Boroughs. Corrected Mortality Among Children. Week Ending August 16, 1913. WEWN 229 Includes Small Pox, Measles, Scarlet Fever, Diphtheria and Whooping Cough. Deaths According to Cause, Annual Rate per 1,000 and Age, with Meteorology and Number of Deaths in Public Institutions for 14 Weeks. Week Ending 17. 24. 31. 7. 14. May May May June June June June July July July July Aug Aug. Aug. 21. 28. 5. 12. 19. 26. 2 9. 16. Total deaths.... 1,531 1,572 1,323 1,447 1,303 1,370 1,182 1,291 1,270 1,250 1,249 1,310 1,390 1,250 Annual death Typhoid Fever.. Meningitis. Tuberculosis Pulmonalis 40 เก 22 32 3 20 14 14 28 22 19 23 14 12 I 5 5 2 4 2. 6 5 2 Mean barometer. 29.90 29.87 29.77 29.88 30.00 29.89 29.89 29.89 29.76 29.80 29.88 29.93 29.91 29.99 66.7 69.4 57.9 63.4 73.9 65.4 60. 59. 61. 71. 68 00 65.4 or snow.... Mean tempera 1.34in .08in .67in .63in.45 in. 1.17 in 3 64in 1.08in 0.13in ture (Fahr- 55.9° 60.7° 61.3° 69.1° 65. 72.9 73 4° 79.° 73.6 75.9° (Fahrenheit)) Minimum tem Prahrenheit) perature 81.. 71.. 80. 84. 90.° 93.° DIRECTORY OF THE DEPARTMENT OF HEALTH OFFICES Headquarters: S. W. Corner Centre and Walker Streets, Borough of Manhattan Borough of The Bronx, 3731 Third Avenue. Telephone, 1975 Tremont. Telephone, 4720 Main. .Telephone, 1200 Jamaica. .Telephone, 440 Tompkinsville Office Hours-9 a.m. to 5 p.m.; Saturdays, 9 a.m. to 12 m. Telephone, 1600 Stuyvesant. Manhattan-Willard Parker Hospital, foot of East 16th Street. Diagnosis Laboratory, Centre and Walker Streets. Telephone, 6280 Franklin. Drug Laboratory. Foot of East Sixteenth Street. Telephone, 1600 Stuyvesant. INFANTS' MILK STATIONS CLINICS FOR SCHOOL CHILDREN Hours: 2-5 p. m. Saturdays, 9-12 m. Manhattan-Gouverneur Slip. Telephone, 2916 Orchard. Pleasant Avenue and 118th Street. Telephone, 972 Harlem. P. S. 144 Hester and Allen Streets. Telephone, 5960 Orchard. 1249 Herkimer Street. Telephone, 2684 East New York. The Bronx-580 East 169th Street. Telephone, 2558 Tremont. Richmond-689 Bay Street. (Dental only). Telephone, 686 W. Tompkinsville. TUBERCULOSIS CLINICS Manhattan-West Side Clinic, 307 West 33d Street. Telephone, 3471 Murray Hill. Harlem Italian Clinic, 420 East 116th Street. Telephone, 2375 Harlem. Southern Italian Clinic, 22 Van Dam Street. Telephone, 412 Spring. Day Camp, Ferryboat "Middletown," foot of East 91st Street. Telephone, 2957 Lenox. The Bronx-Northern Clinic, St. Pauls Place and Third Avenue. Telephone, 1975 Tremont. Southern Clinic, 493 East 139th Street. Telephone, 5702 Melrose. Brooklyn-Main Clinic, Fleet and Willoughby Streets. Telephone, 4720 Main. Germantown Clinic, 55 Sumner Avenue. Telephone, 3228 Williamsburg. Brownsville Clinic, 64 Pennsylvania Avenue. Telephone, 2732 East New York. Eastern District Clinic, 306 South 5th Street, Williamsburg. Telephone, 1293 Williamsburg. Queens-Jamaica Clinic, 10 Union Avenue, Jamaica. Telephone, 1386 Jamaica. Richmond-Richmond Clinic, Bay and Elizabeth Streets, Stapleton. Telephone, 1558 Tompkinsville, SANATORIUM FOR TUBERCULOSIS Otisville, Orange County, N. Y. (via Erie Railroad from Jersey City). Telephone, 13 Otisville. TUBERCULOSIS HOSPITAL ADMISSION BUREAU Maintained by the Department of Health, the Department of Public Charities, and Bellevue and Allied Hospitals, 426 First Avenue. Telephone, 8667 Madison Square. Hours 9 a.m. to 5 p.m. M. B. BROWN PRINTING & BINDING CO. 49 TO 57 PARK PLACE, NEW YORK 522-H-13 (B) 2000 All communications relating to the publications of the Department of Health should be addressed to the Commissioner of Health, 149 Centre Street, New York Entered as second class matter May 7, 1913, at the post office at New York, N. Y., NEW SERIES. VOL. II. AUGUST 23, 1913. No. 34 THE COMPLEMENT FIXATION TEST IN THE DIAGNOSIS OF GONORRHEAL INFECTION. The results obtained from testing the sera of several thousand persons for gonorrheal infection would seem to justify the assertion previously made by Schwartz and McNeil, that the complement fixation test for gonorrhea is specific and that a positive reaction can safely be interpreted as evidence of a focus of gonorrheal infection somewhere in the body. The test is similar in every respect to the Wassermann test for syphilis, with the exception that an antigen prepared from several varieties of gonococci is used in place of the tissue extract in the Wassermann test for syphilis. A positive reaction is practically never obtained in an acute anterior urethritis in the male or in an acute vaginitis in the female. In all chronic gonorrheal infections, however, a positive reaction is usually obtained. With a modification of the usual technique, whereby tests are allowed to stand in the ice box for four hours to bind complement, instead of one hour in the incubator at 37 deg. C, a considerable increase in the number of positive results is obtained. This applies especially to very recent cases, and to cases of very long standing. Excepting in acute cases the reaction persists in those cured for approximately fifty days after the cure has been effected. This fact has been confirmed both by animal experimentation and the study of clinical cases. The sera of persons suffering from gonorrheal joint infections give, as a rule, strongly positive results, making this test of special value in the differential diagnosis between gonorrheal and other forms of joint affections. In a recent series of tests made on the sera of nearly five hundred women confined in a public institution, 65 per cent. gave positive complement fixation tests for gonorrhea, while but five positive vaginal smears were obtained from the same women. The majority of specimens of sera taken from infants suffering from valvovaginitis have given positive results, and in many cases of long standing where the smears have become negative, the complement fixation test has given positive results, While a negative result does not absolutely exclude the possibility of the existence of a gonorrheal infection, it is much more significant than a negative Wassermann test for syphilis, as in this case we are dealing with specific antigens and antibodies. TYPHOID FEVER DURING THE FIRST SIX MONTHS OF 1913. During the first six months of 1913, the reports show that New York City was remarkably free from typhoid fever; more so, in fact, than during any previous semiannual period. This is shown in the following table: The figures for 1913, as shown above, are not only relatively but absolutely less than those for any corresponding period since the incorporation of the Greater City, and, in view of the steadily increasing population, the relative comparisons become even more marked. Thus, in 1908, there were 18 cases per 100,000 of the population; in 1912, 17.6 cases, and in 1913 only 8.8 cases per 100,000. It is probable that a number of favorable influences have contributed to this notable decrease. In the first half of 1913 there were fewer out-of-town infections and fewer secondary infections from the cases occurring in the City. The latter circumstance is partially accounted for by the anti-typhoid immunizations which, since the beginning of the year, have been performed by the department upon persons exposed to the disease. The following ngures show the cases arising from infection out of town and those contracted from city cases during the first half of 1912 and of 1913. It will thus be seen that the out-of-town cases decreased 60 per cent., and the secondary, or contact cases, 70 per cent. These figures are certainly striking. It can hardly be doubted that the improved quality of New York City's milk supply, due in great measure to the pasteurization enforced by the department's regulations, has been prominent among the local factors causing the favorable showing in the total decrease of cases. From the fact that the cases originating in the city were not localized at any time to a single district or districts, it would seem that few, if any. could be attributed to an infected water supply. The educational campaign so persistently pursued by the department for the past several years is undoubtedly producing results. The general public have a better understanding of the proper method of handling typhoid cases occurring in their homes, and some of the press comments on the work of the department have undoubtedly aided, by instructing people generally in regard to the prevention of infectious diseases. It must, of course, be admitted that the number of cases of typhoid fever may again increase in number, and we must never lose sight of the fact that it is not wise to draw too hastily deductions to our own advantage from seeming cause and effect, but the figures given above, even when all allowances are made for the influence of agencies unrecognized or for the present beyond our control, are certainly cause for congratulation so far as they go. DISCONTINUANCE OF REMOVAL OF BEDDING USED BY CONSUMPTIVES. Since July 23, 1913, the removal for steam sterilization of bedding used by consumptives, has been discontinued, with the following exceptions: (1) In those exceptional instances where physicians or members of the family insist upon the goods being removed for sterilization. (2) In special instances where by reason of the nature of the premises proper and efficient fumigation cannot be performed. (3) When, on account of extreme illness and weakness caused by the disease, patients in the advanced stages, with sputum showing tubercle bacilli, have been unable to care for it properly, and have for this reason thoroughly infected their bedding. |