USA > Massachusetts > Middlesex County > Somerville > Report of the city of Somerville 1910 > Part 21
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Typhoid Fever .- Fifty-seven cases of typhoid fever have been reported during the year, six of which have proved fatal. In 1909 there were ninety-nine cases reported, eight of which were fatal. 1
Typhus Fever, Cholera .- No cases of typhus fever or cholera have been reported the past year.
Smallpox .- No case of smallpox has been reported during the year. ! 1
Number of persons with diphtheria or scarlet fever taken in am- bulance to hospital by agent 186
Number of cases of scarlet fever and diphtheria for which houses were placarded 562
. Number of premises disinfected by agent 1,146
It will be seen by the foregoing figures that, in addition to the 562 premises infected with scarlet fever or diphtheria, 584 other premises were disinfected. Twenty-eight disinfections were made at the request of attending physicians whose patients had been ill with typhoid fever or cancer. Four hun- dred forty-three schoolrooms were disinfected, 405 for scarlet fever, thirty-eight for diphtheria, and 113 premises for tubercu- losis, in compliance with the regulations passed by this board.
HEALTH DEPARTMENT.
Many library books have also been disinfected, and quan- tities of infected bedding and other material have been burned.
TABLES.
The prevalence of scarlet fever, diphtheria, and typhoid fever in the city during the several months of the year 1910 is shown by the following table, and in the table next following is given the number of deaths from these three diseases, by months, during the last ten years :-
Scarlet Fever, Diphtheria and Typhoid Fever Reported in 1910.
SCARLET FEVER.
DIPHTHERIA.
TYPHOID FEVER.
MONTHS.
Cases
Reported.
Number of
Deaths.
Percentage
of Deaths.
Cases
Reported.
Number of
Deaths.
Percentage
of Deaths.
Reported.
Number of
Deaths.
Percentage
of Deaths.
January
34
35
5
14.3
6
....
February
12
. .
...
23
3
13.
2
1
50.
March .
21
13
....
. .
April
124
1
0.8
18
2
11.
3
1
33.3
May
76
....
31
2
6.4
4
1
25.
June
18
2
28.6
17
2
11.8
1
....
8
1
12.5
9
.
..
...
September
4
....
....
15
2
13.3
8
1
12.5
October
11
....
....
14
. .
. .
6
1
16.6
December .
15
2
13.3
23
1
4.3
3
....
..
Total
336
5
1.5
226
20
9.0
57
6
10.5
Deaths from Scarlet Fever, Diphtheria and Typhoid Fever in the Last Ten Years.
SCARLET FEVER.
DIPHTHERIA.
TYPHOID FEVER.
MONTHS.
1901.
1902.
1903.
1904.
1905.
1906.
1907.
1908.
1909.
1901.
| 1902.
1903.
1904.
1905.
1906.
1907.
1908.
1909.
1910.
1901.
1902.
1903.
1904.
1905.
1906
1907.
1908.
1909.
1910.
January
10
4
1
3
3
1
February
1
: :
1.2812
1
1
1
2
2
May
3
2
2
3
1
1
1
1
2
1
1
1
1
2
2
1
2
1
1
July
1
1
1
1
1
1
1
1
..
August
2
1
1
3
1
1
1
1
1
1
2
2
3
1
1.
1
1
1
October
1
3
1
1
2
3
1
1
1
3
2
1
December
1
3
1
1
5
2
2
1
4
2
3
1
1
1
..
:
-
-
-
Total
5
3 10
3
4
1 12
4
9
5
129
19
19 14 17 15
9
11 27 20
12
6 10 11
9 11 11 9 8 6
1
-
-
-
-
-
1
-
1
: : :
: : : 1
H: : :
March
1
3
1
April
1
June
2
2
:
.
.
1
1
1
2
4
1
4
November
1
: :
· :
1
-
-
-
-
-
-
-
-
: :
2
H .
: :
1
1
2
1
1
1
September
2
22.
11
..
..
November
8
....
....
18
2
11.
5
1
20.
July
7
August
G
...
...
1
.
...
...
1910.
-
: : 1
2
- :: 11
..
9
Cases
278
ANNUAL REPORTS.
Table of Deaths During the Last Ten Years.
Year.
No. of Deaths.
Rate per 1,000
1901
831
13
1902
890
13
1903
955
14
1904
964
14
1905
968
14
1906
1,004
14
1907
997
14
1908
903
12
1909
988
13
1910
1,043
13
Average death rate per 1,000 for ten years
13
Table Showing the Five Principal Causes of Death in Somerville in 1910.
PNEUMONIA.
HEART DISEASE.
CANCER.
APOPLEXY.
NEPHRITIS.
Number of Deaths.
Number per
10,000 of Pop.
Number of
Deaths.
Number per
10,000 of Pop.
Number of
Deaths.
Number per
10,000 of Pop.
Number of
Deaths.
Number per
Number of
Deaths .
Number per
10,000 of Pop.
150
19.4
108
13.9
82
10.6
81
10.5
79
10.2
·
.
Medical Inspection of Schools.
The medical inspection of the schools of Somerville, which was instituted in December, 1907, has been continued during the year. The value of the system has been constantly demon- strated, and the work has been done in a very satisfactory man- ner. There has been harmony of action between the board of health and the school board, and the school principals and teachers have very generally co-operated with the inspectors in making the system as successful as possible.
The inspectors make daily visits to the schools under their charge, and to them are referred all children who show evi- dences of disease or abnormal conditions. Children who are found to be unfit to remain in school are sent home, accom- panied by a slip properly filled out advising that the family physician be consulted. The inspectors also make an annual inspection of all the children in the schools, and any defects discovered are called to the attention of the parents. Monthly inspections of the school buildings and premises are made, and suggestions or criticisms are referred to the proper authorities.
10,000 of Pop.
279
HEALTH DEPARTMENT.
Every effort is made to protect the health of the children and to co-operate with the parents in keeping the children in as normal a condition as possible.
It is extremely desirable that one or more school nurses should be employed to supplement and make more effective the work of the inspectors, and it is to be hoped that funds will be available to carry out this project.
In accordance with the provisions of the statute, tests of sight and hearing are made by the principals or teachers.
During the year 4,968 children have been referred to the inspectors during their daily visits, and 1,032 have been sent home because of illness.
The following list will show the classes of diseases and de- fects which have been found in the schools, except defects of sight and hearing :-
LIST OF DISEASES AND NUMBER OF CASES REPORTED.
1. Infectious diseases :-
Measles
4
Whooping cough
8
Chicken pox
12
Mumps
13
Scarlet fever
8
Total
45
2. Diseases of the nose and throat :-
713
Inflammatory diseases
246
Other abnormal conditions
6
Total
965
3. Diseases of the eyes :-
Inflammatory conditions of the eyes and lids 139
Foreign bodies and injuries
7
Other abnormal conditions
62
Total
208
4. Diseases of the ears :-
Inflammatory condition
19
Other abnormal conditions
12
Total
5. Diseases of the skin :-
Pediculosis
911
Impetigo
45
Scabes .
27
Eczema .
19
Tinea
.
16
Miscellaneous conditions
99
Total
.
.
, ·
1,139
.
.
.
.
.
22
Herpes ·
.
.
·
31
Enlarged tonsils and adenoids
280
ANNUAL REPORTS.
6. Miscellaneous diseases :-
Constitutional diseases 27
Diseases of the digestive system 67
Diseases of the respiratory system 97
Diseases of the circulatory system 2
Diseases of the lymphatic system .
66
Diseases of the nervous system
59
Diseases of the urinary system
2
Wounds and injuries
42
Other conditions
.
23
Total
Total number of diseases reported 2,778 390
The districts and inspectors are as follows :--.
District No. 1 .- Prescott, Hanscom, Davis, and Edgerly schools. Inspector, Dr. Francis Shaw, 57 Cross street.
District No. 2 .- Baxter, Knapp, Perry, and Bell schools. Inspector, Dr. Edward J. Dailey, 46 Bow street.
District No. 3 .- Bennett, Pope, Cummings, and Proctor schools. Inspector, Dr. L. H. Raymond, 66 Highland avenue. District No. 4 .- Morse, Carr, Durell, and Burns schools. Inspector, Dr. W. L. Bond, 322 Highland avenue.
District No. 5 .- Brown, Bingham, and Forster schools. In- spector, Dr. H. M. Stoodley, 383 Highland avenue.
District No. 6 .- Lincoln, Hodgkins, Highland, and Lowe schools. Inspector, Dr. H. Cholerton, 396 Highland avenue. District No. 7 .- Glines, English High, and Latin High schools. Inspector, Dr. R. F. Gibson, 108 Highland avenue.
Parochial Schools .- Inspector, Dr. M. W. White, 42 Bow street.
Hospital for Contagious Diseases.
Scarlet Fever and Diphtheria .- The hospital has continued to demonstrate its value to the city during the past year. An epidemic of scarlet fever in the spring filled the hospital to over- flowing, and a much more widespread epidemic was undoubt- edly averted by the fact that so many cases could be cared for in this institution. The alterations and improvements begun during the past year were completed in the early part of the present year, and great credit is due Mr. Littlefield, the build- ing commissioner, for his careful consideration of the needs of the institution, and his skilful and painstaking efforts in carry- ing out his plan. The institution is now well equipped and in every way modern and convenient.
Miss Edith M. Grant, who was appointed in October of last year, has continued as matron, and has done excellent work. The hospital has been carried on economically, and in every particular the results have been satisfactory to the board.
The statistical report is included in the report of the medi- cal inspector.
281
HEALTH DEPARTMENT.
Tuberculosis .- For several years there has been a strong agitation in favor of the establishment of a tuberculosis hos- pital, and the board has recommended an appropriation for this purpose. During the spring the matter was again considered, and through the efforts of Mr. Rideout, president of the board of aldermen, a public hearing was held in September, at which the Somerville Visiting Nursing Association, board of health, and several private individuals and representatives of associa- tions or societies strongly urged the necessity of the establish- ment of such a hospital. Early in the fall $8,700 was appro- priated for this purpose, plans were drawn by Mr. Littlefield, bids were received, and a building to accommodate twenty-five patients was begun. This building is now in process of con- struction, and will probably be ready for occupancy early in the year.
Bacteriological Department.
The work of this department was performed by Frank L. Morse, M. D., medical inspector of the board, whose report is appended to this report.
Specimens will be received at the laboratory at the city hall daily, including Sunday, at any time, and they will be examined and reported upon the morning following their reception ..
SPECIMENS AND ANTI-TOXIN.
Outfits for specimens for tuberculosis, diphtheria, and typhoid fever, and diphtheria anti-toxin and vaccine lymph may be obtained at the laboratory and at the following places :-
Adams Pharmacy, Willow and Highland avenues.
Claude Curtis, 154 Perkins street.
Bay State Pharmacy, 173 Washington street.
Edward E. Edwards, 25 Union square.
1
Fred W. Gay, 524 Somerville avenue.
Highland Pharmacy, 263 Highland avenue.
Percy A. Hall, 2 Studio building, Davis square.
Henry W. Perry, 529 Medford street, Magoun square.
Eugene B. Carpenter, 10 Broadway.
Richardson Pharmacy, 310 Broadway. Paul S. Eaton, 693 Broadway.
Willis S. Furbush & Co., 1153 Broadway.
After the specimen is collected, it must be taken or sent directly to the laboratory at the city hall.
Undertakers.
Under the provisions of section 44 of chapter 78 of the revised laws of 1902, twenty-four persons have been duly li- censed as undertakers.
Examiners of Plumbers.
The public statutes provide for a board of examiners of plumbers, consisting of a chairman of the board of health, the
282
ANNUAL REPORTS.
inspector of buildings, and an expert at plumbing, to be ap- pointed by the board of health. This board appointed Duncan C. Greene, the inspector of plumbing, to fill the place of expert. The number of licenses granted will be found in the report of the inspector of buildings.
Financial Statement for 1910. HEALTH DEPARTMENT.
CREDIT.
Appropriation
$8,550 00
Receipts :---
Fees for milk licenses .
294 00
Fees for analysis of milk samples 87 00
Fees for permits to keep swine, goats, etc.
70 00
Use of telephone (E. W. Danforth) .
30
Sale of condemned veal to George W.
Norton
39
Sundry cities and towns, for care of dis- eases dangerous to public health .
758 71
Total credit
$9,760 40
Salaries
$5,300 00
New buggy
90 00
Repairing vehicles
25 50
Repairing generator
27 50
Repairing harnesses
12 00
Horse medicine and doctoring
10 78
Horseshoeing
22 50
Burying dead animals
95 25
Office expenses, milk inspector
905 22
Books, stationery, printing, and postage
197 22
Bacteriological laboratory
113 87
Board of agent's horse
312 50
Telephones
115 98
Care of diseases dangerous to the public health (settlements in Somerville)
4,202 83
Exterminating mosquitoes
53 29
Incidentals
135 94
Total debit
$11,620 38
Amount overdrawn .
$1,859 98
Health Department, Collection of Ashes and Offal.
CREDIT.
Appropriation
.
$50,000 00
Sale of offal
.
8,775 15
Sale of paper, etc.
981 80
Sale of manure
50 00
Sale of three old horses .
250 00
Sale of second-hand buggy
10 00
Received from Health
Department for
labor, exterminating mosquitoes
16 00
Total credit
$60,082 95
DEBIT.
283
HEALTH DEPARTMENT.
DEBIT.
1
Salary of superintendent
$1,400 00
Collection of ashes
34,916 15
Collection of offal
18,588 00
Stable expenses
2,913 75
Two new offal wagons
395 00
New buggy
100 00
New sleigh
25 00
Repairing wagons
648 44
Tools and repairing same
187 88
Harnesses and repairing same
868 93
Eight new horses
2,475 25
Horse doctoring
159 17
Board of superintendent's horse
288 16
Horseshoeing
898 39
Hay and grain .
6,436 70
Incidentals
404 37
Spraying for Health Department for exter- minating mosquitoes 16 00
Total debit
$70,721 19
Amount overdrawn
$10,638 24
Health Department, Hospital for Contagious Diseases.
CREDIT.
Appropriation :
$1,000 00
Received from sundry persons, cities and
towns, and commonwealth of Massa-
chusetts
6,984 93
Total credit
$7,984 93
Salaries of employees
$4,959 77
Supplies
1,193 81
Groceries and provisions
2,510 90
Incidentals
301 87
Total debit
$8,966 35
Amount overdrawn
$981 42
Health Department, Medical Inspection in the Public Schools.
CREDIT.
Appropriation
$1,450 00
Salaries of inspectors .
.
$1,400 00
Balance unexpended .
$50 00
Appropriations Overdrawn.
Health Department .
$1,859 90
Health Department, Collection of Ashes
and Offal
10,638 24
Amount carried forward · $12,498 14 .
1
DEBIT.
.
.
.
.
DEBIT.
284
ANNUAL REPORTS.
.Amount brought forward . for Con-
$12,498 14 Health Department, Hospital
tagious Diseases
981 42
Total overdrawn $13,479 56 Balance unexpended, Health Department, Medical In-
50 00
spection in Public Schools
Net amount overdrawn $13,429 56 WESLEY T. LEE, M. D., Chairman, JACKSON CALDWELL, WILLIAM P. FRENCH,
1
Board of Health.
REPORT OF THE MEDICAL INSPECTOR.
Í
Somerville, January 10, 1911.
To the Board of Health of the City of Somerville :-
Gentlemen,-I herewith present the report of the medical inspector for the year 1910, including the statistics of the con- tagious disease hospital and the bacteriological laboratory.
Scarlet Fever. During the year 336 cases of this disease were reported in the city, an increase of sixteen in number over the previous year. Every case has been inspected, before the house was fumigated, and 334 visits were made at residences to determine when desquamation was complete.
During the latter part of April and the early part of May an extensive epidemic of scarlet fever invaded the city, 116 cases being reported in April and seventy-five in May. From investigation, it was found that the neighboring cities of Mal- den, Everett, and Cambridge, and certain sections of Boston were also involved, and further study of the epidemic showed that the excess of cases were supplied with milk from one con- tractor. Vigorous measures were taken to stop it by restrict- ing and pasteurizing the supply, and the disease soon assumed the normal number.
Diphtheria. During the year 226 cases of diphtheria have been reported in the city, a decrease from the previous year, when 334 cases were reported. The same restrictions are placed upon all cases, and before patients are released from quarantine two successive negative cultures must be obtained. It is optional with the attending physician to take the first culture, but the second must be taken by the medical inspector, and during the year 264 visits were made at houses for this pur- pose.
Typhoid Fever. During the year fifty-seven cases of this disease were reported, a decrease of forty-two cases from the previous year.
Tuberculosis. One hundred and forty-nine cases of tuber- culosis were reported during the year, an increase of five over the year previous. In November, 1906, following a conference with the overseers of the poor, these cases, which had been pre- viously cared for medically by the city physician, were trans- ferred to the board of health and the medical inspector in- structed to care for them. During 1910, 147 visits have been made to thirty patients.
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-
286
ANNUAL REPORTS:
tients transferred to the medical inspector on October 1. Dur- ing 1910 this arrangement has continued, 362 visits having been made at the hospital during the year.
Scarlet Fever. During the year eighty-six cases of scarlet fever were admitted, two of which proved fatal. Forty-two of these cases were among males, and forty-four among females. Twenty-one were under five years of age, twenty-five from five to ten years, and the remainder were over ten years. Vomit- ing was a constant symptom, it occurring in forty-nine cases, and a sore throat in sixty-four cases. In seven cases the raslı occurred on the first day of the illness, in forty-six cases on the second day, and in twenty-three 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; in three cases with rheumatism, in seven cases with discharging ears, in nineteen with enlarged cervical glands, and in addition seven had diphtheria. The average stay in the hospital was forty days.
During the scarlet fever epidemic in April and May one patient was admitted with this disease, and on the following day showed, in addition, an eruption of measles. Although she was immediately isolated, the crowded condition of the hospital did not allow of its complete efficiency, and five other cases con- tracted the disease from her, the incubation period varying from twelve to nineteen days.
One case complicated with measles also came to incubation with complete recovery.
Another patient was admitted with scarlet fever, and five days after admission showed an eruption of varicella, she being promptly isolated. The patient in the next crib, however, had the disease twenty-two days later.
Two other patients were attended by their own physicians.
Diphtheria. During the year 100 cases of diphtheria were admitted, ten of which proved fatal. Of these patients, forty- four were among males and fifty-six among females. Twenty- six were under five years of age; thirty-seven were from five to ten, and the remainder were over ten. Ten entered the hospital on the first day of their illness, and all recovered. Forty-one entered the second day of the illness, and two died ; fourteen on the third day, with one death; eleven on the fourth day, with two deaths; seven on the fifth day, with two deaths; two on the seventh day, with one death; one on the eighth day, with one death; and three on the tenth day, with one death. The importance of early treatment with anti-toxin is thus very obvious. Of the laryngeal cases eight came to intubation, five of whom recovered. In twenty-five patients the membrane ex- tended over both tonsils, uvula and palate, five of whom died from systemic infection involving both the heart and kidneys. The throat was clear of membrane in fourteen cases on the
287
HEALTH DEPARTMENT.
second day, in sixteen cases on the third, in thirteen cases on the fourth, in thirteen cases on the fifth, in nine on the seventh, in three on the ninth, one on the eleventh, and one on the thir- teenth. In fifty-two patients eruptions appeared on the body due to the use of the anti-toxin, and in five patients joint pains occurred from the same cause. The average stay in the hos- pital was eighteen days. Of the ten deaths during the year, three died within twenty-four hours of admission and were hopeless at that time, and were complicated with cardiac paralysis. Three cases were complicated with measles upon admission, all came to intubation, and one died, all being in one family. One case of varicella occurred seventeen days after the patient was admitted. Four cases were attended by their own physicians.
Patients Treated at the Contagious Hospital.
Admission by Months.
Remaining
January.
February.
March.
April.
May.
June.
July.
August.
September.
October.
November.
Total admitted.
Cured.
Died.
January 1, 1911.
Percentage of Fatality.
Scarlet fever .
.
10
4
5
4
28
21
6
3
1
2
00
2
4
86
90
2
4
2.1
Diphtheria
or
12
13
6
01
=
00
0
9
6
4
10
10
100
90
10
5
10
Erysipelas
1
.
1
1
1
..
·
1
:
..
4
A
1
..
..
Carbuncle of lip
.
·
·
.
.
›
Totals
16
16
18
11
34
33
14
12
-1
00
10
13
14
191
194
14
9
..
·
.
.
1
1
1
..
December.
Remaining
DISEASE.
January 1, 1910.
288
ANNUAL REPORTS.
Bacteriological Department.
In March, 1910, the laboratory accommodations which had been provided for the past seven years were considered inade- quate, and a room on the third floor of the city hall was finished and equipped with modern appliances under the direction of the building commissioner. The milk inspector also transferred his work to this laboratory, and it has been performed in the same room.
During the year 1910 1,062 examinations were made of cultures for the diphtheria organism, 185 examinations made of sputum from patients suspected of having tuberculosis, and 120 examinations to detect the Widal reaction in typhoid fever.
Diphtheria. Ten hundred and sixty-two cultures have been examined for diphtheria, 448 being in males and 614 in females. Diphtheria being a disease of children, 341 of these examinations have been made in children under five years of age, 247 in those from five to ten years of age, 235 from ten to twenty, and 222 in adults over twenty years. In seventeen cases the age of the patient was not stated. Five hundred and forty examinations were made for the diagnosis of the case, ninety proving positive and 450 negative. Of the positive re- sults, twenty-four were of cases in which the attending physi- cian's diagnosis of diphtheria was confirmed, fourteen in which the clinical diagnosis was not diphtheria, and fifty-two in which no definite diagnosis was made. Of the 450 negative examina- tions, thirty-one were obtained in which the clinical diagnosis was diphtheria, 144 in which the diagnosis was not diphtheria, and 275 in which no diagnosis had been made.
Five hundred and twenty-two cultures were taken for re- lease of patients from quarantine, seventy-five of which were positive and 447 negative. The importance of taking release cultures is demonstrated by these figures, these patients show- ing the presence of the bacilli in the throat after the clinical evidence of the disease had disappeared. In six examinations there was no growth upon the serum tube.
Tuberculosis. One hundred and eighty-five examinations have been made of sputum suspected of containing the tubercle bacillus, thirty-six of which were positive and 149 negative. In sixty-four cases a definite diagnosis of this disease had been made by the attending physician, but in forty-six of them the organism could not be detected. In the remainder of the cases, eighty-five were stated as not showing evidence of the disease, twelve being positive, and in thirty-six cases no state- ments were made giving information as to its character, six of which were positive. Eighty-eight were males and ninety- seven females. Although printed directions accompany each outfit, telling how the specimen should be obtained, it has not been unusual for specimens to be sent to the laboratory con-
289
HEALTH DEPARTMENT.
taining 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 collection of the sputum, for in some instances a negative report would mis- lead 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 spread. In some cases this is not done by the attending physi- cian, and during the past seven 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 consumption, and the cure of persons afflicted with it, is due to the improved 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 twenty examinations of the blood of patients suspected of having typhoid fever have been made, twenty-four of which proved positive. In thirty- six cases a positive diagnosis of this disease had been made by the attending physician, in five cases it was stated not to be typhoid fever, and in the remainder no statement was made re- lating to the diagnosis. Of the negative results, eighteen were diagnosed as typhoid, five were said not to be typhoid, and in seventy-three no diagnosis was made. Sixty-five were males and fifty-five females.
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