CHILD NEGLECT EQUALS SICKNESS AND INEFFICIENCY.

MONTHLY BULLETIN Indiana State Board of health Entered as second-class matter at the Indianapolis Postoffice

numbeR 9 VOLUME XVII. INDIANAPOLIS, SEPTEMBER, 1914. 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 SEPTEMBER, 1914* H.H, SUTTON, M. D...... Aurora, Total number of deaths, 2,713: rate, 11.8. In the preced­ J. N. HURTY, M D., Phar D>.» Secretary ...... Indianapolis ing month, 2.S50 deaths: rate. 11.6. In the same month last

WM. F. KING, M. D .ASST. SECRETARY AND EPIDEMIOLOGIST. year, 2.810 deaths; rate. 12.3. Deaths by important ages J. L. ANDERSON,, ••-.... .CHIEF CLERK. were: Under 1 year of age, 479. or 17.0 per cent, of total; Chas A, CARTeR, M. D STATISTICIAN. WM. SHiMER, AB„M. D, Supt. BACTERIOLOGICAL LABORATORY. 1 to 4, 211; 5 to 0, 61 : 10 to 14, 44: 15 to 19, 62; 65 and ADA E. SCHWEITZER, M. D, ...... ASSISTANT BACTERIOLOGIST. W. V. BOYLE, M. D.. ASST. PATHOLOGIST. over, 833, or 30.7 per cent, of total. B. E. BARNARD B. 8...... STATE FOOD AND DRUG OOMMISSIOHER AND CHEMIST. H. E. BISHOP, B. S.. ASSISTANT CHEMIST, SANITARY SECTIONS: The Northern Sanitary Sec­ JOHN C. diggS...... ENGINEER AND WATer chemist, WILL H. McABEE...... , ...... DRUG CHEMIST. tion, population 972.129, reports 914 deaths; rate. 11.4. In R. L. SACKETT, C. E ..SANITARY ENGINEER. the preceding month, 978 deaths; rate, U.S. In the same month last year. 1.000 deaths; rate, 12.5. The MONTHLY BULLETIN will be sent to all health officers and deputies In the State. Health officers anil deputies should carefully read and file each copy for future reference. This is very Important for we expect THE CENTRAL SANITARY SECTION, population 1.152,277. re­ to print instructions, rules and general information, which It will be ports 1.1S7 deaths; rate, 12.5. In the preceding month, necessary for officers to preserve. 1.225 deaths: rate. 12.5. In the same month last year. 1,168 deaths; rate. 12.4. CONTENTS. THE SOUTHERN SANITARY SECTION, population 072.551, re­ Page ports 012 deaths; rate. 11.0. In the preceding month. (553 Births for September, 1914 97 deaths; rale. 11.3. In the same month last year, 012 Abstract of Mortality Statistics for September,..... - ...... 9i Summary of Morbidity and Mortality tor September...... 97 deaths; rate, 11.6. Delayed Birth and Death Certificates...... 98 Why Is This?...... -...... -. -•-••• m Report of the Department of Food and Drugs for September...... m REVIEW OF SECTIONS: The highest death rate occurred in the Central Section. It is 0.7 higher than the Inspectors' Reports for September...... v ...... 99 A Sanitary Survey of the Bottling Works Operating in Indiana..... 100 rate for the whole State, The Southern Section presents A Word of Approval. - - • • • • — • — 100 the highest death rate for tuberculosis, diphtheria, scarlet A Study of Fruit Jar Caps...... —...... 100 American Society for the Control of Cancer 101 fever, poliomyelitis, and influenza. The Central Section pre­ Report of Bacteriological Laboratory for September 101 Patients Who Have Taken Pasteur Treatment...... 102 sents the highest death, rate for typhoid fever, pneumonia, A Small Attendance 102 cerebrospinal fever, puerperal septicemia and cancer. The A Live Mayor 102 111 Treatment. .:...... , 102 Northern Section presents the highest death rate from A Progressive School Teacher— — 102 Disinfection Is Abandoned. — 103 whooping cough, diarrhea and external causes. Bungling Medical Work —...... 103 The Awful Tuberculosis ...... 103 Sanitary Milk Pail...... 103 RURAL: Population 1.550.642. reports 1.348 deaths; The Consumptive Cow 103 The Palace of Eats, 10J rate. 10.5. In the preceding month, 1.418 deaths; rate The Prevention of Human Health...... • ...... 10* 10.7. In the same month last year. 1.36S deaths: rate, 10,7. Court Upholds County Health Commissioner. 104 Chart Showing: Geographical Distribution of Deaths. 105 Table 1. Deaths in Indiana by Counties 106 URBAN: Population 1,246,315. reports 1,305 deaths; rate. Table 2, Deaths in Indiana by Cities.... 101 13.3. In the preceding month 1.438 deaths; rate, 13.(5. In Mortality of Indiana for September ...... 108 U, S. Weather Report for September. 108 the same month last year, 1,442 deaths; rate, 14.3. The cities named show the following death rates; Indianapolis, 14,7; Evansville, 13,1; Fort Wayne. 10.7: Terre Haute, 11.2; South Bend. 11.9; Gary. 12.2'; Muncie. 13.1: Rich­ BIRTHS FOR SEPTEMBERf 1914. mond. 12.3; Hammond. 14,5: Anderson. 13.6; East Chicago, Total births, 5.282 (stillbirths excluded). State rate, 11.6; Lafayette. 17.0: New Albany, 12.3; Elkhart 13.(1; 22.9, Michigan City, 10.8. Males. 2.716; females. 2?566. White males. 2.6SS; white females, 2.535. Colored births. 59; males. 2S: females. 31. SUMMARY OF MORBIDITY AND MORTALITY Stillbirths, 14S; white. 144: colored. 4. FOR SEPTEMber 1914. Northern Sanitary Section, population 972.129, reports 1.927 births: rate, 24.1. Typhoid fever, as in the two preceding months, was Central Sanitary Section, population 1,152.277. reports again reported as the most prevalent disease. The order 2.0115 births: rate, 21.S. of prevalence for the month was as follows; Typhoid Southern Sanitary Section, population 672.551. reports fever, diphtheria, scarlet fever, tonsillitis. diarrhea and 1.290 births: rate. 23.3. enteritis, acute rheumatism, pulmonary tuberculosis, acute Highest rate. Lake County, 37.7. bronchitis, dysentery, malaria fever, smallpox, cholera mor­ Lowest rate. Brown County. 7.6. bus, intermittent and remittent fever, influenza, measles, Total births to date for 1914, 46.661, other forms of tuberculosis, bronchial pneumonia, lobar 98 MONTHLY Bulletin. INDIANA STATE BOARD OF HEALTH. pneumonia, rabies in human, whooping cough, chickenpox lightning excepted* H: fractures cause not specified T 4: puerperal fever, erysipelas, poliomyelitis, rabies in animals, other external violence. 4. homicide total. 0: males. 4; fe­ cerebro-spinal fever. males. 5; homicide by firearms, s; homicide by cutting or SMALLPOX: 1140 cases hi -4 counties with no deaths. piercing Instruments. 1. In the preceding month. S5 eases in l> counties with one death. In the same month last year. 00 eases in 15 counties DELAYED BIRTH AND DEATH CERTIFICATES. with no deaths. The disease appeared in the following counties: Adams 2 cases: Allen. 1: Delaware, 1: Elkhart, each month the statistical department receives certificates for births ami deaths that have occurred during pre­ 1: Floyd, 1; Fountain. 2: Franklin. 1: Gibson, 17: Henry. ceding months, which are not sent to this department in 1: Howard, 1 : Jackson, 1: Jefferson, 25; Johnson. .1: Knox. time to be tabulated with the report for the current month. !l; Lake, :>; Madison. ;i: Noble, m: Pike, Hi; Shelby. 14: Si, With the report for September, the following counties Joseph. 1: Tippecanoe, -: Vanderburgh. 1: Vigo, 1: Wash­ named below were delinquent in this matter. ington, i. Tuberculosis: :501 deaths, of which 251 were of the BIRTHS, pulmonary form and .10 other forms, The male tubercu­ Adams, 1: Allen, lo «Fort Wayne 1 for 1000 i : Bartholo­ losis deaths numbered 1-12: females, 150. Of the males. mew. 2 (Columbus It; Boone, :i (Lebanon L Thorntown 25 were married in the age period IK to 40 and left 51) ll: Carroll, 2; Clark, lu Jeffersonville 2, Clarksville 'l orphans under 12 years of age. Of The females. -IS were Sellersburg 11; Clinton. 1 (Frankfort); Crawford. 2; married In the same age period as above and left 1M.J orphans. Daviess. 2; Dearborn, 5 (Aurora o\ Moores Hill 1»; Elk­ Total orphans under 12 years of age made in one month hart. 1 (Middlebury) ; Fayette. 2 (Connersville 1); Floyd, by this preventable disease, 146. Number of homes in­ 2: Fountain, 1: Fulton. 1 (Kewanna i ; Franklin. 1 Brookville) : Grant, 0 (Marion 1. Fairmount 1) : Greene. .'» (Lin­ vaded, 2M. ton 1) ; Hamilton. :» (Noblesville 2) : Harrison. 2 (Cory- PNEUMONIA: 58 deaths: rate. 25.2. In the preceding don) : Hendricks. 1: Henry. 2 (New Castle >: Huntington. month, US deaths; rate, 2sj». In the same month last year, 1 (city): Jasper, 5 (Rensselaer 4i: Jennings. :i -2 lor 72 deaths; rate, MAI In September the male deaths Lum­ 191.1): Knox, 2: LaGrange, 1: Lake. 24 (Gary 4. Whiting bered »i5; females, 2,*!. 2, East Chicago 10. Hammond 4. Miller 1. Lowell 1) ; La- Porte, :; (Michigan City 2) : Lawrence. 1 i Bedford i : Madi­ DIPHTHERIA: 240 cases in 47 counties with 28 deaths, son, 1 (Elwood) ; Marion. 5 (Indianapolis 2. (Clermont. 1) ; In the preceding month 140 cases in M;*> counties with 21) Marshall, 1; Miami, 2: Montgomery. 4; Morgan, •»" Newton. deaths. In the same month last year, *»u7 cases in 50 coun­ 1 (Kentlard); Parke. 1: Perry, 1 (Tell City): Pike. 5; ties with 45 deaths. Posey, 1; Randolph, 1 (Ridgeville): Ripley, 2; Scott. 2: TYPHOID FEVER: :>2.'t cases in (12 counties with 70 Shelby. 2; Starke. 1; Steuben, 4 (Angola) ; St. Joseph, 12 deaths. In the preceding month, .'102 eases in (Jl counties (South Bend !), Mishawaka .T> ; Sullivan, .'»: Tippecanoe, with 05 deaths. In the same month last year, 5;>r> eases in 7 (La Fayette 5. West La Fayette 1): Tipton, 2: Union. '!: 75 counties with 100 deaths. Vanderburgh, 11 (Evansville 10) : Vermillion, 5 (Clinton SCARLET FEVER: PIS cases in oO counties with 0 :o ; Vigo. 11 (Terre Haute 5, West Terre Haute :> i : War­ deaths. In the preceding month, 02 cases in ;il counties rick. 2 (Tennyson 1; Wells, 7. Total. 200. with no deaths, in the same month last year, 227 cases in 40 counties with S deaths. DEATHS. MEASLES: 43 cases in Pi counties with no deaths. In Allen, 4 (New Haven 1) ; Bartholomew, 1 : Boone. 1 ; the preceding month 78 eases in IS counties with -1 deaths. Clark, 1 (Thorntown); Decatur. 1 (Greensburg) : Dear­ POLIOMYELITIS: 5 cases in 5 counties with 5 deaths. born. 1 (Moores Hill); Delaware. 1: Dubois, 1; Elkhart In the preceding month 9 cases in 5 counties with 4 deaths. 1 (Middlebury); Franklin. 1 (Oldenburg): Gibson. 2: In the same month last year 14 cases in l:> counties with Greene, 2; Hendricks. 1 (Plainfield) : Jasper, 1: Jay, 1: 5 deaths. The deaths occurred in Blackford county, mule Knox. 1: Lake. 2; Monroe, 1: Montgomery. 2; Newton. o years: Grant county, male 20 years; Greene county, male :J: Parke. 2; Pike, 1: Posey, 1; Pulaski, 1 (Francisville) : .'! years; Perry county, male 1 year; Washington county, Ripley. 2; Spencer. 1: Steuben. 1; Sullivan. 1 Shelburn : male 1 year. Tipton, 1 (city) : Vermillion, 1: Vigo. 2; Warrick, 1 ; Wash­ RABIES: IS) persons bitten by rabid animals and treated ington. 1 (Salem): Wayne. 1; Wells. :j (Keystone It: by the State Board of Health during September* There White, 2; Whitley, 1. Total, re were no deaths. EXTERNAL CAUSES; Total deaths, 221; males, 151: WHY IS THIS? A builder of garbage carts and ap­ females, 70. suicide total. Ill: males, ,10; females, 7. paratus for handling garbage in the State of Indiana Means of suicide- -Poison, 21 ; asphyxia, t ; hanging writes usstrangulation as follows ,; ;j; drowning, fiirearms, 7; cutting or pierc­ ing instruments, 2. .accidental or undefined total. 175: "Although we have advertised thoroughly in the cities males, 117; females, 5s, Poisoning by food. 5; other acute and towns of our State, we get a great deal more busi­ poisonings. 7; conflagration, 1; burns (conflagration ex­ ness from adjoining States than from Indiana cepted) 10: absorption of deleterious gases (conflagration Our wonder is, why is this? The cities and towns have excepted) 1; accidental drowning, 11; traumatism by tire- been urged over and over to pass garbage ordinances and arms. 5: traumatism by cutting or piercing instruments. separate themselves from their garbage, but very few of I; traumatism by fall. M: traumatism in mines. 0; trau­ them have heeded the advice and still live with their garbage, matism by machines. 1; railroad accidents and injuries, their smells and their flies. We hope the unburied dead o5; street ear accidents and Injuries, 0; automobile acci­ in these towns will soon he buried, and that new life will dents and injuries. 15; injuries by other vehicles. 12; other come into them. It N indeed humiliating to the whole crushing, 2; injuries by animals. 2: lightning. 1: electricity. State that so many municipalities In Indiana refuse to separate themselves from their garbage and their sewage. MONTHLY BULLETIN, INDIANA STATE BOARD OF HEALTH, 99

REPORT OF THE DEPARTMENT OF FOOD AND Two of the 54 drug stores visited were rated excellent, 41 DRUGS, INDIANA STATE BOARD OF HEALTH, good and 11 fair. FOR SEPTEMBER, J9I4, Ninety-three bakeries and confectioneries were inspected.

H. E. Barnard, STATE FOOD AND Drug COMMISSIONER. Of this number 00 were classed as good and ,*»*» fair. Twenty of the o:i hotels and restaurants inspected were During the month of September. 57s samples of food were rated good, 'A2 fair and one poor. analyzed of which r were legal and -U) illegal. The Seventy-three canning factories were inspected during the live vinegar samples sent to the laboratory for analysis all month. Of this number 27 were rated good. .'i7 fair and proved to be illegal, being low in acidity. Most of the time in the food laboratory was devoted to the analysis of U poor. sodas. 547 samples being analyzed. Of this number till Four of the 11 ice cream' parlors visited were rated good, were legal and illegal. The illegal samples were so G fair and one poor. classed because of flu* presence of benzoate of soda sac­ Inspections were also made of "» creameries, ."> milk sta­ charin or were misbranded. tions, 2 wholesale groceries, 5 slaughterhouses, 'i flour mills, Thirty drug samples were analyzed during the month. Of 2 ice cream factories, one fruit and vegetable store, 2 poul­ the 7 illegal samples 3 were spirits of camphor. In the manu­ try houses, and 32 bottling works. facture of which the pharmacist had apparently not fol­ During the month 7 condemnation notices were issued lowed the directions of the United States Pharmacopoeia against one bottling works, one canning factory, one con­ close enough to get a legal product.. Each of the three samples fectionery, one milk depot and two restaurants, G because are about So per cent, of standard strength and have evi­ of unsanitary conditions and 7 because of improper con­ dently been made by adding the total amount of alcohol to struction. the gum camphor instead of making up to volume. -But four prosecutions were brought during the month. One case was brought for the sale of misbranded pop, one RESULTS OF ANALYSES OF FOODS AND DRUGS DURING THE MONTH OP for the sale of misbranded beer. One dealer was prosecuted SEPTEMBER, 1914. for the sale of milk which was below standard. One prose­ cution was brought for exposing food stuffs to dust and Number Number CLASSIFICATION. Legal, Illegal. Total dirt at the State Fair Grounds. The total fines and costs amounted to $87.50.

Beverages— SUMMARY OF INSPECTIONS MADE DURING THE MONTH OF Beers. _...... SEPTEMBER, 1914. Grape juice.... Sodas. Catsup No. No. No. No Fair No. PoorNo . Milk Products- INSPECTIONS. Inspected. Excellent. Good. Bad. Butter Milk...... Mother's milk.. Oleomargarine. Dairies. Syrups Grocery stores Vinegar... Meat markets Miscellaneous .. Drugstores Bakeries and confectioneries Total ...... Hotels and restaurants..... Creameries Milk stations Spirits of camphor Wholesale groceries Carbolic acid Slaughter houses .... Castor oil .... Flour mills...... Turpentine Ice cream parlors Peroxide., _ v • • Ice cream factories.. — ... Patent medicines. Fruit and vegetable store... Miscellaneous .. Poultry houses.... - Bottling works.. Total .... Canning factories..., Total

INSPECTORS REPORTS FOR THE MONTH OF SEPTEMBER, 1914. NOTICES OF CONDEMNATION DURING THE MONTH OF SEPTEMBER, 1914. Six hundred and eighteen places were inspected during Reasons for Condemnation. the month of September and of this number 9 were re­ CLASSIFICATION, Total Unsanitary • Improper ported in excellent condition, .'$03 good, 285 fair, and 21 Conditions, Construction. poor. Three dairies were inspected. One was classed as good Bottling works.. Canning factories. and - fair. Confectionery... Of the 2S8 grocery stores visited 5 were in excellent Milk depot.. - • Restaurants-. ... condition. 101 were good, 119 fair and 3 poor. Total...... Of the 4S meat markets visited 2 were rated excellent, 25 good, 19 fair and 2 poor,

LIST OF PROSECUTIONS DURING THE MONTH OF SEPTEMBER, 1914.

Date of COUNTY Names and Addresses of Defendants Why Prosecuted. Trial Final Disposition

Selling misbranded beer... • 0- 3-14 ' Fined $27.30. Clarke James A. Walker, Jeffersonville DelawarSelline g milk beloJamew ths eK standard.. Catron. , Munci. e 9- 4-14 , Fined I2CJ.0U. Mario:t Morris Burstein, Indianapolis Selling misbranded pop...... 9-7-14 ! Fined S.20.00. Marion . Guy Mascari Broad Ripple, Exposing foodstuffs at State Fair 9-2TH4 1 Fined 130.00. 100 MONTHLY BULLETIN, INDIAnA STATE BOArD OF HEALTH.

A SaniTARY SURVEY OF THE BOTTLING WORKS and dirt in the neck of the bottle unci is unsanitary in OPERATING IN INDIANA. the extreme and its use has been forbidden. In nearly every community one or more bottling houses In general the bottling industry has been so improved that are engaged in the preparation and salt? of bottled soft It now stands on a par with other food industries, and with drinks commonly known as sodas or pops. In years past the few exceptions above noted the bottlers of the State these places have been inspected from time to time for the are honestly endeavoring to obey the laws which protect purpose of determining their sanitary condition, and no­ the consumer, and make for better business. tices to bottlers have been issued for the purpose of im­ proving trade customs. The first of these circulars advised bottlers to discontinue the use of saccharin and preserva­ A WORD OF APPROVAL. tives. Later circulars have discussed the use of proper The Modern Grocer, a trade journal of wide circulation. labels and suggested marking the contents in compliance in its issue of October 10th carries a story of the progres­ with the Weights and Measures Law. sive work of the Indiana State Hoard of Health, and adds In the course of our work with bottlers we have noted its word of approval. Praise is always pleasing and in constant improvement both in methods of manufacture and this instance we are very glad indeed to know that our the conditions under which the business is carried on. The attempts to improve health conditions among food workers Indiana Bottlers Association has co-operated heartily with strike so responsive a chord. the inspectors and in a number of instances has assisted The article reads as follows: in the prosecutions of violators of the law. LOOKING TO The SOURCE. In order to determine the condition of the bottling indus­ try and to get in close touch with individual bottlers TO According to news reports, the Indiana state Food and have recently- made a rather complete survey of all estab­ Drug Commissioner has started a fight to eliminate from lishments operating in the State. This survey, made dur­ the forces of workers engaged in the manufacture of all ing the months of July, August and September, included foods and drugs, persons afflicted with tuberculosis, diph­ a visit to and inspection of one hundred and five bottling theria, epidemic sore throat or venereal diseases. works located in every part of the State. The inspector This information is doubly welcome to every grocer reports that In general the sanitary conditions were good; because up to the present time it has seemed that all that the bottlers were fully informed as to the various the attention of the food authorities has been directed laws under which they operated and were trying so to con­ at the retail end of the distribution of food products, duct their business as to place them above criticism. Al­ while this report would indicate that rhe food and though no establishment was found so ideal as to warrant health authorities are beginning to realize that a high the grade of excellent 45 places were rated as good and 57 standard of sanitary conditions in the factories where were entitled to the grade of fair. But 3 places were poor, foods are prepared is of equally great importance. and in no instance was a plant reported as bad. In com­ However, this thought offers a timely suggestion to parison with other food manufacturing establishments these the man who looks after the clerk hiring. In the future figures show that the bottlers of the State have been dili­ why not investigate the prospective clerk's state of gent in improving sanitary conditions and adopting modern health? Why wouldn't it be a wise plan to require the and sanitary methods of work. applicant to furnish a doctor's certificate of good health? Sanitary appearances arc becoming more and more a All the places visited were equipped with suitable facili­ vital factor in conducting a successful grocery business ties for washing bottles; all the establishments had an and the physical condition and appearance of the clerk adequate supply of pure water. In several Instances an­ cuts a bigger figure with the consuming trade than it alyses were made of waters for the purpose of determining ever did. their quality. It's up to us to keep abreast, of the times. Five hundred and forty-nine samples of bottled pops or sodas were purchased at the plants visited and sent into 'the laboratory for analysis. Of this number 22 were pre­ A STUDY OF FRUIT JAR CAPS. served with benzoate of soda. In nearly every instance the preservative was present In so-called orange soda. GAIL miers STAPP. Seven samples contained salicylic acid. These samples For years the Mason fruit jar has held first place as a were the so-called root beer preparations and It is probable container for many classes of preserved foods. Different that the salicylic acid was not present as a preservative. caps are employed. The most common type has been a Seventeen samples were sweetened with saccharin, and in zinc cap with glass lining which made a perfect closure these cases action has been brought against the pro­ by pressing tightly on a rubber ring. Later types have prietors for violation of the rule of the State" Board of varied the method of closure by placing the rubber ring on Health which prohibits the use of saccharin in food prod­ the edge of the glass neck in such a way that the closure ucts, These seventeen samples were collected at four differ­ was made not with the edge of the cap but by the inside ent establishments. glass lining. In order to determine the relative merits of Seventy-one of the samples gave the net volume of eon- the old and the new style of cap, especially with reference tents as T ounces; 3 as 7| ounces and 39 as 8 ounces. to the solution of metal and perfect seal, we have made Thirty-one of the samples were not properly labeled, no the experiments which are outlined below; statement appearing on the bottle to the effect that the Fourteen clean Mason jars were selected, one-half of product was artificially colored or flavored or otherwise which were sealed with White Crown caps, and the other made in imitation of the genuine article. half with Mason caps. Into each jar sealed with the White Eleven samples were contained in bottles closed by the Grown caps was put 100 c.c. of one of the following solu­ so-called Hutchison stopper, a stopper which is pushed tions: Wc H3P04: 1% H3P04; *% tartaric acid; *<% acetic down Into the bottle instead of being withdrawn when acid; 1% acetic acid; \% HN03: and \% HNO,. The same opened, Such a stopper allows the accumulation of dust was done with the jars sealed with Mason caps. These MONTHLY BULLETIN, INDIANA STATE BOArD Of health 101

jars were inverted ami allowed to stand for six months. REPORT OF BACTERIOLOGICAL LABORATORY, At the end of Unit period the following things were noted: INDIANA STATE BOARD OF HEALTH, Condition of the cap. loss in volume, if solution was FOR SEPTEMBER, 1914. clear or turbid, and if zinc was present. The results are WILL sHIMER, M. D., SUPERINTENDENT. shown in the following tables: Sputum for tubercle bacilli- WHITE CROWN CAPS. Positive ...... Negative Acid. Condition of Cap. Loss in Volume. Solution. Zinc.

Urine for tubercle bacilli- 1/2'.>H2PO« H3po4.. No corrosion. No. Clear. Negative U, TartaricTartaric . 1 S ( Acetic. Pus for tubercle bacilli- 1' ; Acetic. Outer rim slightly , Negative \-i-r HNOhno;.. corroded. Spinal fluid for tubercle bacilli- . r-.1S'' - HNOjHN03.. Outer rim slightly corroded. Negative ! Widal tests for typhoid fever— MASON caps Positive Negative ...... '... Acid. Condition of Cap. Loss in Volume. solution. Zinc.

¥f< H3P0« Corroded.. About. Turbid. Paratyphoid tests for typhoid fever- 1\ HP0«. Badly corroded Completely Evaporated.. Positive ...... } -Tartaric Slightly corroded. Aiw.it 'a. Clear Negative Acetic. Slightly corroded. NO. Acetic, Badly corroded. Completely evaported. HNO, Badly corroded. No. clear. Throat cultures for diphtheria bacilli- HNO3 . Badly corroded. sight loss. Turbid. Negative ...... Positive The following results from the experiment were noted: Suspicious 1. On five out of seven jars, the White Crown caps Unsatisfactory were in perfect condition. All of the Mason caps were corroded. EpidemiJ c diphtheria—- 2. There was no loss in volume in the jars sealed with Positive White Crown caps. In five of the seven jars sealed with Negative Mason caps, there was a decided loss in volume. Suspicious 3. The solution in each of the jars sealed with White Crown caps was clear, while in two of the jars sealed , Brains for rabies- with Mason caps the solution was decidedly turbid. Dogs: 4. Zinc was present in each of the solutions in the jars, Positive sealed with Mason caps. Negative , The following conclusions were, drawn: The White Cows: Crown cap is superior to the Mason cap—ill it does not Positive permit the contents of the jar to come In contact with any Negative metal; (2) it is more sanitary in that it is more easily Cats: cleaned; and (3) it permits a tighter seal. Positive ...... Negative ...... Squirrel: AMERICAN SOCIETY FOR THE CONTrOL OF CAN­ Negative CER : This society, recently organized, has a membership of eminent physicians and lay citizens. The office is 2S0 Feces for typhoid bacilli- Fourth avenue. New York City. The president is George C. Negative Clark, New York, and the executive secretary is Curtis E. Feces for dysentery bacilli- Lakeman. As the name implies, the object of the society Negative ...... is to do what it can to control cancer, which is certainly Blood for counts increasing in prevalence. The mortality from cancer has Blood for malaria Plasmodia increased greatly in the last decade. In the United States, Positive ...... cancer now causes about 75.000 deaths each year. In the Negative ...... age period above forty, cancer as a cause of death stands above tuberculosis, pneumonia and typhoid fever. If the importance of early diagnosis and prompt surgical interventionPus, miscellaneoucould bes brough...... t home to th.e public, there is rea­ son to believe that an appreciable reduction in the cancer Pathological tissues— death rate would result. The society expresses Its belief Carcinoma ...... that public health authorities everywhere should speak Sarcoma ...... loudly to the public in regard to the very great importance Miscellaneous ...... of early diagnosis and surgical intervention In the case of cancer. The State Board of Health will prepare a leaflet Urine for chemical analysis,...... upon this subject for free circulation. Urine for gonoeocci— Negative ...... 102 MONTHLY BULLETIN, INDIANA STATE BOArD OF HEALTH.

Pus for gonococci— A LIVE MAYOr: Mayor P. L. Sisson, of Valparaiso is Females: a live Major. He recently in 011c day addressed the pupils Positive ...... In twenty schools during a tour of the northern part of Negative ...... Porter County with Superintendent Fred H. Cole. Mr. J. Males: A. Shelling furnished the automobile and accompanied Positive ...... Superintendent Cole and Mayor Sisson. Every school in Negative ...... Portage. Westchester. Jackson, Pine and liberty townships Sex not given: was visited. All the pupils were supplied with badges and Negative ...... informed of Disease Prevention Day, October 2. Contrast the work of Mayor Sisson for the Public Health Cause with that of the mayors of some other cities. The mayor of Feces, miscellaneous ..... one of our large cities said: "Disease prevention idea is Meat ...... all folderol. I will do nothing.*' He did nothing and his city stands forth as a do-nothing city. Cities are only Total number specimens examined of the do-nothing kind when they have mayors who will Doses of antityphoid vaccine sent out do nothing. How unfortunate it is for a city to have a OUTFITS SENT OUT during SEPTEMBER 1914. do-nothing mayor, Tuberculosis . Diphtheria . . ILL TREATMENT of children is gradually being pun­ Epidemics . .. ished in the courts, and when all the ill treated children WidaLs . . are looked after it will be necessary to multiply the courts gonococci . .. many fold to consider the cases, An instance comes from Blood counts Rochester, New York, and is printed in the Rochester Malaria Evening Times of September 30. This notice tells of a Bile Media .. woman who had frequently locked her seven-year-old boy in the house by himself while she went out riding in her Total number outfits sent out. 3,- automobile with men. The Society for the Prevention of Cruelty to Children discovered the situation and she was PATIENTS WHO HAVE TAKEN "PASTEur" TREATMENT THIS MONTH. brought before the court. There it was found this bad mother was sadly neglecting her boy. The Judge said in Began Finished NAME, Town. County. Age Sex Treatment. Treatment. his remarks: 'The offense committed is a most reprehensible Bible and deplorable one." From the notice we infer that action will be had to take the custody of the child from the mother. This procedure is all very well, but the mother Evelyn Harvey...... Indianapolis.. Marion..... Cyril Harvey...... Indianapolis.. Marion.,..., some day will very probably have another child and she Dierdre Kennedy Indianapolis.. Marion. Edna Thomas...... Indianapolis.. Marion. will treat it the same way. The mother most probably C. H. Bush Indianapolis.. Marion,..,,, has degenerative elements in her composition. She ought Mrs. Allie Wambaugh. Indianapolis.. Marion, G. 0. Jackson...... Indianapolis,. Marion, not to procreate; or, as said, there will probably be more Baldwin H, Jackson.. Indianapolis.. Marion, .... Lois Jackson Indianapolis., Marion, children for the court to take into custody. This deliber­ Charles W. Reese..... Indianapolis.. Marion. ate manufacturing of evil by producing defectives will Eleanor Reese...... Indianapolis. . Marion. Mrs. Emma Green..., Brownsburg... Boone cease when we learn to strike at the root of the tree of Alma Lyle. Madison...... Jefferson Mrs. Anna Layton Madison Jefferson evil rather than lopping oft' its branches, which grow all the Alden Richardson Glenwood.... Rush.. Georgia Richardson... glenwood.... Rush....,.., faster for the lopping off. Vera Richardson Glenwood..,. Rush. Wendell Webb.... ,. . Francisco, Gibson,. Ralph Avery Waldron Shelby Violet Goldsbury Medaryville... Pulaski Tom Jefford...... North Vernon. Jennings.... A. Hauersperger Hayden. Jennings.... A PROGRESSIVE SCHOOL TEACHER: M. E. Allen, * Months. a teacher out in Guthrie Township, Lawrence County, largely at his own expense, screened the windows and doors A SMALL ATTENDANCE: The Greensburg Times of of his schoolhouse against flies. The newspaper account October 3 says: Out of a total attendance of 35 there from which we secured this information says: "We do not were 11 more women than men at the Disease Prevention recall when any other announcement struck us with such Day exercises, held in the Presbyterian Church October 2, force. We have seen little tots fairly eaten up by the Of the 12 men, 4 were on the program. Mayor Mendenhall hungry flies in schoolhouses. The hundred varieties of din­ presided. Dr. Chas. Burg was the last speaker on the pro­ ners they carry to the country schoolhouses attract mil­ gram. Other speakers were Dr. J. W. Clevenger and lions of insects, which being unable to get into the covered School Superintendent F. C. Fields.'* The interesting thing lunch baskets, pounce upon the poor little children. How about this notice is the fact that a city the size of Greens- much studying can the children do while being eaten alive burg, after due advertisement, could muster only 35 citi­ by flies. What right have we anyhow to pen children up zens, most of them women, to consider the important busi­ in a schoolhouse and then turn flies loose on to them? ness matter of disease prevention. The fact seems to indi­ If flies can carry disease is it not true in our unscreened cate that the business men of Greensburg have not yet schoolhouses that the trustee or other responsible school grasped the great and important truth that the most im­ authority is furthering disease. Predictions upon the portant matter before the business men today is the school teachebusinessr that screened hiofs schoolhouse.the public health' , If the business men do not grasp this Idea very soon and act upon it, we predict a The school authorities in that, township are mentally decrease of population in Greensburg and a decrease in and morally slow. "By their works ye shall know them." the value of Greensburg real estate. It certainly is mental and moral slowness not to protect little children against flies. MONTHLY BULLETIN, INDIANA STATE BOARD OF health, 103

DISINFECTION IS ABANDONED by the New York City doctors of the town to take action in the matter. We sug­ Health Deportment after eases of diphtheria, scarlet fever, gested, as the circumstances are known to them, that they measles, cerebro-spinal meningitis ami poliomyelitis because appeal to the people of the town to relieve this poor widow experience and statistics show the number of return cases woman of the heavy burden which she has cheerfully so are nut affected thereby. The air is not a vehicle of infec­ far borne, We hope the physicians will be successful in tion except indirectly when it conveys saliva spray from arousing the sympathies and securing the help of the people* one person to another. Scarlet fever scales do not carry of the town in this instance. the germs nor is the period when scabs are given off the most important Disinfection is useless to prevent the spread of measles because the organism is so short-lived SANITARY MILK PAIL: We Illustrate herewith a and because the infection is disseminated at the outset Hoosier sanitary invention which we think has much merit before the diagnosis is made. The picture tells its own story. The funnel detaches read­ ily from the extra heavy tin bucket which itself serves as a milk stool. The cover fits tightly and has a wide flange BUNGLING MEDICAL WOrK: In the matter of ob­ thus protecting the contents of the bucket The large taining accurate morbidity information the first step is better medical education and elevation of the conscience of the profession. In a certain city a man was found un­ conscious and taken to the hospital. The case was reported as "epidemic cerebro-spinal meningitis.*' The man died and asi autopsy was held. The autopsy disclosed the fact that he had a fracture of the skull which was the result of a homicidal blow. Morbidity report read— "A case of epidemic cerebro-spinal meningitis.' The death certificate read: "Cause of death, fracture of skull. Contributory, homicidal." This gross error never would have been cor­ rected had it not been carefully traced down by the "rank registrar

THE AWFUL TUBERCULOSIS: Two good women write the State Board of Health concerning tuberculosis in mouth of the funnel is to be covered with two thickness their homes. The first one says; "I heard your lecture of cheese cloth. Milk collected in such a pall under such on tuberculosis in the Christian Church in Hammond and conditions must perforce be very low In bacterial content I learned much therefrom, 1 have a darling daughter, 20 and minimum dirt collection will result This combined years old. that has developed the dreadful disease. She milk stool and pail, as said before, certainly has merit, and has been sick since June. We have a large family and Is highly recommended. This invention is supplied by the practically no means. I am writing to you to find out if Lafayette Sanitary Supply Company. Lafayette, Indiana. there is not some way I can get help. 1 heard there was a State institution where she could get treatment I would bo glad to work for her and from my earnings pay what is THE CONSUMPTIVE COW: Indiana should have a law necessary." The good woman was told about the State which would put the consumptive cow out of existence. She Hospital at Rockville, and we hope she will find it possible is not a paying proposition but an expense and a constant to gain admission for her daughter. threat against health and life. The United States Bureau The second letter says; "I write you in regard to a of Animal Industry, after thorough study of the case, has man who has tuberculosis who is staying at my house. I ruled that an animal not affected with general tuberculosis have harbored him simply because he was a neighbor and may be utilized for meat provided the parts affected with could find no other home. He has had the disease about the disease are not used. For instance, if the animal has six years and has been unable to work four years. He only pulmonary tuberculosis, and the disease is not found came to my house the first time In March, 1912. In the elsewhere in the carcass, then the carcass may be used for fall he secured admission to the State Tuberculosis Hos­ food. If the tuberculosis is local, In the udders only, then pital at Rockville and stayed there 15$ months when the the unaffected parts may be used for food. Of course, a superintendent dismissed him as Incurable and under the liver or kidneys or heart affected with the disease must not law could not keep him longer. He returned to my house be used for food. It Is estimated after careful study by September 20. 1013. and has been here ever since. He Dr. Brown of Saranac Lake, who is certainly an authority cannot be readmitted to the hospital and I am writing that can be depended upon, that 8 per cent of all cases of to you thinking you might know of some place in the State tuberculosis we see are of bovine origin. Accepting this, where he could go. He is without money and is no relation at least 16,000 people die in the United States every year of mine whatever. He is a member of the church and also who derive their infection from tuberculous meat or from of the I. O. O. P. The lodge allows him one dollar a tuberculous milk. This mortality is certainly great enough week which, of course, would not even buy him food. I to Interest us and to call forth strong efforts to guard the am not able to keep him financially or physically. I am people against milk and meat sources of disease and death. a widow d«> years old and my son lives with me and works Milk which is infected with tuberculosis germs causes most by the day for our support. 1 feel that we have done our of the bone tuberculosis and gland tuberculosis which chil­ whole duty in earing for this poor consumptive. I will dren suffer from, The State Board of Health would make will be very grateful for an answer, hoping that you can sug­ it full investigation into this matter and render a report gest relief," We replied there was no place in Indiana with recommendations to the legislature if authorized to do so. This should be done. where this dying man could be taken and appealed to the 104 MONTHLY BULLETIN, INDIANA STATE BOARD OF HEALTH.

THE PREVENTION OF HUMAN HEALTH. have killed many, but even 1 am being overcome. These

BY miss katherine BiTTInger, LAPOrTE INDIANA HIGH people that sleep with their windows open, in fact sleep out of doors, arc too immodest to suit me. I can't stand the SCHOOL puPIL. sunshine and now 1 can find few places where it is'nt. How­ On a large sign board on the principal street of Bacteria- ever, in some tenement buildings its good and dark and ville appeared the following announcement at eight o'clock dusty and a great many people crowded in one room. When in the morning. I find a place like that I am happy. The alleys, too, are IMPORTANT DISCUSSION. sometimes mighty handy. I often ride on the case; those Subject: Prevention OF HUMAN HEALTH. beautiful velvet cushions appeal quite strongly to me. Al­ Open meeting led by prof. Bacllius Typhus. though Man has become so wise, there are a great many TOWN HALL 7 P. M. To-night. things he does'nt know, so keep your eyes open and well A great many inquisitive spectators paused and read the win yet.' sign during the clay. At six-thirty that evening every seat Having thus spoken he took his sear and the meeting soon was filled, and when at seven, Prof. Typhus called the meet­ came to an end and each microbe with these things in ing to order, the house was crowded to its uttermost. mind went about his dully work with a renewed vigor. "My dear fellow Germs, Bacterias, and Microbes,"' began Moral: If the miscrobes thus convene the professor, "this meeting has 'been called to promote our Can't we also plan and scheme? welfare, and to discuss 'The Prevention of Human Health.' As you all know the present times are not what they were years ago. In former days no better dwelling place could "'THE PALACE OF EATS" was the name the owner gave be found than the best parlor of some human being's home. to his restaurant in a small Indiana town. The name was No sunshine or fresh air found its way into that place. so effulgent the inspector was led to make an inspection. The curtains were always drawn, except when the house­ He entered. There was the usual counter with high stools, wife with her broom and feather-duster raised a small the wall shelves with pies, buns, plates of fried meats, etc., amount of dust and then carefully closed the door until the etc., upon them. And the flies! They were numerous and next week. But now such rooms are not to be found. There insistent, and through the unscreened back door could be is no such thing as the 'Parlor,' Every room is used, and seen the open garbage barrel and the outhouse which main­ every day too. They have vacuum cleaners that cleanse tained the supply. In the cracks between the shelves and the rugs, oiled mops that keep the floors immaculate, dustless the wall were found a few maggots, and here was another dust cloths that not only remove the dust but absorb it. I source for the abundant fly supply. All of these conditions can remember when 1 and my mother and father and three did not in the slightest degree work against patronage. million brothers and sisters lived in one of those good old- The customers were many. 'The Palace of Eats'' did a fashioned feather clusters. But alas, times have changed." good business. The boy at the counter had sore eyes and As the meeting was open to all who wished to speak, the constantly rubbed them with his fingers and then with the Rev, Pneumonia now rose. "What our good brother has same fingers lifted sandwiches, cake and pie. The cus­ just said is certainly true These mortals are surely wag­ tomers did not object. Indeed not one noticed the condi­ ing a bitter war against us. The smallest child is taught tions but ate with gusto. The inspector went forth into the household motto of 'Swat the Fly The older children learn to remove all rubbish from the yards, to refrain from the night, His spirits were too low to call forth action. chewing each other's gum, to have their individual drinking cups. those of high school age not only read numerous COURT UPHOLDS COUNTY HEALTH COMMISSION­ articles warning them of germs and microbes and how they ER: In February, 1914, a one room school building in are caught, but write compositions discussing ways to over­ Vernon township, Washington county, was destroyed by fire. come germs. However, brethern, we still have a few places The pupils were transported to other schools, and in the in which to live. Those who are good and pious and come Spring, the trustee, Mr. Rutherford, began to plan for a to church will find peace there. Here, sunshine and fresh new school building. The school house site was a poor one air are little known except on Sunday. Even then such and extremely bad for sanitary reasons, because of its loca­ crowds of people are there that you all may feel comforta­ tion near a swamp, and because much of the school site was ble and safe," covered by water during part of the school year. The Coun­ Having said this, he seated himself and waited for the ty Health Commissioner, Dr. Charles W, Murphy of Salem next person. A scarlet-faced microbe now rose. "The made an inspection of the school site, condemned it as be­ church may be all right for some of you," he said, "but the ing insanitary and ordered the trustee not to build on this 'Movies' for me. There are'nt any windows there to open site. The trustee, however, upon the advice of his attorney, and not much fresh air either, and always crowds enough proceeded to make some changes in the site with the inten­ for any one. There are plenty of us that hang around tion of building thereon. Dr. Murphy brought suit against there.1' It was the young scoundrel Scarlet Fever that spoke, the trustee to enforce his order and to enjoin the trustee and Ms comrades, Whooping-cough, Chicken-pox, Mumps and from using the site for a school building. The case was others, gave vigorous applause. tried before Judge John Edwards of Mitchell, Indiana, re­ "The school room used to he pretty good," said Professor quiring several days on account of the large number of wit­ Typhus, but now they wash all the air before they allow nesses. At the conclusion of the trial Judge Edwards is­ it to enter the rooms. It seems to me that unless we think sued a perpetual injunction against the building of a new of some good mode of attack we will all soon perish. You school house on the site and assessed the cost of the trial. simply can't enter a house with a fly. Every fly that is amounting to $375.00, against the township. seen has twenty persons after it. Every kind of trap has This is one more instance of a trustee whose obstinacy been Invented to catch thein. These human beings have has brought financial loss to the township whose interests Humane Societies,' but not for us. They even keep the he represents, and another instance of unnecessary and pre­ garbage cans to tightly covered that we cannot get within." ventable high taxes. In fact, obstinacy costs the people of General Tuberculosis now arose and said: In my day I Indiana far more than progress. MONTHLY BULLETIN, INDIANA STATE BOARD OF HEALTH. 105

CHART SHOWING GEOGRAPHICAL DISTRIBUTION OF DEATHS FROM CERTAIN COMMUNICABLE DISEASES FOR SEPTEMBER, 1914.

NORTHERN SANITARY SECTION. Total population 972,129 Total death 914 Death rate per 1,000 11.4 Pulmonary Tuberculosis, rate per 100,000.... 80.1 Typhoid, rate per 100,000 , 22.5 Diphtheria, rate per 100,000 10,0 Scarlet fever, rate per 100,000 1.2 Diarrheal diseases rata per 100,000 141.4

CENTRAL SANITARY SECTION. Total population 1,152,277 Total deaths ...... 1,187 Death rate per 1,000 12.5 Pulmonary Tuberculosis, rate per 100,000 .... 117.2 Typhoid, rate per 100,000 36.9 Diphtheria, rate per 100,000 ,,10.5 Scarlet fever, rate per 100,000 ...••.• 1.0 Diarrhea! diseases, rate per 100,000 114.0

SOUTHERN SANITARY SECTION. Total Population...... 672,551 Total Deaths...... 612 Death rate per 1,000,...... '... 11.0 Pulmonary Tuberculosis, rate per 100,000.. 187.4 Typhoid ratepe r 100,000 .. 30.7 Diptheria rate per 100,000...... 18.0 Scarlet fever, rate per 100,000...... 7.2 Diarrheal diseases, rate per 100,000 119.8 INDIANA, TABLE 1. Deaths In Indiana by Counties During the Month of September, 1914. (Stillbirths excluded.)

Annual Death Rate Per 1,000 Population. Important Ages. Deaths from Important Causes.

Popu­ lation, STATE AND Esti­ COUNTIES. mated, 1914. Same' Date, Date . Augus t 1914 . September, 1913 . Pneumonia . Yea r 191 3 to Sam e Date , September . 1914 , th e Yea r 191 4 t o Date , Deaths of non-residents Acut e Anterio r Poli o 1 t o 4 Inclusive . Cancer , Influenza. Puerpera l septicemia . 15 to 19 inclusive. Unde r 1 Year . Whoopin g coug h ! 1 0 t o 14 Inclusive . Othe r form s of tuberculosi Typhoi d fever . | Diphtheri a an d Crou p Measles . Diarrhe a and enteriti s 5 t o 9 Inclusive , August . 1914 Scarle t Mover . J Tota l Death s Reporte d fo r Septembe r 1914 . Septembe r 1913 , Pulmonar y Tuberculosis Cerebro-Spina l Fever , Tota l Death s Reporte d fo r Loba r an d Broncho - Tota l Death s Reporte d fo r Tota l Death s reporte d fo r Tota l Death s Reporte d fo r 65 Year s an d Over , Rat e fo r Yea 191 4 t o Death s i n Institutions . Rat e fo r Yea 191 3 t o Smallpox. External causes. State of Indiana Northern Counties.. Adams Allen...... Beaton,.. . . - Blackford . . Carroll. CMS. Dekalb 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 Southern Counties.. Clark Crawford...... Daviess Dearborn Dubois,,, Floyd., Gibson... , Greene Harrison Jackson...... Jefferson...... Jennings...... Knox.,...... Lawrence.... — Martin...... Ohio...... Orange ,...,,.,. Perry..,....,,,, Pike, ...... Posey....,.,.,.. Ripley...... Scott...... Spencer...... Sullivan...... Switzerland Vanderburgh Warrick...... Washington..,... Urban,,,, Rural,,... TABLE 2. Deaths in Indiana by Cities During the Month of September, 1914, (Stillbirths excluded,.)

Annual Death Rate Per 1.000 Population. Important Ages. Deaths from Important Causes,

cities. Estimated 1914 Date , August , 1914 . September , 1914 September 1913. th e Yea r 191 4 t o Date . Yea r 191 3 t o Sam e Date . unde r 1 Year . 1 t o 4 Inclusive , Tota l Death s Reporte d fu r 1 0 t o 4 Inclusive . 1 5 t o 19 Inclusive . _ Diphtheria an d Crou p August, 1914 . Septembe r 1913. ; Whoopin g Cough . Loba r an d Broncho - Pneumonia . j Diarrhe a an d enteriti s un de r 2 years) . j September , 1914 . 5 t o 9 Inclusive . Puerpera l Septicemia . Death s i n institutions. Tota l Death s Reporte d fo r Tota l Death s Reporte d 'fo r 65 Year s an d Over . j Externa l Causes . i Typhoi d Fever , Scarle t Fever . Smallpox . Cancer . | Rate fo r Yea 191 3 t o Rat e fo r Yea 191 4 t o same Date . ' Tota l Death s Reporte d fo r : Tota l Death s Reporte d fo r I Acut e Anterio r Polio-myelitis . J Measles , 1 Pulmonar y Tuberculosi s Othe r Form o f Tuberculosis { Influenza . [ death s of non residents . I Cities of the First Class. Population 100 000 and over 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 Gary Muncie Richmond Hammond . Anderson East Chicago . . - Lafayette .. • New Albany . - Elkhart Michigan City Cities of the Fourth Class. Population 10,000 to 20,000 Marion Logansport Kokomo. vincennes Mishawaka Peru laporte Elwood Huntington Jeffersonville . Shelbyville

New Castle Cities of the Fifth Class. Population under 10 000... .. Brazil Bloomington Bedford Frankfort.. Columbus . Goshen • • Wabash Connersville Washington • Whiting: Clinton . . valparaiso madison. Linton

Hartford City. Seymour Lebanon • Mt. Vernon Greensburg Kendallville Postland. Noblesville Bluffton, Alexandria Rushville martinsville

Franklin Aurora

Winchester Sullivan Garrett Boonville Tipton Auburn Mitchell Lawrenceburg Plymouth greencastle Columbia City Tell City , Attica ! Rochester • • ' Union city Jasonville

Bicknell Montpelier Angola Rockport Crown Point

Rensselaer . .

Monticello

Delphi Cannelton

Butler City

Vevay Mortality of Indiana for September, 1914. (Stillbirths excluded.)

Annual Death Rate Per 1,000 Important Ages.

Population BY Under 1. 1 to 4 5 to 9. 10to 14 . 15 to li. 65 and Over GEOGRAPHICAL SECTIONS AND Estimated. AS URBAN AMD rURAL. 191 4 t o Date , 191 3 to Sam e Date , Date . Sam e Dale . Pe r Cent . Number . Tota l Death s Reporte d fo r Yea Tota l Death s Reporte d fo r Yea Pe r Cent . Tota l Death s Reporte d for September , 1914 Tota l Death s Reporte d fo r August , Tota l Death s Reporte d fo r September , 1913 . September , 1914 August , 1914 Pe r Cent . Number . Pe r Cent , Pe r Cent , Pe r Cent . Number . Rat e fo r Yea 191 4 t o Rat e fo r Yea 1913 t o September, 1913 . Number . Number . Number , Stele.. 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,

Deaths and Annual Death Rates Per 100,000 Population from Important Causes.

Lobar Diarrhoea Pulmonary Other Diph­ Whoop­ and and Cerebro- Acute Puer­ POPULATION BY Tuberculosis. Forms Typhoid theria Scarlet Anterior Measles. ing Broncho- Enteritis Spinal Polio- Influ­ peral Cancer. External Small­ GEOGRAPHICAL TuberculoisFever , and Fever. Cough. Pneu­ Under Fever. enza. Septi­ Causes. pox. SECTIONS AND Croup, monia. 2 Years.) myelitis. cemia. AS URBAN AND RURAL. Deat h Rate . Deat h Rate . Deat h Rate , Deat h Rate . Number . Deat h Rate . Number . Number . Number . Deat h Rate . Number , Number . Deat h Rate . Deat h Rate . Deat h Rate . Number . Deat h Rate . Number . Deat h Rate . Deat h Rate . Number . Deat h Rate . Number . Deat h Rate . Number . Number . Number . Deat h Rate . Number . Deat h Rate . Number . Number . State....,,,,,,...,. 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 September, 1914.

J. H. ARMINGTON, SECTION DIRECTOR, INDIANAPOLIS, IND.

TEMPERATURE in DEGREES FAHRENHEIT.

Extremes, Departure Section form the average normal. Station. Highest Date, Station. Lowest. : Dais.

Hammond. Collegeville

PRECIPITATION IN INCHES AND HUNDREDTHS.

Extremes. Departure from the Section averagenormal . Greatest Least Station, monthly Station. monthly amount. amount.

Decker Connersville..

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