and 1912. The rate for 1916, however, was ten times as great as that for the preceding year.

Of the 26 states in the registration area in 1916, the 5 showing the highest rates reported 75 per cent of all the deaths from this cause. These states, with their rates, were New Jersey, 41; New York, 32.8; Connecticut,

19.2; Massachusetts, 12.5; and Maryland, 8.1. The next highest 5 rates appear for 'Pennsylvania, 7.8; Rhode Island, 7; New Hampshire, 5.6; Montana, 5.2; and Michigan, 4.9.

Heat Deaths Numerous The deaths resulting from accidents in 1916 numbered 60,071, corresponding to a rate of 83.9 per 100,000 population. This rate is considerably in excess of that for 1915 (56.3). The most marked increases appear for deaths due to railroad and to automobile accidents and for those resulting from the effects of heat.

The rate for deaths from railroad accidents in 1916 (11.3) exceeds the corresponding rates for 1914 and 1915 (10.7 and 9.9, respectively), but with these ceptions, is the lowest one recorded since 1906, the first year for which deaths from this cause were reported separately.

Deaths from automobile accidents and injuries in 1916 totaled 5.193, or 7:3 per 100,000 population. As might be expected, in view of the enormous increase in the number of automobiles in use, the death rate due to these causes has advanced continuously since 1906—the first year for which they were reported separatelywhen it stood at 0.4 per 100,000 population.

Street-Car Accidents Deaths resulting from street-car accidents in 1916 numbered 1,775,

This rate is or 2.5 per 100,000. the same as that for 1914, but shows an increase as compared with 1915. During the past 10 years, however, there has been a material falling off in the rate for this cause.

Machinery accidents caused 1,624 deaths in 1916, or 2.3 per 100,000 population, this rate being somewhat greater than those for the preceding two years—1.9 for 1915 and 2 for 1914.

The number of deaths from mine accidents and injuries in the registration area in 1916 was 2,119, corresponding to a rate of 3 per 100,000. The deaths from these accidents for the last three years show a material decline as compared with those for the preceding 10 years,

There were 2,056 deaths in 1916 from the effects of heat, the rate being 2.9 per 100,000 population. This is the highest rate shown for this cause in the last 15 years, with the exception of that for 1911, which was 5.3.

Suicides Number 10,000 The sumber of suicides reported for 1916 was 10,162, or 14.2 per 100,000. This rate is the lowest for the past 10 years.

The total number of deaths due to the use of firearms in the registration area in 1916 was 8,240, corresponding to a rate of 11.5 per 100,000.

Of these deaths, 3,386 were suicidal, 3,241 were homicidal, and 1,613 were accidental. The suicidal use of firearms shows a decline as compared with 1915 and 1914; their homicidal use decreased as compared with 1914, but increased as compared with 1910, 1911, 1912, and 1915, and the rate was the same as for 1913; and the frequency of accidental deaths due to their use shows a slight decline during recent years.


Ohio's New Registration Bureau for


By Frances M. Hollingshead, A. M., M. D., Director Division of

Child Hygiene, State Department of Health

Feeling a need for special pro- ditions: First, the lack of availtection for Ohio's women and chil- able facilities for many women: dren during the war, 'the State De- second, the almost dense ignorance partment of Health is about to upon the part of some women in all launch a new enterprise — a bureau walks in life. of registration for mothers. The field of pre-natal work, rather spar

Physicians at Work ingly tilled thus far, offers one of The first problem has been atthe greatest opportunities for con- tacked forcibly by the State Medstructive public health work, and ical Association through its obthis opportunity is made even stetrical clinics and it is the provgreater by war conditions. No ince of the State Department of great emergency faces us now in Health to attempt at least to overthe state, but to be sure none will come the second difficulty by a arise in the future, we must be campaign of education. The first alive to all of the possibilities which step in the pre-natal campaign will may exist.

be that of establishing in the State The United States does not stand Department of Health a confidenhigh among the nations from the tial registration of mothers - a standpoint of loss of life from bureau where pregnant women may childbirth. More than 15,000 register and from which informaAmerican women's lives a year go tion may be sent out. As long as out under circumstances which are possible, the answers to questions largely preventable. We stand and information given out will be thirteenth in a group of fifteen of a purely personal nature. A countries with regard to


determined effort will be made to deaths. Furthermore, nearly half bring to the knowledge of as many of our deaths from childbirth are Ohio women as possible the realidue directly to sepsis. This would zation that the pregnant period may indicate that in the country at large be fraught with danger and that we have not advanced very far be- during this period every woman yond the standards which obtained should subject herself to thorough at the time when Oliver Wendell and recurrent examination. Holmes first waged the fight which The woman will be urged to has resulted in the almost complete place herself under the care of the elimination of puerperal sepsis

of puerperal sepsis best physician obtainable. Should from the hospital records of our she be wanting from the financial great cities. We must begin to point of view an effort may be handle the problem in the smaller made to get her in touch with local places as well. There are two out- physicians and agencies which will standing causes for existing con- look after her. In every commu

Let us see

nity where there are public health preparation of the home for the nurses, city or county, in the field, occasion, or the normal after care they will be put in touch with such of the child. Furthermore, the women if not already aware of physician need not fear that the their condition. It is only too well relationship between the family and known a fact that oftentimes the himself will be in any way disgreatest disasters occur among

turbed. women where they might have This bit of work will be done in been averted had the woman her- the Division of Child Hygiene. If self or her husband and family physicians will send in the names known what to avoid. The careless- of patients directly or urge that ness and indifference upon the part they get in touch with the departof a few men to the necessity of ment themselves, every effort will their wives during the child-bearing

be made to answer the needs as period is a familiar fact. An ef- quickly and as intelligently as posfort will be made to educate both sible. The results of such a men and women along these lines. scheme, if it is properly developed,

are obvious. Any effort made Hygiene for Women

right now to conserve the lives of In industrial communities there women or children is of inestimasometimes exists the question of

ble value to the state.

to it that Ohio does not put her the woman remaining in industry

women and children in the first line too long before confinement or re

of defense. She has need of them turning too soon after, and in the rural or even isolated home there for bigger things. is the woman who because of lack

ANTI-TUBERCULOSIS of proper help rather than lack of

WORK IN CINCINNATI funds goes back to the family duties too soon after delivery or does

Plans are under way to have the the family washing too long. An work of the Anti-Tuberculosis attempt will be made to give sane

League in Cincinnati taken over by and safe information to women of the city health department. The this type, always keeping well be

transfer as contemplated includes fore their minds the necessity of both dispensary and educational recurrent visits to the family phy- activities.

It is estimated that sician. It is possible sometimes by $6,000 annually could be saved in a timely word from an outside

salaries by the change, permitting source to turn the tide with a case the employment of more nurses, which, if neglected, might mean the Hamilton County commissioners loss of one or both lives.

are to contribute to the support of The State Department of Health

the Cincinnati municipal tuberculoearnestly solicits the co-operation sis sanitarium after the first of the of the medical profession in this year, if it develops at that time work. To the busy practitioner, that the institution needs funds. who is bound to feel the extra Otherwise the county will pay on a strain of the present situation, it daily basis for patients from outmay well be of some comfort to side the city. This arrangement be able to tell a far away patient was made after the Cincinnati Roto write in to Columbus and ask tary Club had asked the county about the simple questions of hy- commissioners to appropriate $25,giene of the pregnant period, the 000 for the hospital,

Ohio Admitted to Birth Registration Area

After investigation by federal been found that the registration is government agents had demon- more efficiently performed in the strated that Ohio's birth registra- rural districts and the smaller tion was 93.4 per cent efficient, the cities than in the larger centers of state was last month admitted to population - especially the larger the birth registration area of the centers which have grown too bureau of the census. Its birth rapidly for their governmental records will henceforth be accepted equipment to keep pace with them as accurate esough for recognition in the last few years, or in which in the census calculations. The there has been recently a large inregistration area includes 14 of the flux of foreign population. In more populous states of the Union. several cities of the type mentioned

The investigation of Ohio's effi- there was a noticeably large numciency in registering births, as con- ber of unregistered births. Maducted by the census bureau, con- honing County, for instance, in sisted of a test in which independ- which Youngstown is located, had ent data as to births throughout 23 births which were not recorded. the state during a two months' and Jefferson County (Steubenperiod were collected and the re- ville) failed to register 24. sults compared with the registra- "Credit is due local registrars tion recorded by the state bureau asd physicians," says Dr. Monger, of vital statistics. Information as "for enabling us to attain this to births was sought from rural ranking. The result depended almail carriers, postmasters of towns most altogether upon them, and under 1,000 in population and all they worked hard to make our efministers of the gospel. Replies forts successful." from these persons

forwarded to the federal investigator

Scores by Counties is charge, who checked over their

In the list appended the figure lists with the lists on record for the opposite each county listed gives same localities,

the number of unregistered births

found in that county. Counties not 3.4 Per Cent Over Minimum listed had no unregistered births.

The list follows: When the process of checking was completed, it was found that Allen


2 93.4 per cent of the births of

Athens which the government investi

Belmont gators obtained information had Carroll

2 already been recorded in the bu- Champaign

1 Clinton of vital statistics. The proreau

3 Columbiana

1 portion demanded by the bureau


1 of the census is 90 per cent.


2 In going over the reports sub- Cuyahoga (Cleveland)

27 Darke

1 mitted by the census bureau, ac

Defiance cording to Dr. J. E. Monger, state

Delaware registrar of vital statistics, it has Erie




2 6

6 1

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Franklin (one in Columbus)
Hamilton (one in Cincinnati).
Lucas (three in Toledo)

2 2 3 5 2 1 3 2 1 2

Montgomery (three in Dayton).
Van Wert



1 3 4 4 1 23 3 1 1 1 3

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1 4 4 3 1 3 1 1 2


A NEARBY "TONSILITIS” OUTBREAK How easily a serious epidemic in the township did much visiting may develop from apparently small back and forth across the line. beginnings whose importance is un- Several children from the city derestimated at first is demon- called on the "tonsilitis” patient strated in a report by Dr. R. P. who later died, and several also atAlbaugh of the State Department tended the funeral, which was a of Health on a recent investigation public one. which he made into the prevalence Not until the epidemic had atof diphtheria in Findlay.

tained this stage was a diphtheria Prior to September 1, according diagnosis obtained. This resulted to his report, Findlay was practi- when a physician sent swabs from cally free from diphtheria. Dur- the throats of several children to ing the latter part of August there the laboratory of the State Departhad been, however, in Libertyment of Health for examination. Township, Hancock County, ad- Following the Liberty Township joining Findlay, an epidemic of a epidemic, diphtheria appeared in disease at that time diagnosed as the Findlay school district which tonsilitis, but now known to have the country children attended and been diphtheria. One death oc- gradually spread throughout the curred during this epidemic.

city. A number of children from Lib- Eleven cases

were reported in erty Township attended school in

September, 14 in October and 25 in Findlay. Relatives in the city and November. In one school room of

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