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Its system of school inspection is broader in its scope, and cqually, if not more, efficient in its results, than that maintained by any other large city in the country. That the correction of physical defects in school children helps them to progress in their studies has been amply demonstrated. From time to time specialists in some one branch of medicine make investigations to determine the effect on school progress of the correction of the specified defect. There is decided danger that overconcentration in any specialized line may give rise to the assumption that the deiect in question is the only one of supreme importance.
From its extended experience with the subject, the Department of Health is convinced, not only that the correction of defects of vision is a necessity, but that the reduction and correction of the other physical defects in children are of equal importance.
It is a hasty and ill-balanced conclusion to infer that anything less than proper attention to all of the physical defects and deficiencies of the children, with the needed adjustment of home and school conditions, as well as proper medical attention, will give that mental and physical health which is essential to well-rounded child life. The necessity of care and adjustment of the many features which may have an effect upon the health of the child during the nineteen hours of the day when it is not in school are fundamentally of just as great, and, in many instances, of far greater, importance than those conditions which affect it during the five hours it is in school.
The health of the 700,000 children in New York City's public schools should not be judged by the results of any special group of twenty-nine children. Racial, social and economic conditions all must be studied and adjusted as they pertain to the life of the child, both in the school and at home. Proper medical treatment must be provided for the correction of physical defects, and the individual idiosyncrasies of the child studied, in order that individual treatment and care may be assured in each case.
These facts are the fundamental ones upon which the present system of medical examination of school children in New York City is founded. Its greatest efficacy in assuring to the child that normal health to which it is clearly entitled will come when school officials, the medical profession and the laity bring forth their fullest measure of co-operation with the efforts which the Department of Health is making in this line.
METHYL, OR WOOD ALCOHOL.
It has been abundantly proven that methyl alcohol is intensely poisonous to human beings, either when swallowed or when its vapor is inhaled. Whether toxic symptoms can also be produced by its external application is somewhat doubtful, for the reports of such cases do not conclusively eliminate inhalation. The properties of crude methyl alcohol are sufficiently well known to most people. Its odor is well marked and intensely disagreeable and its legitimate use in the trades is practically restricted to the solution of certain gums and resins. In the household it is sometimes employed in lamps in its crude form as a substitute for the more expensive ethyl or grain alcohol. Crude methyl alcohol contains many substances other than the hydroxide of methyl, most important among which, in so far as toxicity is concerned, are acetone and cyanides. It is possible by rectification, long continued, complicated and expensive, to extract these associated products completely, and the fluid which is then left is colorless and has an odor which cannot be distinguished from that of ethyl alcohol. While the literature is slightly conflicting, it seems pretty well established that chemically pure methyl alcohol exerts no more toxic influence upon the animal economy than does ethyl alcohol. The trouble is that, as sold under various trade names, methyl alcohol is only partially rectified. and, while its taste and smell under these circumstances are practically identical with those of ethyl alcohol, the poisonous cyanides and acetone remain in sufficient quantities to cause serious symptoms, and even death, when taken internally. A great many cases of poisoning have thus resulted in this city during the past several years. Most frequently the methyl alcohol has been drunk in the form of an adulterant of cheap spirits. The symptoms in these cases are acute. The person becomes unconscious, with widely dilated pupils, and death frequently results without return to consciousness. The poison seems to exert a specific influence upon the optic nerves more especially, as has been shown, upon the ganglionic nerve cells of the retina, rapidly causing their death, which is followed by an ascending atrophy of the nerve, sometimes preceded by a slight neuritis. The atrophy, in severe cases, involves the entire nerve, and, as a result, complete and incurable
blindness takes place. Consequently, cases which recover consciousness are, generally speaking, blind for the rest of their lives. The blindness comes on very rapidly and is usually complete at the end of twenty-four or forty-eight hours. In its early stages the visual disturbance may manifest some slight temporary improvement. Poisoning by inhalation usually takes place among varnishers who have worked in smali, ill-ventilated quarters. Thus, men who shellac the interior of beer.vats have, on several occasions, become affected. In these cases the symptoms are more chronic. Headache, vomiting and abdominal pain may for several days precede unconsciousness, and the coma may be fatal or the case may recover. When recovery does take place, complete blindess may ensue or there may simply well marked deterioration of vision due to a partial atrophy of the optic nerves, which condition is permanent, but non-progressive. In spite of the fact that the Department of Health has repeatedly investigated cases of poisoning by methyl alcohol and has, on several occasions, brought criminal proceedings against those who have used it to adulterate spirits, cases of poisoning still occasionally occur, and undoubtedly the main reason for their occurrence is ignorance on the part of the public and of the manufacturers of spirits. To most people alcohol means alcohol and if one alcohol is cheaper than another, they do not hesitate to buy it in preference, and it is in this way that the incompletely rectified article, indistinguishable by taste or smell from grain alcohol, has been used in the manufacture of cheap spirits.
At a meeting of the Board of Health held January 23, 1912, the following additional section of the Sanitary Code was adopted :
Section 66a. No person or. corporation shall have, sell or offer for sale any food or drink which contains methyl alcohol (commonly known as wood alcohol), or any preparation or mixture of any kind whatsoever containing the same, intended either for internal or external use by man; nor shall methyl or wood alcohol or any preparation or mixture containing the same be used upon or applied to the person or body of another.
Later this section was deemed too drastic, it having been represented to the Department that no poisonous symptom would arise from the external application of methyl alcohol as rectified at present and in which form it is very extensively used in the arts and manufactures. Accordingly, after a careful and exhaustive review of the literature and a thorough study of all reported cases in which poisoning was supposed to have followed its external use, the Board of Health on September 17, 1912, amended section 66a so as to read as follows:
Section 66a. No person or corporation shall have, sell or offer for sale. any food or drink which contains methyl alcohol (commonly known as wood alcohol), or any preparation or mixture of any kind whatsoever containing methyl alcohol, intended for internal lise by man.
Any preparation or mixture containing methyl alcohol intended for external use by man, or so used, shall, when offered for sale, sold or used, he conspicuously labeled follows: “This preparation contains methyl (wood) alcohol.”
MORTALITY OF THE WEEK.
There were 1.568 deaths reported during the past week as against 1,511 deaths reported during the corresponding week of 1912, an increase of 57 deaths. This increase is almost exactly offset by the increase in the population, the rate for the past week being 15.23 against 15.24 in the previous year, a decrease of .01 of a point, which means a decrease of one death.
The infectious diseases, measles, scarlet fever and typhoid fever, showed considerable decreases; on the other hand, diphtheria and croup and influenza showed material increases.
Deaths of children under five years of age showed an increase of 19 deaths, between five and sixty-five years of age an increase of 68 deaths, and above sixty-five years of age a decrease of 30 deaths.
The deatlıs of adults from lobar pneumonia remained the same; those of broncho pneumonia among young children increased by 20 deaths.
The death rate for the first six weeks of this year was 14,64 per 1,000 as against 15.31 in the corresponding period in 1912.
•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.
465 470 +54 402
446 338 459
402 +85 311 +52 394 365 332 295 497 Diphtheria
+56 and Croup.. 292 296 332
397 Measles 128 175 211 223 276 274 412 298
393 551 463 Scarlet Fever..
301 333 Smallpox...
2 Chickenpox... 95
245 Typhoid Fever 52 62 61 52 56 491 52 21
23 19 | 20 Whooping
19 22 30 Cough......) 32 32 20 31
25 12 26
63 63 Cer-Spinali
9 Total...... 1,071 1,181 | 1,400 1,213 1,482 1,495 1,636 1,436 1,534 1,991 1,933 1,991 2,127
1 156 19 71
8. Diphtheria and
Croup. 9. Influenza...
18 12. Other Epidemic Diseases..
7 13. Tuberculosis Pul
160 monalis........ 14. Tuberculous Men
ingitis.... 15. Other forms of Tuberculosis...)
17 16. Cancer, Malignant Tumor...
84 17. Simple Meningitis. 9
of which 17a. Cerebro Spinal Meningitis.....
5 18. Apoplexy, Soften
ing of the Brain 31 19. Organic Heart] 197 20. Acute Bronchitis..
17 21. Chronic Bronchitis.
4 22. Pneumonia (ex-)
cluding Broncho 167
Pneumonia)...., 22a. Broncho Pneumonia 115 23. Other
15 24. Diseases of the
Stomach (Can. 13
cer excepted).. 25.Diarrhæal diseases (under 5 years)
37 26. Appendicitis and Typhilitis......
9 27. Hernia. Intestinal
11 Ubstruction.... 28. Cirrhosis of Liver.. 19 29. Bright's Disease
and AC. Nephritis: 134 30. Diseases of Worms 6
en (not Cancer) 31. Puerperal Septi
cæmia.. 34 Other Puerperal
Diseases .. 33. Congenital De
bility and Mal- 66
formations.... 34. Old Age.....
14 35. Violent Deaths... 81
a. Effects of Heat.
* If the deaths under one month, numbering 85 from all causes, be deducted from the total death under one year, the resultant rate will be 57 deaths of infants per 1,000 births (weekly average of 1912).
Corrected Mortality. Among Children, Week Ending February 8, 1913.
• 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.
Mean barometer. 29.47 29.87 29.91 29.93 30.02 29.90 29.81 28:43.
71.7 52.9 64.9 Inches of rain };2.26in.zdin. .99in .65in
.72in 133511. 2 331 22.5, Mean temperature (Fahr
51.69 51.70 18.3° 40.1' 48.° 33.4° 41.1 33 6 43% enheit)..... Maximum temperature67.
55. 64.0 46. 51. 44.. ' 2 4, (Fahrenheit) Minimum tem
. 31. PFahrenheites