of our population has passed through one of these forms of severe illness within the past two years, and that one in each 109 of the people of Kentucky has been needlessly sacrificed to these preventable diseases that are even now claiming their victims by the hundreds and barely a voice lifted to save them. Our figures would indicate that $5,802,139.56 has been expended in Kentucky in cash in the past two years for the medicinal care, nurs ing and drugs for persons sick with these diseases, and that 24,828 of our citizens have died with them. Again, placing the conservative valuation of $1,000 upon each one of our people who have been thus needlessly taken from us we find that these preventable diseases in Kentucky in the past two years have cost the enormous total of $30,630,139.56. This means that five times as much money is wasted in this State each year as it costs to run the State government, or expressing it another way, that each and every man, woman and child in this State contributes over $5.60 per year toward the needless drain on our best resources, to say nothing of the sorrow and suffering and death caused thereby. With the view of preventing or restricting the spread of these diseases, the following series of circulars have been carefully prepared for gratuitous distribution. They have been revised from time to time in order that they might voice the latest authentic information, as scientific knowledge has advanced. An attempt has been made to couch all of them in plain terms, adapted to popular use. Copies of these circulars are distributed in every available way as occasion requires. Upon notice, officially or through the newspapers, that any of these diseases exist in a locality, the circulars are sent to the physicians, the postmaster, and to the families, if the names are given. Copies are also sent to the county newspapers with a request for their publication with such editorial comment as may seem pertinent, and this board can not express enough gratitude to the public-spirited editors of our county papers for their prompt and effective circulation of these health matters when occasion arises in their respective localities: "PREVENTION OF TYPHOID FEVER. "Circular Issued by the State Board of Health of Kentucky. "To the Health Officials, Physicians and People of Kentucky: "This board again feels it to be a duty to call the earnest attention of our health authorities and people to the increasing prevalence and mortality from typhoid fever and to the consequent growing importance of the constant use of the methods endorsed and confirmed by scientific research and observation for the prevention of the disease. M. Typhoid Fever Germs in the walls of the bowel, Twenty-two thousand one hundred and twelve cases of this disease and 1,633 deaths were reported in Kentucky last year, chiefly confined to people in the prime of life and usefulness. The cost of caring for those sick of it, to say nothing of the sorrow, suffering and loss of life, for the year, is reported as being $2,120,170.16. "Typhoid fever is probably the most preventable of all diseases, not even excepting smallpox. It is now definitely known that, like cholera and dysentery, the germs of the disease are contained only in the discharges from the bowels and kidneys of those sick of it, and that it is necessary for a person to swallow some of such discharges, or things polluted by them, in some way, in order to contract the disease. It is not a very nice thing to say or think, but the only way that you, reader, can contract typhoid fever is by getting some of the bowel discharge or the urine of a person sick with typhoid fever in your mouth. "They usually gain entrance to the system through infected water from wells or streams draining inhabited areas, and polluted by infected fecal matter, or such matter may be carried by flies and deposited on the food, utensils and hands in unscreened kitchens and dining rooms. The germs may also be carried on the hands of care less attendants, or on soiled clothing, or indirectly, by using milk or other articles of uncooked food or drink from cans and vessels washed in infected water. Ice from infected water is also dangerous, as it has been proven that freezing does not kill the germs. A large volume of water may be infected from one case, and, if already polluted with organic matter, become a ready culture fluid for the multiplication of the germs. In the now noted epidemic at Plymouth, Pennsylvania, involving the sickness of 1,104 persons, and the death of 114, the outbreak was traced to the use of water from a stream infected by the discharges from one imported case. The recent disastrous epidemic at Ithaca, New York, causing many deaths and requiring the suspension of Cornell University, was traced to the use of a public water supply similarly infected. "On the other hand, in the distressing and fatal epidemic which clung to our military camps at Chickamauga, Camp Mead, Montauk Point and other places, during the Spanish-American war, flies were found to be the principal carriers of the disease by the United States Commission appointed to investigate the origin of the outbreak. By A B The Typhoid Carrying Power of the House Fly. If you will imagine that object A in the diagram to be 36 times larger than it is there represented, and object B is still the same in size, an approximate relation in size between the Typhoid Bacillus and the leg of a fly can be obtained. By magnifying a twenty-four-hour old Bouillon culture of the Typhoid Bacillus, I find that an average of 3,980 typhoid bacilli would adhere to a leg of a house fly, Taking into consideration differences in the lengths of the six legs of the fly a rough approximate estimation is made that 18.000 bacilli could be carried about in this way by a single fly. VERNON ROBIN. M. D., Louisville City Chemist and Bacteriologist. the use of white powder sprinkled over the discharges in the latrines, thousands of these pests were tracked direct from these and found covering the food, hands and utensils in the kitchens and mess rooms of the common soldiers. Cultures taken from the feet, legs, bills and intestines of these flies showed the germs of typhoid fever in countless numbers. The kitchens and mess rooms of the officers were screened, and they almost uniformly escaped the disease. Other facts no less convincing as to both water and flies being carriers of this disease might be multiplied indefinitely, if space permitted. In a smaller way, they must be common in the experience of most physicians in active practice. "Based upon the teachings of the foregoing facts, the following rules have been prepared with care for the guidance of all persons interested in their own and the public health: "1. When it is known or suspected that a person has typhoid fever, he should be placed in a large, well ventilated room, with the windows and doors well screened, and such preparation should be made from the first day for the thorough and systematic disinfection of all discharges from the bowels and kidneys as will protect other members of the family, the attendants, and the community. "2. A solution of chloride of lime, eight ounces to the gallon of water, should be provided in quantity, and a quart of this should be put in the bed-pan or vessel each time before it receives the discharges, and should be well stirred and allowed to stand in the vessel at least on hour before it is buried. An equivalent solution of creolin, or a thick white-wash made from fresh quicklime, may be used in the same way when the chloride of lime can not be obtained, but with these at least two hours will be required to complete the disinfection. "3. Soiled bed or body linen should remain in the chloride of lime solution for an hour, and may then be safely put in the family wash. Soiled paper or clothes used about the patient should be immediately burned. Attendants should wash the hands and the lips frequently, and rinse the mouth always before eating. No one should partake of any food which has stood in the sick room. All of these precautions should be continued until the recovery is complete and until all diarrhea has ceased. "4. Typhoid fever is not contagious in the sense commonly understood, and if the precautions above indicated are faithfully and intelligently carried out, a case may be treated in any family or com munity with perfect safety. If others have the disease, it will be be cause they were infected from the same source as the patient, or contracted it elsewhere. The same precautions should be observed in dysentery and all other diarrheal diseases, including summer complaint in children. "5. All well water and unfiltered water from rivers draining inhabited areas, where typhoid fever and diarrheal diseases are likely to occur at any time, and milk stored in cans or vessels washed in such water, should be looked upon as suspicious, and should always be boiled before it is drunk by any one not immune from typhoid fever. In the absence of a reliable, filtered, public water supply, carefully collected and properly stored, cistern water is safest. "6. The windows and doors of all dwelling houses, and especially of the kitchen and dining room, should always be well screened, and the flies actually kept out. Unless this is done, a carelessly managed case of typhoid fever, or other diarrheal disease, even a mile or more away, may be a source of danger on account of flies. As mosquitoes are now known to be the carriers of malaria, the same precautions will protect from this poison also. "The universal and effectual practice of these precautions would require intelligent care and some expense, but would result in the practical disappearance of one of our most common and fatal domestic pestilences, which is not only a disgrace to our civilization, but an annual scourge and tax upon the people of Kentucky, in comparison with which yellow fever and cholera, plague and other exotic diseases, so feared by our people, sink into insignificance. "Copies of this circular, and of others in regard to the prevention of consumption, diphtheria and scarlet fever, may be had by any one for free distribution upon application to the board at Bowling Green. "By order of the board: "J. M. MATHEWS, M. D., President. "J. N. McCORMACK, M. D., Secretary." PREVENTION OF CONSUMPTION. "Circular Issued by the State Board of Health of Kentucky. "To the Health Officials, Physicians and People of Kentucky: "Consumption is the most common and fatal disease with which the people of Kentucky are afflicted. It produces more than twice as many deaths as any other disease, causing one death out of every seven in this State. بھیجا Germs of Consumption, magnified, from Photomicrograph, |