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“ SANITARY VOLUNTEER."
The “Sanitary Volunteer,” a journal devoted to the interests of healthful homes and communities, published monthly, was commenced in January last, and is issued as the official organ of the New Hampshire State Board of Health. The subscription price was placed at fifty cents a year, which, with the income derived from a few advertisements, it was thought would be sufficient to pay for the printing and distribution of the journal, and it was confidently hoped that it would aid in advancing the public health interests of the State. It was designed to supplement and aid the work of the Board, and we believe that it has thus far fulfilled these expectations. The editing of the journal has placed considerable additional work upon the secretary, but ample compensation has been received in the many words of appreciation spoken of it, and in the belief that it is of some service to the public. The additional work imposed upon the Board by making it a Board of Commissioners of Lunacy, will necessitate the suspension of the publication of the journal at the close of the year, much to our regret.
COMMISSIONERS OF LUNACY.
The act of the last Legislature, making this Board a Board of Commissioners of Lunacy, has very largely increased our duties and responsibilities. Although the creation of a Board of commissioners of Lunacy was in a great degree due to the facts which have been gathered by the State Board of Health during its few years of inspection and observation of our county insane asylums, and presented to the Legislature, we were not in favor of placing such duties upon the State Board of Health, but favored an independent organization. It was argued, however, by persons interested in the welfare of the indigent insane, and by the judiciary committee of the House, that the State Board of Health, with its present knowledge of the subject, was better prepared to perform the work which would devolve upon such a commission than a new board would be ; and finally, rather than have the measure defeated, the Board accepted the proposed legislation, with the tacit understanding that if it were found impracticable for the latter to perform the duties and functions of a Board of Lunacy,
any recommendations to relieve them of these duties would be considered by the Legislature. An additional argument in favor of this arrangement was the fact that the work could be done at much less expense to the State in this way.
The new work has already been commenced, and we realize more than ever the great need there was for legislation of this kind. We have long appreciated the fact that while the inmates of our county insane asylums have, as a rule, plenty to eat, good beds, and comfortable rooms, there has been a total lack of remedial treatment on account of the failure of the various counties to provide attendants and the many other means necessary. In the work already done by the commission, this fact has become more obvious than ever before, since we have found at these institutions persons of good intellects and with no structural disease of the brain, and offering good promise of successful treatment, or at least of improvement in their condition. A full report of the work of this commission will be rendered to the Legislature.
THE REGISTRATION OF VITAL STATISTICS.
The registration of vital statistics, a work devolving upon the secretary of this Board, has already become of great importance to the State as a reference, to those interested in the many questions which can be answered only by a study of facts thus placed upon record. The ninth annual report of the registration of births, marriages, divorces, and deaths, is now in press. We can confidently say that no State in the Union has a more accurate and complete registration of deaths and marriages than New Hampshire. The birth records are very incomplete, as they are under any system in this country; in some towns and cities the record is very correct, while in others but little reliance is to be placed upon it. The accuracy of the record depends very largely upon the interest taken by the local registrars in the matter.
This statement is not true regarding marriages and deaths ; certificates are obtained for marriages, and burial permits are required in all cases of death ; hence a registration of approximate accuracy is secured. Our death records are already of considerable value from a sanitary standpoint, and if this system of registration is continued, as it certainly ought to be, in a few
years we shall be in possession of data of great sanitary value. If a record of deaths had been maintained in this State during the last fifty years with the same accuracy that is now secured, we should possess very important facts regarding the prevalence of certain diseases in certain localities, which would, in all probability, present a complete solution of questions that cannot now be answered. The only way in which the public health interests of a state or nation can be correctly demonstrated and compared is through its registration of deaths; although a single volume of the report appears to the casual observer to be a mass of useless statistics, yet the record of deaths alone will be of more actual importance to the welfare of the people than most facts appertaining to the State to be found in the census reports. We would, therefore, urge upon all who are in any way connected with the record of vital statistics of the State, the importance of making every effort possible to secure accuracy and completeness.
TYPHOID FEVER AND DIPHTHERIA.
The following report upon typhoid fever and diphtheria is almost wholly compiled from reports and communications received from physicians. The report was made for the year 1888, as it was then supposed that the annual report of the board would be issued early in the following year, as heretofore. Hence, with one or two exceptions, it does not include any cases reported in 1889. The reports from physicians cover in a great measure the same ground that has been over in former reports, but they are presented once more for the purpose of giving additional testimony relative to these diseases, and to impress still further upon the public mind their connection with bad sanitary conditions.
The testimony of the physicians, which has been printed in the annual reports of the Board, has attracted considerable attention from those interested in studying the conditions connected with the prevalence of typhoid fever and diphtheria, and has done much toward enlightening the public in this direction. The State is greatly in debt to the medical profession for the interest it has taken in the prevention of disease and in securing for the people better hygienic conditions. The people in the several localities from which these reports have been received will read them with great interest.
Acworth — G. H. POWERS, M. D. Typhoid Fever. — None in my practice during the past year. Basing my opinion upon my experience as a practitioner, I believe that, with perfect sanitation of all surroundings and no abnormal changes in the alimentary canal, of secretions or ingesta, we should be free from typhoid fever. I think it well established that any decayed food or bad water, taken in sufficient quantities and long enough continued, will produce typhoid or a similar filth disease. I also think that good food and good drink may be so changed in the alimentary canal of a body already weakened by constant excesses, as to produce at last the necessary organic change for typhoid fever.
Diphtheria. — One case of diphtheria in Concord, and two cases of diphtheritic sore throat in Acworth. In the case of diphtheria, a boy four years of age, decayed grapes had been eaten and retained in the alimentary canal until severe throat symptoms developed. The boy recovered, but the ocular muscles were paralyzed. It has been my experience that unsanitary surroundings furnish all the conditions necessary to develop this disease.
Acworth -- Carl A. ALLEN, M. D.
Typhoid Fever. — Two cases, neither fatal ; one in Unity and one in Alstead. The drinking-water was contaminated in one case ; in the other, a grain thresher who traveled from house to house could discover no cause. It has been my experience that unsanitary conditions may be both direct and exciting cause.
Diphtheria. — Four cases, none fatal. All these cases were the result of contagion, the first case having been visited by a mother and child from another town who were just recovering from the disease, the subsequent cases following from contact with the first. All were mild cases, and by using preventive measures and isolation the disease went no further. If unsanitary conditions do not cause the disease, they certainly have a decided effect upon its severity and continuance.
Alstead — GEORGE H. GORHAM, M. D.
Typhoid fever. — One case in adjoining town, recovered. The drinking-water was polluted. Think contaminated water the principal cause of the disease.
Diphtheria. — Three cases, recovered, imported. Consider poor drainage the exciting cause.