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16th of January, twenty days after the operation, the cause of his death being meningitis or inflammation of the brain. It will thus be seen that, so far as the operative procedures in this case are concerned, the Department of Health did not urge their performance, was not officially cognizant of the conditions for which they were undertaken, and cannot, therefore, be held in any way responsible for the unfortunate result. A New REGULATION RELATING TO THE REMOVAL TO PUBLIC INSTITUTIONS OF SURGICAL
Cases SUFFERING FROM CONTAGIOUS DISEASES. Until quite recently, there has been no rule rigidly adhered to by the Department in its attitude towards surgical cases in public institutions when the patient, after being admitted to these institutions, is attacked by some one of the contagious diseases, When the surgical affection has been trivial in character, the Department has usually removed the case to one of its own hospitals, and the treatment, both of the surgical condition and the contagious disease, from that time onward, has been conducted by the physicians of the Department. When the surgical affection has been of a more serious nature or one requiring special surgical skill, it has been the practice to obtain from the superintendent of the institution his verbal promise to maintain supervision of the surgical character of the case after its removal. As a rule, this rather indefinite arrangement has worked fairly well. Recently, however, the right of the Department to demand such cooperation on the part of the institution from which a case is removed has been seriously questioned, and the Department has decided, therefore, to assume complete charge of these surgical cases, at least, in so far as those removed to the Willard Parker Hospital, in Manhattan, are concerned. For this purpose, four Assistant Attending Surgeons have recently been appointed to the staff of Willard Parker Hospital, and the following circular letter will shortly be mailed to the superintendents of all hospitals and dispensaries :
"Under a new regulation, surgical cases developing scarlet fever or diphtheria in general hospitals, will be admitted to the Willard Parker Hospital, and will be cared for by Surgeons attached to the Medical Board of the Willard Parker Hospital, instead, as was formerly the case, by representatives of the Surgeons previously having charge of these cases. It is obvious that under these circumstances, the Surgeons of the Department of Health should possess a complete history of the case previous to its admission to the Willard Parker Hospital, and such cases will, therefore, only be received by the Ambulance Surgeon if a complete medical history or a complete history with a copy of the X-ray findings (if such an examination has been made) accompanies the patient. Furthermore, in cases having a plaster of Paris cast, such a cast must have been previously properly trimmed and cut so as to permit a quick and satisfactory examination of the parts.”
At the Kingston Avenue Hospital, the hospital for contagious diseases in the Borough of Brooklyn, no visiting surgical staff exists at the present time, and in this hospital, therefore, the Department has no facilities for the care of_surgical cases. The same is true at the Riverside Hospital, on North Brother Island. For the present, therefore, surgical cases suffering from contagious diseases will not be admitted to these hospitals unless they are accompanied by a signed agreement stating that their surgical treatment will be continued by the institution from which they are removed. As soon as possible, however, visiting surgical staffs will be appointed at Kingston Avenue and Riverside Hospitals, after which the Department will undertake complete charge of all such cases.
MORTALITY OF THE WEEK. There were 1.461 deaths reported during the week ending January 25th, with a rate of 14.19 per 1,000, as against 1,564 deaths, and a rate of 15.77 during the corresponding week of 1912, a decrease of 1.58 of a point corresponding to a decrease of 163 deaths.
The most notable decrease was that from typhoid fever, the number of deaths reported during the week fell to the extraordinarily low number of 2, probably the lowest number of deaths from this cause reported weekly during a great many years. The acute respiratory diseases, notwithstanding the peculiar atmospheric conditions, showed a decrease of 42 deaths, heart diseases a decrease of 45 deaths, tuberculosis a decrease of 15 deaths. On the other hand, the deaths from measles and scarlet fever, especially the latter, were augmented considerably.
The mortality from the first of January, 1913, is almost one-half a point below that of the mortality of the corresponding period in 1912.
Summary for Week Ending Saturday, 12 m., January 25, 1913.
*Corrected according to borough of residence.
† The presence of severai large institutions, the great majority of whose inmates are non-residents of the city, increases considerably the death-rate of this Borough.
Deaths by: Principal Causes, According to Locality and Age.
Cases of Infectious and Contagious Diseases Reported.
483 397 463 301
2 Chickenpox... 43
133 149 Typhoid Fever II2 50
49 52 24 36 23 Whooping
19 22 30 32 32 20 31 45 25 12 26
6 Total...... 1,052 1,092 1,071, 1,181, 1,400 1,213 | 1,482 1,495 1,636 , 1,436 1,534 1,991
been so very successful in combatting cpidemics. With professional greetings to yourself and to those who were so courteous to us, we remain, yours, etc.,
"DR. AUG, GARTNER.
"DR. AUG. WEBER." Shortly after the receipt of this letter the bust arrived. It is about two and a half feet tall, and is an excellent likeness of the great bateriologist. It at present adorns the meeting room of the Board, and as a work of art and a token of appre. ciation, it is very highly valued.
EXHIBIT OF THE WORK OF THE DEPARTMENT. An exhibit, in which the various activities and resources of the department are illustrated by means of charts, diagrams and models, is at present in course of establishment on the fifth floor of the department headquarters, No. 149 Centre street, and will be open for public inspection on or about February 1st. Parts of this exhibit have been displayed in the past on various occasions, in Chicago, at Atlantic City and, more recently, at the Congress on Hygiene and Demography in Washington, D. C., but up to the present time it has never had permanent installation. The exhibit contains many interesting features, conspicuous among which is an extensive model of the grounds and buildings of the Tuberculosis Sanatorium ai Otisville. This model was made by a patient of the institution and its entire cost is represented by the materials used in its construction. Two larger models, representing the style of pavilion occupied by patients at the sanatorium, are also to be seen. The work of the Research Laboratory is represented in part by cases containing specimens of the substances, employed in determining various chemical biological reactions. The death rate of different years is definitely shown by means of various charts, while the increasing population of the city from 1800 to 1910 is strikingly shown by means of plaster cubes of increasing sizes. The face of the cube representing the year 1800 is 6/2 inches square, that of 1910, 28 inches square. An interesting feature is an illuminated chart which contains the number of persons living at the end of various years from the first to the ninety-fourth, starting on the basis of 100 children born. Numerous charts and tables are also on view.
This material forms the nucleus of a permanent exhibit at the headquarters building, which will be added to from time to time and will become, it is hoped, an important feature of the educational work of the Department of Health.
MORTALITY OF THE WEEK ENDING JANUARY 18, 1913. There were 1,546 deaths reported during the week with a rate of 15.01 per 1,000 of the population, as against 1,578 deaths and a rate of 15.91 during the corresponding week of the previous year. This difference of nine-tenths of a point corresponds to a weekly decrease of 93 deaths.
Diphtheria and croup, the acute respiratory diseases and the heart diseases showed a decreased mortality compared with the corresponding week of 1912, while scarlet fever, influenza, Bright's disease and nephritis, and the digestive diseases, showed an increased mortality; that of measles, diarrhoeal diseases and pulmonary tuberculosis remained about the same. Considered from the viewpoint of age-grouping, the mortality was slightly decreased at all the age-gro ngs, no particular age-grouping showing a greater decrease than the others.
The mortality so far for the year is a shade lower than that of the corresponding period of 1912.
Summary for Week Ending Saturday, 12 m., January 18, 1913.
* Corrected according to borough of residence.
The presence of several large institutions, the great majority of whose inmates are non-residents of the city, increases considerably the death-rate of this Borough.
Deaths by Principal Causes, According to Locality and Age.
397 463 301
388 398 452 364 402 +85 311 +52 394 365 332 295 497 Diphtheria
307 272 and Croup..) 305 292 296 332 293 317 309 318 338
395 Scarlet Fever 85 93 102
118 167 182
232 259 283 304 Small-pox.... 1
133 149 268 Typhoid Fever
30 32 32 20 31 45 25 12 26 Cerebro-Spinal Meningi 4 6 5 3 II 5 4 4
Total...... 1,010 1,052 1,092 1,071 1,181 1,400 1,213 1,482 1,495 1,636 1,436 1,534 1,991
Deaths According to Cause, Age and Sex,
1. Typhoid fever.... 4
5 6. Scarlet Fever..
5 Whooping Cough. %: Croup
} 25 9. Influenza.
21 12. Other Epidemic
Diseases 13. Tuberculosis Pulmonalis...
171 14. Tuberculous Men
12 ingitis....... 15. Other forms of
16 Tuberculosis... 16. Cancer, Malig- 8+
nant Tumor... 17 Simple Meningitis.
9 Of which 17a. Cerebro Spinal)
6 Meningitis..... 18. Apoplexy, Soften
19 ing of the Brain 19. Organic Heart
Diseases....... 20. Acute Bronchitis.. 18 21. Chronic Bronchitis. 3 22. Pneumonia
(ex-) cluding Broncho 162
Pneumonia)..... 22a. Broncho Pneumonia 123 23. Other Respira
9 tory Diseases.. 24. Diseases of the
cer excepted).. 25. Diarrhoeal diseases
30 (under 5 years) 26. Appendicitis and 8 27. Hernia. Intestinal
16 Obstruction.... 28. Cirrhosis of Liver.. 23 29. Bright's Disease
122 and Ac. Nephritis ! 30. Diseases of Wom
6. en (not Cancer) 31. Puerperal Septicæmia..
5 32, Other Puerperal
Diseases. 33. Congenital De
bility and Mal- 79
formations..... 34. Old Age....
6 35. Violent Deaths.
* If the deaths under one month, numbering 97 from all causes, be deducted from the total deaths under one year, the resultant rate will be 58 deaths of infants per 1,000 weekly average births of 1912.