A WELL MANURED CITY HAS PLENTY OF FLIES,
MONTHLY BULLETIN Indiana State Board of health Entered as second class \matter at the Indianapolis Posloffice.l
VOLUME XVII. INDIANAPOLIS, DECEMBER, 1914. NUMBER 12 25 Cents a year
T. henrY davis, M. D„ PRESIDENT...... Richmond. ABSTRACT OF MORTALITY STATISTICS JAMeS S. BOYERS. M. d., VICE-president.,,, . Decatur. J. L. FREELAND, M, D Indianapolis. FOR DECEMBER, 1914. H. H.SUTTON, M. D ...... ,,.,•...... Aurora. Total deaths reported. 2.S42: rate, 11.0. In the preced J, N. HURTY, M. d. phaR, P.. secretary Indianapolis ing month, 2,682 deaths: rate. 11.4. In the same month last
WM. F. KING, M.D .ASST. SECRETARY ASD EPIDEMIOLOGIST. year, 2,059 deaths: rate, 11.3. Deaths by important ages J. L. ANDERSON...... ,.Chief clerk. CHAS. A. CARTER, M.D...... STATISTICIAN were: Under 1 year of age, 385, or 13.3 per cent, of total: WM. SHIMER, A B,, M. D SUPT. BACTERIOLOGICAL LABORATORY. 1 to 4, 123; 5 to 0, 53: 10 to 14, 30: 15 to 10. 68: 05 and ADA E. SCHWEITZER, M. D...... ASSISTANT BACTERIOLOGIST. W. V. BOYLE, M. D ASST. PATHOLOGIST. over. 082. or 34:5 per cent of total. H. E. BARNARD B. S...... STATE FOOD AND DRUG COMMISSIONS AND CHEMIST H. E. BISHOP. B. S...... ASSISTANT CHEMIST. JOHN C diggS...... ENGINEER AND WATER CHEMIST. SANITARY SECTIONS: The Northern Sanitary Sec WILL H. McABEE...... DRUG CHEMIST. tion, population 972.120. reports 007 deaths: rate, 12.0. In R. l. SACKETT, C. E sanitary ENGINEER. the preceding month,. s97 deaths: rate, 11.2. In the same The MONTHLY BULLETIN will be sent to all health officers and dep month hist year. 880 deaths: rate, 10.8. uties in the State. Health officers and deputies should carefully read and THE CENTRAL. SANITARY SECTION, population 1.1.12,277. re file each copy for future reference. This is very Important, for we expect to print instructions, rules and general Information, which it will be ports. 1,250 deaths: rate. 12.S. In the preceding month, necessary for officers to preserve. 1,133 deaths; rate, 11.9. Tn the same month last year, 1,107 deaths: rate. 12.0,
CONTENTS. THE SOUTHERN SANITARY SECTION, population 072.551, re Page ports 589 deaths: rate. 10.3. In the preceding month, 002 Births for December, 1914 138 deaths: rate, 10.S. In the same month last year, 003 Abstract of Mortality Statistics for December 133 deaths: rate, 10.0. Summary of Morbidity and Mortality for December. 133 Delayed Birth and Death Certificates 134 Purification by Fire...... 134 REVIEW OF SECTIONS: The Central Sanitary Sec Report of the Department of Food and Drugs for December...... 135 tion presents the highest death rate, It is O.!) higher than Inspectors' Reports for December...., ...185 Report of Bacteriological Laboratory for December...... 186 the rate for the whole State. The Northern Sanitary Sec Patients Who Have Finished Pasteur Treatment. 136 tion presents the highest death rate for whooping cough, Spitting on Sandpaper 136 Work of the food, drug and Water Laboratories for 1914...... 137 diarrhea and enteritis, influenza arid smallpox, The Central Bacteriological and Pasteur Laboratories 138 Section presents the highest death rate for tuberculosis, The Public Pays for Quarantine. 138 scarlet fever, measles, cerebro-spinal fever, cancer and ex Diphtheria Diagnosis by Means of Loeffler's Blood Serum, Contain- containing Potassium Tellurate 13terna9 l causes. The Southern Section presents the highest Bakers Products.... 139 death rate for typhoid fever, diphtheria, pneumonia and Notice to Bakers...... — ...139 Seventy-Nine Per Cent...... 140 puerperal septicemia, Tuberculosis Hospitals ...... 140 God Not the Destroyer - -.. —, 140 RURAL: Population 1,550,042. reports 1,300 deaths: rate. Practical Sanitation...... 140 10.7. In the preceding month. 1.312 deaths: rate, 10.2. In The Idiot in the Schools...... • 140 Chart Showing Geographical Distribution of Deaths...... 141 the same month last year. 1.2.12 deaths: rate, 0.5. Table 1. Deaths in Indiana by Counties... 142 Table 2, Deaths in Indiana by Cities.-...... 113 Urban: Population. 1,240,31.1, reports. 1.443 deaths; Mortality in Indiana for December 144 rate. 13.0. In the preceding month. 1,320 deaths; rate, U. S, Weather Report for December.. 144 12.8. In the same mouth last year, 1.407 deaths; rate, 13.5. The cities named present the following death rates: Indi BIRTHS FOR DECEMBER, 1914* anapolis 15.2, Evansville 10.0. Ft. Wayne 14.«>. Torre Haute 10.O. South Bendt 32.1. Gary 7.0, Muncie 14.0, Richmond Total births, 4.041 (.stillbirths excluded) : State rate. 10.5, i:;.n. Hammond 15.5. Anderson 10.0. East Chicago 18.1, Males, 2.395: females. 2,240, Lafayette 15.7, New Albany js.2, Elkhart 13.7. Michigan White males. 2,35d: white females. £2.217. City 15-6. _____ Colored births. 01 : males 30. females 20. Stillbirths. 38,1: white 1*1. colored 4. Northern Sanitary Section, population 072.120. reports SUMMARY OF MORBIDITY AND MORTALITY l.siHi births: rate, 21.8, FOR DECEMBER, 1914. Central Sanitary Section, population 1.152.277. reports Scarlet fever, as in the preceding month, was reported as 1,741 births: rate. 17.7. the most prevalent disease, m per cent, of the observers Southern Sanitary Section population 072.551. reports reporting the disease present. The order of prevalence is as intM births: rate. 19-1. follows: Scarlet fever, diphtheria. tonsillitis, influenza, Highest rate, Lake County. 34.8. acute bronchitis, acute rheumatism, typhoid fever, chickenpox. lobar pneumonia, smallpox, pulmonary tuberculosis. Lowest rate. Jefferson County, 10.3. bronchial pneumonia, measles, diarrhea and enteritis, ery- Total births to date for 1914. 03.(500. 184 MONTHLY BULLETIN, Indiana STATE BOARD OF HEALTH.
sipelas, malaria fever, whooping cough other forms of 3: injuries by other vehicles 3. other crushing 3: injuries tuberculosis, puerperal fever. Intermittent and remittent by animals 4; excessive cold 2: other external violence s. fever, dysentery, cholera morbus, poliomyelitis, rabies in Homicide Total 15: males 12, females 3. Homicide by lire- human, cerebrospinal fever, rabies in animal*. arms 12. homicide by other means 3.
SMALLPOX: 3SG cases in 37 counties with two deaths. The following counties reported smallpox present: Adams DELAYED BIRTH AND DEATH CERTIFICATES. 4, Blackford 18 eases and 1 death. Boone 9 rases. Chirk 13, Each month the statistical department receives certificates Clinton 26, Dekalb 1, Delaware 53, Dubois S Elkhart 2, ? for births and deaths that have occurred during preceding Fayette 10, Gibson 3. Grant «J. Henry L Huntington 4, Jack months, which are not sent to the department in time to be son 3, Jay 21. Jefferson 32, Jennings 1, Johnson 5. Knox '33, tabulated with the report for the current month. With the Lagrange 20, Lake 32, Madison 14. Martin S Montgomery 5, report for December the following counties named below Orange 1, Porter 1 Posey 45. Randolph 2. Scott 4, Shelby 2. Starke 1, Sullivan 5. Tippecanoe 3, Vanderburgh 9. Vigo 1. were delinquent in this matter: Washington o\ DELAYED BIRTH CERTIFICATES. TUBERCULOSIS: SOU deaths, of which 253 were of the Adams 2 (Decatur 1L Allen 5 (Ft Wayne IE Bartholo pulmonary form and 53 other forms: 170 cases of pulmo mew S, Benton 1, Boone 11 (Lebanon 2), Brown 11 (Nash nary form reported. The male tuberculosis deaths numbered ville 2), Carroll 3, Cass 1 LogansportE Clark 1 (Jeffer 148. females 158. Of the males 27 were married in the age sonville). Clay 2 (Staunton 1), Crawford 2. Dearborn 4 period IS to 40 and left 54 orphans under 12 years of age (Aurora 1). Decatur 1, Dekalb 1, Delaware 0 (Yorktown 4). Of the females 35 were married in the same age period as Dubois 1 (Jasper). Elkhart 1 (City), Floyd 1 (New Al above and left 70 orphans under 12 years of age. Total bany), Gibson o. Grant 3 (Marion 1), Green 3, Harrison 4. orphans under 12 years of age made in one month by this (Palmyra Ik Hendricks 1, Henry 2 (New Castle), How preventable disease, 124. Number of homes invaded, 29.1. ard 2. Huntington 1 (College Park), Jackson 1 (Browns- town), Jasper 9 (Rensselaer 1). Jay 2 (Portland). Jeffer PNEUMONIA: 275 deaths: rate. 113.* per 100,000. In son S (Madison 41. Jennings 2, Knox 1, Lake 14 (Hammond the preceding month 10*5 deaths, rate 71.S. In the same S, E. Chicago 3, Gary 1. Whiting J. Dyer 1), Laporte 12 month last year 23$ deaths, rate 101.1. Of the pneumonia (City 3. Michigan City 7). Lawrence 8 (Oolitic 1), Marion deaths 47 were under 5 years of age. 2 (Indianapolis 1). Marshall 2 (Bremen), Miami 4 (Peru 1). Montgomery 3 (Crawfordsville 2. Ladoga 1), Morgan 1. TYPHOID FEVER: 152 cases in 13 counties with 41 Newton S (Kentland 1), Owen 1. Parke I, Perry 1, Pike L deaths. In preceding month 339 eases in 60 counties with Porter 1. Posey 2 «Poseyville 3). Ripley 2. Rush 1. Shelby 1, 7>S deaths, In same month last year LSI cases in 41 coun Spencer 3, Starke 1, Steuben 4 (Fremont IE St. Joseph 23 ties with deaths. (South Bend 22, Mishawaka 1), Sullivan 2, Tippecanoe L Vanderburgh 15 (Evansville 12, Howell 2), Vermillion 3 DIPHTHERIA: 486 eases in 57 counties with 53 deaths. (Clinton 2), Vigo 3 (Terre Haute), Warrick 1 (Tennyson), In the preceding month 521 eases in 52 counties with 50 Washington 1, Wells 5 (Bluffton 4). White 0. Whitley 2 deaths. In the same month last year 487 cases in 47 coun (Columbia City 1). Total 227. ties with 50 deaths. DELAYED DEATH CERTIFICATES. SCARLET FEVER: 520 cases in 02 counties with 20 Allen 2 Brown 2, Carroll 1, Cass 1, Clark E Crawford 1. deaths. In the preceding month 501 eases in 63 counties Dearborn 1 (Greendale), Decatur 1, Delaware 1, Dubois 1. with 7 deaths. In the same month last year 484 eases in 52 Fayette 1, Grant 1, Greene 1, Hendricks 1, Henry 2 (Shir counties with 13 deaths. ley). Knox 1 (Vincennes), Lake 1, Laporte L Madiso\n 1, MEASLES: 221 eases in 28 counties with 2 deaths- In Marion 3 (Indianapolis 2)*, Marshall 1, (Bourbon). Miami the preceding month 2S3 eases in IS counties with 0 deaths. 3 (Bunker Hill 1). Montgomery 1. Orange 1. Pike 1, Posey 1, Putnam 1, Ripley 1, Shelby 3. Spencer 1, Steuben 1 (An POLIOMYELITIS; 1 case in 1 county with no deaths. gola). Sullivan 1, Vermillion 1 (Clinton Wabash 1 (City), The case occurred in Allen county. Warrick 1, Washington 1 (Salem). Wayne 1 (Richmond). RABIES: 31 persons bitten by rabid animals and Wells i. White 4. Total 51. treated by the State Board of Health during the month of December. There were no deaths. PURIFICATION BY FIRE. Near Collins,, Whitley County, there was a miserable, dilapidated house in which PELLAGRA: 1 ease and 1 death in Wayne county, male lived John Glenn with his family, Diphtheria broke out and (H years. the two children and the mother died within twenty-four EXTERNAL CAUSES: Total deaths, 190; males 14$. hours. Dr. E. V. Nolt. health commissioner of Whitley females 42. Suicide Total, 29: males 21, females S. Means County, visited the house and decided that it could not be of suicide: poisons 10; asphyxia!; hanging or strangula disinfected and made safe. He therefore condemned the tion 2; drowning 1 ; firearms 8; cutting or piercing instru house and had the Board of County Commissioners appoint ments i. Accidental or undefined Total, 140: males 115: appraisers to fix a reasonable compensation to the owner. females 31. Food poisoning 1; other acute poisonings 3; The house was appraised at $25.00. which the County Com conflagration 3: burns (conflagration excepted) 21: ab missioners agreed to pay, after which Dr. Nolt. as health sorption of deleterious gases (conflagration excepted) 7: commissioner, burned the house with its contents, thus accidental drowning 2; traumatism by firearms 10; trau effectually putting an end to any possibility of further in matism by cutting or piercing instruments 1: traumatism fection. Tins was the only practical way to handle this by fall 3d; traumatism in mines 11: traumatism by ma dangerous situation and both Dr. Nolt and the County chines 1: railroad accidents and injuries 23; street-car Commissioners are to be congratulated on their promptness accidents and Injuries 4: automobile accidents and injuries and efficiency in protecting the public health. MONTHLY BULLETIN, INDIANA STATe BOARD OF healtH. 136
REPORT OF THE DEPARTMENT OF FOOD AND Two of the 13 ice cream parlors visited were rated good DRUGS, INDIANA STATE BOARD OF HEALTH, and 11 fair. FOR DECEMBER, 1914. Of the 12 poultry houses inspected *1 were rated good, S
H. E. Barnard. STAFF FOOD And drug COMMISSIONER, fair and one poor. It is worthy of note that of almost 1,000 sanitary in During the month of december 4G samples of food spections hut 17 places were found to be in poor condition WIMV ANALYZED f whirli II were legal 5 illegal. and but 2 could be rated as bad. Three of the IV.) milk samples were Illegal either because 1 Hiring the month four prosecutions were brought for of the presence of visible dirt or added water. A number violation of the Pure Food and Sanitary Food Law. Two of samples of English walnuts purchased from street' ped eases were brought for selling orange cider and pop con dlers during the holiday season were classed as adulterated taining benzoate of soda. One ease involved the sale of because of the fact that they contained a large percentage dirty milk. One grocer was lined for maintaining an un of wormy and decayed nuts, sanitary grocery store. The lines and costs levied during of the 21 samples of drugs analyzed but one. a linseed the month amounted to $82,25, oil, was adulterated. Twenty condemnation notices were issued during the month because of unsanitary conditions, and 18 alleging as RESuLTS OF ANALYSES OF FOODS AND DRUGS DURING THE MONTH OF well, improper construction. DECEMBER, 1914.
Number Number INSPECTORS' REPORT FOR THE MONTH OF DECEMBER, M4, CLASSIFICATION. Legal. Illegal. Total.
Mo. No, No. No. No. No. INSPECTIONS, FOODS. Inspected Excellent, Good. Fair. Poor. Bad, beverages— orangeade Fresh pork . Dairies Milk Products— Grocery stores Butter. . Meat markets,...... Milk Drag stores. .••---,-• Bakeries and confectioneries English walnuts.. Hotels and restaurants Creameries...... Total , • • Slaughter houses drugs. Wholesale groceries Flour mills. ExtractsAnise flavor Fish markets Banana flavor . Ice cream parlors...... Lemon flavor Ice cream factories ..... Vanilla flavor Poultry houses. Lime sulphur solutions Bottling works Oils Ire company -. Linseed oil Fruit store Lubricating oil Wholesale fruit store ..... Brewing company...... Miscellaneous Patent medicines Commission house Wholesale confectionery.. . . Total Cream station.. Milk condensory Total. . INSPECTORS REPORTS FOR THE MONTH OF DECEMBER, 1914. During the month of December the inspectors reported NOTICES OF CONDEMNATION DURING THE MONTH OF 085 sanitary inspections. Of this number 22 places were in DECEMBER, 1914. excellent condition. 020 good, :124 fair. IT poor and 2 bad. Reasons for Condemnation. Of the ;>or» grocery stores visited o were in excellent con CLASSIFICATION Total. dition. -OS good, 00 fair, one poor and one bad. Unsanitary Improper Conditions. Construction. Four of the 112 meat markets inspected were rated excel lent. To good. 34 fair and one poor. Bakeries.,.,. Candy factory One hundred and eighty-four drug stores were inspected. Confectionery...... Creamery...... Of this number 2 were rated excellent. 3'KS good, 45 fair Dairy...... - and one poor. Groceries. Meat market? a Meat markets and groceries Nine of the 1G7 bakeries and confectioneries visited were Milk depot. — classed as excellent. 112 good. ,'IS fair and S poor. Poultry house. Restaurants...— Of the one hundred and thirty-nine hotels and restaurants Total..... inspected 2 were rated excellent, 61 good. 75 fair and one poor.
LIST OF PROSECUTIONS DURING THE MONTH OF DECEMBER, 1914.
Date of Why Prosecuted. Final Disposition. COUN. • Names and Addresses of Defendants. Trial.
Bartholomew R. H. Smith, Columbus Ind.. Selling watered milk Bartholomew R. W. Weekly. Columbus, Ind. - Keeping an unsanitary grocery...... Selling: orange cider containing benzoate Fulton, Progress Bottling Works, Rochester, lad Gibson .. . . George W. Gardner, Owensville, Ind selling pop containing benzoate of soda. 186 MONTHLY BULLETIN, indiana STATE BOArB OF health.
REPORT OF BACTERIOLOGICAL LABORATORY Sarcoma of axillary lymph node.. INDIANA STATE BOARD OF HEALTH, Sarcoma, location not given...... FOR DECEMBER, If 1914. Miscellaneous tissues • WILLIAM SHIMER, M. D., superintendent. Urine for chemical analysis...... Sputum for tubercle bacilli— Positive ...... Pus lor gonococci— Negative ...... Females: Positive ...... ••••••••••••••••••*•** urine for tubercle bacilli— Negative ...... *.*....«.••••••••• Negative Males: Positive ...... -..••••••••••••• Cerebrospinal fluid for tubercle bacilli Negative ...... Negative ...... •••....•••••••••. • Sex not given: Positive ...... Feces for tubercle bacilli— Negative ...... Negative ...... Spinal fluid for miningococcus Pus for tubercle bacilli— Positive Negative ...... Negative ... v ......
Widal tests for typhoid fever- Milk for tubercle bacilli— Positive Negative Negative ...... Water for general analysis. . Paratyphoid tests for typhoid fever- Negative Total number specimens examined......
Throat cultures for diphtheria bacilli- Guinea pigs inoculated for tubercle bacilli — Positive Negative ...... •...... •.*...... Suspicious ...... Doses of antityphoid vaccine sent out. Negative Unsatisfactory ...... OUTFITS SENT OUT DURING december, 1914, Tuberculosis epidemic diphtherias— Diphtheria ...... Positive Diphtheria epidemics ...... Negative Widals . gonococci Brains for rabies- Malaria ...... Dogs: Positive ...... Total number outfits sent out,...... Negative ...... cats: Negative ...... PATIENTS WHO HAVE FINISHED "PASTEUR" TREATMENT THIS MONTH. Cows: DECEMBER, 1914. Negative ...... Hogs: Began | Finished NAME. Town. County. Age. Sex. Negative Treatment, Treatment.
Loren Collier...... Indianapolis, Marion. Feces for typhoid bacilli— Hallie Abbott...... Indianapolis. Marion. Positive ...» Iven Snyder...... Indianapolis. Marion. C. Kostenbader Indianapolis. Marion. Negative ...... ,,.,,..•..•.,. Miss A. Kostenbader Indianapolis. Marion. Miss B. Kostenbader Indianapolis. Marion. Dr.E. Modlin...... Indianapolis. Marion. Mrs. G. Allbright... Indianapolis. Marion. Feces miscellaneous ...... Mrs. J. Patterson.... Indianapolis. Marion. Mary J. Palachek. . . New Castle.- Henry.. Feces for hook worm- Negative ...... SPITTING ON SANdpaper to moisten it and then rub Blood for counts* ...,...... *..., bing it with their hands to distribute it over the sheet is Blood for malaria Plasmodia ...... clone in a Columbus, Indiana, factory. A workman in one Pus miscellaneous ,..,•.•...»....„..... of the departments gives the information. He further says; "Until recently the employes were allowed three minutes Pathological tissues— at quitting time to wash. Now they have been notified not Carcinoma of breast to wash." The informant continuing says: "I think this Carcinoma of rectum...... is very unsanitary and It is mean of the employers to re Carcinoma of uterus .... quire their spit for moistening sandpaper when water is Carcinoma of skin plentiful.*' We are agreed with our informant and we think Carcinoma, location not given...... we can bring some pressure to bear against the Columbus Sarcoma of finger ...... furniture factory to prevent this nasty business. MONTHLY BULLETIN, indiana STATe BOARD OF health 137
WORK OF THE FOOD, DRUG AND WATER LABORA RESULTS OF ANALYSEs OF DRUG SAMPLES FOR THE YEAR TORIES OF THE STATE BOARD OF HEALTH OCTOBeR 1 1913, TO SEPTEMBER 30 1914. FOR 1914. ARTICLE. Legal. Illegal. Total 'FOOD LABORATORY. During the year ending September :J0. 1914. 1,810 samples Aspirin tablets...... Liquid phenol of food collected by inspectors or sent hi l.y health officers Oil linseed, Oil olive..,.,.,,...,. or interested consumers have been examined at the labora Oil turpentine...... tory. Of this number 1,^71 samples were legal and 4.T.* Paregoric Patent medicines... illegal, either because they contained ingredients not allow Peroxide of hydrogen Spirits camphor. ." able under the law, such as chemical preservatives, foreign Tincture iodine...... Toilet preparations*. . . • -color so r makeweights, or were misbranded or otherwise Miscellaneous drugs mislabeled. The percentage of adulteration of foodstuffs as Total . shown by the year's work is 24.25. Upon this basis of comparison the results reported for the year are no im WATER LABORATOHY. provement over preceding years. This showing should not Of the 1,645 samples of water analyzed during the year, be taken as evidence that adulterated foods are common in 702 were collected from so-called shallow wells: 050 from our markets. The inspector sends in only such samples as deep wells; 96 from streams; 84 from springs; 48 from he believes to be illegal, instead of. as he once did, sending cisterns; 27 from lakes and ponds and 112 from miscellan in miscellaneous samples, confident that many of them eous sources not otherwise recorded, One thousand three would prove to be adulterated. As a matter of fact, the hundred and forty-two of these samples were from private illegal samples are chiefly found in such foods as milk, wells. Three hundred and three samples were from public where the fault is usually that of (he presence of dirt: of supplies. Of the total number examined 1,021 waters were vinegars, most of which are submitted by farmers who wish reported as good, 414 as bad and 210 as doubtful. In per to know whether their product is sufficiently matured for centage terms Ci of all of the waters examined were of .. , beverages od quality; 25.1% bad and 12.9% as doubtful. These sale; of beers sold as temperance beverages. but in tact. '- , .. ' . * ,, * *, ,, ,. ., . figures show a slight improvement over those of other years containing sufficient alcohol to deny them tha xt distinction t . ..,.,. , * ...... , containing sufficient alcohol v. v in that the percentage of good waters is but little higher, and of ciders sodas and pops, carelessly labeled as to the . , " and of ciders sodas and pops carelessly labeled as to the presence of , private water supplies examined 509 were taken presence of artificial color. from deep wells; 48 from cisterns; (i0 from springs and :i*2 from miscellaneous sources. Seven RESULTS OF ANALYSES OF FOOD SAMPLES FOR THE YEAR hundred and sixty-seven of All the samples examined were OCTOBER i. 1913. TO SEPTEMBER 30, iiU4. potable, 381 were condemned as bad and 194 were classed Per Cent. as doubtful. Of the 509 deep well waters analyzed 426 ARTICLE . Legal, Illegal. Total. Adulteration. are furnishing water of good quality, 36 were reported as bad and 47 as doubtful. Baking powder . Of the 684 shallow wells, however, but 240 furnished Beer Temperance.. potable water, SOS or almost 50% were unqualifiedly bad Bread. - Beverages— and 130 were doubtful. Cider.. . • • - • • Of the 303 public supplies examined 14T were taken from Grape juice. . • • deep wells, 18 from shallow wells, 96 from streams, 27 Lime juice Sodas and pops.. from ponds and lakes and 15 from springs, Of the 14T Whiskey. Wine deep wells examined 142 were good, 3 were bad and 2 were Canned core doubtful, Extracts-— Lemon...... -••• SANITARY INSPECTIONS. Vanilla ....---• During the year ending September 80, 1914, 417 cities and Flour • Honey.. v- • towns with a total population of 1,285,212 were visited. Jam and jelly Lard ••• Many places were inspected several times and a large num Meat... --••• - ber of inspections made in the course of special work are Meat Products— Bologna not recorded in the list. The data referred to by no means Hamburger. Sausage represents the service given. The cities and towns visited Weinerwurst... are trading centers and supply not only their own popula Milk...... Breast milk, tion hut the people throughout the adjoining country. It Milk Products- Butter ...... - Is safe to say that the food supply of ninety per cent, of Cheese the residents of the State is under (he supervision of the Cream Evaporated milk, inspectors, Ice cream...... Miscellaneous foods Twelve thousand one hundred and six place* were visited Oleomargarine .. . . during the year. One hundred and forty-seven reports gave Pickles..- - Sugar— a grade of excellent to the places visited. Six thousand, Cane... Maple. two hundred and seventeen or fifty per cent of all the places Syrup— Maple - • • • visited were in good condition: 5,067 were rated as fair. 547 Sorghum — poor and 128 as bad. Tomato Products— Catsup • • - - • A study of conditions In the various industries is of much Pulp.... • • Vinegar..,. interest of the 444 dairies inspected during the year but one received a grade of excellent and but 43 of the en Total tire number or less than 10 per cent were listed as good; 138 MONTHLY BULLETIN, INDIANA STATE BOard OF HEALTH.
l'JIi were fair: UKJ poor and ION were bad. Although I he have necessitated a good working force and diligent labor dairy work was but •tJJVc of the work done during the to accomplish the work demanded. year, dairies contributed KV/C of the total number of places Although we examined ten times tho number and kind of reported as bud. In other words, while but one per cent specimens done in l!M«i. our first laboratory year, we have of all the inspections reported were lifted as bad, 24*^ of no more working space. Our crowded quarters make out all the dairies were so classed. This condition is wholly work extremely difficult. unsatisfactory and it is to be doubted whether it can be The following is a brief summary of the work done by controlled by state inspection. The improvement so neces the laboratory this year: sary to a satisfactory milk supply cannot be forced by leg Total specimens examined and reports rendered. ULMMHI. islation. It mast come from within the industry and it Sputum for tubercle bacilli 4,04< must come as a result not of legislation but an appreciation BLOOD for Widal Typhoid UKtt of the responsibility the milk producer assumes when he Blood for Widal paratyphoid • • 1*14** undertakes to provide a food supply of so large a percentage Blood for malaria bin of the population. Throat cultures for diphtheria . - • • ~>.;M4 Of the 4»611 gixM-rry stores inspected 80 were rated ex Epidemic diphtheria .>.7oO cellent 2A(>H as good, l.y(S7 as fair, 89 poor and 7 bad. Pus for gonococci b91 Of the 1.700 meat markets visited but 14 were in excel Pathological tissues ;t<»"> lent condition, IKS!) good, 74:1 were fair, 47 were poor and 3 Brains for rabies. .Ill bud. Other specimens 1, o>*_ As usual drug stores are for the most part satisfactory. Of the 1.050 visited 15 were in excellent condition, 830 Total -"-MX*) were good, 208 fair and but 3 poor. Twenty-two of the 1,591 bakeries and confectioneries in- Doses of typhoid vaccine sent out...... 10.5W s]>eeted were rated as excellent. 800 as good. 048 fair. 52 Pasteur treatments i2.'!<> poor and 3 bad. Mailing outfits for specimens, L'4,2Sf» Seven of the 1.520 hotels and restaurants were in excel There is no disease that can so well be controlled by lab lent, condition, 00!) were good. 819 fair. 92 poor and 2 bad, oratory examinations as diphtheria, it is very evident that SUMMARY OP INSPECTIONS. full advantage is not being taken of the facilities ottered by the State laboratory. inning the year tub", there were reported 4UU deaths and 1 No. No. No. No. No. No. INSPECTIONS. Inspected Excellent. Good, Fair. Poor. Bad, 4.0T7 discs from diphtheria. Of the 5.(»75 specimens sent in for first diagnosis only 1.74b were found to be positive. Dairies -, Grocery stores Therefore less than one-fourth of all eases of diphtheria Meat markets... are diagnoses by the State laboratory. Drug stores ..... Bakeries and confectioneries Of Stttf positive diagnostic cultures, only 54',; were re Hotels and restaurants...... Creameries leased upon second cultures. From the above estimations Milk depots...... it is safe to say that in only about 10',; of cases is there Fish markets Slaughter houses a legal laboratory control of release from quarantine. Poultry houses—...... Bottling works — In this one disease alone full time health officers are in Ice cream parlors...... Ice cream factories.... — dispensable for proper control of epidemics. Canning factories...... Epidemics of rabies among domestic animals continue. Produce companies...... Flour mills, Brain positives for rabies were received from 51 counties. Fruit and vegetable stores — Wholesale groceries...... Patients from o(> counties were given the Pasteur treat Wholesale fruit stores...... ment. Ice and cold storage plants.. . Ice plants Thus far 55- patients have been treated by the State Saloons. Breweries.,-.. Board of Health. Of these two have died, giving the Stale Oyster house — Pasteur Institute Ml'/r of failures, the usual percentage Tea and coffee companies.._... Wholesale produce companies. of failure being about .5">. Lunch carts Butter and (cheese factory Stock yards— . — Potato chip factory...... THE PUBLIC PAYS for QUARANTINE: The city au Pharmaceutical manufactories. thorities of Goshen, according to advice ol' their attorney, Total refused to pay for supplies for quarantined families. The groceryman who furnished the supplies brought suit ami secured payment. The judgment was rendered by Judge BACTERIOLOGICAL AND PASTEUR LABORATORIES. James S. .Drake, of the Circuit Court of Elkhart (Vanity. The growth of tin* work of the laboratory for 1914 has The ease read: Albert <\ Folks and Frank Folks vs. the been healthy along all lines, however there has been no City at' Goshen and Township of Elkhart. on account. extraordinary Increase in any one line of work. Judge Drake held thai the township was not liable but Unit Altogether- twenty-two thousand specimens were exam the city must pay the bill and so the rests were assessed ined. against the city of Goshen, other courts have decided that There has been a steady demand for typhoid vaccine. a family under quarantine is virtually in prison tor the More than ten thousand doses were sent out. benefit of the public, not. for its own benefit. There is no Two hundred and thirty persons have been treated to question about supporting a prisoner when he is committed, prevent rabies. why, therefore, should there be any question about sup The large number of specimens examined, the typhoid porting an individual or family when quarantined There vaccine prepared and sent out, the Of teen thousand tubes of have probably been fen or twelve decisions of this kind and Loeffler's blood serum made and the twenty-four thousand yet city attorneys are continually advising against the pay two hundred and eighty-six outfits made up and suit out ment of bills incurred on account of quarantine. MONTHLY BULLETIN, INDIANA STATe BOArD OF health. 180
DIPHTHERIA DIAGNOSIS BY MEANS OF LOEFFLER'S BAKERS' PRODUCTS. BLOOD SERUM CONTAINING POTASSIUM The Pure Food Law has been in operation so long that TELLURATE, many of its details that were a source of worry and con Ono of the greatest difficulties in diagnosing diphtheria fusion to manufacturers and dealers when it was first by means of swab cultures on Loeffler's blood serum is that enacted, are now taken as a matter of course, and in some the other organisms on the swab tend to overgrow the B, instances given less attention than their importance de Diphtheria. Although blood serum is a culture niediuni of mands. This is especially true in the case of bakers' products. The baker is a manufacturer dealing with raw ma election for B. Diphtheria other bacteria also, grow as well terials of which flour is the bulkiest though by no means or hotter than B. Diphtheria on this medium. the most important In the manufacture of pastries and For a long time bacteriologists have been trying to find baker's confections the baker uses a great variety of in some chemical that: would have an inhibitory effect on all gredients, some of which he manufactures himself from raw other bacteria found in the mouth but not on the P». materialDiphtheria., and others he obtainA largs througe numbeh thr e obaker'f compoundss suppl,y mostly basic dyes and salts of metalloids have been tested with the result house. The baker's supply houses are careful to comply that B. diphtheria is among the bacteria most susceptible to with the Pure Food Law and none of their products, a file inhibiting action of these substances, It was discovered, large variety of which are offered the trade, is in violation however, that the salts of tellurium have a much less in of the Pure Food Law in the original unbroken package. If they are artificially colored that fact is declared on tin* hibiting action toward the B. Diphtheria group than the label. If the material used in extracts is imitation a plain staphylococci, streptococci and other pathogenic bacteria in statement is made to that effect. The baker who buys these the mouth. goods knowing that they have been passed by the Pure Food Law has fallen into the mistake of thinking that he can Conradi and Troch' added calcium bimalate and potassium use them freely without being subject to the penalties. He forgets that when he uses imitation flavors, artificial colors, egg substitutes and many of the specialties he finds useful 'Tagung der Freien vereinigung fuir in his industry he is not providing any means by which the .Mikrobiologie in Berlin. 1D12.S.03 ultimate consumer may learn of the actual composition of his product. . tellurate to ordinary Loefflor blood serum with good results. This medium has not been wry widely adopted apparently It is not illegal for him to buy and to use artificial for two reasons, first. tellurite instead of tellurate has been vanilla flavoring but if he sells vanilla wafers without used hy some workers, second, the Conradi media was first labeling them to show that the flavor is imitation or artifi recommended as a color differentiation media as well as an cial, he is violating the law; if he uses an imitation jelly inhibiting media. The color differentiation is now believed in making his jelly roll and does not label the roll so that to be of little help. the consumer knows that the jelly is made from artificially The bacteriological laboratory o( the Indiana State Board dyed apple stock, instead of being a true currant jelly he is of Health luw made parallel inoculations on plain Loeffler's selling an adulterated food stuff. blood serum and on the same media containing 1..' e.e. of a We have recently had occasion to examine twenty-five \. CHART SHOWING GEOGRAPHICAL DISTRIBUTION OF DEATHS FROM CERTAIN COMMUNICABLE DISEASES FOR DECeMBER, 1914 NORTHERN SANITARY SECTION, Total population 972, 129 Tots! deaths . ... 997 Death rate perr 1,000 12.0 Pulmonary Tuberculosis, rate per 100,000 76.2 Typhoid rate per 100,000 14.5 Diphtheria, rat* per 100,000 ...... 15.7 Scarlet fever rate per 100,000. 4.8 Diarrheal diseases, rate per 100,000 23.0 CENTRAL SANITARY SECTION. Total population 1 > 152,277 Total deaths 1,256 Death rate per 3,000 12.8 Pulmonary Tuberculosis, rate per 100,000 ...... 129,7 Typhoid, rate per 100,000 ..... 17.3 Diphtheria, rate per 100,000 .. 23.5 Scarlet fever, rate per 100,000 ..... 13,2 Diarrheal diseases, rate per 100,000 ...... 13.2 SOUTHERN SANITARY SECTION. Total Population 672,651 Total deaths 589 Death rate per 1,000...... 10.3 Pulmonary Tuberculosis, rate per 100,000 110.8 Typhoid, rate per 100,000 ...... 21.0 Diphtheria, rate per 100,000 ...... 29.7 Scarlet fever, rate per 100,000...... 5.2 Diarrheal diseases rate per 100,000. 15.7 Indiana TABLE 1, Deaths to Indiana by Counties During the Month of December, 1914. (Stillbirths excluded.) Annual Death Rate Per 1,000 Population. Important ages. deaths from important causes Population, STATE AND COUNTIES. Estimated Date . Decembe r 1913 . Year 1913 to sam e Date , Sam e Date. th e yea r 1914 to date. Acut e Anterio r Poliomyelitis , Pneumoni a Diarrhe a an d enteriti s unde r 2 years). Rate for year 1913 to 1 t o 4 inclusive. 10 t o 14 Inclusive . 15 t o 19 Inclusive . Decembe r 1913 . Rat e fo r Year 1914 to Total Death s Reporte d fo r Unde r 1 Year . Tota l Deaths reporte d fo r Novembe 1914 Novembe r 1914 . Tota l Death s Reporte d for December, 1914 . Puerpera l Septicemia . Tota l Death s reporte d for Tota l Death s Reported , for novembe r Externa l causes . 5 t o 9 Inclusive . Othe r form s of tuberculosi Measles. Cancer . Diphtheria , an d Croup . Influenza , Smallpox . Death s o f non residents . 6 5 Year s an d Over-, , Loba r An d Bronch o scarle t Fever . Typhoid fever. State of Indiana Northern Counties .. Adams,. ... — Benton...... ••• Blackford...... Carroll...... CASS ...... ,-.*. Elkhart...... Fulton...... Grant...... Howard...... Huntington,,..., Jasper...... Jay,...... T . Kosciusko...... Lagrange,.,....., LAPORTE... .."... Marshall...... Miami,.,,...-., Newton... <.>. .. Noble.,...... Porter...... ~.- -. Pulaski,., Starke Steuben.,..,..,. 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..-.. - . Owan. -.. -.-'-• . Parke..., , . Putnam..- ....-•- Randolph Rush.,.-. .••-.. Shelby...... Tippecanoe...... Tipton,..,..,.,. Union.;...... Vermillion ., Vigo* .. Warren...... <<.. Wayne,.-...... Southern Counties.,. Clark...... Crawford,..--..- Damn...—. .. .. Dubois.. .. Floyd...... Gibson...... Greene. - harrison.,...... Jackson Jefferson... ..,.. Jennings ...... Knox,...... Lawrence.. Martin,...... Ohio...... \-,.-. Orange Perry...... Pike...... Poesy Ripley,,..., .... Scott...... Spencer .... Sullivan...... Switzerland... — vanderburgh..*.. Warrick..«... — Washington....,, URBAN...... Rural..... —1*2— TABLE 2. Deaths in Indiana by Cities During the Month of December, 1914, (Stillbirths excluded,) Annual Death Rate Per 1,000 Population. Important Ages. Deaths from Important Causes. Popu lation, CITIES. Esti mated, 1914. NOVEMBER, 1914 . Date . December, 1913 . Sam e Date , Yea r 191 3 t o Sam e Date . th e Yea r 191 4 t o Date . Rat e fo r Yea 191 3 t o December, 1914 . November, 1914 . December, 1913 , Unde r 1 Year . 1 t o 4 Inclusive . Rat e fo r Yea 191 4 t o sam 1 5 t o 9 Inclusive . 1 0 t o 4 Inclusive . Puerpera l Septicemia , Whoopin g Cough . | External Causes. Tota l Death s Reporte d fo r 5 t o 9 Inclusive . Cerebro-Spina l Fever . Cancer . Tota l Death s Reporte d fo r Tota l Death s Reporte d fo r Tota l Death s Reporte d Fo r Acut e Anterio r Poliomyelitis . | Influenza. Tota l Death s Reporte d fo r 6 5 Year s an d Over . Loba r and Bronch o pneumoni a enteriti s Smallpox . Pulmonar y Tuberculosi s Othe r Form o f Diphtheri a an d Croup . Measles . Scarle t Favor . Deaths in Institutions Deaths of non residents Cities of the First Class. Population 100.000 and over...' Indianapolis, ...... Cities of the Second Class. Population 45.000 to 100.000..; Evansville...... Fort Wayne...... Terre Haute...... South Bend Cities of the Third Class. Population 20,000 to 45,000... I .61 & Gary.t— Muncie...... Richmond...... Hammond...... Anderson East Chicago...... Lafayette...... New Albany...... Elkhart...... Michigan City..... Cities of the Fourth Class. Population 10,000to 20,000.... Marion Logansport Kokomo...... Vincennes Mishawaka...... Peru.. Laporte • Elwood...... Huntington...... Jeffersonville.. Shelbyville. Crawfordsville New Castle.. Cities of the Fifth Class, Population under10,000...... Brazil... Bloomington Bedford,....-..-.- Frankfort...... *.. Columbus. —.... Goshen «• • Wabash Connersville. Washington....- -.. Whiting Clinton Valparaiso...... Madison... Linton...... Princeton Hartford City...... Seymour Lebanon Mt. Vernon...... Greensburg...... Kendallville...... Portland...... Noblesville...... Bluffton., Alexandria...... Rushville.... - Martinsville...... Franklin...... Aurora.. Decatur.. Warsaw Greenfield...... Winchester...... Sullivan...... Garrett Boonville.. Tipton,...... Auburn...... Mitchell...... Lawrenceburg...... i Plymouth . j Greencastle — Columbia City..... Tell City...... Attica...... Rochester...... Union City, — .,. j Jasonville.. — • •.. j Gas City...... I Dunkirk...... ; North Vernon...... ; Bicknell...... -...! Montpelier ..[ Angola... ..j Rockport. j Crown Point...,...: Huntingburg...... | Rensselaer...— ..j Loogootee ..I Batesville....-....• I Monticello...... Ligonier...... — . Delphi...... cannelton.., Covington..... Butler City Veedersburg...— Rising Sun...... ; Vevay. | Mortality of Indiana for December, 1914. (Stillbirths excluded.) Annual Death Rate Per 1.000 Important Ages. Population POPULATION BY Under i. 1 to 4, 5 to 9. 10 to 14, 15 to 19. §5 and Over gEOGrAPHICAL sections AND Population estimated AS URBAN AND RURAL. 191 4 to Date . Date . sam e dat Pe r Cent . Number . Pe r Cent . Number . Pe r Cent . Pe r Cent . Number . Decembe r 1914 . Number . Decembe r 1913 . Novembe r 1914 , Pe r Cent . Pe r Cent . Number , Number . Rat e for Yea r 1914 to rat e fo r Yea 101 3 t o Tota l death s Reporte d fo r Decenber . 1914. Tota l Death s Reporte d for Novembe r 1914 Tota l Death s Reporte d for Yea r Tota l Death s reporte d for Yea r DECEMBER, 1913 . 1913 to Sam e Date , State...... Northern Counties. Centra] 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...... Deaths and Annual Death Rates Per 100,000 Population from Important Causes. Lobar Diarrhoea Acute Pulmonary Other Diph Whoop and and Cerebro Puer Anterior Influenza External Small POPULATION BY Tuberculosisforms tuberculosisTyphoi d theria Scarlet ing Broncho- Enteritis spinal peral Cancer. and Measles. Polio- Septi pox. Geographical fever, Fever. Cough- Pneumonia (Under Fever. myelitis. Causes. sections AND Croup. 2 Years.) cemia, AS URBAN AMD RURAL, Deat h Rate . Deat h Rate . Number . Deat h Rate . Number . Deat h Rate . Number . Deat h Rate . Number . Deat h Rate . Deat h Rate . Deat h Rate . Number . Deat h Rate . Deat h Rate . Number . Deat h Rate . Number . Deat h Rate . Number . Number , Number . Deat h Rate . Deat h Rate , Number , Number . Number . Deat h Rate . Deat h Rate . Number . Number . Number , Stat® 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. Department of Agriculture, Weather Bureau. Condensed Summary for Month of December, 1914, J, H. ARMINGTON, SECTION DIRECTOR, INDIANAPOLIS, IND. TEMPERATURE IN DEGREES FAHRENHEIT, Extremes. Departure Section from the average. normal. Station. Highest. Date. Station, Lowest. Date. Rome. Salem, PRECIPiTATION IN INCHES AND HUNDREDTHS. Extremes. Departure section from th« normal. Greatest Least Station, monthly Station, monthly amount. amount. Vevay vedersburg.