USA > Massachusetts > Bristol County > Attleboro > Reports of town officers of the town of Attleborough 1922 > Part 4
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421
Still-Births
29
Deaths
209
58
ANNUAL REPORT
EIGHTH ANNUAL REPORT OF THE HEALTH DEPARTMENT
To His Honor, the Mayor, and the Members of the Municipal Council:
GENTLEMEN-
The Health Officer hereby submits for your consideration and approval his eighth annual report of the different divisions of the department ending December 15, 1922.
An enormous amount of work has been done by this department as a whole and each individual department has rendered very good service throughout the year.
The Venereal Clinic, which was opened in September 1918, is still doing excellent work and the average attendance is gratifying to the Health Officer.
The work of the Milk Inspector has been carried on in his usual efficient manner, the laboratory work has also been well done, the equipment has been kept up and is now in good condition.
Our inspection of Bakeries and Ice Cream Plants has been more rigidly carried out than ever before and on all sides we have met with hearty co- operation, I believe the bakeries, lunch carts, restaurants and ice cream plants were never in as good condition as at the present time.
I am assured from various sources that the quality of our local milk supply ranks very high-the dealers and producers are surely co-operating with us at the present time as never before.
The Tuberculosis Dispensary has finished its eighth year and the de- tailed report of its activities are included in this report.
I am still of the opinion that the City should pay a salary to the physi- cian in charge of the dispensary, as this work is in no way a part of the duties of the Health Officer.
The garbage collection has been carried on in a very efficient manner this year, and very few nuisances recorded.
The inspection of plumbing has been carried out in a highly satisfactory manner and an increased amount of work done in the past year.
The inspection of slaughtering has been continued in a highly efficient manner, as is customary in this department of the work.
I am very grateful to the physicians for their co-operation in combating the contagious diseases and for their promptness in reporting the con- tagious diseases.
There is an ever increasing amount of work being done for the Tuber- culous patient here-also for the contact and suspected cases.
For about 2 years the Tuberculosis patient has had no aid from the sale of Seal Stamps, but this Fall a small committee was organized to raise, thru the seal sale, a small sum for a milk fund which could be used to buy milk for the children of Tuberculosis parents and all suspected or contact cases. It has not as yet been announced as to the amount received, but we are in hopes that it will be sufficient for our requirements.
59
ANNUAL REPORT
We hope, in conjunction with this work, to have at some near future date a day camp during the Summer months, but in order to do this-we must have some means of transporting the patients and some means of providing lunches.
There has been a decided decrease in the mortality from Tuberculosis. This decrease has not been for one year but has been a persistent decrease from year to year-showing that we are winning in our fight against this disease.
Every citizen should join in the fight and urge compulsory Sanitarium treatment for this disease.
I should urge that such a law should be passed.
We take this opportunity for thanking the Lilly Company for their untiring efforts in keeping the Health supplies up to the demands. Among the various articles kept on hand by them for the use of all our physicians free of charge. are vaccine-sputum boxes-sputum cups-Widals-cul- ture tubes-Wassermann tubes-Antitoxin for diphtheria-Anti-Menin- gitis serum-Pneumonia serum, etc.
The new work undertaken this year was that of collecting garbage in South Attleboro-up to the present time the work is going on satisfactorily and we recommend, if it seems advisable, the scope of the work be increased.
RECOMMENDATIONS.
1. Establishment of one or more Comfort Stations.
2. Forbidding of fishing or boating on Orr's Pond.
3. That money be appropriated for salary of physician at Tuber- culosis Clinic.
4. That water be changed in Wading-Pool at Capron Park-frequent- ly.
5. That, if it seems advisable, a large amount of territory be covered by the garbage contractor in South Attleboro.
Respectfully submitted,
RALPH P. KENT, M. D. Health Officer.
DISEASES DANGEROUS TO THE PUBLIC HEALTH.
Diseases declared by the State Department of Health to be dangerous to the public health, and so reportable by law. Householders and physi- cians must give immediate notice to the local Board of Health of all cases of:
Actinomycosis Anterior Poliomyelitis (Infantile Paralysis)
Anthrax Asiatic Cholera Cerebro-spinal Meningitis Chicken Pox
Measles Mumps
Ophthalmia Neonatorum
Pelagra
Plague Rabies
60
ANNUAL REPORT
Diphtheria Dog-bite
Suppurative Conjunctivitis Scarlet Fever
Septic Sore Throat
(requiring anti-rabic treatment) Dysentery a. Amebic b. Bacillary
Smallpox
Tetanus
Encephalitis Lathargica
Trichinosis
Glanders
Tuberculosis (all forms)
German Measles
Typhoid Fever
Hookworm Disease
Typhus Fever
Influenza
Whooping Cough
Leprosy
Yellow Fever
Lobar Pneumonia
Malaria
Gonorrhea and Syphilis reportable in accordance with special regula- tions.
VITAL STATISTICS.
Births
Deaths
421
Still-Births 29 209
The following contagious diseases were reported to the Health De- partment from December 15, 1921 to December 15, 1922.
Anterior Poliomyelitis.
6
Cerebro-Spinal Meningitis
0
Chicken Pox.
7
Diphtheria.
11
German Measles
4
Influenza.
150
Lobar Pneumonia
11
Measles 105
2
Ophthalima Nenoatorum
0
Scarlet Fever 5
Tetanus. 1
Tuberculosis, pulmonary 23
Tuberculosis, other than pulmonary 5
Whooping Cough. 33
Typhoid Fever 2
The minimum period of isolation or quarantine for:
Cerebro-Spinal Meningitis, 3 weeks after recovery.
Diphtheria, until two successive negative cultures from nose and throat have been obtained.
Scarlet Fever, at least 30 days.
Chicken Pox, 2 weeks.
Mumps, 3 weeks.
Measles, at least 3 weeks.
German Measles, at least 10 days.
Whooping Cough, 7 weeks.
Anterior Poliomyelitis (Infantile Paralysis), 3 to 6 weeks.
Mumps
Trachoma
61
ANNUAL REPORT
DEATHS BY AGES. (Still-Births Excluded). Dec. 15, 1921 to Dec. 15, 1922.
Male
Female.
Deaths of persons under 1 year.
Total 24
13
11
Deaths of persons 1 to 2 years
5
3
2
Deaths of persons 2 to 3 years
6
3
3
Deaths of persons
3 to 4 years
1
0
1
Deaths of persons 4 to 5 years.
0
0
0
Deaths of persons
5 to 10 years.
3
3
0
Deaths of persons 10 to 15 years.
2
1
1
Deaths of persons 15 to 20 years.
7
2
5
Deaths of persons 20 to 30 years.
10
4
6
Deaths of persons 30 to 40 years.
7
5
2
Deaths of persons 40 to 50 years.
26
15
11
Deaths of persons 50 to 60 years.
21
14
7
Deaths of persons 60 to 70 years.
46
27
19
Deaths of persons 70 to 80 years.
30
11
19
Deaths of persons over 80 years.
20
9
11
Deaths of persons 100 years.
1
0
1
209
110
99
DEATHS BY MONTHS. (Still-Births Excluded.)
Dec. 15, 1921 to Dec. 15, 1922.
Male
Female.
December 15, 1921 to January 1, 1922.
16
7
9
January.
20
11
9
February
22
14
8
March.
18
10
8
April
14
10
4
May
11
6
5
June.
11
2
9
July
17
5
12
August.
18
7
11
September
18
9
9
October
15
9
6
November
18
9
9
December.
11
6
5
209
105
104
Total
62
ANNUAL REPORT
CAUSES OF DEATHS, (Still-Births Excluded) Dec. 15, 1921 to Dec. 15, 1922.
Acute Anterior Poliomyelitis
0
Arterio Sclerosis.
6
Accidental deaths.
7
Broncho Pneumonia.
10
Bronchitis
0
Cancer.
17
Cerebral Hemorrhage.
13
Diphtheria .
0
Diarrhoeal Diseases.
7
Diseases of the Heart
33
Diseases of the Brain and Spinal Cord.
13
Diseases of the Kidney
22
Diabetes.
2
Encephalitis Lethargica.
0
Influenza.
1
Lobar Pneumonia.
12
Typhoid Fever.
0
Tetanus.
1
Tuberculosis, pulmonary, living in Attleboro.
5
Tuberculosis other than pulmonary living in Attleboro
3
Tuberculosis all cases non-resident at B. C. Hospital.
22
Other Causes.
35
209
YEARLY REPORT OF THE TUBERCULOSIS DEPARTMENT.
To Dr. R. P. Kent Health Officer:
I hereby submit the annual report of the Tuberculosis Department. I find this year that the Tuberculosis work and the intensive follow up work have proven very satisfactory as only a few cases would not be lo- cated. The Social service side of Tuberculosis which is very necessary in adjusting family conditions has been greatly helped by the splendid co-operation of the Associated Charities-for we know that the best co- operation with every individual and organization in the city is absolutely vital in this great White Plague fight as the best in us is comparatively little in this National fight.
The loan closet of sick room supplies has been in constant use and greatly appreciated by the Tuberculosis patients for the comforts are few in a disease of such long standing.
New files have been greatly appreciated, and the new record system is of great importance in the follow up work in conjunction with that of the District Health Officer. I hope that a desk, typewriter, and telephone can be had for the Clinic.
Approximately 3000 quarts of milk were secured from the Associated Charities and others for the suspicious and contact cases, to build up the system and prevent Tuberculosis-also, material and financial relief from the Overseers of the Poor and the Red Cross. Prenatal cases referred to the District Nurses when possible.
In June, during the school vacation, arrangements were made at the Sturdy Memorial Hospital for the removal of tonsils of Clinic patients.
63
ANNUAL REPORT
Secured the Instructor of the Dennison Paper Company to exhibit articles made of paper, wax, etc., to interest the patients in Occupational Therapy at the Bristol County Tuberculosis Hospital; I was very sorry to be unable to continue this work but the time used was necessary for my regular Tuberculosis work.
Exhibited a table on Tuberculosis work at the Bliss School, March 22 and 23, 1922.
Talked to the Round Table on Tuberculosis work.
Wrote essay on Tuberculosis under Americanization.
Secured Christmas Seal Sale for the Tuberculosis work, the money of which is to be used in prevention of T. B. on suspicious and contact cases by Sanatoria or Health Camp treatments.
Attended Conventions at Boston-April 21, and Taunton-May 12, and meetings at Associated Charity Rooms.
Bed side care on T. B. cases when necessary.
Statistical Report on T. B. Work, (Dec. 15, 1921-Dec. 15, 1922.) Total
No. of T. B. cases supervised.
168
No. of T. B. Cases under private physician. 25
No. of T. B. Cases unknown address 27
No. of T. B. Cases arrested.
No. of visits during year . 56
1307
No. of other visits during year
387
T. B. Seal Sale T. B. Christmas Tree
No. of new positive cases.
29
No. of T. B. cases moved out of town.
6
No. of T. B. Cases removed in town.
1
No of T. B. deaths.
10
No. of T. B. sent to Sanatoria.
23
No. of T. B. remitted to Sanatorium.
4
No. of Clinics held.
44
No. of T. B. Discharged from Sanatoria
13
No. of new Clinic Cases. .
47
No. of Total Clinic Cases
394
No. of Examinations at Clinic.
561
T. & A. operations assisted by family physician
8
Tubercular Tests.
12
Sputum Tests.
24
Wasserman Tests.
5
Urine Tests. .
35
Cases sent to Dr. Webb for care of teeth. 14
Cases sent to Dr. Conro for care of eyes.
6
I wish to thank Dr. R. P. Kent for his personal interest in T. B. Clinic and the many gratis calls made in Clinic cases.
Respectfully submitted,
(MRS.) FRANCES H. BRAMAN, R. N
T. B. Nurse.
64
ANNUAL REPORT
REPORT OF THE SCHOOL DENTIST.
December 15, 1922.
To Dr. Ralph P. Kent, Health Officer:
The following is a report of work done by the School Dentist from December 15, 1921 to date.
Number of patients treated 242
Number of sittings. . .
506
Number of deciduous teeth extracted.
303
Number of permanent teeth extracted.
45
Number of teeth cleaned.
117
Number of amalgam fillings
156
Number of cement fillings.
18
Number of pupils removed
7
Number of roots filled
29
Number of treatments.
61
Respectfully submitted,
E. M. WEBB, D. M. D. School Dentist.
REPORT OF THE INSPECTOR OF PLUMBING TO THE HEALTH OFFICER.
Dr. Ralph Kent, Health Officer, Attleboro, Mass.
S:R:
The following report of work performed by the Inspector of Plumbing during the year 1922 is hereby submitted.
There were 106 permits granted during the year 1922.
Number of new buildings 18
Number of water-closets installed. 112
71
Number of wash-trays installed
23
Number of lavatories installed.
83
Number of bath tubs installed.
68
Number of slop-sinks installed
6
Number of sewer connections installed
14
Number of shower-baths installed
2
Number of urinals installed.
2
Number of changes in work by order of Inspector.
15
Number of inspections made in plumbing. 115
Consultations with owners and plumbers. 32
Respectfully submitted, ARTHUR B. READ
Number of sinks installed .
65
ANNUAL REPORT
REPORT OF THE INSPECTOR OF SLAUGHTER
46 Barrows St., North Attleboro, Mass.
December 21, 1922.
Dr. R. P. Kent, Health Officer:
Attleboro, Mass.
DEAR DOCTOR:
I submit herewith my report as Inspector of Slaughter for the year ending December 15, 1922.
Slaughter House and Field Inspection, 800 carcasses were stamped and passed for food.
Hogs, 460; Cattle, 230; Calves, 110.
Carcasses condemned as unfit for food: Cattle 8, General Tuberculosis, Cattle 2, Pyaemia Abscess, Hogs, 6, General Tuberculosis; Hogs, 5, Deep seated skin diseases; Hogs, 7, Swine Plague; Hogs, 1, Jaundice; Calves, 2, Immature; Calves, 1, Anaemia and emaciation.
Respectfully yours, HUGH GAW, D. V. S. Inspector of Slaughter.
REPORT OF THE INSPECTOR OF ANIMALS.
ATTLEBORO, MASS. Dec. 15, 1922.
To His Honor, the Mayor and the Municipal Council:
GENTLEMEN :
I herewith submit my report as Inspector of Animals from April 1, 1922, to Dec. 15, 1922.
This does not include the annual Inspection of Stables and Examina- tion of Animals as that was done by my predecessor.
I have made thirty-eight calls examining for quarantine and release of animals as follows :----
Examination for release of quarantined animals under observation for development of Rabies :- 8 dogs. 1 Cow.
Examination of animals in herds where tuberculosis had been found :- 17 Cows.
Examination and quarantine on account of suspecting tuberculosis :--- 6 cows; three of which were released.
Examination and identification for release of animals shipped inter- state :- 2 Cows, 1 Bull.
Number of stables inspected after disinfection where tuberculosis was found :- 3.
Number of dogs quarantined and examined for release after having bitten people :- 5.
66
ANNUAL REPORT
Dogs' head sent to State Laboratory for rabies examination-1.
It is gratifying to report that our city has been free from any recent outbreaks of rabies while other cities in the State have not been so fortu- nate.
The outlook for clean herds in Attleboro is encouraging if the dairy farmers will cooperate with the Federal and State Divisions of Animal Industry by taking advantage of the herd testing which is being done by them for the eradication of Bovine tuberculosis.
Respectfully submitted,
FREDERICK L. BRIGGS, D. V. M.
Inspector of Animals.
ATTLEBORO HEALTH DEPARTMENT LABORATORY.
December 15, 1922
Ralph P. Kent, M. D., Health Office, Attleboro, Mass.
DEAR SIR:
I herewith submit my Fifth Annual Report for the year ending Decem- ber 15, 1922:
The main aim of this bureau is to do all in its power to improve Attle- boro's milk supply. Our endeavors are (1) to see that no milk is offered for sale which is unfit for human consumption; and, (2) that no person produces or deals in milk who is unfit to do so. We have obtained a standard of milk here in this city that never has been equalled in the past, as our records for the year show.
I think it is apropos to give a brief summary of the procedure used this year in order to make it clear what this bureau attempts to accomplish.
In order for an individual to obtain the right to produce or sell milk, a satisfactory dairy inspection is made. In making the inspection the health of the employees is taken into consideration. The human factor in its relation to a milk supply is an all important factor from a health point of view. An individual who milks the cows or washes the dairy utensils subjects the milk or the containers to whatever infections he may have by means of his hands and mouth spray. Great care as to the cleanli- ness of the employees is always demanded. I am hoping for the day when- it will be just as much a legal requirement for milk employees to undergo frequent physical examinations as it is now for certain other kinds of food-handlers.
Analysis of the water is made where the source of water is from the well. Our purpose is to determine whether the well is polluted with sewage wastes. All wells found to be infected are condemned, and the right to sell milk is suspended until a safe water supply has been secured.
It can be said with certainty that there is not a well on any farm which furnishes milk to our community that is sewage polluted. There are few cities in this state that take equal precautions on this point.
67
ANNUAL REPORT
As to the washing of utensils it is required that all containers are washed in boiling water along with a weak alkali, rinsed in cold clean water, and then, if possible, sterilized. It is unfortunate that this state does not require that all dairies should be equipped with a sterilizing outfit as does the States of Rhode Island and New York.
The cooling of milk is another important factor considered in the course of the daily inspection. We urge that milk be iced during the warm months of the year. We require that no milk be sold that is over 50 degrees in temperature. We try to make the milk men understand that warm milk sours easily, and, that it is important from an economic stand- point to him that he ice his milk. Of the three factors which cause a high bacteria count, milk is the most favorable medium known in which bacteria can thrive and more particularly when the milk is warm.
The health of the cows is another important factor considered. We require that each cow be physically examined at least once a year. We encourage those who care to have their stock Tuberculin tested to do so. It is unfortunate this is not a legal requirement. The sanitary conditions of the farm is another factor considered. All of the rules regarding general cleanliness are strictly enforced. During the past year many improve- ments have been made. Several of the dairies have installed sterilizing equipment within the past year. At least two dairies have installed machinery whereby they clarify their milk. Several have given up the old custom of straining their milk through cheesecloth, and, have substitu- ted absorbent cotton. But it is clearly stressed that it is more sanitary to keep dirt and foreign sediment out of the milk in the first place. But it is certainly better to remove dirt that does get into the milk than it is to leave it there without giving any thought to its removal.
The temperature of the milk is taken at the time the sample of the milk is taken. We require that no milk be offered for sale above 50 degrees Fahrenheit. A warm milk encourages the growth of bacteria. A milk heavily laden with harmless bacteria is harmful especially to children. It always has been the aim of this bureau to do everything in its power to lower the bacteria count of milk. This is more important to the health of the community than the searching for adulterants.
During the warm seasons of the year it is our custom to perform the sediment test before the eyes of the milk man when the sample is taken. This clearly demonstrates to him, more so than can words, the actual condition of the milk. He sees with his own eyes the clean or unclean condition of his product. During the winter the test is done at the labora- tory because of the usual frozen condition of the milk. Where samples are found that are dirty warnings are invariably sent to those dealers. On the whole our milk is clean.
Our chemical testing is done chiefly for the purposes of determining: (1) whether the sample is below the standard established by law: and, (2) whether the sample has been tampered with. It also aids us in deter- mining the richness of the various milks sold in Attleboro. It has always been a custom of this department to inform any individual, upon request, as to the quality of any milk supply in our city. We have always made it a practise to analyze any sample thought to be doubtful by any Attleboro consumer. We invite complaints that can aid us in improving the milk supply. It is beyond reasonable doubt to believe that the old time practise of watering milk is still in vogue. It can be safely said that rigid inspection has done away with the watered milk days. Every sample is analyzed for preservatives and coloring matter.
We give much attention to the bacteriological examination of milk and more particularly during the warmer months of the year. It is bacteria of a certain sort that sours milk and causes economic loss to the farmer. It is bacteria that occasionally causes harm to the consumer. This is
68
ANNUAL REPORT
where our interest lies. To a considerable extent the health of the commu- nity is wrapped up in the ordinary milk bottle. Our aim is to do every- thing in our power to keep the bacteria count of milk as low as possible. Wherever a milk has a high bacteria count, and continues to be so, the individual who sells such milk, loses his license.
The means of improving the milk supply are two: first, by grading the milk and thus encouraging the dealers to improve their product, and, secondly, by pasteurizing all milk offered for sale in the city.
Milk is a product that can be easily graded and one that should be graded. It should be graded because milk is the most variable of all farm products. Why should a farmer who selling 41/2% Jersey milk, produced under the most sanitary conditions, receive the same return for his product as does a careless unsanitary producer who sells a 312% milk from a low grade Holstein? The answer goes without stating. Milk should be graded on three bases: as to richness, as to cleanness, and as to bacteria count. A four per cent butter-fat milk should demand a higher premium than a three and one-half per cent milk. A milk that is produced under sanitary conditions, and care taken to prevent the bacteria content from increasing should be worth more than one heavily laden with bacteria. A milk with little or no sediment should sell at a higher price than one saturated with bovine feces. But when milk is milk and no grades are established, wherin does it pay the farmer to make improvements and take precautions? It certainly goes without saying that grading milk would encourage the farmer to improve his product. Grading of milk would also aid the final consumer in determining the quality of the milk she is purchasing. I recommend that plans be made within due course of the ensuing year to establish a grading system.
For the proper safeguarding of the milk supply of a community a suitable and enforceable law must first be enacted. In general this law must cover three distinct phases: (1) fraud, (2) disease, and (3) cleanli- ness in the production and handling of milk. One of the most important considerations must be the reasonableness of the law. A law which works a special hardship on a legitimate industry is not reasonable, and a law so stringent that it can not readily be enforced will defeat its own ends.
No local lawmaking body should attempt to draft a milk ordinance, with its standards, grades, and requirements, unless it is entirely familiar with local dairy and milk conditions, as well as with the purposes and in- tent of such an ordinance. A special study by competent authority should be made. In that way only can satisfactory standards-chemical, bacteriological, and sanitary-be prescribed.
With those ideas in view, I have prepared a form of milk ordinance which, I believe, if enacted would assist our community in providing an instrument for bettering the milk supply.
An Ordinance to Regulate the Production and Sale of Milk.
Be it ordained by the Municipal Council of the City of Attleboro, Massachusetts, that for the purpose and within the meaning of this ordinance, (a) "milk" is the lacteal secretion obtained from the complete milking of cows: (b) "skimmed milk" is milk from which substantially all of the milk fat has been removed; (c) "certified milk" is milk produced and handled in conformity with the "Methods and Standards for the Pro- duction and Distribution of Certified Milk", adopted by the American Association Medical Milk Commissions May 1, 1912, and amendments thereto, in effect at the same time of production, and certified to by a milk commission constituted in compliance therewith; (d) "grade A milk" is
69
ANNUAL REPORT
milk produced from healthy cows, as determined by the tuberculin test and physical examination within not exceeding one year previously by a qualified veterinarian, from dairies that score not less than 85% on the dairy-farm score card in current use at the time by the United States Department of Agriculture, which milk shall not at any time contain more than 10,000 bacteria per C. C. and shall not contain less than 4% Butter fat; (e) "grade B milk" is milk produced from healthy cows, as determined by physical examination within not exceeding one year previously by a qualified veterinarian, from dairies that score not less than 75% on the dairy-farm score card in current use at the time by the U. S. Department of Agriculture, which milk shall not, at any time, contain more than 25,000 bacteria per cubic centimeter and shall not contain less than 312% B. F. (f) "pasteurized milk" is milk which has been heated to and for at least 20 minutes held at, a temperature of approximately 145. never less than 142, degrees Fahrenheit; (g) "cream" is that portion of the milk, rich in milk fat, which rises to the surface of the milk on standing, or is separated from it by centrifigal force, and containing not less than 18% of milk fat; (h) "homogenized" or "emulsified", milk or cream is milk or cream which has been subjected to the mechanical process of homogenization, or of emulsification as the case may be; (i) "Unsterilized containers" are con- tainers which either have not been subjected to moist heat at a tempera- ture as high as 205 degrees Fahrenheit for two minutes or longer, or do not comply with such alternative requirements, to be prescribed by the regula- tions made pursuant to this ordinance, as may be necessary to effect sterilization thereof; and (j) "person" imports both the plural and the singular, as the case demands, and includes corporations, partnerships, societies, and associations.
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