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Biennial report of the Kansas State Board of Health. 1893 online

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vinegar, any vinegar not the prodaot of pnre apple jnioet known as apple older, or
vinegar not made exolnsively of apple older, or vinegar into whioh any deleterioas
snbstanoes, drugs or acids have been introdnoed, shall for each offense be ponished
by a fine of not less than $50 nor more than $100.

8kc. 2. Every person who manofactnres for sale, sells or offers for sale, any vin-
egar which contains any preparation of lead, copper, solphario acid or other ingre-
dient injurious to health, shall for each such offense be pnnished by a fine of not less
than $50 nor more than $100.

Sbc. 3. The provisions of sections 1 and 2 shall apply to all preparations of
vegetables, froits, and other products, in whioh vinegar is one of the principal in-
gredients.

Sec. 4. Every person making or manufacturing cider vinegar shall brand on one
head of the cask, barrel, or keg, containing such cider vinegar, the name and resi-
dence of the manufacturer and the words cider vinegar; and any person or manufac-
turer who brands any cask, barrel, keg or other vessel with the name of eider vinegar ^
whioh contains any liquid other than pure cider vinegar, shall upon conviction be
fined not less than $50 nor more than $100 for each barrel, cask, keg or other vessel
so branded.

DUTIES AND POWERS OF LOCAL BOARDS OF HEALTH.

The followiDg iDstructions are published by the State Board of Health for
the purpose of acquainting local boards with the nature and extent of their
duties and authority, and to define their relation to the State Board, that
tliere may be substantial uniformity in the administration of the health laws
of the state. In every county of the state there exists a local board of health.
The law reads :

The county commissioners of the several counties of this state shaU act as local
boards of health for their respective counties. Each local board, thus created, shall
elect a physician, who shaU be, ex offloiOf a member of the board, and the health offi-
cer of the same. . . .

It makes no difference as against this fact that, in some counties, no
formal organization has thus far been effected, and no meeting of the board
held. The responsibility, in case of disaster, is with them. It was not the
intention to create local boards of health for a merely nominal existence; they
have duties to perform.

The boards thus created are subordinate to the State Board, which has
prepared rules for their guidance. Such rules should be formally adopted,
and enacted by ordinance or otherwise; and it is the duty of each board to
formulate and adopt such additional rules and regulations as may be neces-
sary to meet special conditions. All rules must be duly published.

The following form of organization is suggested :

Kansas*

189...

The County Boabd of Health is organized pursuant to,

find for the purpose of carrying out, the provisions of the act of the legislature of



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76 STATE BOABD OF HEALTH.

the state of Kansas, approTed March 7, 1885, creating a state and local boards of
health.

The president of the board of ooonty commissioners shall be president of the
conntj board of health, and he shall perform the ordinary dnties of a presiding
officer.

Stated meetings of the board of health shall be held on the first Mondays of Jan-
nary, March, June, September and December of each year, and at sneh other times
as the board may designate at any meeting thereof. Special meetings of the board
of health may be convened at any time when needed for special dnty, on the call of
the secretary of the board. All meetings of the board of health shall be held in
the official room of the county commissioners, unless otherwise ordered.

The health officer, who shall also be secretary and execntive officer of the board
of health, shaU be elected annually, at the stated meeting on the first Monday in
January.

It shall be the duty of the secretary to keep a record of the proceedings; conduct
the correspondence, and to preserTC all papers and things belonging to the board

requiring preservation; to execute in county the provisions of the

statute creating the state and local boards of health, the orders of the State Board

of Health, and the regulations of the .^ county board of health; to have

supervision of the aatoitary affairs of ^.... county, and to take such meas-
ures, without delay, as shall put and maintain the county in a good sanitary condition.

Ail rules of the State Board of Health in force, pertaining to the duties of the

county board of health, are hereby adopted as a part of the organic

law of this board. M. D.,

SeereCary oiid Health Officer.

While tbeee instructions are addressed to county boards of health, they
are likewise intended for the information and guidance, as far as practicable,
of all local boards of health within the state, not excepting municipal
boards. The secretary of a city board of health will be deemed the health
officer of such board, and shall have the same relation to the county and
state boards as other local health officers; that is, he will communicate the
reports^ and information intended for the State Board through the county
health officer, if there be one; if not, to the Secretary of the State Board,
direct

The proceedings of the board should be recorded separately from those of
the board of county commissioners, in a record book provided for the purpose.
In addition, there should be provided by the board a permanait record book,
in the possesumi of the health officer, for recording the vital statistics of the
county, and such other books and blanks, not supplied by the State Board,
as that officer may require in the performance of his duties.

Great care should be taken in the selection of a health officer, for upon
him will depend much of the success of the board.

The office should not be auctioned off, nor filled contingent upon service
during epidemics only. This would be to invite disaster and failure. The
position demands a high order of ability, unflagging industry, and the wisest
discretion. The law provides that preference shall be given to adepts in sani-
tary science; and this provision, if adhered to, mH generally insure the ap-
pointment of a good physician, who will command the respect and confidence



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NINTH ANNUAL BEPOBT. 77



of his professional brethren and fellow-citizens generally, without which he
cannot succeed, no matter what degree of power and authority is given him.
The cooperation of the people is a cardinal principle, and substantial progress
in sanitation can be made only through the upbuilding of a public sentiment
&vorable to its success. This point is dwelt upon because of the injury that
may be done the cause of public health through the appointment of inefficient
or indifferent health officers, without zeal for their duties or discretion in the
performance of them.

Every proper consideration demands that the health officer be liberally
paid. It is for the interests of the people to secure the best advice, and it
will ultimately prove the wisest economy.

As so much depends upon prompt action on the appearance of the first
case of a communicable disease, and in order that no time may be lost, it is
the duty of every board of health to make provision for prompt action by its
health officer, authorizing and directing him to be prepared at all times, as
executive officer of the board, to take certain actiop, without waiting for a
meeting of the board, whenever a case of scarlet fever, diphtheria, smallpox,
or other disease dangerous to the public health, occurs within its jurisdiction.

A summary statement of the duties of a county board of health would be,
that it shall supervise the health interests of the county. In this respect its
work is the same in its scope as that of the State Board. Both are members
of the sanitary service of the state, which is a unit in organization and duties.
Thb would include the inauguration and maintenance of such sanitary meas-
ures as should prevent the introduction and spread of infectious or contagious
disease within the county, outside the jurisdiction of municipal boards, as by
regulating the intercourse with infected places; the separation and treatment
of persons who have been exposed to such diseases; the abatement of nui-
sances prejudicial or dangerous to public health; the marking of infected
houses or places, and the publication, in the newspapers and otherwise, of the
rules for disinfection, and other sanitary information. Such measures, reso-
lutely enacted, will prevent where prevention is possible, or restrict to the
narrowest possible limits where prevention b impossible.

But it will require the utmost vigilance and promptitude, in connection
with the maintenance of a continuous health service. The Board should
possess the earliest possible information of a dangerous disease within its juris-
diction, so that all measures for the protection of the people may be put in
instant, effective operation. Where such disease meets with no organization
to oppose its progress, the most precious time is lost in preparation, until that
which, by promptitude, could easily have been controlled at its first appear-
ance has, by neglect, spread into a costly and fatal epidemic

In these days of extensive traveling and free and rapid intercommunica-
tion, no locality or community is free from danger. Nor is it alone to guard
against contagion from abroad that boards of health are called into exist-
ence. Our enemies are sometimes of our own household. To preserve the



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^A W ^ tit^ ^rrs^at ^/ Ktum yvmts m o umh i m\tL it k
/•y,«Mr^v*f^^ 'vf *,A^ ,4P«, jMoiAjT la 3u:ifi t&e ;g^;*18 LsoeBC lai yipi of its
Vte iM J ^ j 'v. , «*i!M^ At *r,!!Ut>^iu*7 1-^ all RflKoabie rei ^Ji i LM te^ Owits of
k«^, i>v. vi/v. ^/ tiv^ riny^m^j fd UK int««A9 crcSied &> baj«rdi of keskii,
^<«.r^ *f*^ M^i^ ,f-i^:rsi ^ Ut< <^>cia«c^5<a',<l vf tiie Isvs o^ier whxk tker work.
^ i« V ,/ f^; v.r^ U.a( tiv^r pri««r iiiaII be osed aoSelT awl imputimllT in
#4v^ ,A«>rMt« /"i/ '.r*^ p^#%.,^ h^th, sad ikX (jt aar prirale parpu cc i or ends;
ikA^ 9MMV ar, 'mH, mf^sA^^it th^ Ujctd board§ find is n cedfa l to be <iose; ciUier
Iff ff^ ^fri!f,f^A'P,^fi '4 HrnVtUfTj proTmoQs, the niks of the Stale Board, or
ff^^f ^^tf r 9>m WtA ffffUtiMnt0m fifAiwkA thereon and dulj published, thej have

Vfti mUU all ri^fijl nanitarj reguladood sbould be enforced reeolutely
n^fA m\ih ttrmft^^m, at i\0i Munf; time, health boards shoold carefuUj avoid aa>
ft^/^mnff 0fKiU't'yftm and inr<9^igatioTi«. In a state like our own, where the
ttt'^U f4 f'/fiftfftttftiu^ var/, from those of a pioneer settlemoit, in which there
U ttUUi fM^l ffff tit*i ^ixtifdm (jf extraordinary powers, to the more crowded
i^ui^rn t$t \\h aifd m^itiij, where there is a constant demand for sanitary
/ly^fKf^hf' Aod vi^larii^, there is room for the wisest discretion in this respect.
'\h*^ tufitttiy Hltiiru**y is the officer charged with the prosecution of all cases
HtUUtii fMi/l^r th^ li«9filth laws of the state. He should be freely consulted in
ftU t*futim tff vl/Jatioti of the law and rules of the Board, and his lud solicited
hi fotn\i**\\Uii( A (utm\}\\HiU'jo therewith.

Thi* Htni4\ fJrmnI of Health, while instructing and coordinating the work
nf lh*» loi'iil \utnri\n, will ^'ft^lly cooperate with and aid them, all in its power,
ity ndvhwi Im 0jnnrKiMM'l<'s; by jwrsonal visits of its officers or by a committee,
w\wuf*^t*r such vIhUk arc notually necessary; by the free distribution of blanks
Hfiil «tir(Milnr« nn to tlid management and control of contagious diseases; and



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Ninth Annual Rbpobt. 79

by answering, aB fully as possible, all communications addressed to it by such
boards at any time. To the end that such cooperation shall be of the greatest
benefit, the AiUest communication with all local boards is cordially invited ;
8uch communications to be by wire, in case of an outbreak of dangerous dis-
ease, or other serious emergency.

INSTRUCTIONS AND SUGGESTIONS TO HEALTH OFFICERS.

It is required by law, under certain prescribed penalties, that upon the
appointment of a health officer he shall report the fact, with his post-office
address, to the State Board of Health, and that he shall thereafter perform
such duties as hb local board or the State Board may require of him.
Among these duties is the prompt distribution of all forms from the State
Board to the rightful persons, and the transmittal of returns from physicians,
assessors and other local boards (including those existing by municipal regu-
lation) to the State Board; the transmittal to the State Board of copies of
the reports and publications of his board, and such sanitary information as
may be useful to the people of the state.

The law constitutes him the medium of communication between all local
boards of health ( including those existing by municipal regulation) within
his county and the State Board of Health.

The health officer is a member of the board of health of his county, by
virtue of his office. He should, also, be its secretary, sanitary adviser, and
executive officer. His powers, when not expressly stated in the statute, are
only such as are conferred by his board. They should, therefore, be fully
and clearly defined by resolutions or orders. He should be duly empowered
to act in emergencies, as has been heretofore suggested.

As the sanitary adviser of his board, he will have influence in determin-
ing the action of the board in proportion to his knowledge of sanitary science
and his honest effort for the promotion of the public health. He should
make himself thoroughly acquainted with the health laws of the state and
rules of his board and of the State Board of Health. With this knowledge,
if he be a trained physician, he will be equipped for service.

It would be difficult to enumerate, specifically, all the duties of a health
officer; they are not all comprehended in the statutes. There are many duties
which become apparent only under certain contingent, and often unlooked-
for, circumstances. The chief duties of the position are outlined in the rules
adopted by the State Board and repeated in these pages. He should, without
delay, by circular letter or otherwise, put himself in communication with the
physicians and others from whom he must receive reports, acquainting them
with what is required. In case of neglect or failure on their part to conform
to the requirements, he should, after due and reasonable warning, proceed
against them, taking previous counsel of his board and the county attorney.
This duty requires resolution and good judgment. He should avoid undue
exactions, but once assured of his position, he should be firm and unflincb-



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HUr »;.^ ««M< «>.iu ^sit^yvmsKawukti. Tben will be coauMnDei where
l/A** ma^MakM m hfA .^ &/ ti:a« ^km of apfrrecudn^ k» labo8& TW people

iffMf.f P^ VMi icMJ^fivm *4 iani and gut A jadgment.

Ha i^AfA )0k 4l\ifffa$t io d^Yuiing and execoting meaoar e fl for obcaining
Kf^ftf^ thPffm0t4/ft* Uff U'hing the ianitarj condUioiu and heakh of the people,
h^4 ^XffffH ih hm tfuffttAiMUs e/pmmumiy, bat tiirougfaoat all parts <^ tbe county*
l#fA|«f/|»6^ 0^ ffumi r*!rtu^. and lea«t accearible; and sboald rigidlT note if
\ft§Mtp0m tff fu,utnfgifftm dfneaM ha« attacked neighboring coanties» and take
ffmm*tf^ nMJtffUu^y, \^nf1^ but judicious activity, intelligence and discern*
iiiteitl, f$mi, ift a lar^A m#$ANure, the future comfort and prosperity of his fellow-
(4ii/^m M^*l iMr familiM.

ft ftill ^m hU duty to mvjtrd the vital statistics of the county, and compel
Om r*tt(\*ifiUiou of (ibyMicians and mid wives, as far as possible.

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NINTH ANNUAL BEPOBT. 81

i and decline of each outbreak of epidemic occurring in hb county, and
report the same promptly, by wire if necessary, to the State Board. He
should be able to report some fact connected with every such occurrence
which will be of use in advancing the cause of public health.

The reports of the health officer are a part of the records of the State
Board, to be kept for future reference and comparison with future conditions
which will arise respecting their localities. This fact should stimulate him to
contribute all that is possible to be obtained upon the subjects presented.

To recapitulate: The following are suggested as the health officer's most
important duties, viz. :

To order the prompt and thorough isolation of those sick or infected with
contagious disease, so long as there is danger of their communicating the dis-
ease to other persons. The keynote of safety in such cases is the immediate,
thorough and continued separation of the sick from the well.

To order the prompt vaccination, or isolation, or both, of persons who
have been exposed to smallpox.

To see that no person suffers for lack of nurses, or other necessaries, be-
cause of isolation for the public good.

To give public notice of infected places, by newspaper notice and placard
on the premises, and otherwise if necessary ; and to disseminate the rules for
disinfection, etc.

To promptly notify teachers or superintendents of schools concerning fami-
lies in which are contagious diseases; to exercise especial hygienic supervision
over the schools and schoolhouses within his jurisdiction.

To supervise funerals of persons dead from scarlet fever, diphtheria, small-
pox, or other communicable disease which endangers the public health.

To determine what shall be considered nuisances prejudicial to health, and
take measures for their abatement or removal.

To be vigilant as to violations of the law governing the sale or exposure
for sale of adulterated or unwholesome articles, intended for food or medicine ;
adulterated or watered milk should especially receive his attention.

To investigate the condition of buildings with reference to means of escape
iu case of fire, and to report such as are found unsafe.

To notify parties liable to suffer in health from impure water, the source
of which is near cesspools or privies, or other accumulation of filth, or is pol-
luted by sewage or other contaminations, and to make preliminary tests of
such water when necessary.

To collect, tabulate and transmit to the State Board of Health, as may be
required, the various reports and returns as to the births, deaths, marriages,
registration of physicians, and sanitary conditions pertaining to his county.

In the performance of these various duties, valuable suggestions will be
afforded by an examination of the rules adopted by the State Board and the
health laws of the state. It is expected that he will fully communicate with
the Board as to questions that may arise in connection with the performance



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82 STATE BOABD OF HEALTH.



of hi« duties, especially as to what measures he has inaugurated in the inter-
ests of public health, the nuisances abated, etc.

DISINFECTION.

The object of disinfection is to prevent the extension of infectious diseases,
by destroying (he specific infectious material which gives rise to them. This
is accomplished by the use of disinfectants.

There can be no partial disinfection of such material ; either its infecting
power is destroyed or it is not. In the latter case there is a failure to disin-
fect. Nor can there be any disinfection in the absence of infectious material.
It has been proved for several kinds of infectious material, that their spe-
cific infecting power is due to the presence of living micro-organisms, known
in a general way as ''disease germs;" and practical sanitation is now based
u|K)Ti the belief that the infecting agents in all kinds of infectious material
are of this nature. Disinfection, therefore, consists essentially in the destruc-
tion of disease germs.

Popularly, the term "disinfection " is used in a much broader sense. Any
chemical agent which destroys or masks bad odors, or which arrests putrefac-
tive decomposition, is spoken of as a disinfectant. And in the absence of any
infectious disease, it is common to speak of disinfecting a foul cesspool, or bad-
smelling stable, or privy vault.

This popular use of the term has led to much misapprehension, and the
agents which have been found to destroy bad odors (deodorizers)^ or to arrtst
putrefactive decomposition (antiseptics)^ have been confidently recommended
und extensively used for the destruction of disease germs in the excreta of
patients with cholera, typhoid fever, etc

The injurious consequences which are likely to result from such misappre-

KanaS/^n anri mi.nge of the woid "dislnfcctant" will be appreciated when it

mt researches have demonstrated that many of the agents

found useful as deodorizers or as antiseptics are entirely

the destruction of disease germs.

ir example, as regards the sulphate of iron, or copperas, a
iisively used with the idea that it is a valuable disinfectant,
ot, sulphate of iron, in saturated solution, does not destroy
sase germs, or the infecting power of material containing
s, nevertheless, a very valuable antiseptic, and its low price
le most available agents for the arrest of putrefactive de-
vy vaults, etc

nts also exercise a restraining influence upon the develop-
>rmft, and their use during epidemics is to be recommended,
ganio material in the vicinity of human habitations cannot
tn>yetl, removed, or disinfected.

>ptio agont is not necessarily a disinfectant, all disinfectants
r putrcAictive dei»m(K^tiou is due to the development of
class as that to which disease germs belong, and the agents



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NINTH ANNUAL BEPOBT. 8S

which destroy the latter also destroy the bacteria of putrefaction, or restrain
their development, when brought in contact with them in sufficient quantity.

A large number of the proprietary disinfectants, so-called, are simply deo-
dorizers or antiseptics, of greater or less value, and entirely untrustworthy for
disinfecting purposes.

Antiseptics are to be used at all times when it is impracticable to remove
filth from the vicinity of human habitations, but they are a poor substitute
for cleanliness.

During the prevalence of epidemic diseases, such as yellow fever, typhoid
fever, and cholera, it is better to use, in pnvy vaults, cesspools, etc., those
antiseptics which are also disinfectants — t. e., germicides; and when the con-
tents of such receptacles are known to be infected, this becomes imperative.

FORMULAS.

The following disinfectants, antiseptics and deodorizers are recommended :

For general use: Sunlight, fresh air, soap and water, thorough cleanliness.

For sink pipes and water-closets, privies, ash pits, cesspools, drains, vessels

used for discharges from kidneys and bowels, and other offensive articles and

places:

No.l.

Sulphate of iron (oopperas, green vitriol ) 2 lbs.

Rain water 1 gal.

Mix. Write: Use freely.

When much is wanted, dissolve 60 pounds of copperas in one barrel of
water.

For free and general use in privy vaults, sewers, sink drains, refuse heaps,
stables, and wherever else the odor of the disinfectant is not objectionable,
the following is one of the most effective and cheapest disinfectants and ger-
micides :

No. 2.

Chloride of lime ( bleaching powder) 1 lb.

Water , 4 gals.

Mix.

Cost, 5 cents, or about 50 cents per barrel.

This is so cheap that it may be used with great freedom. A quart or
more per day may be used in an offensive vault or other place, according to
circumstances. It may be used freely with a sprinkler as required. In the



Online LibraryXenia Theological SeminaryBiennial report of the Kansas State Board of Health. 1893 → online text (page 10 of 45)