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. NOVEMBER 15, 1913. No. 46 SUPERSTITIONS AND PREJUDICES WHICH HAMPER THE WORK OF THE SCHOOL INSPECTOR. Among the many difficulties encountered by the Inspectors and Nurses of the Health Department when urging parents to have the various physical defects found in school children treated or corrected, the numerous traditions, prejudices and superstitions existing among the different elements which go to make up the population of our cosmopolitan city stand out prominently. When the Inspector or Nurse suggests that an operation or other treatment be instituted some racial or religious prejudice or superstition will frequently be raised against such intervention. When glasses are suggested for defective vision, they are often told that eyeglasses are a luxury, that they make the child look old, that they are worn for style, that the child will get used to them, that they will become a habit, that they will cause the eyes to grow weaker or that they will interfere with the matrimonial chances of the daughter. When the parents are informed that the children do not hear well as a result, perhaps, of running ears, the Inspector is informed that this discharge allows the poison to escape and thus purifies the blood, and the statement is frequently made that at home the child hears too much. Difficulty of breathing due to enlarged tonsils and adenoids results in the doctors and nurses being told by various elements of the population that God put the tonsils and adenoids there; that if the tonsils are removed, the throat will be too wide and air will rush into the lungs, subjecting the child to inflammation of the chest; that removal of the tonsils will interfere with the speech, the singing voice and the procreative power, or that the children will become nervous and depressed, possibly with suicidal tendencies. Voodooism is quite frequently met with amongst the negro population, and cases have been encountered where different colored yarns have been employed for the cure of contagious and other diseases of the skin and eyes. A request that hair matted by dirt and lice be cut frequently brings the retort that to cut the hair will prevent the growth of the child and diminish its strength. A request to have the defects of teeth remedied meets with the statement that pulling the teeth gives the children sore eyes; that it is bad luck for any poor child to have gold or silver in the mouth, or a mother will exhibit her toothless jaw and say, "I haven't any teeth and still I am alive." The "evil eye" is guarded against in some sections by the mother hastily licking the child's eyes and face, expectorating while she does so, or by sewing some salt in the child's shirt or by tying red ribbon around its wrist or neck. The weakness of the child's memory is frequently attributed to the fact that the child eats the ends of the bread loaves, while bed wetting is not uncommonly ascribed to the fact that the child always plays at the fire or with matches before he goes to bed. Among some of the people wine, beer and coffee are considered as tonics and used to strengthen the child. Many mothers call their children to task for describing how a neighbor's child was operated upon, fearing that a similar operation will be performed upon their own. In spite of these difficulties it is gratifying to note that the records of the examination of school children by the Department of Health show that the percentage of children requiring treatment for defects other than those of the teeth alone has declined from 44.20 in 1909 to 30.1 in 1913 and that the percentage of children requiring dental treatment has declined from 57 in 1909 to 49.4 in 1912. The percentage of defective vision has declined from 13.4 in 1909 to 7.3 in 1912. defective nasal breathing from 18.7 in 1909 to 7.6 in 1912, enlarged tonsils from 22 in 1909 to 10.4 in 1912, and malnutrition from 3.14 in 1969 to 2.8 in 1912. It is also encouraging to note that as the result of persistent follow-up work in the homes the percentage of glasses procured has increased from 27 in 1909 to 50.5 in 1912, and the percentage of operations for the removal of hypertrophied tonsils has increased from 22 in 1909 to 28.0 in 1912. PROPOSED ACTION IN RELATION TO THE SALE OF BICHLORIDE OF MERCURY. On account of the numerous cases of poisoning from bichloride of mercury (corrosive sublimate) which have recently occurred in this city, the Department of Health has had under consideration for some time the advisability of adding a section to the Sanitary Code, controlling the sale of bichloride of mercury. following tentative resolution was submitted at the last meeting of the Board: The Resolved, That the Sanitary Code be and the same is hereby amended by the adoption of an additional section to read as follows, and to take effect on and after January 1, 1914: Sec. 67a. Bichloride of mercury, otherwise corrosive sublimate, shall not be offered for sale or sold at retail in dry form except in a flat, triangular or threecornered tablet, colored blue, and the same shall be dispensed in a blue or amber colored corrugated bottle conspicuously labeled "Poison" in red letters. As an alternative to the above indicated plan, the following resolution was also submitted for consideration: Resolved, That the Sanitary Code be and hereby is amended by the adoption of an additional section to read as follows: Bichloride of mercury, otherwise corrosive sublimate, shall not be offered for sale or sold at retail except upon the prescription of a regularly licensed practitioner. The Board of Health now has these two resolutions under advisement and is considering which of the two plans will be the more effective in accomplishing the protection of the public against accidental poisoning by bichloride of mercury tablets. Bichloride of mercury is usually dispensed in the form of tablets containing seven grains, which were originally intended to make a disinfecting solution for surgical use when added to a pint of water. With the development of aseptic, as opposed to antiseptic surgery, the use of these tablets by surgeons has steadily decreased while, at the same time, their use by the laity has steadily increased, so that at the present time the statement made by the Governor of Pennsylvania that bichloride of mercury "is a household commodity" is altogether too true, particularly of the tablets, pounds if not tons, of which are sold annually for other than medicinal purposes. In the Public Health Reports of November 14. Martin I. Wilbert, of the United States Public Health Service, suggests that "in addition to specific agitation for the proper labeling of all preparations containing poisonous substances, the most promising innovation is the suggestion that a type form of corrosive mercuric chloride tablet or pastille be introduced in the Pharmacopoeia of the United States, with a view of providing adequate safeguards to prevent accidental poisonings. While the suggestions that have been made for this purpose are many and varied, it would appear that in view of the rapidly growing intercourse between the different countries of the world it might be desirable to secure international uniformity in regard to preparations of this type. It has been proposed, unless specific and valid objections could be offered, to adopt for inclusion in the Pharmacopoeia of the United States the description of mercuric chloride pastilles included in the German Pharmacopoeia. This latter Pharmacopoeia provides that pastilles of mercuric chloride consist of equal parts of corrosive mercuric chloride and sodium chloride, and requires that the pastilles be colored bright red with aniline dye, have a cylindrical shape, and be twice as long as thick. These tablets or pastilles must be wrapped individually in black paper, bearing the German equivalent of the word poison in white letters. The weight of a tablet must be stated, and the wrapped tablet is to be dispensed only in suitable glass bottles or tubes." "As an argument for including in the Pharmacopoeia of the United States an official tablet of corrosive mercuric chloride, rather than enacting legislation to compel uniformity in the shape, size, color and odor of all tablets containing corrosive mercuric chloride, it has been pointed out that inclusion in the Pharmacopoeia would not in any way interfere with the legitimately established trade of manufacturers, but would tend to discourage the sale and use of such preparations and bring about the gradual popularization of the official tablet. If, in addition to this, it were practicable to induce manufacturers properly to label all of their preparations so as to indicate the presence of any highly toxic substance, and then to suggest to purchasers of tablets of this kind the need for keeping them apart or in such a way that they could not readily be mistaken for other nontoxic preparations, little or no additional legislation would be necessary, unless it were to restrict newspapers from publishing unnecessary details in regard to the nature and kind of poison used in cases of accidental or intentional poisonings." DEATH RATE FOR THE WEEK. There were 1,250 deaths and a death rate of 12.14 per 1,000 of the population reported during the past week as against 1,216 deaths and a rate of 12.26 during the corresponding week in 1912, an increase of 34 deaths, and a decrease of 12 of a point in the weekly rate. If the increase in population be taken into consideration in lieu of an increase there is a decrease of 12 deaths. The following causes showed a decreased mortality: scarlet fever, cerebro-spinal meningitis, diarrhoeal diseases under five years of age, lobar pneumonia, broncho-pneumonia, Bright's disease and nephritis. The causes showing increases were whooping cough, typhoid fever, diphtheria and croup, organic heart diseases, pulmonary tuberculosis, diseases of the nervous system. The number of deaths reported from measles was 5, the same as in 1912. Viewed from the point of age grouping there were 19 fewer deaths of children under one year of age, 16 of children under five years of age. There was an increased mortality between the ages of five and sixty-five of 43 deaths, and at sixtyfive years and over 7 deaths. The death rate for the first forty-six weeks of this year was 13.81 per 1,000, as against 14.12 for the corresponding period of 1912, a decrease of .31 of a point. VITAL STATISTICS Summary for Week Ending Saturday, 12 M., November 15, 1913. Population Estimated U.S.Census Population Deaths. 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. Week Ending. 30. 6. 13. 20. 27 4. Aug. Sept. Sept. Sept. Sept. Oct Oct. Oct. Oct. Nov. Nov. Nov 11. 18. 25. I. 8 15. |