211. The Health Department of a City *

Some notion of the multifarious activities of a municipal health bureau can be gathered from this extract from a recent departmental report published by the City of Cleveland, Ohio:

of the milk

There are about 3,500 farms which furnish milk for Cleveland. Supervision Since the establishment of dairy inspection last August to the end supply. of the year 630 dairies have been inspected and scored according to the direction and on the score cards used by the Department of Agriculture. The average score was 44 points, which means a farm that ought not to be allowed to send milk to Cleveland. The number of cows which furnish milk to Cleveland is estimated at about 30,000; 427 have been tested with tuberculin and 109 of these or 25.52 per cent reacted, were killed and shown by post mortem to have been tubercular. If this ratio should hold then 7,656 tubercular cows are furnishing milk to the Cleveland market at the present date. The danger is obvious. How to avert it? If we average a cow at forty dollars, it would take $306,240.00 to pay for all these cows and to get rid of them. The sum is not so large as to make the solution of the problem an impossibility.

In the great struggle with tuberculosis which is going on now The fight against all over the civilized world, Cleveland is not behind time. The city tuberculosis possesses a sanitarium on the City Hospital grounds and another in Warrensville. Both are of the approved type of modern structures, especially designed for the treatment of this disease. Without them we would be greatly handicapped in our efforts to retrench the ravages of the White Plague. The more patients can be induced to seek treatment in them, the better it will be for both patients and city. The patients' chances for recovery are greatly enhanced. They are kept in pure air day and night and learn, in a practical way, how to take care of the sputum lest they become dangerous to their fellow men. The city is delivered from a continual source of infection, the family receiving the greatest benefit. The money spent for the maintenance of these hospitals is a

Clinics for the poor.

The economic advantage of the fight.

The de

mand for a contagious disease

hospital.

good investment. The amount of danger taken and kept away from all citizens is incalculable. The educational feature of these institutions is not the least important, for the practical demonstration of the need of precaution and how to take it to avoid selfinfection and infection of others is most fruitful of beneficial results.

As not all tubercular patients can go to the hospitals, clinics become a necessity for the care of the poor unfortunates who must stay in the harness as long as there is an atom of strength left in them. These clinics should be held at convenient hours so that the patients can come to them in the mornings before they go to work and in the evening after their day's labor is over. As long as these poor people, in their very infirmity, which was brought upon them without any fault of their own, strive to the utmost to take care of themselves and their families, the benevolent attention of the community must keep a watchful eye over them. To stretch out a helping hand to them is not an act of charity but the mandate of duty.

Then the economical side has to be considered: Keep these people self-supporting and we accomplish a great deal. Last, not least, is the sanitary aspect. If we could get hold of all our poor tubercular and instruct them how to live in order to regain the road to health, what a blessing we could bestow upon them. If we could prevail upon them to be careful with their sputum, what a danger we could take away from their families, their coworkers and the citizens in general. Just to help these poor people along, who have to work, but on account of their physical weakness are not able to earn enough wages to consult a physician, I established a tubercular clinic in the City Infirmary Office, spending out of my office hours from two to three hours daily in examining and treating patients.

The necessity of a contagious disease hospital becomes every year more apparent. If we should have an epidemic of scarlet fever or diphtheria, forced hospitalization of patients would frequently become necessary, as it is impossible to keep an infected

family in a crowded tenement house strictly isolated. In New York City all such cases are taken to the hospital, by force if necessary. In Chicago they just passed through a serious outbreak of scarlet fever, having as many as sixteen hundred cases a week. The disease did not come on suddenly. It developed rather slowly, and the health officials informed me that the lack of a hospital for contagious diseases was one of the main factors in its spreading. The Cook County Hospital took as many patients from the city as it could, but it was soon filled up and every case had to be left where it developed. That was the way the disease got beyond control. In Cleveland we have no county hospital. We have practically nothing. In case of an epidemic we would be in a deplorable state and would be criticized by the whole United States, and justly so. The erection of a contagious disease hospital ought not to be delayed another season.

street cars.

People do not crowd because they like to, they crowd because Crowded they have to in order to reach their destination. The problem cannot be solved by preventing people from boarding an already filled car, but by putting more cars on the tracks. There have never been enough cars running during the so-called crowded hours to convey all passengers in a decent way. This can be shown by a very little figuring. In the morning people have to reach their work at the appointed hours and the tendency of people. to hurry home after their day's work is done is laudable and needs. encouraging rather than checking. I do not think it would be wise to prevent people from boarding cars and to make them wait for hours around the cold street corners without protection from rain and snow. The city must ultimately force the street car management to keep up with the growth of the city in number of lines and cars needed for the sanitary conveyance of the passengers.

212. Municipal Parks*

The way in which a modern city attempts to provide healthful recreation for the people is illustrated by this statement recently made by the director of parks in Cleveland, Ohio:

An enlightened

tive policy.

The policy inaugurated by the present administration of abolishadministra ing the "Keep Off the Grass" signs and conducting the parks in the interests and for the welfare of all the people of Cleveland, regardless of their social standing or financial rating; of providing healthful forms of recreation and amusement for both young and old, and of extending, enlarging and improving the park system to keep pace with the city's needs and growth, has been continued and broadened. The usual special attractions were presented during the past year, and served to draw thousands of visitors to the parks who would otherwise have remained in ignorance of what Cleveland possesses in the way of landscape beauty in its really beautiful park system.

Band

concerts.

Special

summer events.

Children's days.

Thirty-seven Sunday and 26 evening band concerts were given during the past summer, a total of 63, as against 49 in 1905. Two concerts were held each Sunday · one on the West Side, alternating between Edgewater and Brookside Parks, and one on the East Side in either Gordon, Woodland Hills, Garfield or Washington Park. The evening concerts were held at the smaller parks, giving each section of the city an opportunity to share in the pleasure this form of entertainment furnishes.

The special days have come to be looked forward to as annual events. "May Day" was celebrated on June 2nd in Gordon, Garfield, Brookside and Edgewater Parks. Great interest was aroused on this occasion by the selection, by lot, of the May Queens and Maids of Honor at each park before the ceremonies commenced. "Turners' Day" was held at Rockefeller Park on Sunday, June 3rd, by the German Turning Societies. The annual romp of the children, formerly known as "Romping Day," was held on Monday, July 23rd, and called "Cleveland Day" in observance of the newly established holiday in memory of the birth of the city, which fell on Sunday, the 22nd. The program was rendered at Gordon, Wade, Woodland Hills, Garfield, Edgewater and Brookside Parks. The members of the City Council contributed to the success of the celebration by assisting in arranging the games and races and distributing the prizes. Special exer

cises were also held on this day in the Public Square by the Old Settlers' Association. "Orphans' Day" was conducted on August 7th under the auspices of the Cleveland Automobile Club. The hundreds of inmates of the Cleveland Orphan Asylums were given a ride through the city's parks and treated to a lunch at Gordon Park. . . .

sports.

On account of the mildness of the weather, the main events in Winter the winter sports program had to be abandoned. However, a number of carnivals were held on the small corner lot skating rinks. Besides the seven park lakes, 35 of these made-ponds were in operation during the winter of 1905-1906. During the present winter there are four rinks less than last year in operation, due to the fact that some of the lots formerly used have been built upon and that it is becoming harder to secure suitable locations adjacent to water facilities.

athletics.

During last summer 20 baseball diamonds were maintained in Provision for the parks and 30 on vacant lots in different parts of the city. Seven leagues were accommodated almost entirely on these grounds each Saturday afternoon, while the demands from independent teams for grounds by far exceeded the number available, notwithstanding the fact that the afternoon was divided so as to provide for two games being played on each diamond. Eight foot-ball gridirons were laid out in the parks. Two of these were exclusively for socker football. The golf links of 43 acres in Gordon Park were largely used during the golf season. On account of the proximity of the new shelter house to the links, and the consequent danger of injury being inflicted on the spectators and park visitors, the links will be established in Woodland Hills Park the coming season, where the space for playing this game is larger and more suitable. A cricket ground is located in Gordon Park. This is cared for and the materials furnished by the Cleveland Cricket Club. Three tennis courts were equipped in the parks last sumtwo at Garfield Park and one at Edgewater. During the past summer this department maintained public Playplaygrounds in four of the parks, Clinton, Fairview, Lincoln

mer

grounds.