MISSISSIPPI VALLEY CONFERENCE ON TUBERCULOSIS

LOUISVILLE, OCT. 4f 5, 6, 1916. MONTHLY BULLETIN Indiana State Board of health

(Entered as second-class matter at the Indianapolis Postoffice)

VOLUME XIX INDIANAPOLIS, JUNE, 1916 ' Number 6 JAMES S. BOYERS. M. D.. PRESIDENT. , Decatur ABSTRACT OF MORTALITY STATISTICS H. H. SUTTON, M. D. VICE-PRESIDENT Aurora J. L. FREELAND. M. D .... .Indianapolis FOR JUNE, 1916. CHAS. BRUCE KERN, M, D.. . , . . . Lafayette J. N. HURTY, M. D., Phar. D. SECRETARY...... Indianapolis Total deaths reported 2,494; state rate 10.6. In the pre­ ceding month 2.925 deaths; rate 12.0. In the same month WM. F. KING. M. D...... , . . ASST. SECRETARY H. H. MITCHELL, M, D.,. .EPIDEMIOLOGIST last year 2,360 deaths; rate 10.1. Deaths by important ages J. L. AN DKRSON ...... CHIEF CLERK were: Under 1 year of age, 299 or 11.9 per cent of total; 1 CHAS. A. CARTER. M. D, STATISTICIAN WM. SHIMER, A. B.. M.D...SUPT. BACTERIOLOGICAL LABORATORY to 4, 120; 5 to 9, 47; 10 to 14, 43; 15 to 19, 75; 65 and over, ADA E. SCHWEITZER. M. D .ASSISTANT BACTERIOLOGIST R. J. ANDERSON. M. D •. . ASSISTANT PATHOLOGIST 864 or 34.6 per cent, of total. H. E. BARNARD. R. S., STATE FOOD AND DRUG COM'R AND CHEMIST SANITARY SECTIONS: The Northern Sanitary Sec­ . E. BISHOP. B. S...... ASSISTANT CHEMIST HJOHN C DIGGS ...... -,-. ..ENGINEER AND WATER CHEMIST tion, population 998,000 reports 903 deaths; rate 11.0. In WILL D. McABEE. . . , Duties CHEMIST the preceding month 1,032 deaths; rate 12.2. In the same The Monthly BULLETIN will be sent to all health officers month last year 820 deaths; rate 10.1. and deputies in the State, Health officers and deputies should carefully read and file each copy for future reference. This is The Central Sanitary Section, population 1,178,368 reports very important, for we expect to print instructions rules and general information, which it will be necessary for officers to 1,034 deaths; rate 10,7. In the preceding month 1,268 deaths; preserve. rate 12.7. In the same month last year 1,034 deaths; rate 10.7. CONTENTS Births for June, 1916. 61 The Southern Sanitary Section, population 684,552 reports Abstract of Mortality Statistics for June, 1916. 81 557 deaths; rate 9.9. In the preceding month 625 deaths; Summary of Morbidity and Mortality for June, 1916. 61 Health Officers Attention. 62 rate 10.7. In the same month last year 506 deaths; rate 9.0. The Mississippi Valley Conference on Tuberculosis. 02 Report of the Department of Food and Drugs for June. 63 REVIEW OF SECTIONS: The Northern Sanitary Sec­ Inspectors Report for the Month of June. 63 tion presents the highest death rate, which is 1.6 higher than Progress in Medical Examination 63 Report of Bacteriological Laboratory for June...... 64 that for the entire state, The Northern Section also pre­ Patients Who Have Finished Pasteur Treatment, June...... 65 Miss Pauline Roe. 65 sents the highest, death rate for typhoid fever, lobar and Better Bodies Needed 65 broncho pneumonia, 'cancer and external causes. The Cen­ A Rural Health Officer 65 Hurrah for Bluffton. 65 tral Section presents the highest death rate for scarlet fever, Rural Children , 65 Vitamines. 65 measles, cerebro-spinal fever, influenza and puerperal septi­ The Baby Was Uncomfortable 66 cemia. The Southern Section presents the highest death Dr. Henry E. Vitou.. 66 Report of Committee on Legislation and Physicians Welfare of rate for tuberculosis, diphtheria, whooping cough and diarrhea the Indiana Medical Association 6§ and enteritis. A Municipal Housing Survey. 66 A Pathetic Incident. 66 RURAL: Population 1,552,380 reports 1,189deaths; rate Courses in Public Health 67 Without a Health Officer 67 9.3. In the preceding month 1,402 deaths; rate 10.6. In the The Importance of Legal Registration of Births...... 67 Eugene Norman. 67 same month last year 1,140 deaths; rate 8.8. Sweep Away all Wealth. 68 URBAN: Population 1,308,540 reports 1,305 deaths; rate Wayne Richard Replogle. 68 James Joseph Pagan. 68 12J. In the preceding month 1,523 deaths; rate 13.7. In Baby Explains. 68 Without. Dietary Measures. 68 the same month last year 1,220 deaths; rate 11.6. The,cities Concerning Drugs, Dr. Osier Says. 6S named present the following death rates: Indianapolis, 13.6; Common Drinking Cups 68 Chart Showing Geographical Distribution of Deaths...... 69 Evansville, 12.0; Fort Wayne, 11.9; Terre Haute, 9,3; South Table 1. Deaths in Indiana by Counties...... 70 Bend, 11.2; Gary, 15,5; East Chicago, 11.3; Muncie, 13.8; Table 2 Deaths in Indiana by Cities 71 Mortality in Indiana. . 72 Hammond, 17.9; Richmond, 10.5; Anderson, 14.4; Elkhart, Weather Report for June, ,^.^ ._. .._._._._...... 72 12.0; Michigan City, 6.3; Lafayette, 14.4; New Albany, 11.2; BIRTHS FOR JUNE, 1916. Logansport, 12.5; Marion, 13.7; Kokomo, 11.4. Total births 4,778 (stillbirths excluded); state rate 20.4. Males 2,444; females 2,334. White males 2,397; white females 2,295. SUMMARY OF MORBIDITY AND MORTALITY Colored births 86; males 47, females 39, FOR JUNE, 1916, Stillbirths 154; white 152t colored 2, Measles was again reported as the most prevalent infectious The Northern Sanitary Section, population 998,000 reports disease. The order of prevalence was as follows: Measles, 1,863 births; rate 22.7. pulmonary- tuberculosis, tonsillitis, typhoid fever, acute rheu­ The Central Sanitary Section, population 1,178,368 reports matism, diarrhea and enteritis, scarlet fever, whooping cough, 1,843 births; rate 19.0. diphtheria and croup, acute bronchitis, dysentery, smallpox The Southern Sanitary Section, population 684,552 reports cholera morbus, malaria fever, influenza, chickenpox, inter­ 1,072 births; rate 19.1. mittent and remittent fever, bronchial pneumonia, lobar The highest rate. Lake County, 34.5. pneumonia other forms of tuberculosis, rabies in human, The lowest rate, Union County 7.7. erysipelas, puerperal fever, rabies in animals, cerebro-spinal, Total births to date for 1916, 32,087. fever, poliomyelitis, trachoma. 62 MONTHLY BULLETIN, INDIANA STATE BOArD OF HEALTH.

SMALLPOX: 102 cases reported in 21 counties with no report for June the following counties named below were deaths. The following counties reported smallpox present : delinquent in this matter. Dekalb 2, Delaware 4, Hancock 6. Henry 2, Howard 3, John­ son 3, Lake 2. Madison 2, Marion 1, Miami 10, Parke 12, St. Joseph 8, Vanderburg 2, Vermillion 4, Vigo 2, Wabash 2. TUBERCULOSIS: 323 deaths, of which 270 were of the BIRTHS, pulmonary form and 53 other forms. Male tuberculosis, deaths numbered 155: females 168. Of the males. 23 were Adams 1; Allen 10 (Ft. Wayne 4-1 for October, 1915): married in the age period 18 to 40 and left 46 orphans under Bartholomew 6 (Columbus 2); Benton 1, for September, 1915; 12 years of age. Of the females, 60 were married in the same Boone 13 (Lebanon 6. Thorntown I): Brown 1; Carroll 2: age period as above and left 120 orphans under 12 years of Cass 2 (Logansport); Clark 2; Clinton 1; Crawford 1: Dear­ age. Total orphans made in one month by this preventable born 1: Dekalb 1; Delaware 8 (Muncie 6, Gaston 1); Elkhart disease. 160. Number of homes invaded, 310, 2 (City); Floyd 5 (New Albany 2); Franklin 2; Gibson 2; PNEUMONIA: 99 deaths, rate 42.3 per 100,000. In the Grant 12 (Marion 4, Van Buren 1. Fowlerton 1, Gas City 1, preceding: month 206 deaths, rate 85.0. In the same month for September, 1915); Greene 3-1, for August, 1 for October, last year 88 deaths, rate 37.9, 1915 (Lyons 1, for October, 1915); Hamilton 1; Harrison 1; TYPHOID FEVER: 135 cases in 33 counties with 17 Hendricks 1, for July, 1915; Henry 4 (New Castle 2, Kennard deaths. In the preceding month 111 cases in 23 counties 1); Howard 1; Jackson I; Jasper 5 (Wheatfield 1); Jay 2 with 27 deaths, In the same month last, year 70 eases in 28 (Portland 1, for October, 1915); Jefferson 3 (Madison); Knox counties with 17 deaths, 14 (Vincennes 8, Bicknell 1); Kosciusko 2; Lake 6 (Gary 3, DIPHTHERIA: 99 cases in 27 counties with 10 deaths. Hammond 3-1, for October. 1915); Madison 4 (Elwood 2, In the preceding month 106 cases in 30 counties with 9 deaths. Anderson L for May, 1915); Marion 2; Marshall 1 (Plymouth) In the same month last year 71 eases in 22 counties with 11 Martin 3; Miami 2 (Peru 1): Monroe 3; Montgomery 3, for deaths, September, 1915, (Waynetown I, New Market 1); Morgan 1: SCARLET FEVER: 140 cases in 28 counties with 4 Newton 3 (Brook 1, Mt. Ayr 1); Noble 1; Orange 2 (West deaths. In the preceding month 219 cases in 40 counties Baden 1); Parke 2-1, for July. 1915; Perry 1; Porter 3; Posey with 7 deaths. In the same month last year 136 cases in 34 5 (Cynthiana 2); Pulaski 3-1 for August, 1912, 1 for January, counties with 1 death. 1914 (Winamac 1); Randolph 1 (Lynn); Ripley 2; Rush 3; MEASLES: 4,044 cases in 60 counties with 27 deaths. Scott 2; Shelby 3-1, for August, 1915 (Shelbyville 2); Spencer In the preceding month 5,035 cases in 72 counties with 37 9 (Dale 2); Starke 2, (Knox 1); Steuben 2; St. Joseph 3 deaths. In the same month last year 879 cases in 37 counties (South Bend 2-1. for November, 1915) Sullivan 1 (Farmers- with 8 deaths. burg); Switzerland 2; Tippecanoe 3-1, for June, 1915; (La­ POLIOMYELITIS: 1 case in one county with no deaths. fayette 1); Vanderburgh 14 (Evansville); Vermillion 3 (Clin­ The case occurred in Vanderburg county. ton 1, Universal 1); Vigo 3-1, for January, 2 for October, 1915; RABIES: II persons bitten by rabid animals and treated Wabash 4; Warrick 5-1, for March, 1913 (Boonville 1); by the State Board of Health during the month of June Washington 3 (Salem 1); Wayne 4 (Richmond 1. Spring There were no deaths, Grove 2); Wells 1 (Bluffton); White .1 (Wolcott); Whitley 5-1,

EXTERNAL CAUSES: Total 245, males 179? females for August, 1915; Total 233. 66. Suicide: Total 36, males 24, females 12. Suicide by poison 12, by hanging or strangulation 8, by drowning 1, by firearms 13. by cutting or piercing instruments 2. Accidental or undefined; Total 198, males 146. females 52, Poisoning DEATHS. by food 6, other acute poisonings 5, burns (conflagration Adams 2; Allen 6 (New Haven 2); Benton 1; Car­ excepted) 7, absorption of deleterious gases (conflagration roll 1; Clay 1; Daviess 1; Decatur 2 Greensburg);

excepted) 7, accidental drowning 20? traumatism by fire­ Delaware 1 (Gaston); Gibson 1 (Princeton); Grant 3; Greene 3 arms 5j traumatism by cutting or piercing instruments 3. (Lyons 1); Hancock 1; Henry 4,1 for February Middletown traumatism by fall 39, traumatism in mines 2, traumatism 1); Huntington 3 Markle 1); Jackson 3 Crothersvilie 1); by machines 2, railroad accidents and injuries 33, street-car Jasper 2 (Remington 1); Knox 3 Vincennes 1); Kosciusko 2; accidents and injuries 5. automobile accidents and injuries Lagrange 1; Lake 3 (Hammond 2); Laporte 1; Madison 1

18. bicycle accidents and injuries lt motorcycle accidents (Alexandria); Marion 1 (Indianapolis); Miama 1 (Macy); and injuries 2, injuries by other vehicles 7, injuries by Monroe 1; Newton 1; Owen 1; Parke 1; Pike 1; Posey 3 animals 7, effects of heat 5. lightning 4. electricity (Cynthiana 1); Ripley 1; Rush 1; Spencer 6; Warrick 1 (lightning excepted) 7. fractures (cause not specified) 3, (Lynnville for November, 1915); Washington 1 (Livonia); other external violence 10, Homicide: Total 11, males 9, Wells 3 (Bluffton 1); Whitley 1; Total 70. females 2. Homicide by firearms 8. by cutting or piercing (A typographical error in April bulletin charged Jennings instruments 1, by other means 2. County with 10 delayed death certificates. There was 1 (Three external causes not received in time to be used in delay from this county.) general tabulation.)

HEALTH OFFICERS, ATTENTION. THE MISSISSIPPI VALLEY CONFERENCE ON TUBERCULOSIS willmeet In Louisville, October 4, 5, and 6, Delayed Birth and Death Certificates, Every person interested in the conquest of consumption and Each month the statistical department receives certificates who can possibly do so, should attend this conference. We for births and deaths that have occurred during the preceding urge all health officers who possibly can do m to make a pil­ months, which are not sent to this department in time to be grimage October 4, 5, and 6 to Louisville and join in the con­ tabula-ted with the report for the current month. With the ference on tuberculosis. MONTHLY BULLETIN, INDIANA STATE, BOARD OF HEALTH. 63

REPORT OF THE DEPARTMENT OF FOOD AND INSPECTOR'S REPORT FOB THE MONTH OF JUNE, 1918 DRUGS, INDIANA STATE BOARD OF HEALTH, No. No. No. No. No. No. FOR JUNE, 1916. Inspections Inspec­ Excel­ Good Fair Poor Bad tion lent

Grocery stores...... Meat markets. Drugstores... Bakeries and confectioneries,. H. E. Barnard, Ph.D., State Food and Drug CommisioneHotelr s and restaurants Milk plants... Poultry houses...... During the month of June 106 samples of food were ana­ Totals. lyzed of which 76 were reported as legal and 30 illegal. Of the 66 samples of milk examined 19 were illegal. Several of these NOTICES OF CONDEMNATION DURING THE MONTH OF samples were watered or skimmed and a number were grossly JUNE 1916. contaminated with dirt. Four of the 17 samples of ice cream contained less than the Reasons for Condemna­ Classification. Unsanitary tion Improper Total required eight per cent, of butter fat. Conditions. Construction It is to be noted that only samples suspected of adulteration are collected and sent in for analysis and the high percentage Bakeries Bakery and restaurants. . of adulteration indicated by the chemist's work is in no sense Cafes evidence that the general food supply is unsatisfactory. On Confectioneries...... Confectionery and lunch the contrary it is excellent. rooms. Creameries Twenty-nine samples of drugs were analyzed during the Dairies...... month but one of which, spirits of camphor, was listed as Hotels Groceries. illegal. Grocery and meat markets Meat markets...... Restaur\ants...... Slaughterhouses...... REPORT OF ANALYSIS OF FOODS AND DRUGS DURING THE MONTH OF JUNE, 1916. Totals. . .

CLAssifcaTION. Legal* Illegal.

FOOD. PROGRESS IN MEDICAL EXAMINATION. Beverages— Beer Cider Rapid progress is being made in providing certificates of Flour, . . . Meat Products— good health to all handlers of food. In many cities and Hamburger . . Lard towns the health officers have completed their work and for Preservative the present at least, those who hold certificates are known to Milk Products— Butter. be in good health. Buttermilk, Cream Many complications are arising in the enforcement of the Ice Cream law. This was to be expected. The law is unique and its Milk, Tomato Catsup- . . . . - operation is naturally hindered by lack of knowledge, ignor­ Vinegar,. ance on the part of employer and employees and the half­ Totals hearted co-operation of health officers. DRUGS. In some cities the Health Departments have been very Camphor. Spirits of. ... active in enforcing the order of the State Board of Health. Golden Sea 3. Novocain Tablets. In the city of Logansport for example, Dr. R. E. Troutman, Peanut Oil Miscellaneous Secretary of the Board of Health, issued a notice to all em­ ployees of labor engaged in the production and distribution of Totals...... food. The order read in part as follows: "You are hereby requested to comply with the above order of the State Board of Health. Inspections will be made from INSPECTOR'S REPORT FOR THE MONTH OF time to time and certificates must be shown at such inspec­ JUNE, 1916. tions. Any employee not having such certificate will be at once dismissed and the law enforced." The inspector's report for the month of June shows a total This is effective co-operation and is bound to produce good of 746 visits to food establishments. Three hundred and results. It is apparent that in some instances medical inspec­ sixteen of the places visited were listed as good, 423 fair and tion blanks are being filled out without special attention being 7 poor. This report does not include the work done by given to the inspection. In one instance a physician certified Inspector Bruner who is engaged in making a complete sani­ that forty persons were free from contagious and infectious tary survey of the creameries and ice cream plants of the disease in a single day. It is obviously impossible for any state. physician who is conscientious in his work to make forty Twenty-three condemnation notices were issued during the examinations of the character required in a single day. month, 21 because of unsanitary conditions and 12 because The co-operation of all physicians is necessary to the of improper construction. proper working out- of the law, In the event that such co­ But one prosecution was reported, Ackerman and Wiener operation cannot be secured and that the certificates are of Fort Wayne, Indiana, were fined S24 and costs for selling issued without a rigid examination it may become necessary short weight potatoes. The evidence shows that the defen­ to require, as has always been the case in New York City, dant delivered 571 bushels of potatoes of 600 as alleged. that the certificate be issued by the Health Department. 64 MONTHLY Bulletin, Indiana STATE BOArD OF HEALTH.

REPORT OF BACTERIOLOGICAL LABORATORY, Male- INDIANA STATE BOARD OF HEALTH, Positive FOR JUNE, 1916. Suspicious Negative Will Shimer, M.D., Superintendent Sex not given— Positive. . Sputum for tubercle bacilli— Suspicious .,.....'...... Positive . . Negative Negative

Urine For tubercle bacilli -- Pathological tissues •- Suspicious Carcinoma— Negative Carcinoma of nose...... Carcinoma of lip Pus for tubercule bacilli Carcinoma of breast. Negative Carcinoma of uterus Carcinoma of rectum Spinal fluid for tubercle bacilli— Carcinoma, location not given...... Negative Sarcoma— Sarcoma of jaw ...'...... Feces for tubercle bacilli - Miscellaneous tissues...... Negative

Blood for tubercle bacilli — Urine for chemical analysis. Negative. Feces for hookworm- Milk for tubercle bacilli — Negative Negative. , Feces for amoeba dysentery— Vomitus for tubercle bacilli — Negative Negative . . Feces for typhoid bacilli— Widal tests for typhoid fever— Negative Positive Negative...... Feces for colon bacilli—

Paratyphoid tests for typhoid fever— Positive Positive. Negative Worm for identification

Throat cultures for diphtheria bacilli- Blood for malaria Plasmodia— Positive Positive...... Negative.. . Negative...... No growth

Brains for rabies- Total number specimens examined Dogs— Positive...... Doses of antityphoid prepared and sent out., Rotten Negative. Cats— Guinea pigs inoculated for rabies- Positive Negative. Cows— Guinea pigs inoculated for tubercle bacilli- Positive...... Negative. Hogs-— Positive...... Mules— OUTFITS PREPARED AND SENT OUT DURING Negative...... JUNE, 1910.

Tuberculosis,.. Blood for counts...... Diphtheria.. , . Widals...... Pus for gonococci— Blood counts.. Females-— Gonococci Positive...... Malaria...... Suspicious. Negative. Total number outfits prepared and sent out... MONTHLY BULLETIN, INDIANA STATE BOArD OF HEALTH, 65

PATIENTS WHO HAVE FINISHED PASTEUR" TREATMENT. JUNE, 1916 closets and other sanitary matters are subjects of genera

Treat­ Treat­ regulation and a general system of education should be car­ Name Town County Age Sex ment ment ried on in regard to all such matters. Farmers generally began finished think what was good enough for their father is good enough

Mr. H. H. Willis.. Eberfield.... Warrick.., for them, In consequence they frequently oppose the Mrs. M. Elliott... Muncie. Delaware. health officer in everything that is not absolutely necessary Arthur Elliott Muncie Delaware. Carlton Elliott..,. Muncie Delaware. and then even ridicule the advice of physicians whom they Thomas Smith Gas City .... Grant Frenier Glidewell. Haughville. Marion... have called to attend their sick," Dr. Cope is emphatic in Mr. T. 0. Myers.. Haughville... Marion.,, his contention that the rural district's needs in every state Mr. E. T. Smith.. London Shelby.... Miss B. Chapman. Indianapolis. Marion... are for health officers skilled in the work, thoroughly trained Mrs, M, Kissick., Indianapolis. Marion... Miss K. Kissick ,. Indianapolis. Marion.., in hygiene and sanitary science and giving their whole time. Dr. J. C. Boone of Charleston, Mo., heartily seconded the contention of Dr. Cope. MISS PAULINE ROE, desiring to go to Japan to fill a lucrative position writes the State Board of Health as fol­ HURRAH FOR BLUFFTON! The mayor and city lows: "I was born March 23, 1888, and desire to have a council, and citizens of Bluffton seem to have the right stuff transcript of the certificate of birth. I want this to secure a in them. Very probably many of them are of the kind who passport, also to identify my nationality in Japan where 1 go would dress up like Indians and board a ship and throw tea to engage in the work of teaching." The parents of Miss overboard. These remarks are prompted by the fact that Hoe and attending physician did not realize that some day the Bluffton city council recently authorized the city clerk she would desire greatly to have legal evidence of her birth and city treasurer to continue the payment of S200 per year and therefore no certificate of birth was made. How simple to the city health officer, Dr. C. H. Mead, the council to it would have been for the attending physician to have taken assume the responsibility. This was necessary because it was three minutes time and made out a birth certificate. A found that under the law as interpreted by the accounting transcript of this certificate would be legal evidence of her board it was lawful to pay only $100 per year. Dr, Mead birth and nationality. There is nothing more important to resigned when Ms salary was reduced according to the ruling a child than to have its birth legally recorded. of the accounting board, but following the action of the city council, he continues in office Mayor Mock emphatically states there is no question but the city receives full value for BETTER BODIES NEEDED. the money paid the health officer, and continuing he says: It would appear that the old injunction to "crucify the "The issue between the city and the accounting board re­ flesh" had been taken entirely too literally by a large number solves itself into the question whether or not the city shall be of the American people, with the result that all kinds of de­ permitted to pay enough salary or secure the services of a fects are found in the physical makeup of the folks who have competent health officer and protect Itself against disease," presented themselves for service In. the military army of the If Indiana has a health law which aids and abets disease, it national defense. should be abolished and this is exactly what the law does in An exchange states that at least 80 per cent of the people more than one of its features. Until we have all-time health who present themselves for enlistment are physically unfit, officers, properly paid and properly empowered, there will among the defects being narrow chests, flat feet, poor teeth, be no further reduction in morbidity and mortality rates in hammer toes, heart trouble, weak eyes, defective kidneys and Indiana. stomachs that are not In condition to master the army fare. The fact develops that no phase of national preparedness should be more assiduously urged than the making of the RURAL CHILDREN, and the children of smaller cities manhood of America physically fit. Gymnasiums should be and towns are more defective physically than those in the established in every community. Outdoor sports and pas­ great cities and this is due to the fact that the cities have for times should be encouraged under proper instructors. Sys­ the past 15 to 20 years spent much time in medical supervision tematic physical exercise should be urged. Moderation. In of school children and also because the larger cities have given food and drink should be taught. The burning of life's can­ greater attention to hygiene This is a quotation from Dr. dle at both ends which seems to be verging toward a settled F. M. Hollingshead in the Lancet Clinic of July 8, 1916. system should be inveighed against and the Idea impressed upon the young manhood and womanhood of the country that they are not altogether their own, but that the life of their country depends upon the proper care of themselves.— VITAMINES. Logansport Pharos-Reporter. Vitamines are found in all real foods, Real foods give nourishment and strength. The word vitamines means, life ammonias. They are ammonia compounds and may A RURAL HEALTH OFFICER giving his whole time to be said to give life to foods, Rice, one of our best known foods the work is recommended by Dr. Q. Cope of Lexington, Mo. is wholesome and nourishing, but if we remove its faintly Dr. Cope says: "The sanitation, of the rural districts is brown coat by polishing, it becomes actually poisonous. generally bad. It has never had proper supervision and little Pigeons or chickens fed on polished rice quickly develop or no advice from medical authority. Rural schools, mining paralysis and die, but they grow well and strong if the polishings are given to them. The reason is, the life giving vitam­ camps, unincorporated villages and suburbs of cities are all ines are In the coatings of the grains. Whole unpolished rim too frequently in a. deplorable sanitary condition and there grains, will support life in birds and people, but when polished, Is no one In authority to correct this state of affairs or give they lose their food value. Until lately, polished rice was relief. The water supply, the disposal of dead animals, pro­ sold at all groceries, but now the health authorities forbid Its tection against flies, mosquitoes, proper construction of 66 MONTHLY BULLETIN, INDIANA STATE BOArD of HEALTH sale. It was polished by tradesmen to make it white and I issued four orders to improve very bad sanitary conditions pearl like in appearance. Natural rice is not as pretty as The report shows that Dr. Vitou did a good work. He is polished rice, but "pretty is that pretty does" and so we have letting the people of his county know there is such an official gone back to the natural grain. A disease called beriberi as a county health commissioner, and that he is a valuable which is frequently fatal, is caused by eating foods in which commissioner. There are other county health commissioners the vitamines have been destroyed by over-cooking or re­ who have done likewise but they are all too few. There are moved as in the instance of polished rice. Another disease many counties wherein the people hardly know they have called pellagra which frequently ends in insanity and death such a thing as a health officer. is also produced by eating devitamined foods. It is found that soda kills vitamines and therefore we must not put soda in our foods. Corn bread if cooked with bicarbonate of soda REPORT OF COMMITTEE ON LEGISLATION AND to make it light, has its food value destroyed, If, however, PHYSICIANS WELFARE OF THE INDIANA the corn meal and soda are made into a dough with sour milk MEDICAL ASSOCIATION. instead of water or sweet milk, then the vitamines are not killed. This is because the lactic acid in the sour milk neu­ The committee appointed on Legislation and Physicains tralizes the bicarbonate and makes lactate of soda which Welfare, wish to make the following report. does not attack vitamines. At the same time the lactate We would recommend that the State Narcotic Law, be acid liberates the carbon dioxide gas and it makes the corn repealed and made to conform to the Harrison Narcotic Law, bread light and more wholesome. Biscuits made light with bi­ It is rumored that the National Association of Druggists carbonate of soda (baking soda) and which always have a will endeavor to have a law passed at the coming legislature "soda taste,*' are very unwholesome, Bicarbonate of soda to compel physicians to write prescriptions for all patients r is frequently called simply "soda", but this is not soda as and not allow them to issue any medicine at the bedside, known to chemists for they apply this name to concentrated Such a law would be taking away the rights of the physician, lye. Cooks should not use bicarbonate of soda in cooking besides doing great harm to the public. We condemn such dried beans, dried corn, dried peas, and the like, even if it a law as unjust and uncalled for. does hasten the process. Our modern fine process white We would discourage the habit of druggists refilling pre­ flour, is not as wholesome and nourishing as so-called whole scriptions without the consent of the physician. Often a wheat flour because the high milling process takes out the whole neighborhood will benefit from a doctor's prescription vitamines. Canned goods have no vitamines, or at most only by having it refilled, without any compensation for the doctor. very small amounts. Nevertheless they are desirable foods, We condemn fee splitting as unjust and unprofessional but people who "live out of cans" make a great mistake. and no reputable physician should tolerate it. Everyone should eat some raw food or foods every day, at We recommend that no party or cult be allowed to practice every meal, if possible. All raw fruits and vegetables contain medicine in Indiana without first passing an examination vitamines. Salads are always wholesome, but they like all before an examining board, and that all shall be measured by foods should be eaten in moderation. "An apple a day keeps by the same stick. the doctor away," is an old saying and means eat plenty of We recommend that the Working Men's Compensation raw fruit. Law be so changed that the injured party may employ any physician to his liking, provided he is a licensed physician and in good standing in his community, and that the physi­ THE BABY WAS UNCOMFORTABLE, and no wonder, cian shall have the same fees that prevail in the locality where for it wore a hood and the day was hot and the smoke and the injury occurred, and that the company shall pay fulltime dust came into the train window in generous quantities. I hospital and medical fees instead of for thirty days only. suggested to the mother, who seemed intelligent, that her As people are demanding so much from the Boards of infant would be more comfortable and cease fretting if the Health over the state, and will demand more each year, and, hot hood was removed, and further 1 asked? why oppress the as a practicing physician cannot spare the time to look after helpless thing with a hood anyhow. She replied pleasantly, it, we urge the coming legislature to pass a law creating an "Oh, it'll only be an hour or two before we get off and I don't All Time Health Officer. want the trouble of taking off the hood and putting it on again." She was wholly unappreciative of her terrible selfish­ ness, and yet die doubtless would have willingly given her A MUNICIPAL HOUSING SURVEY has been started in life for the child. To the question why a hood in such hot South Bend. Mayor F. W. Kelly, and city health officer, Dr. weather, she replied, "Oh, she must have a hood Even if C. S. Bosenbury have both issued public statements concern­ it tortures the helpless child. I asked. She hesitated, then ing the importance and benefits to be derived from a thorough said, "Well oh, ah, she must have a hood." So the helpless survey of houses. Many business men are interested and the innocent, continued to suffer. Infant mortality will decrease newspapers have taken up the work. Of course public when mothers care for their offspring with more intelligence opinion, under such an impetus will soon be aroused and then and higher reason. South Bend will go onward and upward. The improvement of the homes of the poor, and the abolishment of slums will be very helpful towards securing more morality, a higher de­ DR. HENRY E. VITOU, who is county health com­ gree of honesty, and an improvement in public health, missioner of St. Joseph County, recently made a sanitary survey of nine townships. He found not a few dirty, filthy farms and ordered them cleaned up. He says in this connec­ A PATHETIC INCIDENT occurred in one of the Indian­ tion; 'T find the farmers are taking more pride in their apolis Schools when a six: year old boy who was near-sighted places than formerly yet it was necessary to order a few to made a pair of spectacles for himself, The health super­ clean up and some to drain their ponds, and improve unsani­ visor found the boy was near-sighted and sent a letter to the tary conditions around their houses. At the town of Lakeville parents directing that the chid be taken to an occulist and MONTHLY BULLETIN, INDIANA STATE BOArD OF HEALTH. m supplied with glasses. Days passed and the youth continued proven by a thesis. The certificate in Public Health is to appear without glasses. Another note was sent to the granted to those students who during the school year from parents and the boy interrogated as to why his eyes were not September until the following June pursue at their home cer­ looked alter. It was finally learned the parents took no tain reading and study courses which are conducted by corres­ interest in their child. At least they took no action for the pondence through the Extension Division of the University. care of his eyes. Finally the ingenious youth realizing his Then the student attends the summer session of the Universi­ need and his parents inability to care for him, secured some ty for six weeks during which time he takes his examinations wire and made a frame. Then taking a milk bottle he broke upon work studied in absentia and pursues certain library off pieces and fitted them in the frame. There was a great courses. This process is repeated for four years and upon the surprise when he appeared in the school with the glasses but successful completion of the course, the University grants a the little fellow contended they helped his eye-sight. This Certificate in Public Health This bulletin of the Univer­ effort to help himself brought him a good pair of glasses from sity of Colorado is another proof of a demand that the public the Health Department. This is not the first instance where health officer shall be a trained man, thoroughly informed in parents have refused or failed to take proper care of their the work he is called upon to do. children.

"WITHOUT A HEALTH OFFICER WHO IS CON­ A sick person, no matter how the sickness was acquired, STANTLY SERVING THE PUBLIC AS HIS ONE AND is a pitiful sight. He does not add to the gayety of the ONLY BUSINESS, THE HEALTH OF THE LOCAL nations. COMMUNITY WILL SURELY BE NEGLECTED." Individuals have their origin in a physiologic process. This sentence occurs in a pamphlet entitled Tuberculosis We cannot lift the race by perpetuating the unfit. Legislation in the United States, Compiled by the National Only through eugenics can the race advance. Association for the Study and Prevention of Tuberculosis. Saving the unfit will not make a strong people. The all-time health officer will come in Indiana just as soon Education is to man what manure is to plants. as Indiana catches up with the public health procession. Permanent progress is a matter of ancestry.

THE IMPORTANCE OF LEGAL REGISTRATION OF "COURSES IN PUBLIC HEALTH" is the title of Bulle­ BIRTHS is well illustrated by the Indian boy who was born tin No. 9 of the University of Colorado. This institution is on the Colville Reservation, Washington, at 11 P. M. on prepared to give the following degrees upon completion of the April 30. If the record had not shown that he was born at various courses of study prescribed: this hour, he would have lost a nice farm of 160 acres of land. Doctor of Public Health President Wilson signed a proclamation throwing open for Master of Science in Public Health settlement by homesteaders the Colville reservation of Master of Science in Sanitary Engineering 350,000 acres of land. The proclamation provided there Certificate in Public Health. should be reserved a quarter of section for each Indian child The requirements for admission are: Graduate of the born before May 1. The Indian baby arrived at 11 o'clock University of Colorado; graduate of any college or scientific P. M. April 30. He is therefore richer by 160 acres of land school of equal rank with the University of Colorado, A than he would have been if his arrival had been delayed a few student from any institution must submit his credits to the hours and it is important to know that a legal certificate of Registrar for evaluation. A graduate student who wishes birth from the attending physician is necessary to secure this to become a candidate for a degree must make special appli­ land to the child, Now suppose the attending physician, cation. Students who are not candidates for a degree but like many Indiana physicians, neglects to report the birth. who desire to pursue courses of studies along public health What a great wrong would be done to the innocent child. lines will be admitted to the University as Special Students of the Department of Preventive Medicine, These students upon the completion of their courses of study will be given a certificate stating the nature and extent of the work com­ EUGENE NORMAN lives at Hope, Indiana. He is, a pleted. The bulletin says "A student who has a degree M. D. grandson to Senator E. A. Norman. The little fellow was will come with certain requisite knowledge and should be able given a penny and gleefully ran to the grocery store to buy to fulfill the conditions for the degree Master of Science in some candy. He was sold a candy egg which contained a Public Health in one year, A student who has little or no small marble, the candy being coated upon the marble, He medical knowledge must of necessity take certain medical swallowed the marble and in consequence suffered terribly. courses before the degree can be conferred. Candidates for All efforts for sometime failed to expel the foreign body but the degree Doctor of Public Health must possess a baccalaur­ finally success was secured. At one time it was thought eate degree from an. institution of recognized standing. The necessary to perform a surgical operation for his relief degree M. D. while not absolutely essential is advisable. Cheap candies are to be regarded as unwholesome and dan­ Certain studies with the degree Master of Science in Engi­ gerous. There should be a law forbidding the manufacture neering and others with the degree B. A. whose work has been and sale of candies which might in any way threaten accidents largely in chemistry and biology will be admitted to candi­ to children. In this connection it would be proper to state dacy A minimum of two full years of graduate study of that too much candy is eaten by children, in these days, The public health problems and demonstration the equivalent of cheap candies at the corner grocery near the schoolhouse cer­ not less than 60 semester hours together with a thesis based tainly raise havoc with the stomachs of the children. The upon original investigation are required for the degree of State Board of Health has testimony from good physicians to Doctor of Public Health. The degree will only be given for the effect that indigestion, gastro-enteritis and other dis­ high attainment in general and marked ability in a special turbances of the intestinal track have frequently been caused field including particular power in original investigation as among children by the eating of cheap grocery candies. 68 MONTHLY BULLETIN, INDIANA STATE BOARD OF HEALTH,.

SWEEP AWAY ALL WEALTH and if the virility of our Oh my, 'twas hard to give it up* whatever should I do? people remains, they will reproduce it, but if our health is They wouldn't let me suck my thumb for that was harmful destroyed and the wealth remains, it would soon crumble too away. A wealthy nation is necessarily a healthy nation. But now the worst is over and I can hardly wait Let ill health, sickness and disease prevail in a certain degree To see about the contour and if my teeth come straight. in any nation, and it will be lost. All of these truths are self- When I get big and see a child who has a pacifier evident yet legislators, and business men are not greatly in­ I'll hunt the mother up and do my duty by her terested in health, the fundamental basis of life, as they I'll tell her all 'bout contour, and spoiling baby's mouth should be. And all the things the doctor said, when we were going South. But how many babies* mothers I can never see Can't some one help me and tell them how careful they should be WAYNE RICHARD REPROGLE, whose picture is Wish every child who sucks his thumb, or has a pacifier, printed on this page was born in Kokomo, December 2, 1915. Could meet a nice good doctor-man, like I did on the Flyer, His mother writes us he weighed seven pounds at birth. She "YOUR HEALTH Cleveland, 0. also informs us "he has never been sick a minute and has never been rocked nor been fed a drop of anything but moth­ ers' milk. He has never slept with his parents but has always slept in his own little bed, he takes his naps in the day time on, the front porch. I give him plenty of sunshine and fresh WITHOUT DIETARY MEASURES all remedies fail air." Wayne Richard Reprogle's picture as here printed, This is the utterance of Roussel and is certainly true. Further, was taken when he was four months old. He then weighed this eminent physician says: ''When drugs and good food are 19-J pounds. Mrs. Reprogle says "I am delighted with 7 simultaneously employed it is to the latter the curative action the Indiana Mothers Baby Book and follow its directions in results. The former exercises simply adjuvant action and is every particular. without proved efficacy except against secondary agents or external complications." In support of this we have long known that scurvy is a dietary disease and needs no medicine. All that is required is a properly balanced diet containing fruits and vegetables, This is also true of pellagra. This disease, frequently ending in insanity and death, is due entirely to wrong living upon an excessive carbo-hydrate diet. People form dietary habits and these habits not infrequently do them injury. What the human body needs is simple foods in proper variety. Both the over-feeding with carbo-hydrates and with proteid result in injury and Injury always appears when fruits and vegetables are omitted. A man is what he eats, how much he eats and how he eats it.

JAMES JOSEPH FAGAN was bom in Indianapolis, July CONCERNING DRUGS, DR. OSLER SAYS: "The only 15, 1875. The fact that he is a born American and the date drugs that are worth an oyster-shucker's oath are those that of his birth were necessary to secure his release from intern­ smell good, taste good, look good and are harmless." Dr. ment in England. The certificate of birth has been for­ Barker, who is Dr. Osier's successor at John Hopkin's warded and it is hoped that it will be sufficient to prove Mr, University, says: "In my opinion there are but six efficacious Fagan's citizenship. Had no birth certificate been made out, drugs known, to-wit: Mercury, iron, quinine, salicylic acid Mr. Fagan would have been in a bad fix. and two more."

BABY EXPLAINS. COMMON DRINKING CUPS. We were riding on the flyer all the family going South WHEREAS, It has been repeatedly demonstrated that I was feeling very comfy pacifier in my mouth the use of what is usually known as the common drinking A doctor man in front of us asked the privilege to inquire cup is dangerous and is an undoubted source of communica­ If mother thought 'twas good for me to use a Pacifier? tion of infectious diseases; now, therefore, in the interest of the public health, And then the doctor spained to her (as we were going South) IT IS ORDERED BY THE INDIANA STATE BOARD How it would surely spoil my teeth and the contour of my OF HEALTH THAT—the use of the common drinking cup in mouth public conveyances, stations, hotels, restaurants, public And then he said an awful thing, how sometimes it would buildings, parks, at fountains and all other places where water make is provided for public use is hereby prohibited from and after Cankers in the saffigus and cause a stomach ache. August 1, 1916. He said it used the saliva up and that it might cause worms Besides 'twas such a dirty thing, all covered with germs The term, "Common drinking cup" as used herein is defined to be any vessel used for conveying water to the mouth This seared my mother dreadful and before we'd traveled far and available for common use by the public. She grabbed the pacifier and threw it from the car. MONTHLY BULLETIN, INDIANA STATE BOARD OF HEALTH.

CHART SHOWING GEOGRAPHICAL DISTRIBUTION OF DEATHS FROM IMPORTANT CAUSES FOR JUNE, 1916.

Northern Sanitary seCTION Total population, . . . . 998.000 Total deaths, , . 903 Death rate per 1.000. 11.0 Pulmonary Tuberculosis rate per 100,000. " 79.4 Other forms of Tuberculosis, rate per 100,000. . 17.1 Typhoid Fever, rate per 1.00,000 8.5 Diphtheria and Croup, rate per 100,000 .*> Scarlet Fever, rate per 100,000...... 2 Measles, rate per 100.000 . 1-2 Whooping Cough, rate per 100,000. . . . .3 Lobar and Broncho - Pneumonia, rate per 100,000 58.7 Diarrhoea and Enteritis (under 2 years), rate per 100,000 33.0 Cerebro-Spinal Fever, rate per 100,000 1.2 Acute Anterior Poliomyelitis., rate per 100.000 " Influenza, rate per 100,000. 6. 1 Puerperal Septicemia, rate per 100,000 6.1 Cancer, rate per 100,000 83.1 External causes, rate per 100.000 117.4 Smallpox, rate oer 100.000 ....

Central sanitary SECTION Total population 1,178,368 Total deaths 1.034 Death rate per 1.000 , , 10.7 Pulmonary Tuberculosis, rate per 100,000 120.1 Other forms of Tuberculosis, rate per 100,000 '. 29.0 Typhoid Fever, rate per 100,000. ... 6.2 Diphtheria and Croup, rate per 100,000 1.0 Scarlet Fever, rate per 100,000 2.0 Measles, rate per 100,000 ...... 11-5 Whooping Cough, rate per 100.000. . . . 12.4 Lobar and Broncho-Pneumonia, rate per 100,000. , - 41.1 Diarrhoea and Enteritis (under 2 year rate per 100,000 2 1.7 Cerebro-Spinal Fever, rate per 100,000 2.0 Acute Anterior Poliomyelitis, rate per 100,000 Influenza, rate per 100,000. . 8.2 Puerperal Septicemia, rate per 100,000 9.3 Cancer, rate per 100,000. 74.5 External causes, rate per 100,000 96. 3 Smallpox, rate per 100,000 ....

Southern Sanitary Section Total population , - 648,532 Total deaths 557 Death rate per 1.000 9.9 Pulmonary Tuberculosis, rate per 100.000 ...... l.>8.> Other forms of Tuberculosis rate per 100,000. 19.6 Typhoid Fever, rate per 100,000 7.1 Diphtheria and Croup, rate per 100.000 7.1 Scarlet Fever rate per 100,000...... Measles, rate per 100,009 5.3 Whooping Cough, rate per 100,000 19.6 Lobar and Broncho pneumonia 100.000 19.6 Diarrhoea and Enteritis (under 2) rate per 100.000 55.2 Cerebro-Spinal Fever, rate per 100,000 Acute Anterior Poliomyelitis, rate per 100,000 Influenza, rate per 100,000 7.1 Puerperal Septicemia, rate per 100,000 . 7.1 Cancer, rate per 100,000 71.2 External causes, rate per 100.000 94.4 Smallpox, rate per 100.000...- • . ... |NDIANA. TABLE 1, Deaths in Indiana by Counties During the Month of June, 1916, (Stillbirths Excluded.)

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

Popu­ lation, STATE AND Esti­ COUNTIES. mated 1916. Date . (unde r 2 years) . Pneumonia . myelitis , berculosi s May . 1916 June . 1916 June , 1915 . Sam e Date . th e Yea r 191 6 t o Date . th e Yea r 191 5 t o Sam Date . Death s o f NON-Residents . Externa l Causes . Puerpera l Septicemia . Death s i n Institutions . Loba r an d Broncho - Acut e Anterio r Polio ­ Influenza . Cancer . Diphtheri a an d Croup . Diarrhoe a an d Enteriti s Smallpox . Measles* . Whoopin g Cough , Cerebro-Spina l Fever . | Pulmonar y Tuberculosis . May , 1916 . 1 5 to 19 Inclusive . Othe r Form s o f Tu ­ Typhoi d Fever . Scarle t Fever . 1 t o 4 Inclusive , 1 0 t o 4 Inclusive . June . 1915 Rat e fo r Yea 1.91 5 t o Unde r 1 Year . 5 t o 9 Inclusive . Rat e fo r Yea 191 6 t o June , 1916 . Tota l Deat h a 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 . Tota l Death s Reporte d fo r Tota l Death s Reporte d fo r

State of Indiana. . Northern Counties Adams...... Allen...... Benton. Blackford...... Carroll.. Cass...... 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 June, 1916 (Stillbirths Excluded.) Annual Death Rate per 1.000 Population Important Ages Deaths from Important Cauaes

Popu­ lation, CITIES Esti­ mated, 1916 May , 191 6 June , 191 5 th e Yea r 191 6 t o dat th e Yea r 191 5 t o sam dat June , 191 6 Dat e Sam e Dat losi s berculosi s Tota l Death s Reporte d fo r Tota l Death s Reporte d for June , 191 8 Tota l Death s Reporte d fo r tota l Death s Reporte d fo r Tota l Death s Reporte d fo r Diphtheri a an d Crou p May , 191 6 15 t o 1 9 inclusiv e Diarrhoe a an d Enteriti s (unde r 2 years ) Rat e fo r Yea 191 6 t o 1 0 t o 4 inclusiv e Rat e fo r Yea 191 5 t o 1 t o 4 inclusiv e 5 t o 9 inclusiv e Loba r an d Broncho - Measle s Whoopin g Coug h Pulmonar y Tubercu ­ June , 191 5 Typhoi d Feve r Unde r 1 Yea Externa l Cause s Scarle t Feve r Acut e A interio r Poliomyeliti s Cance r 6 5 Year s an d Ove r Smallpo x Death s i n Institution Death s o f Non-Resident [Othe r Form s o f Tu ­ J Pneumoni a f Cerebro-iSpina l Feve r Puerpera l Septecemi a Cities of the First Class. Population 100,000 and over.. Indianapolis...... Cities of the Sec­ ond Class. Popu­ lation 45,000 to 100,000...... I Evansville...... Fort Wayne...... Terre Haute South Bend, , Cities of the Third Class. Population 20,000 to 45,000. . . Gary, East Chicago Muncie. Hammond. Richmond. Anderson..,,,,,,., Elkhart. Michigan City Lafayette...... New Albany. Logansport Marion Kokomo...... Cities of the Fourth Class. Population 10,000 to 20,000...... Vincennes...... Mishawaka Peru...... Laporte New Castle Elwood.,... Crawfordsville Shelbyville...... Huntington...... Jeffersonville Brazil. . Bloomington,., Bedford...... Cities of the Fifth Class. Population under 10,000 Frankfort...... Columbus...... Goshen...... Wabash Connersville Whiting Clinton Washington...... Valparaiso ..... Linton Lebanon. Madison...... Princeton...... Hartford City..... Seymour. Kendallville - - Mt. Vernon Greensburg Portland ...... Bluffton.. . Noblesville...... Rushville... . . • Alexandria...... Aurora. Martinsville Franklin...... Warsaw Decatur. Garrett- Sullivan...... Winchester Greenfield Boonville.... Mitchell...... Tipton...... Auburn...... Lawrenceburg Plymouth Greencastle...... ,| Tell City ; Columbia City.....j Attica ' Union City...... Rochester...... ,,, Jasonville...... Gas City..... , Dunkirk .: North Vernon ; Angola...... ' Bicknell.... ! Montpelier...... Rockport...... Crown Point...... Loogootee. Batesville...... Huntingburg Rensselaer...... Jasper...... Monticello...... ligonier Delphi Cannelton...... Covington...... Butler...... ' Veedersburg...... ; Rising Sun...... j Vevay...... i Mortality of Indiana for June 1916, (Stillbirths Excluded.)

Annual Death Rate per 1,000 Population Important Ages

POPULATION 65 and BY GEO­ Popula­ Under l 1 to 4 5 to 9 10 to 14 15 to 19 GRAPHICAL tion Over SECTIONS AND Estimated AS URBAN 1916 AND RURAL fo r June , 191 6 b o sam e dat fo r th e Yea 191 5 t o t o dat e fo r June , 191 5 fo r th e yea 191 5 t o date . sam e dat fo r May , 191 6 Pe r Cent . Numbe r Numbe r Pe r Cent . Pe r Cent . Numbe r PerCent , Numbe r Rat e fo r Yea l91 5 May , 1916 Numbe r June , 191 6 June . 191 5 Rat e fo r Yea 191 6 Pe r Cent , Tota l Death s Reporte d Total Death s Reporte d Tota l Death s Reporte d Tota l Death s Reported Tota l Death s Reporte d [Numbe r

State j 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 Acute Pulmon­ Other Diph­ Whoop­ and and Cere­ An­ Puer­ Ex­ POPULATION BY ary Forms Typhoid theria Scarlet Measles ing Broncho Enteritis bro­ terior Influ­ peral Cancer ternal Small­ GEOGRAPHICAL Tuber­ Tuber­ fever and Fever Cough Pneu­ (Under spinal Polio­ enza Septi­ Causes pox SECTIONS AND culosis culosis Croup monia 2 Years) Fever mye­ cemia AS URBAN AND litis RURAL Deat h Rat e Deat h Rat e Numbe r Numbe r . Death Rat e I Deat h Rat e \ Deat h Rat e Numbe r I Deat h Rat e | Numbe r i Numbe r Numbe r ! Deat h Rat e i Numbe r Deat h Rat e Deat h Rat e ; Numbe r | Deat h Rat e - . Numbe r Deat h Rat e ! Deat h Rat e j Numbe r i Deat h Rat e Numbe r Numbe r Numbe r Numbe r I Deat h Rat e ; I Deat h Rat e j Numbe r Deat h Rat e I Numbe r ; 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 June, 1916. J. H. ARLINGTON, SECTION DIRECTOR, IN CLIMATOLOGICAL DIVISION

TEMPERATURE—IN DEGREES FAHRENHEIT

Departure Extremes Section from the Average Normal Station Highest Date Station _ Lowest Date

Princeton. Auburn

PRECIPITATION IN INCHES AND HUNDREDTHS

Extremes Section Departure Average from the Normal Greatest Least Station Monthly Station Monthly Amount Amount

Shoals Mount Vernon.