It is no doubt true that where plague is present there exists an abnormal supply of rat fleas. Dr. Wherry, of the San Francisco Board of Health, collected one hundred and eighty fleas from two rats sent in from the Latin quarter. On four rats taken from Meiggs wharf, San Francisco, there were counted approximately two hundred and forty fleas. Three of these rats were autopsied, and one was found to have a pronounced case of plague, verified clinically and bacteriologically. In the normal conditions, and in districts removed from plague, the rats harbor an average of three to four fleas. The claim that live fleas invariably leave the cadaver of a rat is a fallacy. I have found fifteen live fleas on the dead bodies of forty rats. These had been cold for thirty-six hours, showing signs and odors of decomposition. Dr. Hobdy, Chief Quarantine Officer of the U. S. P. H. and M. H.-S., located a number of dead rats in a stable near the harbor. Four of these were examined by him and showed about sixty live fleas in the cervical region of each. These rats had been dead for forty-eight hours. At the City Board of Health and the district substations, live fleas have been taken from numerous rats which had been dead for periods ranging from eighteen to sixty hours. The importance of the house fly in the dissemination of the plague should not be overlooked. The writer is making a study of the flies found on cadavers of plague-infected rats. We may feel reasonably sure that the house fly deserves serious consideration in this connection. The writer intends, also, to make a detailed study of the life history of the rat flea. We shall be pleased to identify insects found on the rats in California. Professor A. R. Ward, Director of the State Hygienic Laboratory, directed the writer's attention to the entomological importance of the plague question in San Francisco. With his material aid this study was pursued since October. I am under serious obligation to Dr. Hobdy, Chief of the San Francisco Quarantine Station, and his assistants for their courtesy and timely aid. Professors Woodworth and Quayle, of the University Entomological Department, have directed me in the verification of the species of fleas thus far obtained. The great danger of spreading tuberculosis comes from the carelessness and ignorance of patients, and this danger is the greatest when they live in unsanitary and unhygienic surroundings, especially where the sunlight does not enter and where ventilation is impossible. Scientific experiments show that the direct rays of the sun will kill the bacilli in from a few minutes to a few hours. In dark, illy ventilated apartments, however, the bacilli will live for months. It is wonderful to contemplate that while a tuberculous patient will cast off several millions of bacilli a day, and while the disease usually lasts months. and often years, on an average each case does not infect quite one new one. This fact should certainly be enough to quiet the fears of those who seem to be panic-stricken, thinking this disease so highly infectious. 123 CALIFORNIA STATE BOARD OF HEALTH. Vol. 3. MONTHLY BULLETIN. Entered as second-class matter August 15, 1905, at the post office at SACRAMENTO, DECEMBER, 1907. No. 7 STATE BOARD OF HEALTH. MARTIN REGENSBURGER, M.D., President, F. K. AINSWORTH, M.D. San Francisco Los Angeles HON. J. E. GARDNER, Altorney Watsonville STATE BUREAU OF VITAL STATISTICS. N. K. FOSTER, M.D., State Registrar. Sacramento | GEORGE D. LES LIE, Statistician.. Sacramento * * * New Numbers for Certificates. As some Local Registrars overlooked the matter a year ago, the attention of all is again drawn to the fact that the registration law expressly provides that birth, marriage, and death certificates must all be numbered "in consecutive order, beginning with number one in each calendar year." Local Registrars' fee accounts can not be approved promptly unless all certificates are correctly numbered as the law requires. Complete Reports Each Month.-Local Registrars are also reminded that it is the clear intent of the law that the original certificates forwarded to the State Bureau of Vital Statistics early each month should be an approximately complete report of all births, marriages, and deaths, especially the latter, in the several registration districts in the preceding month. Inaccuracies are introduced into the statistics when a Local Registrar's report for a certain month includes scattering certificates which belong with the returns for an earlier month or months. Though Recorders with Subregistrars scattered over counties of extensive area or of a mountainous nature may be excused for not forwarding early each month certificates for all deaths in the district in the preceding month, yet the aim of every Local Registrar should be to forward as promptly as possible reports that are practically complete, month by month. VITAL STATISTICS FOR DECEMBER. Births.-The births for December, so far as reported to the State Bureau of Vital Statistics, number 2,310, as compared with 1,975 living births reported for November. For an estimated State population of 2,001,193, the December total represents an annual birth-rate of 13.8, against 12.0 for the preceding month. Births for December were registered in freeholders' charter cities as follows: San Francisco, 449; Los Angeles, 367; Oakland, 166: Sacramento, 54; Berkeley, 45; Fresno, 40; Alameda and Pasadena, each 36; San Diego, 32, and San José, 26. Marriages.-The marriages reported for December number 2,174, against 1,843 for November, the annual rate for the final month of the year being 12.8, as compared with 11.2 for the month before. Marriages for December were reported by counties as follows: Los Angeles, 417; San Francisco, 321; Alameda, 266; Santa Clara, 101: Sacramento, 90; Marin, 80; Fresno, 75; San Diego, 58; San Joaquin, 57; and Orange, 55. Deaths. In closing up their work for 1907, many Local Registrars included in their December returns death certificates which belong with reports for earlier months. Consequently, the total of 3,484 deaths reported for December includes from 900 to 1,000 deaths which occurred in November and before. For this reason no death-rate has been calculated for December in contrast with November. The present death-rate in the State, however, can be given on the basis of returns for the whole year 1907. Returns so far received make a provisional total of 30,890 deaths, exclusive of stillbirths, for California in 1907 and for an estimated State population of 2,001,193 this total gives an annual death-rate of 15.4. Deaths for December were reported as follows for the leading cities: San Francisco, 637; Los Angeles, 399; Oakland, 145; Sacramento, 98; San Diego, 69; Stockton, 42; San José, 40; Fresno, 39: Berkeley, 38; Pasadena, 35; Alameda, 28; Riverside, 27; and San Bernardino, 26. Causes of Death. The tabulation 'of deaths reported for December, including belated returns for previous months which, however, do not appreciably affect the relative proportions by diseases, shows that tuberculosis was the leading cause of death in the month, with diseases of the respiratory system and of the circulatory system next in order. There were also considerable numbers of deaths from diseases of the nervous system, from violence, and from diseases of the digestive system. The leading epidemic diseases in the month were typhoid fever, diphtheria and croup, influenza, and scarlet fever. The following table gives the number of deaths from certain principal causes reported for December, as well as the proportions from each cause per 1,000 total deaths for both December and November. Geographic Divisions.-The table below shows the number of deaths from main classes of diseases reported for December for the several geographic divisions of the State, including the metropolitan area, or "Greater San Francisco," in contrast with the rural counties north of Tehachapi: ANNOUNCEMENT. This month's issue of the Bulletin is devoted largely to the Pure Food and Drugs laws, which went into effect on January 1st. The laws and the regulations for their enforcement are printed in full, and will be sent upon application to any person interested. The Laboratory has been established in the State Laboratory at Berkeley, and Prof. M. E. Jaffa, a food expert of wide reputation, made Director, with able assistants in both food and drug analyses. The work has already begun, and it is the aim of the State Board of Health to get from the law the utmost good for the people. The prosecution of offenders is placed upon the District Attorneys of the various counties, and upon their activity will depend much of the success in furnishing the people pure food and drugs. The Laboratory will furnish the evidence of adulteration and deception. if it exists, but the courts must try the cases. The Sheriffs of the counties are agents of the Board to collect samples, and any one believing he is being served with adulterated food or drugs can make a verified complaint to his Sheriff and it is the latter's duty to collect samples according to the legal requirements and forward to the State Laboratory for examination. Each Sheriff will be furnished with proper blanks and seals, and if he is fairly active there is little use of any one having adulterated food or drugs. Special agents will also be employed, but all the State can not possibly be gone over at once, and we shall depend somewhat upon local interest in the matter to furnish us information. It will be useless for an individual to collect samples with the expectation of having an offending seller prosecuted. The samples must be collected by agents of the Department in order to get legal process, and it will only be useless work, where work is already crowding, to send samples that are not thus collected. An impression has gone out that the State Board of Health are not going to strictly enforce the Pure Food law, and a resolution which the Board never even considered has been published. The State Board of Health has no power to set aside any of the provisions of the law and no desire to do so, and will use their utmost endeavor to bring to punishment all willful offenders against the law. We recognize the possibility of a person being an innocent offender. and our strongest endeavors will be made against the willful one, and to instruct those who wish to do right. PLAGUE. As far as human cases are concerned, plague is apparently at an end in California, but one case having appeared since the last issue of the Bulletin. Among the rats, however, the conditions are very different, and more plague rats are caught now than three months ago. This condition of affairs is easily accounted for by the rats being driven by the wet weather into closer quarters and associations and that they feed more upon their own dead. The fleas, being far less active in wet weather, do not carry the disease from the rat to the human. This cessation of cases must not give too much confidence that the trouble is wiped out. Indeed, it is not dead, but only sleepeth, |