EDITOR'S TABLE.

SANITARIAN, OCTOBER NUMBER, 1897.

ALL correspondence and exchanges and all publications for review should be addressed t the Editor, DR. A. N. BELL, Brooklyn, N. Y.

THE YELLOW FEVER OUTBREAK.

The recent occurrence of yellow fever on the Gulf Coast is true to the history of the disease there as elsewhere. Wherever it is wont to prevail the locality is marked by the excessive accumulation of vegetable matter on the surface and in the subsoil, in a more or less putrescible condition; by defective, or total lack, of soil drainage and sewerage; and by a prevailing temperature of about 80°. These conditions appear to have reached a climax about a month ago in the cities and towns of the Gulf Coast, when the yellow fever broke out in Ocean Springs; and since in other places in the vicinity, under similar conditions.

It is no scandal on the civil authorities of those communities to state that they have become so wedded to the exclusive belief in the exotic origin of yellow fever as to have relied wholly upon their quarantines for its prevention, while they have neglected local conditions and the extensive prevalence of such other diseases as have been the common forerunners of yellow fever in the same localities heretofore; as they have been in other places, during periods of prevailing temperature approximating the average common to outbreaks of yellow fever, when the conjunction occurs. It is liable to break out in, or to be introduced into, such places only.

Localities may be never so dirty, and other diseases prevail extensively, but so long as they are not subject to an average temperature of about 80°, they are not subject to yellow fever; and if it happens to be introduced into them it never spreads; it is limited to the cases introduced. And in like manner, clean localities, though subject to an average temperature of 80° the year round, are never subject to yellow fever; if a case is introduced, the disease never spreads. The disease requires dirt and high temperature together for its propagation. Clean localities need have no fear of it under any circumstances; dirty places have reason to fear it whenever there is a prevailing temperature of about or above 80°.

It is communicable by fomites-infected things-and is not contagious like measles, smallpox or other contagious diseases. And considering the supersusceptible conditions and consequent liabilities to the disease common to all the populous localities along the Gulf Coast at this time-so abundantly shown by their own published discoveries since the outbreak-the attempts of the authorities of the localities to quarantine one another, is preposterous and disgraceful in the extreme. And as for "shotgun" quarantines and cordons against infectious diseases of any kind or at any time, they are alike cowardly and inhuman.

There are a few persons in the health service thereabout old enough to remember the twofold practical lesson at Memphis and New Orleans, 1878-'79, and those who are not old enough to remember it should have learned it before undertaking the duty of health officers: that the introduction of the disease and its prevalence were alike shown to have depended upon unclean localities and the dissemination of unclean things, and not upon personal intercommunication; and that it was by the restriction and disinfection, or destruction of such things, and the thorough cleaning and disinfection of the localities, that the disease was promptly checked and finally stamped out. But some of those now in authority seem to have no recollection or knowledge of other means than those which were subsequently used in Texas and Florida, while the disease continued to prevail until the coming on of cool weather, to which time the authorities postponed the cleaning up, and then claimed the credit due to the weather!

It is always estoped by the setting in of frosty weather, or by prevailing "northers" on the Gulf Coast, under a temperature of about fifty degrees.

Practical Sanitation means the prompt rescue of both the sick and the well from infected places and infectious things, and the needful provision for the sick; the promotion of facilities for the well to reach healthful localities, subject only to such temporary detention as may be necessary to divest them of all infectious things; and the utmost dispatch in cleaning up and disinfecting the locality. We make no attempt to present a record of the disease in its progress, because the public press renders any such attempt wholly unnecessary.

THE YELLOW FEVER BACILLUS discovered by Professor Sanarelli, of which we published a description in our March number (Vol. XXXVIII., p. 276), appears to be a mere rediscovery of Dr.

Sternberg's bacillus r, discovered and particularly described by him, eight years ago, but not announced by him as the bacillus of yellow fever, because, he states in a paper read at the recent meeting of the International Medical Congress in Moscow, "scientific conservatism compelled me to withhold any announcement of a discovery in view of the fact that I had failed to obtain this bacillus in a considerable number of undoubted cases of yellow fever."* In summing up his subsequent researches and facts, with special reference to the false claims of Carmona, Freire and others, he confesses to having felt it necessary to be exceedingly careful lest he also should make a mistake by premature announcement, and says that, had he found the bacillus in every case of yellow fever which he had studied, he might have made bold to announce it as such. Had he even found it in eighty or ninety per cent., it might have given him courage to announce the great probability of its being the long-sought-for microbe. But as he only found it in about half the fatal cases then examined, he could not very well announce it as the cause of every case. In this paper, he now says that "if he had had the results announced by Sanarelli on dogs, monkeys, and men, he would not have hesitated as he did." And he further adds: "If these results (of Sanarelli's) are confirmed by other investigators, this bacillus must be accepted as the veritable germ of yellow fever."

THE MILK SUPPLY OF NEW YORK.-According to the report of the board of health for 1896, the number of cows which furnish milk for this city is 115,570. There are 7,000 places in the city where milk is sold both wholesale and retail. The system of granting permits to venders of milk, which went into effect at the commencement of the year 1896, has been found to be of great value. As a result of this, together with the application of the tuberculin test to milch cows, there is now a system of milk inspection which is as perfect as is possible at the present day and with the present force. The milk permits are in force during the pleasure of the board of health, which revokes them on the second trial and conviction for the sale of "adulterated milk," that phrase meaning milk containing more than eighty-eight per cent. of water or fluid and less than four per cent. of milk solids, or less than three per cent. of fat, milk drawn from animals fed on distillery waste, milk

*American Journal of Medical Sciences, September, 1895.

from which any part of the cream has been removed, and milk from cows kept in crowded or unhealthy places. In 1895, in the samples of milk which were tested, 393 cases of adulteration were discovered, while last year the inspection and test showed only 233. The number of arrests in 1895 for selling adulterated milk was 408; in 1896 there were only 220. Nevertheless, in view of the liabilities to impure milk and to deteriorated milk, it is, to say the least, very regretable that Nathan Straus should have been given such offense by an employe of the board of health, on account of what appears to have been the unfaithfulness of one of his employes, as to have caused him to discontinue the supply of sterilized milk to the many thousand babies in the city, whose mothers are otherwise unable to obtain it. Attention is invited to Mr. Straus' letter to this effect, on another page.

THE SPITTING REFORM-HOW IT BEGAN.-A Kentucky tobacco planter visited a merchant in New York about sixty years ago, with whom, after dinner, he drank wine and chewed tobacco, spitting on the carpet (not having been used to carpets at home) much to the annoyance of his host, who desired a spittoon to be brought for his visitor; he, however, pushed it away with his foot, and when it was replaced, he kicked it away again, quite unaware of its use. When it had been thrice replaced, the Kentuckian drawled out to the servant who had brought it: "I tell you what; you've been pretty considerable troublesome with that ere thing, I reckon; if you put it there again, I'm hung if I don't spit in it."

MORTALITY AND MORBILITY REPORTS AND REVIEWS.

Correspondents under this head are particularly requested to be as prompt as possible.

ALABAMA.-W. H. Sanders, M. D., State Health Officer, Mont

gomery.

Mobile, 37.817. J. A. Abrahams, M. D., Health Officer. reports for July: Deaths, 77-29 under five years of age. From typhoid and typho-malarial fevers, 4; consumption, 7. Annual

death rate, 24.3.

September 13, there was one malignant case of yellow fever in the city, and other suspicious cases.

CALIFORNIA.-C. A. Ruggles, M. D., President, Stockton; W. P. Matthews, M. D., Secretary, Sacramento.

San Francisco, 360,000. Reports for July: Deaths, 470-119 under five years of age. From consumption, 70; acute pulmonary diseases, 46; from zymotic diseases, 29; diphtheria (and croup), 5; typhoid fever, 3. Annual death rate, 15.6. Contagious diseases. reported during the month: Diphtheria, 13; scarlatina, 8.

From

Los Angeles, 107,000. Reports for July: Deaths, 121. phthisis, 19; acute pulmonary diseases, 6. Annual death rate, 14.04. "N. B. Of the 19 deaths from pulmonary consumption, as follows: Natives of Los Angeles, I; natives of the Pacific Coast outside of Los Angeles, o; from other parts, 18. Of the 19 deaths 16 had lived here less than ten years."

Alameda, Aug. 7.-The Board of Health decided to ask the City Trustees to pass an ordinance forbidding the distribution of samples of patent medicines about the city. Several of the members reported cases of children being taken sick from eating these samples, which are thrown in dooryards and public places.

COLORADO.-Denver, 160,000. William P. Munn, M. D., Health Commissioner, reports for July: Deaths, 166. Of these 31 were caused by consumption, 26 contracted elsewhere; 13 by acute pulmonary diseases. Annual death rate, 12.45 (excluding phthisis contracted elsewhere), 10.50.

CONNECTICUT.-Professor William H. Brewer, Ph.D., New Haven, President; Professor C. S. Lindsley, M. D., Secretary, New Haven. The Secretary's bulletin for August comprises returns from every town in the State. There were 1,237 deaths reported during the month; 12 more than in July, and 407 less than the average number of deaths in August for the five years preceding the present.

The death rate was 16.9 for the large towns; for the small towns 16.2, and for the whole State 16.8. Deaths from zymotic diseases, 356, being 29.0 per cent. of the total mortality. From diphtheria, 14; typhoid fever, 15; whooping cough, 12; measles, 2; scarlatina, 5; cerebro-spinal fever, 18; malarial fever, 18.

DISTRICT OF COLUMBIA, 276,963-88,176 colored.-Wm. C. Woodward, M. D., Health Officer, reports the mortality for four weeks ending August 28: 395. Of the decedents, 188 were white and 207 colored, the death rate being 14.1 for the white, 35.0 for the colored, and 24.5 for the whole population. The principal causes of death were: Zymotic diseases, 96; constitutional, 75; 40 were from consumption and 15 were from pneumonia. Of the