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. JUNE 14, 1913. ADVICE FOR THE SUMMER MONTHS. No. 24 As the vacation time approaches and many of our citizens are looking forward to their sojourn in the country, the Department of Health desires to call attention to the fact that a large proportion of the cases of typhoid fever which develop in New York City are contracted in the country during the summer. In order to contract typhoid fever, it is necessary to swallow the germ, and this introduction of the poison frequently takes place through the medium of infected well water. Milk may also become infected and convey the disease, and typhoid fever is sometimes transmitted through the contamination of food by flies. It would, indeed, be well if those who seek rest and recreation in the country would pay more attention to their sanitary surroundings and less to the scenery. Typhoid fever derived from an infected well, from manure heaps which breed flies, from a polluted milk supply, or from contaminated shell-fish, is a heavy price to pay for a moderate temperature and pleasant elevation. The disease does not develop until about two weeks after infection, at which time the unfortunate individual will frequently have returned to the city. It is a trite saying that "an ounce of prevention is worth a pound of cure," and fortunately typhoid vaccination is proving to be as successful a preventive as is vaccination in smallpox. Should its use become general, typhoid fever will undoubtedly occupy eventually the almost negligible position held by smallpox in civilized communities. Commissioner Lederle strongly advises those who intend to spend their vacations in the country districts to be vaccinated against typhoid fever. This vaccination is performed free by the Department for those unable to pay a physician. The process is unaccompanied by danger, but as it is best performed by means of successive inoculations a week apart, no time should be lost by those who intend to avail themselves of its benefit. This is the most important advice that can be offered to those about to leave the City for the summer months. In addition, it is needless to say that the clothing should be light and cool, physical exercise should be restricted to that which is necessary, and that one* should keep out of the sun as much as possible. There is no objection to the drinking of considerable quantities of cold water and even of ice water, contrary to the popular belief, which the public honors in theory and violates in practice. Iced tea and coffee are agreeable during hot weather and are harmless to most adults if not indulged in to excess. Alcoholic beverages should not be indulged in during hot weather. The temporary sense of coolness which they induce is quickly followed by a reaction, causing the consumer to feel more uncomfortable than before, and it has been incontestably proven that alcoholics withstand extremes of temperature badly. The diet should be light, consisting for the most part of fish, fruits and vegetables. Rich foods should be avoided and meat indulged in but once a day. Cold baths are agreeable and beneficia! and their number need only be limited by the opportunities of the individual. In regard to the care of infants during the summer, the important points are that they should be properly fed and should be kept as cool as possible. Babies should be nursed and should not be weaned during hot weather. If the mother cannot nurse her baby, she should consult a physician before giving it the bottle. Pure milk for infant feeding can be obtained at the milk stations of the Department, and at the majority of these stations a doctor and nurse are in attendance and will furnish the instructions necessary in regard to bottle feeding. In hot weather most of the baby's clothes should be removed, and it should be bathed every day. Windows should be kept open day and night and the recreation piers, vacation schools, parks and roofs taken advantage of to the fullest extent possible. Special circulars of the Department of Health relating to sunstroke, and to the care of babies during hot weather, will be furnished upon request. NEW DIVISION OF INFECTIOUS DISEASES. For a number of years the supervision exercised by the Department of Health over scarlet fever, diphtheria, measles and other contagious diseases of serious importance was conducted through the Division of Contagious Diseases. When, however, in 1905, the Department decided to exercise a more thorough control over tuberculosis, a new division, styled the Division of Communicable Diseases, was organized, and to this was later assigned the supervision of typhoid fever, venereal diseases and some others of communicable nature. It will thus be seen that for several years work quite similar in character was performed by two divisions, and it was finally decided at the meeting of the Board of Health held March 25 to combine them and thus create a new division, to be known as that of infectious discases. At a meeting of the Board of Health of the Department of Health, held May 6, 1913. a resolution was adopted in accordance with that of March 25, establishing a Division of Infectious Diseases and detailing Dr. John S. Billings as Director of the new division, and on May 21 an executive order of the Commissioner defined the duties of the officials and employees of the new division. CONFISCATION OF MILK. The right of the Department of Health to destroy or confiscate milk without notification of the owner, and without giving him an opportunity to defend the purity of his product has never been tested legally, although it has at times been the subject of comment and discussion. The following decision, which was handed down May 12, 1913, by the Supreme Court of the State of Wisconsin upholds the Department of Health in such confiscation when milk is adulterated or below standard. As a matter of fact, at the present time the department confiscates and destroys only when milk is above a certain temperature or when it contains visible dirt, these two points being capable of immediate and satisfactory demonstration. In cases where adulteration is suspected, samples are taken and submitted to chemical analysis and, upon proof of adulteration, the dealer is prosecuted. The opinion of the Milwaukee court was delivered by Mr. Justice McKenna and affirmed the judgment of the Circuit Court for Milwaukee County, from which the plaintiff had appealed. Justice McKenna stated, in part, as follows: The ordinance (of the City of Milwaukee) provides that no milk drawn from cows outside of the city shall be brought into the city, contained in cans, bottles, or packages, unless they be marked with a legible stamp, tag, or impression bearing the name and address of the owner of the cows, and unless such owner shall, within one year from the passage of the ordinance, file in the office of the commissioner of health a certificate of a duly licensed veterinary surgeon or other person given authority by the State Live Stock Sanitary Board to make tuberculin tests, stating that such cows have been found free from tuberculosis or other contagious diseases. The certificate is required to give a number which has been permanently attached to each cow and a de scription sufficient for identification. The certificate must be renewed annually, 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. JUNE 14, 1913. ADVICE FOR THE SUMMER MONTHS. No. 24 As the vacation time approaches and many of our citizens are looking forward to their sojourn in the country, the Department of Health desires to call attention to the fact that a large proportion of the cases of typhoid fever which develop in New York City are contracted in the country during the summer. In order to contract typhoid fever, it is necessary to swallow the germ, and this introduction of the poison frequently takes place through the medium of infected well water. Milk may also become infected and convey the disease, and typhoid fever is sometimes transmitted through the contamination of food by flies. It would, indeed, be well if those who seek rest and recreation in the country would pay more attention to their sanitary surroundings and less to the scenery. Typhoid fever derived from an infected well, from manure heaps which breed flies, from a polluted milk supply, or from contaminated shell-fish, is a heavy price to pay for a moderate temperature and pleasant elevation. The disease does not develop until about two weeks after infection, at which time the unfortunate individual will frequently have returned to the city. It is a trite saying that "an ounce of prevention is worth a pound of cure," and fortunately typhoid vaccination is proving to be as successful a preventive as is vaccination in smallpox, Should its use become general, typhoid fever will undoubtedly occupy eventually the almost negligible position held by smallpox in civilized communities. Commissioner Lederle strongly advises those who intend to spend their vacations in the country districts to be vaccinated against typhoid fever. This vaccination is performed free by the Department for those unable to pay a physician. The process is unaccompanied by danger, but as it is best performed by means of successive inoculations a week apart, no time should be lost by those who intend to avail themselves of its benefit. This is the most important advice that can be offered to those about to leave the City for the summer months. In addition, it is needless to say that the clothing should be light and cool. physical exercise should be restricted to that which is necessary, and that one® should keep out of the sun as much as possible. There is no objection to the drinking of considerable quantities of cold water and even of ice water, contrary to the popular belief, which the public honors in theory and violates in practice. Iced tea and coffee are agreeable during hot weather and are harmless to most adults if not indulged in to excess. Alcoholic beverages should not be indulged in during hot weather. The temporary sense of coolness which they induce is quickly followed by a reaction, causing the consumer to feel more uncomfortable than before, and it has been incontestably proven that alcoholics withstand extremes of temperature badly. The diet should be light, consisting for the most part of fish, fruits and vegetables. Rich foods should be avoided and meat indulged in but once a day. Cold baths are agreeable and beneficia! and their number need only be limited by the opportunities of the individual. In regard to the care of infants during the summer, the important points are that they should be properly fed and should be kept as cool as possible. Babies should be nursed and should not be weaned during hot weather. If the mother cannot nurse her baby, she should consult a physician before giving it the bottle. Pure milk for infant feeding can be obtained at the milk stations of the Department, and at the majority of these stations a doctor and nurse are in attendance and will furnish the instructions necessary in regard to bottle feeding. In hot weather most of the baby's clothes should be removed, and it should be bathed every day. Windows should be kept open day and night and the recreation piers, vacation schools, parks and roofs taken advantage of to the fullest extent possible. Special circulars of the Department of Health relating to sunstroke, and to the care of babies during hot weather, will be furnished upon request. NEW DIVISION OF INFECTIOUS DISEASES. For a number of years the supervision exercised by the Department of Health over scarlet fever, diphtheria, measles and other contagious diseases of serious importance was conducted through the Division of Contagious Diseases. When, however, in 1905, the Department decided to exercise a more thorough control over tuberculosis, a new division, styled the Division of Communicable Diseases, was organized, and to this was later assigned the supervision of typhoid fever, venereal diseases and some others of communicable nature. It will thus be seen that for several years work quite similar in character was performed by two divisions, and it was finally decided at the meeting of the Board of Health held March 25 to combine them and thus create a new division, to be known as that of infectious diseases. At a meeting of the Board of Health of the Department of Health, held May 6, 1913. a resolution was adopted in accordance with that of March 25, establishing a Division of Infectious Diseases and detailing Dr. John S. Billings as Director of the new division, and on May 21 an executive order of the Commissioner defined the duties of the officials and employees of the new division. CONFISCATION OF MILK. The right of the Department of Health to destroy or confiscate milk without notification of the owner, and without giving him an opportunity to defend the purity of his product has never been tested legally, although it has at times been the subject of comment and discussion. The following decision, which was handed down May 12, 1913, by the Supreme Court of the State of Wisconsin upholds the Department of Health in such confiscation when milk is adulterated or below standard. As a matter of fact, at the present time the department confiscates and destroys only when milk is above a certain temperature or when it contains visible dirt, these two points being capable of immediate and satisfactory demonstration. In cases where adulteration is suspected, samples are taken and submitted to chemical analysis and, upon proof of adulteration, the dealer is prosecuted. The opinion of the Milwaukee court was delivered by Mr. Justice McKenna and affirmed the judgment of the Circuit Court for Milwaukee County, from which the plaintiff had appealed. Justice McKenna stated, in part, as follows: "The ordinance (of the City of Milwaukee) provides that no milk drawn from cows outside of the city shall be brought into the city, contained in cans, bottles, or packages, unless they be marked with a legible stamp, tag, or impression bearing the name and address of the owner of the cows, and unless such owner shall, within one year from the passage of the ordinance, file in the office of the commissioner of health a certificate of a duly licensed veterinary surgeon or other person given authority by the State Live Stock Šanitary Board to make tuberculin tests, stating that such cows have been found free from tuberculosis or other contagious diseases. The certificate is required to give a number which has been permanently attached to each cow and a description sufficient for identification. The certificate must be renewed annually, and |