\ l \ UOP/',?/ T ■ , ■ 0 SPECIAL REPORTS AND COMMUNICATIONS TO THE MICHIGAN STATE BOARD OF HEALTH, RELATIVE TO Communicable and Preventable Diseases. [Reprinted from the Sixth Annual Report of the Michigan State Board of Health, for the year 1878.1 \ SPECIAL REPORTS AND COMMUNICATIONS TO THIS BOARD. Daring the year, communications have been received from health officers, from regular correspondents, and from others, containing valuable statements of facts and important considerations, bearing upon different subjects con- nected with public health. Some of them have been referred to the different committees of the Board, and appear in other parts of this volume ; some have been referred to the Secretary, with authority to publish ; while time has not been found, during the limited sessions of the Board, to present, at length, all communications of this class that have been received. A report of the work of the Board would not be complete without some mention of these com- munications, and a few of those not otherwise disposed of are believed to be of such value as to make it desirable that they be included herewith. Those selected for publication are the following : CASES OF TYPHOID FEVER ATTRIBUTED TO EMANATIONS FROM AN IMPERFECT DRAIN, — REPORT MADE BY JAMES HUESTON, M. D., TO DR. J. M. SWIFT, HEALTH OFFICER OF NORTHVILLE, AND BY HIM TRANSMITTED TO THIS BOARD. Dear Doctor:— In compliance with the law for reporting cases endangering pub- lic health, I might report some cases of diphtheria, scarlet fever, and typhoid fever, hut none under unusual circumstances, or in which my report would differ from hun- dreds of others, excepting the cases of typhoid fever occurring in one family where the local causes were or seem to be poison emanating from an imperfect drain. Eight feet from a new house a hole was dug and filled with small stones; a ditch, also filled with small stones, inclosing a five-inch tile not below freezing depth, led from this to the house. This communicated to the kitchen by means of an open box leading through the floor, and thence through the side wall. Last winter the contents of this drain were entirely frozen, and slops of all kinds were thrown in, filling the parts above stone, tile, and all. In the spring when the frost was out, it did not clear itself; and ©n the whole being removed, the tile and spaces were found filled withfilth andrichwith fever-producing poison, — but discovered too late, as it had nearly cost the life of every member of the household: First, Rev. G. A., wife, and son; next, Prof. K., a music teacher; then a strong woman who was placed in the kitchen to do housework; and after her a more delicate woman who took her place,— each in turn falling victims, all having marked symptoms of typhoid fever of a very low type. None of them entirely recovered until they left the house. These, and similar cases, seem to teach that a law compelling every builder to call a competent health officer to decide how the drains, cesspools, etc., should be located would be as rational as to report after the victims are slain. Northville , Jan. 24 , 1878. JAMES HUESTON. V / lx STATE BOARD OF HEALTH— EEPOKT OF SECRETAKY, 1878. CASES OF SICKNESS AND DEATH ATTRIBUTED TO USE OF WATER CONTAMINATED BY LEAKAGE FROM A SLOPDRAIN, REPORTED BY GEORGE CHAPMAN, M. D., HUDSON, MICH. Secretary State Board of Health: Sir: — Enclosed find a hastily written history of facts respecting cases of paludal or malarial poison. It adds another example to the records of carelessness and ignor- ance. Our people are waking up to the subject; they are clearing out the gutters and waste places, and otherwise trying to avoid sickness. January 1, 1876, at 3 o’clock P. M., I was called to see F. B. I learned from himself that he had been taken the day previous, about dark, with a severe chill; had had chills and fever, with profuse sweating, all night; had taken six Cheeseman’s pills and 10 grains sulphate of quinine. The pills had “operated most too much.” I found him in a bad condition, — pulse full and bounding at SO; extremities cool; head hot and feeling as though it would burst; face flushed; eyes bloodshot; tongue covered with white fur, and dry; he had a feeling of tightness in the chest. I diagnosed paludal poison, and treated accordingly; but all to no purpose. He died on the 4th day. Mr. B. was a merchant, apparently a stout, healthy man; his height was 5% ft.; weight, 180 lbs.; age, 35 years. He was very temperate and moral; always at home or at store; ate regularly and heartily; was early to bed and earl y to rise; bathed often. He drank cold water only, of which “his well furnished the" best and most of any in town.” I inclose a rough sketch of the premises. Outline of premises of F. B. B., Hudson, Mich. Street. Parlor. Family Bed-room. Sitting-Room. Pantry. | Sink. Kitchen. Wood. Plank Drain, 1 foot square. W ' O Well. Barn. * Waste water, etc., from the sink, t Drain for waste water from well. Mrs. B., a stout woman aged 33 years, was sick with the same'fever, in milder form, at the time I was called; but was soon convalescent. The shock produced by the death of her husband induced brain fever, and she died in 4 days. Of the children, one young ladj% aged 17 years, had been puny and sick with “liver complaint” nearly a year; two others, aged 9 and 5, were sick most of the time with SPECIAL REPORTS AND COMMUNICATIONS. lxi ague and “bilious colic.” But on removal from the premises, all recovered and are now healthy and strong. The September previous B. brought a fine parrot from Chicago. It was taken sick;; had chills and all the symptoms of malarial fever. A canary bird, also, was taken sick with the same fever; but on removal to a neighbor’s, both recovered afid were happy. Mrs. B. was a pattern of neatness and boasted sanitary hygiene. She bathed often, aired the house well, had thermometers around to keep the temperature even day and night, always had windows dropped from the top, especially the one in the fam- ily bed-room. The drain, shown in the diagram, was built two years previously to the fatal sick- ness; but the summer previous, Mr. B. had noticed that the slops and waste-water, which were all poured out of the sink, were not running otf but were soaking into the ground, a gravelly soil, the drain being filled up; and he was going to fix it in the spring. The family were broken up; and another family wishing to move in, I told them they must not till a thorough examination was made of well, drains, etc. On at- tempting to pump the water out of the well, which was 10 feet deep in a 30-foot well,, they soon found out that they were making no headway. They took up the drain leading from the well to the street, and so great was the stench that the men were all sick. A current was found leading down from the drain directly into the well, at a considerable depth from the surface. Under the woodhouse and kitchen beautiful mold and dampness covered the ground and walls like frost. We had the whole premises renovated, and there has been no sickness of that sort in or around the neighborhood since. Yours respectfully, Hudson , Lenawee Co ., April 11, 1878. GEORGE CHAPMAN. October 19, 18??, the board of health of Homer township, Calhoun county, — A. M. Allen, Health Officer, — reported an instance of apparent communication of typhoid fever by the person of one sick with it, as follows : “John Windover, aged 23, died of typhoid fever, October 19, 1877. The source of contagion was bad water. He was removed to his father’s residence, and three more of his father’s family were taken sick with the same disease and recovered after a long spell of sickness.” August 16, 18??, Dr. John Tatman, Health Officer of Muskegon, wrote: “Our healthfulness the last few years we attribute to the water in the lake and river keeping up high through the season. If the weather continues dry through this month and September, we will have a great amount of malarious diseases, as the lake is one foot lower now than for the last few years.” November 5, 187?, Dr. Tatman wrote: “We have had very little sickness here the last few years, in comparison with former years; we have had no epidemics, or contagious diseases, this summer; we have had a few mild cases, perhaps one hundred all told, of malarious fevers, inter- mittent, that were easily subdued by treatment.” OUTBREAK OF SMALL-POX IN LE ROY, INGHAM COUNTY; REPORTED BY R. B. SMITH,. M. D., HEALTH OFFICER. Secretary of the State Board of Health : Dear Sir: — Below you will please find report of seven cases of variola in this- vicinity during the month of June. The first case was that of Chauncy Beckwith, aged 18 years. He had been at work on a gravel train, a couple of weeks, at Portland, Mich. He came home June 1, and was taken sick immediately. As soon as we ascertained that we had small-pox to contend with we vaccinated the rest of the family, but too late to prevent their contracting the disease; I also at once notified the township clerk, who called a meeting of the board of health to- Ixii STATE BOARD OF HEALTH— REPORT OF SECRETARY, 1878. to take some action in regard to the matter. A house about three-fourths of a mile from the village was procured, which was converted into a pest-house, where we removed the patients as fast as they were taken sick, and also the clothing and fur- niture belonging to them. Notices were posted on both houses, and at some dis- tance from them, and all persons not needed for nurses were forbidden to enter into or go near either house. Before we were aware of the nature of the disease, there were a number of exposures to the contagion, and they were also notified to remain on their own premises for the period of twenty days. There has been no case of the disease, however, outside of the family where it first broke out; and we hope that by using care in renovating and disinfecting the house and contents, and by keeping the persons who have had the disease at a proper distance, for a couple of weeks yet, to prevent any further spread of the disease in this vicinity. Any information that you may be able to give us in regard to thorough disinfection will be thankfully received. Yours, very respectfully, Le Roy, Ingham Co ., June 10, 1878. R. B. SMITH, M. D., Health Officer. June 6, 1878, William Simonds, M. D., Health Officer of Warren township, Macomb county, reported details of 23 cases of small-pox, occurring from February 1 to May 14, 1877. In some of the cases the disease was derived from clothing from the city ; in some, from the paper-mill. Of the 23 cases, 7 died. OUTBREAKS OF SCARLET FEVER. November 12, 1877, Dr. Wm. P. Maiden, of Alpena, wrote, concerning an outbreak of scarlet fever : “The house was well disinfected with sulphurous acid, and was daily ventilated. Every precaution was used by myself and the family to prevent the spread of the disease, and I trust we have succeeded.” In December, 1877, L. D. Knowles, M. D., Health Officer of Pine drove township, Van Buren county, reported details of 14 cases of scarlet fever, occurring from July 23 to September 27, 1877. The disease was introduced by some one who had been visiting in the eastern part of the State. AN OUTBREAK OF SCARLET FEVER IN MICHIGAMME TOWNSHIP, MARQUETTE COUNTY. AND STATEMENT OF MEASURES TAKEN BY THE LOCAL BOARD OF HEALTH FOR THE RESTRICTION OF THE DISEASE, REPORTED BY JOHN R. CURLEY, CLERK. Secretary State Board of Health : Dear Sir:— I herewith report to you the occurrence of scarlet fever in this town- ship, and the methods we have taken to check the spread of the disease. The first case reported to me was the child James Hayes, aged about five years. It was reported on the 10th day of June, by Dr. Jos. Vandeventer, health officer of the township, as a mild case of scarlet fever. On the 12th, another case was reported, the child of Richard Hackett. I asked the doctor to examine the locality and report if any thing could be done by the board. He did so, and reported that the locality was good in regard to sanitary condition, and that the children reported above were convalescing. So the matter stood until the morning of the ISth, when another case was reported, that of Ann Dolan, 10 years old, who died this morning. To-day two more cases are reported; one in the family of Cornelius Shea, and one in the family of John Shea. On hearing of these new cases, I immediately called our board of health in session to devise some means to stop the spread of the disease. We have had notices printed, of which I send you a copy, besides posting notices of the dis- ease over the doors of the affected buildings. We have also caused all dogs to be tied up, under penalty of being shot. We have also closed our schools. It seems to me that the disease is now at its height. If there is any suggestion you can give us in regard to the restriction of the disease, it will be thankfully received and acted upon. Respectfully yours, Michigamme, Marquette Co., June 20, 1878. JOHN R. CURLEY, Clerk of Board of Health. SPECIAL EE PORTS AND COMMUNICATIONS. Ixiii Copies of the document issued by this Board on the Restriction and Preven- tion of Scarlet Fever (pages xxix-xxxii of the Fifth Annual Report) and of Circulars 25 and 28 (pages xxiii.-xxxiii. of this Report), and also a caution as to the dissemination of the disease by clothing of patients after their recovery, were immediately sent to Mr. Curley. June 25, 1878, Mr. Curley wrote : — “ Dear Sir Yours of the 22d is at hand ; thanks for promptness. The scarlet fever epidemic has not abated yet, but we have managed to confine it to one locality. A death took place Saturday, June 22, a child of John Harrington, aged 10 years, sick three days. As I am now writing this, the health officer, Dr. Yandeventer, just informs me that another death has taken place in the same familjq a girl aged 9 years. We have taken steps this evening to rent a house in an isolated part of the village, and remove the remainder of the family into it. The citizens have given by private subscription enough to procure changes of clothes for the entire family, which consists yet of 9 persons. We have given orders to have all the bedding and clothes of the infected house burned, and we also prohibit children from going within a radius of 300 feet of the infected locality. The other cases mentioned in my last letter are convalescing and in a fair way to recover. “I shall keep you fully posted as to our movements. We are so fortunate as to have for our health officer an efficient and skillful physician, Dr. Jos. Yandeventer, to whose untiring energy we are greatly indebted. I should like to be informed whether in a case like ours it does not become a county charge for the expense incurred, as we have no fund in our township that applies to that purpose. Please give us your advice on this subject. We are determined to root out the disease, though, no matter who pays for it. Respectfully yours, Michigamme, June 25, 1878. ~ JOHN R. CURLEY, Clerk of Board of Healthy In reply to the above inquiry, a copy of the compilation of Public Health Laws and a copy of the compilation of Laws Relating to the Support of Poor Persons were obtained from the State Department and sent. June 29, 1878, Mr. Curley wrote: “I am happy to inform you that the scarlet fever has abated, as there is no new case.” PERIOD OF INCUBATION IN DIPHTHERIA. Referring to the outbreak of diphtheria in Clarkston, reported by him (pages 81-83), Dr. J. S. Caulkins of Thornville, wrote, Oct. 6, 1878 : “Notice the strong probability that in Keillor’s case (mentioned on page 83), the incubatory stage was but -24 hours. There are several good physicians at Oxford, and at Orion, three miles south, careful inquiry among whom shows no other even remotely probable source of the infection. The inference is irresistible that he caught the disease at Bailey’s.”