Connecticut. State Board of Health.

Annual report of the State Board of Health for the fiscal year ending November 30 .. online

. (page 17 of 46)
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dry condition of the ground greatly facilitated the work and less-
ened the cost. The borough was also fortunate in the selection
of Mr. T. H. McKenzie as their Engineer, and the success of the
work is due in a great measure to his skill and attention to the
details. The.labors of Mr. Wm. T. Marsh, our efficient Warden,
who has given most his sole time and attention to the work since
its commencement without any remuneration whatever, cannot
be too highly commended. Every tax-payer and citizen should
feel a personal debt of gratitude to him for his valuable services."

Manchester Sewerage.

The State Board of Health held a special meeting at Manches-
ter, to advise about a proposed mode of sewage disposal and
inspect the site intended for irrigation. The following is the
report to the parties asking the Board's advice :

New Haven, Conn., Jime 26th, 1891.
To whom it mdy concern :

The State Board of Health having been requested by interested citizens
of South Manchester to visit that place and inspect the localities .where
it is proposed to utilize the land for purification of sewage, and to
examine the plans devised by the civil engineers, respectfully report:



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190 STATE BOARD OP HEALTH.

That on June 25th, the majority of the memben^ of the Board in com-
pany with other experts, and with several of the citizens, did visit the
said localities after inspecting the plans of the engineers and hearing
their explanations of the same, and did subsequently in formal session
unanimously adopt the following vote:

That having visited and in8x>ected the field known as the ** Hilliard
Lot,*' with reference to its use as a place of disposal of sewage, this
Board is of opinion that its location is unobjectionable and the character
of its soil is well adapted to the final disposal of sewage by land purifi-
cation. And in the judgment of this Board, the genentl conditions and
qualities of the soil as described by the engineers are superior to those
of the more distant field which was also visited.
AU of which is respectfully submitted,

C. A. LiNDSLEY, Secretary.

The following correspoDdence is published, as giving informa-
tion on points frequently inquired about.

CX)NN., May 5, 1891.
C A, Lindeley, M.D,, Secretary State Board of Health, New Haven,
Conn.

Dear Doctor :— Will you please give your opinion as to what age of
gestation a miscarriage or premature birth should be reported to the
Registrar of vital statistics, as '* a return of a birth," and *' certificate
of death."

It has been my practice in miscarriages at the third or fourth month
to make no return. Such cases generally being the delivery of a dead
and often partially decomposed foetus.

Last night I attended a premattire birth at the fifth mopth. The child
lived an hour or more after its birth. It looks to me as though I should
hand in to the Registrar a certificate of the birth and also one of the
death in this case. Then the question arises, is a burial permit necessary
for such a case ?

The law is silent on this subject, and so I thought I would ask what
you think about it. Your advice will be greatly appreciated.

In case of a death in one town and burial in some other town I have
been in the habit of giving two certificates of death ; one for the town
where the death occurred to get the removal permit on ; the other to be
recorded in the town where the body is buried to get the burial permit
on.

Our town clerk thinks I am right and that was the opinion of the
former Registrar of Norwich, Judge D. A. Y. He was a good lawyer,
too.

The present town clerk of Norwich refuses to pay for a certificate of
death where the death happened in another town, and says all that is
necessary for him to give is a burial permit is the removal permit. He
told me '* you advised him to do so." And therefore he refused to pay
me for certificates of deaths of persons who died in Salem and were



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secretary's report. 191

buried in Norwich. Section 106 of the Revised Statutes does not say
anything about a Registrar giving a burial permit from a removal per-
mit, but does say he ** shall issue such permit whenever such cer*^^^-
cate of death has been received by him."

I hardly see how you could give the Registrar of Norwich the ad
he said you did, which appears to be in direct violation of the law.

But he is very positive about it, so I thought I would ask if you 1
so instructed him.

Yours truly,



New Haven, Conn., May 8th, 181
Dr. :

Dear Sm : — Replying to your enquiries of the 5th inst. The law
all births should be recorded. It does not appear to limit the recoi
any period of gestation. The New York practice is, as here, to rei
every certificate of birth that is returned.

It is also the law that a permit for biirial shall be given stating i
of burial of every deceased person.

In case of death in one town and burial in another, my opini<
that one certificate of death is enough. The law no where requirec
physician to make two certificates. Nor does it require a town to
for certificates of deaths occurring outside of its limits.

The Registrar of a town should issue a burial permit in my opii
on presentation of a '* removal permit." Why? because the rem
permit is conclusive evidence that the death certificate required by
has been returned as the law requires, to the Registrar of the to^
which the death took place. The '* removal permit " also says the *'
tlficate of death required by law, has been received and recorded."

There can be therefore, no good reason for another death certifii
because the removal permit contains what the law says it shall.

It cannot be denied, that the law is not as clear as it should be, 1
believe the above is a proper interpretation of its lang^uage, and a
rect expression of its real intention.

Very respectfully,

C. A. LiNDSLEY, Secreta



, Conn., Oct. 7th, 18

Secretary State Board of Healthy New Haven, Conn,:
Deab Sib :— Several days ago I sent a letter to State Board of H<

in reference to making a dumping ground

brook that runs through our premises. They are placing cider poi
to the extent of several cart loads each day into this brook. My
has failed me from the dry weather and one other well above us.
are compelled to use this water for household purposes. The waf
completely impregnated ; tastes and smells of rotten apples anc
mented cider. My live stock have to depend on this brook for d



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192 STATE BOARD OF HEALTH

Will you act in this matter under the State laws, in reference to pollu-
tion of streams. Something has got to be done.

Yours respectfully.



Cleric of Board of Health,

Netw Haven, Ck)NN., Oct. 10, 1891.
Clerk of the Board of Health of ;

Deab Sir : — In regard to the complaint you make of the pollution of
the brook, permit me to say, if you will examine attentively the
statutes (which it is now your duty to do as Clerk of your Board of
Health) you will find that your own Board is invested with all the
power and authority necessary to abate nuisances which may exist any-
where in your town.

*' The State law in reference to the pollution of streams,*' of which
you speak, does not confer the slightest power upon the State Board of
Health to prevent such pollution. The utmost the State Board can do
under that law is to examine and report to the Governor on or before
Dec. 1st ; and there it ends. The Governor has no more authority than
the State Board to help you. But your own Town Board can cause all
sources of filth found within the town to be removed, which, in its
judgment, shall endanger the health of the inhabitants. Gbn. Statutes,
Section 2592.

As I understand the statutes, this condition which you complain of
comes exactly within the legal function and duty of your Town Board
of Health to investigate and act upon. I do not think of anything
which could more properly come before your Board for intelligent con-
sideration than such a nuisance as you have described.

Your Town Board would find its work greatly simplified and ligh t-
ened if it would enact some sanitary regulations such as are suggested
in Circular No. 38, issued by the State Board.

If your town, for instance, had a sanitary law in force similar to
Rule IV. in the Circular, your nuisance could be very promptly and
easily abated, or might never have occurred.

Very respectfully,

C. A. LiNDSLEY, Secretary.



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REPORT OF DELEGATES

TO THE

EIGHTEENTH ANNUAL MEETING OF THE AMERICA
PUBLIC HEALTH ASSOCIATION.

Held at Charleston, S. C, December 16, 17, 18 and 19, 1890.
By N. E. Wordin, A.M., M.D., Bridgeport.

Charleston, S. C, was the gathering point for the eighteen
annual meeting of the sanitarians who comprise the Americi
Public Health Association. The place is an attractive one, t
time was well chosen and, despite the distance, the attendan
was equal to that when held in larger cities. New England, i
Middle and Western, as well as the Southern States, were w<
represented. The Provinces of Canada had their ablest mi
there and not the least important fact was that the Republic
Mexico completed the limit of the continent. Heretofore tl
clientelle of the Association had been bounded by the ocean <
either side. No other State was more largely represented thi
Connecticut. Besides Doctors Wilson, Goodwin and Wordi
members of the State Board of Health and Prof. Lindsley, i
Secretary, all regularly appointed delegates, there were Docto
Shepherd of Hartford, and DeForest of New Haven.

The Connecticut delegates entered Charleston in the ear
morning of Tuesday the 16th, in time for the first meeting at :
o'clock, which was held in Hibernian Hall. The Presider
Dr. Henry B. Baker, Secretary of the State Board of Health
Michigan, occupied the chair during all the sessions. The loc
arrangements were in the hands of Dr. H. B. Horlbeck, Heali
Officer of Charleston, who spared no pains to make the occasic
a success, both in profit and pleasure to all who attended. Sixt;
two new active members were elected, of whom seven we
from Connecticut.

All of the three papers read during the first morning's sessic
related to Pulmonary Phthisis. The first one, by Dr. Doming
Ozvananos, member of the Superior Board of Health of Mexic
. 18



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194 STATE BOARD OF HEALTH.

presented the claims of the Federal District in the Repnblic of
Mexico as a suitable residence for persons predisposed to tuber-
culous affections and those already afflicted with pulmonary
consumption. The high plateau, the even temperature, the aroma
of the flowers which cover the fields, the rarity of the disease,
so prevalent and so fatal in other places, were glowingly detailed.
The average elevation of the table-land is 2,600 metres (1.63
miles), above sea level. Its location is between 19° 11' and 19°
31' of latitude north. The City of Mexico is nearly in the center
of it. It is two kilometers (1.25 miles) distant from the
eternal snow. The climate is temperate and almost equable, the
difference between the hottest month, April, and the coldest, De-
cember, being 7.5°. The atmosphere is clear and the deaths
from infectious diseases proportionally less than in other countries.
Deaths from tuberculous diseases are 8.4 per cent, with regard
to the general death rate. In England, Belgium, Italy, France
and Spain, tuberculosis causes almost 20 per cent, of the general
mortality; in the low lands of the United States, 18 per cent.;
in the mountain regions 6.47 per cent.

The causes which produce in many places in the district an
almost absolute immunity from tubercles in the lungs are cold,
dryness and sunlight. These natural conditions prevent the
origin and development of Koch's bacilli. The surface tempera-
ture of the soil in the valley of Mexico often goes down to zero.
Microbes can only live and develop in a moist medium. The
soil is dry because of rapid evaporation due to the rarefactibn of
the air and to its lack of relative humidity. Koch's experiments
show that under the direct influence of the sunbeams, death of
the bacillus takes place within a few hours at most. In this
valley the luminous, calorific and chemical intensity of the sun's
rays is extraordinary.

Besides these three, the exhalation of the odor of flowers
which are remarkably abundant, may also contribute to both
the scarceness of the disease and the healing of incipient tuber-
cles.

The second paper, by Dr. Lawrence F. Flick of Philadelphia,
forcibly illustrates what may be done in the prevention of dis-
ease by firm governmental interference. In 1783 the Kingdom
of Naples adopted a legal enactment which provided,

1. That a physician should report every case of ulceration of
the lungs under a penalty of three hundred ducats (about



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B£POBT OF DELEGATES. 195

t690.00) for the first offense mnd of banish]neDt.for ten years f<Nr
the second.

2. That an inventory shall be made of the clothing in the pa-
tients' rooms by the aathorities. If any opposition be made the
penalty shall be three years in the galleys or in prison for the
lower class, three years in the castle and three handred ducats for
the nobility.

3. Household goods not susceptible to infection were to be im-
mediately cleansed ; those liable to carry infection, to be at once
burned.

4. The authorities were to tear out and replaster the house,
alter it from cellar to garret, carry away and bum doors and
wooden windows and put in new ones.

5. The poor sick were to be removed to a hospital at once.

6. Newly built houses could not be inhabited before one year
from completion and six months after plastering had been fin-
ished.

7. Superintendents of hospitals were compelled to keep in sep-
arate places clothing and bedding for the use of consumptives.

No mortality statistics for Italy as far back as 1783 can be
found. The only idea of the amount of tuberculosis can be
gained from contemporary writers. These, both Italian, English,
German and French warrant the statement that in 1782 the mor-
tality rate from tuberculosis for the Kingdom of Naples and for
Italy was ten per one thousand living people. On the other
hand, in 1887 the official returns show a mortality from consump-
tion of 1.29 per one thousand for all Italy. Italy has at present
the lowest mortality rate from consumption of any country in
Europe, with the exception of Spain ; and that part of it which
formerly constituted the Kingdom of Naples is, in the country
districts and small towns, practically free from the disease. The
reduction in the mortality from tuberculosis in Italy, since 1782,
ranges from fifty to ninety per cent.

The lessons to be learned are a practical demonstration of the
preventability of the disease, and some idea of what measures
will bring about such a result.

In England, during the last forty years there has been a re-
duction of fifty per cent, in the mortality from tuberculosis as
the result of isolation in special hospitals.

We have it in our power to wipe out this disease in a single
generation. To do this would require well organized boards of



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196 STATE BOARD OP HEALTH.

health, an enlightened public and the cooperation of the entire
medical profession. Tuberculosis should be placed on the list of
diseases returnable to the Board of Health, so that a record may
be kept of the whereabouts of every case arid of its movements
from house to house. " From a careful topographical study of the
disease in the fifth ward of the city of Philadelphia, extending
over a period of twenty-five years, I am convinced that fully
one-half of the cases of tuberculosis among the poor people have
their origin directly or indirectly in infected houses. It is cer-
tainly humane to extend to the poor protection against a disease
against which they have neither the knowledge nor the means to
protect themselves. Preventive measures against tuberculosis
imply nothing more, and I trust this convention will not adjourn
without taking some steps looking to concerted effort in this
direction."

Dr. B. F. Wyman of Aiken, S. C, closed the morning session
with a short paper on the prevention of phthisis. It was of in-
terest because of the large experience with the disease which one
practicing in that place must have had. Dr. Wyman spoke, in-
deed, largely from personal observation. He maintained that
consumption is as amenable to treatment and can be cured as
readily as any constitutional disease, if it is diagnosed in its in-
cipiency and the proper hygienic and medical treatment used
with vigor. Physicians have failed to insist that the disease can
be cured ; they have resorted to much practice which must be
called empirical. This has led the laity to believe the disease in-
curable and has driven many poor sufferers into the hands of
the quack. Those who practice in Southern resorts rarely ever
see a patient until there is a cavity in the lung and the general
health wrecked. The family physician should not only advise
but insist upon removal to some climate unsuitable to the devel-
opment of the germ. Children predisposed should reside in such
locality during the acquiring of their education. There is a
great advantage in a permanent residence. Where only a few
months of the winter are spent South, the rigors of two spring
seasons are incurred — the most trying of all the months to in-
valids. After presenting the claims of Aiken upon those suffer-
ing from lung troubles, the Doctor presented an invitation to the
Association, in behalf of the Mayor, the Board of Trade and the
people of Aiken, to visit that famous resort at such time as
might suit their convenience. This was accepted by a vote of



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REPORT OF DELEGATES. 197

the Association and acted upon by gentlemen individually after
the sessions of the convention had closed.

Resolutions were adopted that committees be appointed
formulate prophylactic measures for preventing the spread
tuberculosis, especially looking to the protection of the heall
members of the community from tuberculous infection ; and
investigate and report to the next meeting such practica
methods of precaution against tuberculosis as are of univer
application among the common people, including the destruct
of the sputum of all tuberculous persons.

The evening session was held in the Grand Opera House. 1
exercises were complimentary to the Association. The clerj
the law and the medical profession were well represented in
speakers whose words of welcome were brilliant with wit 2
wisdom — fine examples of the native oratory of the South. 1
address of the President of the Association, Dr. Henry B. Bal
of Lansing, Mich., was dignified and scholarly and elicited wa
applause. Its subject was Sanitation in 1890; its theme, a g
eral view of the present status of public health work in t
country, a review of some of the progress made, and suggesti(
where effort seems to be most needed. Progress has been mj
in the knowledge of the causes of disease. Most important
these are Dr. Koch's investigations into the specific cause of c
sumption. The bacillus discovered by Loeffler is the cause
diphtheria. It passes into the milk of cows inoculated with it

By the efficiency of the quarantine service, diseases forme
prominent scarcely attract notice. Comparatively little is n
said of small-pox, cholera or yellow fever. In the year 18
there were reported 22,854 deaths from typhoid fever in
United States, probably one-half the real number. Governm
should investigate the reason for the prevalence of a dise
which leading sanitarians believe unnecessary. Much of 1
wonderful success in surgery is due to antiseptic and asep
measures. Now if all purulent discbarges and all pus whicl
accessible should be destroyed or disinfected, all infiammatio
all the dangerous communicable diseases might be restricted s
eventually stamped out, for all suppurative inflammations
breeding places for micro-organisms.

Inoculation is another means of escaping disease. There
great need that the general government should do for diseases
men in this respect what it has done only as yet for animals.



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198 STATE BOARD OF HEALTH.

our own national government would even do as much as to pub-
lish and thoroughly disseminate among our people the important
results of the researches made by the German Imperial Board of
Health, our people would have cause to rejoice and probably
thousands of human lives would be saved through the knowledge
thus obtained. Such work is of vastly more importance than the
distribution of garden seeds, or any work done by Congress dur-
ing the last twenty years.

The most rapid advancement of sanitary science is made, and
is to be expected, where governmental aid is most complete
and abundant. But certain organizations, such as State Boards
of Health, have done much for the practical application of sani-
tary science. In the immediate practical results of their work
some of these boards rival governmental boards of the most
enlightened countries in the world. In Michigan, through
measures maintained by the State Board of Health, the deaths
from small-pox have been so reduced that more than one thou-
sand five hundred persons have continued to live who would have
died from that disease if its mortality rate had continued as it
was before the establishment of the State Board of Health.
That means six thousand cases of sickness from that loathsome
disease, prevented. Similarly, there have been saved ^ye thou-
sand li^es from scarlet fever, fifty thousand cases. Fifteen hun-
dred cases of sickness from diphtheria are prevented annually.
Other States ought to collect and publish evidence of the results
of their work. For on many questions of public policy, no
useful conclusion can be reached without a thorough knowledge
of the facts involved. What disease is it most important for ua
to strive to prevent ? The one which statistics show to have
caused the most deaths.

Is a disease caused by climatic or meteorological conditions ?
Meteorological conditions must be known. There is a " Depart-
ment of Labor " in the United States government. There should
be a Department of Life and Health. To legislate in this direction
is the wisest statesmanship. " Our people are destroyed for lack
of knowledge." Under neglect of proper governmental protec-
tion of life and health a large proportion of the people pre-
maturely die, and still larger proportions suffer sickness, life-long
pain and physical and mental degradations, from causes which
under proper governmental protection are easily preventable.



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BEPOBT OF DELEGATES. * 199

The exercises were opened promptly at 9 o'clock on Wednes-
day morning. Dr. G. C. Ashmun of Cleveland, Ohio, presented
the report of the Committee on the Cause and Cure of Diph-
theria. This Committee was appointed at Brooklyn, last year.
They have directed their efforts chiefly to a report upon the
clinical and sanitary fields of observation. The public seem
apathetic and hopeless in regard to the prevention of diphtheria
more than toward any other disease. There are not less than
forty thousand cases yearly in the United States and Canada,
with a mortality of ten thousand, with little demonstration of
organized resistance. To remove this indifference by demon-
strating specified causes or sources of the disease which can be
resisted and overcome by any method compatible with the well-
being of those aflfected, a list of inquiries was prepared and dis-
tributed. Opinions were sought from men known to have had
experience and education in contact with the disease and who
are also men of discrimination.

The very many interesting and valuable facts brought out
by this report cannot be given here. A brief r6sum6 shows that
it is the generally accepted belief that diphtheria is dependent
upon a specific germ ; that as water and food are media by which
. the virus gains entrance, and the air passages, mouth and throat
are the channels, that the disease is never caused by any agent
developed within the body, but is always from without ; that those
affected should be carefully isolated from one to eight weeks after
recovery ; that sulphur, mercuric bichloride, heat, carbolic acid
and pure air are the substances most reliable for disinfection ; that
public health demands the maintenance of hospitals for the isola-
tion and treatment of those affected ; that no climatic limitations
affect either the development or the spread of it, and that domes-



Online LibraryConnecticut. State Board of HealthAnnual report of the State Board of Health for the fiscal year ending November 30 .. → online text (page 17 of 46)