USA > Massachusetts > Middlesex County > Somerville > Report of the city of Somerville 1907 > Part 23
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REGULATION III.
SECTION 1. No person shall sell or deliver or have in his possession with intent to sell or deliver any milk of a temperature exceeding fifty degrees Fahrenheit.
SECT. 2. Milk kept for sale in any store, shop, restaurant, market, bakery, or elsewhere shall be kept in a covered cooler, box, or refrig- erator. No vessel containing milk for sale shall be allowed to stand outside said cooler, box, or refrigerator, except while a sale of said milk is being made. Every such cooler, box, or refrigerator shall be properly drained and cared for, and shall be kept only in such locations and under such conditions as shall be approved by the board of health.
REGULATION IV.
SECTION 1. Every person engaged in the business of producing, storing, selling, delivering, or distributing milk in the city of Somerville shall immediately notify the board of health of the occurrence of any infectious disease in himself, or in his family, or amongst his employees, or within the buildings or premises where milk is produced, stored, sold, or distributed, and he shall suspend the sale and distribution of milk until authorized to resume the same by the board of health.
SECT. 2. No vessels which have been handled by persons suffering with or directly exposed to an infectious disease shall be used to hold or convey milk until they have been thoroughly sterilized.
WILLIAM P. MITCHELL, Clerk.
Keeping of Medical and Surgical Appliances in Factories.
In Board of Health,
Somerville, October 2, 1907.
Ordered, that the following regulation be and hereby is adopted :---
In accordance with the requirements of Chapter 164, Acts of the Massachusetts legislature of 1907, providing for the keeping of medical and surgical appliances in factories, the board of health adjudges that
297
HEALTH DEPARTMENT.
the following articles are necessary, and that they must be kept in a suitable dust-proof case :-
Adhesive plaster, 1-inch roll and 2-inch roll.
Bandages, 2 dozen assorted sizes, 1 to 4 inches.
Absorbent cotton, 1 pound.
Gauze, 1 package of 10 yards.
Elastic tourniquet, 24 inches.
Safety pins, 2 dozen.
Splint material, 4 whitewood strips 30 by 4 by 3-16.
Scissors, straight, 3-inch blade.
Basin, enamel.
Tablets, cor. sub. and citric acid, 100.
Carron oil, 1 quart.
Aromatic spirits of ammonia, 4 ounces.
(Signed) WILLIAM P. MITCHELL, Clerk.
The following is a copy of the Act referred to above :-
SECTION 1. Every person, firm, or corporation operating a factory or shop in which machinery is used for any manufacturing purpose, or for any other purpose, except for elevators, or for heating or hoisting apparatus, shall at all times keep and maintain, free of expense to the employees, such a medical and surgical chest as shall be required by the local board of health of any city or town where such machinery is used, containing plasters, bandages, absorbent cotton, gauze, and all necessary medicines, instruments, and other appliances for the treatment of per- sons injured or taken ill on the premises.
SECT. 2. Any person, firm, or corporation violating this act shall be subject to a fine of not less than five dollars nor more than five hun- dred dollars for every week during which such violation continues.
Approved March 1, 1907.
Financial Statement for 1907. HEALTH DEPARTMENT.
CREDIT.
Appropriation
$8,000 00
Receipts :-
Milk fees
152 24
Permit fees
63 00
Sundry cities and towns, for care of
contagious diseases in 1904, 1905, 1906,
and 1907
1,266 65
Total credit
$9,481 89
Salaries
$5,050 08
Repairing and painting vehicles
23 79
Repairing regenerator
24 50
Repairing harnesses
38 70
Horseshoeing
27 50
Burying dead animals
182 50
Office expenses of milk inspector .
253 39
Books, stationery, printing, and postage
176 47
Bacteriological laboratory
49 84
Board of agent's horse
315 00
Telephones
95 53
Amounts carried forward
$6,237 30
$9,481 89
DEBIT.
298
ANNUAL REPORTS.
Amounts brought forward .
$6,237 30
$9,481 89
Care of contagious diseases
(settlements in Somerville)
2,755 32
Care of smallpox case
299 27
Incidentals
268 69
Total debit
$9,560 58
Amount overdrawn
$78 69
Health Department, Collection of Ashes and Offal.
CREDIT.
Appropriation
$40,000 00
Sale of offal, rags, paper, etc.
8,153 89
$48,153 89
DEBIT.
Salary of superintendent
$1,200 00
Collection of ashes .
24,733 70
Collection of offal
16,040 25
Stable expenses
2,251 50
One new ash cart
125 00
Two new paper wagons
348 00
One new offal wagon
200 00
Repairing wagons
682 72
Tools and repairing same
259 07
New harness and repairing harnesses
528 04
Six new horses
1,822 50
Horse clipping
2 00
Horse doctoring
58 31
Board of superintendent's horse
278 73
Horseshoeing
792 19
Hay and grain
5,706 68
Building incinerator
914 48
Incidentals
253 47
Total debit®
$56,196 64
Amount overdrawn
$8,042 75
Health Department, Hospital for Contagious Diseases.
CREDIT.
Appropriation
$1,000 00
Receipts :-
Sundry cities and persons, care of patients
5,663 00
Board of health
(patients settled in Somerville)
1,502 16
Webcowit Press
(bill paid twice)
2 50
Total credit
$8,167 66
Amount carried forward
$8,167 66
.
.
.
299
HEALTH DEPARTMENT.
Amount brought forward
$8,167 66
1
DEBIT.
Salary of matron
$767 44
Salary of assistant matron
263 42
Salaries of nurses
1,244 84
Cook
389 50
Janitor
469 62
Housework
207 05
Laundry and cleaning
445 37
Frank L. Morse, M. D. (3 monthis)
49 98
Supplies
865 93
Groceries and provisions
1,360 66
Incidentals
168 85
Total debit
$6,232 66
Amount unexpended
$1,935 00
Health Department, Medical Inspection in the Public Schools.
CREDIT.
Appropriation
DEBIT.
Salaries of inspectors
$1,400 32
Printing
105 50
Total debit
1,505 82
Amount overdrawn
$5 82
Appropriations Overdrawn.
Health Department
$78 69
Health Department, collection of ashes and offal
8,042 75
Health Department, medical inspection in the public schools
5 82
Total amount overdrawn
$8,127 26
Appropriation Unexpended.
Health Department, hospital for contagious diseases
$1,935 00
Net amount overdrawn
$6,192 26
ALLEN F. CARPENTER, Chairman, WESLEY T. LEE, M. D., ZEBEDEE E. CLIFF,
Board of Health.
$1,500 00
REPORT OF THE MEDICAL INSPECTOR.
Somerville, January 10, 1908. To the Board of Health of the City of Somerville :-
Gentlemen,-I herewith present the report of the medical inspector for the year 1907, including the statistics of the con- tagious disease hospital and the bacteriological laboratory.
Scarlet Fever. During the year 400 cases of this disease were reported in the city, a considerable increase in number over the previous year. For the month of January 191 cases were reported, at which time this city shared with Boston, Cam- bridge, and Everett, one of the largest epidemics of scarlet fever ever reported, aggregating over 1,000 cases. From January 1-5 only three cases were reported. For the week January 5-12 115 cases occurred; from the 12-17 thirty cases were reported ; from the 17-24 twenty-nine cases were reported, and during the last week of the month fourteen cases were reported. During the month of February the number reached that usually preva- lent, except for other cases already existing in the same house- hold. This epidemic therefore reached its height during the week of January 5-12. Careful inquiry made by a visit to each infected household showed that ninety-two per cent. of the cases obtained milk from one dealer, but a study of this milkman's business carried on with the assistance of the inspector of milk failed to show the exact source of infection. From the sudden onset of the cases and its rapid decline it can be almost definitely stated that infection was only of limited extent, perhaps not more than a single day, and from four cases, in which it is defi- nitely known that infection could have taken place on only one day, January 6, we must conclude that it was this day's milk which became infected. These four cases also give some infor- mation upon the incubation period of the disease, for in three of them the symptoms developed on the third day, and in the other on the fourth day of this period. For the remainder of the year no unusual number of cases occurred. Every case has been in- spected, before the house was fumigated, and 427 visits were made at residences to determine when desquamation was com- plete.
Diphtheria. During the year 194 cases of diphtheria have been reported in the city, a marked decrease from the previ- ous year, when 236 cases were reported. The same restric- tions are placed upon all cases, and before patients are released from quarantine, two successive negative cultures must be ob- tained. It is optional with the attending physician to take the first culture, but the second must be taken by the medical in- spector, and during the year 326 visits were made at houses for this purpose, and a total of 481 cultures taken.
301
HEALTH DEPARTMENT.
Typhoid Fever. During the year ninety-one cases of this disease were reported, the greater number in any one month appearing in October, when forty-three cases occurred. From August 8-31 only one case was reported; from September 1-22, seven cases, and during the last week of this month eleven cases occurred. Upon investigation of the fifty-four cases developing between September 22 and October 31 it was learned that eight of them had probably contracted the disease while away on their summer vacation, for symptoms of the disease showed soon after their return; in four cases no definite information could be ob- tained, and of the remaining forty-two cases, thirty-seven of them obtained milk from one dealer. With the assistance of the inspector of milk, the investigation was carried to the farms where the milk was produced, but no source of infection could be discovered. Attention was then directed to the milk route itself, and it was found that the milk dealer was taking away bottles from two houses where the disease already existed, and where it was possible from the conditions for those bottles to have become infected.
Tuberculosis. Eighty-three cases of tuberculosis were re- ported during the year, an increase of twenty-five over the year previous. In November, following a conference with the overseers of the poor, these cases which had been previously cared for medically by the city physician were transferred to the board of health and the medical inspector instructed to care for them, since which time thirty-three visits have been made to them.
Smallpox. One case of this disease was reported upon Oc- tober 21, the patient having recently arrived from Prince Ed- ward Island, where her sister was ill with the disease apparently unrecognized, and no restrictions placed on the family. Upon the discovery of the case, the smallpox hospital was opened, the patient transferred to it, where she remained until recovery. Many persons were exposed to her, as she traveled in an electric car after the eruption appeared, but no other cases developed from it. She had never been vaccinated.
Contagious Disease Hospital.
In September, 1906, following a change in the city charter, the city physician, who, up to this time, had treated the cases at the hospital, was relieved of this duty, and the care of the pa- tients transferred to the medical inspector on October 1. Dur- ing 1907 this arrangement has continued, 377 visits having been made at the hospital during the year.
Scarlet Fever. During the year ninety-five cases of scarlet fever were admitted, seven of which proved fatal. Thirty-seven of these cases were among males, and fifty-eight among females. Twenty-seven were under five years of age, thirty-one from five
302
ANNUAL REPORTS.
to ten years, and the remainder were over ten years. Vomiting was a constant symptom, it occurring in fifty-one cases, and a sore throat in sixty-nine cases. In twenty-one cases the rash occurred on the first day of the illness, in sixty-three cases on the second day, and in five instances on the third day. There was membrane present on the tonsils in thirty-one cases; in twelve cases the disease was complicated with nephritis, and in eight cases with rheumatism. One mastoid operation was performed.
Of the deaths, all were complicated with nephritis, and in addition four had diphtheria.
Diphtheria. During the year fifty-one cases of diphtheria were admitted, six of which proved fatal. In order to make the records complete, however, the cases dating from October 1, 1906, are included, making a total of sixty-seven cases in fifteen months, with eight deaths. Of these patients, thirty-four were among males, and thirty-three among females. Seventeen were under five years of age; twenty were from five to ten, and the remainder were over ten. Sixteen entered the hospital on the first day of their illness, and all recovered. Twenty entered the second day of the illness and three died; two on the third day with one death; six on the fourth day with no deaths; six on the fifth day with no deaths, and three on the seventh day, all of whom died. The importance of early treatment with anti- toxin is thus very obvious. Of the laryngeal cases one had been ill one day, four for two days, two for three days with one death, one for four days, three for five days with one death, and three for seven days, all of whom died. In ten patients the membrane extended over both tonsils, uvula and palate, four of whom died from systemic infection involving both the heart and kidneys. In fifty-six cases the cultures were positive. The throat was clear of membrane in three cases on the first day, in twelve cases on the second, in thirteen cases on the third, in twelve cases on the fourth, in six cases on the fifth, in one on the sixth and seventh, and in four on the eighth day. In twenty- seven patients eruptions appeared on the body due to the use of the antitoxin, and in four patients joint pains occurred from the same cause. The average stay in the hospital of fifty-eight pa- tients was fourteen days. The dose of the antitoxin varied from 4,000 to 48,000 units, depending upon the severity of the case, the largest aggregate dose being 60,000 units. Our best record was from November 9, 1906, to November 9, 1907, dur- ing which period forty-five consecutive cases were treated, with one death, that patient dying eight hours after admission. Of the six deaths during the year three died within nine hours of admission and were hopeless at that time. Two died on the sixth dav, and the last on the sixteenth day, all being compli- cated with nephritis.
Sixteen cases of laryngeal diphtheria were treated, five of
303
whom died. Of these cases, one came to intubation and was
discharged well. Of the deaths, two had recovered from the acute symptoms, the tube had been removed, but nephritis was fatal on the sixth day, and the other three all died within nine
among the attendants at the hospital, but we have yet to record a case of diphtheria developing among patients admitted for
Two patients were sent to the hospital as diphtheria, in
which the diagnosis was syphilis, one case of measles was sent as scarlet fever, and one case of typhoid fever was sent as erysip- elas. One patient with chicken pox was also treated.
Patients Treated at the Contagious Hospital.
Admission by Months.
Remaining
January.
February.
March.
April.
May.
June.
July.
August.
September.
October.
November.
December.
Remaining
January 1, 1908.
Percentage of
Fatality.
Scarlet fever .
3
31
co
2
5
6
2
3
5
8
7
11
95
84
7
-7
7.1
Diphtheria
0
4
2
00
4
4
3
3
0
2
5
00
51
38
6
7
11,7
Erysipelas
·
. .
..
..
. .
..
..
.
.
Smallpox
.
.
..
. .
..
.
.
..
..
1
1
.
Chicken pox .
Measles
·
Totals
3
35
15
10
co
10
CT
6
8
00
11
18
15
150
126
13
14
.
..
.
·
1
1
1
·
..
.
1
1
·
..
.
1
Total admitted.
Cured.
Died.
.
hours of admission.
·
·
1
1
1
1
.
January 1, 1907.
DISEASE.
HEALTH DEPARTMENT.
One case of diphtheria has developed
scarlet fever, or of scarlet fever among diphtheria patients.
2
304
ANNUAL REPORTS.
Bacteriological Department.
During the year 1907, 971 examinations were made of cul- tures for the diphtheria organism, 227 examinations made of sputum from patients suspected of having tuberculosis, and 110 examinations to detect the Widal reaction in typhoid fever.
Diphtheria. Nine hundred and seventy-one cultures have been examined for diphtheria, 423 being in males, and 548 in females. Diphtheria being a disease of children, 224 of these examinations have been made in children under five years of age, 346 in those from five to ten years of age, 185 from ten to twenty, and 210 in adults over twenty years. In six cases the age of the patient was not stated. Four hundred and sixty-two examinations were made for the diagnosis of the case, 107 prov- ing positive, and 445 negative. Of the positive results, forty-five were of cases in which the attending physician's diagnosis of diphtheria was confirmed, ten in which the clinical diagnosis was not diphtheria, and fifty-two in which no definite diagnosis was made. Of the 445 negative examinations, thirty-four were obtained in which the clinical diagnosis was diphtheria, 104 in which the diagnosis was not diphtheria, and 217 in which no di- agnosis had been made.
Five hundred and six cultures were taken for release of patients from quarantine, ninety-eight of which were positive, and 408 negative. The importance of taking release cultures is demonstrated by these figures, these patients showing the pres- ence of the bacilli in the throat after the clinical evidence of the disease had disappeared. In three examinations there was no growth upon the serum tube.
Tuberculosis. Two hundred and twenty-seven examinations have been made of sputum suspected of containing the tubercle bacillus, seven of which were positive and 220 negative. In eighty-three cases a definite diagnosis of this disease had been made by the attending physician, but in seventy-nine of them the organism could not be detected. In the remainder of the cases, eighty-six were stated as not showing evidence of the disease, two being positive, and in fifty-eight cases no state- ments were made giving information as to its character, one of which was positive. One hundred were males and one hundred and twenty-seven females. Although printed directions accom- pany each outfit, telling how the specimen should be obtained, it has not been unusual for specimens to be sent to the laboratory containing only saliva from the mouth, with no excretion from the lungs or bronchial tubes. - Physicians should be urged to give definite instructions to each patient, relating to the collec- tion of the sputum, for in some instances a negative report would mislead both physician and patient. Consumption to-day is rec- ognized as an infectious disease, and all persons afflicted with it should be instructed in the modern methods for preventing its
305
HEALTH DEPARTMENT.
spread. In some cases this is not done by the attending physi- cian, and during the past four years your board has required that this disease be reported to you, as other infectious diseases are, and that printed instructions and advice be sent to each patient ill with the disease. The decrease in the death rate of consump- tion, and the cure of persons afflicted with it, is due to the im- proved and intelligent manner with which cases are treated, and the prevention of further spread of the disease is a subject which is of importance to all local boards of health.
Typhoid Fever. One hundred and ten examinations of the blood of patients suspected of having typhoid fever have been made, forty-five of which proved positive. In thirty-five cases a positive diagnosis of this disease had been made by the attending physician, in three cases it was stated not to be typhoid fever, and in the remainder no statement was made relating to the diagnosis. Of the negative results, ten were diagnosed as ty- phoid, three were said not to be typhoid, and in fifty-two no diagnosis was made. Fifty-eight were males and fifty-two fe- males.
Summary for Five Years, 1903, 1904, 1905, 1906, 1907.
Diphtheria Cultures.
No. Examined
Males
Females
0-5
5-10
10-20
Over 20
Age not No. stated growth
1903
817
387
430
282
199
125
185
26
1.2
1904
1,429
629
800
537
400
231
261
34
2:
1905
792
346
446
204
260
139
170
19
4
1906
968
407
561
282
370
158
152
6
6
1907
971
423
548
224
346
185
210
6
3
For Diagnosis Clinical Diagnosis Diph. Clin. Diag. not Diph. Clin. Diag. not stated
Positive
Negative
Positive
Negative
Positive
Negative
1903
360
56
35
11
122
27
109
1904
406
72
37
11
96
59
131
1905
263
15
23
10
76
36
103
1906
419
55
60
14
130
47
107
1907
462
45
34
10
104
52
217
For Release
Positive
Negative
1903
95
362
1904
233
761
-
1905
139
386
1906
85
464
1907
98
408
Sputum for Tuberculosis.
No. Examined
Males
Females
Positive
Negative
Clin. Diag. Tuberculosis Positive Negative
1903
137
66
71
26
111
15
21
1904
124
54
70
28
96
14
29
1905
162
69
93
22
140
11
38
1906
175
95
80
9
166
7
44
1907
227
100
127
7
220
4
79
.
306
ANNUAL REPORTS.
Clinical Diagnosis not Tuberculosis Clinical Diagnosis not stated Positive
Negative
Positive
Negative
1903
9
61
2
29
1904
11
43
3
24
1905
5
59
6
43
1906
1
85
1
37
1907
2
84
1
57
Blood for Typhoid Fever.
No. Examined
Males
Females
Positive
Negative
Clin. Diag. Typhoid Fever Positive Negative
190₴
72
39
33
27
45
18
7
190
76
53
23
32
44
18
4
1905
78
45
33
26
50
11
1
1906
94
57
37
24
70
14
15
1907
110
58
52
45
65
25
10
Clin. Diag. not Typhoid Fever Clin. Diag. not stated
Positive
Negative
Positive
Negative
1903
2
6
7
32
1904
0
6
14
34
1905
1
5
14
44
1906
0
8
10
47
1907
0
3
20
52
1
1
Respectfully submitted,
FRANK L. MORSE, Medical Inspector.
1
REPORT OF INSPECTOR OF ANIMALS AND PROVISIONS.
OFFICE OF THE BOARD OF HEALTH, CITY HALL, Somerville, Mass., January 7, 1908.
To the Board of Health of the City of Somerville :-
Gentlemen,-I herewith submit the report of the inspector of animals and provisions for the year 1907.
The following is a statement of the number of animals killed during the year at the five slaughtering establishments in the city :-
Swine, 1,181,148; sheep, 304,325; calves, 66,485; cattle, 26,504, and goats, 476. The work of the four large establish- ments, being under the inspection of the United States govern- ment, requires only the inspection of the premises by the local inspector, who reports very favorably on the same.
Somerville is still the leading city in slaughtering, east of Chicago, and is the largest quarantine station for the export of animals in the United States, the number exported last year being 108,341.
The total number of neat cattle kept in the city is 253, all of which have been inspected several times during the year.
There have been 1,963 horses examined in stables where contagious diseases were reported to exist, thirty-three being killed and five released.
One cow was killed for tuberculosis.
There have been 2,624 visits made to stores and markets, and 965 pedler's carts have been inspected from which fish, pro- visions, and produce were sold.
There are sixty-one barber shops and seventy-eight bakeries in the city, all of which have been frequently inspected, most of them being found in excellent condition.
I have inspected, condemned, and caused to be destroyed 213 whole haddock, 92 whole codfish, 63 pounds of salt cod, 2,057 herring, 81 pounds of halibut, 176 pounds of salmon, 123 whole pollock, 47 pounds of swordfish, 114 dozen smelts, 1 1-2 bushels of oysters, 2 1-2 gallons of oysters, 2 bushels of clams, 19 quarts of clams, 16 whole lobsters, 419 whole shad, 138 mackerel, 51 cups of raspberries, 17 quarts of blueberries, 27 baskets of grapes, 84 quarts of strawberries, 33 quarts of blackberries, 31 quarts of cranberries, 36 dozen lemons, 2 1-2 boxes of oranges, 3 1-2 barrels of apples, 61 pineapples, 16 watermelons, 23 crates of canteloupes, 84 dozen bananas, 6 barrels of squash, 5 bush- els of onions, 4 bushels of turnips, 4 barrels of cabbage, 1 1-2 bushels of cauliflower, 14 crates of tomatoes, 1 bushel of toma- toes, 8 bushels of sweet potatoes, 19 bushels of white potatoes, 51
308
ANNUAL REPORTS.
bunches of celery, 14 bushels of greens, 4 crates of cucumbers, 5 bushels of lettuce, 29 packages of cereals, 49 loaves of bread, 17 loaves of cake, 1 box of common crackers, 1-2 barrel com- mon pickles, 4 kegs of pickles, 19 pounds of butter, 4 gallons of mixed pickles, 1 barrel of mixed pickles, 2 boxes of dates, 7 boxes of figs, 291 pounds of fresh beef, 436 pounds of corned beef, 812 pounds of fowl, 108 pounds of veal, 119 pounds of fresh pork, 87 pounds of salt pork, 138 pounds of mutton, 5 whole swine, 57 pounds of smoked pork, 5 whole livers, 197 pounds of chopped meat, and 1 1-2 kegs of pigs' feet.
In conjunction with the above, numerous other duties have been performed as required by your board, including the inves- tigation of eleven cases of dogs suspected of having rabies, all of which have been properly attended to.
Respectfully submitted,
Dr. Charles M. Berry, Inspector of Animals and Provisions.
1
REPORT OF INSPECTOR OF MILK AND VINEGAR.
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