which have been reported to the State Health Officer and which professional care has thereupon been authorized by the state Health Officer; and in such cases the Board will pay a per diem of five dollars for your professional services, or a proportion of that amount for fractional days. When rendering bills for such services Form 221 of the Board should be used and strictly followed in all its details. Unless these requirements are complied with, the Board can make no payment for services nor reimbursements for expenses incurred. It will be found that the form referred to has upon it a Certificate of Claims to be signed by you when rendering your bill for services. This may seem rather strict upon a professional man, but it is not a strict requirement between an officer in charge of work of the Board and the State Health Officer in charge of the disbursement of state funds. It is a matter of business and is required by the State Comptroller and advised by the Attorney of the State Board of Health. Therefore, at the time you report an initial case of a communicable disease, especially smallpox, you should state whether or not you are willing, in accordance with these instructions, to take charge of the situation. If unwilling, and it is not feasible for the State Health Officer to detail one of the field staff of the Board, and if the situation is serious, other arrangements will have to be made for representation at the time. The desirable qualities in a health officer are firmness, decision, self-possession and good judgment, and these, if linked with kindness, attention and carefulness in detail of work, can never fail to inspire confidence, without which a health officer's work will be barren of good results. "Give every man thine ear, but few thy voice," is as excellent advice to a health officer as it was to the son of Polonius. Pay respectful attention to all complaints and listen to all rumors, but be slow to make decision, carefully and calmly weighing all facts. In times of suspicious sickness, at home or abroad, maintain a cool head and calm deportment. Do not yourself, and discourage in your associates in health matters any inclination to, indulge in mysterious nods, whisperings and secret meetings. Such a course inspires distrust instead of confidence, and alarms the timid and nervous. Be frank, truthful and candid with the people and they will show their appreciation of your acts by evincing additional confidence and faith in your ability and authority, and by attending to their business cares, thus per mitting you to discharge yours without annoying and harassing suggestions. Sanitation and hygiene being the co-partners of education, it is necessary, therefore, that the health officer should be a teacher in this line. Every opportunity should be embraced by you to inpress the public and its servants, county officials and the town council with the necessity for cleanliness in cities and benefits to individuals and communities always resulting from the observance of hygienic and sanitary laws. Respectfully, JOSEPH Y. PORTER, EXCERPTS FROM THE 1911 ANNUAL REPORT OF THE CITY BOARD OF HEALTH OF JACKSONVILLE, FLA. DR. CHARLES E. TERRY, CITY HEALTH OFFICER RABIES There has occurred in this city, during the past year, an epidemic of rabies among animals. During the fall and winter of 1910 cases were reported throughout the state, but not until February, 1911, were any cases known to have developed in this city. These earliest cases were reported to the State Board of Health office about the middle of February. A white child, Albert Miller, was bitten by a stray dog and, in about five weeks, developed rabies and died March 16th. The diagnosis was verified on autopsy by Dr. H. Hanson, State Bacteriologist, and inoculation experiments performed by him, with material from this child's brain, developed the disease in two rabbits. Active measures were at once instituted by this department and during March fifteen heads of animals (14 dogs and one monkey) were submitted to the State Laboratory for examination. Thirteen were reported positive and two negative. The existing muzzling ordinance was found to be totally inadequate to the necessity of the occasion and on March 21st the City Council passed Ordinance K-92 "To Regulate and Suppress the Running at Large of Dogs." Following the passage of this ordinance, a large number of dogs were killed and impounded by the City Marshal, his deputies and the Police Department. April showed four positive heads, four doubtful and four negative. About 2,000 dogs, mostly wandering curs, were disposed of during this period. At this time an unfortunate accident occurred, a negro was wounded by a policeman while the latter was trying to kill a dog. This put an end to the shooting of dogs on the streets. The effects of the crusade of extermination were seen, however, in May and June, with only two and three positive heads, respectively. Here again an interruption, in the shape of a municipal election, occurred and the City Marshal lost interest in rabies while searching for votes. The result is shown by six positive heads in July and nine in August. Throughout this epidemic, despite the fact that the public was kept informed of the exact conditions, and in open disregard of the muzzling ordinance, a muzzle has been an uncommon sight, the large majority of all dogs being permitted to run at large unhampered. The result of this negligence on the part of those whose duty it is to enforce this ordinance is shown in detail in Table No. 2. TABLE NO. 2 Animals Reported Rabid and Heads Sent to State Laboratory for Examination, *Note-Four other cases reached the State Laboratory in February but did not pass through this office and are not included in this table. Three deaths from rabies have occurred during the year among human beings, two white and one colored, while seventy-five individuals have been obliged to submit to the discomforts and expense of the Pasteur treatment. This treatment has been furnished by the State Board of Health free to indigent cases and at cost to those able to pay. A short summary may serve to bring out more forcibly some features of the epidemic not shown in the table. Animals which have bitten human beings quarantined and under observation for ten days Animals known to have been bitten by rabid animals killed... ..... Pasteur treatments administered free at this office. 9 Pasteur treatments administered free by Dr. Day, City Physician.. . II Total cost of Pasteur treatments to State Board of Health and to patients able to pay . $1,612.50 Estimated cost to patients for administration when treated by family physician . $1,100.00 Entirely aside from the three lives needlessly sacrificed, from the anguish of mind of those bitten; from the pain, inconvenience and loss of time necessitated by the taking of the Pasteur treatment, the expense alone, borne by the state and the individuals bitten, would appear sufficient to indicate the necessity of a strict enforcement of the dog ordinance. It seems, however, that there are individuals, some private, some official and some editorial, in this community, who, rather than cause their dogs the inconvenience of a muzzle, prefer to see this inexcusable epidemic |