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Mortality Among Children, Week Ending January 18, 1913.
Under 1 Year of Age.

Under 5 Years of Age.

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• Includes Small Pox, Measles, Scarlet Fever, Diphtheria and Whooping Cough. Deaths According to Cause, Annual Rate per 1,000 and Age, with Meterology and

Number of Deaths in Public Institutions for 13 Weeks.

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Total deaths... 1,213 1,238 1,149 1,302 1,216 1,354 1,25 1,420 ' 1,333 1,481 1,403 1,519 1,512 1,:46 Annual death

} rate.......

12.53 12.48 11.59 13.13 12.26 13.65 12.62 | 14.32 13.44 14.93 14.15 14.75 11.68 15.01 Typhoid fever.. 18

14

14
12 6

7 3
Malarial Fevers.
Small-pox ......
Measles
2

8 Scarlet Fever...

9
8

8

15

14 II Whooping Cough

4 3
4 3

3

5 Diphtheria and Croup .....

13
15 17 22 26 22 19 3c 27 26 22

26

25 Influenza 3 + 3 4 2

5

16 17 14 21 Cerebro-Spinal Meningitis.)

9
1

3 4

6 Tuberculosis Pulmonalis

13
122
135 140

166
153 175
147 176

171 Other Tubercul lous...... 18 26

33 18
27
25 II 16

23

26 17 28 Acute Bronchitis

10 TO
11 12

10

13

19 18 Pneumonia.. 90 89 89 77 115

127 135 150

141

191 130 162 Broncho Pneumonia...... 79 72

69
102 80 I09

I10 104 123 Violent Deaths.. 68 73

98
73 76 87

81

77 74

6 :7578 6 2

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Under one year.

261
273
231 22€ 246

237 177 204 199 249 243 270 Under five years 372

331
332 315 354
345 279 311 325 363 366

383 Five to sixty-five

717 671 776
791 782

859 863 845 Sixty-five years

198

236 and over...

253 230 224
284 272

397 283 318 In Institutions...

514 451

535 1 457 592 508 561 492 586 590 608 Inquest cases .... 162 183

205 179

215 231

244 192 203 Mean barometer. 30.03 29.85 29.86 29.97 29.87 29.91 29.93 30.02 29.96 29.81 29.93 29.69 30.16 30.19 Mean humidity.. 59. 74.9 62. 63.6 63.6 55.3 01.7 71.7 152.9 64.9 €6.4 68. 74.6

71.9 Inches of rain

3.79in .Soin 2.26in.28in. 1.99in .65in or snow....

.72in 1335 in 2.33in .72in. .78in Mean tempera

ture (Fahr

enheit)..... Maximum tem

1 perature 172.o 69. 72.o 67.°

72.o
66. 55.0 64.0 '46.0 51.

44.

59.9 58.0 63.0 (Fahrenheit) Minimum temperature 47. 37. 31.° 35. 32.° 28.0 34.

18.

200

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57.90 156.40 54.40 56.60 31.70 18.30 40.11 48.0 33.40 41.10 33.6 43.60 39.90 11.99

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32.° 24.

18. (Fahrenheit)

40.0

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522-A-13 (B) 2000

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DEPARTMENT OF HEALTH

Report for Week Ending January 25, 1913

THE PUBLIC AND THE NEw MilK REGULATIONS. A circular which has recently been issued by the department calls attention to the different grades of milk which are permitted to be sold in New York City and describes the purposes for which the various grades may properly be used. The importance of obtaining a pure milk supply for a large city can hardly be overestimated, not only from the viewpoint of the nutritive value of the milk, but also on account of the danger of transmission of a number of diseases through this medium. The circular which follows will be supplied in quantity to associations or individuals volunteering to assist in its distribution. The Department wishes to disseminate this information as widely as possible in order that all citizens may avail themselves to the fullest possible extent of the protection afforded by the recent improvements in the official control of New York's milk supply.

“ADVICE TO THE PUBLIC ON THE USE OF MILK. "The rules and regulations of the Department of Health require that all milk, whether in bottles or cans, shall be labeled with the grade for which a permit has been issued.

"The rules and regulations relating to the sale of milk will be sent to anyone on application. By calling at the Department any person may obtain information as to the grade of milk each dealer in the City is permitted to sell.

“The Department should be informed whenever these regulations are not complied with.

"Plan for Milk Grading. “Grade A. Suitable for infants and children—This grade of milk is sold only in bottles, the caps of which must be marked 'Grade A.' This grade comprises certified milk, guaranteed milk, inspected milk raw and selected milk pasteurized.

"Grade B. Suitable for adults—This grade may be sold in bottles or cans, caps and tags of which must be marked "Grade B.' in large, green letters on a white ground. This grade comprises pasteurized milk and selected milk raw.

"Grade C. Suitable for cooking purposes only_Must be plainly marked in red letters 'Grade C. for cooking. From the sanitary standpoint, this is the poorest grade of milk that is permitted to be sold and should never be used for babies or children. All milk stores selling Grade C. will be required to display a placard so stating.

"Pasteurized milk of either grade must be plainly labeled 'pasteurized.' Pasteurized milk is considered by the Department safer than raw milk of the same grade.

"Whenever milk is sold for immediate use by adults, as in restaurants, hotels, clubs, bakeries, lunch counters, dairies, it must be either Grade A or Grade B quality.

"Whenever possible, bottled milk should be purchased so that the quality may be known from the label. This holds true when milk is bought for the family or when used at the table in hotels, restaurants or similar places.

"Advice to Mothers. "It is advised that Grade A milk only be used for infants. In case Grade B milk must be used, the pasteurized is the safer. If Grade B raw milk must be used, it should be first pasteurized or boiled in the household.

“Grade C milk should never be used for infants. If you cannot obtain Grade A milk from your dealer, apply to the nearest infant's milk station, a list of which is published.

"This information is promulgated by order of the Board of Health." APPLICATION OF OSTEOPATUS FOR AMENDMENT OF SECTION 163a, SANITARY CODE.

A hearing was held before the Board of Health at its meeting on Tuesday, the 21st inst., upon the application of Guy Wendell Burns, Chairman, Board of Directors. Osteopathic Society of The City of New York, on behalf of the practicing osteopaths of the City, for the amendment of the Sanitary Code, whereby certificates of death signed by osteopaths might be accepted and burial or transit permits granted thereon. The New York Osteopathic Society, the New York County Medical Society, the Kings County Medical Society, and the Queens-Nassau County Medical Society were represented. Arguments pro and con were heard from 3:30 until 6 p. m. Commissioner Lederle announced that a decision would be given in two weeks.

Previous to the passage of chapter 344 of the Laws of 1907, the practice of oesteopathy was not recognized in this State. By the passage of this law, it was so recognized, and subsequent to the refusal of the Department of Health to register signatures of osteopaths with it, a writ of mandamus was issued by Justice Aspinall, compelling the Department of Health to register their signatures in accordance with the provisions of that act, and that the word “osteopath” be included in such registration. On March 31, 1909, the Board of Health amended the Sanitary Code by the addition of the following sub-section, known as section 163a :

“Sec. 163a. No transit permit shall be granted for the removal or burial of the remains of any person who may have died in The City of New York, unless a certificate of death, made out upon a blank form furnished by this Department, and signed by a physician upon whom has been conferred the degree of Doctor of Medicine, be filed in the Bureau of Records of this Department.”

A representative osteopath sought to enjoin the enforcement of this section of the Sanitary Code. The Corporation Counsel of the City entered a demurrer, which was sustained. Hon. Justice Putnam handed down a decision from which the following may be quoted :

"While the State has wisely allowed the practice of osteopathy, it does not follow that it thereby holds out one without any practice in surgery or experience in prescribing drugs as fully qualified to certify the cause of death. Indeed, it is not certain that a board of health would be compelled to take the certificate of death of all licensed physicians in the event of an epidemic or the spread of some new and mysterious disease. Granted that the theoretical education of the osteopath is of a standard equal to that of a doctor of medicine, after he enters on his profession his practice is restricted, so that it does not appear that he can make the tests by examination of blood and tissues by which alone many diseases can be certainly detected. The Sanitary Code is discriminatory, but the discrimination is not personal and arbitrary. It is based on a limitation which the osteopath may be said to make for himself, and deprives him of no rights which he ought to exercise, consistent with the public safety."

DEATH FOLLOWING THE REMOVAL OF TONSILS AND ADENOIDS. On January 23d, an article appeared in the "New York World" describing the death of Julius Reif, thirteen years of age, of 493 Wendover ave., a pupil of Public School No. 42, and stating that his death, which occurred on January 16, was the result of an operation for the removal of enlarged tonsils and adenoids, the operation having been advised by the representatives of the Department of Health. The death of a child in consequence of such an operation, which is usually regarded as trivial and involving no especial danger, is regrettable enough, and especially so in the case of a boy 13 years of age who, as described by the “World,” had evinced such creditable evidences of good scholarship. Some of the statements, however, in the article referred to, are inaccurate in so far at least as the Department of Health was concerned. The facts are as follows:

The boy was examined on the 12th of November in Public School No. 42 by a medical inspector of the Department, and it may be mentioned that the Inspector in question is considered one of the best and most conservative men on the staff. The Inspector noted that the boy was suffering from defective nasal breathing, and stated, as his records of the case show, that the obstruction was due to a deviated septum, that is to say, to a malposition of the partition which separates one nostril from the other. He did not note the occurrence of adenoids or hypertrophied tonsils, and his case record makes no mention of their existence. Following this diagnosis, a Nurse irom the Department called at the home of the parents November 23d and advised that the boy be taken to the family physician for advice and treatment. She said nothing about operative procedures for, as the result of her past experience in such cases, she did not believe that a boy of this age would be operated upon for the correction of a deviated septum. She called again November 30th, but made no reference to any operation, and at neither of these two visits was anything said about enlarged tonsils or adenoids. Her third and last visit was made on the 27th of December, when she was told that the boy had been operated upon in the Fordham Hospital for adenoids and hypertrophied tonsils. On the 2d and 13th of January, a Nurse from the Department visited the boy's home in order to make inquiries in regard to his condition. He was finally taken to the Harmoriah Hospital, where he is said to have died on the

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