Cases of Infectious Diseases Reported for Week Ending July 24, 1915.

172 Cerebro Spinal) Meningitis..

18. Apoplexy, Softening of the Brain

19. Organic Heart

Diseases........

20. Acute Bronchitis.. 21. Chronic Bronchitis. 22 Pneumonia (excluding Broncho Pneumonia)......

22a. Broncho Pneumonia 23. Other

Entered as Second-class Matter May 7, 1913, at the Post-Office, at New York, N. Y.,
Under Act of August 24, 1912.

NEW SERIES, VOL. IV.

AUGUST 7, 1915.

ALCOHOL A POOR KIND OF FOOD.

No. 32

The question as to whether alcohol is, in any sense, a food, has given rise to much heated controversy. Much of this has been unscientific and partisan and has arisen from a loose use of the term "food." It may not be amiss to remind our readers that there are two great classes of foods, those which serve mainly or wholly as fuel, i. e., supply heat and energy, and those which serve largely to reconstruct worn-out tissue or to build new tissue (as in growth). Chief among the fuel foods are sugars and starches and fats; chief among the tissue-building foods are proteins and mineral salts.

Physiologists are agreed that moderate quantities of alcohol taken into the body in diluted form, are completely burned, just as sugar is burned. In this process, it undoubtedly serves as a source of heat and it is probable that under these conditions it can also serve as a source of mechanical energy.

On the other hand, alcohol differs from other fuel foods, such as the sugars, starches, and fats, by not lending itself to storage in the body. Even though physiologists regard alcohol as, under certain conditions, a food, we should be careful to note that they do not class alcohol as at all equal to the other fuel foods mentioned. But this is not all. Not only does alcohol lack certain valuable properties possessed by other fuel foods. but it possesses injurious qualities in so high a degree as to make its intemperate use the greatest single menace to health known. The injurious qualities are (a) the toxic effect on the body tissues, (b) the habit-forming character of alcoholic indulgence.

Inasmuch as small amounts of alcohol, taken into the body are rapidly oxidized, i. e.. completely burned up, the claim has been made that under these conditions, alcohol is without toxic effect on the body tissues. That it does injure these tissues, even when taken in moderation, is indicated by studies conducted by various life insurance companies, to which reference has been made in previous numbers of the BULLETIN. Unlike the observations by physiologists on relatively small numbers of individuals, the figures collected by the insurance companies are derived from an analysis of the life histories of millions of persons.

The habit-forming properties of alcohol are so well known that further comment on this phase of the alcohol problem is unnecessary.

Altogether, the conclusion is inevitable that though technically, physiologists are correct in classing alcohol under certain conditions as a food, practically, the consumption of alcohol, even in moderate quantities, constitutes a grave menace to health. As Woods Hutchinson has well said "Alcohol as a food is a joke, and rather a bad joke at that."

66

SUBWAY RESULTS.

'Sky-rockets and Roman-candles" was the comment of a cynical observer when the Department of Health, early in April, announced its subway policy. Recent evidence shows that the particular variety of sky-rocket which the Department uses is peculiar in its power of sustained flight.

On April 17th, in a presentation of his views on the subway question, the Commissioner of Health said:

"What we propose to do is to persuade the Company, if we can, and to compel it if we must, to maintain its winter schedule throughout the summer. Any attempt to reduce the number of trains or the number of cars below the number operated during the winter will be regarded as a deliberate act on the part of the Company tending to create or to aggravate a nuisance. The method which will be followed for the purpose of preventing this will be one which will enable the City to collect so many fines for the violation of our orders that the Company, which is usually discreet and businesslike in such a situation, will probably think it worth while to comply with our demands. The problem is a practical one, and we are approaching it in a way which will appeal to practical men.

"From now on, Department inspectors will keep the subway service under constant observation, and the Department believes that it can promise a mite of comfort to subway passengers, at least during the summer season."

In order to carry out this policy, the Board of Health, at a meeting held on May 7th, adopted the following order:

"That the carrying of passengers on the cars running on the subway lines in the City of New York, operated and controlled by the Interborough Rapid Transit Company, be so regulated that the total number of passengers on any such car at any time shall not exceed one and one-half times the seating capacity of the car, except when, by employing the maximum number of trains and cars which can, with safety to the passengers, and with practical service efficiency be run on such lines, it becomes necessary to permit the number of passengers on any such car to exceed one and one-half times the seating capacity of the car, at all of which latter times, you are hereby ordered to so regulate the carrying of passengers on the cars running on such lines that the total number of passengers on any such car shall not exceed one and one-half times the seating capacity of the car to any greater extent than is rendered necessary upon employing the said maximum number of trains and cars."

Mr. Theodore P. Shonts, President of the Interborough Rapid Transit Company, has courteously supplied official figures showing the number of passengers who have used the subway during the past year, month by month. These figures are as follows July, 1914

Aug.

Sept.

Oct.

Νον.

Dec.

Jan., 1915

Feb.

March

April

24,120,915

22,900.952

25,347,116

30,359,765

29,868,262

32,349,796

29.985.268

28,851,887

32.678,729

30.947,807

30,726,791

27,448,461

May
June

In March the traffic attained its maximum. In April it was still high, but in June. summer conditions had already asserted themselves, and judging by last year's official figures, July and August will show a further diminution in the number of passengers using the subway. In the meantime, Department inspectors have been at work in the subway constantly, and their observations show that the Interborough Rapid Transit Company has continued uninterruptedly the use of its full winter complement of trains There is still overcrowding, of course, but there has been a very decided relative improvement.

and cars.

A comparison of the number of cars in service during rush hours on April 10th and July 14th, considered in connection with the official passenger counts, indicates that the order of the Board of Health is being complied with. The business judgment of

the Interborough Rapid Transit Company is thus vindicated. The figures given below are based upon observations made by the Department inspectors at the following stations: Brooklyn Bridge, 14th street, 72d street, 18th street, 33d street.

WHERE TO SEND SPINAL FLUID FOR EXAMINATION.

In order to avoid harmful delay in the examination of specimens of spinal fluid, physicians should send them direct to Dr. Josephine Neal, Research Laboratory, foot of East 16th Street, Manhattan. When specimens are sent to the Diagnosis Laboratory, a delay of some twenty-four hours frequently occurs.

BOOK AGENT CLAIMS TO BE HEALTH DEPARTMENT NURSE. Physicians are warned to be on the lookout for a wily woman book agent who secures her introduction into homes where there is a case of contagious disease by representing herself to be from the Department of Health. In an instance reported to us by a physician in Brooklyn, the mother of a child ill with measles was visited by a woman who said that she came from the Board of Health, had received word of the case and had called to tell what to do in such cases. With this the visitor brought out a book on health and disease. Under the belief that this woman was from the Health Department and that the publication she represented was sanctioned by it, the mother was induced to sign her name to a blank and pay one dollar down. After a while she began to realize that she was contracting to buy a book which was to be paid for twenty-five cents a week for many months. She thereupon demanded her money back, which was refused, the woman departing saying that the book would be sent the following Monday. The receipt she left tells of a book on health and disease in which people are taught how to get along without doctors by treating their own families according to the prescriptions therein. The book is to cost twelve dollars, and there is no address on the blank.

Almost needless to say, the Department of Health is not promoting the sale of any such book. On the contrary, it is glad to send, free of charge to all who ask, carefully written circulars of information regarding almost all matters of public health, including, of course, special leaflets on the various contagious diseases.

EFFECTIVE CO-OPERATION IN LOCAL HEALTH ADMINISTRATION.

The experimental health district, known as Health District No. 1, and comprising the area between Pike, Clinton, Division Streets and the East River, with Headquarters at 206 Madison Street, has now been in operation for about six months. During that time it has demonstrated the feasibility of local health administration, for which purpose it was organized by Commissioner Goldwater. The experiment has been carried along two lines: (1) The perfection of methods for combining the functions of the various bureaus and administering them in conformity with local needs, and (2) The co-operation and utilization of all existing local agencies for the improvement of local health conditions.

The first of these is an accomplished fact, and the work of the Bureaus of Child Hygiene, Preventable Diseases, Sanitary Inspection, Food Inspection and Public Health Education, is now being locally administered very satisfactorily. To accomplish this, a new registration and filing system, as well as a new method of reporting the work of the employees has been installed. A technical description of this system is omitted at this time, because that would exceed the purpose of this article. In all other work done, great stress has been laid upon the development of the community spirit and in arousing in the people themselves, a desire for co-operation in the work undertaken in their behalf, and for that purpose, visits, consultations and conferences at the Health District headquarters, have been constantly fostered. To fully realize the work that has been done along these lines, a brief resumé is herewith given :

Lectures.

The people of this district being practically all Hebrews, a great many unable to speak English, a course of lectures on selected health subjects has been given in Yiddish at the Educational Alliance Building, with an average attendance of over four hundred at each lecture. The size of the audience and the interest displayed, have fully justified such a course.

Boys' Health League.

In order to fully develop in the younger generation a sense of responsibility for local health conditions a "Boys' Health League" has been formed upon a military basis, with a captain and three lieutenants in charge of a square block, these in turn, placing one boy in charge of a house, the whole district thus being effectively covered. This League has its own elected officers, and is supervised by one of the school teachers who is the executive director and by the Medical School Inspector, who acts as the medical director. This organization is being used to take a periodical census of the district, to distribute the monthly bulletin and other literature and will co-operate in every way with all City departments that can be utilized for the improvement of local health conditions, each department in turn, delivering to the League, short talks on the subject of co-operation with their respective departments. These boys all belong to the 7th and 8th grades of Public School No. 62, so that the benefits of graduating yearly a class of "Health League" boys is very manifest. The formation of an Alumni of "Boys' Health League" is the next logical step.

Conferences With Storekeepers.

A new method of dealing with those who handle and sell food has been introduced. Conferences with various groups of storekeepers are being held for the purpose of instructing them in regulations relating to their business. A Food Inspector gives them a short talk in their own language and answers the questions which they are encouraged to ask. The success of these conferences can best be judged by an attendance of sixty out of a possible seventy-five ice cream and candy store keepers, and forty-five out of a possible sixty butchers. Hand in hand with this there has been a reduction in the number of violations found and summonses issued.