USA > Massachusetts > Middlesex County > Somerville > Report of the city of Somerville 1912 > Part 22
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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 patients transferred to the medical inspector on October 1. During 1912 this arrangement has continued, 375 visits having been made at the hospital during the year.
296
ANNUAL REPORTS.
Scarlet Fever. During the year forty-nine cases of scarlet fever were admitted, one of which proved fatal. Eighteen of these cases were among males, and thirty-one among females. Seventeen were under five years of age, fifteen from five to ten years, and the remainder, seventeen, were over ten years. Vomiting was a constant symptom, it occurring in twenty- seven cases, and a sore throat in thirty-one cases. In three cases the rash occurred on the first day of illness, in nineteen cases on the second day, in eleven instances on the third day, and two on the fourth day. There was membrane present on the tonsils in nineteen cases ; in four cases the disease was complicated with nephritis; in four cases with rheumatism; in three cases with discharging ears, with three mastoid opera- tions; in five with enlarged cervical glands, and in addition one had diphtheria, and four mumps. The average stay in the hospital was forty-six days.
One patient was operated on for suppurating axillary glands.
Diphtheria. During the year sixty-four cases of diphtheria were admitted, six of which proved fatal. Of these patients, thirty-seven were among males and twenty-seven among females. Eighteen were under five years of age; twenty-three were from five to ten, and the remainder, twenty-three, were over ten. Two entered the hospital on the first day of their illness, and all recovered. Nine entered the second day of the illness, all recovered; twenty on the third day, with two deaths ; fourteen on the fourth day, with one death; five on the fifth day, all recovered ; three on the sixth day, all recovering; two on the seventh day, all recovering; two on the tenth day, all recovering; one on the eleventh and one on the fourteenth day, both recovering. The importance of early treatment with anti-toxin is thus very obvious. Of the ten laryngeal cases six came to intubation, two of whom recovered. In sixteen patients the membrane extended over both tonsils, uvula and palate, all recovering. The throat was clear of membrane in two cases on the second day, in nine cases on the third, in twelve cases on the fourth, in ten cases on the fifth, in five on the sixth, in one on the seventh, two on the eleventh, one on the thirteenth. one on the seventeenth, and one on the eighteenth. In thirty patients eruptions appeared on the body due to the use of the anti-toxin, and in four patients joint pains occurred from the same cause, four patients had enlarged cervical glands. The average stay in the hospital was twenty days. Of the six deaths during the year, three died within forty-eight hours of admis- sion, two being intubations and one septic. One case was complicated with measles two days after admission and died. One case had scarlet fever upon admission. Three cases were attended by their own physicians.
297
HEALTH DEPARTMENT.
Tuberculosis.
In March, 1911, the tuberculosis hospital, accommodating eighteen patients, was completed by the building commissioner and transferred to the board, the first patient being admitted March 8. During 1912 eighty-eight patients ill with this disease have been admitted, and several times during the year the hospital has reached its normal capacity, which indicates its well-founded need.
Many of these patients were in the advanced stage of the disease, thus removing from the patients' homes the danger of infection of the members of the family. Twenty-five deaths have been recorded.
Other patients have been discharged with the disease ar- rested, and others have been transferred to the state hospitals for treatment. The need of this department will be more marked during the coming year, and recommendations should be made to provide for its enlargement.
Other Diseases.
Fifteen other patients have been admitted during the year as follows: Seven cases of measles, two of erysipelas, and six mental cases, which were admitted to the hospital, upon the request of the police department, as required by Chapter 394, Acts of 1911. The latter patients were cared for in a room on the first floor of the hospital and attended by police officers if they were males, and nurses if females. The accommoda- tions were visibly inadequate for such patients, and they were usually committed to an insane hospital on the following day.
Diphtheria. Six hundred and fifty-one cultures have been examined for diphtheria, 312 being in males and 339 in females. Diphtheria being a disease of children, 165 of these examinations have been made in children under five years of age, 179 in those from five to ten years of age, 95 from ten to twenty, and 192 in adults over twenty years. In twenty cases the age of the patient was not stated. Three hundred and twenty-five examinations were made for the diagnosis of the
During the year 1912 651 examinations were made of cul- tures for the diphtheria organism, 251 examinations made of sputum from patients suspected of having tuberculosis, and 105 examinations to detect the Widal reaction in typhoid fever.
Bacteriological Department.
Admission by Months.
Remaining
January.
February.
March.
April.
May.
June.
July.
August.
September.
October.
November.
Discharged.
Died.
Remaining
January 1, 1913.
Scarlet fever .
7
13
4
9
0
5
4
3
2
2
3
4
49
50
1
Cr
Diphtheria
10
6
6
4
5
9
4
6
5
2
5
5
64
60
00
3
Tuberculosis . · .
14
12
7
9
12
Co
5
7
00
3
00
10
10
88
8
25
17
Totals
26
31
17
2
17
20
13
16
15
07
16
13
16
201
170
32
25
ANNUAL REPORTS.
298
Patients Treated at the Contagious Hospital.
DISEASE.
January 1, 1912.
Total admitted.
December.
.
·
Of the
case, forty-one proving positive and 284 negative.
299
HEALTH DEPARTMENT.
positive results, fifteen were of cases in which the attend- ing physician's diagnosis of diphtheria was confirmed, seven in which the clinical diagnosis was not diphtheria, and nineteen in which no definite diagnosis was made. Of the 319 negative examinations, twenty-seven were obtained in which the clinical diagnosis was diphtheria, 112 in which the diagnosis was not diphtheria, and 145 in which no diagnosis had been made.
Three hundred and twenty-six cultures were taken for release of patients from quarantine, seventy-two of which were positive and 254 negative. The importance of taking release cultures is demonstrated by these figures, these patients showing the presence of the bacilli in the throat after the clinical evidence of the disease had disappeared. In two examinations there was no growth upon the serum tube.
Tuberculosis. Two hundred and fifty-one examinations have been made of sputum suspected of containing the tubercle bacillus, ninety-seven of which were positive and 154 negative. In forty cases a definite diagnosis of this disease had been made by the attending physician, but in eighteen of them the organism could not be detected. In the remainder of the cases, seventy-five were stated as not showing evidence of the disease, twenty being positive, and in 136 cases no statements were made giving information as to its character, fifty-five of which were positive. One hundred and twenty-six were males and 125 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- 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 mislead both physician and patient. Consumption to-day is recognized as an infectious disease, and all persons afflicted with it should be instructed in the modern methods for pre- venting its spread. In some cases this is not done by the attending physician, and during the past nine 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 five examinations of the blood of patients suspected of having typhoid fever have been made, nineteen of which proved positive. In forty-three cases
300
ANNUAL REPORTS.
a positive diagnosis of this disease had been made by the attending physician, in eleven 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, twenty- eight were diagnosed as typhoid, ten were said not to be typhoid, and in forty-eight no diagnosis was made. Fifty-two were males and fifty-three females.
Summary for Ten Years, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912. 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
5
1904
1,429
629
800
537
400
231
261
34
29
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
1908
1,293
542
751
278
421
238
150
6
3
1909
1,537
694
843
375
657
206
284
15
9
1910
1,062
448
614
341
247
235
222
17
6
1911
887
459
429
367
198
157
162
3
1
1912
651
312
329
165
179
95
192
20
2
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
1908
524
57
48
14
96
92
217
1909
637
54
28
18
121
117
299
1910
540
24
31
14
144
52
275
1911
372
24
30
10
116
19
172
1912
325
15
27
7
112
19
145
For Release
Positive
Negative
1903
95
362
1904
233
761
1905
139
386
1906
35
464
1907
98
408
1908
136
630
1909
165
726
1910
75
447
1911
124
391
1912
72
254
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
1908
173
84
89
14
159
9
59
1909
192
100
92
14
178
10
69
1910
185
88
97
36
149
18
46
1911
212
93
119
50
162
32
45
1912
251
126
125
97
154
22
18
... .
1
1
HEALTH DEPARTMENT.
301
Clinical Diagnosis not Tuberculosis Positive
Negative
Clinical Diagnosis not stated 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
1908
3
63
2
43
1909
3
65
1
44
1910
12
73
6
30
1911
7
58
14
56
1912
20
55
55
81
Blood for Typhoid Fever.
Clin. Diag. Typhoid Fever
No. Examined Males
Females
Positive
Negative
Positive
Negative
1903
72
39
33
27
45
18
7
1904
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
1908
110
59
51
31
79
20
14
1909
150
89
61
52
98
33
24
1910
120
65
55
24
96
18
18
1911
100
58
42
29
71
24
10
1912
105
52
53
19
86
15
28
Clin. Diag. not Typhoid Fever
Clin. Diag. not stated
Positive
Negative
Positive
Negative
1903
2
6
7
32
1904
0
6
14
34
190
1
5
14
44
1906
0
8
10
47
1907
0
3
20
52
1908
0
6
11
59
1909
0
5
19
69
1910
0
5
6
73
1911
0
7
5
54
1912
.
1
10
3
48
Respectfully submitted,
FRANK L. MORSE,
Medical Inspector.
.
.
REPORT OF INSPECTOR OF ANIMALS AND PROVISIONS.
OFFICE OF THE BOARD OF HEALTH, CITY HALL, Somerville, Mass., January 1, 1913.
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 1912. The following is a statement of the number of animals killed during the year at the five slaughtering establishments in the city :-
Swine, 1,179,057; sheep, 438,485; calves, 69,777; cattle, 34,339.
The work of all these establishments, being under the inspection of the United States government, requires only the inspection of the premises by the local inspector, who reports very favorably on the same.
The total number of neat cattle kept in the city is 165; swine, 114; cows, forty-eight; and goats, one, all of which have been inspected by me during the year. Under Chapter 381 of the Acts of 1911, all stables where neat cattle are kept have been visited several times this year, and all are now in good sanitary condition. All dairy rooms have also been visited by Mr. Bowman, the milk inspector, and all doors and windows have been screened, the premises cleaned and white- washed, and the ventilation improved. All of the factories, workshops, and laundries have been visited several times during the year, first-aid medicine chests installed, and proper sanitary conditions insisted upon in cases where needed. All stables have been visited and the owners required to disinfect and otherwise clean them as needed. There have been 4,307 horses examined in stables to determine the existence of con- tagious diseases. Fifty-nine were quarantined, and of this number fifty-four were killed and five released.
All of the blacksmiths' shops of the city have been dis- infected to prevent the prevalence of contagious diseases. Five hundred and fifteen visits have been made to the barber shops and 642 visits to the bakeries and restaurants in the city, all of which will now be found in good condition.
There have been 3,171 visits made to stores and markets, and 1,261 pedlers' carts have been inspected from which fish, provisions, and produce were sold. The following articles have been condemned and destroyed :-
Meat.
Fresh beef, 1,192 pounds; corned beef, 863 pounds; mutton and lamb, 697 pounds; poultry, 921 pounds; liver, 105 pounds; fresh pork, 316 pounds; salt pork, 42 pounds; whole hogs, 6; sausages, 149 pounds; frankforts and bologna, 82 pounds; hamburger steak, 178 pounds; pigs' feet, 79 pounds; tripe, 67 pounds, veal, 237 pounds.
303
HEALTH DEPARTMENT.
Fish.
Oysters, in shell, 1 bushel; oysters, 10 quarts; clams, in shell, 3/4 bushel; clams, 15 quarts; haddock, 513 pounds; halibut, 314 pounds; pollock, 198 pounds; salmon, 61 pounds; sword fish, 24 pounds; shad, 52 pounds; blue fish, 19 pounds; herring, 297 pounds; mackerel, 158 pounds; lobsters, 16 pounds.
Vegetables.
White potatoes, 16 bushels; sweet potatoes, 11 baskets; squash, 14 barrels; greens, 16 bushels; onions, 8 bushels; carrots, 112 bushels; celery, 49 bunches; lettuce, 4 boxes; string beans, 8 crates; string beans, 2 bushels; cabbage, 8 barrels; cauliflower, 2 boxes; rhubarb, 14 boxes; tomatoes, 5 bushels; tomatoes, 11 baskets; beets, 82 bunches; yellow turnips, 14 barrels; asparagus, 193 bunches.
Fruit.
Cantaloupes, 27 crates; bananas, 205 dozen; apples, 9 barrels; black- berries, 38 quarts; raspberries, 47 cups; stawberries, 2 crates; oranges, 16 boxes; grape fruit, 7 boxes; lemons, 21/2 boxes; grapes, 21 baskets.
Miscellaneous.
Candy, 55 pounds; sugar, 130 pounds; flour, 40 bags; cereals, 380 packages; bread, 23 loaves; crackers, 134 packages; pickles, 9 gallons; salt, 38 pounds; lard, 19 pounds.
Assistance has been rendered when required to the agent, Mr. Page, in sanitary inspections of yards and premises and the conveyance of patients by ambulance to the Contagious Hospital.
Respectfully submitted, CHARLES M. BERRY, Inspector of Animals and Provisions.
REPORT OF THE INSPECTOR OF MILK AND VINEGAR.
LABORATORY OF THE INSPECTOR OF MILK AND VINEGAR,
City Hall, Somerville, Mass., January 1, 1913.
To the Board of Health of the City of Somerville :-
Gentlemen,-I herewith present my annual report for the year ending December 31, 1912.
By referring to the chart showing the routine work of the year it will be seen that there were sixteen less milk licenses granted this year than in 1911.
This is accounted for in part by dealers retiring perma- nently from the milk business and other stores have not changed owners as in previous years.
At the beginning of 1912 about seventeen per cent. of the stores carried bottle milk, and at the end of the year very nearly fifty per cent. carried milk in this manner, an increase of about thirty-three per cent. During the year every effort has been made to impress upon the minds of the dealers and the public that this is the only sanitary way to handle milk, and the results have been very satisfactory.
I wish to take this opportunity to thank my co-workers in the Health Department for the assistance they have rendered along these lines.
I believe a regulation requiring a dealer to post a sign over his milk tank stating as follows: "This milk is suitable for cooking purposes only," would assist the consumer, and go a long way to prevent the sale of poor milk.
Quality.
The quality of the milk sold in this city continues to improve. Dr. North of New York, an authority throughout the country on the subject of "pure milk," stated publicly a short time ago that Greater Boston has the finest milk supply of any large city in the world.
During the year 146 samples of milk have proved to be below the chemical standard, and 102 samples of milk high in bacterial content.
Of this number it was necessary to prosecute only eight dealers, all for second offense.
Dealers.
I wish to call the attention of the milk distributors to the absolute necessity of reporting to this office immediately any change in the source of supply and the correct name and address of each employee. In the event of an epidemic of a contagious disease appearing on the route of any dealer much time and inconvenience may be saved the dealer and
305
HEALTH DEPARTMENT.
this department, and what is of more importance, much danger to the consuming public may be averted by having this in- formation on file.
Bacteriological.
Routine examination of milk for type and numbers of bacteria has been continued throughout the year. A milk carrying large numbers of bacteria may be a dangerous article of food. The results of these examinations may be obtained by calling the board of health office on the telephone. A low bacterial count is only obtained by the most careful handling and scrupulous cleanliness at the dairy, in transit and by the distributor, and much inconvenience may be saved the consumers by availing themselves of this information before deciding from whom to purchase their supply of milk.
Pasteurization.
Dr. M. J. Rosenau defines pasteurization as · follows : "Pasteurization is the simplest, cheapest, most effective and least objectionable method of destroying dangerous germs in milk. It prevents sickness and saves lives."
To properly pasteurize milk it must be held at 140 degrees Fahrenheit for twenty minutes and then immediately cooled. In the home this process might be called "parboiling," and is not-intended to preserve milk, but to destroy any harmful bacteria that may be present. When pasteurized at the proper temperature and time it is unchanged and cannot be dis- tinguished from raw milk either in taste, odor, or appearance, yet such milk is free from the danger of conveying tuber- culosis, typhoid fever, diphtheria, scarlet fever, and dysentery, and is much safer for infants.
A supply of safe fresh milk is the goal toward which all health officers are striving, but it must be remembered that with the most exacting care milk will occasionally become infected, and this sometimes happens even with certified milk. The reason is that people having an infectious disease in a mild form are not detected until the damage is done.
All our milk-borne epidemics have been traced to the use of raw milk, and not one single instance is on record in which a milk-borne outbreak has been traced to the use of pasteurized milk.
Many scientists unhesitatingly state that the tubercle bacillus, the typhoid and dysentery bacilli, the diphtheria bacillus, the cholera vibrio, the specific cause of scarlet fever, the streptococci, and other harmful micro-organisms which get into the milk are rendered harmless by being heated to sixty degrees centigrade (140 degrees Fahrenheit) for twenty min- utes. It is fortunate that the temperature at which the patho- genic bacteria are destroyed is lower than those of the ferments
306
ANNUAL REPORTS.
in milk, for in this manner the infection may be destroyed without injuring the quality.
Scarlet Fever.
During the week of July 20 seven cases of scarlet fever were reported on the route of one distributor, and in an adjoining town eight cases were reported during the same period, all supplied by the same party.
The milk supplied this distributor is produced at sixteen different farms in the east central part of this state.
Visits were made at the several dairies and a thorough investigation made. It appears that scarlet fever had been quite prevalent in this section for some time, and on July 16 a five-year-old grandchild of Mr. X., the owner of one of these dairies, was taken ill with this disease. This house was quarantined by the local board the next day, and on July 18 an inspector from the State Board of Health visited the place.
It had been the usual custom on this farm for the milk pails and strainers to be washed in the house by the daughter of Mr. X., and this was done on July 16 and 17, during which time she acted as nurse.
At this place there were nine cans of milk produced daily, and the milking was done by three men who were employed on this farm.
Interviews with Mr. X., his daughter, and the men who did the milking produced different stories regarding the wash- ing of the milk utensils.
Mr. X. stated that they were washed at the barn. His daughter claimed that she washed them in the kitchen of the house, and the hired men asserted that they had washed them for over a year. In consequence of these discrepancies, and at the suggestion of the State Board of Health, the dealer was informed that unless the cows were removed from the premises, and a definite knowledge of the manner in which the milk was handled could be obtained, none of the milk could be brought to this city for distribution, and it was arranged that the cows should be taken to a farm about one-half mile distant, there to be kept until the quarantine was removed from the house.
It appears that the infection of the milk must have been during the 16th or 177th of July, as, a few days after these precautions were established, no new cases de- veloped, and the epidemic subsided as quickly as it appeared.
TABLE A .- SHOWING WORK ACCOMPLISHED DURING 1912.
Months.
License
Issued.
License
Fees.
Fees.
Cash paid
City Treas.
Analyses
on Account.
Total
Dept.
Chemical
Bact.
Total
Collections.
Samples
Office.
Total
Analyses.
Chem.
Bact.
Notices.
Sanitary
Notices.
Total
Notices.
Infected
Samples.
January
20
$10.00
$4.00
$14.00
$6.50
$20.50
82
80
162
21
183
3
1
11
15
1
February
12
6.00
1.00
7.00
24.00
31.00
101
74
175
50
225
16
2
9
27
0
March
8
4.00
13.50
17.50
20.00
37.50
88
44
132
67
199
6
3
8
17
0
April
11
5.50
8.00
13.50
38.00
51.50
80
80
160
92
252
. . . .
. . . .
....
0
May
311
155.50
6.50
162.00
22.50
184.50
72
20
92
45
137
10
2
6
18
0
June
126
63.00
3.00
66.00
9.50
75.50
95
40
135
19
154
11
0
12
23
1
July
17
8.50
3.00
11.50
18.50
30.00
83
71
154
43
197
23
8
16
47
1
August
15
7.50
5.50
13.00
31.50
44.50
107
80
187
45
232
20
28
12
60
0
September
8
4.00
1.50
5.50
8.00
13.50
55
40
95
19
114
13
8
4
25
0
October
15
7.50
7.50
17.50
25.00
97
100
197
35
232
27
19
7
53
0
November
4
2.00
2.50
4.50
7.00
11.50
80
42
122
19
141
10
28
23
61
0
December
12
6.00
3.00
9.00
15.50
24.50
61
69
130
37
167
7
3
10
20
2
Total
559
$279.50
$51.50
$331.00
$218.50
$549.50
1,001
740
1,741
492
2,233
146
102
118
366
5
HEALTH DEPARTMENT.
During the year 55 samples of butter, vinegar and oleomargarine were examined and 1,500 dairies have been examined for visible dirt by the Lorenz method.
307
1: 1
Income for
Collections.
Collections.
left at
Notices.
Analytical
308
ANNUAL REPORTS.
Condensed Milk.
Last year I submitted figures to prove that this much-used article of food is in my opinion not always what it should be.
At that time it did not compare favorably with pure raw milk in price or cleanliness. To show the cost of a quart of the diluted product made by adding an equal quantity of water to each can of condensed or evaporated milk I submit the following table compiled by Professor James O. Jordan, milk inspector for the city of Boston :-
TABLE SHOWING RELATIVE VALUE OF CONDENSED MILK.
Approximate volume
by diluting contents
of can with an equal
amount of water.
Approximate cost of
a quart of the prod-
uct based on pur-
chase price and
diluting
with equal volume of water.
Challenge
$.10
20.3
15.8
Eagle
15
24.3
19.7
Grandmothers
.10
22.6
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