive citizens. That sputum contains the disease germs, that these germs live for a certain time after the sputum has dried and become dust, that they are carried to homes on shoes and clothing, that as dust they get on our food and into our drink, are all demonstrable propositions, and that many of those dying received their infection from this source there can be no doubt.

The laws are now in force and should be enforced, and it is the duty of every police officer, sheriff, or constable to arrest any one caught violating the expectoration law. A few arrests of prominent spitters in every city or town would put a stop to the filthy and dangerous habit by making sentiment strong enough to outlaw any one who practiced it.

Will these officers do their duty? We fear not, unless the sentiment is created first. And for this work there is no power so great as the newspaper and magazine. These publications in California have always been found willing and anxious to enlighten and help the people. Will they not now take up the question and publish the law so that none may be ignorant of its existence and show to their readers þy editorials the dangers which exist in public spitting? Why can not our civic improvement organizations, our women's clubs, our different labor unions and our fraternal societies all lend a helping hand, for all are exposed to the same dangers. If they would spend ten minutes at each meeting in listening to a plain exposition of the dangers of this habit, more good would be received than by any other way it could be spent.

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, 1894.

Vol. 2.

SACRAMENTO, APRIL, 1907.

No. 11

STATE BOARD OF HEALTH,

MARTIN REGENSBURGER, M.D., President,

F. K. AINSWORTH, M.D.

San Francisco A. C. HART, M.D. WALLACE A. BRIGGS, M.D., Vice-President,

0. STANSBURY, M.D..
Sacramento | W. LE MOYNE WILLS, M.D.

N. K Foster, M.D., Secretary ... Sacramento
Hon. J. A. ELSTON, Altorney

_San Francisco Sacramento

Chico Los Angeles

Oakland

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 APRIL. Summary.For April there were reported 1,938 living births; 2,694 deaths, exclusive of stillbirths; and 2,019 marriages. For an estimated State population of 2,001,193, these figures give annual rates as follows: Births, 11.8; deaths, 16.4; and marriages 12.3. The corresponding rates for March were, respectively, 11.7, 15.8, and 8.6.

The number of marriages was highest in the following counties : Los Angeles, 418; San Francisco, 385; Alameda, 279; Santa Clara, 95; Sacramento, 91; Marin, 62; and Orange, 50.

The birth total was greatest for the following freeholders' charter cities: San Francisco, 402; Los Angeles, 322; Oakland, 138; Berkeley, 52; Alameda, 49; San José, 44; Fresno, 36; and Pasadena and Sacramento, each 32.

The death list was greatest for the following cities : San Francisco, 562; Los Angeles, 366; Oakland, 160; San Diego, 77; Sacramento, 62; Stockton, 56; Alameda, 35; Berkeley, 34; San José, 30; Pasadena, 27; and Fresno and Long Beach, each 26.

The deaths reported for April were distributed by geographic divisions, as follows: Northern California-coast counties, 112; interior counties, 227; total, 339. Central California-San Francisco, 562; other bay counties, 369; coast counties, 163; interior counties, 465; total, 1,559. Southern California—Los Angeles, 552; other counties, 244; total, 796. State total, 2,694.

Causes of Death.--There were 372 deaths from tuberculosis of the lungs and 37 from tuberculosis of other organs, making a total of 409, or 15.2 per cent of all for April, from various forms of tuberculosis. There were 394 deaths, or 14.6 per cent of all, from diseases of the respiratory system, 312 being from pneumonia and broncho-pneumonia and 82 from other diseases of this class. Third in order, as usual, are diseases of the circulatory system, causing 349 deaths, or 13.0 per cent. There were 82 deaths from meningitis and 185 from other diseases of the nervous system.

Typhoid fever, as is nearly always the case, was the most fatal epidemic disease in the month. The total for typhoid fever was 34, against 27 for whooping-cough, 25 for diphtheria and croup, 19 for measles, 18 for influenza, and 16 for all other epidemic diseases.

Detailed figures on causes of death in California appear in the table below, which shows the number of deaths due to certain principal causes for April, as well as the proportions from each cause per 1,000 total deaths for both April and March :

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ALL CAUSES.
Typhoid fever
Malarial fever
Measles.
Scarlet fever
Whooping-cough
Diphtheria and croup
Influenza
Other epidemic diseases
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

MEETING OF HEALTH OFFICERS. Dr. E. E. Stone, President of the Northern District Medical Society, has arranged to have a Section of Public Health at the next meeting of that society, which will be held at Napa, Tuesday, June 11, 1907. There will be a paper by Dr. David Powell of Marysville, discussing the pollution of the Sacramento River by the cities and towns along its banks. As this river is the water supply of many thousands of the inhabitants of California, it is a question of vital importance, and every health officer in the district should attend the meeting prepared to give his views on the subject.

There is an awakening among health officers of the State, and the various medical societies are encouraging it by devoting a portion of the time at their meetings to subjects especially relating to this work. The response from the health officers should be a large attendance, for the meetings are at once interesting and instructive.

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