MONTHLY
BULLETIN
Indiana State Board of Health
(Entered a s second-class m a t t e r a t t h e I n d i a n a p o l i s Postoffice)
INDIANAPOLIS, FEBRUARY, 1917
VOLUME XX
J A M E S S. B O Y E R S . M . D „ P R E S I D E N T .
,
Decatur
H. II. S U T T O N , M . D.. V I C E - P R E S I D E N T . . . . . . . .
. . . . . .Aurora
J. L. F R E E L A N D , M . D.. . . . . . . . . . . . . . . . . . . . . . . . . . I n d i a n a p o l i s
CHAS. B R U C E K E R N , M. D . . . . . . . . . . . . . . . . . . . . . . . .Lafayette
J. X . H U R T Y . M . D., P h a r . D . . SECRETARY
Indianapolis
WM.
f
K I N G . M. D..
,
. . . . . A S S T . SECRETARY
H. H . M I T C H E L L , M . D . . . . . . .
, . .EPIDEMIOLOGIST
J. L. AN D E r S O N
C H A S . A. C A R T E R . M . D . .
WM.
ADA
R. J .
H. E .
CHIEF CLERK
..STATISTICIAN
S H I M E R , A. B . . M , D . . . S U P T . B A C T E R I O L O G I C A L L A B O R A T O R Y
E. S C H W E I T Z E R . M . D
ASSISTANT BACTERIOLOGIST
A N D E R S O N . M. D.
ASSISTANT PATHOLOGIST
B A R N A R D . B . S., S T A T E F O O D AND D R U G C O M ' R AND C H E M I S T
H. E. B I S H O P , B. S , . . . . . . . . . . . . . . . . . . . .
JOHN
C.
ASSISTANT C H E M I S T
D I G OS . . . . . . . . . . . . . . . E N G I N E E R AND W A T E R C H E M I S T
W I L L D. M c A B E E . , , . . . , . . . . . .
DRUG CHEMIST
T h e M O N T H L Y B U L L E T I N will b e s e n t t o a l l h e a l t h o f f i c e r s
a n d d e p u t i e s i n t h e S t a t e . H e a l t h officers a n d d e p u t i e s s h o u l d
c a r e f u l l y r e a d a n d file e a c h c o p y for f u t u r e r e f e r e n c e . T h i s i s
very i m p o r t a n t , for we e x p e c t t o p r i n t i n s t r u c t i o n s , r u l e s a n d
g e n e r a l i n f o r m a t i o n , w h i c h i t will b e n e c e s s a r y for officers t o
preserve.
CONTENTS
Births for February
Abstract of M o r t a l i t y Statistics for February
S u m m a r y of Morbidity and Mortality for F e b r u a r y .
Health Officers. Attention
Report of Bacteriological Laboratory
,
,,
Things of Interest from t h e L a b o r a t o r y
Report of Food a n d Drug D e p a r t m e n t .
Inspectors' Report . . . . . . . . . . . * . . . . . .
Evading t h e Health Officer
First Aid Instructions
Health a n d Disease Prevention
C l i m a t e and Tuberculosis.
Grand Rapids. Michigan, . . . .
He Drained t h e City Sewer into M y Cellar
Colon Hygiene.
.
Pulmonary Tuberculosis
x, . , . , , . . . . , . , , .
If is a Social a n d Civic Crime
Perry Stafford of Garrett
,
Batesville T a k e s t h e Prize. . .
. . .
A Tragedy Indeed
,. .. .
Measles. Diphtheria a n d Scarlet Fever,
T h e National Board of Medical E x a m i n e r s .
Three T h o u s a n d Privy Vaults
. .. ......
Dr. .1. G. Walthall. *
Fire Drills in t h e Schools
Chart Showing Geographical Distribution of D e a t h s
. .
T a b l e 1. D e a t h s in Indiana by Counties . . . . . . . . . . . . . . . . .
Table 2. Deaths in Indiana by Cities
,. ....
Mortality of Indiana
..............
W e a t h e r Report for F e b r u a r y .
,
no
m
5f»
f>
BIRTHS FOR FEBRUARY. 1917
Total births 5,104 (stillbirths excluded): State rate 23.0.
Males 2,645, females 2,459.
White males 2.005: white females 2,410.
Colored births 89: males 40. females 49.
Stillbirths 195: white IS5, colored 10.
The Northern Sanitary Section, population 1,009.304 reports 1.S40 births, rate 23.8.
The Central Sanitary Section, population 1.191.458 reports t.€f4 births, rate 21.S.
The Southern Sanitary Section, population 688.793 reports
1.202 births, rate 23.8.
The highest rate Dubois County. 42.5,
Tip.- lowest, rate Newton County, 7.4,
Total births to date for 1917, 10,765,
NUMBER 2
25 Cents a Year
ABSTRACT OF MORTALITY STATISTICS
FOR FEBRUARY, 1917.
Total deaths reported 3,786; state rate 17.0. In. the preceding month 3,647 deaths; rate 14.9. In the same month
last year 3,299 deaths; rate 14.5. Deaths by important
ages were: Under 1 year of age, 533 or 14.0 per cent of total,
1 to 4, 205; 5 to 9, 75; 10 to 14, 47; 15 to 19, 95; 65 and over,
1,360 or 35,9 per cent of total
SANITARY SECTIONS: The Northern Sanitary Section, population 1.009,364 reports 1,277 deaths; rate 16,4.
In the preceding month 1,250 deaths; rate 14.7. In the same
month last year 1,177 deaths; rate 14.8.
The Central Sanitary Section, population 1.191,458 reports
1,002 deaths; rate 17.5. In the- preceding: month 1,585 deaths,
rate 15.6. In the same month last year 1,372 deaths, rate
14.8.
The Southern Sanitary Section, population 688,793 reports
907 deaths; rate 17.1. In the preceding month 8,12 deaths,
rate 13.8. In the same month last year 750 deaths; rate 13,8.
REVIEW OF SECTIONS: The Central Sanitary Section
presents the highest death rate, which is .5 higher than that
for the entire state. The Southern Section also presents a
death rate .1 higher than the state rate, The Northern Section presents the highest death rate for typhoid fever, scarlet
fever, diarrhoea and enteritis, acute poliomyelitis and cancer.
The Southern Section presents the highest death rate for
whooping cough, lobar and broncho-pneumonia, cerebrospinal fever and influenza. The Central section presents the
highest death rate for tuberculosis, diphtheria and croup,
measles and puerperal septicemia.
RURAL: Population 1.554.481 reports 1,879 deaths; rate
15.7. In the preceding month 1,781 deaths, rate* 13.4. In
the same month last year 1,719 deaths; rate 13.9.
URBAN: Population 1.335,134 reports 1907 deaths; rate
18.6. In the preceding month 1.806 deaths; rate 16,4, In
the same month last year 1.580 deaths; rate 15.2. The cities
named present the following" death rates: Indianapolis 20.2,
Evansville 18.9, Fort Wayne 15,7, Terre Haute 15.1, South
Rend 18.3, Gary 24,6, East Chicago 25,5. Hammond 29.0,
Muncie 18.1, Richmond 16.8, Anderson 22.3, Elkhart 11.3,
Michigan City 10.2, Lafayette 23,9, Kokomo 20.8, Logansport 20.7, New Albany 24,0, Marion 18.9.
SUMMARY OF MORBIDITY AND MORTALITY
FOR FEBRUARY. 1917.
Measles was reported as the most prevalent infectious
disease. The order of prevalence was as follows: Measles.
scarlet fever, tonsillitis, influenza, diphtheria and croup, lobar
pneumonia, acute bronchitis, bronchial pneumonia, smallpox, pulmonary tuberculosis, acute rheumatism, chickenpox,
whooping cough. typhoid fever, erysipelas, other forms of
tuberculosis, diarrhoea and enteritis, intermittent and remittent fever, puerperal fever, malaria fever, dysentery, poliomyelitis, rabies in human, trachoma, cerebrospinal fever,
cholera morbus, rabies in animals.
141)
.MONTHLY
BULLETIN,
INDIANA
S M A L L P O X : 540 eases in 40 counties with no d e a t h s .
Tin* counties reporting smallpox present were: Boone
C o u n t y 3 ease*. Cass 1, Clark 3. Clay 2. Dekalb 1, Floyd 2,
Fountain 28, Fulton 7. Gibson 18, G r a n t 6, Greene 5, Hamilton 3. Hancock 1. Hendricks 1, Howard 1, Jackson 6T J a y 9,
Johnson S. Knox 1, Lake 15, Laporte H, Madison 20, Marion
23. Owen 40. P a r k e 2, Pike 7, Posey 17, P u t n a m 3, Rush 3,
Spencer 3, St. Joseph 3, Sullivan .SI. Tippecanoe 23, T i p t o n 8,
Vanderburg 10. Vermillion 11. Vigo 170, Warren 1, W a s h ington (i. W h i t e 30.
T U B E R C U L O S I S ; 302 deaths, of which 314 were pulmonary form and 48 other forms. Male tuberculosis d e a t h s
numbered 189, females 173. Of the males, 27 were married
in tin 1 age period IS to 40 and left 54 orphans u n d e r 12 years
of age. Of the females, 53 were married in the same age
period as above, and loft 106 orphans u n d e r 12 years of age.
T o t a l orphans m a d e in one m o n t h by this preventable disease.
Hit). N u m b e r of homes invaded, 35(5.
P N E U M O N I A : 057 deaths, r a t e 296.0 per 100.000. In
the preceding m o n t h 607 deaths, r a t e 248. In t h e same
monih last year 427 deaths, r a t e 186.6. Males numbered
370. females 287. Of the pneumonia deaths, 148 occurred
tinder one year of age.
T Y P H O I D F E V E R : 74 cases in 20 counties with 25
deaths.
In the preceding m o n t h 130 eases in 21 counties
with 35 deaths. In the same m o n t h last year 142 cases in
28 counties with 31 deaths.
D I P H T H E R I A : 257 cases in 47 counties with 31 d e a t h s .
In tin* preceding m o n t h 409 cases in 58 counties with 46
d e a t h s . In t h e same month last year 125 eases in 39 counties
with 25 deaths,
S C A R L E T F E V E R : 548 eases in 52 counties with 16
d e a t h s . In the preceding m o n t h 490 eases in 58 counties
with 13 d e a t h s . In the same m o n t h last .year 406 eases in 55
counties with 13 deaths,
M E A S L E S : 5,353 cases in 79 counties with 74 d e a t h s .
In the preceding m o n t h 4,145 cases in 72 counties with 32
d e a t h s . In the same m o n t h last year 1,712 eases in 45
counties with 21 deaths.
P O L I O M Y E L I T I S : 4 eases in 3 counties with 2 d e a t h s .
In the preceding m o n t h 4 cases in 4 counties with 4 d e a t h s .
R A B I E S : T w o persons bitten by rabid animals and
t r e a t e d by t h e S t a t e Board of Health during t h e m o n t h .
T h e r e were no d e a t h s .
E X T E R N A L C A U S E S : Total 210, males 150. females 50,
Suicide:
Total 20, Males 18. females 2. Suicide by poison 2,
by asphyxia 2, by hanging or strangulation 6, by firearms 8.
by cutting or piercing i n s t r u m e n t s 2. Accidental or
1, other acute poisonings 6, conflagration 6, burns (conflagration excepted) 13, absorption of deleterious gases (conflagration excepted) 6, accidental drowning 6, t r a u m a t i s m by firea r m s 7. t r a u m a t i s m by fall 40. t r a u m a t i s m in mines 0.
car accidents and injuries 5, automobile accidents and injuries
S. motorcycle accidents a n d injuries 1T injuries by other
vehicles 4, injuries by animals 2, excessive cold 5, electricity
lightning excepted 2, fractures (cause not specified) 5. other
external violence 13. Homicide:
Total 16, males 13,
i n s t r u m e n t s 2. by other mean** 2,
STATE B O A r D
OF
HEALTH.
HEALTH OFFICERS
ATTENTION
Delayed Birth a n d Death Certificates.
Each month the statistical d e p a r t m e n t receives certificates
for births a n d d e a t h s that h a v e occured d u r i n g t h e preceding
m o n t h s , which are not sent to this d e p a r t m e n t in t i m e to be
t a b u l a t e d with the report for the current m o n t h . W i t h t h e
report for F e b r u a r y the following counties named below were
delinquent in this m a t t e r .
BIRTHS.
A d a m s 1: Allen 2 ( F o r t W a y n e ) ; Bartholomew 4 ( C o l u m b u s
I); Benton 2 (Oxford 1); Boone 0; Brown 1—for October 1910;
Cass 0—J for December 1915 (Logansport !. W a l t o n 2 ) ;
Clark 2 (Jeffersonville); Clay 4—1 for D e c e m b e r (Brazil I ) :
Crawford 2 ( L e a v e n w o r t h ) : D e c a t u r 5 (Greensburg 2 for D e cember); Delaware 7 (Muncie 2 ) ; Dubois 3 ; E l k h a r t 1 ( N a p panee); F o u n t a i n 2 (Attica 1); F r a n k l i n 3 ; F u l t o n 1; Gibson
1; G r a n t 7—2 for N o v e m b e r 1 for D e c e m b e r (Gas C i t y 1,
.Jonesboro 1); Greene 5 ( W o r t h i n g t o n 1, Lyons 1 for D e c e m b e r ) ; H a m i l t o n 2; Hendricks 3 "(Plainfieid 1; C l a y t o n 1)
H e n r y 8 (New Castle 3 ) ; H o w a r d 1) H u n t i n g t o n 2 ( R o a n o k e
1. for N o v e m b e r and D e c e m b e r ) ; J a c k s o n 1 (Crotherville);
J a s p e r 1 ( R e m i n g t o n ) ; J a y 1; Jefferson 7 ( M a d i s o n 4 ) ; J e n nings 1) Knox 3 (Vincennes 2 ) ; L a p o r t e 2 (City 1); Lawrence
5 (Bedford 3 ) ; Madison 1; Marion 1 (Broad R i p p l e ) ; M i a m i 1;
M o n t g o m e r y 4—I for December (Ladoga 1): M o r g a n 1
(Morganto
P o r t e r 2; Posey 4 (Poseyville 1); Ripley 4 (Osgood 1); Scott
1) Spencer 5—1 for December (Rockport I ) ; S t a r k e 2 ( N o r t h
J u d s o n 1—for N o v e m b e r 1916); Steuben 2) St. Joseph 4
(South Bend 3. M i s h a w a k a 1); Sullivan ] ; Vanderburgh 0
(Evansville 4 ) ; Vermillion 3—1 for D e c e m b e r ; Vigo 7 (Terre
H a u t e 3, W. Terre H a u t e 2, Seelyville 1— for D e c e m b e r ) ;
W a b a s h 2; Washington 1 (Little Y o r k ) ; W a y n e 4 ( R i c h m o n d ) ;
Wells 3 (Bluffton 1, Uniondale 1); W h i t e 4. T o t a l 169.
DEATHS.
A d a m s 2; Allen 1 (Fort W a y n e ) ; Bartholomew 2 (Columbus
1. Elizabeth town, 1); Brown. 1; Cass 3 (Walton 1); Clay 4 ;
Crawford 2; Daviess 2 (Odon 1); D e k a l b 1 ( G a r r e t t ) ; E l k h a r t 1 ( C i t y ) ; Floyd 1 (New A l b a n y ) ; F o u n t a i n 1; F r a n k l i n
1; F u l t o n 1; Gibson 1; G r a n t 1 ( U p l a n d for D e c e m b e r ) ;
Greene 1; Harrison 1 (Lanesville); H u n t i n g t o n I ; J a c k s o n 1;
J a s p e r 1; J e n n i n g s 1; Lake 5 ( H a m m o n d 1. E. Chicago 2 for
N o v e m b e r ) ; Madison 3 (Alexandria 1); M a r t i n 1; M o n t gomery 2—(1 for D e c e m b e r ) ; P o r t e r 2 ( K o u t s 1); Posey 1;
P e r r y I ( C a n n e l t o n ) ; P u t n a m 2 (Bainbridge for D e c e m b e r ) ;
Rush 1; Shelby 2 (Shelbyville); Steuben 1; Tippecanoe 1:
Union 2 (Liberty 1); Vigo 1 (Terre H a u t e ) ; W a r r i c k 2
Whitley 1. Total 66.
(L
REPORT OF BACTERIOLOGICAL LABORATORY,
INDIANA STATE BOARD O F H E A L T H .
Undefined:
164,
F O R Total
FEBR
U Amales
R Y . 129.
1917,females 45. Poisoning by
Will S h i m e r , M . D.„ S u p e r i n t e n d e n t .
S p u t u m for tubercle b a c i l l i traumatism
Positive. , . . . . . . . . . . . .by
. . .machines
. . . . . . t ...
6, railroad
accidents
145
and injuri
t ..,,
Negative. . . . .
,.,....
397
—
542
Urine for tubercle b a c i l l i Positive.
l
r .................. . . . .
N e g a t ifemales
ve.
3. „Homicide
. . .by firearms
2
12, by cu
Cerebro Spinal fluid for tubercle bacilli—
Negative... . .
^ ..............
1
MONTHLY BULLETIN, INDIANA STATE BOABD OF HEALTH,
147
Guinea pigs inoculated for rabies, n e g a t i v e . . . . . .
Guinea pigs inoculated for tuberculosisPositive
Negative.
Pleural fluid for tubercle bacilliNegative.
Pus for tubercle bacilliNegative
Doses of antityphoid vaccine prepared and sent out.
Widal tests for typhoid f e v e r Positive. . . . . . . . . . . . . . . . . .
Negative.................
Throat cultures for diphtheria bacilli—
Positive.
Suspicious.
Negative.
Unsatisfactory
OUTFITS PREPARED AND SENT OUT DURING
FEBRUARY, 1917.
158
29
442
14
Epidemic cultures for diphtheria bacilli-—
Positive.................................
44
Suspicious
39
N e g a t i v e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,076
Unsatisfactory.....,.....".....,.
11
Brains for rabiesDogs—
Positive.
Negative....
Hogs—
Positive.
CatsNegative. . . .
Horses—
Negative....
Urine for chemical analysis
Feces miscellaneous.
Uterine secretion for abortus b a c i l l u s . . . . . .
Stomach contents. . . . . . . . . . . . . . . . . . . . . . .
Total number examinations made.
2,936
PATIENTS TAKING \"PASTEUR" TREATMENTS FEBRUARY, 1917.
Town,
Dorothy Deen Barter. Mt. Vernon.
Fred Gunter......... Camby. ...
County
Age. Sex
Treat- Treatment
ment
began. finished.
Posey
Morgan. ,.
THINGS OF INTEREST FROM THE LABORATORY.
Most physicians have an indefinite arid hazy notion of the
sources of infection of their typhoid patients, their sources
rarely including more than water or milk, The bedding and
clothing of typhoid patients are not often thought of as dangerous and very few precautions are taken to prevent the
infection of washwomen.
Recently the laboratory had one ease of a washwoman contracting typhoid after handling the clothing of a typhoid
patient.
Positive.
Pus m i s c e l l a n e o u s . . . . . . . . . . . . . . . . . . . . . .
Pathological t i s s u e s Carcinoma—
Carcinoma of mouth. . . . . . . . . . , . . . , ,
Carcinoma of b r e a s t . . . . . . . . . . . . . . . .
Carcinoma of skin over r i b . . . . . . . . . .
Carcinoma of pyloric end of stomach .
Carcinoma of cervix u t e r i . . . . . . . . . . .
Carcinoma of femur.
Miscellaneous tissues
Gasserian Ganglions.
Total number outfits
Name,
Blood for c o u n t s . . . . . . . . . .
Blood for malaria plasmdiaNegative.............
Pus for gonococci—
Females—
Suspicious,...........
Negative..
.......
MalesPositive
Suspicious
Negative..............
Unsatisfactory....... «.. .
Sex not given—
Negative
Tuberculosis.....................................
654
Diphtheria
587
Diphtheria epidemics
1»450
Widals.
117
Gonococci
70
Blood counts
27
Malaria.
20
Bile media
, ...................
11
Prigge1 reports the sources of 5275 eases as follows:
Arbeiten Aus dem Kaiserlichen Gesundheitsamte
6
2
20
1
Vol. 41, pg. 184.
Source of infection
Number of cases
C o n t a c t . . . . . . . . . ......................
4,202
Water................................
399
Milk
309
Food
141
W-A-S-H-I-N-G
39
Attending sick
1*08
Soil
">
Privy
....................
26
Laboratory.....................
11
Teachers..
10
Miscellaneous...................
25
Total... . . . . . . . . . . . . . . . . . . .
5.27">
Boiling is practically the only sure means of freeing infected linen from its infections.
Sehroeder and Sutherland 2 report as follows on soap.
Pub. Health Reports Vol. 32, pg. 225, 1917.
bleaches arid disinfects ordinarily employed in laundries ;—
""Using the methods employed by the United States
Public Health Service, approximately fifty tests were
made of soap, bleaches and disinfectants used in
washing. A study of the soap solutions used showed
MONTHLY BULLETIN, INdIANA STATE BOArB OF HEALTH.
148
that they possessed no germicidal value In the
strenghts employed. In one instance we were able
to isolate a staphylococci from one of the strong solutions which was ten times as strong as the solution
ordinarily used in the washing machine,
In the study of the bleaches we found that the average bleach and disinfectant used required an average germicidal strength of at least 1 % to prove
effective in destroying B. Coli in thirty minutes,'*
REPORT OF THE DEPARTMENT OF FOOD AND
DRUGS, INDIANA STATE BOARD OF
HEALTH FOR FEBRUARY, 1917.
H. E. Barnard, Ph. D., State Food and Drug
Commissioner.
During the month of February 305 food samples were analyzed 92 of which were reported as illegal. The large number
of adulterated samples is due to the fact that the inspectors
are finding meat products such as hamburger and both pan
and link sausage grossly adulterated. For a number of years
the use of sulphites in hamburger, cereal and sausage has been
restricted to an occasional butcher, but at the present time
because the high price of meats, or perhaps the unusual activity of salesman for chemical preservatives and starch
fillers, we are finding meat foods to be adulterated more commonly than at any time since the enactment of the Pure Food
Law. Out of 41 samples of hamburger. 8 contained sulphites.
Of 148 samples of sausage 54 were adulterated either with
starch or sulphites. Three samples of weinerwurst were in
every case loaded with starch. Many of the defendants in
these cases have1 plead guilty and frankly admitted that they
were using starch and water, in some cases to the extent of
twenty percent of the total weight of the sausage. One
butcher said that he was adding four pounds of filler and
about fifteen pounds of water to every hundred pound batch
of sausage. Water and cereal at sausage prices adds materially to the high cost of living,
Of fifty-one milk samples, IS were listed as illegal in several
eases because of skimming and watering and in other instances
because- of the presence of visible dirt.
Thirty-four drug samples were analyzed. In every case
they were found to be pure.
RESulTS OF ANALYSIS OF FOOD AND DRUGS DURING THE MONTH OF
FEBRUARY. 1917.
CLASSIFICATION'.
FOOD.
Cider. . . .
Cocoa
Temperance Beers .
Wine
Honey . . . .
Meat Products-—
Hamburger
. .
Liverwurst
Oysters
sausage
.
. . .
Miscellaneous Meats
Weinerwurst
.
Milk P r o d u c t s Butter. . .
Cream
Ice Creami
Milk
. .........
Milk, Breast . . . . . . .
Vinegar. . . . . . . . . . . .
Miscellaneous
. . . . . .
Total . . . . .
Aspirin Tables
Codes a Tablet
Miscellaneous
Total.
Number
Legal-
Number
Illegal.
Total
INSPECTORS
REPORT FOR THE MONTH OF
FEBRUARY. 1917.
During the month of February the inspectors visited 844
places where food stuffs were handled. They report 5 establishments in excellent condition, 427 good, 276 fair, 127
poor and nine bad. Six of the nine bad places reported were
dairies, 31 of which were visited. None were found in excellent condition, 5 were reported good, 14 were fair, 6 poor
and 6 bad. These figures can only be taken as evidence that
the dairy situation is not improving and we are convinced
that it will not be improved until state and local officials
compel the dairymen by sheer force of law to operate their
places with some regard to the health of the consumer and
the decencies of life, We have hoped that the dairy industry
would finally be developed on a business bases; that the small
renters who keep two or three cows and who have no equipment, would stop selling milk and that the farmers with capital would see an opportunity to develop a profitable business.
The State Board of Health is interested in better dairying.
It would place no obstacle in the way of this development. It
would have its rules reasonable and exact no investment which
was unnecessary or expensive, but it would require the men
who produce milk to product it under just as sanitary conditions as is required of the man who produces bread in a
bakery; who runs a restaurant or who operates a canning
factory. The State Board of Health would not discourage
the farmer—rather it would encourage him by helping him
not only to build up a good business but by pointing out to
him the opportunity he has to serve the public by providing
the most necessary of all foods under such conditions that it
is absolutely safe.
Of the 334 grocery stores visted, 2 were rated excellent*
168 good, 117 fair, 46 poor and one bad.
Of the 225 meat markets inspected 2 were in excellent condition. 108 were good, 56 fair, 58 poor and one bad,
Twenty-five drug stores were inspected and all found to
be in good condition. The druggists apparently appreciate
better than other business men the importance of operating
a sanitary shop in strict compliance with the food and drug
laws.
Of the 109 bakeries and confectioneries visited 75 were
in good condition, 31 were fair, 2 were poor and one was reported as bad.
But one of the eighty hotels and restaurants visited was
reported excellent; 23 were good, 45 fair and 11 poor.
Other places visited included fish markets, ice cream parlors and factories, bottling works, slaughter houses, wholesale groceries, etc.
During the month of February 12 prosecutions were brought
against dealers for selling adulterated food stuffs. Four
samples involved the sale of sausage containing starch; 3
the sale of hamburger steak preserved with sulphites; two
the sale of low grade ice cream; one the sale of food stuffs not
properly protected against dust and dirt and two for the sale
of misbranded foods,
The total fines and costs collected during the month
amounted to $252.65.
..
Drugs,
Thirty-three condemantion notices were issued in February against confectioneries, dairies, groceries and restaurants
Twenty-six of the 33 condemnations were issued against
dairies which in every case were unsanitary and in 8 cases
were in addition improperly constructed.
MONTHLY
BULLETIN, INDIANA
INSPECTORS' REPORT FOR THE MONTH OF FEBRUARY, 1917.
INSPECTED.
No.
Inspected.
No.
Excellent .
No.
Good.
No,
Fair.
No.
Poor-
No.
Bad,
Dairies
Grocery Stores
Meat markets
,
Drue stores.
Bakeries and Confectioneries,,
Hotels and restaurants
Ice cream parlors
,
Ice Cream factories
,.
Mottling works
.
Poultry houses
Fish
markets
. ...
Slaughter houses. .
Wholesale groceries
W holesale
confectionery
Milk plant
'.
Fruit and Vegetable stores ...
Wholesale coffee and spire company
Total...,..,
LIST OF PROSECUTIONS DURING THE MONTH OF
FEBRUARY, 1917.
Names and
Addresses of
Defendants
COUNTY
Lake.
Marion
Tipton.,
Wayne
Wells •
Why Prosecuted
Date of
Trial
Final.
Disposition
Tittle Brothers, Gary
SellingsausagecontainingstarchDouble Eagle Grocery Selling hamburger containing sulphite.
Co., Gary . . . .
Andrew Kmetz. Gary Selling sausage containing starch.
Edwin E. Shoracker, Selling sausage conIndianapolis
taining cerealEd. H. Fielder, Indian- Selling hamburger containing sulphites.
apolis
Scott M. Ford, Indian- Selling sausage containing cereal.
apolis
Frank Faher, Indian- Selling hamburgercontainingsulphites._
apolis
.. Ed. Hawkins, Tipton. Selling ice cream below
standard.
Roscoe C
Marine. Selling ice cream below
Tipton
-. standard.
Surface and Newhouse, Selling m i s b r a n d e d
sausage.
Tipton
J.M.Eggemeyer
and Selling exposed foodstuffs.
Son. Richmond
frank
Humphrey, Selling cider not properly labelled.
Bluffton.
NOTICES OF CONDEMNATION DURING THE MONTH OF
FEBRUARY, 1917.
CLASSIFICATION.
Reasons for
Unsanitary
Conditions.
Condemnation
Improper
Construction.
Total
Confectioneries.. .
Dairies
..
Groceries. . . . . . . .
Restaurants. . . . . .
Slaughterhouses...
Total.........
M r . S. G. Engle, a chemist of the D e p a r t m e n t of H e a l t h
a n d Charities of Gary, I n d i a n a reports an interesting
p r i n t his story in t h e hopes t h a t other inspectors a n d health
officers who h a v e h a d similar experiences will m a k e t h e m
public. This kind of publicity helps.
EVADING T H E HEALTH
OFFICER.
Soon after t h e S t a t e H e a l t h authorities ordered t h a t all
persons In the s t a t e of Indiana, who handled food for h u m a n
consumption, must have a certificate of health, signed b y a
physician who is acceptable to t h e health officers, t h e food
inspector of G a r y , I n d i a n a was passing t h e blanks to such
persons with t h e proper instructions. In one of the bakeries
on N o r t h Broadway, he met a baker, who looked as tho he
might have a communicable disease. H e h a n d e d him a
STATE
BOARD
OF
HEALTH,
149
blank and told him to have it filled out a n d signed by the next
morning, a t which time he would call for it. T h e baker
seemed sullen, but said nothing.
T h e next morning when t h e inspector called at the bakery,
the baker had resigned and gone, leaving no word as to his
where-a-bouts.
L a t e r in t h e week, when t h e inspector entered a n o t h e r
bakery in the city, he t h o u g h t he recognized the " F r i e n d
Baker" 4 in the back room, but was not sure. A b o u t t h a t
time, the baker saw t h e inspector, a n d immediately needed
to get something in t h e basement. T h e inspector followed
him, but found the basement so d a r k that, he had to use his
flash light to see a n y t h i n g . T h e basement was well filled
with bags of flour a n d boxes of canned goods. After Hashing
his light in all corners as he went, t h e inspector finally found
the baker hidden behind some bags of flour, shaking as t h o
lie had t h e palsey. " W h a - w h a t do you w a n t ? " , asked t h e
baker. " Y o u r health certificate," answered the inspector.
T h e baker came out of his hiding place and pleaded ignorance
as to what he was supposed to do, 'but could give no reason
for trying to hide. T h e inspector finally granted him time
until t h e next morning to produce his signed certificate, b u t
m a d e it clear to him t h a t , if he did not have it t h e n he could
not work at his t r a d e in this city.
Well, he called the next morning, but there was no baker
to be seem T h e proprietor came up and said, " W h a t in the
world h a v e you done to my foreman? You nearly seared him
to death y e s t e r d a y . " " N o t h i n g but d e m a n d a health certificate,"' replied the inspector. "Well he's gone," said the
proprietor." \"ou h a d no more t h a n gone yesterday, when
he came in and said he was thru with G a r y . l i e said this was
a h — _ — (> f a s l a t e with such laws, and that he would go to
Michigan where they did not have such d —
laws.*"
This is only one of m a n y cases, where the food handlers t r y
to dodge the health authorities. How much b e t t e r would itbe. if all proprietors, before hiring any one, would require a
health certificate and keep it on tile for the inspection of the
health officer. Another great step forward in food work
would be some kind of interstate cooperation, or better still
a national law so that diseased food dispensers could not
dodge the law by merely j u m p i n g the state line.
F I R S T AID I N S T R U C T I O N S .
Dr. C. W . Hopkins. Chief Surgeon of t h e Chicago and
N o r t h Western Railway gives the following instructions in
regard to first aid to tho injured.
O P E N W O U N D S . — D o n ' t touch open wounds with bare
hands.
D o n ' t disturb blood clots or wash t h e m away.
Don\'t t r y to cleanse a n d wash wounds.
experienee
in the
course of
duties
at toG astop
r y , bleeding,
W e are glad to
D o n ' t use a quid
of tobacco
or his
spider
webs
H E M O R R H A G E . — T o control hemorrhage place t h e compress on t h e bleeding part and m a k e firm pressure with the
cambric bandage. Elevate the limb. If this fails, place a
b a n d a g e around t h e limb, above the bleeding point, and twist
with a stick until the bleeding stops. Secure t h e stick in
position.
D o n ' t use a tight bandage around the limb unless hemorrhage is active.
B U R N S A N D S C A L D S . — B u r n s and scalds should be
treated in t h e same m a n n e r as open wounds. C u t the clothing away if necessary.
D o n ' t a t t e m p t to remove pitch, varnish or wax from a
burn.
D o n ' t use oils on b u m s .
150
M O N T H L Y B U L L E T I N , I N D I A N A STATE BOARD OF H E A L T H
S H O C K . A person in shock has pale, clammy skin, weak
pulse, siphin.e: respiration.
Place patient on his back. Cover him u p , M o v e him to
t h e best place of shelter a t once. If possible apply external
heat by means of blankets or hot w a t e r bottles or hot bricks.
Be careful not to b u r n the patient.
Hot water, hot tea, or hot coffee, beef t e a or broth are the
best stimulants. Don't give him whiskey or other alcoholic
stimulants.
F R A C T U R E S . - If an arm or leg is broken, use splints
composed of folded newspapers, pieces of board, or h e a v y
pasteboard and secure1 in position with bandages or h a n d k e r chiefs. If the arm is broken, place it in. a sling. If t h e leg
is broken, tie t h e legs together if no splint is available.
Don't try to set broken bones. Straighten to relieve pain,
t h e n apply splints,
D o n ' t allow fractured limb to dangle in handling t h e
patient.
F I T S . A person suffering from a fit should be kept quiet
on t h e back. Loosen the clothing a b o u t t h e neck a n d a b domen, a n d be careful he does n o t injure himself.
A wedged handkerchief or piece of wood or cork should be
placed between the teeth to p r e v e n t injury to t h e tongue.
H E A T E X H A U S T I O N A N D S U N S T R O K E . In h e a t
exhaustion the skin will be cold a n d clammy a n d t h e condition
will be the same as shock; the same t r e a t m e n t will be required.
In case of sunstroke the body feels hot to t h e touch; is d r y .
Cloths wet in ice water, or in t h e coldest w a t e r a t h a n d ,
should bo at once applied to t h e head a n d body, a n d along
t h e spine from the head downward, a n d frequently renewed.
For the head, t h e application of cracked ice in a towel is
recommended.
F O R E I G N B O D Y I N EYE.- Foreign bodies should be
removed from t h e lids only.
D o n ' t touch t h e eye with d i r t y fingers or unclean cloths.
D o n ' t try to remove a foreign body from t h e eyeball.
Dirty toothpicks or dirty i n s t r u m e n t s are dangerous, and m a y
cause serious results.
IN GENERAL.
D o n ' t try to do too much.
D o n ' t apply bandages too tightly.
D o n ' t tell an injured person his condition is dangerous.
D o n ' t uncover a wound after it has been bandaged. If it
bleeds, apply more bandages.
D o n ' t apply a sling or splint until the wound has been
dressed.
D o n ' t soil dressings.
T h e two welfare movement, ''Safety First a n d First A i d / '
on the part of organized combinations of industrial workers
must have their influence on less well organized industries a n d
on legislation affecting- workmen's compensation a n d on t h e
organization of hospitals provided with facilities for t h e economic and efficient care of industrial workers.
H E A L T H A N D D I S E A S E P R E V E N T I O N will receive
special a t t e n t i o n at. t h e Conference of N a t i o n a l Charities and
Corrections which meets in P i t t s b u r g , Pennsylvania, J u n e 13
to 16, 1917. T h e president of t h e Association is D r . Fred
Almy, and the secretary is W m . T. Cross, C i t y Club Building,
315 P l y m o u t h Court, Chicago. T h e health a n d disease p r e vention section will be under t h e chairmanship of Prof. C. E .
Winslow, who is professor of Public H e a l t h , Yale University,
assisted by Dr. H . M . Bracken, Secretary S t a t e Board of
Health, Minneapolis, M i n n . M r . H o m e r Folks of N e w York
will give an address upon w h a t t h e social worker h a s d o n e for
public health. . O t h e r prominent speakers on t h e public
health program a r e — J u l i a C. L a t h r o p , Chief U. S. Children's
B u r e a u ; Dr. C h a s . E. T e r r y , late h e a l t h officer of Jacksonville.
Florida; G r a h a m Lusk, medical d e p a r t m e n t , Cornell University; a n d others. T h e I n d i a n a S t a t e B o a r d of H e a l t h hopes
t h a t I n d i a n a will be well represented a t this conference.
C L I M A T E A N D T U B E R C U L O S I S , is t h e title of an excellent essay b y Assistant Surgeon General J o h n W . T r a s k of
the U n i t e d States Public H e a l t h Service, a n d from t h e s a m e
we print t h e following:
Things the C o n s u m p t i v e Should Consider,
T h e c o n s u m p t i v e who c o n t e m p l a t e s going to a distance in
search of a favorable climate m u s t consider t h e a d v a n t a g e s
a n d d i s a d v a n t a g e s , how m u c h good t h e b e t t e r climate will
do, a n d w h a t he forfeits in making: t h e c h a n g e — w h e t h e r t h e
gains compensate for t h e losses.
Living in a favorable a t m o s p h e r e is highly desirable. I t
is one of t h e factors which will materially assist in regaining
health. Climate, however, m u s t n o t be secured a t t h e expense of o t h e r factors of equal i m p o r t a n c e . I n considering
climate one should have-in mind t h e expense, t h e kind of life
t h a t will be necessary in t h e new locality, t h e possible absence
of family a n d friends, a n d t h e facilities for p r o p e r medical
care a n d nursing.
Expense.
I t costs considerable to go a w a y from h o m e a n d
live as a c o n s u m p t i v e m u s t live. T h e r e is t h e question of
railroad fare, living expenses, a n d medical supervision. T h e r e
is usually a far b e t t e r chance of regaining h e a l t h at h o m e t h a n
in going a w a y with insufficient funds chasing t h e will o ? t h e
wisp, t h e M best c l i m a t e , " which m a y possibly after all b e
found in one's own d o o r y a r d d u r i n g as m a n y m o n t h s of t h e
year as in t h e prospective new locality. C o n s u m p t i v e s a r e
prone to t r y first one locality, t h e n a n o t h e r , ever in search of
t h e wished-for climate which will miraculously restore h e a l t h ,
often living in boarding houses, h a v i n g unsatisfactory food
a n d poor medical supervision, lonely a n d sick.
Food.—The c o n s u m p t i v e needs g r e a t e r a t t e n t i o n t o his food
t h a n does t h e well individual. T h e food should be good well
prepared, a n d appetizing. One should consider w h e t h e r t h i s
will be obtainable a w a y from home,
Work
M a n y expect to secure work to p a y their expenses
in t h e locality to which they go in search of h e a l t h , One
should k n o w w h e t h e r work can be o b t a i n e d a n d of w h a t kind,
w h e t h e r it will be indoor work u n d e r unfavorable conditions ;
w h e t h e r t h e work will be too g r e a t a tax on t h e s t r e n g t h of t h e
individual. I t should be understood t h a t in t h e new locality
there will probably be m a n y o t h e r h e a l t h seekers also w a n t i n g
work, and t h a t t h e competition is likely bo k e e n ; also t h a t
t h e a t m o s p h e r e of t h e office or workshop is likely t o be little
b e t t e r in one locality t h a n in a n o t h e r . One w h o m u s t work
should carefully consider w h e t h e r more suitable work under
more favorable conditions can n o t be secured in t h e h o m e
locality.
Medical supervision.
E v e r y c o n s u m p t i v e needs at times
c o m p e t e n t medical advice a n d supervision. T h i s is p a r t i c u larly so for a p a t i e n t w h o has not h a d training as to how a
consumptive should live arid what- he should avoid, such as is
usually best acquired a t a well-managed s a n a t o r i u m . One
should consider w h e t h e r b e t t e r medical supervision can b e
obtained a t home t h a n a w a y .
Absence of family and friends.
I n leaving family and friends
to go a m o n g strangers in a new locality one should realize t h e
possible effects. This is particularly t r u e for one who h a s
MONTHLY B U L L E T I N , IN
never before been away from home. If is practically impossible for a consumptive who is homesick to regain health. His
best chance for recovery is where ho can at least occasionally
see his family and friends.
Summary,
A favorable climate for a consumptive m one t h a i is not too
w a r m . A moderately cool atmosphere is invigorating, while
a too warm one is depressing. Very cold weather, on "the
other hand, makes the living" of an outdoor life more difficult
and less a t t r a c t i v e . Moderately cool atmospheric conditions
are those to be sought.
No locality has a climate that is favorable all t h e year, and
most localities in the United States h a v e favorable climates
for a considerable portion of the year if one will only t a k e adv a n t a g e of them.
In one's quest for a favorable climate one must not forfeit
suitable food, rest, and peace of mind, or gain a more favorable
a t m o s p h e r e in which to live at the price of homesickness a n d
worry.
T h e consumptive can usually obtain t h e most favorable
conditions for recovery, including an outdoor life, suitable
food, rest, medical a t t e n t i o n , and nursing, at or near his home.
A suitable a t m o s p h e r e or climate can be obtained during m a n y
hours of the day by avoiding overheated or crowded rooms
and by sleeping on a porch in all ordinary weather and in a
room with open windows when it is very cold or stormy.
Leaving home, except to go to a sanatorium, is fraught with
much danger, unless one is financially able to meet all possible d e m a n d s , a n d it should be most carefully considered
even then.
G R A N D R A P I D S , M I C H I G A N , has passed the model
fly ordinance of the I n d i a n a S t a t e Board of Health. We are
glad this ordinance has gone beyond the confines of our s t a t e
for u p to this d a t e we have not been very successful in securing its passage in cities and towns of Indiana. Cities a n d
towns with flies on them are frequent in the old Hoosier s t a t e .
and strange to say the business men seem to be more indifferent to flies t h a n other citizens. School children wage the
best warfare against flies and they must be led by the women.
Just why business men are not interested in sanitation and
public health m a t t e r s , it would be hard to tell. T h e y should
be interested for as frequently heretofore said—The most
important business before the business men t o d a y is the
business of the public health. We wonder when this will be
understood a n d p u t into practical every day operation by
business men.
HE D R A I N E D T H E CITY SEWER INTO MY CELL A R " says M r . M a h o n e y of Washington, Indiana, T h e
" h e " referred to was the contractor. T h e gentleman asks
what he can do about it and was told that the contractor
who did the botch job was responsible. H e had no right
to drain the city sewer into a cellar when the employer desired the cellar to be drained into the city sewer, There is
n o t a little of this work being done in Indiana, a n d of course.
such botch work will continue to be done so long as any old
person, anywhere, at any time, digs drains a n d sewers a n d pits
and v a u l t s as he pleases.
" C O L O N H Y G I E N E " is the title of a book by Dr. J o h n
H . Kellogg. It t r e a t s t h e subject of colon hygiene in a highly
scientific "and practical m a n n e r , laying special stress upon the
evils of purgatives, laxatives and physics. As an example of
STATE BOARD OF HEALTH
151
his forceful expressions, t h e following is excellent, " I s it not
foolish practice to blast o u t a n y t h i n g as delicate as your digestive a p p a r a t u s ? If you want, to clean u p a factory, you
would not do it with a charge of d y n a m i t e , would you?
Blasting o u t your insides weakens the bowel walls—reduces
their resisting power and makes t h e m less able to do their
w o r k . " "Colon Hygiene** a n d one full year of t h e magazine
" G o o d Health** can be had for 13.65, of t h e Good H e a l t h
Publishing Co., B a t t l e Creek, M i c h .
" I T IS A S O C I A L A N D C I V I C C R I M E " says Dr. Thomas
D . Wood of Columbia University, s i to neglect a n y t h i n g essential for health, in construction, equipment and care of
the rural or city school p l a n t . " Few people seem to really
u n d e r s t a n d t h a t a sin of omission is one as b a d as a sin of
commission, for if they did, we surely would not find so m a n y
insanitary school houses; nor, would there be so m a n y sick and
more or less defective school children.
PULMONARY
TUBERCULOSIS
P r e s e n t Classification as Approved by t h e N a t i o n a l Association for the S t u d y a n d Prevention of Tuberculosis.
INCIPIENT
Slight or no constitutional s y m p t o m s (including particularly
gastric or intestinal disturbance or rapid loss of weight), slight
or no elevation of t e m p e r a t u r e or acceleration of pulse at a n y
time during t h e twenty-four hours
Expectoration usually
small in a m o u n t or absent. Tubercle bacilli may be present
or absent. Slight infiltration limited to the apex of one
or both lungs or a small p a r t of one lobe,
N o tuberculous
complications.
MODERATELY
ADVANCE
N o marked i m p a i r m e n t of function, either local or constitutional.
M a r k e d infiltration more extensive t h a n under incipient,
with little or no evidence of cavity formation. N o serious
tuberculosis complications.
FAR
ADVANCED
M a r k e d impairment of function, local a n d constitutional.
Extensive localized infiltration or consolidation in one or
more lobes. Or disseminated areas of cavity formation. Or
serious tuberculous complications.
Rearranged Classification Devised b y Dr. W a l t e r R a t h b u n
and adopted by the American S a n t a t o r i u m Association,
LESIONS,
SYMPTOMS.
Incipient.
Slight infiltration
limited to the apex of one or
both lungsf or a small part- of
one lobe,
No tuberculous
complications.
Moderately Advanced.—-Marked
infiltration more extensive
than under incipient, with
little or no evidence of cavity
formation. No serious tuberculous complications.
(A) (Slight or None».
Slight
or no constitutional symptoms,
including particularly gastric
or intestinal distrubance. or
rapid loss of weight; slight or
no elevation of temperature or
acceleration of pulse at any
time during the twenty-four
hours. Expectoration usually
small in amount or absent.
Tubercle bacilli may be present
or absent.
Far Advanced.—Extensive localized infiltration or consolidation in one or more lobes. Or
disseminated areas of cavity
formation. Or serious tuberculous 'Complications-
(11) (Moderate), No marked
impairment of function, either
local or constitutional.
(C) (Severe). Marked impairment- of function, local and
constitutional-
152
MONTHLY
BULLETIN, INDIANA
P E R R Y S T A F F O R D O F G A R R E T was fined $20 b e eansed he violated a diphtheria q u a r a n t i n e . Dr. F . L.
Clevenger assessed the fine and sentenced him to six m o n t h s
at the penal farm b u t suspended the last p a r t of t h e sentence.
Dr. R o d e b a u g h s a y s — " Q u a r a n t i n e s must not be taken lightly
for 1 intend to punish all who violate them in the f u t u r e . "
B A T E S V I L L E T A K E S T H E P R I Z E in t h e m o n t h of
F e b r u a r y in the m a t t e r of d e a t h r a t e s . T h e r e was n o t a
single death in the town, which has a population of 2,151 inh a b i t a n t s . This is remarkable b u t the fact has been verified.
Dr. Jos. F. Ziteke, the city health officer has m a d e special
examination and inquiry and reports this is the first time in
his experience there has not been a death in Batesville in a n y
given m o n t h .
A T R A G E D Y I N D E E D occurred in the family of Earl
Ellery Barnes at Shelburn, Indiana. In two m o n t h s three
children and the m o t h e r of the Barnes family died. This
loaves the father and an infant daughter. At the time of the
m o t h e r ' s death, M r . Barnes was confined to his house with
smallpox and waited upon his wife in her last hours alone. A
greater tragedy t h a n this has not been recorded in Indiana.
MEASLES, DIPHTHERIA AND SCARLET FEVER
v i s i t e d Greensburg in epidemic form in F e b r u a r y . T h e
schools were closed, public gatherings were forbidden and
moving picture theatres were discontinued. Only one death
resulted and it was from scarlet fever.
T H E N A T I O N A L BOARD OF M E D I C A L E X A M I N E R S will hold examination in Washington, J u n e 13, 1917 of
all applicants desiring to enter the Reserve Corps of either the
Army or N a v y . Examination will last about one week.
T h e certificate of the National Board will be accepted as
qualification for admission in the G r a d u a t e School of M i n n e sota, including the M a y o F o u n d a t i o n . T h e following states
will recognize the certificate of the National B o a r d : Colorado. Delaware, Idaho, Iowa, K e n t u c k y , M a r y l a n d , N o r t h
Carolina. New Hampshire. N o r t h D a k o t a and Pennsylvania.
Application blanks and further information may be obtained
from the secretary, .1. S. R o d m a n , 2016 Walnut Street. Philadelphia, Pennsylvania,
T H R E E T H O U S A N D P R I V Y V A U L T S abolished in Ft,
Wayne without a prosecution. This is actually what has
happened in the city named. Dr. Gilpin, city health officer,
got it firmly fixed in his head t h a t he could do a good service
for Fort W a y n e by abolishing open privies, H e went to work
hard and strong and within a short time has abolished 3.000
privy vaults without a single prosecution a n d with very few
objections. This was a great a n d good service and his
example might well be followed by health officers or other
cities.
STATE BOARD
OF
HEALTH.
D R . J . G. W A L T H A L L , health officer of G a s C i t y was
requested
Rodebaugh.by letter from
health
thisofficer
office oftothe
look
city,
u p arrested
a b i r t h Stafford
which and M
h a d not been reported from his c i t y . I n reply he said: " I
a m unable to find a n y t h i n g a b o u t the birth in question by
inquiry," a n d then he added, 54 The city council is p a y i n g me
all the salary allowed b y s t a t e law a n d I a m doing a b o u t
three times t h e work I should for this a m o u n t , a n d I h a v e n ' t
the time to spare, neither h a v e I t h e inclination to go h u n t i n g
for births in t h e m a n n e r you suggest unless you see proper
recompense me for the same, I will further say this, t h a t
if our law-makers are not satisfied with t h e work as it is being
carried out, the most effectual r e m e d y t h a t I know of, would
be to pay a reasonable compensation for such services."
I n reply we told Dr. Walthall .he h a d an erroneous view of the
situation a n d should purge himself of the same. T h e p a y is
ridiculously small b u t when he accepted t h e position he
assumed a moral obligation a n d all the responsibilities t h a t
go with it. I t will not do for him to claim t h a t he did not
know w h a t the responsibilities were for t h a t would be equival e n t to confessing ignorance, and ignorance excuses no one.
T h e proper view is: a m a n accepts the position of health
officer. He knows the pay and he knows the duties. H a v i n g
accepted, he should perform the duties and not afterwards
claim t h a t the pay is not sufficient to w a r r a n t him to preform
such duties.
In regard to the pay, we will call attention, to t h e fact
t h a t health officers do not give their help when the legislature
is in session in the m a t t e r of securing b e t t e r health laws.
On the contrary, some of t h e m write letters to their legislators
antagonizing proposed laws, and also against the S t a t e Board of
Health. W e have seen more t h a n one such letter. T h e S t a t e
Board has repeatedly tried to secure b e t t e r laws i n regard to
health officers, which would give t h e m proper p a y and give
them a dignified and honorable position in t h e c o m m u n i t y .
Such efforts have been uniformly opposed b y most health
officers, although a n u m b e r recognizing their duties to the
state and being extra good citizens h a v e lent their influence
in favor of the same.
F I R E DRILLS IN T H E SCHOOLS.
T h e last Legislature passed a law t h a t in every school room
in the s t a t e when school was in session teachers should give
fire drills, Teachers failing to fulfill this c o m m a n d of the
law would not be entitled to their pay and therefore, school
authorities are commended not to p a y teachers unless there
is a s t a t e m e n t affirmed or sworn to t h a t one m o n t h l y fire drill
or more h a v e been given. M r , H . H . Friedley, S t a t e Fire
Marshal suggests to t h e State Board of H e a l t h t h a t these fire
drills would present an admirable o p p o r t u n i t y for physical
training. "Set u p " exercises could be associated with the
drills and in this way round shoulders and hollow chests be
prevented in a measure. T h e suggestion is certainly a good
one and we hope t h a t all health officers will t a k e u p with the
idea and carry it to the schools of their districts. N o officials
have a greater opportunity to help t h e people of the state
and to better conditions t h a n health officers and we are sorry
to say that all too m a n y health officers do not act upon these
conditions,
MONTHLY BULLETIN, INDIANA STATE BOArD OF HEALTH.
153
CHART SHOWING GEOGRAPHICAL DISTRIBUTION OF DEATHS FROM IMPORTANT
CAUSES FOR FEBRUARY, 1917.
NORTHERN
SANITARY
SECTION
Total population. . . , ,
1,009,364
Total deaths,
,
1,277
D e a t h r a t e p e r 1,000.
.
16.4
Pulmonary
Tuberculosis,
rate
pet
100,000...
.
95,6
O t h e r f o r m s of T u b e r c u l o s i s , r a t e p e r
100,000
15,5
T y p h o i d F e v e r r a t e p e r 100,000
20-6
D i p h t h e r i a a n d C r o u p , r a t e p e r 100,000
9,0
S c a r l e t F e v e r , r a t e p e r 100,000
11.6
M e a s l e s , r a t e p e r 100,000
28.4
W h o o p i n g C o u g h , r a t e p e r 100,000. . . .
9.0
Lobar a n d Broncho-Pneumonia, rate
per 100,000.
304.9
Diarrhoea
and Enteritis
(under
2
y e a r s ) , r a t e p e r 100,000.
3 1.0
C e r e b r o - S p i n a l F e v e r , r a t e p e t 100,000
...
Acute Anterior Poliomyelitis, rate per
100,000
.
1.2
I n f l u e n z a , r a t e p e r 100,000. . . . . . . . . . . .
57.1
P u e r p e r a l S e p t i c e m i a , r a t e p e r 100,000
7.7
C a n c e r , r a t e p e r 100,000
105.9
E x t e r n a l c a u s e s , r a t e p e r 100,000. . . . , ,
99.4
S m a l l p o x , r a t e o e r 100,000.
CENTRAL
SANITARY
*
.
I
SECTION
Total population
.1,191.458
Total deaths.
.
1*602
D e a t h r a t e p e r 1,000
17.5
Pulmonary
Tuberculosis.
rate
per
100,000
....
171-"
O t h e r f o r m s of T u b e r c u l o s i s , r a t e p e r
100,000
25.1
T y p h o i d Fever, r a t e p e r 100,000.
4.3
D i p h t h e r i a a n d C r o u p , r a t e p e r 100,000
19.6
S c a r l e t F e v e r , r a t e p e r 100,000
6.5
M e a s l e s , r a t e p e r 100,000.
39.3
W h o o p i n g C o u g h , r a t e p e r 100,000
3.2
Lobar a n d Broncho-Pneumonia, rate
per I 00,000
283.3
Diarrhoea
and
Enteritis
(under
2
y e a r s , r a t e p e r 100,000.
,
14.2
C e r e b r o - S p i n a l F e v e r , r a t e p e r 100,000
...
Acute Anterior Poliomyelitis, rate per
100,000.,,.
1.0
I n f l u e n z a , r a t e p e r 100,000
65.6
P u e r p e r a l S e p t i c e m i a , r a t e p e r 100,000
1.2,0
C a n c e r , r a t e p e r 100,000
80.9
E x t e r n a l c a u s e s , r a t e p e r 100,000. . . . . .
95.3
S m a l l p o x , r a t e p e r 100,000
,,
....
SOUTHERN
SANITARY
SECTION
Total population
Total deaths
D e a t h r a t e p e r 1,000.
Pulmonary
Tuberculosis,
rate
p e r 100,000
....
Other
forms
of T u b e r c u l o s i s ,
r a t e p e r 100,000
T y p h o i d Fever, r a t e p e r 100,000.
Diphtheria a n d Croup, rate per
100,000
S c a r l e t Fever, r a t e per 100,000...
M e a s l e s , r a t e p e r 100.000
.
Whooping
Cough,
rate
per
100,000.
Lobar a n d B r o n c h o - P n e u m o n i a
100,000
•
Diarrhoea and Enteritis (under
2) r a t e p e r 100.000
C e r e b r o - S p i n a l Fever, r a t e per
100,000
Acute
Anterior
Poliomyelitis,
r a t e p e r 100,000
I n f l u e n z a , r a t e p e r 100,000
P u e r p e r a l S e p t i c e m i a , rate
per
100,000
C a n c e r , r a t e p e r 100,000
....
E x t e r n a l c a u s e s , r a t e p e r 100,000
S m a l l p o x , r a t e per 1 0 0 , 0 0 0 - , . . .
688,793
907
17. i
157. I
24.6
9. %
11.3
1.8
30.2
18.9
306.6
3,7
1,8
130.6
7.5
104.1
8i,0
....
INDIANA
State of I n d i a n a . . :
Northern Counties '
Adams, . . . . . . . . .
Allen......... . . .
Benton..........
Blackford........
Carroll. . . . . . . . . .
Cass.. . . . . . . . . . .
DeKalb....
i
Elkhart..........
Fulton...........
Grant
;
Howard . . . . . . . . . '
Huntington......
Jasper...........
Jay.....
•
Kosciusko
,
Lagrange
Lake.......»,,.,
Laporte,
Marshall
Miami
Newton
Noble
Porter...........
Pulaski
Starke...
Steuben
St. Joseph, . . . . . .
Wabash..... . . .
Wells............
White...
....
Whitley
Central
Counties.
Bartholomew . . . .
Boone
Brown.......
Clay
;;;;
Clinton
Decatur. ..,.'.'.['.
Delaware........
Fayette
»
*
Fountain
Franklin
Hamilton........
Hancock....,."!
Hendricks...,...'.
Henry.
Johnson......]..
Madison
Marion...,,.,...
Monroe
'. .
Montgomery,
Morgan....".
Owen..... ,
Parke.
'.[][]
Putnam. . . . . . . . .
Randolph..
Rush......
Shelby......'.;.".*.*
Tippecanoe.
Tipton
Union...........
Vermillion....!..
Vigo............
Warren
Wayne...,..."..
S o u t h e r n Counties
Clark............
Crawford
,
Daviess.
Dearborn
Dubois,......
Floyd
Gibson. .
Greene.
Harrison
Jackson
,,.,
Jef f er so n . . . . . . . . .
Jennings.........
Knox............
Lawrence
Martin
Ohio
Orange..........
Perry,...........
Pike......-,....,.
Posey
Ripley
Scott
Spencer..........
Sullivan.....,,.,
Switzerland......
Vanderburgh.....
Warrick.........
Washington
Urban
Rural.............
9 Deaths occurred in Northern Insane Hospital.
*3 Deaths occurred in Central Insane Hospital.
** Deaths occurred in the Eastern Indiana Insane Hospital.
•13 Deaths occurred in the Southeastern Insane Hospital.
Deaths of Non-Residents.
Deaths in Institutions.
External Causes.
Smallpox.
Cancer,.
Puerperal Septicemia..
Influenza.
Acute Anterior Poliomyelitis
Diarrhoea and Enteritis
(under 2 years).
Cerebro-Spinal Fever,
Lobar and BronchoPneumonia.
Whooping Cough.
"Measles.
Scarlet Fever.
^
Diphtheria and Croup.
Typhoid Fever, ^ ^
Other Forme of Tuberculosis
Pulmonary Tuberculosis.
Years and Over.
Death from Important Causes.
65
10 to 14 Inclusive.
15 to 19 Inclusive.
1 to 4 Inclusive.
5 to 9 Inclusive.
Important Ages.
Under 1 Year.
February, 1916.
Rate f o r Year 1917 to
Date.
Rate for Year 1916 to
Same Date.
January, 1917.
Annual Death Rate
per 1,000 Population.
February . 1917.
Total Deaths Reported for
the Year 1910 to Same Date,
Total Deaths Reported f o r
the Year 1917
to Date.
Reported f o r
Deaths
Total
Population,
Estimated
1917.
Total Deaths Reported f o r
January, 1917.
STATE AND
COUNTIES.
Total Deaths Reported f o r
F e b r u a r y . 1917.
TABLE I. Deaths In Indiana, by Counties During the Month of February, 1917. (Stillbirths Excluded.)
Cities of t h e First
Class. Population
100,000 a n d over.
Indianapolis
Cities of the Second Class. P o p u lation 45,000 to
100,000...,
,.
Evansville. . ,
Fort W a y n e . . . . . .
Terre Haute, . . . . . .
South Bend.
Cities of t h e Third
Class, Population
20,000 to 45,000,.
Gary
East Chicago.
Hammond,
Muncie
,
Richmond........
Anderson.........
Elkhart
Michigan City
Lafayette
Kokomo
,..
Logansport,.......
New Albany.
Marion...........
C i t i e s of t h e
Fourth
Class
P o p u l a t i o n 10.001
to 2 0 , 0 0 0 . , . , . . . . .
Vincennes.
Mishawaka.......
Peru
La pone.
New Castle. . . . . . .
Elwood
Crawfordsville.
Shelbyville
..
Huntington.......
Jeffersonville.
Bedford...........
Brazil.. . . . . . , . . . ,
Bloomington
Cities of the Fifth
Class. Population
u n d e r 10,000.
Frankfort
Columbus.........
Goshen...........
Wabash. . . . . . . . . .
Connersville.......
Clinton..
Whiting, . . . . . . . . .
Washington,
Linton
........
Valparaiso........
Lebanon..
Madison.
Princeton
Hartford City.
Seymour
Kendallville..
Mt. V e r n o n . . . . . . .
Greensburg.......
Portland
Bluffton......
Noblesville
Rushville.....
Alexandria........
Aurora..,,.,..,..
Martinsville
Franklin.
Sullivan
Warsaw
Decatur, . ,
Garrett,
Winchester........
Boonville.........
Greenfield
Mitchell
Tipton
Auburn...........
Plymouth. . . . . . . . .
Lawrenceburg. .. . .
Greencastle
Tell City ^
Columbia City. . . .
Attica
Union City, . . . . . . .
Rochester.........
Jasonville
Gas City
Dunkirk
North Vernon,
Angola. . . . . . . . . . .
Bicknell . . . . . . . . .
Montpelier
..
Rockport
Crown Point... . . .
Loogootee.........
Batesville........
Rensselaer........
Huntingburg.
Jasper.
Monticello
Delphi............
Ligonier..........
Cannelton........
Covington. . . . . . . .
Veedersburg.......
Butler
Rising S u n . . . . . . . .
Veray...........
Three deaths in Central Insane Hospital.
Cerebro-.Spinal Fever
Acute
Anterior Poliomyelitis
Deaths in Institutions
Deaths of Non residents
External Causes
Smallpox
Puerperal Septecemia
Cancer
Influenza
Enteritis under 2 years)
Diarrhoea and Enter-
Diphtheria and Croup
Scarlet Fever
Typhoid Fever
Other Forms of TuTuberculosis
Pulmonary Tubercu-
15 to 19 inclusive
65 Years and Over
10 to 14 inclusive
1 to 4inclusive5 to 9 inclusive
Measles
Whooping Cough
lobar and Broncho-
Deaths from Important Causes
Important Ages
Under 1 Year
Rate
for Year 1917 to
Date
Mate for Year 1916 to
same Date
February 1916
J a n u a r y . 1917
February, 1917
TotalDeathsReported for
the Year1916to same date
TotalDeathsReported for
the Year 1917 to date
Total Deaths Reported for
February, 1916
Total
Deaths Reported
January, 1917
Total Deaths reported for
F e b r u a r y . 1917
Population,
Estimated,
1917
Cities
Annual Death Rale
per 1,000 Population
Important Ages
Per Cent.
Over
Number
Per Cent,
Number
Per Cent.
Number
Per Cent,
Number
65 and
10 to 14 15 to 19
Number
5 to 9
1 to 4
Per Cent,
Under 1
Per Cent.
Rate for Year 1916
to same date
Rate for Year 1917
to date
January
1917
"February, 1917
February,1917
Annual Death Rate
per 1,000 Population
Total Deaths reported
for the Year 1916 to
same date
Total Deaths reported
for the year 1917 to
date.
Total Deaths Reported
.or F e b r u a r y , 1917
Total
Reported
for January, 1917
(Stillbirths Excluded,)
Number
Total DeathsReportedfor February,
POPULATION
PopulaBY GEOtion
GRAPHICAL !
SECTIONS AND, Estimated
1917
AS URBAN !
AND RURAL
Mortality of Indiana for F e b r u a r y , 1917
State. ............
Northern Counties
Central Counties .
Southern Counties
All C i t i e s
Over 100.000 . . .
45,000 to 100,000.
20,000 to 45,000, .
10.000 to 20.000. .
Under 10.000
Country
Deaths and Annual Death Rates Per 100,000 Population from Important Causes.
Slate............
Northern Counties.
Central Counties,,.
Southern Counties.
All Cities. . . . . . . . .
Over 100.000.
45,000 to 100.000,. ,
20,000 to 45,000.,, ,
10,000 to 20,000.. . .
Under 10.000
Country. ,
U. S. D e p a r t m e n t of A g r i c u l t u r e , W e a t h e r B u r e a u .
C o n d e n s e d S u m m a r y for M o n t h of F e b r u a r y , 1917.
J, H. ARMINGTON, SECTION DIRECTOR, IN CLIMATOLOGICAL DIVISION
TEMPERATURE—IN DEGREES FAHRENHEIT
Section
Average
Extremes
Departure
from the
Normal
Station
Highest
Station
Date
Lowest
Date
Howe
Vevay
PRECIPITATION—IN INCHES AND HUNDREDTHS
Section
Average
Extremes
Departure
from the
Normal
Station
Jeffersonville
t
Greatest
Monthly
Amount
Station
Auburn.
Least
Monthly
Amount
Death Rate
Smallpox
Number
Death Rate
External
Causes
Number
Death Rate
Cancer
Number
Number
'Death Rate
Number
Death Rate
Puerperal
Influ'enzaSepticemia
Death Rate
Number
Death Rate
Number
Death Rate
Number
Death Rate
Number
Death Rate
Number
Death Rate
Number
Death Rate
Number
Death Rate
Acute
Diarrhea
Lobar
Cere- AnWhoopand
and
Diphbroterior
Broncho Enteritis
theria Scarlet Measles ing
Fever
Cough
(Under spinal PolioPneuand
Fever
mye2 Years)
monia
Croup
litis
Number
Number
Death Rate
Death Rate
Other
TyForms phoid
Tuber- Fever
culosis
Number
Number
Death Rate
PulmonPOPULATION BY
ary
GEOGRAPHICAL TuberSECTIONS AND culosis
AS URBAN AND
RURAL