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On October 6. 1913, a Diagnostic Clinic for Venereal Diseases was opened at 29 3d ave., Brooklyn. The hours are from 9 to 11 a. m., daily, except Sundays, and a night clinic will be held at the same address every Tuesday and Friday from 8 to 9 p. m. Physicians may refer patients for the Wassermann reaction, and for the examination of fresh specimens to determine the presence of treponema. No patients will be examined unless referred by physicians, and under no circumstances will the results of examinations be reported to patients.
ADMISSION OF SURGICAL TUBERCULOSIS TO OTISVILLE.
The open air treatment of surgical tuberculosis has received much less attention in this country than abroad.
The favorable results obtained at the Sea Breeze Hospital, Coney Island, fully warrant the extension of this work by the City,
Provision has been made to care for a certain number of such cases at the Municipal Sanatorium at Otisville, N. Y. Those cases should be selected which require little surgical treatment. Patients with glandular involvement, those undergoing treatment by means of mechanical appliances, and post operative cases, will be considcred most suitable.
Applications for admission should be made, as for adults, through the Associated Tuberculosis Clinics, which will, in turn, forward the application to the Hospital Admission Bureau, 426 1st ave., Manhattan.
ADMISSION OF TUBERCULOSIS PATIENTS TO SEA VIEW HOSPITAL.
On or about November 1, 1913, tuberculosis patients will be admitted to the Sea View Hospital of the Department of Public Charities. Fifty men and fifty women can he cared for at that time, and those patients are desired who have been found to be unsuitable for Ray Brook or Otisville, but for whom favorable results may be expected, with proper treatment.
As soon as possible, at latest by October 15, it is desirable that a waiting list from which those pat nts may be drawn should be available. All the tuberculosis clinics of the Department will be notified to recommend patients for admission.
Recommendations will be made to, and admission cards issued by, the Hospital Admission Bureau. 426 1st ave., Manhattan, in the same manner as for admission of patients to other city hospitals.
A PLAN FOR SECURING UNIFORM HOSPITAL MORBIDITY STATISTICS.
Except in the case of certain notifiable diseases, public health administrators have no ready means of learning the prevalence and distribution of diseases other than through an analysis of death certificates. Yet it is well known that certain diseases are practically never directly fatal, and, therefore, do not normally come to the attention of health authorities. It is clear that the occurrence and control of these discases are of extreme importance to the community,
Inasmuch as a large proportion of cases of illness are treated in hospitals, it follows that these institutions ought to be a valuable source of information regarding the occurrence of various diseases. Students of public health have, therefore, repeatedly turned to hospital reports as sources of morbidity statistics, but the reports have almost always proven worthless for their purpose. This is due in the main to the fact that hardly any two hospitals employ the same system of nomenclature for diseases and the reports of different institutions are, therefore, not comparable.
About two years ago, Dr. Charles F. Bolduan. Assistant to the General Medical Officer, devised a plan, which, by those best capable of judging, was regarded as a practicable scheme for collecting and preparing uniform hospital morbidity statistics and making them available for analytical study. The merits of the plan, aside from its simplicity, consist in the fact that:
First-Various hospitals are not compelled to adopt any particular system of nomenclature.
Second-Valuable morbidity statistics can be obtained through the voluntary cooperation of several hospitals.
Third-The amount of labor required on the part of the hospitals is very small.
The plan provides for the filling out of "discharge certificates” by the hospital authorities on the discharge of each and every patient. Such certificates would resemble death certificates and record certain social data concerning the patient, certain data concerning the mode of admission, length of stay and condition on discharge, and finally the diagnosis, giving the main cause of illness and the complications. The plan provides for transmitting discharge certificates promptly to a central bureau, preferably the Bureau of Vital Statistics, and there tabulating and analyzing the data provided. In order to make the returns from the various hospitals comparable, the nomenclature employed on the discharge certificates is translated in the central filing bureau into terms of a standard nomenclature. In the plan as proposed, the Bellevue classification is advocated, but it is obvious that any other standard classification may be employed.
In a paper read before the recent annual meeting of the American Public Health Association at Colorado Springs, Dr. Bolduan made a strong plea for the introduction of some such method for securing hospital morbidity statistics, and, in the discussion which followed, it was generally agreed that the plan outlined was both simple and practicable and should be put into operation. The association passed the following resolution unanimously:
"Resolved, That we recommend the enactment of laws prescribing the manner of keeping the morbidity records of all institutions for the care of the sick, and requiring the filing of transcripts of so much of such records as may be necessary for statistical purposes, with the proper registration officials of the several jurisdictions in which such institutions are located.”
In the Budget of the Department of Health for 1914, which is at present under discussion, a request has been made for an extension of the work of the Bureau of Records. If sufficient funds are provided, it is planned to have the Department of Health inaugurate a system of hospital morbidity reports according to the method described. It may be added that the Hospital Conference, composed of representatives of all the large hospitals in this city, has carefully considered the plan and given it its hearty indorsement.
DEATH OF MEMBER OF NEW YORK CITY'S FIRST HEALTH DEPART
MENT. News was recently received by the Registrar that Captain James S. Griswold died at his country home at Ostran, New Jersey.
Captain Griswold was one of the original force when the Department of Health was first organized in 1866, and was probably the last survivor of that period. He was connected with the Department for more than twenty years, and for a great many years was the Clerk who received all varieties of complaints.
DEATH RATE FOR THE WEEK. There were 1,153 deaths and a death rate of 11.20 per 1,000 of the population reported during the past week, as against 1.243 deaths and a rate of 12.53 for the corresponding week of 1912, a decrease of 90 deaths, and if the increase in population be taken into consideration, a decrease of 137 deaths and of 1.33 points in the rate. This is the lowest weekly death rate that has ever been recorded in the history of the City, the next lowest being that of the week ending June 28, 1913, when the death rate was 11.48.
The following causes showed a decreased mortality: scarlet fever, whooping cough, typhoid fever, diarrhoeal diseases under five years of age, lobar and broncho pneumonia. The causes showing increases were diphtheria and organic diseases of the heart. The mortality from pulmonary tuberculosis and Bright's disease and acute nephritis was about the same as that of last year.
The mortality of infants under one year fell from 273 deaths to 229, a decrease of 44 deaths; that of children under five years of age, from 372 to 319, a decrease cf 53. Between the ages of five and sixty-five years, there were 32 fewer deaths, and over sixty-five years of age there were 5 fewer deaths.
The death rate for the first forty-two wecks of the year was 13.99 per 1.000 of the population as against 14.29 during the corresponding period in 1912, a decrease of .30 of a point.
Summary for Week Ending Saturday, 12 M., October 18, 1913.
620 50 13.31 12.35 12.27 The Bronx 430,980 583,981 116
71 11 11.39 8.;6 7.95 Brooklyn 1,634,351 1,845,443
292 31 12.18 10.co 10.91 Queens
9.71 Richmond.. 85,962 95,872 25
1 15.76 14.69 14.15 City of New York... 4,766,883
12.53 11.20 • Corrected according to borough of residence.
1 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.
Aug. Aug. Aug. Aug. Aug. Sept. Sept. Sept. sept.' Oct
* If the deaths under one month, numbering 99, from all causes, be deducted from the total deaths under one year, the resultant rate will be 50 deaths of infants per 1,000 births (weekly average July 1, 1913 to July 1, 1913).
Corrected Mortality Among Children, Week Ending October 18, 1913.
Spiall 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 – July | July Aug. Aug. | Aug. Aug. Aug. Sept. Sept. Sept. Sept. Oct.
Mean barometer. 29.80 29.88 29.53 29.91 29.99 29.99 29.86 30.06 30.01 30.08 29.98 29.73 30.01 29.86 Mean humidity.. 59. 61. 71. 168.00 65.4 69.3 83.
167.6 73. 86.3 64. Inches of rain
1.45 in. 1.17 in 3.64in 1.08in 0.13in -49in .i8in 4.15 in .47in 1.18in 1.20in 5.28in 1.1 zin 1.ooin or Snow.... Mean tempera
ture (Fahr-175.90 75.0 77.3° 74.90 72.99 75.1° 72 7° 21.90 64.9€ 61.0 63.70 61.71 66.3° 56.7°
enheit).. Maximum temperature 88. 195..
95. 94.° 84.° 84.° 77.0 77. 77.69.0 (Fahrenheit) Minimum temperature 60.9 64.0 63.9 60. 61.o 60." 61.o
49.° 5.o (Fahrenheit)