Pittsburg dispatch. [volume] (Pittsburg [Pa.]) 1880-1923, 1889-07-30
IT WAS FORESEEN.
A Medical Authority Which FOretold
the Typhoid Trouble.
EVEN THE DISTRICT INDICATED.
The Causes and the Most Effective Remedies
Pointed Out.
NORTHSIDE PHYSICIANS UNRUFFLED

N0RTHSIDE PHYSICIANS UNRUFFLED
Now that SO much has been said of the in
ability of the Allegheny Board of Health
to grasp the typhoid fever situation, sug-
gestions as to remedy are in order. On
May 81 DR.. w. P. Mum, of Allegheny,
read very spicy paper before the County
Medical Society on ''The Functions and
Duties Of Health Boards" 1t never
reached the daily papers, and as it treats of
this identical trouble, though two months
before typhoid fever broke out on the North
side, part of it is timely now:
There is in the city of Allegheny a very gen.
eral Noncompliance with the ordinances re-
Quiring the prompt report of all cases of infec-
tious diseases occurring within the city limits
Physicians are Indifferent because the law has
never been properly enforced and because COM
pliance with it has not as a rule met with
proper cooperation from the municipal health
authorities The body known as the Board of
Health seems to be of the opinion that its
functions begin and end in the investigation of
cesspool and similar nuisances, and annually
congratulates itself and the city that merci-
full Providence has not sent smallpox visita-
fever, scarlet fever, and diphtheria, each due
to entirely different but almost equally pre-
venIable causes,
SLAY THEIR THOUSANDS
where smallpox only numbers its victims by
dozens. and that there are other preventative
measures than the enforced cleansing of over
flowing cesspools. The reasoning even of pro-
fessional men who should know better seems to
We that nothing is a nuisance unless it otfends
thN eye or nose, that the cesspool cleaner is the
only practitioner of preventive medicine and
that physicians sole prerogatiye is to sign
death and birth certificates and not to bother
about anything else outside of his private prac-
tice.
The proposition that every city, and especial
ly every large city, should have board of
health, or a department of public health, re-
quires no elaboration or proof. The duties
devolving upon such body may be viewed
from various standDoints, but no practical
hygienist would deny to such body police
power sufficiently strong to enforce its regula-
Iions.
Suggestion No then is: That health in
spectors should be known as sanitary police,
and as such should in the pursuit of their
duties, have the same emblems OF authority,
powers of arrest and privileges OF search that
are given to other police officers in preserva-
tiOn of the peace. The moral effect of a prop
erly uniformed and efficiently directed sani-
tary police force would be great. Their report
of statistics might be made the basis for med
ical regulation.
HOW TO GRAPPLE IT.
Suggestion No. 3-A sketch of a proposed
plan of action for ordinary times leaving out
of consideration those times when some dread
disease becomes so prevalent as to call for ex-
ceptIonal measures
First-Every case of communicable disease
should be reported promptly to the Board of
Health (age, sex and residence carefully speci-
hed). Measles is included under this head and
mild cases OF scarlet fever, sometimes called
scarlatina or scarlet rash. are also included.
Second-Every such case reported should be
marked accurately upon large scaled map of
the city, SO that the number of cases in any
given square or in any Typographical section
may be determined at glance. This map
should also have all sewers and water pipes ac-
curately indicated, and diameters marked so
that the number of cases in unsewered dis
tricts. in the neighborhOOd of dead ends of
water pipes, and in uhwatered and partially
watered districts, might be known and properly
appreciated.
Third-A complete list of all cases of com
diseases reported during the preced-
ing "a hours should be sent by special messen-
ger every morning to the principals of all the
schools in the city, and, acting on this informa-
ton. the principals should send home all chill
dren residing in the houses from which cases
are reported. By this means hundreds of cases
of scarlet fever, diphtheria and measles might
be prevented each year, and The number of
deaths among school children largely de-
creased.
FOurth-Every case of the more serious con-
tagious diseases. viz, scarlet fever, diphtheria
and smallpox. should be visited in less than "a
hours after being reported, by a medical in
spector, who should give personal directions in
regard to disinfection, isolation and attention,
and use his discretion in regard to posting an
official notice or card on the door.
MORE vIRULENT DISEASES.
Fifth-Cases of death from the more viruIent
diseases should be at once reported, and the
funeral should be held under the personal
supervision of the health inspector having
special police powers. The Board should adopt
for the preparation, carriage and
disposal of all bodies dead of virulent contagi-
Gus disease.
Illustrative of the necessity of some such
will narrate the following in
stance, occurring in my own practice: In an
isolated district at that time free from any |
scarlaLina. one case Of scarlet fever occurred; |
the medical attendant was lax the fact that it |
was scarlet fever was kept quiet, and the chld's
brother continued attending school for several |
days. From the same room in the school two |
other children, living half and quarter mile |
awav. and not exposed in any other manner
became sick of the disease both recoyerlng
From one of these children five others, one in |
the same house and four living next door, con- |
tracted the disease and two OF them died. Then |
the outbreak ceased. / cannot help thinking |
that had the first case been promptly reported |
and the brother kept from school, the other |
eases might not have occurred.
The health authorities should have an intel |
ligent understanding of water supply, sewerage |
disposal of waste material, ETC.. and should |
have sufficient authority for the sanitary con- /
troll of these departments.
The recommendations of the health officers |
II based on the prevalence of disease in un-
severed or partially severed districts as con-
clusively shown by the map process previously |
detailed would be of great weight in deter |
mining the location, size and drainage area of |
sewers. In relation to water supply it would |
be equally weighty.
CTrrn
For example, such graphic illustration of |
The number of cases OF typhoid fever in the
triangular space bounded by Ridge avenue
avenue and Rebecca street. and the
number of resulting DEATHS would when taken
n connection with the impertectly severed
condition of the district and the accumulation
If surface water there, be productive of prompt
Iction; provided that an intelligent medical
health officer and an intelligent sanitary engi-
leer co-operated in the work. Again, a similar
,raplic illustration and statement of the per
,entage of preVentable sickness in the totally |
hill district of ALLEGHENY having an
.stimated population of eighteen Thousand |
$4,000, might be productive of good results.
would give a detailed description of these
districts and detailed statement of the cases
u communicable diseases occurring in them if
here was any likelihood of correct figures
'eing obtainable, but such statement is i'm
lossible.
Lastly, would suggest consideration of a
natter seldom taken into account by health
'oards, and of material interest to the mass of
is NInNsr So