Report of the city of Somerville 1912, Part 22

Author: Somerville (Mass.)
Publication date: 1912
Publisher: Somerville, Mass.
Number of Pages: 528


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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