fit for human food and a large amount certificates of vaccination on blanks furnished of it has been destroyed. by the county. Every person owning, having custody or control of any dog so vaccinated shall present said certificate of vaccination to the health officer, who shall issue an official vaccination tag which shall be securely fastened to a collar, which collar must at all times be worn by such vaccinated dog. It shall be unlawful to attach an official vaccination tag to any dog unless the same has been duly vaccinated as herein provided. Sec. 3. The sheriff and his deputies, and every constable and his deputies, and every poundkeeper, and also any person employed for that purpose by the board of supervisors must, and are hereby authorized and empowered to capture any dog not vaccinated, as required by this ordinance, and which is found going free or running at large in or upon any place within the county, outside of incorporated cities, or such officer or person shall be authorized and empowered to kill and destroy such dog. Sec. 4. Officers or persons capturing a dog under the provisions of section 3 may separately confine, in some safe place, such dog captured by them, and shall report the capture to the health officer, and shall submit such dog to the examination of the health officer, or his representative, and it shall be the duty of the health officer, when called upon, to examine or have examined such dog, and to ascertain whether or not such dog is affected with rabies. Sec. 5. Whenever the owner or person having the custody or possession of the animal shall observe or learn that such animal shows symptoms of rabies, or acts in a manner which would lead to a reasonable suspicion that it may have rabies, such owner or persons having the custody or possession of such animal shall immediately notify the health officer or his representative to make an inspection or examination of such animal until it shall be that such animal has or has not rabies. established to the satisfaction of said official Sec. 6. Whenever it is shown that any dog has bitten any person, the owner or person having the custody or possession thereof shall, upon order of the health officer, quarantine it and keep it tied up or confined for a period of three weeks, and shall allow the health officer or other official of the board of health to make an inspection or examination thereof at any time during said period. Sec. 7. If it shall appear to the health officer or his representative upon examination of the aforesaid or otherwise, that a dog or other animal has rabies, he shall kill and destroy such animal forthwith. Sec. 8. Whenever any animal shall be bitten by another animal having rabies, the owner or person having the custody or possession of the animal so bitten shall, upon being informed thereof, either kill such animal or quarantine it, and keep it confined ог tied up for a period of six months, and the health officer or his representative shall have power, in his discretion, to kill or quarantine the animal so bitten, in case the owner or person having custody or possession thereof shall fail to do so immediately, or in case the owner or person having the custody or possession thereof is not readily accessible. Section 1. It shall be unlawful for any person owning, having an interest in, harboring, or having the care, charge, custody, or possession of a dog to allow or permit such dog to go on the public streets in any manner, or to go free and run at large in or upon any place outside of incorporated cities in the Sec. 9. No person shall take a dog, or percounty, unless such dog has been vaccinated mit or encourage a dog to go from a city or with canine rabies vaccine-one injection or town in which rabies exists, or has existed other approved method-within a period of within six months previously, or from a place twelve (12) months, and is officially tagged as in the county within five miles of which rabies provided in section 2 hereof. exists or has existed within six months Sec. 2. Said vaccinations shall be per- previously, to any county in which rabies does formed by the health officer, or any duly not exist, or has not been known to be qualified and licensed physician or veterinarian. present within six months. The persons vaccinating said dog shall issue Sec. 10. No person shall bring a dog into San Francisco reported one case of ENCEPHALITIS (Epidemic) TYPHUS FEVER cerebrospinal meningitis. YELLOW FEVER LEPROSY PLAGUE *From reports received to date for last week. 1 DEATHS PER YEAR Entered as second-class matter February 21, 1922, at the post office at Sacramento, California, under the 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 © CALIFORNIA STATE BOARD OF HEALTH. LIVES LOST A SURGEON'S ANSWER. By W. W. KEEN, M.D. In A. W. W. Lea's "Puerperal Infection," page 24, the results of the application of antiseptics to destroy. The true history of the conquest of this deadly germ are given. childbed fever is as follows: In the Rotunda Hospital, Dublin, by In February, 1843, Dr. Oliver Wen-adopting Pasteur's and Lister's methods, dell Holmes showed conclusively that the mortality was reduced to three in puerperal or childbed fever was con- each two thosuand cases. In the Baudetagious and that the doctors and loque Clinic in Paris, to 0.09 per cent! nurses carried the disease from the Boxall in the York Road Hospital, Lonsick woman to the well. This started don, had a record of 8373 consecutive a violent controversy, the embers of cases without a single death from childwhich were still red-hot when I began bed fever! the study of medicine seventeen years later. The first successful weapon against puerperal fever was obtained by SemIn 1846, Semmelweiss of Vienna melweiss' experiments on animals, and was struck with the different rates of by his use of antiseptics, but the real mortality from this fever in those cause of the fever was not absolutely women who were attended in child known until Pasteur proved it. Then birth by medical students who, natur- the remedy was clear. ally, were often working in the dissecting room and brought into connection with other sources of contamination, and those who were attended by midwives who were not so exposed. In the former the deaths from childbed fever were 11.4 per cent. In the latter, only 2.7 per cent! He made experiments on rabbits and became convinced that the students carried the poison to the mothers. He, therefore, compelled every student to cleanse his hands first with chlorine water and later with chloride of lime. Observe that both of these were antiseptics or germicides, as now we know. Of course, he knew nothing of germs. Nobody then did. The result was that very shortly the deaths from childbed fever in his wards fell to 1.27 per cent! The puerperal mortality in all countries has long been deplorable because we knew nothing of bacteriology until the 80's. In my early days in the 60's and 70's, the usual mortality was about 5 per cent. Often "epidemics," as they were called, caused a mortality of 20, 30, 50, and even 55 per cent! The present mortality from childbed fever is clearly due to the ignorance and the neglect of the attending physiciansan ignorance which, in my view, is culpable and inexcusable. It is a blot on our escutcheon. Proper antiseptic precautions would surely give results similar to those I have cited from Dublin, Paris and London. It is time for our professors of obstetrics, our county medical societies, the American Gynecological Association, for the Academy of Medicine in New York City, for the College of Physicians in Philadelphia, to begin a campaign for saving the lives of the brave mothers of our race. They have a right to life, and their babies have a right to the fostering care of their mothers. We doctors can give this boon to both.-The Woman Citizen. Breaking Quarantine. Quarantine, or the isolation of any person who has a disease which may be transmitted to others, is probably the oldest method of preventing the spread of such a disease. Even in Biblical times, lepers were kept in In 1879, in a debate in the French separate colonies, and not allowed Academy of Medicine, on the cause of to mingle with uninfected people. these epidemics, various probable causes Apparently the first use of quaranwere cited, but Pasteur declared that tine in what may be termed an official none of them caused the fever. He way was in Venice and other ports drew on the blackboard what we know in the fourteenth century, when vesas the Streptococcus. "That is the sels suspected of carrying plague cause," he said. This germ is also re- were held for forty days after arrival sponsible for erysipelas and various so that those aboard who might just forms of blood poisoning which were so rife during our Civil War. Others then proceeded to investigate Pasteur's assertion and soon the Streptococcus was be coming down with the disease could not land and spread the infection. The word quarantine comes from the Italian quarante or forty, the Most countries still practice quarantine at ports of entry, but the forty day rule is no longer in use. Instead, if the vessel comes from a port where an epidemic is known to exist, or if cases of infectious diseases are found on board, the ship is held for the period of incubation of the disease; that is the usual number of days between exposure and the time of becoming sick. Where no infectious disease is found, the port physicians examine the passengers and if all seem well the vessel is "passed" and the people are allowed to land. Quarantine in the home is on the same general principle-keeping suspects and those with the disease from mingling with others until there is no danger of spreading the disease. It used to be the practice to quarantine the whole house; today it is the more common practice in most diseases to isolate the patient in his own room and allow adult members of the household to come and go so long as they do not come in contact with the patient. The nurse who takes care of the sick person must also take specific care not to spread the disease herself. Quarantine or isolation is fairly easy to enforce if the patient is ill in bed, for a really sick person doesn't want to see anybody. But once the patient is convalescent, a natural desire develops to see other members of the household and any visitors who may appear. When the patient is getting well is the time, in the case of many diseases, when he must be watched to see that he doesn't come in contact with others, particularly young children. The problem of the isolation of a person infected with the germs of a communicable disease, but not confined to bed and only slightly sick or apparently completely cured, is a far different proposition, particularly if the infected person is a child. It is naturally difficult for a person who feels well to understand how he or she can possibly be dangerous to other people. But such persons are really the most dan gerous because they are eager to associate with others. Quarantine rules and regulations are solely for the purpose of preventing the transmission of the germs of disease from an infected person to a non-infected person. If, for the sake of giving your child more liberty of action, you are the indirect cause of the infection of others through their contact with your child, your health board can hold you responsible for your action. Moreover, although your child may have had a light case, the infection in passing to another child may cause a very serious case and even result in death. Your personal belief that your child is no longer infective is no excuse for taking chances. The period of isolation for a given disease is based either on actual laboratory tests for the presence of the infectious germ or on the length of time which long experience has shown is necessary for these organisms to disappear. The only safe rule to follow is to obey the quarantine regulations laid down for you by your local board of health, remembering that if you violate these rules for your own convenience, your neighbor may follow your example, thus unreasonably exposing some member of your family to a dangerous disease. You should be willing to apply the Golden Rule in this as in other phases of human intercourse.-Herman M. Biggs, M. D., New York State Commissioner of Health. Typhus Fever Case Reported. Another case of typhus fever was reported recently. The patient is an elderly man residing in Los Angeles. On the fifth day of his illness the typical rash appeared. Blood examination made at the Los Angeles city laboratory for the Felix-Weil reaction showed agglutination in 1:160 positive. Mild cases of typhus fever appear at frequent intervals in California. The health officers in the southern part of the state are specially active in their efforts to keep the disease under control. Mothers and fathers are particularly While it is believed that Mexicans conapt to be lenient if the pet of the house- | stitute the only sources of infection for hold has recovered from all symptoms, cases of typhus that occur in California, is apparently well, and wants to go out it is a conspicuous fact that most cases in the yard for a little sunlight and reported within the state do not occur fresh air, but it should be remembered in Mexican people. Typhus is endemic that if a child is unguarded, other chil- in Mexico and as long as the disease dren are very likely to crowd around a is prevalent in that country, California playmate whom they have missed on must maintain active and continuous account of illness. It is probably in such work in preventing the spread of the a manner that most children become ill. disease in this state. |