dite' binding, may be ordered directly
from technical book dealers or from
Merck & Co., Inc., Publications Dept.,
Rahway, N. J. 07065.
Those extra pounds you put on dur-
ing the winter will be showing in your
next summer's light-weight clothes, says
the N. C. Heart Association.
Bathing suits and sports wear
demand slim, trim figures as all the
clothing designers tell you, but the
slim, trim figure could mean more to
you than high fashion on vacation. It
may mean years of longer life. To get
the figure back in shape there are two
rules to follow.
First, push yourself away from the
table. No one ever lost weight by feast-
ing, and a sensible moderate diet with
an eye on the calorie intake will go
far in losing those extra unwanted
inches. The North Carolina Heart Asso-
ciation reminds everyone to avoid fad
diets. While losing weight, always
maintain a well-balanced diet. There is
no quick and healthy way to lose
weight, but by watching the intake of
calories and increasing the level of your
physical exercise, weight can be lost.
The second road to a trim figure is
exercise. Here again the North Caro-
lina Heart Association reminds you
that, like eating, exercise should be
done in moderation. Develop your level
of exertion slowly. If you have a his-
tory of heart disease, by all means,
check with your physician before at-
tempting any unusual exercise or exer-
tion. Muscles tone slowly, but through
day by day effort you can reduce un-
wanted fat and increase the overall
muscle tone of your body. Remember
obesity is never popular and can be
dangerous. If you are 20 percent over
your ideal weight, then you are obese.
Lose weight, tone the muscles and
you'll feel better, you'll look better,
and you may live longer.
September, 1968
THE HEALTH BULLETIN
13
New Federal
Program
Treats
Drug Addicts
As of a mid-year report, over 450
narcotic addicts have been committed
for examination or treatment under a
new Federal program described in a fly-
er now available from the Public Infor-
mation Branch, National Institute of
Mental Health, Health Services and
Mental Health Administration.
Entitled "The Narcotic Addict Rehabil-
itation Act of 1 966— A New National
Policy," the flyer outlines the provisions
of a total treatment program that views
narcotic addiction as an illness rather
than a crime.
The law provides for the civil com-
mitment of addicts, including those
charged with or convicted of violating
certain Federal criminal laws as well as
others not charged with an offense.
Addicts who have committed a crime
of violence are ineligible.
For the first time the Federal govern-
ment is assuming the responsibility for
aftercare services, which are to be
developed in the addict's home com-
munity. The NIMH is also administering
a grant support program authorized by
this Act for States, local governments
and organizations to develop communi-
ty treatment and rehabilitation facilities.
NIMH field offices in New York,
Chicago, and Los Angeles are already
in operation, providing consultation to
local planners and negotiating and
monitoring contracts for providing after-
care. Offices will be established in the
near future in many other cities where
there is a high incidence of narcotic
addiction.
The NiMH is responsible for the
administration of all aspects of the
NARA program except those pertaining
to the treatment of convicted criminals.
This phase of the progam is adminis-
tered by the Office of the Attorney
General in cooperation with the NIMH.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Asheville
Lenox D. Baker, M.D., Vice-President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hiddenite
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. State Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.M., M.P.H. Director, Epidemiology Division
Ronald H. Levine, M.D., M.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S., M.P.H. Director, Dental Health Divisiori
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, M.D. Director, Personal Health Division
14
THE HEALTH BULLETIN
September, 1968
North Carolinians
Working On
Heart- Research
Grants
Eight North Carolina scientists have
been named by the American Heart
Association to receive research grants
during this fiscal year, according to Dr.
James A. McFarland, President of the
North Carolina Heart Association.
The newly announced Grants-in-Aid
av/ards are part of a record $12,000,-
000 research effort being underv/ritten
by the Amercan Heart Association and
its affiliates for the 1968-69 fiscal
period. Dr. McFarland said. The Associ-
ation's research program is supported
by public contributions to the Heart
Fund campaign in February.
Of the $12,000,000 total, approxi-
mately $5,000,000 represents alloca-
tions made this year by the Associa-
tion's national Research Committee. The
$7,000,000 balance v^ill be expended
by state and local Heart Associations
for their own research programs.
"Since 1949 when the Heart Associ-
ation made its first grants, about 140
million Heart Fund dollars have been
channeled into cardovascular research,"
Dr. McFarland pointed out. He con-
tinued:
"Over the years, with ever-increas-
ing public contributions of Heart Fund
dollars, our most gifted research scien-
tists have been enabled to search for
answers to the complicated problems
of the heart and circulatory diseases.
Following are grants made in North
Carolina by the American Heart As-
sociation: Dr. Carl Gottschalk of UNC;
Dr. Peter Halloway, Dr. Frans Jobsis,
Dr. Bettie Masters, Dr. Klaus Brendel,
and Dr. James Clapp of Duke; Dr. Mar-
garet Conrad and Dr. Robert Bond of
Bowman Gray Schools of Medicine.
ANNUAL MEETING
N. C. Health Council, Inc.
Hotel Jack Tar — Durham
December 3, 1968 - 10 A.M. - 4 P.M.
In this annual meeting, the Council, composed of 65
State and area-wide organizations concerned with
health, will give emphasis to the role of the voluntary
health associations in North Carolina.
Edwin S. Preston, President
September, 1968
THE HEALTH BULLETIN
15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
LIHHARIAN
DIVISION OF HEALTH AFFAIRS LIBRARY
N.C. 1^'EN^ l-iOSP. U. N. C.
CHAPEL HILL, N.C
If you do NOT wish to con-
tinue receiving The Health Bul-
letin, please check here i — i
and return this page to
the address above.
iX
%\\^
^^
\^
Printed by The Graphic
^
,WgRi&c., Ra«!^?j3??
W^
Nursing Home
Seminar Approved
For March
Chairman William T. Herzog, UNC
School of Public Health, informed the
Advisory Committee for Nursing Home
Seminar that $2,000 in funds had been
approved by the Governor's Council on
Aging for the proposed executive
course next spring. The Committee
approved March 24 through 28 as the
dates for the course which v\/ould be
conducted in Chapel Hill.
Additional funds will be requested
from the Public Health Service. Herzog
advised. The $2,000 grant from the
Governor's Council would provide tui-
tion costs for forty students but could
not be used for their living expenses
at the course, it is planned to conduct
another course in the fall of 1969 for
those who cannot attend the March
course.
r.»A
Fluorkkifibn Legislation
Staf-e-wide in Minnesota
Thousands of Minnesota children will
enjoy less tooth decay in their growing-
up years as a result of the State legisla-
ture's passage of a state-wide water
fluoridation law affecting all municipal
water systems.
Hailed as a landmark contribution to
dental health by Dr. Viron L. Diefen-
bach, Assisfant Surgeon General and di-
rector, Division of Dental Health, Pub-
lic Health Service, the act calls for
fluoridation of all municipal water sup-
plies within the State of Minnesota by
January 1, 1970. More than 500 com-
munities will be affected by the new
law.
Minnesota is the second State to
adopt a measure authorizing fluorida-
tion of all municipally-supplied water.
Connecticut passed a similar measure in
1965, but that law covers only those
communities with 20,000 population or
over.
16
THE HEALTH BULLETIN
September, 1 968
9'^i>
rifiii
nSnfiiiBii!iiHuiiinHisii
The Officiol Publication
Inside
Jacksonville Woman Is
First To Win National Award 3
Measles Shutout 7
THE HEALTH BULLETIN
First Published — April 1886
The official publication of the North Caro-
lina State Board of Health, 106 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
The Local Health Department:
What Is It? 8
State Board of Health
Holds Quarterly Meet
11
Editorial Board
John c. Lumsden, B.C.H.E., Raleigh
Jacob Koomen, Jr., M.D., M.P.H., Raleigh
John Andrews, B.S., Raleigh
Glenn a. Flinchum. B.S.. Raleigh
H. W. Stevens. M.D.. M.P.H.. Asheville
Patient Expenses Under
Medicare Going Up 13
Your Driver's License
Could Save Your Life .
New Planning Officer
For Health Agency ...
14
15
Vol. 83
Editor: H. B. Rogers
October 1968
No. 10
Cover: Fannie King of Jacksonville
is first North Carolinian to receive
Humanitarian Award for saving a
life. Governor Moore made the
presentation.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Asheville
Lenox D. Baker, M.D., Vice President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hiddenite
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. State Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.M., M.P.H. Director, Epidemiology Division
Ronald H. Levine, M.D., M.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S., M.P.H. Director, Dental Health Division
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, M.D. Director, Personal Health Division
THE HEALTH BULLETIN
October 1968
Humanitarian Award
HAPPY OCCASION — The Governor's office in the State Capitol was
the scene as Mrs. King received her award. Sharing the moment are
(left to right) Elmer King, Vance Kee, Mrs. King, Gail King, Governor
Moore.
Jacksonville Woman Is First
Tar Heel to Win National Award
Less than three weeks after
completing a course in medical
self-help training, Fannie W.
King of Jacksonville used the
knowledge she had gained to
save the life of a teenaged boy,
following a surfing accident at
Topsail Island.
A year later, Mrs. King be-
came the first North Carolinian
— and the seventh American —
ever to win the Medical Self-
Help Humanitarian Award of
the United States Public Health
Service and Office of Civil De-
fense.
October 1968
THE HEALTH BULLETIN
Governor Dan K. Moore pre- Two hours later Mrs. King,
sented the award to Mrs. King alone in the cottage, relaxing
at ceremonies at his office in with a book, was startled by a
the State Capitol on September scream from her daughter. She
rushed to the door.
"Mama, Randy is about
drowned!"
"Where?"
"In the back seat of the car."
Later Mrs. King said she
thought for a moment that her
6.
Mrs. King, wife of Elmer
King, is the mother of two teen-
aged daughters. She is also a
licensed practical nurse, em-
ployed by Onslow Memorial
Hospital in Jacksonville.
She completed her course in daughter was "pulling her leg."
medical self-help training on
July 10, 1967. Nineteen days
later — on July 29 — she per-
formed an act of heroism that
saved the life of a fellow human.
Mrs. King and her daughter
She rushed to the car parked
out front. There she found Ran-
dy Koonce — on the back seat.
"He was covered with sand,
extremely cyanotic [blue]
around the mouth and eyes.
Gail had gone to the family's completely limp, cold to the
cottage at Surf City, on Topsail touch, and not breathing." Thus
Island, just off the North Caro- Mrs. King remembers Koonce's
lina coast. condition.
White-Capped Water
It was a hot, windy Saturday.
The water was white-capped.
Surfers were having trouble in
the water.
At noon two teenaged couples
dropped by the cottage for sand-
wiches and sodas. They had
been trying to ride the waves
on surfboards. One of the boys
was William Randall (Randy)
Koonce, 16, a neighbor of the
Kings in Jacksonville.
Mrs. King fed the youths and
urged them not to return to the
water. The ocean was too rough,
she thought. But the teenagers
went on.
Only Adult
The boy's companions were
crying and sobbing. Mrs. King
was the only adult around.
"Take my car and go for
help," she told her daughter.
She looked again at young
Koonce. Oxygen, immediately,
she decided.
She pulled the limp body
across the seat of the car far
enough for the head to hang
off the seat, slightly backward,
chest facing up.
She cleared the victim's
throat with her finger, grasped
his chin in her right hand with
her thumb inside his mouth,
THE HEALTH BULLETIN
October 1968
pressed his nostrils together
with her left hand, covered his
mouth with her own — and be-
gan to blow.
Afterwards, Mrs. King said
she gave only passing thought
to the "gunky" mucus covering
the patient's nose, upper lip
and mouth.
Applying mouth-to-mouth re-
suscitation, she forced air into
the youth's lungs at the rate of
12 breaths a minute.
There was a gag reflex. She
turned his head to the side. But
nothing happened.
A few more puffs into his
lungs — and another gag. Then
another. And another.
She pulled the boy out of the
car and onto the ground. He
was still cyanotic, still not
breathing.
She continued m o u t h-to-
mouth resuscitation. He gagged
again. This time when she
turned him to the side, he vom-
ited, a thick, amber-colored
fluid. He gasped for breath.
She administered more
mouth-to-mouth resuscitation —
ten seconds, thirty, a minute.
Suddenly Koonce began to
breathe on his own — short,
gaspy breaths, without rhythm.
Neighbor's Oxygen
By now a crowd of onlookers
had gathered. One, a beach
neighbor, had brought a porta-
ble oxygen tank and face mask.
Mrs. King took it. She broke the
seal and administered the oxy-
gen — two minute doses, broken
by 30-second intervals.
The ten-minute supply of
oxygen was exhausted. Now
Koonce's respiration was rhyth-
mical, 36 a minute. His pulse
rate was 140. Cyanosis had
diminished to a minimal point.
Three men from the gather-
ing of onlookers helped Mrs.
King move young Koonce out of
the hot sunshine and into the
cottage. She placed him in
shock position.
In a few minutes he opened
his eyes and spoke.
"What, I don't remember,"
said Mrs. King later. "By this
time I had a terrific headache
and was getting nervous."
But by this time, Mrs. King
had saved a life.
A beach patrolman arrived
and took Koonce to a doctor in
the nearby town of Burgaw.
Seemed Like Hours
Looking back, Mrs. King says
she has no idea how long the
mouth - to - mouth resuscitation
procedure took. "Probably it
was three to five minutes, but it
seemed like hours."
However, one of the onlook-
ers, H. B. Hodnett of Raleigh,
says that he arrived on the
scene after Mrs. King had start-
ed mouth-to-mouth resuscita-
tion, and even then she worked
October 1968
THB HEALTH BULLETIN
over the victim five to eight
minutes before administering
the oxygen.
What had happened to Randy
Koonce before Mrs. King was
startled by the scream from her
daughter?
Despite the rough seas,
Koonce had gone back into the
water with his surfboard.
Shortly afterward, a compan-
ion, Kenneth Edward Hill, 17,
of Charleston, S. C, looked up
from the beach and saw
Koonce's surfboard floating free
in the water. Then he spotted
Koonce more than 200 yards
out, fighting to stay afloat.
Hill plunged into the water
and swam out to help. But
when he reached Koonce, he en-
countered a nearly drowned
victim who was almost hysteri-
cal in his struggle against the
undertow.
Koonce lost consciousness be-
fore Hill could make any head-
way toward shore.
When Hill was finally able
to get Koonce onto the beach,
one of the other youths tried an
arm-pulling, chest-pumping ma-
neuver. Koonce vomited. But
that was all.
On His Back
Koonce's Jriends put him on
a surfboard on his back and car-
ried him over the sand dunes
to their car.
By this time Gail King had
Randy Koonce
arrived on the scene and learned
what had happened.
"Take him to my mother,"
she said. "She will know what
to do."
The medical diagnosis of
Koonce's injuries gave practi-
THE HEALTH BULLETIN
October 1968
cally no clue to the actions of
Mrs. King or Kenneth Hill. It
read: "Concussion caused by
hitting him on the head, with
no ill effects of near drowning."
The Humanitarian Award
won by Mrs. King is given to
an individual who saves a per-
son's life using knowledge
gained from medical self-help
training. It consists of an
inscribed sterling silver medal,
a sterling silver emblem to wear
on her dress, and a certificate
signed by officials of the award-
ing agencies.
Medical self - help training
goes beyond the ordinary first-
aid course. First-aid training
teaches what to do until a doc-
tor arrives. Medical self-help
training teaches life - saving
techniques to use when a doctor
is not available.
More than 100,000 Tar Heels
have taken medical self-help
training since it was first
offered in 1962 by the State
Board of Health and the North
Carolina Civil Defense Agency.
Mrs. King took the course
while she was a student in the
practical nurse education pro-
gram at Onslow Technical Insti-
tute. Her teacher was Vance
Kee, director of the Jackson-
ville - Onslow Civil Defense
Agency.
Randy is the son of Mr. and
Mrs. W, T. Koonce of Jackson-
ville.
Measles
Shutout
Not a single case of measles
was reported to the State Board
of Health in September. It was
the first month in which no cas-
es turned up in North Carolina
since measles became a reporta-
ble disease in 1913.
For the "epidemic year" run-
ning from October 1, 1967
through September 30, 1968, a
total of 363 cases of measles was
reported to the State Board of
Health — a decrease of 70 per
cent from the preceding epi-
demic year, when 1,212 cases
were reported.
The sharp drop in reported
cases is due mainly to immuni-
zation. The State Board of
Health distributed 220,000 dos-
es of live measles virus vaccine
to local health departments and
private physicians throughout
North Carolina over the past 30
months. In addition, physicians
gave the vaccine privately.
Because of the low incidence
of measles, officials at the State
Board of Health now propose to
investigate each case of the dis-
ease reported.
October 1968
THE HEALTH BULLETIN
The Local Health Department:
What Is it ?
By Barbara Kahn
Health Education Consultant
North Carolina State Board of Health
Wherever you live in North
CaroHna, there is a local health
department to serve your needs.
It may be a county department,
or it may be a district depart-
ment serving more than one
county.
Local health departments
throughout our State carry out
programs and offer services de-
signed to promote and protect
the public health of all North
Carolinians.
The community is the health
department's "patient." Con-
versely, the health department
is the community's "doctor."
The effectiveness of many ac-
tivities of your local health
department is measured not by
what happens, but by what does
not happen. Many activities are
aimed at preventing health
problems.
For its "patient" — the com-
munity — the local health de-
partment collects facts, makes
the diagnosis, then sees that
treatment is applied. It keeps
track of health problems —
where they occur and with
what severity. It keeps tabs on
the leading causes of death. And
it stands ready to commit its
resources to solve any problem
that may come up.
Individual Meaning
What are some of the services
provided by local health depart-
ments? And what meaning do
THE HEALTH BULLETIN
October 1968
they have for you, as an in-
dividual North Carolinian?
Safe Water . . .
A constant surveillance of
your water supply and sewer-
age system to be sure they are
safe is one — if you live in the
city. If you live in the country,
health department officials are
prepared to give free advice
regarding a safe well and sani-
tary septic facilities.
Sanitarians from your health
department work with restau-
rant owners and workers to
make sure the food you eat
there is safe. If it is not, either
the unsanitary conditions must
be corrected or the restaurant
must close. The same thing
goes for grocery stores, meat
and seafood markets, food pro-
cessing plants, shellfish har-
vesters and packers and other
food haVidling businesses.
Advice and assistance regard-
ing the elimination of insects
and rodents are available from
the sanitarian.
In schools, the rest rooms,
drinking fountains and kitch-
ens are checked for sanitation.
When communicable diseases
such as dysentery and hepatitis
are reported, the public health
physician, nurses and sanitari-
ans work together to find and
eliminate the source, and thus
prevent further spread.
X-rays, skin tests and clinics
for physical examinations are
provided for detecting tubercu-
losis. Help in getting proper
treatment is available for those
who contract the disease.
Public health workers find
and treat venereal diseases not
cared for by private physicians.
Birth Certificates
The health department keeps
track of all births and provides
birth certificates. Many depart-
ments provide clinics for ex-
pectant mothers and for regular
check-ups of infants and pre-
schoolers. All departments pro-
vide clinics for immunization
against smallpox, polio, diph-
theria, whooping cough and
tetanus.
If you are going to travel
abroad, you can receive what-
ever shots are required at your
local health department.
Special clinics are provided
within easy traveling distance
for children from birth to age
21 who have crippling condi-
tions, cystic fibrosis, burn scars,
rheumatic and other heart con-
ditions, birth defects, and other
handicaps.
There are clinics for persons
suffering seizures, others to de-
termine the condition of chil-
dren who seem to be mentally
retarded.
October 1968
THE HEALTH BULLETIN
Eye clinics for children are
held in many health depart-
ments in cooperation with the
Commission for the Blind.
Some local health depart-
ments provide tests to discover
diabetes and glaucoma. When
these diseases are discovered
early enough, your doctor can
help you keep them under con-
trol.
Dental inspections of school-
age children are provided. Some
corrective work is done for chil-
dren whose parents are unable
to pay for private care.
Nurses Counsel
Public health nurses — the
girls in blue — make home visits
to help families learn how to
carry out their doctors' orders.
They counsel the family about
nutrition and child growth and
development.
Some departments have ac-
credited Home Health Agencies,
in which nurses, and sometimes
physical therapists, give per-
sonal care to persons ill at
home. Medicare patients in par-
ticular enjoy these services.
Public health nurses also know
about community and state
health resources, and can help a
family obtain the aid it needs.
Health information is an im-
portant service of the health
department. Organizations may
obtain speakers, films, and
pamphlets on health topics, as
well as help in planning pro-