Public Health

The state of the nation's health for the week ended Oct. 1 and for the comparable week of 1926, as reported last week by the U. S. Public Health Service, was:

CASES 1927 CASES 1926

Diphtheria 1,733 1,650

Measles 750 1,081

Infantile Paralysis 595 88

Scarlet Fever 1,656 1,741

Smallpox 147 79

Typhoid Fever 844 1,417

Data was supplied by public health officers of 96 cities (with 30,380,000 total population) and 43 states. Many of those officials were at Cincinnati last week for the 56th yearly convention of the American Public Health Association where they presented problems that vexed them.

Alcohol roused the noisiest discussion. "The one fact that hits back at the legislation [on alcohol] is the fundamental physiological law, as demonstrated by physiological chemistry, that alcohol is a normal constituent of the brain tissue," stated Dr. Charles Alfred Lee Reed, University of Cincinnati professor emeritus of gynecology and onetime (1900-1901) president of the American Medical Association. He went on: "When this supply runs low there is a natural demand for alcohol as such." His declaration was reply to two papers on the subject, which had just been presented.

Dr. Haven Emerson, professor of public health administration at Columbia had said: "In the absence of any evidence that health, as revealed by vital statistics, is less good in the U. S. in 1927 than it was in 1920 [when prohibition became law], and since we have good reason to believe that less rather than more alcohol per capita is now being consumed in this country than when traffic in alcoholic beverages was an industry acceptable under the law, and since we know that alcohol used by healthy persons does not add to their health, it is my opinion that some of the general improvement in health since Prohibition is the result of outlawing commerce in alcoholic beverages."

Dr. Louis Israel Dublin, of the Metropolitan Life Insurance Co. had said: "Beginning with 1920 there has been a continuous and marked rise in the number of deaths resulting from the use of alcohol. . . . The quality of liquor used throughout the country is sufficiently bad to make up for the smaller quantity consumed. . . . We may summarize our findings as follows: that the Prohibition period is characterized by sharply declining mortality rates among children and adolescents of both sexes, and that this decline is continued over a number of additional age periods among women. The improvement is retarded among young male adults and disappears altogether during the middle years of life in that sex. In fact, the mortality has definitely risen among men after the age of 35."

Dr. Reed's rebuttal excited the public health convention. Men shouted and gesticulated. Dr. Reed wanted to speak further. "Dr. Emerson," said he, "tried to make prohibition responsible for about everything except the frost on the pumpkin and the swallow's homeward flight." Dr. Charles Value Chapin of Providence, R. I., chairman of the meeting, ordered the discussion closed, soothed everybody.

Less exciting were discussions of other subjects.

Heart Disease "is often caused by repeated infections, such as the common cold, which do injury to the organ," said Dr. Henry Albert of Des Moines, Iowa. "From 15% to 25% of all cases of heart disease are apparently due to rheumatic fever, a disease which occurs early in life, in children of about 10 years of age, and which almost always does permanent damage to the heart." More than 100,000 people die yearly in the U. S. of heart disease. It is increasing.

Cancer. A definite program to help prevent cancer (responsible for more than 103,000 U. S. deaths yearly) was the recommendation of a committee made up of Dr. George Albert Soper, managing director of the American Association for the Control of Cancer, Dr. Geo. H. Bigelow, Health Commissioner of Massachusetts and Dr. Henry Frieze Vaughan, Health Commissioner of Detroit. The program:

1) State Health Department and those of large county and municipal units should handle this work in separate bureau or in an existing bureau as local conditions may indicate.

2) A survey should be made to determine: cancer cases and the death rate; facilities available for diagnosis and treatment ; cost of medical treatment; ability of the sick to meet expense.

3) Co-operation should be invited from the medical profession and the American Society for the Control of Cancer in regard to a well planned campaign against cancer.

4) The public should be instructed in methods of preventing cancer and in the recognition of early signs of cancer and the necessity of seeking competent medical advice immediately upon the appearance of such symptoms.

Infantile Paralysis. There was no loud huzzahing about infantile paralysis. Last year at this time the entire country had only 88 cases; at the beginning of this month there were 595. And there is no known cure. From newspaper dispatches, the public health men learned that Dr. Milton Joseph Rosenau of Harvard had told the Interstate Post Graduate Medical Association convention at Kansas City last week that doctors were "no longer in the dark." Experiments with human serum had given some favorable results. From Manhattan came information that Dr. Wm. Hallock Park and Dr. Josephine Neal of the New York Health Department were beginning experiments on 20 rhesus monkeys with serum from infantile paralysis patients kept at Willard Parker Hospital, the city's contagious disease hospital on the East River front. Said Dr. Neal: "To the average child there is not the terrible danger connected with infantile paralysis, which many who are uninformed believe exists."*

Infant Mortality. The public health officers heard Dr. Leo Kaufer Frank of the Metropolitan Life Insurance Company say that infant mortality has decreased considerably during the last 25 years. There were only half as many deaths among children during 1926 as during 1900. Babies above one month of age had gained better chances of living. Death on the first day of life had not decreased at all during the last ten years. But deaths of mothers in childbirth had decreased less than 2% a year since 1917. Each year 17,000 mothers and 200,000 babies die.

Mortifying Debts. How debts mortify, Dr. Robert E. Humphreys of the New Jersey Orthopedic Hospital told: "A man buys more than he can pay for. Then he worries about how he is going to meet the payments. He may get injured and his income immediately drops to the amount of compensation he receives. He is then further worried by the regular visits of the collectors to see what is coming to them, and by the time he is well from his injury he is sick from worry." Eating. Dr. Humphreys also supplied a set of 14 rules for sane living--

1) Don't eat when tired.

2) Don't eat when upset by worry or excitement.

3) Don't eat when you are going to do things that are upsetting.

4) Don't stuff when you are hungry.

5) Don't think you need three meals a day.

6) Don't eat hurriedly.

7) Don't drive an automobile immediately after a heavy meal.

8) Don't get into debt too deeply.

9) Don't make your golf or other recreation, work.

10) Don't rush when you know it's bad for you.

11) Don't force a child to eat when he doesn't want to eat.

12) Keep a child out of excitement as much as possible.

13) Don't scold him at meal times.

14) See that he gets plenty of rest.

Food Poison comes from 1) meat of ailing animals, 2) rats and mice, 3) unsanitary packing and handling, said Dr. Edwin Oakes Jordan of the University of Chicago. Source number three was possible, although not proven.

New President. The American Public Health Association chose to succeed Dr. Charles Value Chapin as president, Dr. Herman Niels Bundesen, ablest publicist of all U. S. public health officials. He has been health commissioner of Chicago since 1922, under Mayor Wm. Hale ("Big Bill") Thompson, under Mayor Wm. Emmett Dever, and again under Mayor Thompson. The Chicago Tribune last week called this persistence in office "an unusual record. He has been one of the few owing their position to political appointment in Chicago who have remained in office despite the shifting of administrations."

*To find the cause and cure of infantile paralysis are part purposes of the $1,750,000 Neurological Institute, for the construction of which ground was broken in Manhattan last week. Its general aim is to assault nervous diseases. "One out of 25 of the population of the United States now has or has had a nervous breakdown or some other form of nervous disease," said Dr. Frederick Tilney of Columbia University.