MONTHLY BULLETIN Indiana State Board of health [Entered as second-class matter at the Indianapolis Postoffice
VOLUME XVI. INDIANAPOLIS, SEPTEMBER, 1913 25 cents a year
T. HENRY DAVIS, M, d„ presideNT ...... Richmond. ABSTRACT OF MORTALITY STATISTICS FOR JAMES 8, BOYERS, M. D., VICE- PRESIDENT Decatur. JOhN R. HICKS, M. D.. .., covington SEPTEMBER. 1913. H.H.SUTTON, M. D Aurora. Total number of deaths, 2,810: rate, 12.8. In the preced J. N. HURTY, M. d, PHAR. D., SECRETARY Indianapolis ing month, 3,155 deaths-; rate. 13*4. In the same month last year, 2,802 deaths; rate, 12.5. Deaths by important WM, F. KING, M .D ASST. SECRETARY AND EPIDEMIOLOSIST. ages were: Under 1 year of age, 523, equal to 18.6 per cent J. L. ANDERSON .CHIEF CLERK. of total; from 1CHAS to .4 , 233; 5 to 9, 65; 1A0. CARTER to 14,. 47M. D; 15 to 19, .STATISTICiAn. WM. SHIMER. A B.. M. D, SEPT. BACTERIOLOGICAL LABORATORY". 77; 65 and over, 80S, or 2S.7 per cent, of total. ADA E. SCHWEITZER, M. D...... ASSISTANT BACTERIOLOGIST. L, W, BARRY, M. D... Asst. Pathologist. SANITARY SECTIONS: THE NORTHERN SANITARY SECTION, population 902,039, reports 1,000 deaths; rate, 12.5. K. W. HIDY, M. D...... ASSISTANT, PASTEUR LABORATORY. H. E. BARNARD, B. S.....STATS FOOD AND DRUG COMMISSIONER AND CHEMIST. In the preceding month, 1,050 deaths; rate, 12.S, In the H.E. BISHOP, B. S... ASSISTANT CHEMIST. same month last year, S64 deaths; rate, 11.2. J. A. CRAVEN.... , WATER CHEMIST. WILL H. McABEE • •• Drug Chemist. R. L. SACKETT, C. E • • ....Sanitary Engineer. THE CENTRAL SANITARY SECTION; population 1^139,717, reports 1.1GS deaths; rate, 12.4. In the preceding month, 1.307 deaths; rate, 14.1. In the same month last year, 1,190 deaths; rate, 12.9.
The MONTHLY BULLETIN will fee sent to all health officers and deputies in the State. Health officers and deputies should carefully read and file each copy for future reference* This is very important, for we expect THE SOUTHERN SANITARY SECTION, population 007.954 reports 642 deaths: rate* 11.6. Tn the preceding month. 73S to print Instructions, rules and general information, which It will be deaths; rate, 13.0. In the same month last year, 742 accessary for officers to preserve. deaths; rate, 13.6.
REVIEW OF SECTIONS: The Northern Sanitary Section presents the highest death rate, which Is .2 higher CONTENTS. than the State rate. The death rate in the Central Sanitary ——— page Section Is also higher than the State rate by .4 per cent The Central Sanitary Section presents the highest death Births for September. 1013 — 249 Abstract of Mortality Statistics for September — ...... 249 rate from pulmonary tuberculosis, other forms of tuberculosis, poliomyelitis, influenza, puerperal septicemia, and Summary of Morbidity and Mortality for September 250 external causes. The Northern Sanitary Section presents Deaths of Non-Residents...... t... 25-0 the highest death rate from scarlet fever, lobar and broncho Report of Department of Food and Drugs — ...... 250 pneumonia, diarrhea, and enteritis {under 2 years) and Inspectors' Report for the Month of September 251 Report of Bacteriological Laboratory for September 251 cancer. The Southern Sanitary Section presents the highest death rate from typhoid fever, diphtheria and croup, Delayed Birth and Death Certificates 252 whooping cough and cerebro-spinal fever, Upholds Benzoate of Soda Law., ...... 253 New Vital Statistics Law ...... 253 The Evolution of a School House 254 Three Typhoid Epidemics Due to Milk...... 256 The Appellate Court Decides That a City May Not Pollute a Stream 256 RURAL; Population 1,548,339, reports 1.36S deaths; Chart Showing Geographical Distribution of Deaths...... 257 rate, 10.7. In the preceding month, 1,522 deaths; rate, 11,5. Table 1. Deaths in Indiana by Counties in September 258 In the same month last year, 1,430 deaths; rate, 11.2. Table 2. Deaths in Indiana by Cities in September... 259 Mortality of Indiana for September. — 260 URBAN: Population. 1,221,371, reports 1,442 deaths; Weather Report 260 rate. 14.3. In the preceding month, 1,633 deaths; rate, 15.7, .In the same month last year. 1,372 deaths; rate, 14.1. The death rates of the following cities were; Indianapolis, 15.4; Evansville, 11.*; Ft, Wayne, 12.8; Terre Haute, J5.0; South BIRTHS FOR SEPTEMBER, 1913. Bend* 11.6; Gary, 21.3; Muncie, 16.3; Richmond. 9.4; Ander Total births, 4.747 (stillbirths excluded) ; State rate 20.$. son, 12.7; Hammond, 1-s.7; New Albany, 14.1; Lafayette, Males, 2,453; females, 2,294. 14.2: Bast Chicago, 25.8; Elkhart 15.7. The following cities White males, 2,431; white females, 2.273. of the fourth class present a death rate higher than the Colored births, 43; males, 22; females, 21. urban State rate; Michigan City. 22; Logansport, 17.9; Kokomo, 19.2; Laporte. 16.2. The following cities of the fifth Stillbirths, 124: white, 122; colored. 2. class present a death rate higher than the urban State rate: Northern Sanitary Section, population, 962,430; total Crawfordsville, 12.9; Columbus, 14.9; Washington, 21,5; births. 1,572; rate, 19.8. Madison, 19.2; Princeton. 14.S; Lebanon, 25.6; Bluffton, Central Sanitary Section, population, 1,139.717: total 2S.6; Rushville, 14.5; Sullivan, 19.7: Tipton, 23.p; Boonville, 26.5; Auburn. 21.1; Lawrenceburg, 18.5; ; Mitchell, births. 1,927: rate, 20.5. 25.7; Tell City, 20.S; Rochester. IS; Jasonville, 2^.5; Bicknell. 21,7; Huntingburg. 14.7; Rensselaer, 15; Cannelton, Southern Sanitary Section, population, 667,954; total 17.1; Veedersberg, 27,3; Vevayt 19.3, births, 1,248: rate, 22.7. Highest rate, Martin County. 87.1, Lowest rate, St Joseph County, 6.5. Total births to date, 1918, 35,214. EXTERNAL CAUSES: Total deaths, 238; males 170; 250 Monthly BULLETIN, INDIANA STATE BOARD OP HEALTH.
females, Kb. Suicide total, ,11: males. 35; females, 16, POLIOMYEliTIS: 14 cases were reported from 13 Means of suicide, poison, 30: asphyxia, 1: hanging or counties, with 5 deaths as follows: Allen, female age 3 strangulation, 7: drowning. 2; firearms, t); cutting or pierc years: Crawford, male, o years;'Marion, male, 2 years; ing instruments. 1 : other suicide, "L Accidental or unde Montgomery, female. 3 years; Tippecanoe, female. o years. fined total, 1>1: males. 130; females. ol. Poisonings by foods, 2; other acute poisonings, S: burns < conflagration excepted), 12; absorption of deleteriousgase s (conflagrationDEATH exceptedS i,O F1 ; NOaccidentaN RESIDENTSl drowning, , <5: traumatism by firearms, JO; traumatism i»y fall, "10; traumatism in Beginning with the returns for H»14, an effort will be mines. 4; traumatism by machines, 4; railroad accidents made to present n statement of DEATHS OF NONRESI and injuries, 39; street car accidents and injuries, '.»: automobile accidents and injuries. Kj; injuries by other vehicles, r»; other crushing, 4; injuries by animals, 7; ef DENTS in connection with the usual compilation of total fects of heat. 4; lightning, 2; electricity (lightning ex deaths that occurred in each registration area. The follow cepted!, 4: other external violence, s. Homicide total. U: ing plan Is proposed. males. r»; female. 1. Homicide by firearms. r>; homicide by 1. Deaths of nonresidents shall include deaths from dis other means, 1. ease i not from violence'! in which LENGTH OF RES IDENCE (a) at place of death or (b) in the Stare is LESS than the DURATION OF CAUSE OF DEATH and not more than one year, 2, Deaths of inmates of state institutions without regard SUMMARY OF MORBIDITY AND MORTALITY to length of residence at place of death. FOR SEPTEMBER, 1913. In order to make this separation uniformly it will be necessary that DURATION OF ILLNESS and LENGTH OF Typhoid fever was reported as the mo>t prevalent infectious RESIDENCE, as provided in Items 17 and Is of the stan si per cent, of observers reported the dis dard certificate, shall be given more fully than heretofore. ease present. The order of disease prevalence was as fol Each health officer should see that this information is given lows; typhoid fever, tonsilitis. diphtheria and croup, if scarletthe propose d distincfevert ,io ndiarrhe is to ab e anmaded enteritis. , acute bronchitis, acute rheumatism, pulmonary tuberculosis, malaria fever, influ enza, intermittent and remittent fever, dysentery, cholera morbus, measles, lobar pneumonia, smallpox, other forms of REPORT OF THE DEPARTMENT OF FOOD AND tuberculosis, whooping cough, bronchial pneumonia, polio DRUGS, INDIANA STATE BOARD OF HEALTH, myelitis, rabies in human, puerperal fever, erysipelas, cerebro-spinal fever, chickenpox, rabies in animals, FOR SEPTEMBER, 1913,
H. E. BARNARD, STATE FOOD AND DRUG COMMISSIONER. SMALLPOX: tit) cases reported in 15 counties with no Eighty-three samples of food were analyzed during the deaths. In the preceding month b.j eases in 7 counties with month of September of which 55 were legal and 28 illegal. no deaths. In the corresponding month last year 4 cases Two of the 22 milk samples were illegal because they con reported in 4 counties with no deaths. tained visible dirt and were below standard. Eleven of the 21 samples of soda pop analyzed were classed as illegal be TuberculosiS: 275 deaths, of which 227 were of the cause they were not properly labeled or contained benzoate pulmonary form and 4N other forms: males 132, females of soda or saccharin. Twenty vinegars were analyzed and 14S. Of the males. 22 were married in the age period IS 11 classed as legal and 0 illegal. The illegal vinegars were to 40 and left 8f> orphans under 12 years of age. Of the so classed because they were low in acidity. In some cases females, 40 were married in the same age period and left this was due to incomplete fermentation. 71 orphans under 12 years of age, Total number of or Eighteen samples of drugs were analyzed during the phans caused by tuberculosis in one month. 110. Number month. All of the samples were classed as legal, of homes- invaded, 251.
PNEUMONIA : Total deaths, 72: rate, 31.0 per KJlMXK). RESULTS OF ANALYSES OF FOODS AND drugS durinG the MONTHS In the preceding month 54 deaths; rate, 22.y per KJO.OOO. OF september 113. fn the same month last year 91 deaths; rate, 4
INSPECTORS REPORT FOR THE MONTH OF SUMMARY OF INSPECTIONS MADE DURING THE MONTH OF SEPTEMBER, 1913. SEPTEMBER, 1913. During the month of September the inspectors visited 41 cities and towns and reported 0.*U sanitary inspections. Of IN ^PKCTIONS, this number is places were in excellent condition, .122 good. No . Bad
'Ml fair. -II poor and <> had. One hundred and sixty-two of No , Poor. | N o Excellent . I No . Fai r I No , Fair . } the *J4N grocery stores -visited were in good condition, 7.~» I N o Inspected , ( fair. 5 poor, one bad and 5 excellent. Three of the fifteen Dairies . Grocery stores ,,, dairies insspected were found in good condition. 10 were Meat markets! ,, drug stores fair, one poor and one had, Ninety-live meat markets were Bakeries and confectioneries Hotels and restaurants , . inspected. Of this number 2 were rated excellent. 02 good. Creameries ,«,..,.. .'Jo fair and one poor. Of the 7S drug stores visited 5 were Slaughterhouses,,.. . , , found in excellent condition, 03 good and 10 fair. Three of Wholesale groceries...... Bottling works the 142 bakeries and confectionaries visited were rated ex Ice cream parlors Ice cream factory.. cellent. 09 good, ->7 fair and three poor. One hundred ami Poultry houses...... Canning factories...... forty hotels and restaurants were inspected. Of this Milk depots number 2 were found in excellent condition, r>9 good, 08 fair, 0 Flow mill poor and 2 bad. One hundred and twenty-eight canning Wholesale confectionery factories were visited, one was rated, excellent, 42 good, Co fair. 1<» poor and 2 bad. Four of the ice cream parlors Ice and cold storage plants.. . visited were rated good and 10 fair. Seven of the S poultry Total. houses inspected were rated fair and one poor. The three wholesale grocery stores visited were found to be in good condition. Three of the 5 slaughter houses inspected were NOTICES OP CONDEMNATION DURING THE MONTH OF SEPTEMBER, 1013. found good, one fair and one poor. Inspections were also made of creameries, bottling works, milk depots, fruit Reasons for Condemnation, stores, ice and cold storage plants and saloons. CLASSIFICATION, Total Unsanitary Improper During the month three prosecutions were brought for Conditions. Construction. violation of the pure food and sanitary food law. Two cases were brought for selling misbranded beverages. A Bakeries-..Canning Factories . dealer was fined for selling ice cream below standard. The Creameries Groceries, . . . total fines and costs levied during the month amounted to Grocery and meat markets. Meat markets Restaurants', Saloons. Twenty-seven condemnation notices were issued during Slaughterhouses the month because of unsanitary conditions and seven al Total leging as well improper construction.
LIST OF Prosecutions DURING THE MONTH OF SEPTEMBER, 1013
date of COUNTY. Name and Address of Defendant. Why Prosecuted. Trial Final Disposition.
Crawford j Chas. E. Moore. English, Ind I Selling misbranded beverage. 9-I0-13 ! Fined $10 and costs Crawford ! Robert Longest, English, Ind , j Selling misbranded beverage, . . 9-19-13 Fined $10 and costs. Grant . i John Sohn, Marion, Ind . Selling ice cream below standard 8-23-13 Fined $10 and costs.
REPORT OF BACTERIOLOGICAL LABORATORY Widal tests (or typhoid fever— INDIANA STATE BOARD OF HEALTH, Positive ...... 75 FOR SEPTEMBER, 1913. Negative ...... 201 WILL Shimer. M. D„ superintendent. 2*0 Sputum for tubercle bacilli— Widal tests for paratyphoid fever- Positive ...... 1<>2 Positive 10 Negative ...... 274 Negative ...... 270 570 280 Feces for tubercle bacilli— Feces for typhoid bacilli- Negative Positive Urine for tubercle bacilli— Negative ...... Negative Pus for tubercle bacilli— Throat cultures for diphtheria bacilli— Negative ... • Positive 155 Pleural fluid, for tubercle— Negative ...... 140 Negative Unsatisfactory ...... 1 Cerebro spinal fluid for tubercle bacilli— Suspicious ...... 13 Negative ...... 315 252 MONTHLY BULLETIN, INDIANA STATE BOarD OF HEALTH,
Epidemic throat cultures for diphtheria bacilli— OUTFITS SENT OUT DURING SEPTEMBEr, 1913- Positive ...... 0 Tuberculosis ...... ,...... ••••••••••• '°^u Negative , *...... ,...,...... 24 Diphtheria - 034 Suspicions ...... ,...... ,..<.. 2 Widal ...... -10*2 3* Special ...... *5 Brains for Negri bodies— Malaria ...... ,.,...... *...... 33 Dogs Bile Media • •. S Positive 12 Hook worm 13 Negative ...... 0 Epidemic diphtheria 100 Rotten 5 16SI
Cats PATIENTS WHO FINISHED PASTEUR TREATMENT SEPTEMBER. Negative ...... 2
Hogs Began Treatment Finished Treatment Rotten 1 Name. Town. County. i Age.!Sex,. ] , ;- _«_._„«___>,._ ! Pathological tissues— Mrs. Ed. Miller...... ! Indianapolis. [ Marion..,..,. Frank Allison....,,.,! Indianapolis . - Marion. Sarcoma 4 Chas. Swodoba., . .. Indianapolis ., Marion. ., Mm A. Swoboda, .. j Indianapolis. .' Marion.. .,,,.• Carcinoma . 13 Norman Swoboda.,.. j Indianapolis..! Marion. .... Miscellaneous 18 Freida Swoboda...,.. j Indianapolis.. j Marion...... Mrs. J. Noll .,....! Indianapolis, . [ Marion...... ] 35 Mrs. T. Druding Indianapolis. .j Marion...... j C. Miller...... Indianapolis. .' Marion j Guinea pigs inoculated with urine for tubercle Marcella Lennox,, ,,.! Indianapolis. .; Marion Mrs. Von Grimenstein.' Indianapolis.. • Marion.. ... bacilli- Ed. Miller ,. | Indianapolis, . : Marion...... I Negative Mrs. H. C. Huber.. . .| Huntington ..j Huntington ..! Lucile Huber 1 Huntington.,.! Huntington.... Lois Huber. ! Huntington... i Huntington,.,'. Guinea pigs inoculated for rabies— Robert Huber j Huntington...; Huntington.., j Mrs. L. Raber.,,..,.. j Huntington...! Huntington.,. | Negative R. Backmeyer.... ! Richmond — j Wayne ; W. Backmeyer | Richmond.... Wayne , W. Johnson Richmond.... I Wayne j Guinea pig inoculated with abdominal fluid for Norman Mueller Richmond.. >.' Wayne.,.,,,. I C, Lane.,. ,. Greencastle... | Putnam.,.,,.! tubercle bacilli— J. M. Osborn i Crawfordsville. Montgomery.. | Dr. F. G. Wirt... ' Crawfordsville. Montgomery.. I Negative ...... '...... 4 Chas, Smith \ Bloomington.. Monroe . j Blood for counts.....•.•, 10 John Cline. j Mooresville... Morgan ; Clay Daniels | Keystone.....' Ripley...... I Louis Overton...... Poseyville..... Posey...... j Blood for malaria Plasmodia— Clay Parker. LaFayette .,. Tippecanoe... j Miss G. Chamberlain.. Vevay—.... Switzerland... j Positive ...... 1 Wilbur Lind. Pleasantville.. Daviess j Negative ...... 23 Monroe Bedunnah j Milan ' Ripley 24 Pus miscellaneous 1 DELAYED BIRTH AND DEATH CERTIFICATES. Feces miscellaneous 8 Each month the statistical department receives certifi Urine for chemical analysis,. 39 cates for births and deaths that have occurred during the preceding months which are not sent to this department in Pus for gonococci—- time to be tabulated with the report for the current month. Females With the report for September, the following counties Positive . G named below were delinquent in this matter. Negative 17 BIRTHS. Suspicions ...... 2 Adams 3, Allen 11, Boone 5, Brown 7, Carrol! 1, Cass ],
Males Clark 10, Clay 3, Clinton 5? Crawford 2, Daviess 3, Dearborn 1, dekalb 1, Delaware 12, Dubois 1, elkhart 4, Fa Positive ...... 8 yette 1, Floyd 1, Franklin 2, Gibson 8, Grant 19, Greene 2, Negative 11 Hamilton 1, Hancock 1, Harrison 4, Hendricks 1, Henry 5, Suspicious 4 Howard 7, Huntington 1, Jasper 1, Jay 2, Jefferson 1, Knox Sex not given 11, Kosciusko 1, Lake 10, Laporte 3. Madison 2, Marion 3. 7 Positive 2 Marshall 1, Martin 2, Monroe (», Montgomery 5, Morgan 2, Negative 3 Noble a Ohio 1, Orange 1, Owen 6\ Parke 2, Perry 3, Pike Suspicious ...... 1 1, Porter 1, Pulaski 3, Ripley 0, Rush I, Scott 2, Shelby 0. Spencer 3, Steuben 2, St. Joseph 144, Sullivan s, Tippecanoe Feces for hook worm — 0, Tipton 1, Vanderburgh 5, Vermilion 1, Vigo 1. Warrick Positive 1 1, Washington 2, Wayne f». Wells 4, White 2, Whitley 3. Negative 11 Total, 395. 12 Sausage for intestinal bacteria- DEATHS. Boone 2, Brown 5, Crawford 2. Daviess 1, Elkhart 1, Negative 1 Grant 7, Greene 1, Henry 1, Jay 1, Kosciusko 1, Lake 1, Laporte 2, Lawrence 1, Marion 1, Marshall 2. Martin 1, Miami Milk for tubercle bacilli- 1, Monroe 3, Morgan 1, Newton 1, Noble 2, Orange 1, Parke Negative .* 1 1, Perry 1, Pike 2, Shelby 1, St. Joseph 1, Sullivan 1, Switz Milk for bacteria count 1 erland 1, Tippecanoe 1, Tipton 1, Vigo 2, Wabash 1, War rick 2, Wayne 3, White 1, Whitley 1. Total, 02. Total number specimens examined...... 1524 MONTHLY BULLETIN, INDIANA STATE BOARD OF HEALTH, 258
UPHOLDS BENZOATE OF SODA LAW. NEW VITAL STATISTICS LAW. (Approved March 14, 1013.) U. S. Court Holds Indiana Health Board Has right To Forbid The parts in this style type are amendments. Preservatives In Food; Pickle and Catsup Case Long In Litigation. AX ACT entitled an act to amend sections one (l)f two {'!), and three (3) of an act entitled "An act to collect accurate records of deaths, births, contagious diseases and mar The right. to bar the sale of food products in which riagesbenzoate, prescribin g the dutieof sods ao f liathes statbeene boarusedd aosf ahealt preservativeh , Is upheld and declared an open question iu the scientific world ac and of all health officers, in relation thereto, providing cording to an opinion handed, down at Chicago early in penalties for the violation of the provisions of this act. October by the Knifed States Circuit Court of Appeals of and repealing all acts in conflict," approved March 7. tlie seventh Circuit. Section l. Be It enacted by the General Assembly of the State of Indiana, That section one (!) of the above entitled In delivering this opinion on this question which has act be amended to read as follows: agitated manufacturers during the past year, the court af firmed a decision of the dated States Circuit Court of In Section 1. Be it enacted by the General Assembly of the dianapolis, refusing to issue an injunction restraining the State of Indiana, That it shall be the duty of all physicians, Indiana food and drug Commissioner and the Indiana midwives and all other persons who are now -permitted or State Board of Health from interfering with the sale of entitled to treat diseases or deformity or practice obstetrics catsup and pickles containing benzoate of soda. in the State to report upon blank forms supplied by the The decision is of far-reaching effect iu that it gives the state board of health all deaths and births which may oc Indiana slate officials a free hand in prohibiting the sale of cur, under their supervision, and also all cases of contagious food products containing the preservative. The opinion was and infectious diseases which may occur under their super handed down in the case of Curtice Bros. Company against vision and which are listed as reportable in the rules of the Harry E. Barnard and other members of the State Board state board of health. The report of deaths and cases of of Health. infectious diseases shall be made immediately, and a certifi It is the outcome of litigation started soon after the pas cate of death shall he filed- and a burial or removal permit sage of a statute by the Indiana legislature in 1907. The issued prior to any disposition of the body. Reports of statute provides that any person selling food products con deaths, births, and cases of such infectious and contagious taining benzoate of soda is liable to criminal prosecutions. diseases as are listed in the rules of the state board of The bill was fought bitterly by the various manufacturers of health, which occur in cities and towns, shall be made to food products who used preservatives. health officers of said cities and towns, and when they oc cur in the country outside of cities and towns they shall be The appellant company, large manufacturers of preserved reported to the county health commissioner or his deputies: foods, took the case into the Federal courts and tried to get but reports of deaths occurring outside of cities and towns an injunction against the State officials, restraining them may be made to the health officer located nearest to the from interfering with the sale of their catsup and sweet place where the death occurs; and said health officer or pickles. The court refused to grant the injunction and the commissioner, if the certificate of death be properly made case was appealed^ out shall Issue a burial permit, which permit shall be valid The opinion of the Appellate Court was delivered by in all parts of the State, Upon the reporting of any death Judge C. C. Kohlsaat occurring outside of critics and incorporated towns to the "From the evidence and the master's report thereon," he nearest health officer, other than the comity health commissioner of the county wherein said death occurred, mid said, "if is evident the question of the harmlessness of certificate benzoateof death shall be sent immediatelof soda isy afors yerecord,t an opebyn question in the scientific world, said health officer to the county health commissioner of the county wherein said death occurred. When any death, "While the voluminous record of this case deals largely birth or case of listed infectious or contagious disease may with that question. It is a question of fact. The finding of occur with no physician or midwife in attendance, then fact of the master may not, in the absence of convincing said death, birth or case of infect ions or contagious disease evidence to the contrary, be set aside. To show that the shall be reported by the householder or other person having report is erroneous and not justified by the evidence, the said death, birth or case of infectious or contagious disease burden is not convincingly sustained by the record. It was in charge, to the health officer having jurisdiction. or his within the power of the Indiana legislature to prohibit the deputy: and the officer to whom the report is made shall use of benzoate of soda in the preparation of foods. make inquiry and inspection, and. In the case of a death, if "Manifestly, if the Legislature of Indiana in the reason he finds no evidence of death by violence or criminal prac- able exercise of its police power, and for the welfare of its tice. he may fill out the certificate of death and grant a citizens, condemns as an adulteration the use of benzoate burial permit; hut if evidence of death by violence or crim <»of soda in the preparation of articles of food, then, in the inal practice M found, he shall refer the case to the coroner, absence of a general acceptance of the proposition by the who shall make due investigation according IO law. Any scientific world that such is not the case, there can as to death coming under the supervision of any coroner shall be that matter arise n«> question of the violation of the con by him reported upon official death certificate blanks to the stitution of the United States, or, as here charged, of the health officer hating jurisdiction within three days after the State of Indiana, When deemed necessary by the Legisla inquest is held, and such death shall not be reported by any other person. Any death or birth occurring under the ture for the public health, property rights such as here in supervision f superintendent or head of any institution volved must give way. Butterfield v. Stranahan. W2 V, 8, 0 anv shall be Immediately reported by him upon official certifi 470-4!».T cates to the proper health officer. Stillbirths or seven Ii is therefore apparent that the position taken by monthsappellanr' gestatio n and over shalwithl referenche reportee tdo aths ebot constitutionalith births y of the act to question is without, merit, as are also the other matters and deaths, and all reports of deaths, births, contagious or covered by the assignment of errors/* 254 MONTHLY BULLETIN, INDIANA STATE BOARD OF health. infectious diseases as herein commanded shall be made word of a birth, or death when properly certified by the upon blanks furnished by the state board of health. It secretary of said board to be a true copy thereof, shall be shall be the duty of the clerk of the circuit court of each prima fane evidence in all courts and places of the facts county to report To the county health commisioner on or therein stand. They shall have the power to pass rules before the fourth day «>f each month the number of governinmarriagesg the duties of all fohealtr thh e boardprecedins angd monthhealth, witoffih such facts relating thereto as may be provided for on blanks furnished to such cers governing the hygienic disposal, transportation and clerk from the state hoard of health. All persons author disinterment of the dead and for the enforcement of this ized to perforin marriages shall report all marriages per act and any violation of said rules shall IK? punished by a formed by them within three days after their occurrence to fine of not less than live nor more than fifty dollars for each the clerk of the circuit court of the county wherein the offense. The state board of health shall make an annual marriage license was issued, and any one failing to so re report of ail vital statistics for each calendar year to the port shall be fined live dollars for each offense. All records governor, the same to be published with their report of if deaths, births and cases of contagious and infectious dis transactions and expenditures for the fiscal year by the eases shall be kept by health officers in record books, the commissioners of the public printing and stationery, forms of which shall be supplied by the state board of Sec. :}. That section three (tf) of the above entitled act health, Any physician or midwife refusing or neglecting to be amended to read as follows: make death, birth and infectious or contagious disease reports as herein provided, or who shall knowingly make a false report thereof, shall, upon conviction, be lined for the Section 3. it shall be the duty of the superintendent or first offense in any sum not less than ten or more than of any person or persons having charge of hospitals, poor fifty dollars, and any physician or midwife who is convicted asylums, lying-in or other institutions, public or private, to the second time for the violation of any of the above pro which persons resort for treatment of disease, confinement visions shall be fined not less than fifty or more than one or are committed by due process of law, to make and keep hundred dollars, and any physician or midwife who is con on file a record of alt personal and statistical particulars victed the third time for the violation in' any of the above relative to the inmates of such institutions, as may be re provisions shall be lined one hundred dollars. Householders and others made responsible in this act and failing quired by the state hoard of health. and any such superintendent. person or persons failing to make or keep such to report as herein provided, or who shall furnish false information for the purpose of an Incorrect certificate or re port, shall, upon conviction, be lined not less than ten or record, shall be liable to punishment by a fine of not less more than fifty dollars for each offense. It shall be unlaw than fire nor more than fifty dollars for each offense. ful for any undertaker, sexton, or other person to bury, cremate, or otherwise dispose of any human body until he Sec. 4. All laws or parts of laws coming in conflict with has received a permit to do so from a health officer; and this act are hereby repealed, except that this act shall not no such permit shall be issued by any health officer or be construed to repeal, affect or modify any of the provi deputy until there has been delivered .to him a certificate sions of an net entitled "An act to pre rent infant blindness of death written in unfading ink or indelible pencil, and completely and accurately filled out by the proper person. earned- by the preventable disease known as ophthalmia* In the event of a burial or other disposal of a dead human neonatorum," approved March 4 1911, body without a permit as herein provided, the offending person, upon conviction, shall be lined not less than five or more than one hundred dollars, and if the remains are buried, the coroner of the county in which the illegal burial THE EVOLUTION OF A SCHOOL HOUSE or other disposal occurs shall disinter or otherwise secure The photographs on the opposite page show the "old" and the remains, hold an inquest and within three days there the "new" in Indiana schoolhouses. Picture No. 1 is the after make a return of his findings upon official blanks to Header schoolhouse in White Post Township, Pulaski the officer having jurisdiction. The cost of said inquest County, as it was when condemned by the Indiana State shall be borne by the county, but the same may be recovered Board of Health. The ok! building speaks for itself. With in the courts of the county from the person or persons who no foundation, utterly dilapidated both inside and 0111, with are responsible for such illegal burial or other disposal of no ventilation, heated by a box-stove and seated with old- said human body. fashioned, non adjustible adjustable. deformity-producing seats and desks, certainly no one could mourn its passing. Picture No. 2 is the new Header schoolhouse. completed and in use for the first time this year. From a sanitary standpoint ir is a model two-room school building. Both class rooms are well and properly lighted, the light coming from one side Sec. 2. That section two (2) of the above entitled act be only and from the left ; the healing is by steam with indirect amended to read as follows; wall ventilation to each classroom: there is a dry, well Section 2. It shall be the duty of the state board of lighted basement under the entire building. Indoor, sanitary closers have been provided. health to collect and tabulate the vital statistics, to study them and endeavor to make intelligent and profitable use There are approximately I.IMMI school buildings of the of the same for sanitary purposes and the benefit of the type of the old Header school yet in use in the State. people. They shall have supervision of the system of, regis every building of tin's type l< an assault upon childhood, tration of deaths, births, infectious and contagious diseases, and should be condemned as such. Not until these old and they shall make up from time to time such blank forms buildings are replaced by new ones similar to the new Read er school. can it be said that Indiana has done* its full duty as they may deem necessary for the collection, registra toward the State's future citizens, tion and report of vital and sanitary statistics throughout David Bowman is Trustee of White Post Township. To the State. 77M7/ shall, upon request, furnish any applicant him and to if. L. Rogers, County Superintendent of Schools a certified copy of the record of ana birth or death registeredof Pulaskunderi Countythe , provisionsmuch o f ofth ethe crediact,t amifor suchthis copsplendiy of d the school building: is due. MONTHLY BULLETIN. INDIANA STATE BOARD OF HEALTH. 256
No. 1. THE OLD.
No. 2. THE NEW. 266 MONTHLY BULLETIN, INDIANA STATE BOArB OF HEALTH.
THREE TYPHOID EPIDEMICS DUE TO milk was sometimes obtained. Most of the 17 cases of typhoid WILL sHImER, M. D. had began three weeks previous to our visit. The dairy For a. number of years water lias been recognized as the bam and surroundings were very unsanitary and the dairymen knew nothing of the possibility of milk being infected source of typhoid epidemics. The massiveness of many of with typhoid bacilli. the water epidemics of typhoid has been so appalling that cities and towns have been wiling to spend enormous sums The three towns investigated are fairly representative ot of money to insure a safe water supply, most of the cities and towns in Indiana for they know very When water supplies are made safe milk becomes? more little about the farms from which their milk is coming or and more prominent as the source of typhoid infectious. the conditions under which it is handled and are unwilling Milk differs in two ways from water, first, only a limited to spend the money necessary to get efficient dairy inspection. In some of the largest cities in the United Scales quantity of milk is inefected at a time, while the whole of there is sufficient demand for a certified milk to make its a water supply may be infected. Second, a small number production profitable, but there is no city or town in Indiana of typhoid bacilli added to milk multiply so rapidly that at the present time that is huge enough. the whole quantity of milk soon contains great numbers of bacteria, while even if very large numbers of typhoid bacilli Typhoid epidemics due to milk are occurring all over Indiana and will continue to occur and become more and more are added to water, comparatively few infections occur be frequent so long as all of the milk is not efficiently pasteur cause of the great dilution and the fact that typhoid bacilli ized. do not multiply in water but soon die off. There are great difficulties in the way of getting a milk Milk now holds a more important place than water in the supply always free from infection. A great deal of work has etiology of typhoid. The most practical solution of the pres been done on milk standards, looking to the accurate classi ent difficulty is to pasteurize all of the milk all of the time. fications of market milks. Too great stress has been laid There have been a lot of objections to pasteurized milk, on clean milk us against dirty milk, confusing cleanness with every one of which have been proven to be without founda safeness and dirtyness with dangerousness. A milk may tion by recent investigations made by the Korean of Animal contain less than 10,000 bacteria per c.c. but most of these Industry, Department of Agriculture, at Washington. 1>. C, may be typhoid bacilli. A dirty milk may contain an enor THE APPELLATE COURT DECIDES THAT A CITY mous number of colon • bacilli with no typhoid bacilli. MAY NOT POLLUTE A STREAM. Marked attention has been paid to the fat and proteid con That a city has no right negligently to pollute a stream tent of milk which have to do with its food value and is of to the damage of others down the stream is the decision of economical importance but of little importance from the the Appellate Court in affirming the Henry Circuit Court standpoint of disease prevention. In every community in giving Mahon D. Harvey and his wife a judgment where sanitarians have tried to improve the milk from the of $400 damages against the city of Newcastle and per bacteriological standpoint by improving sanitary conditions petually enjoining the city from further pollution of the in the dairies they have been met by a blank wall of con stream to their damage. servatism and ignorance against which they have been able The Harveys owned some land near Newcastle on which to make very little progress, they constructed a fish pond, which was fed by a nearby With regards to water, the sanitary disposal of sewage is stream on their farm. Afterward they sold most of the the ideal, but filtration is now the most practical, so with farm and the land along the stream, but reserved the rights milk the ideal is a clean milk free from disease, producing of the stream in the deed. The town (now city) then leased bacteria but pasteurization of milk is the most practical a hillside of a farmer, Joseph M. Brown, on which to de solution. posit its garbage and proceeded to make it a garbage dump. The last three epidemics of typhoid investigated by the The garbage from this dump washed into the stream and Indiana State Board of Health showed them to be due to contaminated the water to the damage of the fish pond and typhoid infected milk. The epidemic at Indiana Harbor suit was begun to enjoin the city and collect damages. was due to milk being infected by a farmer with "walking The city contended that its act was an act of necessity typhoid." Over sixty persons had typhoid and there were for the protection of the health of the inhabitants of the several deaths. The milk supply for Indiana Harbor comes city, but the Appellate Court said: "As appellant (the city from a considerable distance and at the time of our visit of Newcastle) contends, the town of Newcastle was charged there was no dairy inspection and no one, not even the Milk with the duty of preserving the health of its citizens, and Company, had ever seen most of the farms from which the was within the bounds ot its governmental functions when milk came. it provided a suitable place in which to deposit its garbage. At Evansville at the time of our investigation there were But while it has such authority, it may not deposit garbage 107 cases of typhoid and more than 00 per cent, of cases at such place in a careless and negligent manner, causing were among the customers of one milk company. The a nuisancecompany, nor may it negligentlwas theny permitakingt ththee garbagempty e milandk bottles from the homes of the typhoid patients and filling them again with offal properly deposited, to escape upon the lands of another out sterilization, This company pasteurizes its milk but to his damage. * * municipal corporation has no examinations of several samples of pasteurized milk showed more right to maintain a nuisance than an individual would high counts and colon bacilli on two occasions. Evansville have, and for a nuisance maintained upon its property, the has only one sanitary inspector. No one in Evansville knew same liability attaches against a city as to an individual." anything about the dairies more than four miles out from The court further held that the city can not escape its which the milk was coming and the milk company had never liability by reason of the fact that the Harveys sold the visited the farms from which they received their milk. part of their farm through which the stream ran, saying that, though a person who takes the water from a stream At Greenfield there were twenty cases of typhoid at the without right takes it in the condition In which he finds it time of our visit, seventeen of which were among the cus without recourse for damages, the Harveys having reserved tomers of one milk man. Here the infection seemed to be the rights of the stream when they sold that part of their due to a case of typhoid, five weeks previous to our visit, on farm, can claim all the rights of a riparian owner in the the dairy farm and the one adjoining farm from which milk use of the waters of the stream. MONTHLY BULLETIN, INDIANA STATE BOArB OF HEALTH. 25?
CHART SHOWING GEOGRAPHICAL DISTRIBUTION OF DEATHS FROM CERTAIN COMMUNICABLE DISEASES FOR SEPTEMBER, 1913,
NOrthern SANitarY Section. total population 962,039
Total deaths 1S0O0 Death rate per 1?000 12.5 Pulmonary Tuberculosis,rat epe r 100,000 72.1 Typhoid rate per 100,000 ,.. 32.8 Diphtheria, rate per 100,000 24 0 Scarlet few, rate per 100,000 ...... 7.5 Diarrheal diseases, rate per 100,000 .... .„,..... 193.5
central SANITARY SECTION. Tolal population .3,139,717 Total deaths 1,168 Death rate per 1,000 ,.... 12.4 pulmonary tuberculosis per 100,000 115.8 typhoid, rate per 100,000 50.1 Diphtheria rate per 100,000 11.7 Scarlet fever, rate per 100,000 LO Diarrheal diseases, rate per 100,000 104.6
total population .667,954 Total deaths ...... 642 death rate per1,00 0 . 11.6 pulmonary tuberculosis, rate per100,000. . 112.9 typhoid, rate per 100,000 ...... 60.1 diphtheria, rate per 100,000 27.3 scarlet fever, ratepe r 100,000 18 diarrheal diseases rate per100,00 0 .... 118.4 INDIANA. TABLE 1. Deaths in Indiana by Counties During the Month of September, 1913, (Stillbirths excluded.)
Annual Death rate Causes Per 1,000 Population. important Ages. Deaths from Important
Population STATE AND COUNTIES. Estimated, 1913 mated, 1913. September 1912. External Causes Death s in Institution I Loba r an d Broncho- , Diarrhoe a an d Enteriti s Influenza . 1 5 t o 19 inclusiv e Cancer , Rate for year 1913 to Cerebro-Spinal Fever Acut e Anterio r Poliomyeliti s Puerpera l Septicemia , i Smallpox . MEASLES. Rate for year 1912 to Tota l Death s reporte d for 1 to 4 inclusive. 5 to 9 inclusive. Total Death s Reporte d fo r September 1912 10 to 14 inclusive 65 years and over Pulmonar y Tuberculosi s Scarle t Fever , Septembe r 1913 . August 1913 under 1 year. (unde r 2 years). ! Whooping Cough | Total deaths reported for | Tota l Death s Reporte d for j Yea r 191 2 to sam e date. : Tota l Deaths reporte d fo r I Yea r 1913 t o Date . !65 Year s and over . j Diphtheri a an d Crou p i Typhoid Fever i Other forms of tuberculosis ' , Unde r 1 Year . State of Indiana... Northern Counties... —
Alien Blackford.,.,,.,,,.. Cam .... Dekalb...... Elkhart , ... Pulton...... Grant...... •
Jay....,,,, Kosciusko
Laporte Miami,..., Newton Noble,,..,, Porter. Starke. Steuben,...,..,...,. St Joseph,, Wabash,.....,,.,... Wells .... White Whitley Central Counties Bartholomew Brown Clay...,,..,-.,.-... Clinton...... ,,,.... Decatur....,,,,.....
Fountain Hamilton ' Hendricks Henry .
Montgomery Morgan, Parke...... Randolph...,,.,.... Rush. •. Shelby.. Tippecanoe Tipton....,...,,,,.. Union...... Vermillion ....,,.., Vigo, Warren..., Wayne,.,,,, Southern Counties.,.,. Clark, Crawford Daviess Dubois ....,,.... Floyd ......
Harrison...... Jackson...... Jefferson , -
Lawrence...... — 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, 1913 (Stillbirths excluded.)
Annual Death Rate Per 1,000 Population, Important Ages. Deaths from Important Causes,
Population
CITIES. Estimated mated, 1913. (unde r 2 years ) | Yea r 191 2 t o Sam e Date . Tota l Death s Reporte d fo r 65 Year s an d Over , Diphtheri a an d Croup . Diarrhoe a an d Enteriti s Influenza. Pulmonar y Tuberculosis ; Cancer . I Tota l Death s Reporte d fo r | Date . | Rat e for " Yea r 101 2 t o , I Yea r 101 5 t o Date . I Sam e Date . ! 1 Tota l Death s Report fo r Septembe r 1913 . I Septembe r 1912 . I Unde r 1 year . j 1 t o 4 inclusive . | September , 1913 . | Tota l Death s Reporte d fo r | Augus t 1913 . I Othe r Form s o f Tuberculosi | Typhoi d Fever . j | Scarle t Fever . | Measles . j . Whoopin g Cough j j Loba r an d Broncho - I Pneumonia . | ! Cerebro-spina l Fever , j j Acut e Anterio r Poliomyeliti s I Puerpera l Septicemia, } ' Externa l Causes . i Smallpox , ' Death s i n Institutions. | Augus t 1013 . | September , 1912 . I 1 5 t o 9 inclusive . I Tota l Death s Reporte d fo r " I Rat e for year 191 3 t o | 5 t o 0 inclusive . | 1 0 t o 4 inclusive , Cities of the First Class. Population 100,000 and
Indianapolis Cities of the Second Class, Population 45,000 to 100,000.,,.. Evansville,..,..
South Bend Cities of the Third Class. Population 20,000 to 45,000, ,...,,, . Gary..... Muncie Richmond...... Anderson......
Cities of the Fourth Class. Population 10,000 to 20,000 East Chicago Elkhart.....,,,,.
Peru,,...... ,...... ,
New Castle.. Cities of the Fifth Class. Population under 10,000, Shelbyville..
Bedford ......
Wabash......
Whiting......
Linton...... Hartford City ...... Seymour
Portland......
Bluffton Rushville Martinsville
Greenfield i.. Sullivan Garrett...... Tipton...... Boonville... Auburn
Columbia City Tell City Attica ..
Gas City
Bicknell......
Huntingburg .
Delphi...... •• 1 Covington Butter City......
No deaths. Mortality of Indiana for September, 1913. (Stillbirths excluded,)
Annual Death Rate Per 1,000 Important Ages. Population.
POPULATION BY Under 1. 1 to 4. 5 to 9. 10 to 14. 15 to 19. I S5 and Over. GEOGRAPHICAL Population SECTIONS AMD Estimated AS URBAN AND 1913. RURAL. 1912 . 1913 t o Date . 1912 to Sam e Date . Date . 1913 , Sam e Date . Pe r Cent . Number . Pe r Cent , Number . Pe r Cent . Number . PER CENT Number . Augus t 1913 . Pe r Cent , Number . Rat e fo r Yea 191 3 t o Rat e fo r Yea 191 2 t o September , 1013 Tota l Death s Reporte d fo r Augus t Tota l Death s Reporte d for Septembe r Tota l Death s Reporte d fo r Yea i Number . j Pe r Cent . i Tota l Death s Reporte d fo r September , 1913 . j September , 1912. I Tota l Death s Reporte d fo r Yea Slats ...... Northern Counties., Cental Counties— Southern Counties... All Cities......
Oyer 100t000...... 15,000 to 100,000... 20,000 to 45,000 10,000 to 20,000 , , Under 10,000......
Deaths and Annual Death Rates Per 100,000 Population from Important Causes.
Lobar Diarrhoea Acute Pulmonary Other Diphtheria Whooping and and Cerebro Puerperal POPULATION BY Typhoid Scarlet Measles, Broncho* Anterior Influenza Cancer. External Small Tuber- Forma diphtheria Enteritis spinal Polio GEOGRAPHICAL tuberculosis.Tuberculosis Fever . and Fever. Cough. Pneumonia. Under Fever. myelitis. . Septicemia Causes. pox. SECTIONS AND . Croup. 2 Years.) AS URBAN AND RURAL. Deat h Rate . Deat h Rate . Number , Number . Deat h rate . Deat h Rate . Deat h Rate , Deat h Rate . Number . Deat h Rate . Deat h Rate . Deat h rate . Number . Deat h Rate , Number . Deat h Rate . Deat h Rate , Deat h Rate . Number . Number . Number . Number . Number . Deat h Rate . Number . Number . Deat h Rate . Number . Number . Number . Deat h Kate . 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
U. S, department of Agriculture, Weather Bureau, Condensed Summary for Month of September, 1913.
V. H. CHURCH, SECTION DIRECTOR, INDIANAPOLIS, IND.
TEMPERATURE IN DEGREES FAHRENHEIT.
Extremes. Departure Section from the normal. average. Station. Highest, Date. Station. Lowest. Date.
Home.. salamonia...
PRECIPITATION IN INCHES AND HUNDREDTHS.
Extremes.
Departure Section from the average. normal. Greatest Least Station. monthly Station, monthly amount. amount.
—0.04 Huntingburg. '.27 Whiting. 1.14