MISSISSIPPI VALLEY CONFERENCE ON TUBERCULOSIS LOUISVILLE, OCT. 4f 5, 6, 1916.

MONTHLY

BULLETIN

Indiana State Board of health ( E n t e r e d a s second-class m a t t e r a t t h e I n d i a n a p o l i s Postoffice)

INDIANAPOLIS, JUNE, 1916 ' Number 6 ABSTRACT OF MORTALITY STATISTICS FOR JUNE, 1916. Total deaths reported 2,494; state rate 10.6. In the preceding month 2.925 deaths; rate 12.0. In the same month W M . F. K I N G . M. D . . . . . . . . . . . . . . . , .. ASST. SECRETARY last year 2,360 deaths; rate 10.1. Deaths by important ages H. H. M I T C H E L L , M, D.,. .EPIDEMIOLOGIST J . L. AN D K R S O N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C H I E F C L E R K were: Under 1 year of age, 299 or 11.9 per cent of total; 1 C H A S . A. C A R T E R . M . D , STATISTICIAN to 4, 120; 5 to 9, 47; 10 to 14, 43; 15 to 19, 75; 65 and over, W M . S H I M E R , A. B . . M . D . . . S U P T . B A C T E R I O L O G I C A L L A B O R A T O R Y ADA E. S C H W E I T Z E R . M . D .ASSISTANT BACTERIOLOGIST 864 or 34.6 per cent, of total. R. J . A N D E R S O N . M . D • . . ASSISTANT PATHOLOGIST H . E . B A R N A R D . R. S., S T A T E F O O D AND D R U G C O M ' R AND C H E M I S T SANITARY SECTIONS: The Northern Sanitary Sec. E. B I S H O P . B. S . . . . . . . . . . . . . .ASSISTANT CHEMIST JOHN C D I G G S . . . . . . . . . - , - . . . E N G I N E E R AND W A T E R C H E M I S T tion, population 998,000 reports 903 deaths; rate 11.0. In WILL D. McABEE. .., Duties C H E M I S T the preceding month 1,032 deaths; rate 12.2. In the same The Monthly B U L L E T I N will be sent to all health o f f i c e r s month last year 820 deaths; rate 10.1. a n d d e p u t i e s i n t h e S t a t e , H e a l t h officers a n d d e p u t i e s s h o u l d c a r e f u l l y r e a d a n d file e a c h c o p y f o r f u t u r e r e f e r e n c e . T h i s is The Central Sanitary Section, population 1,178,368 reports very i m p o r t a n t , for w e e x p e c t t o p r i n t i n s t r u c t i o n s r u l e s a n d 1,034 deaths; rate 10,7. In the preceding month 1,268 deaths; g e n e r a l i n f o r m a t i o n , w h i c h i t will b e n e c e s s a r y f o r officers t o preserve. rate 12.7. In the same month last year 1,034 deaths; rate 10.7. CONTENTS The Southern Sanitary Section, population 684,552 reports B i r t h s for J u n e , 1916. 61 A b s t r a c t of M o r t a l i t y Statistics for J u n e , 1916. 81 557 deaths; rate 9.9. In the preceding month 625 deaths; S u m m a r y of M o r b i d i t y a n d M o r t a l i t y for J u n e , 1916. 61 rate 10.7. In the same month last year 506 deaths; rate 9.0. Health Officers A t t e n t i o n . 62 T h e Mississippi Valley Conference on Tuberculosis. 02 REVIEW OF SECTIONS: The Northern Sanitary SecR e p o r t of t h e D e p a r t m e n t of Food a n d Dru gs for J u n e . 63 I n s p e c t o r s R e p o r t for t h e M o n t h of J u n e . 63 tion presents the highest death rate, which is 1.6 higher than Progress in Medical E x a m i n a t i o n 63 that for the entire state, The Northern Section also preR e p o r t of Bacteriological L a b o r a t o r y for J u n e . . . . . . . . . . . . . . . . . 64 P a t i e n t s Who H a v e Finished P a s t e u r T r e a t m e n t , J u n e . . . . . . . . . . 65 sents the highest, death rate for typhoid fever, lobar and Miss Pauline Roe. 65 B e t t e r Bodies Needed 65 broncho pneumonia, 'cancer and external causes. The CenA Rural H e a l t h Officer 65 tral Section presents the highest death rate for scarlet fever, H u r r a h for Bluffton. 65 Rural Children , 65 measles, cerebro-spinal fever, influenza and puerperal septiVitamines. 65 T h e B a b y Was Uncomfortable 66 cemia. The Southern Section presents the highest death Dr. H e n r y E . V i t o u . . 66 rate for tuberculosis, diphtheria, whooping cough and diarrhea R e p o r t of C o m m i t t e e on Legislation a n d Physicians Welfare of t h e I n d i a n a Medical Association 6§ and enteritis. A Municipal Housing Survey. 66 A P a t h e t i c Incident. 66 RURAL: Population 1,552,380 reports 1,189deaths; rate Courses in Public H e a l t h 67 9.3. In the preceding month 1,402 deaths; rate 10.6. In the W i t h o u t a Health Officer 67 T h e I m p o r t a n c e of Legal Registration of B i r t h s . . . . . . . . . . . . . . . . 67 same month last year 1,140 deaths; rate 8.8. Eugene N o r m a n . 67 Sweep Away all W e a l t h . 68 URBAN: Population 1,308,540 reports 1,305 deaths; rate W a y n e Richard Replogle. 68 12J. In the preceding month 1,523 deaths; rate 13.7. In J a m e s Joseph P a g a n . 68 Baby Explains. 68 the same month last year 1,220 deaths; rate 11.6. The,cities Without. Dietary Measures. 68 Concerning Drugs, D r . Osier Says. 6S named present the following death rates: Indianapolis, 13.6; C o m m o n Drinking C u p s 68 Evansville, 12.0; Fort Wayne, 11.9; Terre Haute, 9,3; South C h a r t Showing Geographical Distribution of D e a t h s . . . . . . . . . . . 69 T a b l e 1. D e a t h s in I n d i a n a b y C o u n t i e s . . . . . . . . . . . . . . . . . . . . . . 70 Bend, 11.2; Gary, 15,5; East Chicago, 11.3; Muncie, 13.8; T a b l e 2 D e a t h s in I n d i a n a b y Cities 71 Hammond, 17.9; Richmond, 10.5; Anderson, 14.4; Elkhart, M o r t a l i t y in I n d i a n a . . 72 W e a t h e r R e p o r t for J u n e , ,^.^ ._. .._._._._....... . . . 72 12.0; Michigan City, 6.3; Lafayette, 14.4; New Albany, 11.2; Logansport, 12.5; Marion, 13.7; Kokomo, 11.4. BIRTHS FOR JUNE, 1916. Total births 4,778 (stillbirths excluded); state rate 20.4. Males 2,444; females 2,334. SUMMARY OF MORBIDITY AND MORTALITY White males 2,397; white females 2,295. FOR JUNE, 1916, Colored births 86; males 47, females 39, Measles was again reported as the most prevalent infectious Stillbirths 154; white 152t colored 2, The Northern Sanitary Section, population 998,000 reports disease. The order of prevalence was as follows: Measles, pulmonary- tuberculosis, tonsillitis, typhoid fever, acute rheu1,863 births; rate 22.7. The Central Sanitary Section, population 1,178,368 reports matism, diarrhea and enteritis, scarlet fever, whooping cough, diphtheria and croup, acute bronchitis, dysentery, smallpox 1,843 births; rate 19.0. The Southern Sanitary Section, population 684,552 reports cholera morbus, malaria fever, influenza, chickenpox, intermittent and remittent fever, bronchial pneumonia, lobar 1,072 births; rate 19.1. pneumonia other forms of tuberculosis, rabies in human, The highest rate. Lake County, 34.5. erysipelas, puerperal fever, rabies in animals, cerebro-spinal, The lowest rate, Union County 7.7. fever, poliomyelitis, trachoma. Total births to date for 1916, 32,087.

VOLUME X I X

J A M E S S. B O Y E R S . M . D . . P R E S I D E N T . , Decatur H. H . S U T T O N , M . D . VICE-PRESIDENT Aurora J. L. F R E E L A N D . M . D . . . . .Indianapolis CHAS. BRUCE K E R N , M, D . . . , . . . Lafayette J. N . H U R T Y , M . D., P h a r . D . SECRETARY. . . . . . . . . .Indianapolis

H

62

MONTHLY B U L L E T I N , I N D I A N A

S M A L L P O X : 102 cases reported in 21 counties with no deaths. T h e following counties reported smallpox present : Dekalb 2, Delaware 4, Hancock 6. Henry 2, Howard 3, J o h n son 3, Lake 2. Madison 2, Marion 1, Miami 10, Parke 12, St. Joseph 8, Vanderburg 2, Vermillion 4, Vigo 2, W a b a s h 2. T U B E R C U L O S I S : 323 deaths, of which 270 were of the pulmonary form and 53 other forms. Male tuberculosis, deaths numbered 155: females 168. Of the males. 23 were married in the age period 18 to 40 and left 46 orphans under 12 years of age. Of the females, 60 were married in the same age period as above and left 120 orphans under 12 years of age. Total orphans made in one m o n t h by this preventable disease. 160. N u m b e r of homes invaded, 310, P N E U M O N I A : 99 deaths, r a t e 42.3 per 100,000. In the preceding: m o n t h 206 deaths, rate 85.0. In the same m o n t h last year 88 deaths, rate 37.9, T Y P H O I D F E V E R : 135 cases in 33 counties with 17 deaths. In the preceding m o n t h 111 cases in 23 counties with 27 deaths, In the same month last, year 70 eases in 28 counties with 17 deaths, D I P H T H E R I A : 99 cases in 27 counties with 10 deaths. I n the preceding month 106 cases in 30 counties with 9 deaths. In the same m o n t h last year 71 eases in 22 counties with 11 deaths, S C A R L E T F E V E R : 140 cases in 28 counties with 4 deaths. In the preceding m o n t h 219 cases in 40 counties with 7 deaths. In the same month last year 136 cases in 34 counties with 1 death. M E A S L E S : 4,044 cases in 60 counties with 27 deaths. In the preceding month 5,035 cases in 72 counties with 37 deaths. In the same m o n t h last year 879 cases in 37 counties with 8 deaths. P O L I O M Y E L I T I S : 1 case in one county with no deaths. T h e case occurred in Vanderburg county. R A B I E S : I I persons bitten by rabid animals and treated by the State Board of Health during the month of J u n e There were no deaths, E X T E R N A L C A U S E S : Total 245, males 179? females 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 by food 6, other acute poisonings 5, burns (conflagration excepted) 7, absorption of deleterious gases (conflagration excepted) 7, accidental drowning 20 ? t r a u m a t i s m by firearms 5j traumatism by cutting or piercing instruments 3. t r a u m a t i s m by fall 39, t r a u m a t i s m in mines 2, t r a u m a t i s m by machines 2, railroad accidents and injuries 33, street-car accidents and injuries 5. automobile accidents and injuries 18. bicycle accidents and injuries l t motorcycle accidents and injuries 2, injuries by other vehicles 7, injuries by animals 7, effects of heat 5. lightning 4. electricity (lightning excepted) 7. fractures (cause not specified) 3, other external violence 10, Homicide: Total 11, males 9, females 2. Homicide by firearms 8. by cutting or piercing instruments 1, by other means 2. (Three external causes not received in time to be used in general tabulation.) HEALTH OFFICERS, ATTENTION. Delayed B i r t h a n d D e a t h Certificates, E a c h m o n t h the statistical d e p a r t m e n t receives certificates for births a n d deaths t h a t have occurred during t h e preceding m o n t h s , which are not sent to this d e p a r t m e n t in time to be tabula-ted with the report for the current m o n t h . W i t h t h e

STATE B O A r D

OF

HEALTH.

report for J u n e the following counties n a m e d below were delinquent in this m a t t e r .

BIRTHS, A d a m s 1; Allen 10 (Ft. W a y n e 4-1 for October, 1915): Bartholomew 6 (Columbus 2 ) ; Benton 1, for September, 1915; Boone 13 (Lebanon 6. T h o r n t o w n I ) : Brown 1; Carroll 2 : Cass 2 (Logansport); Clark 2; Clinton 1; Crawford 1: Dearborn 1: Dekalb 1; Delaware 8 (Muncie 6, Gaston 1); E l k h a r t 2 (City); Floyd 5 (New Albany 2 ) ; Franklin 2; Gibson 2; G r a n t 12 (Marion 4, Van Buren 1. Fowlerton 1, Gas City 1, for September, 1915); Greene 3-1, for August, 1 for October, 1915 (Lyons 1, for October, 1915); Hamilton 1; Harrison 1; Hendricks 1, for July, 1915; Henry 4 (New Castle 2, K e n n a r d 1); Howard 1; Jackson I ; Jasper 5 (Wheatfield 1); J a y 2 (Portland 1, for October, 1915); Jefferson 3 (Madison); Knox 14 (Vincennes 8, Bicknell 1); Kosciusko 2; Lake 6 (Gary 3, H a m m o n d 3-1, for October. 1915); Madison 4 (Elwood 2, Anderson L for M a y , 1915); Marion 2; Marshall 1 (Plymouth) M a r t i n 3 ; M i a m i 2 (Peru 1): Monroe 3 ; M o n t g o m e r y 3, for September, 1915, (Waynetown I, New M a r k e t 1); M o r g a n 1: Newton 3 (Brook 1, M t . Ayr 1); Noble 1; Orange 2 (West Baden 1); P a r k e 2-1, for J u l y . 1915; Perry 1; P o r t e r 3 ; Posey 5 (Cynthiana 2 ) ; Pulaski 3-1 for August, 1912, 1 for J a n u a r y , 1914 (Winamac 1); Randolph 1 ( L y n n ) ; Ripley 2 ; Rush 3 ; Scott 2; Shelby 3-1, for August, 1915 (Shelbyville 2 ) ; Spencer 9 (Dale 2 ) ; Starke 2, (Knox 1); Steuben 2; St. Joseph 3 (South Bend 2-1. for November, 1915) Sullivan 1 (Farmersb u r g ) ; Switzerland 2 ; Tippecanoe 3-1, for J u n e , 1915; (Lafayette 1); Vanderburgh 14 (Evansville); Vermillion 3 (Clinton 1, Universal 1); Vigo 3-1, for J a n u a r y , 2 for October, 1915; Wabash 4; Warrick 5-1, for M a r c h , 1913 (Boonville 1); Washington 3 (Salem 1); W a y n e 4 (Richmond 1. Spring Grove 2 ) ; Wells 1 (Bluffton); W h i t e .1 (Wolcott); Whitley 5-1, for August, 1915; T o t a l 233.

DEATHS. Adams 2; Allen 6 (New H a v e n 2 ) ; B e n t o n 1; C a r roll 1; Clay 1; Daviess 1; D e c a t u r 2 Greensburg); Delaware 1 (Gaston); Gibson 1 (Princeton); G r a n t 3 ; Greene 3 (Lyons 1); Hancock 1; H e n r y 4 , 1 for F e b r u a r y M i d d l e t o w n 1); H u n t i n g t o n 3 M a r k l e 1); J a c k s o n 3 Crothersvilie 1); Jasper 2 (Remington 1); Knox 3 Vincennes 1); Kosciusko 2; Lagrange 1; Lake 3 ( H a m m o n d 2 ) ; L a p o r t e 1; Madison 1 (Alexandria); M a r i o n 1 (Indianapolis); M i a m a 1 ( M a c y ) ; M o n r o e 1; N e w t o n 1; Owen 1; P a r k e 1; Pike 1; Posey 3 (Cynthiana 1); Ripley 1; R u s h 1; Spencer 6; W a r r i c k 1 (Lynnville for N o v e m b e r , 1915); Washington 1 (Livonia); Wells 3 (Bluffton 1); Whitley 1; T o t a l 70. (A typographical error in April bulletin charged J e n n i n g s C o u n t y with 10 delayed d e a t h certificates. T h e r e w a s 1 delay from this c o u n t y . )

T H E MISSISSIPPI VALLEY C O N F E R E N C E ON T U B E R C U L O S I S w i l l m e e t In Louisville, October 4, 5, a n d 6, E v e r y person interested in t h e conquest of consumption a n d who can possibly do so, should a t t e n d this conference. W e urge all health officers who possibly can do m to m a k e a pilgrimage October 4, 5, and 6 to Louisville a n d join in t h e conference on tuberculosis.

63

MONTHLY BULLETIN, INDIANA STATE, BOARD OF HEALTH.

REPORT OF THE DEPARTMENT OF FOOD AND DRUGS, INDIANA STATE BOARD OF HEALTH, FOR JUNE, 1916.

H. E. Barnard, Ph.D., State Food and Drug

REPORT OF ANALYSIS OF FOODS AND DRUGS DURING THE MONTH OF JUNE, 1916. Legal*

Inspections

No. Inspection

No. Excellent

No. Good

No. Fair

No. Poor

No. Bad

Grocery stores....... Meat markets. Drugstores... Bakeries and confectioneries,. Commisioner Hotels and restaurants Milk plants... Poultry h o u s e s . . . . . . . . . . . . .

During the month of June 106 samples of food were analyzed of which 76 were reported as legal and 30 illegal. Of the 66 samples of milk examined 19 were illegal. Several of these samples were watered or skimmed and a number were grossly contaminated with dirt. Four of the 17 samples of ice cream contained less than the required eight per cent, of butter fat. It is to be noted that only samples suspected of adulteration are collected and sent in for analysis and the high percentage of adulteration indicated by the chemist's work is in no sense evidence that the general food supply is unsatisfactory. On the contrary it is excellent. Twenty-nine samples of drugs were analyzed during the month but one of which, spirits of camphor, was listed as illegal.

CLAssifcaTION.

INSPECTOR'S REPORT FOB THE MONTH OF JUNE, 1918

Totals.

NOTICES OF CONDEMNATION DURING THE MONTH OF JUNE 1916.

Classification.

Reasons for C o n d e m n a Unsanitary tion I m p r o p e r Conditions. Construction

Total

Bakeries B a k e r y and r e s t a u r a n t s . . Cafes Confectioneries.......... Confectionery a n d lunch rooms. Creameries Dairies................. Hotels Groceries. Grocery a n d m e a t m a r k e t s Meat m a r k e t s . . . . . . . . . . . Restaur\ants. . . . . . . . . . . . Slaughterhouses......... Totals. . .

Illegal.

FOOD.

Beverages— Beer Cider Flour, . . . Meat Products— Hamburger .. Lard Preservative Milk P r o d u c t s — Butter. Buttermilk, Cream Ice C r e a m Milk, T o m a t o Catsup- . . . . Vinegar,. Totals DRUGS.

C a m p h o r . Spirits of. . . . Golden Sea 3. Novocain T a b l e t s . Peanut Oil Miscellaneous Totals. . . . . . . . . . . .

INSPECTOR'S REPORT FOR THE MONTH OF JUNE, 1916. The inspector's report for the month of June shows a total of 746 visits to food establishments. Three hundred and sixteen of the places visited were listed as good, 423 fair and 7 poor. This report does not include the work done by Inspector Bruner who is engaged in making a complete sanitary survey of the creameries and ice cream plants of the state. Twenty-three condemnation notices were issued during the month, 21 because of unsanitary conditions and 12 because of improper construction. But one prosecution was reported, Ackerman and Wiener of Fort Wayne, Indiana, were fined S24 and costs for selling short weight potatoes. The evidence shows that the defendant delivered 571 bushels of potatoes of 600 as alleged.

PROGRESS IN MEDICAL EXAMINATION. Rapid progress is being made in providing certificates of good health to all handlers of food. In many cities and towns the health officers have completed their work and for the present at least, those who hold certificates are known to be in good health. Many complications are arising in the enforcement of the law. This was to be expected. The law is unique and its operation is naturally hindered by lack of knowledge, ignorance on the part of employer and employees and the halfhearted co-operation of health officers. In some cities the Health Departments have been very active in enforcing the order of the State Board of Health. In the city of Logansport for example, Dr. R. E. Troutman, Secretary of the Board of Health, issued a notice to all employees of labor engaged in the production and distribution of 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 time to time and certificates must be shown at such inspections. Any employee not having such certificate will be at once dismissed and the law enforced." This is effective co-operation and is bound to produce good results. It is apparent that in some instances medical inspection blanks are being filled out without special attention being given to the inspection. In one instance a physician certified that forty persons were free from contagious and infectious disease in a single day. It is obviously impossible for any physician who is conscientious in his work to make forty examinations of the character required in a single day. The co-operation of all physicians is necessary to the proper working out- of the law, In the event that such cooperation cannot be secured and that the certificates are issued without a rigid examination it may become necessary to require, as has always been the case in New York City, that the certificate be issued by the Health Department.

64

MONTHLY

Indiana

STATE B O A r D

REPORT OF BACTERIOLOGICAL LABORATORY, INDIANA STATE BOARD OF HEALTH, F O R J U N E , 1916.

MalePositive Suspicious Negative Sex not given— Positive. . Suspicious Negative

Will S h i m e r , M . D . ,

Bulletin,

Superintendent

S p u t u m for tubercle bacilli— Positive Negative

. .

HEALTH.

.,.....'...............

Pathological tissues •Carcinoma— Carcinoma of nose. ............. Carcinoma of lip Carcinoma of breast. Carcinoma of uterus Carcinoma of rectum Carcinoma, location not g i v e n . . . . . . . . . . . Sarcoma— Sarcoma of jaw ...'........... Miscellaneous t i s s u e s . . . . . . . . . . . . . . . . . . . . .

Urine For tubercle bacilli -Suspicious Negative Pus for tubercule bacilli Negative Spinal fluid for tubercle bacilli— Negative Feces for tubercle bacilli Negative

Urine for chemical analysis.

Blood for tubercle bacilli — Negative.

Feces for h o o k w o r m Negative

Milk for tubercle bacilli — Negative. , Vomitus for tubercle bacilli — Negative

OF

..

Widal tests for typhoid fever— Positive Negative. ......... P a r a t y p h o i d tests for typhoid fever— Positive. Negative Throat cultures for diphtheria b a c i l l i Positive Negative.. . N o growth Brains for r a b i e s Dogs— Positive.......................... Rotten Negative. Cats— Positive Cows— Positive.... . . . . . . . . . . . . . . . . . . . . . . Hogs-— Positive............................. Mules— Negative.........................

Blood for c o u n t s . . . . . . . . . . . . . . . . . . . . . . P u s for gonococci— Females-— Positive.......................... Suspicious. Negative.

Feces for amoeba dysentery— Negative Feces for typhoid bacilli— Negative Feces for colon bacilli— Positive W o r m for identification Blood for malaria Plasmodia— Positive............................. Negative............................ T o t a l n u m b e r specimens examined Doses of antityphoid prepared a n d sent o u t . , Guinea pigs inoculated for r a b i e s Negative. Guinea pigs inoculated for tubercle b a c i l l i Negative.

OUTFITS P R E P A R E D A N D SENT OUT .JUNE, 1910.

DURING

Tuberculosis,.. Diphtheria.. , . Widals........ Blood c o u n t s . . Gonococci Malaria....... Total n u m b e r outfits prepared and sent o u t . . .

MONTHLY BULLETIN, INDIANA STATE BOArD OF HEALTH, PATIENTS WHO HAVE FINISHED

Town

Name

Mr. H. H. Willis.. Mrs. M. Elliott... Arthur Elliott Carlton Elliott..,. Thomas Smith Frenier Glidewell. Mr. T. 0. Myers.. Mr. E. T. Smith.. Miss B. Chapman. Mrs, M, Kissick., Miss K. Kissick ,.

Eberfield.... Muncie. Muncie Muncie Gas City . . . . Haughville. Haughville... London Indianapolis. Indianapolis. Indianapolis.

PASTEUR" T R E A T M E N T .

County

Age

Sex

JUNE, 1916

Treatment began

Treatment finished

Warrick.., Delaware. Delaware. Delaware. Grant Marion... Marion.,, Shelby.... Marion... Marion... Marion..,

MISS PAULINE ROE, desiring to go to Japan to fill a lucrative position writes the State Board of Health as follows: "I was born March 23, 1888, and desire to have a transcript of the certificate of birth. I want this to secure a passport, also to identify my nationality in Japan where 1 go to engage in the work of teaching." The parents of Miss Hoe and attending physician did not realize that some day she would desire greatly to have legal evidence of her birth and therefore no certificate of birth was made. How simple it would have been for the attending physician to have taken three minutes time and made out a birth certificate. A transcript of this certificate would be legal evidence of her birth and nationality. There is nothing more important to a child than to have its birth legally recorded.

BETTER BODIES NEEDED. It would appear that the old injunction to "crucify the flesh" had been taken entirely too literally by a large number of the American people, with the result that all kinds of defects are found in the physical makeup of the folks who have presented themselves for service In. the military army of the national defense. An exchange states that at least 80 per cent of the people who present themselves for enlistment are physically unfit, among the defects being narrow chests, flat feet, poor teeth, hammer toes, heart trouble, weak eyes, defective kidneys and 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 manhood of America physically fit. Gymnasiums should be established in every community. Outdoor sports and pastimes should be encouraged under proper instructors. Systematic physical exercise should be urged. Moderation. In food and drink should be taught. The burning of life's candle at both ends which seems to be verging toward a settled 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.— Logansport Pharos-Reporter.

A RURAL HEALTH OFFICER giving his whole time to the work is recommended by Dr. Q. Cope of Lexington, Mo. Dr. Cope says: "The sanitation, of the rural districts is generally bad. It has never had proper supervision and little or no advice from medical authority. Rural schools, mining camps, unincorporated villages and suburbs of cities are all too frequently in a. deplorable sanitary condition and there Is no one In authority to correct this state of affairs or give relief. The water supply, the disposal of dead animals, protection against flies, mosquitoes, proper construction of

65

closets and other sanitary matters are subjects of genera regulation and a general system of education should be carried on in regard to all such matters. Farmers generally think what was good enough for their father is good enough for them, In consequence they frequently oppose the health officer in everything that is not absolutely necessary and then even ridicule the advice of physicians whom they have called to attend their sick," Dr. Cope is emphatic in his contention that the rural district's needs in every state are for health officers skilled in the work, thoroughly trained in hygiene and sanitary science and giving their whole time. Dr. J. C. Boone of Charleston, Mo., heartily seconded the contention of Dr. Cope. HURRAH FOR BLUFFTON! The mayor and city council, and citizens of Bluffton seem to have the right stuff in them. Very probably many of them are of the kind who would dress up like Indians and board a ship and throw tea overboard. These remarks are prompted by the fact that the Bluffton city council recently authorized the city clerk and city treasurer to continue the payment of S200 per year to the city health officer, Dr. C. H. Mead, the council to assume the responsibility. This was necessary because it was found that under the law as interpreted by the accounting board it was lawful to pay only $100 per year. Dr, Mead resigned when Ms salary was reduced according to the ruling 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 the money paid the health officer, and continuing he says: "The issue between the city and the accounting board resolves itself into the question whether or not the city shall be permitted to pay enough salary or secure the services of a competent health officer and protect Itself against disease," If Indiana has a health law which aids and abets disease, it should be abolished and this is exactly what the law does in more than one of its features. Until we have all-time health officers, properly paid and properly empowered, there will be no further reduction in morbidity and mortality rates in Indiana.

RURAL CHILDREN, and the children of smaller cities and towns are more defective physically than those in the great cities and this is due to the fact that the cities have for the past 15 to 20 years spent much time in medical supervision of school children and also because the larger cities have given greater attention to hygiene This is a quotation from Dr. F. M. Hollingshead in the Lancet Clinic of July 8, 1916.

VITAMINES. 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 be said to give life to foods, Rice, one of our best known foods is wholesome and nourishing, but if we remove its faintly brown coat by polishing, it becomes actually poisonous. Pigeons or chickens fed on polished rice quickly develop paralysis and die, but they grow well and strong if the ines are In the coatings of the grains. Whole unpolished rim grains, will support life in birds and people, but when polished, they lose their food value. Until lately, polished rice was sold at all groceries, but now the health authorities forbid Its

66

MONTHLY BULLETIN, INDIANA STATE BOArD

sale. It was polished by tradesmen to make it white and pearl like in appearance. Natural rice is not as pretty as polished rice, but "pretty is that pretty does" and so we have gone back to the natural grain. A disease called beriberi which is frequently fatal, is caused by eating foods in which the vitamines have been destroyed by over-cooking or removed as in the instance of polished rice. Another disease called pellagra which frequently ends in insanity and death 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 to make it light, has its food value destroyed, If, however, the corn meal and soda are made into a dough with sour milk instead of water or sweet milk, then the vitamines are not killed. This is because the lactic acid in the sour milk neutralizes the bicarbonate and makes lactate of soda which does not attack vitamines. At the same time the lactate acid liberates the carbon dioxide gas and it makes the corn bread light and more wholesome. Biscuits made light with bicarbonate of soda (baking soda) and which always have a "soda taste,*' are very unwholesome, Bicarbonate of soda is frequently called simply "soda", but this is not soda as known to chemists for they apply this name to concentrated lye. Cooks should not use bicarbonate of soda in cooking dried beans, dried corn, dried peas, and the like, even if it does hasten the process. Our modern fine process white flour, is not as wholesome and nourishing as so-called whole wheat flour because the high milling process takes out the vitamines. Canned goods have no vitamines, or at most only very small amounts. Nevertheless they are desirable foods, but people who "live out of cans" make a great mistake. Everyone should eat some raw food or foods every day, at every meal, if possible. All raw fruits and vegetables contain vitamines. Salads are always wholesome, but they like all foods should be eaten in moderation. "An apple a day keeps the doctor away," is an old saying and means eat plenty of raw fruit. THE BABY WAS UNCOMFORTABLE, and no wonder, for it wore a hood and the day was hot and the smoke and dust came into the train window in generous quantities. I suggested to the mother, who seemed intelligent, that her infant would be more comfortable and cease fretting if the hot hood was removed, and further 1 asked? why oppress the helpless thing with a hood anyhow. She replied pleasantly, "Oh, it'll only be an hour or two before we get off and I don't want the trouble of taking off the hood and putting it on again." She was wholly unappreciative of her terrible selfishness, and yet die doubtless would have willingly given her life for the child. To the question why a hood in such hot weather, she replied, "Oh, she must have a hood Even if it tortures the helpless child. I asked. She hesitated, then said, "Well oh, ah, she must have a hood." So the helpless innocent, continued to suffer. Infant mortality will decrease when mothers care for their offspring with more intelligence and higher reason.

DR. HENRY E. VITOU, who is county health commissioner 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 connection; ' T find the farmers are taking more pride in their places than formerly yet it was necessary to order a few to clean up and some to drain their ponds, and improve unsanitary conditions around their houses. At the town of Lakeville

of

HEALTH

I issued four orders to improve very bad sanitary conditions The report shows that Dr. Vitou did a good work. He is letting the people of his county know there is such an official as a county health commissioner, and that he is a valuable commissioner. There are other county health commissioners who have done likewise but they are all too few. There are many counties wherein the people hardly know they have such a thing as a health officer.

REPORT OF COMMITTEE ON LEGISLATION AND PHYSICIANS WELFARE OF THE INDIANA MEDICAL ASSOCIATION. The committee appointed on Legislation and Physicains Welfare, wish to make the following report. We would recommend that the State Narcotic Law, be repealed and made to conform to the Harrison Narcotic Law, It is rumored that the National Association of Druggists will endeavor to have a law passed at the coming legislature to compel physicians to write prescriptions for all patients r and not allow them to issue any medicine at the bedside, Such a law would be taking away the rights of the physician, besides doing great harm to the public. We condemn such a law as unjust and uncalled for. We would discourage the habit of druggists refilling prescriptions without the consent of the physician. Often a whole neighborhood will benefit from a doctor's prescription by having it refilled, without any compensation for the doctor. We condemn fee splitting as unjust and unprofessional and no reputable physician should tolerate it. We recommend that no party or cult be allowed to practice medicine in Indiana without first passing an examination before an examining board, and that all shall be measured by by the same stick. We recommend that the Working Men's Compensation 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 physician shall have the same fees that prevail in the locality where the injury occurred, and that the company shall pay fulltime hospital and medical fees instead of for thirty days only. As people are demanding so much from the Boards of Health over the state, and will demand more each year, and, as a practicing physician cannot spare the time to look after it, we urge the coming legislature to pass a law creating an All Time Health Officer.

A MUNICIPAL HOUSING SURVEY has been started in South Bend. Mayor F. W. Kelly, and city health officer, Dr. C. S. Bosenbury have both issued public statements concerning the importance and benefits to be derived from a thorough survey of houses. Many business men are interested and the newspapers have taken up the work. Of course public opinion, under such an impetus will soon be aroused and then 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 degree of honesty, and an improvement in public health,

A PATHETIC INCIDENT occurred in one of the Indianapolis Schools when a six: year old boy who was near-sighted made a pair of spectacles for himself, The health supervisor found the boy was near-sighted and sent a letter to the parents directing that the chid be taken to an occulist and

MONTHLY BULLETIN, INDIANA STATE BOArD OF HEALTH. supplied with glasses. Days passed and the youth continued to appear without glasses. Another note was sent to the parents and the boy interrogated as to why his eyes were not looked alter. It was finally learned the parents took no interest in their child. At least they took no action for the care of his eyes. Finally the ingenious youth realizing his need and his parents inability to care for him, secured some wire and made a frame. Then taking a milk bottle he broke off pieces and fitted them in the frame. There was a great surprise when he appeared in the school with the glasses but the little fellow contended they helped his eye-sight. This effort to help himself brought him a good pair of glasses from the Health Department. This is not the first instance where parents have refused or failed to take proper care of their children.

A sick person, no matter how the sickness was acquired, is a pitiful sight. He does not add to the gayety of the nations. Individuals have their origin in a physiologic process. We cannot lift the race by perpetuating the unfit. Only through eugenics can the race advance. Saving the unfit will not make a strong people. Education is to man what manure is to plants. Permanent progress is a matter of ancestry. "COURSES IN PUBLIC HEALTH" is the title of Bulletin No. 9 of the University of Colorado. This institution is prepared to give the following degrees upon completion of the various courses of study prescribed: Doctor of Public Health Master of Science in Public Health Master of Science in Sanitary Engineering Certificate in Public Health. The requirements for admission are: Graduate of the University of Colorado; graduate of any college or scientific school of equal rank with the University of Colorado, A student from any institution must submit his credits to the Registrar for evaluation. A graduate student who wishes to become a candidate for a degree must make special application. Students who are not candidates for a degree but who desire to pursue courses of studies along public health 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 completed. The bulletin says "A student who has a degree M. D. will come with certain requisite knowledge and should be able to fulfill the conditions for the degree Master of Science in Public Health in one year, A student who has little or no medical knowledge must of necessity take certain medical courses before the degree can be conferred. Candidates for the degree Doctor of Public Health must possess a baccalaureate degree from an. institution of recognized standing. The degree M. D. while not absolutely essential is advisable. Certain studies with the degree Master of Science in Engineering and others with the degree B. A. whose work has been largely in chemistry and biology will be admitted to candidacy A minimum of two full years of graduate study of public health problems and demonstration the equivalent of not less than 60 semester hours together with a thesis based upon original investigation are required for the degree of Doctor of Public Health. The degree will only be given for high attainment in general and marked ability in a special field including particular power in original investigation as

m

proven by a thesis. The certificate in Public Health is granted to those students who during the school year from September until the following June pursue at their home certain reading and study courses which are conducted by correspondence through the Extension Division of the University. Then the student attends the summer session of the University for six weeks during which time he takes his examinations upon work studied in absentia and pursues certain library courses. This process is repeated for four years and upon the successful completion of the course, the University grants a Certificate in Public Health This bulletin of the University of Colorado is another proof of a demand that the public health officer shall be a trained man, thoroughly informed in the work he is called upon to do.

"WITHOUT A HEALTH OFFICER WHO IS CONSTANTLY SERVING THE PUBLIC AS HIS ONE AND ONLY BUSINESS, THE HEALTH OF THE LOCAL COMMUNITY WILL SURELY BE NEGLECTED." This sentence occurs in a pamphlet entitled Tuberculosis Legislation in the United States, Compiled by the National Association for the Study and Prevention of Tuberculosis. The all-time health officer will come in Indiana just as soon as Indiana catches up with the public health procession.

THE IMPORTANCE OF LEGAL REGISTRATION OF BIRTHS is well illustrated by the Indian boy who was born on the Colville Reservation, Washington, at 11 P. M. on April 30. If the record had not shown that he was born at this hour, he would have lost a nice farm of 160 acres of land. President Wilson signed a proclamation throwing open for settlement by homesteaders the Colville reservation of 350,000 acres of land. The proclamation provided there should be reserved a quarter of section for each Indian child born before May 1. The Indian baby arrived at 11 o'clock P. M. April 30. He is therefore richer by 160 acres of land than he would have been if his arrival had been delayed a few hours and it is important to know that a legal certificate of birth from the attending physician is necessary to secure this land to the child, Now suppose the attending physician, like many Indiana physicians, neglects to report the birth. What a great wrong would be done to the innocent child.

EUGENE NORMAN lives at Hope, Indiana. He is, a grandson to Senator E. A. Norman. The little fellow was given a penny and gleefully ran to the grocery store to buy some candy. He was sold a candy egg which contained a small marble, the candy being coated upon the marble, He swallowed the marble and in consequence suffered terribly. All efforts for sometime failed to expel the foreign body but finally success was secured. At one time it was thought necessary to perform a surgical operation for his relief Cheap candies are to be regarded as unwholesome and dangerous. There should be a law forbidding the manufacture and sale of candies which might in any way threaten accidents to children. In this connection it would be proper to state that too much candy is eaten by children, in these days, The cheap candies at the corner grocery near the schoolhouse certainly raise havoc with the stomachs of the children. The State Board of Health has testimony from good physicians to the effect that indigestion, gastro-enteritis and other disturbances of the intestinal track have frequently been caused 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 people remains, they will reproduce it, but if our health is destroyed and the wealth remains, it would soon crumble away. A wealthy nation is necessarily a healthy nation. Let ill health, sickness and disease prevail in a certain degree in any nation, and it will be lost. All of these truths are selfevident yet legislators, and business men are not greatly interested in health, the fundamental basis of life, as they should be.

WAYNE RICHARD REPROGLE, whose picture is printed on this page was born in Kokomo, December 2, 1915. His mother writes us he weighed seven pounds at birth. She also informs us "he has never been sick a minute and has never been rocked nor been fed a drop of anything but mothers' 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 air." Wayne Richard Reprogle's picture as here printed, was taken when he was four months old. He then weighed 19-J pounds. Mrs. Reprogle says "I am delighted with the Indiana Mothers Baby Book and follow7 its directions in every particular.

Oh my, 'twas hard to give it up* whatever should I do? They wouldn't let me suck my thumb for that was harmful too But now the worst is over and I can hardly wait To see about the contour and if my teeth come straight. When I get big and see a child who has a pacifier I'll hunt the mother up and do my duty by her I'll tell her all 'bout contour, and spoiling baby's mouth 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 Wish every child who sucks his thumb, or has a pacifier, Could meet a nice good doctor-man, like I did on the Flyer, "YOUR HEALTH

Cleveland, 0 .

WITHOUT DIETARY MEASURES all remedies fail This is the utterance of Roussel and is certainly true. Further, this eminent physician says: ''When drugs and good food are simultaneously employed it is to the latter the curative action results. The former exercises simply adjuvant action and is 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 15, 1875. The fact that he is a born American and the date of his birth were necessary to secure his release from internment in England. The certificate of birth has been forwarded and it is hoped that it will be sufficient to prove Mr, Fagan's citizenship. Had no birth certificate been made out, Mr. Fagan would have been in a bad fix.

CONCERNING DRUGS, DR. OSLER SAYS: "The only drugs that are worth an oyster-shucker's oath are those that smell good, taste good, look good and are harmless." Dr. Barker, who is Dr. Osier's successor at John Hopkin's University, says: "In my opinion there are but six efficacious drugs known, to-wit: Mercury, iron, quinine, salicylic acid and two more."

BABY EXPLAINS.

COMMON DRINKING CUPS.

We were riding on the flyer all the family going South I was feeling very comfy pacifier in my mouth A doctor man in front of us asked the privilege to inquire If mother thought 'twas good for me to use a Pacifier?

WHEREAS, It has been repeatedly demonstrated that the use of what is usually known as the common drinking cup is dangerous and is an undoubted source of communication of infectious diseases; now, therefore, in the interest of the public health,

And then the doctor spained to her (as we were going South) How it would surely spoil my teeth and the contour of my mouth And then he said an awful thing, how sometimes it would make Cankers in the saffigus and cause a stomach ache. He said it used the saliva up and that it might cause worms Besides 'twas such a dirty thing, all covered with germs This seared my mother dreadful and before we'd traveled far She grabbed the pacifier and threw it from the car.

IT IS ORDERED BY THE INDIANA STATE BOARD OF HEALTH THAT—the use of the common drinking cup in public conveyances, stations, hotels, restaurants, public buildings, parks, at fountains and all other places where water is provided for public use is hereby prohibited from and after August 1, 1916. The term, "Common drinking cup" as used herein is and available for common use by the public.

MONTHLY BULLETIN, INDIANA STATE BOARD OF HEALTH.

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

Sanitary

seCTION

Total population, . . . . Total deaths, , . D e a t h r a t e p e r 1.000. Pulmonary Tuberculosis rate per 100,000. " O t h e r f o r m s of T u b e r c u l o s i s , r a t e per 100,000. . T y p h o i d F e v e r , r a t e p e r 1.00,000 D i p h t h e r i a a n d C r o u p , r a t e p e r 100,000 S c a r l e t F e v e r , r a t e p e r 100,000. . . . . . . . . M e a s l e s , r a t e p e r 100.000 . W h o o p i n g C o u g h , r a t e p e r 100,000. . . . L o b a r a n d Broncho - P n e u m o n i a , r a t e per 100,000 Diarrhoea and Enteritis (under 2 y e a r s ) , r a t e p e r 100,000 C e r e b r o - S p i n a l F e v e r , r a t e p e r 100,000 A c u t e A n t e r i o r Poliomyelitis., r a t e per 100.000 " I n f l u e n z a , r a t e p e r 100,000. P u e r p e r a l S e p t i c e m i a , r a t e per 100,000 C a n c e r , r a t e p e r 100,000 E x t e r n a l c a u s e s , r a t e p e r 100.000 S m a l l p o x , r a t e o e r 100.000 Central

sanitary

998.000 903 11.0 79.4 17.1 8.5 .*> .2 1-2 .3 58.7 33.0 1.2 6. 1 6.1 83.1 117.4 ....

SECTION

Total population 1,178,368 Total deaths 1.034 D e a t h r a t e per 1.000 ,, 10.7 Pulmonary Tuberculosis, rate per 100,000 120.1 O t h e r f o r m s of T u b e r c u l o s i s , r a t e per 100,000 '. 29.0 T y p h o i d F e v e r , r a t e p e r 100,000. . . . D i p h t h e r i a a n d C r o u p , r a t e p e r 100,000 S c a r l e t F e v e r , r a t e p e r 100,000 M e a s l e s , r a t e p e r 100,000 ....... W h o o p i n g C o u g h , r a t e per 100.000. . . . Lobar and Broncho-Pneumonia, rate p e r 100,000. , Diarrhoea and Enteritis (under 2 year r a t e per 1 0 0 , 0 0 0 C e r e b r o - S p i n a l F e v e r , r a t e p e r 100,000 Acute Anterior Poliomyelitis, rate per 100,000 I n f l u e n z a , r a t e p e r 100,000. . P u e r p e r a l S e p t i c e m i a , r a t e p e r 100,000 C a n c e r , r a t e per 100,000. E x t e r n a l c a u s e s , r a t e p e r 100,000 S m a l l p o x , r a t e p e r 100,000

6.2 1.0 2.0 11-5 12.4 41.1 2 1.7 2.0 8.2 9.3 74.5 96. 3 ....

Southern Sanitary Section Total population , Total deaths D e a t h r a t e p e r 1.000 Pulmonary Tuberculosis, rate p e r 100.000 ........ Other forms of Tuberculosis r a t e per 100,000. T y p h o i d F e v e r , r a t e p e r 100,000 D i p h t h e r i a a n d C r o u p , rate per 100.000 S c a r l e t Fever r a t e per 100,000... M e a s l e s , r a t e p e r 100,009 Whooping Cough, rate per 100,000 Lobar and Broncho p n e u m o n i a 100.000 Diarrhoea and Enteritis (under 2) r a t e p e r 1 0 0 . 0 0 0 Cerebro-Spinal Fever, rate per

100,000 Acute Anterior Poliomyelitis, r a t e per 100,000 I n f l u e n z a , r a t e p e r 100,000 Puerperal S e p t i c e m i a , r a t e per 100,000 . C a n c e r , r a t e p e r 100,000 E x t e r n a l c a u s e s , r a t e per 100.000 S m a l l p o x , r a t e per 100.000...- •

648,532 557 9.9 l.>8.> 19.6 7.1 7.1 ..... 5.3 19.6 19.6 55.2

7.1 7.1 71.2 94.4 . ...

|NDIANA.

Reported f

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. c e n t r a l 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..............

Deaths of NON-Residents.

Deaths in Institutions.

Smallpox.

Puerperal Septicemia.

Cancer. External Causes.

Influenza.

Acute Anterior Poliomyelitis,

Whooping Cough, Lobar and BronchoPneumonia. Diarrhoea and Enteritis (under 2 years). Cerebro-Spinal Fever. |

Diphtheria and Croup.

Scarlet Fever.

Typhoid Fever.

Pulmonary Tuberculosis.

Other Forms of Tuberculosis

Years and Over.

15 to 19 Inclusive.

65

10 to 14 Inclusive.

1 to 4 Inclusive,

5 to 9 Inclusive.

Measles*.

Death from Important Causes.

Important Ages.

Under 1 Year.

Rate for Year 1916 to Date. Rate for Year 1.915 to Same Date.

May, 1916.

June. 1915.

Annual Death Rate per 1,000 Population.

J u n e , 1916.

Total Deaths Reported for the Year 1915 to Same Date.

Reported Total Death a June, 1915.

Total Deaths Reported for the Year1916to Date.

Reported Total Deaths May. 1916.

for

Deaths

Population, Estimated 1916.

Total June. 1916.

STATE AND COUNTIES.

for

TABLE 1, Deaths in Indiana by Counties During the Month of June, 1916, (Stillbirths Excluded.)

Cities of t h e First Class. Population 100,000 a n d o v e r . .

Indianapolis....... Cities of t h e Second Class. P o p u lation 45,000 t o 100,000. . . . . . . . . . . I

Evansville......... Fort W a y n e . . . . . . . Terre Haute South Bend, , Cities of t h e Third Class. Population 20,000 t o 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 t h e Fifth Class. Population u n d e r 10,000 Frankfort......... Columbus......... Goshen. . . . . . . . . . . Wabash Connersville Whiting Clinton Washington. . . . . . . Valparaiso ..... Linton Lebanon. Madison.......... Princeton.......... Hartford C i t y . . . . . Seymour. Kendallville -Mt. Vernon Greensburg Portland ...... Bluffton.. . Noblesville........ Rushville... .. • Alexandria........ Aurora. Martinsville Franklin.......... Warsaw Decatur. GarrettSullivan.. . .... Winchester Greenfield Boonville.... Mitchell.. . . . . . . . . Tipton........... Auburn........... Lawrenceburg Plymouth Greencastle....... ,| Tell C i t y

;

Columbia C i t y . . . . . j Attica ' Union C i t y . . . . . . . . Rochester... . . . . , , , Jasonville.......... Gas C i t y . . . . . , Dunkirk .: North Vernon ; Angola...........' Bicknell.... ! Montpelier........ Rockport.......... Crown P o i n t . . . . . . . Loogootee. Batesville.... . . . . . . Huntingburg Rensselaer......... Jasper............ Monticello........ ligonier Delphi Cannelton......... Covington....... Butler.. . . . . . . . . . . ' Veedersburg.......; Rising S u n . . . . . . . . j Vevay............i

Deaths in Institutions

Deaths of Non-Residents

External Causes

Smallpox

Septecemia Cancer

Puerperal

Acute A interior Poliomyelitis

f Cerebro-iSpinal Fever

Diphtheria and Croup

Typhoid Fever

Pulmonary Tuberculosis [Other Forms of Tuberculosis

to 19 inclusive 15

Whooping Cough Lobar and BronchoJ Pneumonia

Deaths from Important Cauaes

65 Years and Over

10 to 14 inclusive

5 to 9 inclusive

1 to 4 inclusive

Diarrhoea andEnteritis(under 2 years)

(Stillbirths Excluded.)

Important Ages

Under 1 Year

Rate for Year 1916 to Date Rate for Year 1915 to Same Date

May, 1916

June, 1915

June, 1918

Total Deaths Reported for the Year 1915 to same date

Total Deaths Reported for the Year 1916 to date

Total June, 1915

Annual Death Rate per 1.000 Population

Scarlet Fever Measles

Deaths Reported for

total Deaths Reported for May, 1916

Population, Estimated, 1916

CITIES

Total Deaths Reported for June, 1916

TABLE 2. Deaths in Indiana by Cities During the Month of June, 1916

Important Ages

Number

Per Cent.

Over

PerCent,

Number

Per Cent.

[Number

65 and

15 to 19

10 to 14

Per Cent.

5 to 9 Number

1 to 4

Number

Number

Under l

Per Cent,

Rate for Year l 9 1 5 bo same date

Rate for Year 1916 to date

June. 1915

June, 1916

May, 1916

Annual Death Rate per 1,000 Population

Total Deaths Reported for the Year 1915 to same date

Total Deaths Reported for the year 1915 to date.

Total Deaths Reported for J u n e , 1915

Total Deaths Reported for May, 1916

POPULATION PopulaBY GEOtion GRAPHICAL SECTIONS AND Estimated 1916 AS URBAN AND RURAL

Total Deaths Reported for June, 1916

Mortality of Indiana for J u n e 1916, (Stillbirths Excluded.)

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. External Causes

Smallpox

Number

Death Rate

Number

Death Rate

Number

Death Rate

Death Rate I

Cancer

.

Puerperal Septicemia

Number

I Death Rate j

i

Influenza

Number

Death Rate |

Number

Death Rate

I

I

Acute Cere- Anbro- terior spinal PolioFever myelitis

I Number

Death Rate i

! Number

|

Death Rate \

Number

Death Rate !

Number

Death Rate ;

i

Death Rate -.

Number

Death Rate j

Number

;

Number

Death Rate

Number

I Number

Death Rate

Number

Death Rate ;

Lobar Diarrhoea and Whoopand Pulmon- Other Typhoid DiphBroncho Enteritis Forms fever theria Scarlet Measles ing ary POPULATION BY (Under Cough Fever Pneuand TuberTuberGEOGRAPHICAL 2 Years) monia Croup SECTIONS AND culosis culosis AS URBAN AND RURAL

State Northern Counties. Central Counties... Southern Counties. All Cities Over 100,000..... .

45,000 20,000 10,000 Under

to 100,000. . to 45.000.. . to 20,000. . . 10,000

Country. . . . . . . . .

U. S. Department, of Agriculture, Weather Bureau. Condensed S u m m a r y for M o n t h of J u n e , 1916. J. H. ARLINGTON, SECTION DIRECTOR, IN CLIMATOLOGICAL DIVISION TEMPERATURE—IN DEGREES FAHRENHEIT

Section Average

Extremes

Departure from the Normal

Station

Highest

Lowest

Date

Auburn

Princeton. PRECIPITATION

Section Average

Station _

Date

IN INCHES AND HUNDREDTHS Extremes

Departure from the Normal

Station Shoals

Greatest Monthly Amount

Station Mount Vernon.

Least Monthly Amount