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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.,

under the Act of August 24, 1912.

New SERIES. VOL. II.

DECEMBER 13, 1913.

No. 50

TYPHOID FEVER DURING 1913. The typhoid fever figures for the first eleven months of the year 1913, after the elimination of the duplicates and reported cases proving not to be typhoid fever, amount to a total of 2,487 cases. This compares favorably with the figures of previous years. During 1912 there were 2,881 cases, and the average for the past five years was 3,096. The showing of 1913 is the more remarkable on account of the sharp outbreak which occurred in the lower eastern section of Manhattan. There were fewer cases reported in the city as a whole than during any corresponding period since the organization of the greater city.

All of the boroughs except Manhattan have participated in this showing. Manhattan exceeded the five-year average by 65 cases. Up to the week ending September 6 the number of cases reported for this borough was considerably less than during the previous year and much below the average of the past five years. From this time up to the week ending October 11 the number of cases reported was in excess of all figures for corresponding periods, but declined thereafter from week to week until on November 22 it reached the average of the previous years. There were fewer cases reported in the week ending December 6 than during the same period of 1912, and a smaller number than the average for the last five years. But for the decisive action taken early in September in excluding a suspected milk supply, the sharp outbreak might have reached epidemic proportions. Unless something unforeseen occurs. we shall close the year with an unprecedentedly low figure for the city as a whole.

TUBERCULOUS INFECTION OF CHILDREN. It has long been known that children are very susceptible to tuberculous infection. but there has been considerable difference of opinion as to how and when this iniection is acquired. Through a combination of favorable circumstances, Dr. Alfred Hess was recently able to study this question in the case of some children left for six weeks in the charge of an attendant who was suffering with tuberculosis of the lungs. (Transactions National Association for the Study and Prevention of Tuberculosis. Washington, 1913.)

Thanks to the skin test devised by von Pirquet, we now have a simple means of determining the presence of tuberculous infection, and in many institutions for children routine skin tests are now made on all children admitted. The children studied by Dr. Hess were part of the population of a large infant asylum in this city, where for some time past routine skin tests were made on all children every six months. The results were found to be remarkably constant-a negative reaction on admission meaning almost always a negative reaction later on. In the case of the children studied by Dr. Hess, seven out of ten were free from tuberculosis (as shown by the von Pirquet test) prior to their being in charge of the tuberculous attendant. Three months later all of the children gave a positive reaction, and since all other sources of infection could be excluded, there was no doubt of the role played by the tuberculous attendant.

Dr. Hess's report emphasizes the importance of safeguarding young children exposed to tuberculous infection in their homes, and also furnishes a strong argument for the need of tuberculous preventoria conducted along the lines of the institution now successfully operated at Farmingdale, N. J.

RESOLUTION AFFECTING THE SALE OF BICHLORIDE OF MERCURY.

On account of the numerous cases of poisoning from bichloride of mercury (corrosive sublimate) which have recently occurred, the Department of Health has had under consideration for some time the advisability of adding a section to the Sanitary Code controlling its sale. At a meeting of the Board of Health of the Department of Health of The City of New York, held in the said city on the ninth day of December, 1913, the following resolution was adopted :

Whereas, Bichloride of mercury, otherwise corrosive sublimate, a poison, has frequently been taken by mistake and loss of life has resulted therefrom, therefore be it

Resolved, That the Sanitary Code be and the same is hereby amended by the adoption of an additional section to be known as section sixty-seven (a), to take effect March 1, 1914, and to read as follows:

Section 67a. Bichloride of mercury, otherwise known as corrosive sublimate, shall not be held, kept, sold or offered for sale at retail in the dry form except in colored tablets individually wrapped, the wrapper to have the word "POISON” in plain letters conspicuously placed, and dispended in sealed containers of glass, conspicuously labeled with the word "POISON” in red letters.

This section does not apply to tablets containing one-tenth of a grain or less of bichloride of mercury.

TRICHINOSIS MADE NOTIFIABLE. At a meeting of the Board of Health of the Department of Health, held December 9, 1913, the following resolution was adopted :

Whereas, Trichinosis, a very painful disease occasionally followed by death, is caused by eating meat, especially pork, which has been invaded by the trichinella spiralis and has not been sufficiently cooked to destroy this worm, which causes trichinosis, therefore be it

Resolved, That the Department of Health requires all physicians to report cases of human trichinosis.

AMENDMENT AFFECTING REMOVAL OF REFUSE. At a meeting of the Board of Health of the Department of Health of The City of New York, held December 9, 1913, section 108 of the Sanitary Code, which defines the duties of owners, tenants, lessees and occupants of buildings in relation to the preparation of refuse material for removal by the Street Cleaning Department, was amended in so far as its action applies to the Borough of Richmond, as follows:

* in the Borough of Richmond ashes from house furnaces shall be kept in a receptacle separate and apart from the remainder of the household waste, and no material other than furnace ashes shall be placed in said receptacle. Other household waste materials, including garbage, kitchen ashes, sweepings, soiled paper or rubbish shall be placed in a separate metal or metal lined receptacle, which, when placed outside of a building for removal, shall be covered and kept covered with a tight fitting cover.

"No receptacle shall when filled contain more than two cubic feet of material nor weigh more than one hundred pounds, and a sufficient number of receptacles shall be provided by the owner, lessee or occupant of a building to hold whatever ashes or other waste materials may accumulate thereat during sixty hours next preceding the removal thereof.

“Newspapers, wrapping paper and other light rubbish likely to be blown or scat tered about the street shall be securely bundled, tied or packed before placed for removal. Yard sweepings, hedge cuttings, grass, leaves, earth, stone, bricks or trade waste shall not be mixed with household waste.

"Accumulations of household refuse resulting from failure to take advantage of the regular collection service shall be removed at the expense of the person or persons concerned."

DEATH RATE FOR THE WEEK. There were 1,343 deaths and a death rate of 13.04 reported during the past week, as against 1,333 deaths and a rate of 13.44 during the corresponding week of 1912, an increase of 10 deaths, but a decrease of .40 of a point in the rate, equivalent to a relative decrease of 41 deaths.

Most of the infectious diseases, such as measles, scarlet fever, diphtheria and croup, whooping cough and typhoid fever showed relative decreases. Organic heart and kidney diseases and lobar pneumonia showed material decreases. Cerebro-spinal meningitis, diarrhoeal diseases and other digestive diseases and broncho-pneumonia showed material increases.

Vicwed from the point of age grouping, there were 34 more deaths of infants under one year of age; between the ages of one and five years there were 8 less deaths; between five and sixty-five years there were 32 less deaths, and 4 less deaths over sixty-five years of age.

The death rate for the first fifty weeks of this year was 13.75 per 1,000 of the population as against 14.07 for the corresponding period of 1912, a decrease of .32 of a point.

VITAL STATISTICS
Summary for Week Ending Saturday, 12 M., December 13, 1913.

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1. Typhoid Fever....
3. Malarial Fever..
4. Small-pox.....
5. Measles...
6. Scarlet Fever.
7. Whooping Cough.
8: Diphtheria

and
Croup ..
9. Influenza....

8 12. Other Epidemic

Diseases... 13. Tuberculosis Pulmonalis...

152 14. Tuberculous Men

2 ingitis... 15. Other forms of

7 Tuberculosis... 16. Cancer, Malig

82 nant Tumor. 17. Simple Meningitis. 5

Of which 17a Cerebro Spinal Meningitis.....

4 18. Apoplexy, Soften

29 ing of the Brain 19. Organic Heart

Diseases... .... 20. Acute Bronchitis.. 21. Chronic Bronchitis. 5 22. Pneumonia (ex

cluding Broncho 86

Pneumonia)..... 22a. Broncho Pneumonia 81 23. Other Respira

8 tory Diseases.. 24. Diseases of the

Stomach (Can

cer excepted).. 25.Diarrheal diseases

31 (under 5 years) 26. Appendicitis and 13 27. Hernia. Intestinal

Obstruction.... 28. Cirrhosis of Liver.. 17 29. Bright's Disease

and Ac. Nephritis 30. Diseases of Wom

9 en (not Cancer)) 31. Puerperal Septi

camia.. 32. Other Puerperal Diseases

7 33. Congenital De 1

bility and Mal- 82

formations..... 34. Old Age..

7 35. Violent Deaths... 75

a. Effects of Heat.
b. Other Accidents. 67

c. Homicide... 30 Suicide

13 37 All other causes.... 204 38. Ul-defined causes..

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* If the deaths under one month, numbering 94, from all causes, be deducted from the total deaths under one year, the resultant rate will be 41 deaths of infants per 1,000 births (weekly average July 1, 1912, to July 1, 1913).

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