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THE  LIBRARIES 
COLUMBIA  UNIVERSITY 


HEALTH  SCIENCES 
LIBRARY 


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Digitized  by  tine  Internet  Arcinive 

in  2010  with  funding  from 
Columbia  University  Libraries 


http://www.archive.org/details/annualreportofbo1916newy 


,*  '   .■^  :       ■  .  •;';-,.; 


ANNUAL  REPORT 


DEPARTMENT  OF  HEALTH 


THE  CITY  OF  NEW  YORK 


CALENDAR   YEAR,   1916 


NEW  YORK  CITY 


,  v^  \ 


f'^ 


CHART  VIII. 


OCATM  RATE  or  IMWMT8  UNOCT  ONC  YtAR  OFACE  FOR  1000  BIRTHS  BEPORTEO 
rROM  COHOtMlTAL-nESPiRATORY-DIABRHOCA-CONTACIOUS  DISEASES  AND  Aa  OTHE«  CAUSES 


OOP    1901    190f  1903   1904  190?  1906   1907  1908  1909   1910  1911     l91g    1313    1914  1913  1916 


The  uppermost  line  of  this  chart  represents  the  yearly  death  rate  from  all  causes  under  one 
year.  The  rate  of  each  of  the  principal  disease  groups  is  shown  as  a  part  of  the  whole  rate;  and 
the  rate  of  each  group  taken  separately  is  stated  in  the  first  and  last  columns.  Because  regis- 
tration was  not  sufficiently  complete  prior  to  1908  the  rates  for  the  earlier  years  have  been 
computed  upon  the  estimated  population  under  one  year.  In  the  later  years,  however,  tbe 
rates  have  been  computed  upon  the  number  of  births  reported. 


ANNUAL  REPORT 


DEPARTMENT  OF  HEALTH 


THE   CITY  OF  NEW  YORK 


CALENDAR   YEAR,    1916 


NEW  YORK  CITY 
19  17 


25-5007-17-B 


New  York,  January  31,  1917. 


Hon.  John  Purroy  Mitchel, 

Mavor  of  the  Citv  of  New  York. 


Sir:  On  behalf  of  the  Board  of  Health,  I  have  the  honor  to  transmit  herewith, 
as  required  by  Section  1168  of  the  Charter  of  the  City  of  New  York,  a  report  of  all 
the  operations  of  the  Department  of  Health  of  the  City  of  New  York,  for  the  year 
ended  December  31,  1916. 

Respectfully, 

HAVEN  EMERSON,  M.  D., 

Commissioner   of    Health. 


13 


BOARD  OF   HEALTH. 


Covimissioncr  of  Health  and  President  of  the  Board. 
HAVEN  EMERSON,  M.  D. 

Health  Offiecr  of  the  Port. 
LELAND  E.  COFER,  M.  D. 

Poliee  Cotnmissioner. 
ARTHUR  WOODS. 


14 


HONORARY   AND    CONSULTING    OFFICERS. 


Medical  Advisory  Board. 


HERMAXX  M.  BIGGS,  M.  D. 
JOHN   WINTERS  BRANNAN,  M.  D. 
GLEXTWORTH  R.  BUTLER,  M.  D. 
SIMON  FLEXNER,  M.  D. 
L.  EMMETT  HOLT,  M.  D. 


ABRAHAM  JACOB!,  M.  D. 
WALTER  B.  JAMES,  M.  D. 
WILLIAM   M.   POLK,  M.  D. 
T.  MITCHELL  PRUDDEN,  M.  D. 
FRANCIS  CARTER  WOOD,  M.  D. 


Honorary  CoiisuUauts. 

CHARLES   F.   CHANDLER,   PH.   D.     .  Consulting  Sanitarian. 

DAXIEL    DRAPER,    PH.    D.     .      .     .  Consulting  Meteorologist. 

SIMON   FLEXXER,  M.  D Consulting  Pathologist. 

GEORGE   HEXRY   FOX.    M.    D.     .      .  Consulting  Dermatologist. 

ROGER  S.  TRACY,  M.  D Consulting  Statistician. 


MEDICAL  BOARD   OF  THE  WILLARD   PARKER  AND   RIVER- 
SIDE   HOSPITALS. 

JOHN  WINTERS  BRANNAN,  M.  D.       President. 
HENRY  W.   BERG,  M.  D Secretary. 


Visiting   and   Consulting 
HENRY  W.  BERG,  M.  D. 
ARTHUR  W.  BINGHAM,  M.  D. 
WILLIAM  H.  BOESE,  M.  D. 
JOHN  WINTERS  BRANNAN,  M.  D. 
ARTHUR  CILLEY,  M.  D. 
RUFUS  P.  COLE,  M.  D. 
ARTHUR  B.  DUEL,  M.  D. 
LOUIS   FISCHER,   M.   D. 
EDWARD  D.  FISHER,  M.  D. 
HOWARD   FOX,  M.   D. 
JAMES  T.  GWATHMEY,  M.  D. 
ROYAL  S.  HAYNES,  M.  D. 
ALFRED  F.  HESS,  M.  D. 
PHILIP  D.  KERRISON,  M.  D. 
S.  ADOLPHUS  KNOPF,  M.  D. 
ELI  LONG,  M.  D. 
HENRY  L.  LYNAH,  M.  D. 


Physicians  and  Surgeons. 
MATTHIAS  NICOLL,  Jr.,  M.  D. 
WILLIAM  P.  NORTHRUP,  M.  D. 
J.  J.  NUTT,  M.  D. 
WILLIAM  H.  PARK,  M.  D. 
GODFREY  R.  PISEK,  M.  D. 
WILLIAM  JOSEPH  PULLEY,  M.  D. 
JOHN  B.  RAE,  M.  D. 
HENRY  S.  SATTERLEE,  M.  D. 
DOUGLAS   SYMMERS,   M.   D. 
THOMAS  ALLISON  SMITH,  M.  D 
WILLIAM  E.  STUDDIFORD,  M.  D. 
ALBERT  T.  SWAN,  M.  D. 
PHILIP  VAN   INGEN,  M.  D. 
BERTRAM  H.  WATERS,  M.  D. 
JOSEPH  E.  WINTERS,  M.  D. 
HERBERT  W.  WOOTTON,  M.  D. 


MEDICAL  BOARD  KINGSTON  AVENUE  HOSPITAL. 

ELIAS   H.   BARTLEY,   M.  D.     .      .      .       President. 
EUGENE  S.  DALTON,  M.  D.     .      .      .       Secretary. 


Visiting  and  Consulting 
LEWIS   P.  ADDOMS,   M.  D. 
LOUIS   C.   ACER,  M.   D. 
ELIAS  H.  BARTLEY,  M.  D. 
EDWIN  M.   BEERY,  M.  D. 
FRANK  E.  BROWN,  M.  D. 
GLENTWORTH  R.  BUTLER,  M.  D. 
EUGENE  S.  DALTON,  M.  D. 
H.  BEEKMAN  DELATOUR,  M.  D. 
WARREN  L.  DUFFIELD,  M.  D. 
SAAIUEL  FELDSTEIN,  M.  D. 
JACOB  FUHS,  M.  D. 
0.  PAUL  HUMPTSTONE,  ^I.  D. 
HARTWIG  KANDT.  M.   D. 
JOHN  A.  LEE,  M.  D. 


Physicians  and  Surgeons. 
WALTER  D.  LUDLUM.  M:  D. 
HENRY  L.  LYNAH,  M.  D. 
GEORGE  A.  MERRILL,  M.  D. 
LEFFERTS  A.  McCLELLAND,  M.  D. 
THOAIAS  A.  McGOLDRICK,  M.  D. 
H.  L.  RATNOFF.  AI.  D. 
ALEXANDER  SPINGARN,   M.   D. 
GUSTAVE  STRACK,  M.  D. 
BINFORD  THRONE,  M.  D. 
WALTER  TRUSLOW,  M.  D. 
J.  M.  WALLFIELD,  M.  D. 
JAMES      McFARLAND      WINFIELD, 
M.  D. 


QUEENSBORO    HOSPITAL. 

Visiting  and  Consulting  Physicians  and  Surgeons. 

SAMUEL  P.   BRUSH,  M.  D.  ELIOT   SHIPMEN,  M.  D. 

THOMAS    CLARKE    CHALMERS,  M.     W.  C.  A.  STEFFEN,  M.  D. 

D.  WILLIAM   METCALFE   STONE,  M.  D. 

HENRY  C.   COURTEN,   M.  D.  CHARLES  B.  STORY,  M.  D. 

NORMAN  C.  GOODWIN,  M.  D.  HENRY  LING  TAYLOR,  M.  D. 

MORTON  M.  KITTELL,  M.  D.  FRED  B.  TILNEY,  M.  D. 
J.  HOWARD  MOSS,  M.  D. 

16 


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EXECUTIVE  STAFF. 


Commissioner. 
Deputy   Commissioner. 

Secretary   to  the  Commissioner. 


HAVEN  EMERSON,  M.  D 

JOHN  S.  BILLINGS,  M.  D 

FLOYD  W.  FISKE  (Jan.-July)      •     ■      ■{ 

HUGH  M.   FOSTER    (July-Dec.)       .      .\ 

EUGENE  W.  SCHEFFER  ( Jan.-June) .  Secretary  of  the  Department  and  Direc- 
tor, Bureau  of  General  Adniinistration. 

ALFRED    E.    SHIPLEY,    M.    D.     (July     Acting  Secretary  of  the  Department  and 

to  Dec.) Acting    Director,    Bureau    of    General 

Adniinistration. 

ALONZO  BLAUVELT,  M.  D Assistant  and  Acting  Sanitary  Superin- 
tendent. 

WILLIAM    H.    GUILFOY,    M.    D.     .     .     Director,  Bureau   of  Records. 

S.    JOSEPHINE    BAKER,    M.    D.     .      .     Director,  Bureau   of  Child  Hygiene. 

BERTRAM    H.    WATERS,   M.   D.     .      .     Acting   Director,   Bureau    of  Preventable 

Diseases. 

LUCIUS    P.    BROWN Director,  Bureau  of  Food  and  Drugs. 

ROBERT   J.    WILSON,    M.    D.     .      .      .     Director,  Bureau   of  Hospitals. 

CHARLES  F.  BOLDUAN,  M.  D.  .  .  Director,  Bureau  of  Public  Health  Edu- 
cation. 

WILLIAM  H.  PARK,  M.  D Director,  Bureau   of  Laboratories. 


EMPLOYES. 


Bureau. 

Physi- 
cians. 

Nurses. 

Labora- 

TORIANS. 

Inspec- 
tors. 

Clerks. 

Others. 

Total. 

General  Administration .  .  . 
Sanitary 

3 

10 

12 

176 

174 

64 
3 
9 

329 
225 

152 

2 

17 
2 

111 

7 
61 

i 

127 
1 

1 

78 
19 
25 
30 
51 
22 
26 
5 
15 

155 
77 
14 

104 

107 
21' 

720 
1 

110 

245 
167 

Records 

Child  Hygiene 

Preventable  Diseases 

Food  and  Drugs 

51 
639 
558 
187 

Hospitals 

Public  Health  Education.  . 
Laboratories 

965 

9 

266 

Total 

451 

706 

152 

198 

271 

1,309 

3,087 

18 


REPORT  OF  THE  DEPARTMENT  OF  HEALTH,  CITY  OF 
NEW  YORK,  FOR  THE  YEAR  1916. 

INTRODUCTION. 

In  addition  to  the  transaction  of  the  routine  business  required  by  the  Charter, 
the  Board  of  Health  found  it  necessary  during  1916  to  add  to  or  amend  the  Sanitary 
Code  in  respect  to  the  following  matters  pertaining  to  public  health. 

CvANiDE  Fumigation  Prohibited. 

Owing  to  dangers  and  abuse  of  the  modern  commercial  method  of  fumigating 
premises  to  rid  them  of  vermin,  the  employment  of  cyanide  for  this  purpose  was  for- 
bidden, except  at  the   discretion  of  the  Board.      (Section   104.) 

Protecting   Public  Food   Supply. 

Extending  the  valuable  principle  of  protecting  the  city  food  supply  from  con- 
tamination, it  was  found  necessary  to  forbid  the  employment  of  persons  suffering 
from  infectious  or  venereal  diseases  in  places  where  food  is  prepared  or  handled. 
(Section  146.)  A  further  provision  with  the  same  object  in  view  requires  the  proper 
cleansing  of  cooking,  eating  and  drinking  utensils  after  being  used.     (Section  144.) 

After  careful  analysis  of  ice  cream  products  and  full  consideration  of  the  matter 
with  representatives  of  the  trade,  regulations  were  established  which  have  made  it 
possible  to  exclude  from  public  sale  and  use  much  inferior  and  contaminated  food. 
(Section  170.) 

A  much  needed  regulation  now  requires  the  tuberculin  testing  of  all  cows  brought 
into  New  York  City.     (Section  13.) 

Control  of  B.\thing  Establishments. 

A  new  industry  in  the  form  of  so-called  "  bathing  establishments,"  but  without 
shore  front  property  or  responsibilities,  was,  at  the  request  of  the  Board  of  Alder- 
men, brought  under  control  in  the  interest  of  public  decency  and  the  prevention  of 
communicable   disease.      (Section   340.) 

Sanitary  Control  of  Traffic  Conveyances. 

Various  bacteria,  particularly  pneumococcus,  streptococcus,  influenza  bacilli, 
tubercle  bacilli  and  diphtheria  bacilli,  are  generally  spread  directly  from  person  to 
person  during  ordinary  social  intercourse.  These  pathogenic  organisms  commonly 
cause  acute  infections  of  the  upper  respiratory  tract  and  of  the  lungs.  The  present 
regulation  of  the  sanitary  environment  of  public  assemblages  and  of  all  premises 
where  people  gather  within  confined  spaces  for  living,  working,  recreation,  etc.,  is 
based  upon  this  sound  and  fundamental  principle -of  the  obvious  and  demonstrated 
method  of  transmission  of  preventable  diseases.  The  workshops,  the  theatres,  dance 
halls  and  all  variety  of  places  of  assembly  in  fixed  premises  in  this  City  are  controlled 
to  some  degree  as  to  their  cleanliness,  light,  heat,  ventilation,  and  number  of  occu- 
pants by  provisions  of  the  Sanitary  Code.  The  owners  or  operators  of  such  premises 
recognize  and  accept  the  jurisdiction  and  regulations  at  present  demanded. 

There  is  no  difference,  from  the  point  of  view  of  sanitary  control  of  preventable 
and  communicable  forms  of  respiratory  disease,  between  the  risks  to  which  the  public 

19 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

is  exposed  in  movable  places  of  public  assembly,  such  as  public  traffic  conveyances, 
and  the  risks  from  which  they  are  now  in  a  measure  protected  in  fixed  premises. 

The  conditions  of  traffic  in  New  York  City  have  for  many  years  been  a  matter  of 
grave  concern  to  the  entire  body  of  citizens,  and  in  no  small  degree  can  the  annual 
winter  increase  in  certain  types  of  disease  be  attributed  to  serious  and  insanitary 
overcrowding  of  our  traffic  conveyances  at  some  time  every  day  on  most  lines,  and 
at  all  times  and  every  day  on  some  lines  or  parts  of  lines.  The  Department  of 
Health  has  studied  and  can  prove  the  increase  in  virulent  infectious  bacteria  in  the 
air  of  the  cars  of  this  City,  in  proportion  to  the  degree  of  human  overcrowding. 

The  remedy  must  be  sought  in  the  diminution  of  the  number  of  passengers  or  in 
a  sufficient  increase  in  the  amount  of  air  per  person  to  accomplish  a  practicable 
dilution  of  the  human  infection  to  a  point  of  reasonable  safety.  An  insignificant 
fraction  of  the  cars  at  present  in  use  are  equipped  to  make  adequate  mechanical  ven- 
tilation possible.  Overcrowding  can  be  prevented  to  a  very  great  degree  if  the  full 
track  capacity  of  all  lines  is  used  as  far  as  practicable  to  meet  the  demands  of  the 
traveling  public. 

The  public,  in  allowing  the  pulilic  service  companies  to  operate,  puts  upon  the 
companies  certain  limitations  and  demands  which  cannot  be  ignored  even  in  the 
interest  of  public  health.  These  are  the  width  of  the  streets,  the  conditions  of 
general  vehicular  traffic,  provision  for  switching,  etc.,  and  the  social  habits  of  work 
and  recreation  to  which  the  community  is  accustomed.  It  is,  therefore,  proposed 
to  accept  these  limitations  as  justifying  an  exemption  from  the  proposed  control  of 
passengers  per  car  in  the  interest  of  health  protection.  When  the  operating  com- 
panies are  using  to  the  full  all  the  available  facilities  which  the  public  allows  them,  it 
would  be  unreasonable  to  demand  that  they  exclude  excess  passengers  from  their 
cars.  The  orders  of  the  Board  of  Health  were  therefore  revoked  and  the  following 
sections  of  the  Sanitary  Code  were  adopted  : 

"  Section  306.  Cars  not  to  be  overcrowded.  The  carrying  of  passengers 
on  railroad  cars  in  the  City  of  New  York  shall  be  so  regulated  at  all  times 
that  the  number  of  passengers  on  any  such  car  at  any  time  shall  not  exceed 
one  and  one-half  times  the  seating  capacity  of  the  car;  provided,  however,  that 
the  foregoing  provisions  of  this  section  shall  not  apply  when  the  full  number  of 
cars  which  shall  have  been  ordered  by  the  Public  Service  Commission  to  be 
operated  on  any  line  or  part  of  a  line  are  so  operated;  and  provided,  further, 
that  the  foregoing  provisions  of  this  section  shall  not  apply,  in  the  absence  of 
such  an  order  of  the  Public  Service  Commission,  when  the  maximum  number 
of  cars  which  can  be  practicably  operated  on  any  line  or  part  of  a  line  are  so 
operated. 

"  Section  307.  Public  vehicles  not  to  be  overcrowded.  The  carrying  of 
passengers  on  all  public  vehicles  in  the  City  of  New  York  other  than  railroad 
cars  shall  be  so  regulated  at  all  times  that  the  number  of  passengers  on  any 
such  vehicle  at  any  time  shall  not  exceed  one  and  oen-half  times  the  seating 
capacity  of  such  vehicle." 

New  Procedure  in  the  Coxtrol  of  Poliomyelitis  Authorized. 
In  order  to  meet  the  needs  of  the  unusual  situation  presented  by  the  unprecedented 
outbreak  of  poliomyelitis,  various  changes  in  procedure  were  authorized  by  the  Board 
of  Health.     (Section  96.) 

Removal  of  Typhoid  Patients  Authorized. 
Recognizing  the  high   incidence  of  secondary  cases   of   typhoid   fever  in   families 
where  typhoid   fever  patients  are  cared   for  in  crowded  tenements  without  adequate 

20 


IN'TRODUCTIOX. 

provision  for  isolation,  the  Board  adopted  regulations  which  have  proved  so  far 
effective  tliat  the  incidence  of  this  disease  has  been  reduced  339©  in  the  past  year 
(Section  86.) 

Education  and  Co-operation  with  the  Mkdical  Profession  and  the  General  Public. 

Recognizing  that  the  Department  of  Health  will  accomplish  its  highest  ends  only 
when  the  medical  profession  especially,  as  well  as  the  public  at  large,  take  an  active 
part  in  the  broad  phases  of  community  self-protection  and  in  establishing  education 
instead  of  restriction  and  prosecution  as  the  proper  basis  of  administrative  work 
in  public  health,  there  has  been,  during  the  past  year,  special  emphasis  upon  the 
initiation  and  organization  of  many  co-operative  agencies. 

Associates  in  Public  Health. 

To  enlist  the  co-operation  of  private  physicians  in  health  work,  a  plan  was  formu- 
lated to  organize  in  each  borough,  groups  of  physicians  who  would  be  allowed  to 
assume  entire  charge  of  their  infectious  disease  cases.  These  physicians  are  known 
as  "  Associates  in  Public  Health."  This  plan  went  into  effect  on  June  3,  1916,  in  the 
Borough  of  Queens,  and  it  has  proved  successful  enough  to  warrant  extending  it  to  the 
other  boroughs  in  1917. 

Examination  of  Food  Handlers  by  Private  Physicians. 

The  regulations  governing  the  work  of  providing  medical  examinations  of  food 
handlers  have  been  so  modified  that  private  physicians  now  need  but  to  notify 
the  Department  of  the  number  they  intend  to  examine  and  proper  forms  are  forthwith 
forwarded.  These  examinations  by  private  physicians  are  encouraged  in  conformity 
with  the  policy  of  the  Department,  of  availing  itself  of  private  physicians  of  the 
city  as  a  part  of  the  force  used  in  the  detection  of  disease  and  the  protection  of 
the  public. 

About  fifty  thousand  (50,000)  food  handlers  were  examined  by  private  physicians 
in  1916  and  about  thirty  thousand  (30,000)  by  the  physicians  of  the  Department  of 
Health.  Of  this  total,  one  hundred  and  eighty-three  (183)  were  excluded  from 
food  handling  pursuits.  A  follow-up  system  has  been  instituted,  thereby  giving 
assurance  that  these  excluded  workers  will  not  return  to  lines  of  work  requiring  the 
handling  of  foods. 

Examination  of  School  Children  by  Private  Physicians. 

The  plan  of  having  school  children  examined  by  their  private  physicians  before 
their  first  admission  to  school,  which  was  begun  in  1915,  was  considerably  extended  in 
1916.  Of  the  195,953  children  entering  school  for  the  first  time  in  1915  9.317  were 
examined  and  reports  issued  by  their  family  physicians  and  in  1916  of  189,720  new 
admissions,    12,669   were   examined   by   their   family   physicians. 

Examination  of  School  Children  by  Teachejis. 

For  the  purpose  of  more  thoroughly  eradicating  pediculosis  from  the  public  schools, 
teachers  were  authorized  to  examine  children  for  that  particular  ailment ;  they  were 
also  instructed  in  the  detection  of  the  early  signs  of  infectious  diseases  of  children  in 
order  that  suspicious  symptoms  may  be  more  promptly  referred  to  the  school  medical 
inspection,  and  the  sick  child  excluded  from  class.  A  beginning  has  also  ^een  made 
in  the  preliminary  test  of  vision  by  teachers,  in  the  first  weeks  of  the  school  term, 
thus  ensuring  a  much  earlier  correction  of  the  common  defects  of  the  eyes,  after 
reference   to   the   school   medical   inspector. 

21 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

Advisory  Council. 

The  various  Committees  of  the  Advisory  Council,  corresponding  to  the  several 
Bureaus  of  the  Department,  were  reorganized,  the  number  of  members  being  reduced 
to  a  more  effective  working  force,  a  uniform  procedure  of  business  adopted,  and  a 
schedule  of  regular  meetings  arranged. 

Improved  Co-operation  of  Social  Agencies. 

Special  post  cards  for  reporting  conditions  dangerous  to  health,  found  by  field 
workers,  were  printed  and  distributed  to  the  several  social  agencies  of  the  City,  whose 
co-operation  had  been  promised.  The  field  worker  indicates  on  the  card  the  condition 
found,  and  drops  the  card  in  the  nearest  post  box.  The  Health  Department  forwards 
the  card  to  the  proper  bureau,  or  to  the  proper  City  department,  for  attention.  These 
complaints  are  of  special  value,  because  they  are  made  by  trained  observers  familiar 
with  the  general  problem  of  disease  prevention. 

Public  Health  Education. 

Special  campaigns  of  publicity  and  education  were  directed  against  sneezing, 
spitting,  unmuzzled  dogs,  mosquitoes  and  poliomyelitis.  The  Department  co-operated 
with  the  various  Baby  Welfare  organizations  throughout  the  City  in  conducting  a 
Baby  Week  during  the  month  of  May.  The  recent  "  Open  Window  "  campaign  was 
instituted  in  order  to  teach  the  value  of  fresh  air. 

Anti-Sneeze  Campaign. 

Owing  to  the  sudden  marked  increase  in  deaths  from  respiratory  diseases  in 
January,  chiefly  infectious  colds,  grippe  and  pneumonia,  an  educational  campaign  of 
publicity  was  carried  on  to  focus  attention  on  sneezing,  coughing  and  spitting  as  the 
main  factors  in  the  spread  of  these  diseases.  The  campaign  enlisted  the  interest  of 
newspapers  generally  and  secured  the  publication  of  a  large  number  of  health  maxims, 
feature  stories,  cartoons,  etc. 

Spitting  Crusade. 

On  January  12,  as  part  of  the  campaign  against  respiratory  diseases,  a  crusade 
against  spitting  was  begun  which  resulted  in  1,740  arrests  and  the  levying  of  $2,549  in 
fines.  But  more  important  than  the  arrests  and  the  fines  was  the  salutary  effect  on  the 
public,  caused  by  the  wide  publicity  given  the  crusade  by  the  newspapers. 

Muzzling  of  Dogs. 

On  April  20th,  every  employe  of  the  Department  of  Health  was  ordered  to  count 
the  unmuzzled  dogs  observed  during  the  day,  and  report  them  on  special  blanks.  The 
net  result  of  this  City-wide  observation  was  that  1,365  owners  were  arrested  and  1,339 
of  them  fined  $1,131.  The  newspapers  of  the  City  and  elsewhere  gave  wide  publicity  to 
this  census  and  to  a  general  round-up  of  stray  dogs,  which  followed  it  closely,  with  the 
result  that  very  few  unmuzzled  dogs  were  to  be  found  on  the  streets  for  some  time 
thereafter. 

Mosquito  Week. 

During  the  first  week  in  May,  a  special  publicity  campaign  of  education  was 
carried  on  to  enlist  public  support  for  the  anti-mosquito  work  planned  by  the  Depart- 
ment of  Health.  Thousands  of  simple  leaflets  were  distributed,  explaining  the  life 
history  of  mosquitoes.  In  addition  to  this,  jars  of  living  mosquito  larvae  were 
collected  and  sent  to  all  public  schools  throughout  the  City,  where,  following  arrange- 

22 


INTRODUCTION. 

merits  made  with  the  Department  of  Education,  they  were  used  in  classroom  instruc- 
tion by  the  teachers.  Moving  pictures  in  all  the  "  movie  "  theatres  were  also  utilized 
extensively  in  this  campaign. 

Patf.nt  Medicine  Campaign. 
A  vigorous  campaign  was  conducted  against  patent  medicines  and  medical  quacks 
and  a  good  beginning  was  made  in  the  endeavor  to  stamp  out  the  pernicious  activities 
of  these  individuals.  Where  the  Department  was  compelled  to  resort  to  legal  pro- 
ceedings, it  received  no  reversals  in  the  courts,  but  was  successful  in  a  large  number 
of  prosecutions. 

ADVANCES   IN   DEPARTMENTAL  PROCEDURE. 

To  secure  more  effective  co-operation  between  the  office  of  the  Commissioner  and 
the  various  Directors  of  the  Bureaus  of  the  Department,  the  following  procedures 
have  been  instituted : 

For  the  information  of  the  Commissioner  and  for  the  preparation  of  health 
bulletins  and  press  notices,  weekly  reports  giving  the  "  Important  Activities  and 
Events  "  in  each  Bureau,  with  condensed  statistics,  are  now  submitted  by  Directors  of 
Bureaus. 

Once  a  month  the  directors  of  the  various  bureaus  have  met  in  the  Commissioner's 
office  for  the  discussion  of  some  problem  or  policy  of  the  department.  Some  of  the 
subjects  have  been:  "The  Cause  of  the  Increase  of  Pulmonary  Diseases  in  Cities,  and 
the  Means  Available  for  Its  Control  and  Diminution  " ;  "  The  Department  Procedure 
in  the  Control  of  Measles";  "The  Publicity  Campaign  of  the  Department  of  Health"; 
"Procedure  for  More  Intensive  Control  of  Typhoid  Fever";  "The  Attitude  of  the 
Department  of  Health  Toward  Alcohol." 

EXTENSION   OF   HEALTH    DISTRICT    PLAN. 

The  e.xpcrimcnt  of  public  health  administration  on  the  district  plan,  which  was 
started  in  1915  on  the  East  Side  of  Manhattan,  in  what  is  known  as  "  Health  District 
No.  1,"  was  extended  on  May  1.  1916,  to  the  Borough  of  Queens.  It  is  intended  to 
further  extend  the  operation  of  this  plan  during  the  next  year  in  other  boroughs. 

Employes. 
There  were  3,206  persons  connected  with  the  Department  on  January  1st.  Of 
these,  119  gave  their  services  free  in  hospitals  or  clinics,  465  gave  part-time  service, 
the  remainder,  2,622.  being  full-time  employes.  During  the  year,  423  full-time  and 
140  part-time  employes  were  added  to  the  roster,  exclusive  of  the  temporary  appoint- 
ments necessitated  by  the  poliomyelitis  epidemic;  525  resigned,  16  were  retired  on 
pension,  and  27  were  dismissed  on  charges,  and  14  died.  The  number  of  paid  employes 
at  the  end  of  the  year  was  3,068. 

R.\TINGS. 

In  co-operation  with  the  Civil  Service  Commission,  a  new  system  of  rating 
employes  was  adopted  and  special  cards  were  prepared  for  recording  such  ratings. 
The  Ciz'il  Scrz-ice  Commission  ruled  that  }iot  more  than  40%  of  the  total  number  of 
employes  in  any  bureau  mi[/ht  be  rated  aboTe  standard. 

Physical  Examination  of  City  Employes. 
The  procedure  which  has  been  in  operation  during  the  past  few  years  whereby 
the  employes  of  this  Department  are  periodically  examined,  has  been  extended  in  a 
small   degree  to   city   employes   in   other   departments,   through    the   examination   and 

23 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

treatment  by  Health  Department  physicians,  of  City  employes,  in  accordance  with  the 
provisions  of  the  Workman's  "Compensation  Law.  372  men  and  873  women  employes 
of  the  Health  Department  received  physical  examinations  and  486  re-examinations. 

The  result  of  3,004  examinations  showed  among  other  ailments  that  438  employes 
of  the  Department  were  over  weight  and  280  under  weight;  161  were  afifected  by  some 
form  of  heart  trouble;  162  pulmonary  impairment:  191  suffered  from  nasal 
obstruction;  21  had  hernias;  enlarged  thyroid  was  found  in  83;  defective  hearing  was 
found  in  118. 

The  detailed   results  of   these  examinations  are   shown   in  the    following  table: 


PHYSICAL  EXAMINATION  OF  EMPLOYES. 


Women. 


Overweight 285 

Underweight 245 

High  blood  pressure 66 

Low  blood  pressure 235 

Cardiac  impairment 92 

Pulmonary  impairment 74 

Indigestion 108 

Constipation 233 

Gastroptosis 12 

Probable  gastric  ulcer 4 

Pain  on  abdominal  palpation,  including 

over  McBurney's  point 8 

Defective  teeth 66 

Insomnia 36 

Pyorrhoea  alveolaris 16 

Abnormal  throat  conditions 282 

Nasal  obstructions 138 

Movable  kidney 7 

Enlarged  thyroid 51 

Disorders  of  menstruation 156 

Varicose  veins 33 

Hernia 5 

Glycosuria 3 

Defective  hearing 59 

Anaemia 44 

Exaggerated  reflexes 137 

Fine  tremor  of  hands 102 

Defects  of  speech 1 


Men. 


Overweight 153 

Underweight 35 

High  blood  pressure 89 

Low  blood  pressure 38 

Cardiac  impairment 69 

Pulmonary  impairment 88 

Indigestion 32 

Constipation 68 

Pain  on  abdominal  palpation,  including 

pain  at  McBurney's  point 6 

Defective  teeth 147 

Insomnia 15 

Pyorrhoea  alveolaris 3 

Abnormal  throat  conditions 65 

Nasal  obstructions 63 

Hernia 16 

Palpable  liver 3 

Anaemia 9 

Flat,  weak  or  painful  arches 2 

Defective  hearing 59 

Defects  of  speech 

Exaggerated  reflexes 

Movable  kidney 

Enlarged  thyroid 

Varicose  veins 

Varicocele 


Albuminuria  (both  sexes) 303 

Albuminuria  with  high  blood  pressure 34 

During  the  past  year  19,879  days'  work  were  lost  on  account  of  absence  because 
of  illness,  or  1.8%  of  1,112,842  possible  days'  work  required  of  the  employes  of  the 
Department. 

Poliomyelitis  Epidemic. 

The  poliomyelitis  epidemic  made  a  profound  impression  upon  the  public  because 
of  the  severe  and  dramatic  results  seen  in  those  attacked  by  the  disease,  and  the 
policy  of  absolute  frankness  as  to  the  limitations  of  scientific  knowledge  under  which 
the  Department  of  Health  acted. 

This  important  episode  in  the  City's  history  will  be  the  subject  of  a  separate 
report  now  in  preparation  for  early  publication. 

24 


INTRODUCTION. 

It  is  sufficient  to  say  iiere  that  without  any  discoverable  cause,  the  disease,  which 
has  been  one  of  tlie  uncommon  reportable  diseases  for  some  years  past,  suddenly 
developed  an  epidemic  character  and  showed  a  greatly  increased  virulence  early  in 
June.  From  this  time  until  November  1  there  were  8,991  cases  and  2,448  deaths  from 
poliomyelitis.  During  this  period  all  the  assistance  which  was  found  of  practical 
value  was  enlisted  through  the  United  States  Public  Health  Service  and  through  the 
medical  profession  in  this  City  and  from  all  parts  of  the  country. 

The  policies  and  acts  of  the  Department  of  Health  were  endorsed  at  the  time  by 
the  opinion  and  statement  of  the  best  informed  medical  authorities  of  the  country  and 
the  principles  upon  which  the  preventive  measures  were  instituted  during  the  epidemic 
in  New  York  City  were  based  have  been  declared  by  the  .^merican  Public  Health 
Association  to  be  the  only  ones  which  could  be  justified,  until  our  knowledge  is  supple- 
mented by  certain  fundamental  facts  as  to  the  means  of  conveyance  and  the  duration 
of  infection  by  the  disease. 

To  combat  the  epidemic  funds  were  provided  through  special  revenue  l^onds  and 
expended  as  follows  : 

For    Personal    Service $150,684  39 

For  Supplies  and  Equipment 104,068  86 

For  treatment  of  cases  in  other  than  Department  of  Health  Hospitals....        46.451  25 

Total     $301,204  50 

NOTABLE   ACCOMPLISHMENTS   AND    NEW   ACTIVITIES. 
DRAiN.\r,i-:  OK  Mosquito  MAR.'iHE.s. 

The  marshes  in  the  Boroughs  of  Brooklyn  and  Queens,  including  those  of  th« 
Islands  of  Jamaica  Bay,  were  ditched  and  drained. 

Bran'CH   of   Municipal   Library   Established   in    Department. 

A  branch  of  the  Municipal  Library  has  been  established  in  the  Centre  Street 
Building  of  the  Department,  in  which  all  books,  monographs  and  periodicals  relating 
to  public  health  work  are  gathered  for  the  use  of  Health  Department  officials  and 
others. 

QuEEN.siiORO  Hospital  Opf.neii. 

On  July  1,  1916,  a  Department  Hospital  for  the  Borough  of  Queens,  with  a  capacity 
of  80  beds  was  opened.  This  building  is  a  short  distance  outside  of  Jamaica.  It  has 
been  of  great  service,  there  being  as  many  as  112  patients  at  a  time  cared  for  during 
the  epidemic  of  poliomyelitis  last  summer. 

Restaurants  Inspected  and  Graded. 
During  the  summer  some  four  hundred  restaurants  of  the  City  were  inspected  to 
determine  their  compliance  with  sanitary  regulations,  with  the  object  in  view  of 
grading  according  to  the  results  of  the  inspection.  Since  then  the  question  of  placing 
these  food-handling  estal)lishments  under  the  permit  plan  has  also  been  considered, 
but  no  conclusion  regarding  this  method  has  yet  been  reached.  Final  decision  is 
awaited  at  the  hands  of  the  Mayor  and  tlie  Commissioner  of  Accounts. 

Sanitary  Survey  of  a  Typical  Business  Block. 
A    sanitary    survey   of    downtown    office    buildings    undertaken    late    in    1915    was 
finished  early  in   1*^16,   for  the  purpose  of  determining  whether  adequate  lighting  and 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

ventilating  facilities  were  furnished  to  ofifice  workers,  and  whether  the  atmospheric 
conditions,  particularly  in  regard  to  temperature  and  humidity,  existing  in  these 
buildings  were  in  any  way  detrimental.  Inadequate  provision  for  light  and  ventilation 
was  found  to  be  quite  general.  Further  studies  to  determine  reasonable  interpretation 
of  the  terms  "  adequate  light  and  ventilation  "  are  nearing  completion. 


ACHIEVEMENTS  IN  HEALTH  PROTECTION  DURING  1916. 
Reduction  in  Death  Rate. 

Despite  the  poliomyelitis  epidemic,  with  its  2,448  deaths,  the  general  death  rate 
for  the  entire  City  is  slightly  less  than  in  1915.  The  death  rate  for  the  City  in  1915 
was  13.93  per  1,000  population;  for  1916  this  has  been  reduced  to  13.89,  the  lowest 
rate  so  far  recorded  for  New  York  City.  It  may  be  noted  that  in  1910  the  rate  was 
16.00.  If  the  poliomyelitis  death  rate  were  deducted,  the  general  death  rate  would  be 
.48  less  than  last  year,  equivalent  to  the  saving  of  2,689  lives. 

Reduction  in  Infant  Mortality. 

The  death  rate  of  infants  under  one  year  decreases  with  but  slight  variation  from 
year  to  year.  In  1915  the  rate  was  98.2.  The  rate  for  1916  is  93.1 ;  in  1910  it  was 
125.6.  The  diminution  of  flies,  the  continued  pasteurization  of  milk,  the  campaign 
of  education  of  the  public  through  the  press,  and  the  increased  use  of  Baby  Health 
Stations,  have  all  contributed  toward  this  reduction  of  infant  mortality,  which  is 
properly  considered  to  reflect  most  promptly  improvements  in  the  sanitation  and 
hygiene  of  a  community. 

Reduction  of  Typhoid  Fever. 

The  number  of  typhoid  fever  cases  reported  during  the  past  year  was  1,617 
compared  with  2,456  for  the  year  preceding,  showing  a  decrease  of  839. 

There  were  215  deaths  resulting  from  this  disease  in  1916  against  333  in  1915,  a 
decrease   of   118. 

This  is  an  excellent  showing  and  is  due  largely,  no  doubt,  to  the  following  of 
individual  cases  to  their  source,  to  removing  patients  from  their  homes  when  condi- 
tions cannot  be  so  maintained  as  to  prevent  infection  of  other  members  of  the 
household,  to  the  education  of  the  public  through  the  means  of  circulars  and  placards, 
to  the  increased  use  of  anti-typhoid  serum  by  inoculation  (12,403  immunizations  in 
1916  as  against  3,481  in  1915)  and  to  a  vigorous  campaign  against  fly  breeding. 

Reduction  in  Tuberculosis. 

Last  year  the  city  experienced  the  lowest  death  rate  in  tuberculosis  which  has  been 
recorded,  the  rate  being  1.50  per  1,000  population,  while  in  1915  the  rate  was  1.61, 
and  in  1910  it  was  1.81. 

It  is  more  than  probable  that  this  reduction  is  due  to  the  fact  that  during  the 
past  year  the  department  instituted  a  campaign  to  extend  its  control  over  tubercle 
bacilli  carriers  who  are  a  menace  to  the  public  and  to  their  families.  Among  other 
methods  employed  to  secure  better  control  of  these  carriers,  are  detention  at  Riverside 
and  Metropolitan  Hospitals  of  patients  entering  voluntarily,  and  at  Bellevue  Hospital 
of  cases  found  in  the  Municipal  Lodging  House,  and  the  removal  from  their  homes 
of  the  positive  sputum  patients  who  failed  to  observe  sanitary  precautions  to  prevent 
the  infection  of  others. 

26 


INTRODUCTION. 

Reduction  of  Diphtheria. 

The  reduction  in  the  total  number  of  cases  and  of  deaths  and  case  fatality  in 
diphtheria  in  1916  was  remarkable — 

In  1915 — 15,572  cases, 

1,278  deaths — and 
8%  case  fatality, 

while  in  1916  there  were: 
1.3,521  cases, 
1,031  deaths  and 
7.6%  case  fatality, 

showing  the  lowest  number  of  deaths  and  the  lowest  death  rate  so  far  recorded.  This 
condition  may  be  attributed  to  several  important  factors,  the  chief  of  which  was  the 
adoption  on  February  28,  1916,  of  a  definite  period  of  quarantine,  a  minimum  period 
of  twelve  days,  together  with  two  consecutive  negative  cultures  made  twenty-four 
hours  apart.  In  addition,  the  more  intensive  use  in  institutions  and  schools,  of  the 
Schick  test  for  susceptibles  and  the  active  immunization  of  exposed  susceptibles,  has 
doubtless  contributed  to  the  reduction  of  diphtheria. 

Reduction  of  Rabies. 

The  effectiveness  of  the  campaign  against  unmuzzled  dogs  can  be  measured  by 
the  fact  that  in  1916  only  3,205  people  w-ere  bitten  by  dogs,  as  compared  with  3,648 
in  1915,  and  but  23  rabid  dogs  were  found,  as  compared  with  113  in  1915. 

Reduction  of  Glanders. 

The  control  of  public  horse  troughs,  the  sanitary  supervision  of  blacksmith 
shops,  the  more  general  use  of  the  diagnostic  mallein  test,  have  all  contributed  to 
the  reduction  of  glanders  among  horses  from  704  in  1915  to  403  in  1916.  Human 
cases  are  so  rare  as  not  to  serve  as  a  safe  index  of  the  reduction  of  the  disease — 2  in 
1915  and  2  in  1916. 

Reduction  in  Per  Capita  Cost  of  the  Dep.\ftment  of  Health. 

The  following  figures  show  the  per  capita  cost,  based  upon  the  estimated  popula- 
tion and  the  appropriations  for  this  department,  for  the  years  1915  and  1916.  It 
will  be  seen  that  there  has  been  a  considerable  drop  in  the  per  capita  cost  during  this 
time,  yet  the  general  death  rate  per  1.000  population,  likewise  the  death  rate  of  infants 
under  one  year  of  age  per  1,000  births,  shows  a  decided  fall. 


1915. 


1916. 


Appropriation 

Estimated  Population 

Per  capita  cost,  all  Department  activities 

Per  capita  cost  of  all  except  Hospital  Service 

General  Death  Rate 

Infant  Death  Rate 


$3.507.0.3.5  22 

$3,310..361  60 

5,4(>S,1!)() 

5,602,S41 

.6415 

.5008 

.4369 

.4079 

13.93 

13.89 

98.2 

93.1 

27 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

GENERAL  CONSIDERATIONS. 

While  there  is  a  natural  satisfaction  in  recording  the  improvements  in  the  health 
of  the  community,  it  cannot  be  gainsaid  that  there  is  a  shocking  amount  of  preventable 
disease  and  death   which  bears  as  a  heavy  burden  upon  all  classes. 

Especial  attention  is  called  to  the  great  annual  increase  in  diseases  of  the 
respiratory  tract,  pneumonia,  bronchitis  and  influenza  during  the  months  of  housing, 
and  congestion  of  traffic,  and  to  the  great  numbers  of  permanently  disabled  and 
dependent  sufiferers  from  syphilis  and  the  effects  of  gonorrhoea,  and  to  the  increase 
in  the  so-called  degenerative  diseases  of  later  life,  due  in  no  small  degree  to  unsuitable 
personal  habits  of  occupation,  diet  and  the  use  of  alcohol. 

It  is  obvious  that  until  there  is  a  marked  and  permanent  improvement  in  the 
conditions  of  human  transportation  in  public  conveyances  in  this  city,  and  until 
the  education  of  the  public  has  substantially  reduced  the  per  capita  consumption  of 
alcohol,  the  diseases  of  respiration  and  the  degenerative  diseases  of  the  later  decades 
of  life  cannot  be  expected  to  show  a  marked  reduction. 

Further  efforts  in  the  control  of  syphilis  and  gonorrhoea  demand  either  the 
establishment  of  municipal  hospitals  and  dispensaries  sufficient  to  provide  facilities 
approaching  what  is  now  available  for  the  care  and  prevention  of  tuberculosis,  or 
the  organization  and  operation  of  the  municipal  and  privately  owned  hospitals  and 
dispensaries  with  a  radically  different  point  of  view  from  the  one  now  generally  held. 

The  highest  type  of  service  for  the  prevention  of  disease  can  be  obtained  only 
when  the  administration  and  use  of  all  hospitals  and  dispensaries  is  controlled  by 
a  l)oard  or  commission  convinced  of  the  superior  possibilities  and  advantages  of  a 
policy  of  prevention  as  compared  with  the  belief  at  present  generally  held  that  a 
hospital's  sole  duty  is  the  treatment  and  relief  of  the  sick. 

Division   of   He.'>ilth   Districts. 
(Created  in  May,  1916,  under  the  office  of  the  Deputy  Commissioner.) 

Changes  in  Staff — The  Qiief  of  the  Division  of  Health  Districts  was  placed  in 
charge  of  the  four  districts  in  the  Borough  of  Queens  when  they  were  established 
on  May  1st.  The  Bureaus  of  Child  Hygiene  and  Preventable  Diseases  were  repre- 
sented by  medical  supervisors  and  supervising  nurses.  These  were  later  in  the  year, 
detached  from  these  Bureaus  and  assigned  as  subordinates  of  the  Chief  of  the  Divi- 
sion of  Health  Districts.  At  the  end  of  the  year,  the  staff  consisted  of  a  chief,  who 
directed  the  work  of  all  health  districts,  a  medical  supervisor  and  clerks  in  the 
administrative  office;  a  health  officer,  a  supervising  nurse,  a  clerk,  nurses,  medical 
inspectors  and  clinic  physicians  in  each  Health  District  office.' 

Chanacs  in  Organisation — On  May  1st,  the  diagnostic  work  of  the  Borough  was 
done  by  one  Borough  diagnostician.  Later,  in  order  to  conform  more  thoroughly 
with  the  Health  District  idea,  the  diagnostic  work  was  apportioned  to  the  various 
health  centres  and  was  done  by  the  medical  inspectors  attached  to  them. 

Changes  in  Procedure — Weekly  Reports.  To  supply  information  needed  by  the 
various  Bureaus,  weekly  textual  reports  were  adopted  in  addition  to  the  regular 
reports  required  by  the  Health  District  plan. 

Tuberculosis  files — To  conform  to  the  Health  District  idea  of  having  all  services 
given  any  family  group  filed  under  that  family's  name,  the  system  of  filing  records  was 
changed  from  the  alphabetical  to  the  address  system. 

Central  tuberculosis  file — Owing  to  the  abolition  of  the  Borough  Chiefs  Office, 
the  central  tuberculosis  file  was  transferred  to  the  Borough  Office  of  Brooklyn. 

A  new  record  card  has  been  adopted  for  recording  the  examinations  of  pre-school 
children. 

28. 


INTRODUCmON. 

Employrriciic  certificates — On  June  20th,  the  issuance  of  employment  certificates 
and  vaccinations  was   distributed  to   the   Health   Districts. 

Dog  bite  hearings — The  hearings  on  dog  bites  were  held  in  the  various  Health 
Districts  instead  of  in  the  Borough  office. 

Birth  certificates — Instead  of  mailing  copies  of  birth  certificates  to  parents, 
nurses  deliver  them  when  they  call  to  enroll  the  babies  at  Baby  Health  Stations. 

Midwife  and  foundling  inspections — Instead  of  having  specially  designated 
inspectors  make  these  inspections,  this  work  was  distributed  to  the  medical  inspectors 
in  the  various  Health  Districts. 

Consultations  with  parents — The  custom  of  holding  consultations  with  parents 
in  the  schools  was  extended  to  the  Health  District  offices  where  the  health  officers 
now  advise  parents  about  the  termination  of  the  physical  defects  of  their  children. 

Inspectors  of  the  Sanitary  Bureau  and  the  Bureau  of  Food  and  Drugs  were 
detached  from  the  Central  Borough  Office  and  attached  to  the  various  Health 
District  offices. 

Important  Activities — January  29th,  Monthly  Edition  of  the  East  Side  Qironicle 
was  enlarged  from  5,000  to  15,000  copies.  The  Seward  Park  Public  Lilirary,  the 
Educational  Alliance,  the  Beth  Israel  Dispensary,  the  Henry  Street  Settlement,  the 
Jacob  A.  Riis  House  and  the  Gouverneur  Dispensary  were  induced  to  assist  in  its 
distribution. 

February  12th,  a  special  investigation  was  begun  of  breast  fed  and  bottle 
fed  babies.  As  this  investigation  will  last  about  five  years,  no  conclusions  are  yet 
possible. 

A  special  study  of  city  born  children  was  also  begun  for  the  purpose  of  comparisotf 
with  a  similar  study  made  at  Johnstown,  Pa.,  by  the  United  States  Public  Health 
Service.     The  result  of  this  study  will  be  made  the  subject  of  a  special  report. 

February  19th,  a  midwinter  illness  census  was  taken  in  Health  District  No.  1,  200 
nurses  being  detailed  for  that  purpose. 

May  6th,  "  Baby  Week  "  was  observed  by  various  activities,  such  as  lectures  in 
public  and  parochial  schools,  demonstrations  at  the  milk  stations  and  a  large  meeting 
at  the  Educational  Alliance. 

June  3d,  a  plan  to  enlist  the  co-operation  of  private  physicians  in  health  work 
was  put  into  effect  in  the  Borough  of  Queens.  A  group  of  physicians  known  as 
"Associates  in  Public  Health"  are  now  assuming  entire  charge  of  such  of  their 
infectious  disease  cases  as  remain  at  home. 

June  17,  conferences  with  food  handlers  in  the  Queens  Health  Districts  was 
begun,  the  object  being  to  teach  them  how  to  conduct  their  business  in  accordance 
with  Health  Department  regulations,  in  order  to  reduce  the  number  of  violations 
usually  found  on  inspection. 

Jime  29tli,  a  conference  was  held  with  police  inspectors  and  captains  in  Queens 
for  the  purpose  of  securing  larger  co-operation  by  the  Police  Department  in  Health 
Department  work.  It  was  decided  to  utilize  the  patrolmen  while  on  their  beats,  to 
perform  certain  Health  Department  functions,  such  as  enforcing  quarantine,  placarding 
and  making  reinspections  for  the  Bureau  of  Food  and  Drugs  and  Sanitary  Bureau. 

July  1st,  the  Health  District  idea  of  publishing  local  newspapers  was  extended 
to  the  Health  Districts  in  Queens. 

October  21st,  arrangements  were  completed  for  a  course  of  lectures  in  Yiddish  for 
Health  District  Xo.  1  on  popular  health  subjects,  the  lecturers  being  chosen  from  the 
Advisory  Committee  of  that  district. 

November  20th,  representatives  of  the  Department  of  Charities  were  given  per- 
mission to  use  the  various  Health  District  offices,  and  a  record  of  their  cases  was 

29 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

entered  on  the  family  record  card  of  the  district,  this  information  being  considered 
valual)le  addition  to  the  economic  history  of  the  family. 

Three  dental  clinics  were  estaljlishcd  by  private  subscription,  one  at  Flushing 
Hospital,  one  at  P.  S.  No.  81  and  one  at  St.  John's  Hospital. 

November  25th,  Advisory  Committees  were  organized  in  all  the  Health  Districts 
to  assist  the  local  health  ofticer  in  spreading  public  health  education  and  accomplishing 
charitable   work  in  the   district. 

December  2d,  the  Health  District  plan  was  investigated  and  studied  from  all 
possible  angles  by  the  Public  Health  Committee  of  the  Academy  of  Medicine,  by 
the  Association  of  Tuberculosis  Clinics,  by  the  School  Community  Centres  and  by 
30  students  of  the  Teachers  College. 

December  4th,  "  Open  Window  Week  "  was  celebrated  in  schools,  meeting  halls, 
etc.,  125  lectures  being  given  to  audiences  aggregating  over  34,000  people. 

December   19th,   the   New  Queens   Plaza  tuberculosis  clinic,  was  opened. 

Pre-school  examinations — The  examination  of  children  of  pre-school  age  for  the 
purpose  of  correcting  their  physical  defects  before  they  enter  school  was  undertaken 
on  an  extensive  scale.  This  work  will  not  curtail  any  other  activities,  as  it  will 
be  done  by  the  baby  health  inspectors  and  the  clinic  physicians  while  these  employees 
are  on  their  regular  duty. 

Opening  of  two  tuberculosis  clinics — By  the  establishment  of  Health  District 
offices,  the  Department  was  enabled  to  open  two  additional  tuberculosis  clinics, 
making  four  in  the  Borough  now,  instead  of  two. 

Boys  Health  Leagues — These  leagues  have  been  organized  in  all  Health  Districts, 
with  a  captain  and  three  lieutenants  in  each  sub-district.  They  are  given  lectures  on 
the  sanitary  code,  contagious  diseases,  personal  hygiene,  violations  and  abating  nuis- 
ances by  personal  effort. 

Achievements — Tennination  of  physical  defects — The  correction  of  physical  defects 
of  school  children,  which  is  considered  one  of  the  most  important  activities  of  the 
Bureau  of  Child  Hygiene,  has  been  brought  to  a  high  grade  of  efficiency  in  Health 
District  No.  1,  where  the  Health  District  System  has  been  in  existence  long  enough 
to  show  results.  In  this  district  practically  100%  were  terminated  at  the  end  of  the 
school  year,  including  dental  defects. 

Infant  vwrtalify  rate — The  infant  mortality  rate  may  be  said  to  be  an  index  of 
the  effect  of  Health  Department  activities  in  a  district.  In  Health  District  No.  1,  it 
has  been  progressively  reduced  as  follows:  1914 — 77.86  per  1,000,  1915 — 72.32  per 
1,000,  1916—71.91  per  1,000.  In  the  Borough  of  Queens  102.6  per  1,000  in  1915  and 
95.6  per  1,000  in  1916. 

Co-operation  of  nezi'spapers — That  the  Community  spirit  of  the  Borough  of 
Queens  has  been  enlisted  in  favor  of  the  Health  Department  activities  is  very  well 
shown  in  the  commendatory  items  and  special  articles  on  Health  Subjects  that  have 
appeared  at  intervals  in  the  local  newspapers. 

Saving  of  time — That  considerable  time  can  be  saved  on  nurses'  service  on  account 
of  a  combination  of  functions  is  shown  in  Health  District  No.  1,  where  the  congested 
conditions  of  the  district  lend  themselves  especially  to  a  demonstration  of  this  princi- 
ple. The  nurses  of  that  district  have  been  able  to  serve  in  the  field  7  functions  per 
nurse  per  hour,  which  under  other  conditions  would  necessitate  a  visit  for  every 
function  served,  and  would  necessarily  reduce  the  work  performed  by  them.  In 
the  Borough  of  Queens,  a  comparison  of  the  work  shows  a  large  increase  in  every 
kind  of  work  performed  by  an  equal  number  of  employees  for  the  period  May  1st 
to  December  31st  as  compared  with  the  same  period  in  1915. 

30 


INTRODUCTION. 
WORK  PERFORMED  BY  DIVISIOX  OF  HEALTH  DISTRICTS— 191G. 


Manhattan. 


H.  D. 

No.  1. 
From  Jan. 
1st  to  Dec. 
31st,  1916. 


Queens  Borough — Health  Districts. 
From  May  Ist  to  December  31st,  lOltl. 


Queens. 


RidRC- 
wootl. 


Flushing. 


Jamaica. 


Bureau  of  Child  Hyoiene: 

New  babies  enrolled 

Total  attendance  of  babies 

Pre-natal  cases  enrolled 

Pre-8  -hool  children  examined 

Vaccinations 

Employment  certificates  issued 

Employment  certificates  refused 

Physical    examinations    and    re-exami 
nations  of  school  children 

Inspections  for  contaKion 

Instructions  of  Pupils  about  physical 
defects 

Consultations  with  parents  about  physi- 
cal defects 

Physical  defect  cases  terminated. . . 

Little   mothers  and  boys  health  league 
meetings 

Total  attendance 

Total  field  visits 


Bureau  of  Preventable  Diseases: 

Visits  to  cases  of  tuberculosis 

^'isits  to  cases  of  infectious  diseases.  . 
New  patients  enrolled  at  tuberculosi 

clinics 

Total  attendance  at  tuberculosis  clinics 

BcKEAU  or  Public  Health  Education: 
Public       Lectures,      conferences       and 

meetings 

Total  attendance 

Literature  distributed 


Sanitary  Bureau: 

Total  number  of  inspections. 

Bureau  of  Food  and  Drugs: 
Total  number  of  inspections. 


618 
9,469 

78 
204 
574 


4,072 
38,587 

7,5C5 

235 
1,943 

68 

1,919 

16,834 


938 
1,439 


44 

11,405 
218,900 


2,755 


226 

4,150 

20 

12 

1,478 

527 

41 

4,719 
56,980 

1,951 

1,068 
829 

6 

110 

6,239 


1,000 
3,424 


40 
51 


56 
10,164 
48,840 


4,071 


573 


675 

9.201 

27 

3 

898 

1,086 

33 

8,082 
149,505 

13,035 

2,596 
1,897 

11 

1.7.56 

12.025 


2,329 
6,490 


280 
1,486 


144 
26,274 
39,800 


6,698 


3.317 


104 
142 


1,903 
25,924 

2,204 

195 
896 

2 

30 

3.718 


755 
1.997 


1.54 
1,177 


46 

3.083 

36.9.55 


2,610 
351 


335 

469 

28 

7.399 
97,940 

11,222 

2.574 
2,368 

10 

437 

9,188 


1,456 
5,812 


122 
1,388 


67 
13,099 
17,450 


12,760 
3.741 


Reduction  of  Violations — The  effect  of  an  intensive  public  health  educational 
campaign,  such  as  has  been  carried  on  in  Health  District  No.  1,  is  shown  by  the  reduc- 
tion in  the  percentage  of  the  number  of  violations  found  by  the  Health  Department 
inspectors  as  follows:  Out  of  every  100  inspections  made  in  1914  there  were  19  per 
cent,  of  violation,  in  1915  there  were  16  per  cent,  of  violation  and  in  1916  there  were 
13  per  cent,  of  violation. 

DIVISION  OF  INSTITUTION  INSPECTION. 
(In  the  Oflfice  of  the  Deputy  Commissioner.) 

Changes  in  Staff — On  January  1st  the  Division  of  Institution  Inspection  was 
formed  by  the  amalgamation  of  the  Divisions  of  Institution  Inspection  attached  to  the 
Bureau  of  Child  Hygiene  and  Preventable  Diseases. 

Organisation — Districts  were  established  corresponding  to  those  of  the  Bureau  of 
Preventable  Diseases  in  the  five  Boroughs.    An  inspector  was  assigned  to  each  district. 

Functions — The  Division  is  charged  with  the  inspection  of  all  institutions  in  the 
city,  the  physical  examination  of  children  in  child-caring  institutions,  semi-annually, 
diagnosis  and  sanitary  supervision  of  infectious  diseases  in  institutions  of  all  classes, 
administration  of  sera,  toxins,  application  of  the  Schick  test,  collection  of  cultures 
smears  and  blood  for  laboratory  examination,  medical  examination  of  food  handlers 

31 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HP:ALTH. 

in  the  institutions,  the  issuance  of  permits  for  day  nurseries,  child-caring  institutions 
and  private  hospitals,  vertification  of  the  monthly  medical  reports  of  child-caring 
institutions  required  by  the  State  Public  Health  Law,  diagnosis  of  sickness  among 
employees  and  performance  of  the  field  work  for  the  Divisions  of  Epidemiology, 
Venereal  Diseases  and  Industrial  Hygiene,  so  far  as  it  concerns  institutions. 

Important  Activities — January  8th,  inspection  was  begun  of  child-caring  institu- 
tions outside  of  the  City  of  New  York  to  which  New  York  City  children  are  com- 
mitted. 

January  15th,  202  institutions  were  added  to  the  total  of  those  in  the  file,  making 
a  total  of  760  institutions  inspected  by  this  Division. 

January  22nd,  a  system  of  sanitary  inspections  for  all  institutions  was  inaugurated. 

February  5th,  co-operation  was  established  with  the  Bureau  of  Fire  Prevention 
relative  to  private  hospitals. 

February  12th,  an  effort  was  directed  towards  establishing  small  wards  for  chil- 
dren in  hospitals  to  limit  quarantine  and  lessen  inconvenience. 

February  19th,  a  crusade  was  begun  in  co-operation  with  the  Police  Department 
against  violation  of  Mendicacy  Act  by  day  nursery  collectors.  Seven  arrests — all 
guilty— sentence  suspended. 

February  26th,  co-operation  was  established  with  the  Charities  Department  in 
relation  to  the  return  of  children  from  the  Metropolitan  Hospital  whence  they  had 
been  sent  for  minor  contagious  diseases,  as  soon  as  contagious  period  has  passed 
instead  of  being  kept  there  until  cured  as  was  the  custom. 

March  2nd,  two  night-shelters  for  babies  were  established.  This  is  a  much 
needed  facility  to  help  mothers  who  work  at  night  and  is  similar  in  operation  to  the 
day  nurseries. 

April  1st,  750  food  handlers  in  institutions  were  examined.  This  was  done  because 
of  the  refusal  of  employees  to  be  examined  by  institution  physician. 

May  6th,  800  typhoid  immunizations  were  made  in  the  House  of  Refuge,  on  Ran- 
dall's Island. 

New  York  Hospital  was  induced  to  adopt  rules  relating  to  the  admission  of  chil- 
dren, to  wit :  The  large  children's  ward  was  subdivided  into  smaller  wards,  in  which 
children,  when  admitted,  were  segregated  according  to  past  history  of  the  disease. 
The  entrance  of  an  infectious  disease  was  thus  limited  to  one  small  room  instead  of 
a  large  ward. 

The  Children's  Aid  Society  of  Brooklyn,  was  induced  to  have  the  physical  defects 
of  children,  placed  in  boarding  homes  by  them,  corrected,  operations  being  performed 
at  the  headquarters  of  the  Society. 

May  13th,  an  investigation  was  begun  to  ascertain  what  factor  visiting  children 
to  child-caring  institutions  play  in  the  dissemination  of  diseases  of  a  communicable 
nature.    A  tabulated  result  of  this  investigation  will  be  ready  in  the  spring  of  1917. 

May  20th,  the  Orphans'  Home  in  Brooklyn  was  induced  to  limit  their  visiting  days 
to  two  days  a  month  instead  of  every  day,  as  heretofore,  and  child  visitors  are  to  be 
excluded. 

May  27th,  the  House  of  Refuge  was  induced  to  adopt  typhoid  immunization  for 
every  new  admission. 

Messiah  Home  was  induced  to  assign  two  nurses  to  devote  their  entire  time  to 
the  supervision  of  the  physical  welfare  of  the  children. 

Brooklyn  Training  School  for  Girls  was  induced  to  adopt  a  regulation  of  requir- 
ing negative  smears  before  admission  of  applicants. 

June  3rd,  Nursery  and  Child's  Hospital  was  induced  to  adopt  the  application  of 
the  Schick  test  as  a  matter  of  routine. 

32 


IXTRODL'CTION. 

New  York  Hospital  was  induced  to  establish  an  educational  class  for  syphilis  in 
connection  with  social  service. 

June  10th,  a  census  was  taken  of  the  cases  of  cerebrospinal  meningitis,  paresis 
and  locomotor-ataxia  of  syphilitic  origin  in  the  institutions  in  Greater  Xew  York. 
There  were  78  cases  of  cerebrospinal  meningitis,  Z22  cases  of  paresis  and  233  cases 
of  locomtor-ataxia. 

June  17th,  the  Colored  Orphan  Asylum  was  induced  to  maintain  two  separate 
isolating  quarters,  one  for  new  admissions  and  one  for  permanent  inmates. 

July  8th,  Convent  of  Mercy  was  induced  to  have  every  physical  defect  in  their 
children  corrected  or  improved. 

October  7th,  Brooklyn  Orphan  Asylum  was  induced  to  appoint  an  orthopedic 
surgeon  to  its  staff. 

November  11th,  Fordham  Hospital  was  required  to  erect  mosquito  net  screens 
over  each  individual  bed  occupied  by  a  typhoid  fever  patient. 

November  25th,  analysis  of  the  cases  of  infectious  diseases  occurring  in  institu- 
tions during  the  first  quarter  of  1916,  shows  that  institutions  schooling  their  own 
children  and  prohibiting  children  visitors,  there  occurred  75  per  cent,  less  cases  of 
contagious  diseases  than  in  other  institutions  not  so  regulated.  A  recommendation 
was  made  that  all  institutions  sending  their  children  outside  for  schooling  be  required 
to  provide  for  schooling  their  children  within,  but  this  was  abandoned  due  to  the 
great  expense  entailed.  A  majority  of  institutions  are  willing  to  exclude  children 
under  the  age  of  16  years  as  visitors  and  this  policy  will  be  urged  on  all  child-caring 
institutions  in  the  coming  year. 

The  Greenpoint  Hospital  was  induced  to  open  a  special  ward  in  the  isolation 
building  for  the  care  of  vaginitis  cases. 

December  9th,  on  suggestion  of  this  Division,  the  Nursery  and  Child's  Hospital, 
Manhattan,  divided  up  a  large  ward  into  stalls,  10  by  9  feet,  by  erecting  glass  par- 
titions 7  feet  high,  thus  making  an  admirable  quarantine  ward.  This  hospital,  in  the 
past,  has  been  a  heavy  contributor  to  the  contagious  diseases,  but  since  this  improve- 
ment was  made,  no  secondary  cases  have  developed  in  this  ward,  so  far,  although 
there  have  been  cases  of  measles,  diphtheria,  scarlet  fever  and  poliomyelitis  there. 

Improvements  Accomplished  by  Personal  £#orf— Through  the  personal  efforts 
of  inspectors  of  this  Division,  the  following  institutions  made  improvements  during 
the  year : 

St.  John's  Home  installed  model  facilities  for  children. 

The  Master's  School  Day  Nursery  expended  over  $4,000  for  the  improvement 
of  sanitary  conditions. 

Messiah  Home  adopted  a  scientific  dietary. 

The  Osanam  Home  for  P'riendless  Women  installed  new  hot  water  system. 
New   York  Foundling  Hospital   painted  the   walls   and   halls   throughout  the 
entire  building. 

St.   Cecelia's   Day    Nursery   supplied   paper   towels   and   drinking   cups,    liquid 
soap  and  nipples  kept  in  antiseptic  solution  in  individual  wide  mouth  bottles,  and 
renovated  and  put  the  building  in  a  sanitary  condition  throughout. 
Friend  in  Need  Day  Nursery  moved  into  new  building. 
Scalabrini  Day  Nursery  completely  renovated  their  premises. 
French  Maternal  Day  Nursery  and  Chelsea  Day  Nursery  adopted  the  use  of 
paper  towels. 

St.  Columbkills  Day  Nursery  moved  into  new  quarters. 
Ridgewood  Day  Nursery  painted  the  day  nursery  for  training  work. 
Messiah  Home  improved  its  grounds  and  utilized  them  as  a  place   for  rec- 
reation. 

33 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

St.  Mary's  Home  completely  remodeled  and  renovated  their  premises. 

Brooklyn  Industrial  Home  for  Destitute  Children,  Brooklyn  Nursery  and 
Infant  Hospital  and  Dominican  Convent  made  extensive  improvements. 

Sea  Breeze  House  installed  new  plumbing  and  steam  heat. 

International  Sunshine  for  Blind  Babies  renovated  the  entire  building. 

Industrial  Home  in  Brooklyn  erected  new  isolation  building,  following  the 
condemnation  of  the  old  building  by  this  Department. 

Home  of  Our  Sorrowful  Mother  built  a  new  roof  and  a  laundry  building. 

The  Mission  of  the  Immaculate  Virgin  converted  two  storage  rooms  into 
additional  isolation  rooms. 

The  Mission  of  the  Immaculate  Virgin  on  Staten  Island  installed  a  $1,000 
pasteurizing  plant. 

All  hospitals  and  several  of  the  institutions  in  the  Chelsea  district  estalilished 
a  social  service  department. 

The  Lincoln  Hospital  in  The  Bronx  vacated  the  old  isolation  quarters  and  con- 
verted them  into  a  laboratory. 

The  Kallman  Home  provided  glass  tops  for  all  their  dining-room  tables. 

The  Colored  Orphan  Asylum  at  Riverdale  prepared  a  scientific  dietary  with 
the  result  that  considerable  improvement  in  the  physical  condition  of  the  children 
has  been  noted. 

The  German  Hospital,  Brooklyn,  installed  liquid  soap  and  paper  towels. 

Brooklyn  Nursery  and  Infant  Hospital  adopted  the  Schick  test  as  a  routine 
procedure. 

St.  Mary's,  Manhattan,  made  extensive  sanitary  improvements. 

St.  Joseph's  Female  Orphan  Asylum  installed  a  new  refrigerating  plant. 
Achievements— Schick  Test:  The  Schick  test  has  been  adopted  by  nearly  all  of 
the  child-caring  institutions  in  this  city  through  the  eflorts  of  this  Division. 

Improvements — Twenty-nine  institutions  in  this  city  were  induced  to  make  exten- 
sive improvements  to  their  premises. 

Control  of  Whooping  Cough — Through  the  prompt  removal  of  12  children  and  the 
injection  of  others  with  whooping  cough  vaccine,  an  outbreak  of  whooping  cough 
at  the  New  York  Nursery  and  Child's  Hospital  was  controlled. 

DIVISION  OF  RESEARCH  AND   EFFICIENCY. 

(In  the  Office  of  the  Commissioner,  January-July.     In  the  Bureau  of  General 

Administration,  July-December.) 

Changes  in  Staff — One  medical  inspector,  one  clerk  did  the  work  of  the  Division 
until  July  1st,  when  it  was  merged  in  the  Bureau  of  General  Administration. 

Functions — This  Division  was  charged  with  administrative  research  and  the 
development  of  more  efficient  methods  of  operation  in  and  between  Bureaus. 

Important  Activities — January  8th,  a  study  was  begun  of  the  follow-up  system  in 
vogue  for  discharged  patients  from  hospitals  with  a  view  to  improving  it. 

An  investigation  was  made  of  the  culture  station  service.  Superfluous  supply 
stations  were  eliminated  and  a  better  system  established  for  furnishing  supplies  and 
the  collection  of  culture  outfits  and  other  diagnostic  material. 

January  18th,  an  investigation  of  the  printed  forms  in  use  in  the  various  Bureaus 
resulted  in  changing  many  forms  so  as  to  conform  to  standard  sizes. 

An  investigation  of  the  laboring  force  in  the  Manhattan  building  was  made. 

January  22nd,  co-operating  with  the  Civil  Service  Commission,  a  new  service 
record  system  was  planned. 

34 


IXJRODUCTION. 

Analysis  of  the  space  used  in  the  Brooklyn  Borough  building  was  made  with  a 
view  to  providing  room  for  the  Brooklyn  branch  of  the  Division  of  Stenography  and 
Typewriting  and  securing  space  in  the  basement  for  storing  stationery,  which  up  to 
that  time  had  taken  valuable  floor  space  in  the  Manhattan  building.  Analysis  was 
made  of  the  space  used  in  the  Manhattan  building  for  the  various  Bureaus  with  a 
result  that  the  entire  third  floor  was  vacated  for  the  use  of  the  Bureau  of  Preventable 
Diseases. 

January  29th,  plans  were  made  for  the  establishment  of  branches  of  the  Division 
of  Stenography  and  Typewriting  in  the  Boroughs  of  The  Bronx  and  Queens.  A 
report  was  made  recommending  that  branches  be  established  in  these  boroughs. 

February  5th,  an  investigation  was  made  of  drug  stores  relative  to  prices  charged 
for  laboratory  products.  A  revision  of  the  Department  prices  for  laboratory  products 
followed,  the  prices  generally  being  reduced  and  a  more  liberal  commission  given  to 
druggists  for  distributing  them. 

An  examination  was  made  of  the  method  of  reporting  transactions  in  laboratory 
products  m  the  Division  of  AduUs  and  Accounts. 

_  February  19th,  by  request  of  City  Chamberlain  Bruere.  assistance  was  given  him 
m  compiling  a  survey  of  the  work  performed  by  the  various  Bureaus  of  the  Depart- 
ToT.\a7...^   ''^''''   *°  ''''    ^^^^'°'   °"    "^''''   ^'""'^   ^''y''   Administrative    Progress 

February  26th,  an  investigation  was  made  of  the  correspondence  filed  in  the  Sani- 
tary Bureau  and  of  the  use  of  forms  in  the  Bureau  of  Child  Hygiene. 

March  11th,  an  investigation  was  made  of  the  disposition  of  monies  received 
from  pay  patients  at  Otisville. 

Alarch  18th,  a  study  was  made  of  the  accounting  system  of  the  Department  with 
a  view  to  its  improvement. 

April  1st,  the  preparation  of  the  annual  budget  was  begun. 

April  8th,  an  investigation  was  made  of  a  new  system  of  periodical  reports  to  be 
used  by  the  Bureau  of  Food  and  Drugs. 

An  investigation  was  made  of  the  messenger  service  in  the  Boroughs  of  Brooklyn 
and  Queens,  and  a  better  service  planned  without  any  additional  cost  to  the  Depart- 
ment. 

April  15th,  a  study  was  made  of  the  clerical  service  in  the  Bureau  of  Child 
Hygiene  for  the  purpose  of  securing  clerks  for  the  new  health  centres  in  the  Borough 
of  Queens. 

April  22nd,  an  investigation  was  made  of  the  labor  service  in  the  Borough  of  The 
Bronx. 

May  6th,  a  campaign  known  as  baby  week  was  directed  by  this  Division,  co-operat- 
ing with  the  various  baby  welfare  agencies  throughout  the  city. 

July  1st,  a  visible  index  was  installed  to  be  used  in  following  up  the  personnel 
of  the  Department,  the  organization  of  Bureaus  and  keeping  the  information  required 
by  the  Bureau  of  Standards  and  the  Civil  Service  Commission  as  to  the  employees 
of  the  Department. 


35 


BUREAU  OF  GENERAL  ADMINISTRATION. 

Changes  in  Staff — On  December  31,  1916,  Mr.  Eugene  W.  Scheffer,  Secretary  of 
the  Department,  retired.  From  July  1st  to  December  31st,  Dr.  A.  E.  Shipley  was 
Acting  Secretary. 

Changes  in  Organization — Branches  of  the  Division  of  Stenography  and  Type- 
writing were  organized  in  the  Boroughs  of  The  Brohx,  Queens  and  Richmond. 

December  11th,  the  general  transportation,  janitorial  and  messenger  service  here- 
tofore scattered  in  some  of  the  Bureaus,  was  concentrated  under  the  direction  and 
control  of  this  Bureau. 

Plans  have  been  prepared  to  reorganize  this  Bureau,  to  take  effect  January  1, 
1917,  by  which  the  administration  of  the  Bureau  will  be  apportioned  to  the  following 
divisions:  (1)  Division  of  Supplies  (purchase  and  storage),  (2)  Division  of  Con- 
struction and  Repairs  (general  transportation  and  janitorial  service),  (3)  Division  of 
Clerical  Service  (supervision  of  clerical  work,  telephone  and  messenger  service  and 
the  sale  of  laboratory  products  at  the  various  offices  in  the  five  boroughs),  and  (4) 
Division  of   Stenography  and  Typewriting    (branches  in   each   one  of  the  boroughs). 

Important  Activities — January  29th,  the  rules  and  regulations  for  all  employees 
of  the  Department  of  Health  were  revised  and  printed. 

January  29th,  regulations  governing  the  registration  of  patent  and  proprietary 
medicines  were  amended. 

March  4th,  a  new  procedure  was  adopted  for  diphtheria,  to  wit :  A  minimum 
period  of  duration  is  to  be  12  days  and  no  later  cultures  are  to  be  examined  before 
the  expiration  of  that  period. 

March  18th,  the  regulation  governing  the  establishment  and  maintenance  of  hos- 
pitals was  amended. 

April  29th,  the  following  sections  of  the  Sanitary  Code  were  amended: 

Section  57 — Schools,  gymnasiums  and  places  of  public  worship ;  duties  and 
responsibilities  of  persons  in  charge. 

Section  222 — Schools,  permits  required. 

Section   104 — Cyanide  used   for   fumigating  purposes,  use  of,  regulated. 

Section  146 — Employment  of  persons  affected  with  infectious  or  venereal 
diseases  prohibited. 

Section  301 — Public  vehicles  and  other  public  places  to  be  cleaned  daily. 

Section  170 — Ice  cream,  manufacture  in  and  bringing  into  the  City  of  New 
York  regulated. 

Section  144 — Cooking,  eating  and  drinking  utensils  to  be  properly  cleansed 
after  being  used. 

Alay  31st,  a  resolution  was  adopted  by  the  Board  of  Health,  to  wit:  (1)  that 
the  Department  of  Health  adopt  a  policy  of  compulsory  detention  of  all  vagrant 
consumptives  (popularly  known  as  "the  lodging  house  type"),  whose  sputum  is 
positive  and  who  are  a  menace  to  the  community.  (2)  That  for  this  purpose  River- 
side Hospital  so  far  as  it  makes  provision  for  tuberculous  patients,  be  used  entirely 
as  a  detention  hospital. 

April  25th,  rules  were  adopted  to  govern  the  employees  at  the  Municipal  Sana- 
torium at  Otisville.  The  administration  of  the  Sanatorium  was  organized  into  three 
divisions:   (1)  Hospitals,  (2)  Farm  Industries  and   (3)   Construction  and  Repairs. 

36 


BUREAU    OF    GENERAL    ADMINISTRATION. 

July  1st,  the   following  sections  of  the  Sanitary  Code  were  amended: 

Section  340 — Bathing  establishments  regulated. 

Section  327 — Slaughtering  of  horses  and  sale  of  horseflesh  for  food  regulated. 

January  29th,  the  following  sections  of  the  Sanitary  Code  were  amended  : 

Section  352 — Vessels  from  infected  ports,  or  liable  to  quarantine,  not  to  be 
brought  within  three  hundred  yards  of  docks  or  piers  unless  permitted. 

Section  13 — Tuberculin  test  of  cows  ;  certificate.    Regulation  1 — Manner  of  testing. 

September  26th,  a  new  form  of  agreement  and  price  list  was  adopted  for  anti- 
toxin and  culture  station  supplies. 

October  14th,  a  new  procedure  was  adopted  in  relation  to  Departmental  mail,  with 
ai  view  to  eliminating,  as  far  as  possible,  the  receipt  of  personal  letters  by  Department 
employees. 

November  11th,  an  investigation  was  made  of  the  janitorial,  messenger  and  trans- 
portation service  of  the  Department  with  the  result  that  on  December  1st  these  activi- 
ties were  transferred  from  the  various  Bureaus  to  the  Bureau  of  General  Adminis- 
tration. 

December   16th,  the  following  sections  of  the   Sanitary  Code   were  amended: 

Section  301 — Public   vehicles   and   other   public   places   to   be   cleaned   daily. 

Section  302 — Railroad  cars  and  other  public  vehicles,  carrying  or  conveying 
soiled  or  dirty  clothing  restricted. 

Section  303 — Railroad  cars  and  other  public  vehicles,  to  be  adequately  and 
suflFiciently  ventilated. 

Section   304 — Heating  of   railroad   cars   and  other  public   vehicles. 

Section  305 — Lighting  of  railroad  cars  and  other  public  vehicles. 

Section  306 — Cars  not  to  be  overcrowded. 

Section  307 — Public  vehicles  not  to  be  overcrowded. 

December  28th.  the  following  sections  of  the  Sanitary  Code  were  amended  : 

Section  138 — Possession  of  food  or  drugs,  prima  facie,  deemed  to  be  held  for 
sale. 

Section  136 — Inspection  of  food  and  other  substances  authorized. 
Section  129 — Condemnation  and  destruction  of  drugs  authorized. 

Section  127 — Room,  factory,  stall,  place  and  appurtenances  to  be  kept  in  a 
cleanly  and  wholesome  condition  ;  food,  drugs  and  drink  to  be  clean  and  whole- 
some, and  not  poisoned,  infected,  or  rendered  unsafe;  personal  responsibility  of 
owner,  lessee,  occupant  or  person  in  charge. 

Section  53 — Nuisances,  conditions  dangerous  and  prejudicial  to  life  or  health; 
duties  oF  owners,  tenants,  lessees,  occupants  and  persons  in  charge  of  buildings 
and  lots. 

Regulation  No.  3  governing  the  establishment  and  maintenance  of  hospitals  was 
amended. 


37 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF    HEALTH. 

TABLE  No.  L 

STATEMENT  SHOWING  EXPENSES  OF  THE  DEPARTMENT  OF  HEALTH 

1914,  1915  AND  1916. 


1914. 

1915. 

1910.* 

From  Budget 
Allowance. 

Poliomyelitis 
Allowance. 

Total. 

$207,356  24 

$287,.568  36 
18,405  05 
65,884  73 
671,809  99 
536,611   .58 
293,393  63 
248,710  05 
223,377  89 

12,0.'')9  32 

11,100  .5.S 

253,495  79 

281,916  26 

194,276  92 

$301,012  74 
16,495  89 
64,596  .56 
6.50,362  07 
.508,987  88 
314,417  67 
241,040  25 
227,894  06 

17,473  01 

$2,814  64 
17  00 

$303,827  38 
10,512  89 
04  596  56 

65,417  67 
657,965  .58 
571, .396  77 
277,276  .39 
214,710   16 
201,730  07 

4,230  90 

9,230  92 

253,468  07 

288,113  49 

186,840  40 

650  362  07 

Preventable  Diseases 

39,341    14 
33  67 

.548,329  02 
314  451   34 

241,040  25 

Laboratory  Service 

Hospital  Service: 

7,421   45 

235,315  51 
17,473  01 

Willard  Parker 

Riverside 

KinRston  Avenue 

2 74,. 307  65 

286,353  00 

204,373  77 

30,101   53 

253,286  89 

133,752  97 

36,7.50  04 

30,804  37 

6,225  09 

408,060  62 

323,103   10 

235,238   14 

36,386  62 

253  286  89 

Municipal       Sanatorium, 

250,562  02 

223,755  34 

Total 

$3,248,311   28 

$3,322,426  09 

$3,390,763  03 

$257,220  37 

83,647,983  40 

*NoTE. — The  reason  that  estimated  figures  are  given  for  the  year  1916,  is  that  no  reports  of  amounts 
expended  for  the  last  quarter  of  1916  have  been  received  from  the  Bureau  of  Hospitals  and  it  will  be  some 
time  before  such  reports  are  received,  and  all  bills  for  purchases  made  in  1916,  will  not  be  in  until  April 
l»t,  1917. 

TABLE  No.  2. 

COMPARATIVE   STATEMENT   OF   RECEIPTS   OF  THE   DEPARTMENT   TURNED 

OVER  TO  THE  GENERAL  FUND. 


1915. 


1916. 


Laboratory  Products — Total 

Searches  and  transcripts 

Care  and  Maintenance  of  Hospitals 

Auction  Fat 

Waste  Paper 

ISIiscellaneous 

Total 


$55,199  SO 
36,175  55 

'""88383 

li2  U 


)2,371  32 


579,764  19 

35,585  40 

2,121  00 

402  63 

117  24 

218  43 


$118,208  89 


LAW    DIVISION. 

Changes  in  Organization — In  order  to  fix  more  definitely  the  responsibility  for 
carrying  out  the  legal  policy  and  court  procedure  of  the  Department,  and  provide 
a  more  effective  administrative  control,  eliminate  trivial  and  unnecessary  prosecutions, 
and  promote  co-operation  between  Bureaus,  a  plan  was  adopted  to  centralize  the 
legal  work  of  the  Department  and  place  it  under  control  of  the  Law  Clerk. 

Changes  in  Procedure — Municipal  Term  Court:  A  Municipal  Term  Court  was 
established  in  the  Boroughs  of  Manhattan  and  Brooklyn  in  the  early  part  of  the  year. 
The  purpose  of  this  Court  is  to  centralize  all  prosecutions  based  upon  complaints  of 
the  various  branches  of  the  Municipal  Government  alleging  violations  of  the  Sanitary 
Code  and  the  Ordinances  of  The  City  of  New  York. 


38 


BUREAU  OF  GENERAL  ADMINISTRATION. 

Prior  to  this,  a  complaint  had  to  be  submitted  to  the  District  Magistrates'  Court 
wherein  the  violation  occurred  The  cases  were  thus  widely  scattered  throughout  the 
city,  much  confusion  resulted  and  adequate  administrative  control  and  legal  repre- 
sentation was  impossible. 

Now  a  representative  of  the  Corporation  Counsel's  Office  is  always  present  to 
protect  the  interests  of  the  Department,  the  administrative  control  of  the  court  pro- 
cedure is  definite  and  certain,  and  the  confusion  due  to  the  scattering  of  cases 
throughout  the  whole  city  has  been  eliminated. 

Important  Activities — Food:  As  a  result  of  the  efforts  of  the  Bureau  of  Foods 
and  Drugs  to  eliminate  the  source  of  the  supply  of  unwholesome  and  adulterated 
foods,  the  number  of  prosecutions  against  large  dealers  has  materially  increased 
during  the  past  year  and  a  number  of  heavy  fines  have  been  imposed. 

Drugs — Four  patent  medicine  fakers  were  convicted  and  received  prison  sentences 
and  three  paid  heavy  fines.  Two  druggists  were  convicted  of  substituting  ingredients 
in  prescriptions  and  heavy  fines  were  imposed  by  the  Court  in  each  instance. 

The  question  of  the  right  of  the  Department  to  regulate  the  sale  of  patent  and 
proprietary  medicines  in  TTie  City  of  New  York  is  now  pending  before  the  Appellate 
Division,  Second  Department,  for  decision. 

Births  and  Deaths — Two  hundred  and  thirty-six  physicians  and  midwives  were 
prosecuted  for  their  failure  to  report  births  within  ten  days.  Civil  actions  were  insti- 
tuted and  penalties  collected  amounting  to  $929. 

A  number  of  undertakers  and  cemetery  keepers  were  prosecuted  for  their  failure 
to  comply  with  the  regulations  governing  the  transportation  and  burial  or  other 
disposition  of  the  bodies  of  human  beings. 

Infectious  Diseases — A  number  of  persons  were  prosecuted  for  their  failure  to 
comply  with  the  quarantine  regulations.  Severe  penalties  were  imposed  where  the 
facts  indicated  a  wanton  disregard  of  law. 

TABLE  No.  1. 


Civil  Actions. 


1915. 


1916. 


Violations  received  and  notices  sent 

Violations  complied  with  before  suit 

Civil  Actions  begun 

Amount  of  penalties  collected  in  civil  actions 

Criminal  Actions — Magistrates'  Courts 

New  cases  in  Magistrates'  Courts 

Held  for  Special  Sessions 

Discharged 

Fined 

Sentence  suspended 

Jail  sentence 

Amount  of  fines  imposed 

Criminal  Actions — Courts  of  Special  Sessions 

Fined 

Discharged 

Sentence  suspended 

Jail  sentences 

Amount  of  fines  imposed 


7,439 

4,367 

7,270 

4,280 

123 

242 

$918  00 

$956  00 

12,346 

11,567 

2,192 

345 

1,582 

1,201 

6,756 

7,975 

1,789 

2,063 

17 

12 

$13,888  75 

$23,933  00 

1,241 

1,658 

386 

255 

954 

506 

15 

10 

$29,326  00 

$34,170  86 

39 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


SANITARY  BUREAU 


TOTAL  COMPLAINTS      ^^H 


RESULTS  OF 
INSPECTIONS 


NO  CAUSE 
FOR  ACTION 

ABATED   BY 
PERSONAL  EFFORT 

REFERENCES 

NOTICE    OR 
ORDERS 


PEND1NC   END 
\  OF    YEAR 


€215 
4955 

}4352 
14899 

179 
372 


TOTAL    INSPECTIONS     ^1%11| 

/«.».c»    eiiABC  33151 

72781 


BARBER  SHOPS 
LODGING  HOUSES      |Sf  o 
VACANT  LOTS 


PRIVIES  & 
CESSPOOLS 


11525 
12995 


STABLES 

WATER  SUPPUES  J^<5 

SMOKE  /igg 

HORSC  TROUGHS  [2J4 


TOTAL      ARRESTS 


'215  L 
2/09  I 


1      ♦34?|9I3 


43^.1915 
■IHISiS 


■^1916 


rrnigis 

1    1915 

iHligie 


♦  IOg^l9l5 

■IHioie 


H9I5 

1^HI9I6 


♦  101^1915 
^■■1916 


— — |I9I5 
F^I9I6 

Jiifl9lS 
■■1916 


11915 


52%   1916 

1<-I9'^I9I5 
■■■1916 


II9I5 

="85%  1916 

474?^  1915 


I1916 


40 


SANITARY  BUREAU. 

Changes  in  Staff— The  Bureau  lost  an  Assistant  Sanitary  Superintendent,  Dr.  T. 
R.  M'axfield,  and  two  sanitary  inspectors,  by  death.  Two  sanitary  inspectors  were 
added  to  the  staff. 

Chaiiga  in  Procedure — File:  On  January  1st,  the  house  file  system  was  insti- 
tuted. Under  the  address  visited,  an  envelope  is  filed  containing  all  complaints  and 
other  papers  with  a  record  of  all  visits  made  to  the  premises. 

Book  of  Recommendations — Each  inspector  was  supplied  with  a  book  of  instruc- 
tions containing  standardized  recommendations  pertaining  to  notices,  orders,  etc. 

Municipal  Term  Court — The  establishment  of  the  new  Municipal  Term  Court  for 
handling  violations  of  the  Sanitary  Code.  The  improvement  in  this  change  is  that 
an  inspector  can  now  arraign  a  number  of  violators  in  one  court  where  before  he 
was  compelled  to  spend  considerable  time  traveling  to  the  different  courts  having 
jurisdiction  over  the  premises  in  which  the  violation  occurred. 

Seasonal  Notices — Notices  issued  on  seasonal  nuisances  are  now  filed  as  pending 
during  the  winter  months  and  reinspections  on  these  are  made  at  the  beginning  of  the 
spring.  These  notices  were  formerly  filed  as  sufficiently  complied  with  and  only  a 
tickler  file  or  the  memory  of  the  inspector  was  depended  upon  to  institute  a  spring 
inspection. 

Important  Activities — Stables:  During  the  poliomyelitis  epidemic,  each  stable  in 
the  vicinitj^  of  a  case  reported  was  at  once  inspected  with  a  view  to  enforcing  the 
stable  regulations  especially  as  regards  the  breeding  of  flies  from  manure  heaps. 

Manure — The  transportation  of  manure  was  rigorously  supervised,  the  proprietors 
of  stables  being  compelled  to  use  lime  or  borax  on  the  manure  before  shipping  and 
the  railroad  companies  being  required  to  cement,  grade  and  drain  the  loading  sidings. 

Sanitary  Surveys — Sanitary  surveys  were  made  in  certain  selected  sections  of  the 
city.  Insanitary  conditions  were  corrected  and  the  proper  care  and  removal  of  refuse, 
garbage  and  other  material  were  enforced. 

Tenement  House  Nuisances — This  Bureau  took  direct  action  in  compelling  owners 
of  tenement  houses  in  infected  areas  to  remedy  insanitary  conditions  instead  of  re- 
ferring them  to  the  Tenement  House  Department  as  was  formerly  done.  This  change 
in  procedure  was  justified  by  the  poliomyelitis  epidemic. 

Scicage — A  study  of  the  sewage  system  of  the  city  is  in  progress  for  the  purpose 
of  formulating  a  definite  program  of  sewage  disposal  which  this  Department  can  con- 
sistently demand.  The  removal  of  sewage  from  the  ground  surfaces  and  its  disposal 
beyond  fly  contact,  is  one  of  the  most  important  activities  of  this  Bureau.  A  campaign 
has  been  conducted  for  the  installation  of  sewers  in  unsewered  areas  and  the  sub- 
merging of  sewer  outlets  when  connection  with  a  disposal  plant  has  been  impracticable. 

Representatives  of  the  Bureau  appeared  at  the  meetings  of  local  boards  in  the 
different  Boroughs  and  advocated  the  construction  of  sewers  wherever  possible. 
Where  such  personal  efforts  are  unavailing,  such  as  for  example  at  South  Beach  and 
Midland  Beach,  where  there  are  no  sewers  and  where  the  sewage  from  all  the  con- 
cessions and  from  a  large  colony  further  inland  finds  its  way  through  shallow  ditclies 
to  the  waters  washing  the  beaches  which  are  used  by  thousands  of  bathers,  the  Board 
of  Health  has  declared  the  existing  conditions  to  be  a  public  nuisance  and  has  called 
on  the  Board  of  Estimate  and  Apportionment  to  take  steps  to  correct  these  conditions. 

41 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

The  County  Jail  and  County  Farm  on  Staten  Island  were  induced  to  provide  suit- 
able sewers  and  disposal  systems.  These  institutions  have  for  years  been  dis- 
charging sewage  either  on  the  public  highways  or  upon  private  and  public  land. 

Orders  were  issued  to  owners  of  property  on  Beaver  Creek  to  discontinue  drains 
into  the  creek  and  provide  suitable  cesspools  for  their  premises. 

In  various  low-lying  sections  in  the  city,  property  owners  were  induced  to  build 
private  sewers  to  connect  with  public  sewers  or  with  the  waters  around  the  city,  so 
as  to  prevent  the  discharge  of  sewage  into  the  streets. 

Owners  of  private  property  along  the  banks  of  the  Bronx  River  were  compelled 
to  discontinue  discharging  sewage  into  the  river.  The  removal  of  the  public  sewers, 
however,  has  been  a  more  difficult  problem.  The  engineers  of  the  Board  of  Estimate 
and  Apportionment  have  been  requested  to  change  the  outlet  for  the  sewer  now  dis- 
charging into  the  Bronx  River  at  234th  Street  and  carry  this  sewage  by  a  siphon 
and  line  to  one  of  the  other  sewers  to  the  eastward. 

Many  old  sewers  and  their  connections  have  had  to  be  altered  or  removed  in 
excavating  for  the  new  subway  which  runs  through  the  Boroughs  of  Manhattan, 
Brooklyn  and  The  Bronx.  There  was  a  disposition  on  the  part  of  some  owners  and 
contractors  to  allow  house  sewage  to  escape  into  the  open  cut  or  into  uncovered  box 
flumes,  but  by  means  of  board  orders,  these  contractors  were  compelled  to  provide 
suitable  sewers  and  house  connections. 

Refuse  Dutnps — Regular  periodic  inspections  have  been  made  of  refuse  dumps 
and  all  the  carts  transporting  refuse  material.  The  regulations  relative  to  the  cover- 
ing of  carts,  disinfection  of  dumps  and  prevention  of  Ry  breeding,  the  regular  removal 
of  salable  material  salvaged  and  the  proper  covering  of  any  offensive  materials,  were 
rigidly  enforced. 

Spitting  Crusade — In  co-operation  with  the  sanitary  police  and  the  Police  Depart- 
ment, crusades  have  been  carried  on  at  different  times  during  the  year  against  spitting 
in  public  conveyances,  railway  stations,  public  buildings,  etc.  Numbers  of  arrests 
were  made  and  most  of  those  arrested  were  fined. 

Labor  Camps — Labor  camps  established  by  railroad  companies  during  the  recent 
strikes  and  by  other  large  employers  of  labor,  due  to  the  shortage  of  laborers  in  the 
city,  were  inspected  and  those  in  charge  were  required  to  comply  with  the  regulations 
governing  camps  of  this  character. 

Anti-Mo sqi'Ato  Work — The  owners  of  land  along  the  meadows  from  Chelsea  to 
Linoleumville,  in  the  Borough  of  Richmond,  in  the  Westchester  section  of  The 
Bronx,  in  the  Sunswick  Creek  section  of  Long  Island  City,  in  Corona,  in  the  Rockaway 
section  of  Queens  and  in  the  Bath  Beach,  Bay  Ridge,  Bensonhurst  and  Brighton 
Beach  sections  of  Brooklyn,  have  been  compelled  to  ditch  and  drain  sunken  or 
swampy  land  or  fill  in  the  same  with  ashes,  street  sweepings,  dirt  from  the  subway 
and  dirt  pumped  from  the  bed  of  waterways.  Where  filling  or  draining  has  been 
impracticable  the  stagnant  water  has  been  oiled.  Over  5,000  gallons  of  oil  have  been 
spread  by  the  mosquito  squad  under  the  supervision  of  the  sanitary  engineer. 

To  educate  the  public  and  especially  school  children  in  the  method  of 
mosquito  propagation,  1,200  quarts  of  mosquito  larvae  were  collected  and  distributed 
in  pint  bottles  to  all  public  and  parochial  schools  and  to  public  buildings  throughout 
the  city. 

A  special  squad,  known  as  the  mosquito  squad,  has  kept  the  ditches  open  in  the 
swamp  lands  of  the  Borough  of  Richmond,  and  has  cleaned  up  mosquito  and  fly- 
breeding  places  in  other  Boroughs.  For  example,  the  premises  known  as  the  new 
court  house  site,  in  Manhattan,  found  to  be  in  an  insanitary  condition  and  breeding 
mosquitoes,  were  cleaned  up  and  the   mosquito-breeding  water  drained  by  drilling  a 

42 


SANITARY    BUREAU. 

hole  in  a  sidewalk  vault.  Thirteen  loads  of  rubbish  were  burned  and  twenty-five 
loads  of  tin  cans  and  other  debris  were  removed  by  the  Department  of  Street  Cleaning. 
The  salt  marshes  from  Coney  Island  to  the  city  line,  including  the  islands  in 
Jamaica  Bay  and  the  marsh  lands  of  Baychester,  Eastchester  and  Westchester  in  the 
Borough  of  The  Bronx,  and  of  the  College  Point  section  of  Queens,  have  been 
drained  by  means  of  ditching. 

Public  Conveyances — Frequent  day  and  night  inspections  have  been  made  of 
public  conveyances  to  compel  proper  ventilation  and  thorough  cleaning.  The  recent 
amendment  to  the  Sanitary  Code  will  permit  this  Bureau  to  compel  the  cleaning  of 
cars  at  least  once  in  every  twenty-four  hours.  The  heating  of  cars  has  been  tested 
whenever  the  outside  temperature  has  been  below  40  degrees,  and  the  transportation 
companies  have  been  promptly  notified  of  any  violation  of  the  heating  regulation. 
Out  of  910  cars  tested  in  one  day,  56  were  found  to  have  a  temperature  of  less  than 
40  degrees,  the  standard  set  by  the  Public  Service  Commission.  It  is  intended  to 
begin  court  action  against  the  companies  if  these  violations  are  persisted  in. 

Private  Schools — The  inspection  and  supervision  of  private  schools  was  begun 
early  in  the  year  as  a  result  of  an  amendment  to  the  Sanitary  Code  providing  that 
no  schools,  other  than  those  maintained  by  the  Department  of  Education,  shall  be 
operated  without  a  permit  from  the  Department  of  Health. 

Motion  Picture  Theatres — In  co-operation  with  the  Bureau  of  Licenses,  inspec- 
tions were  made  of  motion  picture  theatres  during  night  performances  and  nearly 
every  one  was  found  to  be  improperly  ventilated.  The  Bureau  of  Licenses,  under 
whose  jurisdiction  these  houses  arc,  disciplined  the  owners. 

Noxious  JUceds — During  the  spring  and  summer,  through  the  personal  efforts  of 
sanitary  inspectors,  a  great  deal  of  poison  ivy,  rag  weed  and  other  noxious  weeds 
were  removed  from  highways  and  vacant  lots. 

Horseshoeing  Shol^s — All  the  horseshoeing  shops  in  the  city  have  been  brought 
under  permit  from  this  Department.  Compliance  with  the  regulations  drawn  up  for 
the  guidance  of  the  owners  of  these  shops  has  been  secured.  This  will  aid  in  the 
material  reduction  of  glanders. 

Dense  .S');!rAv— Several  owners  and  captains  of  tugboats  have  been  arrested  and 
convicted  and  fined  $25  on  the  charge  of  allowing  dense  smoke  to  issue  from  their 
boats. 

The  officers  of  railroad  companies  and  the  owners  of  factories  have  been 
repeatedly  warned  and  the  nuisances  have  always  been  abated.  Several  owners  of 
factories  have  been  advised  as  to  the  best  methods  of  operating  their  plants  with  a 
view  to  the  elimination  of  dense  smoke. 

Soot  Fall  Studies — To  determine  the  amount  of  soot  and  dust  in  the  air  of  the 
city,  a  number  of  jars  containing  about  two  inches  of  distilled  water,  and  weighted 
to  prevent  tipping,  were  placed  on  the  roofs  of  buildings  in  each  Borough.  It  is 
intended  to  continue  to  collect,  analyze  and  weigh  this  soot  and  dust  falling  into  these 
containers  at  monthly  intervals. 

Lodging  Houses — During  cold  weather  each  lodging  house  has  been  inspected  at 
least  twice  weekly  after  10  p.  m.  These  night  inspections  are  made  with  a  view  to 
determine  the  actual  operation  of  these  houses,  their  ventilation,  sanitary  condition 
and  number  of  occupants.  Conditions  have  improved  to  a  marked  degree  and  these 
houses  are  now  maintained  in  a  sanitary  condition. 

Pigs — Board  orders  have  been  issued  against  the  owners  of  piggeries  in  the 
Borough  of  The  Bronx  because  of  the  offensive  conditions  and  the  accumulated  gar- 

43 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

bage  used  to  feed  the  pigs.     A  determined  effort  will  be  made  to  secure  compliance 
with  such  orders  or  to  compel  abandonment  of  the  business  in  the  spring  of  1917. 

Summer  Resorts — A  crusade  was  begun  early  in  the  spring  against  the  use  of 
bathing  establishments,  houseboats,  bungalows  or  tents  without  permits  from  this 
Department.  These  establishments  were  regularly  inspected,  and  those  proprietors 
who  violated  departmental  regulations  were  arrested  and  in  most  instances  fined  by 
the  Court. 

Trial  Block — A  sanitary  survey  was  made  of  a  block  in  the  office  district  of  the 
Borough  of  Manhattan,  to  determine  the  conditions  under  which  employees  in  these 
offices  work.  Tests  were  made  of  the  quality  and  quantity  of  light  and  air  and 
inspections  were  made  of  the  sanitary  conditions  maintained.  Practically  all  of  the 
employees  in  the  block  worked  eight  hours  or  more  daily.  Only  50  per  cent,  of  them 
were  allowed  an  hour  for  lunch.  Artificial  light  was  used  very  generally,  natural 
light  being  insufficient.  Great  varieties  in  the  quantities  of  light  were  found,  varying 
from  one-half  a  foot-candle  to  40  foot-candles  of  light.  Eighteen  per  cent,  of  the 
office  workers  did  not  have  a  sufficient  amount  of  cubic  space  allotted  to  them. 
Mechanical  means  of  ventilation  were  used  only  in  first  floors  and  basements,  of  four 
buildings  in  this  block.  The  air  was  filtered  in  only  one  of  the  buildings  in  the  block. 
The  average  temperature  of  the  buildings  was  found  to  be  from  two  to  three  degrees 
too  high  (over  70  degrees).     The  humidity  was  found  to  be  20  degrees  too  low. 

Dusty  Trades — Orders  have  been  issued  to  many  manufacturers  requiring  that 
where  dust,  gases,  fibres,  etc.,  are  released  in  quantities  sufficient  to  injure  health, 
suitable  suction  devices  or  other  means  to  protect  the  workers  must  be  provided. 

Water  Supply — Periodic  sanitary  surveys  of  the  watershed  supplying  New  York 
City  with  water  have  been  made,  and  any  cases  of  possible  contamination  in  the 
vicinity  of  the  streams  have  been  investigated.  Samples  of  the  water  have  been 
collected,  regularly,  from  the  various  reservoirs  and  submitted  to  the  Department 
laboratory  for  analysis. 

Bottled  Waters — Inspectors  have  taken  samples  of  bottled  waters,  other  than 
medicinal  waters,  sold  in  the  city  and  have  submitted  them  to  the  laboratory  for 
analysis.  A  number  of  these  waters  were  found  to  be  ordinary  city  water  that  had 
or  had  not  been  filtered.  Tlie  facts  in  each  case  have  been  presented  to  the  Assistant 
Corporation  Counsel  for  prosecution. 

Dog  MuazUng — Inspectors  of  this  Bureau  have  served  summonses  on  dog  owners 
throughout  the  year  for  violation  of  the  muzzling  ordinance.  In  addition  to  this 
regular  work,  several  dog-muzzling  crusades  have  been  participated  in  by  this  Bureau. 

Achievemevts — Trades  Regulated:  Laundries,  horseshoeing  shops,  barber  shops, 
lodging  houses  and  stables  of  the  city,  have  been  brought  effectively  under  sanitary 
control  and  compliance  with  regulations  is  now  uniformly  maintained. 


44 


SANITARY    BUREAU. 


TABLE  No.  1. 
COMPLAINTS,  NOTICES,  INSPECTIONS,  ETC. 


191.5. 


1916. 


Complaints  disposed  of 

No  cause  for  action 

Abated  by  personal  effort 

Notices  or  orders  issued .  . 
Total  Inspections 

Cesspools  and  privies.  .  .  . 

Animals 

Barber  shops 

Baths 

Conuuon  towel — utensils. 

Dwellings 

Horse  trough 

Lodging  houses 

Lots  vacant 

Odors 

Smoke 

Stables 

Water 

Miscellaneous 

Arrests 

Pounds  offal  removed 

Dead  cats  and  dogs  removed  . 
Other  dead  animals  removed  . 


35,324 

47,892 

13,251 

18,030 

7,741 

9,635 

14,332 

14,899 

243,744 

223,616 

11,025 

12,993 

14,299 

9,794 

3,313 

7,278 

2,S2() 

1,862 

G30 

818 

50,600 

43,233 

1,421 

214 

3,069 

6,320 

17,448 

15,483 

2,623 

2,995 

7,801 

9,340 

49,814 

37,793 

7,170 

3,431 

93,289 

69,953 

1,215 

2,109 

,676,039 

3,205,.-)97 

343,688 

564,212 

15,202 

15,590 

45 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


BUREAU  OF  CHILD  HYGIENE. 


SCHOOL 
MEDICAL 
INSPeCTION 


CHILDRENS 
CLINICS 


INSTITUTIONS 
aCHILP  CARING 
AGENCIES 


MILK 
STATIONS 


EXAMINED 

NO.  NEEDING 
TREATMENT 


23)QjSlr 
2766111 


n+rs%i9o9 


I909 
1916 


-|»2S^I909 

mam  19)6 


EXCLUDED  FOR 
GENERAL  CONTAGION 

CONTAGION  FOUND 
IN  HOMES 

CONTAGION  FOUND 
IN  SCHOOLS 

VACCINATIONS 

EMPLOYMENT 
CERTIFICATES 

REFRACTIONS 
PERFORMED 

CONTAGIOUS  EYE 
OPERATIONS 

TONSIL 
OPERATIONS 

DENTAL 
TREATMENT 

MIDWIVES  UNDER 
SUPERVISION 

FOUNDLINGS  UNDER 
SUPERVISION 

DEFECTIVES  CURED 
IN  INSTITUTIONS 

INFANT 
MORTALITY 

No.  OF  MILK 
STATIONS 

CASES  UNDER 
SUPERVISION 


5441 

i3, 


1909 
19)6 


5711 


PISCONTINUED 


53101 
56074 


J  1912 
I9t€ 

♦5^i9i2 
1916 


3328 
33297 


46 


BUREAU  OF  CHILD  HYGIENE. 

Changes  in  Staff— The  Bureau  lost  during  1916  one  chief  of  division,  one  full  time 
medical  inspector,  seven  medical  inspectors  and  thirty-one  cleaners  by  transfer  within 
the  Department ;  seven  medical  inspectors,  five  cleaners,  seven  domestics,  two  orderlies, 
three  hospital  helpers,  two  watchmen,  one  laborer  and  four  hospital  clerks  by  the 
discontinuance  of  one  of  its  functions. 

The  Bureau  gained  twelve  inspectors  and  twenty-five  nurses. 

Cliangcs  in  Organization — The  clinics  for  school  children  were  discontinued  early 
in  the  year  because  of  lack  of  provision  for  them  in  the  budget.  Some  equipment 
was  saved,  however,  and  with  this,  dental  and  eye  clinics  were  established  in  the  public 
schools. 

The  Division  of  Institutions  and  Day  Nurseries  was  combined  with  the  Division  of 
Institution  Inspection  of  the  Bureau  of  Preventable  Diseases  under  the  immediate 
supervision  of  the  Deputy  Commissioner. 

The  control  of  supplies  was  transferred  to  the  Bureau  of  General  Administration. 

Changes  in  Procedure — On  May  16th  the  district  medical  supervisors  discontinued 
their  visits  to  sick  employees  of  the  Bureau.  This  work  was  given  over  to  the  depart- 
mental diagnosticians. 

The  issuance  of  employment  certificates  in  the  Borough  of  Queens  is  no  longer 
done  by  special  employees  in  the  borough  of?ce,  but  has  been  distributed  to  the  different 
Health  Districts  as  a  part  of  their  regular  functions. 

In  the  matter  of  children  boarded  out,  a  notification  is  sent  to  the  Bureau  by  the 
Children's  Home  Bureau  of  the  Department  of  Public  Charities;  an  inspection  is 
made,  and  if  same  is  satisfactory  a  permit  is  issued  and  the  Home  Bureau  notified 
within  thirty-six  hours.  The  Home  Bureau  makes  the  subsequent  social  investigations, 
supplying  the  Division  of  Midwives  and  Foundlings  with  a  monthly  report  on 
conditions  found. 

Teachers  are  now  permitted  to  examine  school  children  for  pediculosis  capitis. 
The  adoption  of  this  plan  means  a  tremendous  saving  of  work  to  the  nurses,  and  so 
far  no  objections  have  arisen. 

When  a  case  of  ophthalmia  neonatorum  is  reported,  an  inspector  is  sent  to  the 
case  to  make  a  tentative  diagnosis  and  take  a  smear,  which  he  forwards  to  the 
laboratory.  On  receipt  of  the  report  of  this  smear  an  oculist  is  sent  to  the  case.  He 
leaves  orders  for  the  nurse  and  makes  subsequent  visits  until  he  terminates  the  case. 

Important  Activities — March  11th,  a  conference  was  held  with  the  President  of 
the  Board  of  Education  on  washing  facilities  in  schools.  Insufficient  funds  have  so 
far  prevented  the  Board  of  Education  from  supplying  the  necessary  equipment. 

May  13th,  during  Baby  Week,  lectures  by  inspectors  and  nurses  were  delivered  in 
public  schools  of  the  City,  literature  was  distributed,  special  activities  were  carried 
on  in  milk  stations  and  baby  contests  held. 

May  27th,  a  special  examination  of  the  eyes  of  all  children  placed  in  classes 
for  the  blind  in  the  Borough  of  Manhattan  was  made  by  one  of  the  oculists  of  the 
Bureau.  He  found  that  a  number  of  cases  were  of  luetic  origin  and  recommended 
such  children  for  salvarsan  treatment.  A  number  of  others  have  been  referred  to 
suitalile  eye  clinics  for  operations  which  have  materially  improved  the  sight.  One 
particular  case  which  had  lost  the  sight  of  one  eye.  and  in  which  the  other  eye  could 
only  count  fingers,  was  by  a  suitable  operation  enabled  to  have  the  sight  restored 
to  20/30  of  normal. 

47 


ANNUAL     REPORT     OF     THE    DEPARTMENT     OF     HEALTH. 

A  dental  clinic  was  opened  at  the  Flushing  Hospital. 

"Record  of  Weight"  booklet  was  issued  for  recording  the  weight  of  children  at 
the  infant  milk  stations. 

June  3rd,  three  cases  were  taken  to  court  for  persistent  pediculosis.  The  parents 
were  reprimanded  for  gross  neglect  and  the  children  committed  to  an  institution  for 
six  months. 

A  system  of  physical  examination  of  truants  was  inaugurated.  The  truants  were 
examined  very  thoroughly  with  special  reference  to  their  nervous  history  and  previous 
habits,  and  tests  were  made  to  determine  the  blood  pressure. 

A  volunteer  dental  clinic  was  established  at  P.  S.  No.  128,  Brooklyn.  The  entire 
outfit  was  purchased  by  voluntary  subscription  and  a  small  fee  was  charged  for  the 
purpose  of  buying  dental  materials. 

Preliminary  alcohol  study  of  expectant  mothers  was  begun  with  a  view  to  deter- 
mining the  number  of  mothers  giving  birth  to  living  and  still-born  children,  who  were 
addicted  to  the  use  of  alcohol  moderately,  habitually  or  not  at  all.  As  the  study  is 
not  yet  completed,  results  and  statistical  figures  are  not  available. 

June  10th,  court  action  was  taken  against  parents  failing  to  attend  to  the  condition 
of  their  children.  Through  the  co-operation  of  the  Society  for  the  Prevention  of 
Cruelty  to  Children,  four  parents  were  warned  that  their  children  needed  glasses.  In 
three  cases  children  were  taken  away  from  parents  on  account  of  head  conditions  and 
physical  defects  not  treated.  One  parent  was  fined  $5.00  for  keeping  a  child  oift  of 
school  on  account  of  pediculosis. 

A  volunteer  dental  clinic  was  established  at  P.  S.  No.  90,  Brooklyn. 

A  special  survey  was  made  to  determine  the  status  of  pediculosis  in  school 
children.  During  the  study  83,697  children  were  examined  and  13,654  were  found  to 
be  suffering  from  pediculosis.  Of  these,  4,202  were  cured  and  9,241  remained  pending 
at  the  completion  of  the  study.     This  amounts  to  about  10%  of  the  children  examined. 

June  17th,  a  volunteer  dental  clinic  was  established  at  P.  S.  No.  169,  Brooklyn. 

Court  action  was  taken  against  a  parent  for  refusing  to  cut  the  hair  of  his  child 
suffering  from  persistent  pediculosis.     Parent  was  fined  $5.00. 

June  20th,  1,500  ice  books  donated  by  the  Knickerbocker  Ice  Company  and  the 
Ice  Publicity  Company  were  distributed  to  the  Baby  Health  Stations. 

July  1st,  a  series  of  Schick  Tests  were  made  at  a  Baby  Health  Station  by  the 
Bureau  of  Laboratories  in  order  to  determine  the  susceptibility  to  diphtheria  of  the 
several  children  in  different  families.  About  70  children  were  tested,  of  whom  it  was 
found  necessary  to  immunize  about  25.  This  study  will  be  carried  out  more  com- 
pletely and  to  cover  a  greater  number  of  cases  during  the  next  year. 

The  Children's  Aid  Society  opened  a  camp  for  boys  who  are  refused  employment 
certificates  because  of  malnutrition.  This  is  called  Camp  Goodhue,  and  its  purpose 
is  that  by  out-of-door  living  and  good  food  these  cases  will  be  speedily  brought  up  to 
their  required  weight  and  condition.  The  work  has  been  very  successful,  the  large 
majority  of  boys  referred  there  being  granted  their  working  papers  upon  their  return 
to  the  City. 

July  15th,  a  conference  of  the  supervising  nurse  in  the  Brownsville  Clinic,  Brook- 
lyn, with  police  officers,  street  cleaning  men,  boy  scouts  and  boy  police  resulted  in  a 
general  clean-up  of  all  hallways,  cellars,  garbage  cans  and  fire  escapes. 

On  Barren  Island,  Boy  Scouts  and  Camp  Fire  Girls  made  71  home  visits  in  a 
campaign  of  education  on  cleanliness. 

In  Schools  No.  21  and  92,  where  free  lunches  are  given  to  school  children,  an 
inspection  resulted  in  having  screens  provided  for  an  adjoining  stable  and  new  tubs 
for  dish  washing. 

48 


BUREAU    OF    CHILD     HYGIENE. 

July  29th,  the  name  of  the  infant  milk  stations  was  changed  to  baby  health 
stations  by  order  of  the  Commissioner.  The  reason  for  this  change  was  to  correct  a 
wrong  impression  as  to  the  object  of  the  stations,  which  is  to  educate  parents  in  baby 
care  rather  than  the  dispensing  of  milk. 

August  12th,  400  slides,  making  short  and  pointed  references  to  the  various  phases 
of  infant  diet,  hygiene  and  care  of  infants,  were  distributed  to  moving  picture  houses 
located  in  the  sections  of  the  City  where  the  infant  mortality  is  highest. 

Through  the  efforts  of  the  Baby  Welfare  Association  the  New  York  Herald  opened 
a  station  at  Hughes  avenue  and  187th  street.  The  Bronx,  for  the  distribution  of  free 
ice. 

A  group  of  students  from  Teachers  College  visited  the  baby  health  station  at 
2287  First  avenue  and  were  instructed  in  the  practical  workings  of  the  station,  includ- 
ing prenatal  instruction  and  milk  modification. 

August  26th,  three  midwives,  arrested  for  attempting  criminal  operations,  were 
held  under  $1,000.00  bail  each. 

Certificates  of  honorable  mention  were  prepared  for  distribution  to  patrons  of 
the  baby  health  stations  for  faithful  attendance  and  attention  to  the  advice  of  doctors 
and  nurses. 

The  Chief  of  the  Division  of  Midwives  and  Foundlings  began  a  personal  super- 
vision of  still-birth  reports.  An  inspector  was  sent  to  investigate  each  case.  If  con- 
ditions were  satisfactory  the  case  was  at  once  referred  to  the  suitable  authorities  for 
use  as  a  wet  nurse.  If  it  was  decided  that  the  conditions  found  on  investigation 
warranted  the  presumption  that  preventative  measures  would  affect  subsequent  preg- 
nancies, the  case  was  referred  to  the  baby  health  station  for  supervision. 

A  plan  was  adopted  by  which  the  Department  of  Health  inspectors  gave  instruc- 
tion to  school  teachers  by  means  of  lectures  and  talks  regarding  the  new  syllabus  on 
Child   Hygiene. 

September  16th,  the  time  between  the  scheduled  opening  of  schools  and  the  actual 
opening,  on  account  of  poliomyelitis,  was  used  by  the  medical  inspectors  in  delivering 
lectures  to  the  teachers  of  the  Teachers  Institute,  conducted  by  the  Department  of 
Education,  on  the  work  this  Department  is  trying  to  do  in  the  schools. 

September  21st,  several  members  of  the  Public  Health  Course  visited  the  baby 
health  station  and  were  instructed  in  the  practical  workings  of  same. 

Five  talks  were  given  to  parents'  clubs,  reaching  about  11,000  persons,  on  the 
subject  of  what  the  Department  of  Health  is  doing  to  safeguard  the  health  of  their 
children. 

A  school  nurse  gave  a  talk  to  38  teachers  as  to  how  they  could  co-operate  with 
her  and  help  her  in  her  work  for  school  children. 

A  medical  talk  was  given  to  over  12,000  teachers  at  the  Morris  High  School  in 
The  Bronx,  on  the  syllabus  on  child  hygiene. 

The  Polisli  Times  was  induced  to  publish  an  article  in  relation  to  "  The  Expectant 
Mother." 

October  7th,  the  dairymen's  strike  resulted  in  a  diminished  supply  of  milk  for  the 
City.  Through  the  personal  efforts  of  the  Directors  of  the  Bureau  of  Child  Hygiene 
and  the  Bureau  of  Food  and  Drugs,  sufficient  milk  was  obtained  for  supplying  the 
baby  health  stations.  A  statement  was  prepared  for  mothers  explaining  the  various 
substitutes  for  cow's  milk,  which  could  be  used  as  temporary  measures  for  the  feeding 
of  infants.  The  list  comprised  condensed  milk,  infants'  foods,  cereal  waters  and 
gruels,  egg  water,  broths,  bread  and  crackers,  vegetables,  beef  preparations,  etc. 

In  P.  S.  No.  169,  Manlvittan,  arrangements  were  made  by  the  nurse  for  the 
provision  of  facilities  for  washing  tlie  hands  of  the  children,  since  no  provision  is 
made  for  the  purpose  by  the  school  itself.     The  children  bring  to  the  school  a  piece  of 

49 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

soap  in  a  container.  A  piece  of  gauze  is  furnished  to  each  child,  for  washing  the  hands 
each  time  after  leaving  the  room.  The  child  takes  the  gauze  home  every  few  days 
to  be  washed. 

A  special  club  for  nervous  children  was  organized  in  P.  S.  No.  30,  The  Bronx, 
the  particular  nervous  hal)it  to  be  corrected  being  biting  of  nails. 

October  4th,  seven  girls  were  sent  to  Holiday  Farm,  Rhinebeck,  New  York,  five 
of  whom  were  applicants  for  employment  certificates  who  had  been  refused  because 
of  malnutrition  and  who  were  under  the  standard  weight  for  their  ages.  Arrange- 
ments had  been  made  to  keep  these  girls  until  they  show  definite  improvement. 

Six  students  of  Teachers'  College,  who  are  taking  a  course  in  public  health  nursing, 
were  instructed  in  the  work  of  this  Department  and  were  supplied  with  a  short 
synopsis  of  the  work  performed  in  the  schools,  milk  stations  and  clinics.  Arrange- 
ments and  assignments  were  made  for  these  students  to  visit  schools,  milk  stations  and 
clinics,  and  to  observe  the  work  of  our  nurses  in  the  field. 

October  14th,  a  l)aby  health  station  was  established  in  Bellevue  Hospital  Medical 
School  Dispensary.  Students  of  the  College  are  visiting  the  station  and  are  being 
afforded  every  opportunity  to  familiarize  themselves  with  the  details  of  infant  feed- 
ing and   care. 

October  21st,  a  special  study  of  nutrition  was  inaugurated  in  the  Bowling  Green 
District  by  the  Department  and  the  A.  L  C.  P.  acting  in  co-operation.  No  results  are 
as  yet  available. 

A  class  was  formed  by  a  baby  health  station  for  the  instruction  of  older  children 
with  disorders  of  nutrition  and  for  the  correction  of  physical  defects  which  may  be 
accomplished  by  gymnastics. 

A  school  nurse  organized  a  parents'  club,  calling  it  "  Help  Your  Neighbor  Club," 
and  a  "Welfare  League"  among  the  older  boys  of  the  school,  whose  meetings  sWe 
attends.  The  members  of  this  league  visit  cases  in  the  neighborhood,  both  truant 
and  charity,  which  require  immediate  attention,  and  report  facts  to  the  nurse. 

November  4th,  weekly  lectures  were  begun  at  Baby  Health  Stations  regarding 
measures  for  the  prevention  of  respiratory  diseases  in  infants  and  children.  The 
points  discussed  were  the  value  of  fresh  air,  proper  clothing,  bathing,  dangers  of 
coughing,  sneezing  and  kissing,  isolation  of  children  from  adults  and  other  children 
ill  with  coughs  and  colds,  avoidance  of  large  gatherings,  proper  breathing  exercises, 
nasal  and  oral  hygiene,  home  cleanliness,  etc. 

Three  nurses  from  the  Charity  Settlement  of  Asheville,  N.  C,  visited  the  baby 
health  station  and  were  instructed  by  the  nurses  in  charge  concerning  the  organization 
and  work  of  the  station. 

A  plan  was  prepared  for  a  model  system  of  school  medical  inspection  to  be 
located  in  P.  S.  No.  21,  on  Mott  street,  Manhattan.  This  will  consist  of  the  entire 
services  of  an  inspector  and  nurse,  the  establishment  of  a  dental  clinic,  contagious 
eye  and  refractive  clinics  for  this  school,  which  is  already  equipped  with  shower- 
baths  for  the  pupils  under  the  supervision  of  bath  attendants,  and  a  free  school  lunch 
for  the  children.     Open-air  classes  for  anaemic  children  are  also  contemplated. 

November  11th,  three  midwives  charged  with  attempted  abortion  were  arrested 
One  pleaded  guilty  and  was  released  on  liail.  One  was  acquitted  by  direction  of  the 
Court.     The  third  pleaded  guilty,  hut  sentence  was  suspended. 

Efforts  were  made  to  promote  cleanliness  by  having  school  children  bring  indi- 
vidual towels  and  soap  to  school.  The  teachers  fear  that  the  towels  may  be  mislaid 
and  the  children  infected  from  one  another.  In  one  school  the  children  use  toilet 
paper  in  place  of  towels  and  the  results  are  fairly  satisfactory.  In  another  school, 
through  the  efforts  of  the  nurse  and  teachers,  old  clothes  have  been  gathered  together, 
washed  and  cut  up  into  squares  for  use  as  towels.     In  a  number  of  the  schools,  the 

50 


BUREAU    OF    CHILD     HYGIENE. 

teachers  prefer  to  send  the  children  home  when  they  present  themselves  in  a  dirty 
condition.  In  one  school  the  sewing  teacher  has  given  each  child  a  large  piece  of 
muslin  to  be  hemmed  during  the  sewing  lesson  and  then  used  as  a  towel.  The 
teacher  has  taught  the  children  to  make  soap  boxes  from  cardboard  taken  from  the 
backs  of  pads.  The  children  bring  the  soap  from  home.  In  another  school  the 
children  have  brought  towels  and  clothes  from  home  and  on  the  second  day  three 
nf  the  towels  were  stolen. 

Eleven  children,  who  had  been  refused  employment  certificates,  were  sent  to  the 
country.  The  boys  were  sent  to  New  Hamburg,  New  York,  and  the  girls  to  Holiday 
Farm  at  Rhinebeck,  New  York.  The  children  showed  great  improvement  and  in  most 
instances  were  able  to  obtain  their  certificates  on  their  return  to  the  city. 

November  18th,  a  large  health  league  was  organized  in  a  public  school  in 
The  Bronx,  with  all  pupils  enrolled  as  members,  and  a  class  officer  for  each  class. 
These  groups  have  been  formed  among  the  older  children  to  assist  one  another  in 
freeing  their  heads  from  nits.  Gold  stars  are  given  to  those  who  keep  their  heads 
clean  for  ten  weeks. 

\  class  for  anaemic  children  was  organized  in  P.  S.  No.  30  and  thirty  members 
were  weighed  once  a  month  and  given  a  prescribed  diet  with  instruction  as  to  general 
health  care.  Those  who  obey  instructions  and  show  a  gain  in  weight  are  given  a 
health  league  button  with  pink  and  blue  ribbon. 

Certificates  of  honorable  mention  were  prepared  and  distributed  to  baby  health 
stations  to  be  given  to  mothers  who  have  visited  and  w^ill  visit  the  stations  regularly 
and  who  follow  the  advice  and  instructions  given  them. 

Eleven  physicians,  enrolled  in  the  Public  Health  Course,  visited  the  baby  health 
station  at  112th  street,  Manhattan,  where  demonstrations  of  the  various  phases  of  the 
work  and  the  methods  of  record-keeping  and  report-making  were  shown  to  them. 

Visitors  from  Elizabeth,  N.  J.,  Newburgh,  N.  Y.,  and  Australia  were  instructed 
in  the  regular  work  of  the  stations  and  in  prenatal  instruction  and  supervision. 

Novem])er  25th,  a  midwife  was  arrested  for  attempted  abortion  and  convicted, 
but  sentence  was  suspended. 

A  study  was  made  of  the  clerical  efficiency  in  tliis  T'ureau  which  showed  that 
there  has  been  a  definite  increase  in  the  amount  of  work  performed,  with  a  decrease 
in  the  amount  of  appropriation  for  clerical  service  for  the  years  1914,  1915  and  1916. 

A  crusade  was  begun  for  teaching  mothers  to  give  their  children  proper  break- 
fasts. A  cereal  with  milk  was  recommended  to  be  added  to  the  usual  breakfast  of 
coffee  and  bread. 

.Achievements:  Reduction  of  Infant  Mortality — There  has  been  for  the  year 
1916  a  reduction  of  infant  mortality  to  93.1,  which  is  below  the  previous  low  figure 
established  in  1914  of  94.6. 


51 


ANNUAL     REPORT     OF    THE     DEPARTMENT     OF     HEALTH. 

TABLE  No.  1. 
PHYSICAL  EXAMINATIONS— 1916 


Regular  examinations. .  . . 

Normal 

Teeth  defects  only . . . 

General  defects 

Re-examined 

Athletic  contest 

For  charitable  institution . 

Defective  vision 

Vision  not  tested 

Defective  hearing 

Defective  nasal  breathing. 
Hypertrophied  tonsils. .  . . 

Defective  nutrition 

Cardiac  disease 

Pulmonary  disease 

Orthopedic  defects 

Nervous  defects 

Defective  teeth 


School  Medical  Inspection. 


Re-examination  96813. 

Regular 

Received  Treatment — Improved 

Left 
School 

nations. 

Refused     before 

Treat-      Defect 

ment.         was 

Glasses. 

Medical. 

Surgical. 

Other 

Cor- 

rected. 

276,611 

62,987 

116,146 

97,478 

96,813 

39,199 

18,811 

27,769 

14, 

108 

1,419 

34 

3^ 

i        1,418  1      1,191 

91,937 

2,145 

1,070 

47 

( 

) 

85            i02 

32,765 

7,038 

6,045 

2t 

i        2 

,182        1,366 

39,731 

6,767 

6,810 

4i 

I        2,955  1      1,685 

28,989 

13,244 

66 

2,19J 

> 

280           914 

5,404 

2,516 

5 

( 

) 

72           299 

940 

571 

8 

[ 

J 

9             53 

2,785 

899 

65 

r 

I 

96           105 

2,202 

1,001 

1 

r. 

I 

59             91 

183,572 

22,65. 

) 

TABLE  No.  2. 
CERTIFICATES  AND  PERMITS- 


-1916. 


Employment 
Certificates. 


Supervision  of 


]\Iidwives. 


Children 
Boarded  Out. 


Day 
Nurseries. 


Applications  brought  forward . 
Applications  received  (first).. . 
Applications  received  (renewal) 

Total 

Applications  granted 

Applications  denied 

Applications  pending 

AppUcations  expired 

Applications  revoked 

Applications  in  force 

First  inspections 

Re-inspections 

Special  visits 

Total  inspections 

Special  inspections 

Children  examined 


152 
51,443 


51,595 

47,033 

4,033 

529 

39,298 

65,169 


173 

69 
993 


1,235 

1,188 

21 

26 

754 

101 

1,798 

1,062 

12,077 

6,308 

19,447 


293 

2,812 
3,358 


6,463 

5,751 
166 
546 
1,251 
3,910 
5,330 
6,170 

34,378 
8,639 

49,187 


15 
51 


66 

59 
3 
4 

34 

2 

123 
66 
927 
164 
1,157 
487 


52 


BUREAU    OF    CHILD     HYGIENE. 

TABLE  No.  3. 
GENERAL  SUPERVISION— 1916. 


Reduction 
OF  Infant 
Mortality. 


Schools. 


Milk 
Stations. 


Little 
Mothers' 
Leagues. 


Number 

Under    supervision     (children    and 
babies) 

Attendance  of  mothers  total  visits.  . 

Diarrhocal  deaths 

Deaths,  other  causes 

Quarts  of  milk  sold 


17,563 


65 
134 


791 
938,454 


59 

33,297 

577,034 

127 

327 

3,885,813 


17 

10,093 
No.  of  members 

41,676 
att.  of  members 


TABLE  No.  4. 
HOME  VISITS— 1916. 


School  Medical  Inspection. 

Milk 
Stations. 

Reduction 

Infectious 
Diseases. 

Physical 
Defects. 

Dispen- 
saries. 

Special 
Visits. 

Infant 
Mor- 
tality. 

Visits  by  Nurses 

Visits  by  Inspectors 

9,607 
11,932 

220,260 
57,349 

4,661 

46,645 

11,878 

140,701 
706 

146,037 
934 

TABLE  No.  5. 
GENERAL  CONTAGION— 1916. 


Found  in  Schools 
(Excluded). 


Found  in  Homes 
(Unreported). 


Diphtheria 

Scarlet  Fever .  .  . . 

Measles 

German  Measles. 

Chicken  Pox 

Whooping  Cough 

Mumps 

Tuberculosis 

Gonorrhoea 

Syphilis 

Miscellaneous . .  . , 

Total.  ., 


4,291 


1 
36 
367 
54 
451 
306 
209 


1,424 


53 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE  No.  6. 
MINOR  CONTAGION— 1916. 


Found  in  School. 


Excluded. 


Pediculosis 

Trachoma 

Conjunctivitis 

Ringworm 

Scabies 

Impetigo 

Favus 

Molluscum  Contagiosum 

Miscellaneous 

Follicular  conjunctivitis . 

Total 


288,096 

8,798 

26,042 

4,122 

2,428 

16,264 

318 

62 

2,109 

6,640 


8,203 

98 

2,182 

136 

237 

M9 

4 

2 

"28 


354.879 


11,239 


TABLE  No.  7. 
CLINICS  FOR  SCHOOL  CHILDREN— 1916. 


Refraction. 


Contagious 
Eyk. 


Nose  and 
Throat. 


Dental. 


Cases  brought  forward 

New  cases  received 

Total  registered 

Cases  discharged 

Cured 

Dropped 

Pending 

Operations 

Treatments 

Refractions 

Extraction  teeth,  deciduous . 
Extraction  teeth,  permanent 
FilUngs  teeth,  temporary .  . . 
Fillings  teeth,  permanent . . . 


9,132 
9,132 
5,581 
4,634 
947 
3,551 

12,379 
20,922 


14,324 
14,334 


Clinic 
abolished 
Dec.  30th, 

1915 


130,626 


6,713 
6,713 
5,167 
4,902 
265 
1,546 

56,674 


11,916 

2,718 

2,541 

20,796 


54 


BUREAU    OF    PREVENTABLE    DISEASES. 


BUREAU  OFPREVENIABIE  DISEASES 


CASES  OF  DIPHTHERIA  Jaif® 
CASES  OF  SCARLET  FEVER  !/;|?| 
CASES  OF  TYPHOID  FEVER  fifj 

UNREPORTED   CASES  ^^o 

OF  TYPHOID  FEVER      ^^^ 


I9IA 


-^8^(916 


CASES  OF  TUBERCULOSIS -fljjj 


^  VOLUNTARY 
RENOVATIONS 
ENFORCED 
RENOVATIONS 


TUBER- 
CULOSIS 


9.-297 

10.063 
14.04^ 


INSPECTIONS 


/30  7C: 

219529 
2eS4 


NEW  PATIENTS        is4qz 
ADMITTED  TO  CLINICS /tf-^fi-Z 

TOTAL  VISITS  OF     5^2^ 
V  PATIENTS  TO  CLINICS  fi2  74a 


GLANDERED  HORSES 
DOC  BITES 


TOTAL  INSPECTIONS 
INFECTIOUS  DISEASES 


2Z9.706 
22afi46 


1 9/0 
Z9%1916 


"^98%  1916 


19 IC 


JrSrn4 
1916 


SYrj 


UvSYr, 


"=^3^1916 


lArSYrs. 
\t^l9l6 


55 


BUREAU  OF  PREVENTABLE  DISEASES. 

Changes  in  Staff — On  January  1st,  the  Bureau  gained,  by  appointment,  7  nurses, 
70  assistant  clinic  physicians,  3  clerks  and  6  other  employees.  On  the  same  date  there 
were  dropped  from  the  service  35  assistant  clinic  physicians,  12  stenographers,  12 
disinfectors  and  11  other  employees.  On  January  1st  one  clerk  was  added.  On 
December  11th,  there  were  transferred  to  the  Bureau  of  General  Administration  2 
medical  inspectors,  6  clerks  and  30  other  employees.  On  the  same  date  there  were 
transferred  to  the  Bureau  of  Hospitals  1  hospital  physician  and  44  other  employees. 
On  Dcember  31st,  there  were  transferred  to  the  Division  of  Institution  Inspection 
8  medical  inspectors  and  1  clerk. 

Changes  in  Organisation — On  January  1st,  the  Division  of  Institution  Inspection 
was  transferred  to  the  Deputy  Commissioner's  office. 

On  December  llth,  the  ambulance  service  was  transferred  to  the  Bureau  of 
Hospital.  On  the  same  date  the  stable  and  transportation  service  was  transferred  to 
the  Bureau  of  General  Administration. 

On  August  1st,  the  supervision  of  the  work  of  the  Bureau  in  the  Borough  of 
Queens  was  assumed  by  the  Division  of  Health  Districts. 

Changes  in  Procedure — A  minimum  period  of  quarantine  was  established  for 
diphtheria,  to  wit:  No  later  culture  will  be  examined  for  release  from  quarantine 
which  is  made  earlier  than  twelve  days  from  the  date  of  report  of  the  disease. 

A  new  procedure  for  terminating  typhoid  fever  cases  was  adopted,  to  wit:  The 
attending  physician  shall  submit  to  the  Department  of  Health  specimens  of  feces  and 
urine  for  examination  for  the  presence  of  typhoid  bacilli,  at  least  ten  days  after  the 
patient's  temperature  reaches  normal,  and  before  he  or  she  shall  resume  their  occupa- 
tion. If  typhoid  liacilli  are  found  in  the  excreta,  such  convalescent  shall  not  resume 
his  or  her  occupation  without  permission  from  the  Department  of  Health. 

On  March  4th,  forcible  removal  of  typhoid  fever  cases  was  begun.  Physicians 
were  notified  by  letter  that  cases  of  typhoid  fever  would  be  removed  to  a  hospital 
if  the  following  regulations  were  not  observed:  (1)  a  Widal  test  of  the  blood  must 
be  made;  (2)  immunization  must  be  offered  to  all  members  of  tlie  household;  (3) 
the  following  quarantine  rules  must  be  observed :  (a)  the  patient  must  be  actually 
isolated;  (b)  stools  and  urine  must  be  adequately  disinfected;  (c)  all  susceptibles 
must  be  immunized;  (d)  the  attendant  must  have  nothing  to  do  with  the  family 
cooking,  care  of  children,  etc.;  (e)  there  must  be  a  separate  toilet  for  the  patient's 
family;  (/)  the  family  must  be  intelligent  and  willing  to  carry  out  the  rules  of  the 
Department  of  Health;  (4)  typhoid  fever  cases  will  be  terminated  by  bacteriological 
examination  of  feces  and  urine. 

Infectious  diseases  in  institutions.  New  rules  were  promulgated,  to  wit:  (1) 
children  having  measles  complicated  with  broncho-pneumonia  would  be  sent  to  their 
homes  in  preference  to  a  hospital,  providing  investigation  of  the  home  proved  satis- 
factory; (2)  no  measles  cases  will  be  removed  later  than  seven  days  after  the  appear, 
ance  of  the  eruption,  and  (3)  typhoid  fever  carriers  need  not  be  retained  in  hospitals 
or  institutions  if  not  desired.  They  will  be  sent  home  if  home  conditions  are  satis- 
factory or  to  a  Department  hospital. 

Important  Activities — 'On  January  8th,  a  rule  that  all  cases  from  the  Society  for 
the  Prevention  of  Cruelty  to  Children  recommended  for  admission  to  the  Willard 
Parker  or  other  Department  hospitals  be  sent  by  a  diagnostician,  was  adopted. 

A  morbidity  census  of  old  and  new  law  tenements  in  iHealth  District  No.  1  was 
made.  A  large  corps  of  nurses  visited  every  'family  in  the  district  and  obtained 
information  concerning  every  member  of  the  household,  those  who  were  ill,  the  nature 
of  the  illness,  etc.  This  information  was  tabulated  by  the  Bureau  of  Records  and 
was  the  subject  of  a  special  report. 

56 


BUREAU    OF    PREVENTABLE    DISEASES. 

January  10th,  social  service  work  in  infectious  diseases  was  begun.  This  work 
h  the  result  of  an  experimental  attempt  made  in  April,  1914,  to  visit  all  cases  of 
infectious  diseases  discharged  from  hospitals  for  the  purpose  of  determining  how 
many  new  cases  of  diseases  were  caused  by  such  convalescents.  The  importance  of 
continuing  social  service  among  these  cases  was  recognized,  but  could  not  be  continued 
on  account  of  the  inadequate  number  of  nurses.  Since  the  discontinuance  of  visits 
in  cases  of  measles,  however,  this  work  became  possible,  and  a  special  staff  of  nurses, 
under  the  direction  of  the  supervisor  attached  to  the  Tuberculosis  Hospital  Admission 
Bureau,  were  assigned  to  such  social  service  home  visits.  Special  attention  is  paid 
to   (a)   cleanliness,   (b)   overcrowding,  and    (c)   financial  condition. 

January  12th,  a  study  of  housing  conditions  in  relation  to  tuberculosis  was  begun. 
This  was  made  the  subject  of  a  special  report  and  will  be  printed  as  a  monograph. 

January  14th,  an  investigation  of  anthrax  infection  was  made  following  the 
report  of  a  death  from  anthrax.  The  investigation  showed  that  "wearers  of  fur  are 
as  free  from  the  dangers  of  anthrax  infection  as  any  other  members  of  the  com- 
munity." 

A  study  of  wood  alcohol  poisoning  was  made  following  two  deaths  of  beer-vat 
varnishers.  It  was  found  that  wood  alcohol  was  used  in  the  shellac  with  which  the 
interior  of  the  beer  vats  are  varnished.  This  investigation  culminated  in  a  letter 
being  sent  to  all  the  breweries  in  New  York  City,  with  the  result  that  37  New  York 
brewers  and  9  New  Jersey  brewers  have  pledged  themselves  to  exclude  methyl  alcohol 
in  their  premises  for  varnishing  purposes. 

January  22d,  the  Evening  Telegram  was  induced  to  refuse  advertisements  of 
medical  specialists  on  venereal  diseases. 

January  26th,  the  work  of  the  Division  of  Epidemiology  was  extended,  to  wit : 
new  epidemiological  history  cards  were  prepared  for  typiioid  fever,  scarlet  fever  and 
diphtheria.  Daily  individual  reports  were  submitted  of  infectious  diseases,  especially 
reports  of  school  children,  so  that  the  "  accumulation  "  of  any  disease  in  any  school 
or  in  any  area  of  the  city  might  be  noted  at  once.  Information  was  obtained  as  to 
the  location  and  occurrence  of  typhoid  fever  during  recent  years  in  the  State  of  New 
York,  and  the  relation  of  such  occurrence  in  pasteurizing  plants,  ascertained  and 
plotted  upon  a  map;  similar  information  is  being  obtained  from  all  portions  of  the 
milk  shed.  This  will  enable  any  locality  with  excessive  typhoid  morbidity  to  be 
located.  It  was  decided  to  exclude  all  typhoid  carriers  as  food  handlers  and  to 
supervise  them. 

February  26th,  an  outbreak  of  trichinosis  occurred  in  the  Borough  of  Queens. 
Twelve  patients  were  treated  at  St.  Joseph's  Hospital,  everything  being  done  for  them 
therapeutically  that  was  possible,  and  yet  four  of  the  patients  died,  a  mortality  of 
33'/j  per  cent.  Tlie  source  of  infection  appears  to  have  been  a  pig  owncfl  and 
slaughtered  at  Far  Rockaway.  The  exact  method  of  preparing  the  meat  for  food  is 
not  clear,  but  cooking  played  a  very  small  part  in  it.  The  victims  included  all  the 
members  of  the  family,  an  employe,  who  afterwards  died,  a  boarder,  and  some 
friends. 

March  6th.  the  Division  of  Industrial  Hygiene  entered  a  new  held  of  adult 
hygiene.  Through  the  co-operation  of  the  "American  Museum  of  Safety,"  the  services 
of  a  physician  have  been  placed  at  the  disposal  of  the  occupational  clinic  for  the 
purpose  of  giving  advice  to  those  industrial  workers  examined  at  the  clinic  by  means 
of  (1)  timely  medical  and  hygienic  counsel;  (2)  distribution  of  educational  booklets 
and  leaflets,  and  (3)  attempts  to  secure  for  them  the  aid  of  private  physicians,  hos- 
pitals or  dispensaries. 

.•\n  examination  of  children  in  trade  schools  was  undertaken  by  the  occupational 
clinic    to    determine    their    physical    condition,    their    limitations,    if    any,    for    certain 

57 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

employments,  and  with  the  end  in  view  of  connectng  up  the  physical  examination  of 
school  children  with  the  examination  of  adults,  by  the  examination  of  the  inter- 
mediate group  of  children  working  under  employment  certificates  or  as  trade  school 
pupils. 

March  18th,  the  treatment  of  Mary  Mallon,  "  typhoid  fever  carrier,"  was  begun 
by  injecting  her  with  typhoid  vaccine  and  later  with  intravenous  injections  of  anti- 
typhoid serum.     So  far  she  continues  to  be  a  dangerous  "  carrier." 

March  31st,  a  circular  letter  was  prepared  urging  physicians  to  have  all  members 
of  the  household  of  a  typhoid  fever  case  immunized,  sending  them  blank  forms  for 
reporting  such  immunizations. 

April  7th,  a  new  dog  circular  was  prepared  consisting  of  a  poster  card  24  by  1-1 
inches,  containing  pictures  of  muzzled  and  improperly  muzzled  dogs.  Section  17  of 
the  Sanitary  Code,  a  reminder  of  the  importance  of  the  occurrence  of  hydrophobia 
(rabies)  and  a  proper  muzzle.  This  poster  was  widely  distributed  with  a  three-fold 
circular  of  information  concerning  rabies,  provisions  of  the  Sanitary  Code  with  refer- 
ence to  muzzling,  and  the  legislative  action  authorizing  activities  of  the  American 
Society  for  the  Prevention  of  Cruelty  to  Animals. 

A  new  typhoid  poster  was  prepared  calling  attention  to  vacation  typhoid  and 
warning  persons  regarding  the  danger  of  using  possibly  infected  water  and  foods 
during  their  vacation  periods.  These  posters  were  distributed  widely  in  shops,  public 
places,  schools,  etc.,  and  a  considerable  demand  for  them  was  received  by  employers 
generally  following  a  description  of  them  in  the  daily  press. 

April  20th,  the  examination  of  peddlers  in  Brooklyn  was  begun  under  the  new 
arrangements  of  the  Department  of  Licenses.  A  branch  office  for  the  examination 
of  peddlers  previous  to  the  issuance  of  licenses  by  the  Department  of  Licenses,  was 
opened  at  29  Third  Avenue,  Brooklyn,  for  Brooklyn  and  Queens  applicants.  This 
examination  is  entirely  by  inspection,  applicants  being  stripped  to  the  waist  and  only 
those  held  for  later  and  more  searching  examination  whose  appearance  suggests  the 
presence  of  disease. 

A  census  of  unmuzzled  dogs  was  taken  by  members  of  the  Health  Department, 
each  employe  reporting  on  a  special  blank  those  unmuzzled  or  improperly  muzzled 
dogs  seen  during  the  day.  Over  7,000  unmuzzled  dogs  were  thus  counted.  This 
information  was  tabulated  and  through  the  co-operation  of  the  Police  Department 
1,365  owners  were  arrested  and  $1,031  was  collected  in  fines. 

April  29th,  the  ferryboat  "  Stapleton  "  was  exchanged  for  the  ferryboat  "  Jersey 
City,"  to  be  used  as  a  Day  Camp. 

A  separate  medical  board  for  the  tuberculosis  hospitals  was  formed. 

May  1st,  a  special  study  of  "  at  home "  cases  of  tuberculosis  was  begun.  This 
study   is   not  yet   completed. 

May  13th,  a  small  outbreak  of  typhoid  fever  (13  cases)  in  the  Borough  of  The 
Bronx  was  traced  to  an  infected  milk  supply,  which  was  immediately  shut  off,  result- 
ing in  the  subsidence  of  the  outbreak. 

May  20th,  a  supervising  laryngologist  was  appointed   for  the  tuberculosis  clinics. 

June  10th,  dog  circular?  and  posters  were  distributed  to  all  dealers  in  muzzles, 
kennels,  police  precinct  stations  and  branch  offices  of  the  Department. 

Venereal  disease  signs  were  placed  in  Coney  Island  bath  houses  and  saloons. 

September  2d,  during  the  month  of  August  a  slight  increase  of  tj-phoid  fever 
occurred  in  the  Borough  of  Manhattan,  50  cases  being  reported.  It  was  found  that 
nine  of  these  cases  gave  a  definite  history  of  contact  and  eight  were  clearly  the  result 
of  out-of-town  infection.  The  milk  supply  from  some  of  these  cases  was  traced  to 
Gravesville,  Herkimer  County,  New  York,  where  there  had  been  nine  cases  of  typhoid 
fever  since  1909.    This  milk  supply  was  immediately  excluded. 

November  11th,  a  study  was  begun  of  tuberculous  families,  in  which,  because  of 

58 


BUREAU    OF    PREVENTABLE    DISEASES. 

the  financial  and  other  burdens  of  caring  for  the  patient,  the  family  would  be  better 
off  if  the  case  were  removed,  with  a  view  to  extending  and  broadening  the  reasons 
for  forcible  removal. 

Three  cases  of  anthrax  were  carefully  studied  in  relation  to  the  brush-making 
industry.  One  of  the  fatal  cases  was  a  peddler  who  carried  about  his  neck  a  string 
of  feather  dusters  by  which  it  is  presumed  he  was  infected.  Owing  to  the  shortage  of 
bristle  stalk,  much  use  is  now  being  made  of  Japanese  horsehair,  thus  indicating,  per- 
haps, a  new  source  and  route  of  this  infection. 

November  18th,  a  change  of  procedure  in  typhoid  fever  was  made,  to  wit :  phy- 
sicians will  be  communicated  with,  by  telephone,  regarding  all  negative  or  doubtful 
widal  reactions.  Special  inquiry  will  be  made  regarding  the  use  of  loose  milk  and  the 
patrolman  making  loose  milk  investigation,  or  a  nurse,  will  endeavor  to  obtain  from 
neighboring  loose  milk  shops  the  names  and  addresses  of  all  persons  Imying  of  them. 
This  information  will  be  telephoned  to  the  branch  office  and  the  inspection  time  of 
typhoid  reports  will,  in  this  way,  be  shortened. 

November  15th,  the  Night  Camp  Rutherford  was  discontinued  for  the  reason  that 
its  administration  presented  unusual  diflficuUies  added  considerably  to  the  annual 
maintenance  cost  of  the  boat  and  has  become  of  questionable  value,  since  a  few  only 
of  the  men  who  took  advantage  of  its  opportunities  were  bona  fide  patients  who  were 
employed  in  the  day  time. 

The  Advisory  Committee  of  the  Hospital  Admission  Bureau  modified  the  restric- 
tions regarding  the  admission  of  children  to  prevcntoria,  so  as  to  admit  those  children 
whose  mothers  are  about  to  enter  a  tuberculosis  institution.  This  will  facilitate  the 
admission  of  mothers  who  frequently  decline  to  enter  a  hospital  if  children  be  left 
alone  at  home. 

November  25th,  special  exhibits  were  prepared,  sliowing  tlie  proper  muzzling  of 
dogs,  consisting  of  easels  carrying  a  framed  panel  on  which  have  been  placed  plaster- 
of-paris  models  of  two  dogs'  heads  showing  proper  and  improper  muzzles,  together 
with  the  poster  card   "  Muzzle  Your  Dog." 

A  citizen  having  reported  the  death  of  a  number  of  mice  which  were  affected  with 
a  cutaneous  disease,  an  investigation  was  made  by  the  Chief  Veterinarian,  who  reports 
that  one  of  the  mice  examined  by  him  and  by  the  Research  Laboratory  .showed  a 
lesion  believed  to  be  Favus,  which  is  peculiar  to  mice.  .\n  inquiry  regarding  children 
in  the  house  who  might  have  a  cutaneous  disease  failed  to  show  any. 

Following  the  return  to  the  city  of  the  National  Guard  regiments  from  the  border, 
arrangements  were  made  to  control  the  soldiers  who  had  had  typhoid  or  para-typhoid 
while  away. 

December  9th,  following  correspondence  on  the  subject,  the  Healtii  Officer  of  the 
Port  has  agreed  to  report  all  cases  of  typhoid  fever  among  alien  immigrants,  previous 
to  their  discharge  if  fecal  examination  shows  the  presence  of  bacilli. 

December  21st,  the  Committee  on  Venereal  Diseases  of  the  Advisory  Council 
approved  and  licensing  of  clinics  for  infectious  diseases  and  appointed  a  committee  to 
prepare  supplementary  regulations  for  proposed  section  of  the  Sanitary  Code.  .-K  spe- 
cial committee  was  also  appointed  to  consider  the  establisiimcnt  of  an  Association  of 
'Venereal  Clinics,  similar  to  the  Association  of  Tuberculosis  Clinics.  It  also  approved 
the  licensing  of  diagnostic  laboratories  and  the  removal  and  detention  of  cases  of 
venereal  diseases  and  disapproved  the  sending  of  W'assermann  examination  reports 
direct  to  patients. 

December  16th,  4  cases  of  small  pox  and  19  contacts  were  removed  from  the  S.  S. 
Herm,  from  Seville,  Spain,  Erie  Basin,  Brooklyn.  The  ship  and  its  crew  were  imme- 
diately quarantined  thereby  preventing  the  entrance  of  small  pox  into  the  city. 

December  23.  physical  examination  of  massage  operators  was  begun  in  the  Occu- 
pational Clinic  in  compliance  with  a  new  Aldermanic  ordinance. 

59 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


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60 


BUREAU    OF    PREVENTABLE    DISEASES. 


TABLE  No.  2. 
INFECTIOUS  DISEASES— GENERAL  FIGURES. 


Cases  Diphtheria  and  Scarlet  Fever  removed  to  Hospital 

Visits  to  cases  of  Infectious  Diseases 

Cultures  taken  in  Diphtheria 

Diphtheria  immunizations  performed ' . .  . . 

Vaccinations  performed 

Houses  visited — Disinfections  performed 

Houses  visited — Disinfections  postponed 

Rooms  disinfected 

Total  calls  for  ambulance 


4,369 

228,046 

39,585 

3,704 

849 

98 


247 
9,692 


TABLE  No.  3. 
TYPHOID  FEVER— 1916— 1915. 


Cases  reported . 

True  cases . 

No  cases .  . 
Deaths 


Blood  sent  to  Laboratorj^ — 

Positive 

Negative 

Treated  at  home , 

Treated  at  hospital 

Contact  cases 

Probably  out  of  town  infection 

Additional  cases  with  out  of  town  history 

Total  with  out  of  town  history 

Number  of  People  Exposed  to  cases  in  families  and  institutions 

Immunization  refused 

Immunization  accepted 


61 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

TABLE  No.  4. 
TUBERCULOSIS  LIVING  CASES— 1916. 


Man- 
hattan. 


The 
Bronx. 


Brook- 
lyn. 


QUEENB. 


Rich- 
mond. 


Total. 


Cases  in  file  January  1st,  1916.  . 

Under  care  of  private  physician.  . 

Under  care  of  non-department  clinics.  .  . 

Cases  in  city  institutions 

City  eases  out  of  town  and  in  sanatoria.  . 

Homeless — not  found  cases 

Cases  "at  home"   and  under  care  of  De 
partment  of  Health  Clinics 

New  cases  report  during  1916 

Total  cases  added  to  register  in  1916 

Total  cases  enrolled  in  1916 

Cases  removed  from  register  in  1916 

Cases  in  file  December  31st,  1916 

Under  care  of  private  physician.  . 

lender  care  of  non-department  clinics.  .  . 

Cases  in  city  institutions 

City  cases  out  of  town  and  in  sanatoria.  . 

Homeless — not  found  cases .■.■••■ 

Cases  "at  home"  and  under  supervision  of 
Department  of  Health  Clinics 

Visits  by  physicians 

Visits  by  nurses. 

Co-operative  visits 

Total  visits 

Renovations  compelled  by  riurses 

Renovations  made  voluntarily 


22,993 
1,545 
1,754 
4,340 
1,521 
7,629 

6,204 

11,113 
15,947 
38,940 
17,304 

21,636 
1,687 
1,455 
4,965 
1,721 
5,594 

6,214 

2,771 

104,448 

10,040 

117,259 

1 

7,612 


3,782 
461 

'  597 
381 

772 

1,571 

1,660 
2,076 
5,858 
2,462 

3,396 
527 

'  271 
257 
562 

1,779 

225 
19,530 

911 
20,666 


9,805 
1,274 

1,052 

689 

2,720 

4,070 

5,493 

6,790 

16,595 

7,503 

9,092 
1,348 


1.076 


1,168 

724 

1,947 

3,905 

479 

50,130 

5,335 

55,944 

14 

4,844 


1,474 
271 

'  169 
119 

188 

727 

828 
2,. 568 
4,042 
2,468 

1,574 
311 

'  'i56 
123 
189 

795 

40 

7,925 

481 

8,446 

6 

361 


366 
56 


110 
55 
30 

115 

203 
238 
604 
244 

360 
50 

'  "gi 

63 
34 

122 

97 

2,691 

367 

3,155 

3 

152 


38,420 
3,607 
1,754 
6.268 
2,765 

11,339 

12,687 

19,297 
27,619 
66,039 
29.981 

36,0,58 
3,923 
1,455 
6,651 
2,888 
8,326 

12.815 

3,612 

184,724 

17,134 

205,470 

24 

14,045 


TUBERCULOSIS  CLINICS— 1916. 


1915. 


1916. 


Under  observation  for  diagnosis  January  1st 

New  Patients  examined 

Re-admitted  for  diagnosis 

Total  diagnosis ■ 

Found  not  tuberculous  and  transferred  or  discharged 

Suspected  cases  transferred  to  other  cHnics 

Found  tuberculous 

Discontinuing,  not  coming  for  diagnosis 

Under  observation  for  diagnosis  December  31st 

Under  treatment  January  1st 

New  cases  under  treatment 

Old  cases  re-admitted 

Total  cases  under  treatment 

Found  not  tuberculous  and  discharged 

Deaths  of  cases  attending  clinics 

Transferred  to  other  clinics 

Entered  Hospitals 

Entered  Sanatoria 

Arrested  or  cured 

Discontinuing,  not  found 

Discontinuing,  not  coming  for  treatment 

Under  treatment,  December  31st 

Total  visits  of  patients 

Prescriptions  filled  for  clinic  patients 

Number  of  clinic  physicians 

Number  of  volunteer  physicians 

Home  visits  by  clinic  physicians 


1,536 

2,894 

19,225 

16,582 

3,458 

4,504 

24,219 

23,980 

11,996 

12,534 

610 

473 

6,068 

4,651 

2,651 

3,463 

2,894 

2,859 

4,950 

6,962 

19,225 

16,636 

8,821 

9,102 

32,996 

32,700 

11,743 

12,420 

277 

276 

1,740 

1,252 

1,667 

1,543 

697 

697 

1,556 

517 

550 

9,393 

8,400 

6,962 

6,006 

127,522 

112,740 

173,216 

115,059 

67 

76 

41 

20 

2,853 

2,312 

62 


BUREAU    OF     PREVENTABLE    DISEASES. 


TABLE  No.  5. 
DIVISION  OF  INDUSTRIAL  HYGIENE. 


Factorie  i  investigated . . . 
Complaints  investigated . 

Peddlers  examined 

Diseased 

Bakers  examined 

Diseased 

Food  Handlers  examined 
Diseased 


248 
59 
6,682 
1,697 
5,755 
2,045 
10,633 
3,599 


765 
112 

2,583 
521 

5,193 

1,733 
18,502 

6,245 


TABLE  No.  6. 
ANIMAL  DISEASES. 


Horses  examined 

Horses  tested  with  mallein 

Horses  vaccinated 

Horses  condemned 

Post-mortem  examination  of  horses 

Cows  examined 

Dogs  examined 

Dogs  destroyed 

Cases  of  rabies 

Persons  examined  for  dog  bit« 

Cats  examined 

Cats  destroyed 

Number  of  persons  examined  in  anti-rabies  clinics 

Number  of  anti-rabies  injections 

Number  of  tetanus  injections 


63 


ANNUAL     REPORT     OF    THE     DEPARTMENT     OF     HEALTH. 


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64 


BUREAU  OF  FOOD  AND  DRUGS. 


BUREAU  OF  FOOD  AND  DRUGS 


/?LL  rOOD.  /MSPCCTIONS    ^|§'^5 


SAMPLES 
OF 

MILK 


SAMPLES 
or 
FOOD 


^CHLnAUAL%io  I 
ADULTERATED     g| 

BACTERIAL     f,l%^n. 


EXAM. 


63202 


'chem.anal|';^| 


ADULTERATED    ||j 


PROSECLITIONS 


TOTAL  CASES 
DISPOSED      -^391- 


D/SCHARGED    ^|[ 


SEMTENCE 
SUSPENDED 


PRISOW 
SENTENCE 


FfNETD 


G3%1 


SUCCESSFUL    PROSECUTIONS  6L 
PCR     lOOO    INSPECTIONS         '2' 


IW  CREASE-- OECRfASE 
I    1915 
-^1  %      1916 


HI   I9»5 


(9/^ 
(916 


i'*i9,5 


19/6 


191^ 


-J4%       1916 


191^ 
1916 


+29?    1915 
^H     1916 


1915 
19\6 


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1916 


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1916 


191^ 
1916 


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CHART  No.  2. 

Erratum — In  Cliart  No.  2  the  proportion  of  prison  sentences  should  be  0.28  and 
0.24  of  one  per  cent,  respectively,  instead  of  28  per  cent,  and  24  per  cent. 


65 


BUREAU  OF  FOOD  AND  DRUGS. 

Changes  in  staff—During  the  year,  5  inspectors  were  retired;  8  inspectors,  2 
veterinarians,  2  chemists,  7  clerks  and  4  laboratory  assistants  resigned;  6  inspectors, 
7  veterinarians,  1  clerk  and  1  laboratory  assistant  were  dismissed  on  charges  of 
receiving  bribes,  drunkenness  and  making  false  reports.  Two  inspectors  died.  These 
positions  were  lilled  by  new  appointments. 

Changes  in  organisation — May  1st,  a  Terminal  Squad  consisting  of  a  supervisor 
and  7  inspectors,  was  organized  to  supervise,  at  the  various  railway  and  boat  terminals, 
the  entry  of  all  foodstuffs  into  the  city. 

May  20th,  the  number  of  field  inspection  districts  was  reduced  from  12  to  10 
in   order  to   better  concentrate  control. 

August  26th,  on  suggestion  of  the  New  York  Milk  Committee,  4  men  were 
detailed  to  try  out  a  better  systematized  plan  of  milk  inspection,  which  is  designed  to 
link  in  the  most  effective  way,  the  control  of  the  milk  supply  in  both  its  country  and 
city  aspects. 

September  15th,  the  number  of  field  inspection  districts  was  further  reduced  from 
10  to  8. 

A  Factory  Squad,  consisting  of  a  supervisor  and  5  inspectors,  was  organized, 
with  picked  men  to  specialize  in  the  sanitation  and  operation  of  food  factories. 

September  20th,  a  Warehouse  Squad,  consisting  of  a  supervisor  and  5  inspectors, 
was  organized  to  specialize  on  storage  problems  and  storage  places. 

October  1st,  the  country  inspectors  of  milk  were  reorganized  into  two  squads  in 
charge  of  supervisors. 

December  10th,  various  changes  were  made  in  the  organization  of  the  chemical 
laboratory:  c.  g.,  primary  chemical  analysis  is  made  by  the  laboratory  assistant;  if 
illegality  is  found,  the  results  are  confirmed  for  court  purposes  by  assistant  chemists. 
A  distinct  line  has  been  drawn  between  purely  routine  and  research  work,  and  the 
chief  of  the  laboratory  has  been  relieved  of  much  routine  work. 

Changes  in  Procedure — The  practice  of  issuing  certificates  of  condemnation  for 
spoiled  foodstuffs,  was  discontinued,  the  burden  of  knowing  when  foods  are  spoiled, 
being  placed  on  the  owners.  The  right  to  issue  condemnation  cards  was  withdrawn 
from  inspectors.  Certificates  of  condemnation  are  now  issued  only  after  application 
to  the  Office  of  the  Chief  Clerk  of  the  Department,  on  reports  coming  from  the 
inspector  through  the  office  of  the  Bureau. 

In  June,  the  Police  Department  was  called  .upon  for  co-operation  in  enforcing  the 
ordinance  against  the  exposure  to  dust,  dirt  and  flies  of  food  on  push  carts  and 
outdoor   stands. 

June  2d,  the  sale  of  food  "  as  is "  was  ordered  discontinued.  This  means  the 
sale  of  food  which  contains  some  unsound  material  offered  for  sale  at  the  risk  of 
the  purchaser. 

June  15th,  a  plan  was  put  into  effect  of  sending  laboratory  assistants  into  the 
field  for  certain  classes  of  field  work  for  which  a  certain  amount  of  scientific  training 
is   desirable  such  as  investigations  on  oysters. 

In  July,  the  method  of  determining  adulteration  of  milk  by  means  of  differences 
in  freezing  point  in  milk  serum,  was  adopted  as  a  routine  procedure  in  the  laboratory, 
former  methods  not  being  satisfactory  for  additions  of  small  amounts  of  water. 

July  28th,  the  Board  of  Health  amended  regulations  governing  the  tuberculin 
testing  of  cattle  so  as  to  allow  the  completion  of  a  tuberculin  test  at  the  end  of  the 
twentieth  hour,   except  imder  certain  specified  conditions  of  reaction. 

August  12th,  the  regulation  of  side  walk  stands  and  push  carts  was  begun.     These 

66 


BUREAU  OF  FOOD  AND  DRUGS. 

push  carts  must  be  clean,  and  have  tight  body,  which  must,  in  certain  cases,  be  metal- 
lined  and  drained  to  an  underslung  pail.  The  stands  must  be  provided  with  properly- 
drained  and  cleaned  ice-boxes,  the  food  must  be  sound  and  properly  protected  and 
raised  two  feet  above  the  ground  and  there  must  be  garbage  cans  easily  accessible, 
properly  covered  and  kept  clean. 

October  31st,  regulations  governing  the  sale  of  oysters  were  amended  so  as  to 
require  tiiat  oysters  produced  in  the  City  of  New  York  shall  not  be  sold  in  the  city, 
except  at  times  of  the  year  approved  by  the  Board  of  Health,  and  oysters  grown  in 
the  waters  of  Jamaica  Bay  shall  not  be  sold  between  April  15th  and  December  1st, 
unless  purified  for  seven  days  in  unpolluted  waters. 

November  1st,  to  devise  a  more  rapid  method  than  the  freezing  point  test,  for 
the  detection  of  milk  watering,  a  study  was  begun  on  the  electrical  conductivity  of 
milk   serum. 

Ini/^ortaitt  Aclivities — Patent  Medicines — January  7th,  the  stamping  of  patent  medi- 
cines in  stock  in  all  retail  drug  stores,  was  completed. 

Skim  Milk — February  25th,  out  of  41  replies  to  a  questionnaire,  sent  to  cities  of  over 
100,000  population,  all  cities  allowed  the  sale  of  skim  milk.  The  range  of  prices  was 
from  3  to  5  cents  per  quart.  Thus  New  York  is  the  only  large  city  in  the  country 
forbidding  the  sale  of  skim  milk. 

Cleaning  of  Glasses — March  6th,  the  campaign  for  the  installation  of  running  hot 
water,  for  washing  glasses  used  in  serving  liquid  refreshments,  was  pushed.  A  certain 
inspector  on  the  lower  east  side  secured  the  proper  equipment  of  184  stands  without 
summoning  a  single  owner  to  court. 

Adulterated  Rscallofys — March  18th,  in  co-operation  with  the  U.  S.  Department  of 
Agriculture,  adulterated  escallops  shipped  from  Eastern  and  Soutlicrn  States  were 
seized  and  the  shipper  is  being  prosecuted  by  tlie  U.  S.  Government. 

Carbolic  Acid  and  Bichloride  of  Mercury — March  25th,  a  special  investigation 
regarding  the  sale  of  carbolic  acid  and  bichloride  of  mercury  was  made.  In  4  out  of 
36  drug  stores  tested,  carbolic  acid  was  purchased.  In  all  of  30  drug  stores,  bichloride 
of  mercury  was  purchased.  At  hearings  held,  the  proprietors  of  all  these  places  were 
warned  that  the  next  offense  would  mean  prosecution,  and  publicity  w-as  given  the 
investigation  so  that  others  of  the  trade  might  be  warned. 

Wood  Alcohol  in  Toilet  Articles — March  27th,  a  manufacturer  of  bay  rum,  witch 
hazel  and  a  toilet  water,  all  of  which  contained  wood  alcohol,  was  convicted  and  sen- 
tenced to  30  days  in  prison  and  fined  $250. 

The  Cost  of  Living — April  4th,  a  survey  was  made  of  the  relative  cost  of  food- 
stuffs in  various  sections  of  the  city.  Certain  selected  goods  were  purchased  and  an 
analysis  of  the  prices  indicated  that  the  current  retail  prices  were  practically  the 
same,  that  the  stores  in  poorer  sections  were  in  reality  obtaining  a  greater  profit  than 
were  those  in  the  other  sections  and  that  the  margin  of  profit  in  all  cases  was  suffi- 
cient to  permit  the  retail  dealers  to  conduct  business  in  an  honest  manner. 

Inspection  of  Cattle — May  1st,  an  ante-mortem  veterinary  inspection  of  all  cattle 
coming  into  the  city  was  begun  in  co-operation  with  the  federal  authorities.  The 
result  lias  been  a  decided  improvement  in  tiic  class  of  cattle  coming  into  the  city. 

Lead  in  Urine — As  a  result  of  the  requirements  of  the  Division  of  Industrial 
Hygiene,  a  new  method  for  the  determination  of  lead  in  urine  was  perfected. 

Physical  Examination  of  Milk  Handlers— 'SUy  1st,  the  milk  dealers  of  the  city 
were  notified  that  all  persons  handling  milk  sold  raw,  and  all  persons  handling  milk 
after  pasteurization  must  be  physically  examined  at  an  early  date,  so  that  employees 
with  infectious  diseases  might  be  excluded. 

67 


ANNUAL  REPORT  OV     THE  DEPARTMENT  OF  HEALTH. 

Seashore  Resorts — May  6tli,  a  preliminary  campaign  was  begun  to  put  food  estab- 
lishments at  seashore  resorts  in  a  sanitary  condition  before  the  regular  opening  for 
the  summer  season.  A  special  oversight  was  kept  throughout  the  summer,  and  as  a 
result  the  conditions  under  which  foods  and  beverages  were  sold  were  greatly  improved 
over  preceding  years. 

Olcomarcjarinc  vs.  Butter — May  21st,  an  investigation  of  123  hotels  and  restaurants 
showed  that  not  in  one  instance  was  oleomargarine  illegally  served  v/hen  butter  was 
called  for. 

Bribery  in  Slaughter  Houses— May  26th,  as  a  result  of  an  investigation  requested 
by  the  Director  of  the  Bureau  and  conducted  jointly  by  this  Department  and  the 
office  of  the  Commissioner  of  Accounts,  7  veterinary  inspectors  were  dismissed  from 
the  service  on  charges  of  accepting  bribes  from  the  operators  of  slaughter  houses.  As 
a  result  of  the  same  worlc,  indictments  for  bribery  were  brought  against  12  of  the 
operators  and  four  of  them  have  been  convicted.  At  the  same  time  permits  for  the 
operation  of  the  slaughter  houses  were  revoked. 

Free  Lunches — May  27th,  an  inspection  of  saloons  serving  free  lunches,  especially 
in  the  neighborhood  of  the  Bowery  and  water  front,  was  begun  with  a  view  to  com- 
pelling sanitary  conditions  and  proper  handling  of  foods. 

Hempstead  Bay  Oysters — May  29th,  a  sanitary  survey  showed  that  oysters  coming 
from  certain  parts  of  the  waters  of  Hempstead  Bay,  L.  L,  were  dangerously  polluted 
because  the  effluent  from  the  Long  Beach  Sewage  Disposal  Plant  was  not  sterilized 
and  because  the  leaching  cesspools  were  subject  to  tidal  action.  Such  oysters  were, 
therefore,  barred  from  sale  in  this  city. 

Pastenri::ation  of  Butter — Tune  6th,  a  special  committee  of  the  Advisory  Council 
on  Food  and  Drugs  reported  that  it  would  be  inadvisable  to  make  any  recommenda- 
tion as  to  bacterial  standards  for  butter  until  exact  information  was  available  on  the 
possible  danger  to  health  from  butter  as  now  offered  for  sale  in  this  city  and  on  the 
method  of  meeting  the  practical  problems  of  enforcement  of  possible  regulations. 
The  collection  of  such  information  was  at  once  begun  and  is  still  proceeding. 

Neiv  Jersey  Oysters — June  20th,  an  investigation  of  the  conditions  of  oyster  culture 
in  the  waters  of  Raritan  Bay  was  conducted,  with  the  New  Jersey  State  Board  of 
Health  and  the  United  States  Department  of  Agriculture.  The  result  was  that  oysters 
grown  in  Raritan  Bay  were  admitted  to  this  city  unless  they  were  floated,  "  drinked  " 
or  otherwise  treated  in  the  waters  of  Chesquake  Creek,  Matawan  Creek  or  Luppatcong 
Creek. 

Drug  Substitution — July  6th,  a  druggist  was  fined  $100  for  substituting  something 
else  for  panopeptone  in  a  physician's  prescription. 

Condition  of  Drug  Stores — July  8th,  a  survey-  was  made  of  the  sanitary  condition 
of  62  drug  stores  in  the  city.  Sixty-one  were  found  in  an  insanitary  condition. 
Owners  were  warned  and  improvement  was  noted  on  reinspection.  In  some  of  these 
places  crude  drugs  were  found,  spoiled  and  dirty  and  were  destroyed. 

Patent  Medicines  on  Push  Carts — The  sale  of  patent  medicines  by  irresponsible 
dealers,  from  push  carts,  was  ordered  discontinued,  it  having  been  found  that  many 
of  the  preparations  sold  had  lost  any  slight  medicinal  value  they  might  have  once 
possessed,  and  others  contained  opium  or  other  habit-forming  drugs. 

Old  Bottles — An  investigation  of  the  old  bottle  trade  revealed  the  fact  that  about 
40  dealers  collected  400,000  weekly  from  the  city  dumps.  These  dealers  were  in- 
structed that  the  bottles  would  have  to  be  properly  washed  and  sterilized  before  using. 

Spot  Eggs — July  27th,  "  The  Spot  Egg  King "  was  caught  receiving  eggs  from 
the  New  York  Egg  Yolk  Company,  who  receives  rotten  egg.^   for  the  tanning  trade. 

68 


BUREAU  OF  FOOD  AND  DRUGS. 

He   was   arrested   and   taken   to   court   and    released   on   bail   pending   the    filing   of   a 
revised  "information  affidavit"  by  the  Corporation   Counsel. 

Ice  Cream — August  1st,  as  a  result  of  a  campaign  for  the  systematic  bacterio- 
logical examination  of  ice  cream  begun  June  1st,  certain  dealers  whose  ice  cream 
showed  high  bacterial  counts  were  warned  that  better  sanitary  conditions  must  pre- 
vail in  their  factories  and  that  thorough  sterilization  of  their  utensils  must  be 
practised. 

Exposure  of  Milk  to  Warm  Weather — August  5th,  an  investigation  was  begun  to 
determine  why  the  bacterial  content  was  found  to  be  excessive  in  milk  received  at 
railway  terminals  in  the  city  and  it  was  found  that  the  chief  fault  lay  in  the  care- 
lessness of  dealers  in  allowing  milk  to  stay  on  discharging  platforms  for  several 
liours,  without  ice  or  poorly  iced,  thus  becoming  warmed  and  promoting  bacterial 
grc/wtli.     Tlie  destruction  of  such  milk  promptly  resulted  in  lower  counts  thereafter. 

Fake  Poliomyelitis  Preventive — August  25th,  a  man  who  sold  a  bag  of  cedarwood 
shavings  perfumed  with  napthalene  as  a  "protector"  against  infantile  paralysis,  was 
convicted  and  fined  $250. 

Saccharine — August  31st,  the  Court  of  Special  Sessions  upheld  the  Department 
in  its  contention  that  saccharine  should  not  be  used  as  a  sweetener  and  all  manufac- 
turers of  beverages  were  warned  that  this  drug  must  not  be  used  as  a  sweetener  or 
prosecution  would  result. 

Gravesville  Creamery — August  31st,  milk  from  Gravesvillc,  New  York,  was  ex- 
cluded from  sale  in  the  city.  It  was  found  that  the  manager's  son  at  the  plant  was 
ill  with  typhoid  and  that  another  employee  had  a  typhoid  history  and  that  the  water 
supply  was  contaminated.  After  five  analyses,  however,  bacilli  coli  were  noted  in  only 
10  c.c.  and  the  water  was,  thereupon,  declared  safe.  The  employees  who  were  found 
to  have  a  typhoid  history  were  excluded  from  work  in  the  plant  and  the  milk  supply 
was  resumed  on  November  13th. 

Poliomyelitis  "Cure" — September  21st,  a  faker  who  sold,  for  $1  a  4-oz.  bottle  of 
a  nostrum  which  he  called  "Sol"  as  a  cure  for  infantile  paralysis,  tuberculosis,  rheu- 
matism and  a  few  other  ailments,  was  convicted  and  sent  to  the  city  prison  for  30  days. 
Analysis  of  his  nostrum  showed  that  it  consisted  of  red  pepper,  sassafras  oil  and 
alcohol. 

Unripe  Citrus  Fruits — In  September  attentirin  was  concentrated  on  citrus  fruits 
coming  into  the  city  from  the  West  India  Islands,  particularly  Porto  Rico  and  Jamaica. 
The  Federal  Food  and  Drugs  Act  of  June  30,  1906,  while  allowing  the  seizure  of  mis- 
brande<l  and  adulterated  fruits,  does  not  allow  the  seizure  of  fruits  or  vegetables 
which  are  immature.  The  New  York  City  Sanitary  Code  directs  the  seizure  of  such 
unwholesome  material.  This  Bureau  was  informed  by  the  U.  S.  Department  of 
Agriculture,  of  all  shipments  of  citrus  fruits  and  as  a  result  of  careful  inspection 
500,000  pounds  of  such  unripe  fruit  were  destroyed. 

Rotten  Eggs — From  October  to  December,  inclusive,  a  special  watch  was  kept  on 
bakeries  to  detect  the  use  of  rotten  eggs  which  at  this  time  of  the  year  are  apt  to 
be  used  on  account  of  the  high  market  price  of  eggs. 

Physical  Examination  of  Milk  Handlers — October  1st,  milk  dealers  were  again 
advised  that  handlers  must  be  physically  examined  at  once.  The  work  is  proceeding 
slowly,  and  was  mucli  hampered  by  the  milk  strike. 

Celery  Tonics — October  2d,  manufacturers  of  so-called  celery  tonics  were  notified 
the  falsity  of  claims  that  such  beverages  have  medicinal  properties  and  that  their 
labels  must  be  so  corrected  as  to  tell  i)nly  the  trutii. 

69 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

Milk  Strike — October  17th,  the  shortage  of  milk  during  the  milk  strike  forced 
dealers  to  seek  elsewhere  for  supplies,  and  from  sources  uninspected  by  this  Bureau, 
such  as  the  milk  sheds  of  Boston,  Philadelphia,  Chicago,  Cleveland  and  Pittsburg. 
All  such  milk  was  admitted  only  after  the  Board  of  Health  of  the  city  in  question 
had  certified  to  this  Department  the  wholesomeness  of  the  supply  and  only  raw  milk 
was  admitted,  which  was  subsequently  pasteurized  under  the  supervision  of  this 
Department. 

Frozen  Eggs — October  21st,  an  interstate  shipment  of  some  21,000  pounds  of  frozen 
eggs,  at  a  value  of  $4,000  was  seized,  condemned  and  destroyed  as  unfit  for  human 
consumption.  This  case  indicates  the  close  co-operation  now  existing  between  the  U.  S. 
Department  of  Agriculture  and  this  Bureau. 

Moving  Pictures  of  Food  Control — October  31st,  the  Universal  Film  Company 
made  a  number  of  pictures  of  the  actual  field  and  office  work  of  this  Bureau.  The 
educational  value  of  the  display  of  such  films  at  the  thousands  of  moving-picture 
theatres  in  this  city  and  the  country  can  hardly  be  estimated.  A  copy  of  each  film 
is  to  be  furnished  to  the  Department  gratis. 

Tuberculosis  "Preventive" — October  31st,  a  faker  was  arrested  for  selling  an  in- 
haler containing  menthol  and  oil  of  eucalyptus  as  a  preventive  of  tuberculosis.  Sen- 
tence was  suspended  after  a  warning  was  given  to  him  not  to  repeat  offense. 

Soft  Drinks — In  November,  the  sale  of  so-called  orange  juice  in  the  city  was 
investigated.  Analysis  showed  that  the  beverage  was  composed  of  %  juice  of  oranges 
and  lemons  and  ^  water  and  sugar.  Dealers  were  notified  to  correct  labels  under 
penalty  of  prosecution. 

Cold  Storage  Eggs — November  13th,  an  investigation  was  begun  of  the  sale  of  eggs 
to  determine  whether  cold  storage  eggs  were  being  sold  as  fresh  eggs.  This  was 
found  to  be  rather  a  widespread  practice,  storage  eggs  actually  being  sold  to  inspectors 
under  these  false  representations.  One  hundred  and  eighty-three  violations  were 
found,  50  dealers  warned,  133  cases  were  taken  to  court,  62  of  these  have  already  been 
fined  from  $2  to  $10. 

Exhibit  at  Food  Show — November  18th,  a  food  exhibit  was  installed  at  the  22nd 
Regiment  Armory  as  part  of  the  food  show  of  the  New  York  Retail  Grocers'  Ass'n. 
This  exhibit  showed  the  method  of  work  of  the  Bureau,  the  great  waste  of  food  stuffs 
due  to  poor  handling  and  shipping  and  some  samples  of  adulterated  foods.  An  in- 
spector acted  as  a  demonstrator. 

Clarifying  Oysters — November  18th,  the  U.  S.  Bureau  of  Chemistry  and  this 
Bureau  agreed  that  the  waters  of  Hassock  Creek  in  Jamaica  Bay,  are  free  of  sewage 
contamination  and  are,  therefore,  suitable  for  the  clarification  of  contaminated  oysters. 
No  oysters  are  allowed  to  be  clarified,  however,  unless  under  the  supervision  of  an 
inspector. 

Drug  Substitution — November  21st,  a  druggist  was  fined  $100  for  substituting 
asperin   for  phenacetin  in  a  physician's  prescription. 

Tomato  Catsup  Fraud— In.  November,  the  Factory  Squad  discovered  that  much 
tomato  catsup  of  a  fraudulent  character  had,  for  a  long  time,  been  manufactured  in 
the  city.  This  stuff  was  often  made  by  adding  a  large  amount  of  cereals  or  flour  and 
red  dye  to  a  small  amount  of  pure  catsup  of  tomato  pulp,  spices  and  vinegar  and  in 
some  cases  the  tomato  pulp  was  omitted  entirely.  The  manufacturers  of  and  whole- 
sale dealers  in  such  products  were  notified  to  discontinue  this  fraudulent  labeHng. 
It  was  ruled  that  products  containing  less  than  50  per  cent,  tomato  pulp  must  be 
labeled  "  imitation  catsup."  Those  containing  over  50  per  cent,  tomato  pulp,  but  with 
a  filler  added  such  as  cereal,  flour,  etc.,  are  to  be  labeled  "  tomato  compound  "  and  only 

70 


BUREAU  OF  FOOD  AND  DRUGS. 

products  without  fillers  and  consisting  solely  of  tomato  pulp  with  added  spices,  etc., 
are  to  be  labeled  "  tomato  catsup  "  and  the  presence  of  artificial  color  or  benzoate  of 
soda  must  be   declared. 

High  Cost  of  Foods — December  1st,  the  Department  being  constantly  called  on  to 
quote  comparative  prices  of  foodstuffs,  investigation  was  made  and  it  was  found  that, 
compared  with  the  same  period  of  1915,  the  rise  of  prices  on  staples  including  vege- 
tables and  fruits  was  from  8  to  500  per  cent.,  the  majority  being  from  25  to  60 
per  cent. 

Poliomyelitis  "Cure  " — December  5th,  a  faker  selling  a  nostrum  called  "  sumacyl," 
consisting  essentially  of  malt  extract  and  salicylic  acid,  as  a  cure  for  infantile  paralysis, 
was  sentenced  to  the  city  prison   for  30  days. 

"Ladle  "  Butter — December  6th,  a  special  investigation  was  made  of  ladle  butter 
and  2,000  pounds  were  seized  and  destroyed  and  warning  given  to  all  "  ladlers  "  that 
acceptance  and  possession  of  such  "  packing  stock "  would  result  in  prosecution,  if 
found  mouldy,  dirty  or  otherwise  unfit  for  use.  Ladle  butter  is  butter  collected  by 
peddlers  and  country  stores  from  farmers  and  shipped  in  bulk  to  dealers  in  the 
city,  who  rework  and  soften  it  with  the  aim  of  producing  a  fairly  good  product  for 
the  use  of  bakers,  pie-makers,  etc. 

Poliomyelitis  Preventive  and  Remedy — December  12th,  two  fakers,  one  a  doctor, 
were  fined  $500  and  $300  each  for  manufacturing  and  selling  a  nostrum  which  they 
claimed  was  a  preventive  and  remedy  for  infantile  paralysis  and  which  consists  of 
water,  alcohol  and  a  very  small  amount  of  plant  extract. 

"  Cure  "  for  Tuberculosis,  Diabetes,  etc. — December  14th,  a  faker  was  fined  $100 
for  selling  an  8  oz.  whiskey  flask  of  a  solution  of  chloride  of  tin  in  water  for  $2  as 
a  preventive  and  cure  for  tuberculosis,  diabetes,  cancer,  infantile  paralysis,  etc. 

Oyster  Adulteration — December  17th,  an  exhaustive  investigation  of  commercial 
methods  of  freeing  oysters  of  mud  and  sand  demonstrated  that  without  exception 
these  resulted  in  an  addition  of  water  to  the  oysters  with  a  consequent  decrease  of 
solids,  thus  constituting  an  adulteration.  The  increase  in  volume  was  from  5  to  20 
per  cent,  in  shucked  stock,  and  from  20  to  25  per  cent,  in  shell  stock.  Experiments 
showed  that  oysters  could  be  cleansed  by  methods  which  would  not  thus  increase  the 
volume  and  dealers  were  accordingly  notified  that  on  and  after  January  10th,  no 
method  of  cleansing  must  be  used  which  will  result  of  an  increase  of  the  volume  of 
oysters  on  penalty  of  prosecution. 

Old  Egg  Offender  Heavily  Fined — December  20th,  Samuel  Strudler,  an  egg  dealer, 
who  had  been  connected  with  various  firms  which  have  been  convicted  sixteen  times, 
and  fined  an  aggregate  of  $4,000  for  violation  of  the  code  ordinances  of  the  Depart- 
ment, was  convicted  and  fined  $1,000,  in  two  cases,  the  heaviest  possible  fine  under  the 
law. 

Wood  Alcohol — December  21st,  a  druggist  was  sentenced  to  30  days  in  the  city 
prison  for  manufacturing  and  selling  tincture  of  iodine,  spirits  of  camphor  and  tincture 
of  larkspur  which  were  prepared  with  the  poisonous  and  cheaper  wood  alcohol  instead 
of  the  grain  alcohol  called  for  by  law. 

Wicks  Committee — December  23rd,  several  members  of  this  Bureau  testified  before 
the  Wicks  Committee,  which  was  appointed  by  the  legislature  to  inquire  into  conditions 
surrounding  the  sale  of  foodstuffs  in  this  city,  particularly  of  milk,  eggs  and  poultry. 

Drugs  Belozv  Standard — December  26th,  a  wholesale  druggist  was  fined  $500  for 
manufacturing  and  selling  tablets  of  salol,  salicylate  of  soda  and  other  important  drugs 
which  were  not  only  less  than  the  declared  weight,  but  below  standard  in  the  amount 
of  drugs  contained.     Some  contained  less  than  12  per  cent,  of  the  active  drug. 

71 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

Proprietary  Medicines — December  30th,  998  manufacturers  had  registered  3,648 
different  preparations  with  this  Bureau,  in  conformity  with  Section  117  of  the  Sani- 
tary Code. 

Achievements — Drug  Stores — A  plan  has  been  perfected  for  controlling  drug 
stores  both  as  to  the  character  of  the  product  sold  by  them  and  their  sanitary  con- 
dition. 

]\rilk  Strike — During  the  milk  strike,  new  supplies  of  milk  were  allowed  to  enter 
the  city  in  such  a  way  as  not  to  endanger  in  any  degree  the  health  of  the  city. 

Systematic  Food  Inspection — For  the  first  time  in  the  United  States  a  plan  of 
systematically  handling  the  food  control  of  a  large  city  was  put  into  effect.  This  plan 
controls  the  food  at  every  place  which  it  reaches,  from  the  moment  it  enters  the  city 
until  it  gets  to  the  consumer. 

Jl'ood  Alcohol — This  Bureau  has  at  last  succeeded  in  practically  eliminating  the 
sale  of  spurious  liquors,  drugs  and  barber's  supplies,  containing  poisonous  wood  alcohol 
instead  of  grain  alcohol  and  in  enforcing  the  proper  labeling  of  materials  in  which 
wood  alcohol  is  allowed  to  be  used. 

Inspection  of  Hotels  and  Restaurants — Due  to  concentration  during  the  summer 
on  hotels  and  restaurants,  a  very  marked  improvement  has  been  made  in  most  of  these 
establishments. 

Oysters — As  a  result  of  systematic  work  in  the  inspection  of  oyster  beds  and  the 
insistence  of  the  effective  clarification  of  oysters  from  polluted  areas,  both  from 
within  and  without  the  city,  it  can  be  said  that  the  oysters  now  sold  in  the  city  are 
wholesome  and  sound. 

Agencies  of  U.  S.  Government — The  establishment  of  more  close  relations  with 
those  agencies  of  the  U.  S.  Government  and  of  the  States  which  have  to  do  with  the 
supervision  of  the  food  control,  resulted  in  increased  effectiveness  in  the  work  of  all 
these  agencies. 

Co-operation  zvith  Tradesmen— Tht  establishment  of  a  constructive  policy  having 
in  view  close  relations  with  every  branch  of  the  trade  in  foods  and  to  the  end  that  the 
Bureau  may  have  effective  co-operation  with  the  reputable  elements  in  these  trades. 

Explanation  re  Charts. 

In  reading  the  charts  shown  below,  making  comparisons  of  activities  of  this 
Bureau,  it  must  be  borne  in  mind  that  during  the  year  1916  a  complete  change 
has  taken  place  in  its  methods  of  work,  this  change  being  designed  to  eliminate  lost 
motion  and  to  reduce  comparative  cost  for  results  obtained. 

The  chart  herewith  designated  as  No.  1  shows  the  manner  in  which  the  problem  is 
now  attacked.  Following  out  the  above  plan  and  in  the  interests  of  efficiency,  in- 
spections are  made  only  where  it  is  believed  thej^  are  most  needed.  The  large  estab- 
lishments handle  the  most  foods.  If  they  transmit  the  foods  in  good  condition  to  the 
small  men,  such  foods  are  much  more  likely  to  remain  in  good  condition  and  the  small 
dealers  not  only  have  the  temptation  to  sell  bad  foods  lessened  but  have  an  example 
which  they  are  likely  to  follow. 

Inspections  of  large  places,  have,  likewise,  been  made  much  more  exhaustive.  All  this 
means  fewer  inspections  but  better  and  more  effective  work.  The  inspection  of  a 
pushcart  or  sidewalk  stand  takes  only  a  minute  or  two-,  of  a  large  warehouse  or 
hotel  a  half  day.  TTius  there  are  196,224  fewer  inspection  of  pushcarts  and  stands 
and  1.255  more  inspections  of  warehouses.  The  total  number  of  inspections  shown 
in  Table  No.  1  is  therefore  31^  per  cent,  less  than  in  1915,  but  the  successful  prose- 
cutions as  shown  by  Chart  No.  2,  per  1,000  inspections,  are  double  those  in  1915.  It 
must  be  borne  in  mind  that  the  number  of  inspections  made  is  absolutely  no  criterion 

72 


BUREAU  OF  FOOD  AND  DRUGS. 


of  the  eflfectivencss  of  the  work.     This  is  to  be  sought  rather  in  the  improvement  of 
the  food  supply  m  general  and  of  the  sanitary  conditions  surrounding  its  handling 

Reference  is  made  in  the  body  of  the  report  to  change  of  procedure  in  issuing 
certificates  of  condemnation.  As  a  consequence  of  this  and  of  the  placing  of  in- 
spectors at  the  points  of  entrj'  of  foods,  less  unsound  food  enters  the  city.  Likewise, 
dealers  themselves  destroy  unsound  foods  without  waiting  to  get  certificates  of  con- 
demnation from  the  Health  Department  as  they  formerly  did.  It  is  a  safe  state- 
ment that  the  amounts  of  condemnations  stated  in  former  reports  were  no  measure 
of  the  effectiveness  of  methods  for  the  detection  of  unsound  foods  and  represented 
in  large  degree  a  "padding"  of  returns.  Even  the  figures  for  1916  are  no  criterion 
for  future  years  because  the  present  system  was  not  put  into  operation  until  about 
May  1st.  Consequently,  there  is  a  reduction  in  the  amount  of  food  shown  as  con- 
demned, of  about  one-half  as  compared  with  1915,  and  it  is  to  be  expected  that 
such  figures  will  show  further  reduction  as  efficiency  becomes  greater. 

TABLE  No.   1. 
INSPECTIONS  OF  FOOD  ESTABLISHMENTS. 


Chakacter  of  Establishments. 


Bakeries 

Butchers 

Cafes 

Carbonated  and  Mineral  Waters.  . 

Cold  storage  plants 

Comniission  houses 

Confectionery 

Creameries 

Dairies 

Delicatessen 

Drug  stores 

Eggs,  wholesale 

Egg  breaking 

Fat  rendering 

Fish 

Frozen  products 

Groceries 

Markets 

Milk  platforms 

Miscellaneous 

Pasteurizing  plants — City 

Pasteurizing  plants — outside  city .  . 

Piers  and  wharves 

Push  carts 

R.  R.  terminals 

Restaurants  and  hotels 

Slaughter  houses — cattle 

Slaughter  houses — poultry 

Smoke  house  and  meat  preserving . 

Stands 

Stock  yards 

Stores — general 

Supply  houses 

Warehouses 


Retail 
Establishments. 


1915. 


23,985 

34,760 

9,().S1 


22,472 
2,430 

24,007 
5,537 

11,675 


1916. 


3,262 


50,468 
4,586 


Total 617,423 


18,082 


202,618 


20,951 


129,633 


53,216 


27,168 

49,275 

3,837 


25,660 
3,068 

18,081 
4,986 
5,140 


3,875 

46,752 
3,157 

47,893 


83,837 
21,400 

52,190 
1,330 


Wholesale 
Establishments. 


1915. 


11,880 

1,467 

898 

32,921 

703 


877 

532 

478 

10,152 

1,417 

282 

2,159 

17,109 

OS 

5,209 

9,550 

5,645 

1,925 
6,108 
1,194 

92 


1916. 


397,649 


495 
1,565 


112.726 


9,100 

2,327 

271 

29,745 

1,342 


1,899 

484 

207 

5,037 

1,558 

1,171 
6,785 
12,610 
1,684 
4,432 
9,441 

2,033 

2,205 
4,740 
1,895 


2,820 


Total 
Inspections. 


1915. 


23,985 

46,640 

9,681 

1,467 

898 

32,921 

23,175 

2,430 

24,067 

5,537 

11,675 

877 

532 

478 

13,414 

1,417 

50,468 

4,868 

2,159 

35,191 

68 

5,209 

9,550 

202,618 

5,645 

20,951 

1,925 

6,108 

1,194 

129,633 

92 

53,216 

495 

1,565 


1916. 


101.786  730,149 


27,168 

58,375 

3,837 

2,327 

271 

29,745 

27,002 

3,068 

18,081 

4,986 

5,140 

1,899 

484 

207 

8,912 

1,558 

46,752 

4,328 

6,785 

60,503 

1,684 

4,432 

9,441 

83,8:^7 

2,033 

21,400 

2,205 

4,740 

1,895 

52,190 

1,330 

2,820 


499,435 


7Z 


ANNUAL    REPORT    OF    THE    DEPARTMENT     OF    HEALTH. 


TABLE  No.  2. 
CONDEMNATION  OF  UNWHOLESOME  FOODSTUFFS. 


Character  of 
Foodstuffs. 

1915. 
Pounds. 

1916. 
Pounds. 

Character  of 
Foodstuffs. 

1915. 
Pounds. 

1916. 
Pounds. 

Fruit 

Vegetable 

10,827,745 

3,134,637 

1,108,246 

137,607 

1,216 

46,853 

55,441 

5,812 

69,080 

6,678 

2,483 

46,173 

6,909,915 

1,656,418 

766,263 

'44,430 

179,464 

827 

5,271 

5,033 

36,884 

Beef 

Veal 

563,416 

170,250 

35,093 

96,056 

386,388 

15,400 

1,032,166 

9,786 

9,016 

449,401 

73,534 
28,906 
11,665 
74,478 
97,465 

148,790 

1,297,754 
737,884 

Canned  goods 

Groceries 

Drugs 

Eggs 

Milk 

Cream 

Condensed  Milk 

Butter 

Cheese 

Confectionery 

Mutton  or  Iamb . . . 

Pork 

Poultry 

Game 

Fish 

Shell  Fish 

Assorted  Meats .  .  . 
Miscellaneous 

Total 

18,479,275 

12,074,981 

TABLE  No.  3. 
PROSECUTIONS— 1916. 


New  arrests 

Held  on  bail 

Discharged 

Fined 

Sentence  suspended 
Amount  of  fines . .  . . 
Prison  sentence .  .  .  , 


1915. 


1916. 


4,381 

6,223 

1,369 

383 

446 

341 

3,133 

4,792 

1,402 

1,158 

$33,221. 

$44,402. 

14 

15 

74 


BUREAU    OF     HOSPITALS. 


BUREAU  OF  HOSPITALS. 


PATIENTS 
TREATED 


TOTAL 
DIPHTHERIA 
SCARLET  FEVER 
MEASLES 


"-yis 


fl6l 


"K  OX  1915 
■■  1916 


=^  llll 


DEATHS 


TOTAL 
DIPHTHERIA 
SCARLET  FEVER 
MEASLES 


I224[ 
I690| 


m 


^^  1916 


^75%  l9;6 

1  I9IS 

^^SJ%  1916 

1  1915 


FATALITY 
% 


TOTAL 
DIPHTHERIA 
SCARLET  FEVER 
MEASLES 


I3.3i 
13.71 

4.9  r 
4.0I 

ikll 


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1916 


ni9i5 

ri9)6 


1915 
1916 

19)5 
1916 


PATIENT 
DAYS 


TOTAL 
DIPHTHERIA 
SCARLET  FEVER 
MEASLES 


5tl0€3 
441216 


79797[ 


90034| 

97390 
45917 

33&Q2 
19669 


ri^l9»6 


1916 


I9IS 

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75 


BUREAU  OF  HOSPITALS. 

Medical  Progress — Twenty  cases  of  chronic  laryngeal  stenosis  spent  the  summer 
at  the  Municipal  Sanatorium.  The  physical  condition  of  all  were  much  improved  and 
six  apparently  recovered. 

Cross  infection  with  diphtheria  has  been  minimized  by  the  use  of  the  Schick 
Test  and  active  immunization. 

Operative  procedure  for  chronic  laryngeal  stenosis  gives  hope  for  cures  in  the 
chronic  tubes  cases. 

The  admission  of  anterior  poliomyelitis  demanded  new  methods  of  adminis- 
trative and  medical  procedure  and  radical  changes  in  the  hospital  personnel  and 
equipment  were  required. 

The  whooping  cough  clinic  operated  in  conjunction  with  the  Research  Labora- 
tory, having  furnished  all  infdrmation  needed  relative  to  vaccine  therapy  for  this 
disease,  has  been  closed. 

The  application  of  X-ray  diagnosis  to  tuberculosis  patients  has  added  greatly 
to  the  statistical  value  of  the  medical  histories. 

The  future  patients  of  the  Willard  Parker  Hospital  will  benefit  by  the  addition 
of  an  X-Ray   Laboratory  to  this  institution,  installed  during   1916. 

Research  in  the  hospitals  has  been  evidenced  by  the  publication  of  11  contribu- 
tions to  scientific  literature. 

Clinics  for  medical  students.  Department  of  Health  Nurses  and  Institution  In- 
spectors have  been  held  throughout  the  year. 

The  Queensboro  Hospital,  capacity  for  80  patients,  was  oflficially  opened  by  the 
Department  of  Health,  June  29th,  1916. 

Btiildings — The  following  buildings  for  patients  are  now  under  construction 
and  should  be  ready  for  occupancy  about  July  1st,  1917: 

Diphtheria  Building,  Kingston  Avenue  Hospital,  Capacity  80? 
Tuberculosis  Pavilion?,  8  and  9,  Riverside  Hospital,  Capacity  160. 
Venereal  Building,  Riverside  Hospital,  Capacity  80. 
Pavilion  No.  112,  Municipal  Sanatorium,  Capacity  40. 

The  following  administrative  buildings  were  completed  during  the  year : 
Stafif  House,  Willard  Parker  Hospital. 
Antitoxin  Horse  Barn,  Municipal  Sanatorium. 
Hennery,  Municipal  Sanatorium. 
Silo,  Municipal  Sanatorium. 

Menu  Committee — The  work  of  the  Menu  Committee  has  resulted  in  keeping 
the  per  capita  costs  of  food  below  the  standard  of  the  Board  of  E.-stimate  and  Ap- 
portionment. 

Standard  Figures.     Actual  Cost. 

Doctors    58  .479 

Nurses     418  .345 

Help     22  .216 

Patients     165  .158 


Committee  on  Fire  and  Fire  Hazards — A  committee  consisting  of  the  Resident 

Physicians.   Chief   Engineers  and   Sanitary  Inspector,  formerly  a' captain  in  the  Fire 

Department,   has   been   appointed   to   investigate   fire   hazards   iuid    fires    for  the   pro- 
tection of  the  patients  and  property  of  the  Department  Hospitals. 

76 


BUREAU    OF    HOSPITALS. 

Employees — Six  employees  were  dismissed  from  the  City  Service  on  charges ; 
six  died,  two  retired  on  pension  and  1,740  resigned.  Most  of  the  latter  were  do- 
mestics and  orderlies  employed  by  the  week,  who  were  afraid  to  remain  on  account 
of  the  poliomyelitis  epidemic.  Others  were  patient  help  at  Otisville  and  Riverside, 
who  left  when  sufficiently  well  to  leave  the  institution. 

Seven  employees  were  mobilized  with  the  National  Guard  and  entered  the  United 
States  Army. 

The  establisimieiit  of  dispensaries  for  employees  has  resulted  in  a  decided  saving 
to  the  city. 

Twenty-seven  employees  of  the  Contagious  Disease  Hospitals  developed  con- 
tagious diseases  as  a  result  of  their  work. 

Physicians — Diphtheria    1 

Nurses,  15 — 

Diphtheria     9 

Scarlet   Fever    3  , 

German    Measles    ■ 2 

Chicken    Pox    1 

Domestics,  11 — 

Diphtheria     9 

Measles     2 

At  the  request  of  the  Municipal  Civil  Service  Commission  Resident  Physicians 
were  designated  Institutional  Examiners. 

Nurse  Service  with  Ambulance — Hospital  care  for  patients  to  be  transferred  to 
contagious  disease  hospitals  begins  in  the  home  by  sending  a  nurse  as  well  as  a 
doctor  on  the  ambulance  that  transports  them. 

Venereal  Disease  .Idmitted — Patients  suffering  from  venereal  diseases  are  now 
accepted  in  the  hospital  of  the  Department. 

Legal  Decision  in  Favor  of  Department — A  legal  decision  of  importance  to 
hospital  administrators  was  made  by  Justice  Manning  in  the  Supreme  Court  of  the 
Kings  County  denying  the  petition  of  the  plaintiff  in  the  case  of  O'Brien  vs.  The 
City  of  New  York  where  an  attempt  was  made  to  oust  nurses  of  this  Department 
from  the  house  rented  for  their  use. 

Experiments  ZL'ith  Coal — Experiments  to  determine  the  efficiency  of  Buckwheat 
No.  3  coal  as  a  fuel,  are  being  carried  out  in  tlie  power  houses  of  the  hospitals. 

Transfer  of  Drug  Laboratory — The  drug  laboratory  of  the  Department  of  Health 
was  merged  in  that  of  the  General  Drug,  Department  of  Charities. 

Kings  County  Hospital  to  Furnish  Electric  Current — An  agreement  has  been 
reached  by  the  Department  of  Health  and  Charities  to  recommend  tliat  electric  cur- 
rent be  furnished  from  Kings  County  Hospital  to  furnish  light  and  power  for  the 
Kingston    .Avenue   Hospital. 


77 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


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BUREAU    OF    HOSPITALS. 

TABLE  No.  3. 
TUBERCULOSLS— lOK). 


Otisville. 


Riverside. 


Total. 


1915. 


1916. 


Census,  December  31st 

Admissions 

Total  treated 

Total  died 

Total  discharged 

Total  discharged  or  died 

After  treatment  of  less  than  1  month 

1-3  months 

3-6  months 

Over  6  months 

Discharged  to  home 

Patient  days 

Average  days  per  patient 

Largest  number  at  one  time 

Smallest  number  at  one  time 

Average  patients  per  day 

Incipient  cases 

Arrested 

Apparently  arrested 

Quiescent 

Improved 

I'nimproved 

Transferred 

Died 

Cured 

Xon-tubercular 

Moderately  advanced  cases 

Arrested 

Apparently  arrested 

Quiescent 

Improved 

Unimproved 

Transferred 

Died 

Under  treatment 

Far  advanced  cases 

Arrested 

Apparently  arrested 

Quiescent 

Improved 

Unimproved 

Transferred 

Died 

Under  treatment 


566 

934 

1,501 

13 

922 

935 
76 
.  205 
236 
428 
922 

209,154 

223.48 

601 

528 

.571.4 

418 

69 

84 

112 

131 

18 

2 

1 
1 

443 
19 
23 

1S8 

146 

60 


74 
1 
3 

23 

26 
17 


212 
600 
S36 
117 
507 

624 
169 
253 
135 
67 
364 

62,817 

73.08 

260 

33 

172.01 

24 


4 

20 


293 


90 
20 
70 


113 
519 


80 
170 

53 
117 

99 


803 
1,4.S.S 
2,2.S.S 

213 
1,272 

1,485 
234 
383 
378 
490 

1,248 

295,826 

129.3 

875 

763 

810.5 

400 
38 
94 
139 
103 
12 
22 


519 

10 

39 

174 

196 

92 

1 


566 

1 

2 

20 

150 

186 
1 

206 


778 
1,534 
2,337 

130 
1,429 

1,559 
245 
458 
371 
48.5 

1,286 

271,971 

296  56 

861 

561 

743.41 

442 

69 

84 

112 

135 

18 

20 

2 

1 
1 

736 
19 
23 

18.8 

2;i6 

80 

70 

7 

113 

593 

1 

3 

23 

106 

187 

53 

121 

99 


*  Apparent  decrease,  due  to  closing  tuberculosis  wards  3  months. 


81 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


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BUREAU  OF  PUBLIC  HEALTH  EDUCATION. 

Important  Activities — January  8th,  an  extensive  anti-sneeze  campaign  was  con- 
ducted by  the  usual  means  of  lectures,  wide  distribution  of  health  leaflets  and  posters, 
issuance  of  press  notices,  etc.,  the  incentive  being  an  extraordinary  prevalence  of 
grip  and  infectious  colds  in  the  city,  the  object  being  to  educate  the  public  in  the 
methods  of  preventing  respiratory  diseases. 

In  January,  book  marks  were  distributed  to  school  children.  These  book  marks 
consisted  of  cartoons  with  yellow  and  white  printing  on  a  black  ground  commenting 
on  and  illustrating  some  health  aphorism,  such  as  "  Cover  up  each  cough  or  sneeze, 
if  you  don't,  you'll  spread  disease." 

In  February,  courses  were  planned  for  the  instruction  of  physicians  in  con- 
tagious diseases.  On  receipt  of  applications  for  enrollment  in  the  courses,  sections 
were  organized  comprising  8  physicians,  for  a  period  of  bed  side  instruction,  lasting 
two  weeks. 

In  March,  the  semi-centennial  of  the  Department  of  Health  was  celebrated  and 
in  connection  therewith,  a  monograph  was  published  giving  the  history  of  health 
administration  in  New  York  City,  during  the  past  100  years. 

In  April,  attempts  were  made  to  focus  attention  on  mosquito  extermination  by 
distributing  jars  of  live  mosquito  larvae  to  public  schools  throughout  the  city,  with 
the  request  to  the  Department  of  Education  to  have  teachers  instruct  the  children 
on  the  life  history  of  the  mosquito.  Moving  pictures  were  made  of  the  mosquito 
extermination  activities  and  simply  written  leaflets  giving  important  facts  and  life 
history  of  the  mosquito  and  describing  methods  of  their  extermination  were  distributed 
to  all  public  and  parochial  schools. 

Two  moving  picture  companies  made  special  films  showing  the  Department's  anti- 
mosquito  work.  Through  press  bulletins,  interviews,  feature  stories,  etc.,  considerable 
newspaper  publicity  was  given  the  mosquito  campaign. 

In  May,  mosquito  exhibits  were  set  up  in  various  parts  of  the  city.  These  ex- 
hibits consisted  of  panels  of  pictures  (photographs  and  cartoons),  a  short  text  in  large 
letters  and  a  jar  of  mosquito  larvae. 

In  connection  with  baby  week,  ten  films  of  moving  pictures  were  shown  in  large 
moving  picture  theatres  throughout  the  city  on  baby  subjects. 

A  press  bulletin  of  feeding  a  family  of  five  for  $7.31  per  week  was  issued  which 
excited  widespread  favorable  comment.  Requests  were  received  from  almost  all 
parts  of  the  U.  S.  for  copies  of  the  bulletin  or  for  additional  information  concern- 
ing it.  This  list  of  foodstuffs  was  designed  to  give  the  proper  nourishment  to  a 
family  of  two  adults  and  three  children  for  one  week. 

June  10th,  a  plan  was  devised  for  establishing  an  anatomical  exhibit  to  combat 
quackery  in  the  treatment  of  venereal  diseases,  in  conjunction  with  the  New  York 
State  Social  Hygiene  Society  and  the  Brooklyn  Hospital  Dispensary.  The  Depart- 
ment of  Health  contributed  some  photographs  and  supplied  two  different  leaflets  for 
distribution. 

July  30th,  a  special  patent  medicine  exhibit,  disclosing  the  composition  of  30 
well-known  patent  medicines  was  set  up  in  Coney  Island. 

August  27th,  arrangements  were  made  with  the  Motion  Picture  Exhibitors'  As- 
sociation of  Brooklyn,  to  show  three  health  reels  in  about  250  theatres  in  Brooklyn. 
The  subject  of  these  reels  was  (1)  "Long  Haul  vs.  Short  Haul,"  a  story  depict- 
ing the  advantages  of  breast  feeding:  (2)  "The  Life  History  of  a  Fly,"  an  effect- 
ive story  in  relation  to  the  fly  menace,  and  (3)  "  The  Price  of  Human  Lives."  a 
stirring  picture  of  the  havoc  wrought  by  tuberculosis.     The  Association  arranged  all 

83 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

tliC  details  in  connection  with  these  films  and  at  its  own  expense  sent  the  films  from 
theatre  to  theatre. 

September  9th,  arrangements  were  made  for  co-operation  with  the  Department 
of  Education  in  relation  to  teachers'  institutes.  Speakers  were  furnished  for  a  num- 
ber of  the  teachers'  meetings.  A  health  exhibit  was  maintained  at  the  Washington 
Irving  High  School,  where  the  meetings  were  conducted.  This  exhibit  showed  the 
various  activities  of  the  Department  in  relation  to  the  care  of  infants,  school  chil- 
dren and  the  children  in  our  hospitals. 

November  4th,  health  mottoes  were  prepared  for  distribution  to  shops,  factories, 
dispensaries,  milk  stations,  etc.  The  mottoes  will  be  issued  monthly  throughout  the 
year,  and  will  be  seasonable. 

November  11th,  moving  pictures  were  taken  by  the  Universal  Film  Company  of 
the  work  of  the  Bureau  of  Food  and  Drugs  and  the  work  of  the  Bureau  of  Labora- 
tories in  preparing  anti-toxins  at  the  anti-toxin  farm  at  Otisville.  These  pictures 
will  be  released  in  magazine  form  and  will  be  shown  in  thousands  of  moving  picture 
theatres  throughout  the  country  during  the  next  year  or  two. 

December  2nd,  1,000  fresh  air  leaflets  were  sent  to  the  different  High  Schools; 
19,000  were  sent  to  the  Chief  of  the  Division  of  Health  Districts,  and  10.750  were  sent 
ro  the  Tuberculosis  Committee  of  the  Charity  Organization  Society.  15.000  open 
window  week  placards  were  sent  to  the  New  York  Car  Advertising  Company  to  be 
placed  in  all  cars  operated  in  New  York.  400  of  these  cards  were  sent  to  the  Inter- 
boro  Rapid  Transit  Company  to  be  placed  in  subway  stations. 

December  4th,  in  place  of  tuberculosis  week,  the  Bureau  of  Public  Health  Edu- 
cation organized  an  educational  campaign  under  the  name  of  "  Open  Window  Week." 
Several  cards  were  prepared  for  display  in  street,  elevated  and  surface  cars,  on  rail- 
road stations  and  in  store  windows.  A  large  amount  of  favorable  newspaper  public- 
ity resulted.  Open  Window  Week  ended  in  the  Finley  Hike,  a  walk  from  the  stadium 
of  the  College  of  the  City  of  New  York  to  Yonkers.  Nearly  1,000  walkers  partici- 
pated in  the  hike.    Prizes  were  donated  by  President  Finley  and  the  New  York  World. 

December  9th,  special  letters  were  written  to  all  the  clinics,  through  the  co- 
operation of  the  Public  Health  Committee  of  the  Academy  of  Medicine,  arranging 
for  physical  examinations  of  all  applicants  presenting  themselves,  for  such,  in  answer 
to  the  call  issued  by  the  Department  for  periodical  medical  examinations. 

The  work  of  the  Department  of  Health  was  described  to  a  representative  of  the 
Russian  Government,  the  information  to  be  used  in  the  inauguration  of  our  health 
methods  in  Russia. 

Publications — There  are  seven  regular  publications  issued  by  this  Bureau,  Weekly 
Bulletin.  Monthly  Bulletin,  School  Health  News,  Alonthly  Drug  Bulletin,  Staff  News, 
Otisville  Ray  and  Neighborhood  Chronicles. 

In  addition  to  these,  scientific  papers  are  published  in  the  form  of  reprints,  aver- 
aging about  12  a  year,  and  monographs  averaging  about  3  a  year. 


Summary  of  Some  of  the  Bureau's  Activities. 

1916. 

1915. 

Public  lectures  arranged  for  and  delivered  under  the  auspices  of  the 
Bureau  of  Public  Health  Education 

201 
431 

1,978 
200 

140 

Moving  pictures  shown  (number  of  different  pictures) 

270 

Requests  for  health  literature  filled 

No  record 

Number  of  Press  Bulletins  issued     

79 

84 


BUREAU  OF  PUBLIC  HEALTH  EDUCATION. 

A  large  number  of  occasional  leaflets  of  great  variety  and  dealing  with  many 
different  phases  of  health  work,  are  published,  from  time  to  time.  Some  of  these 
have  been,  "  Tuberculosis  Leaflets,"  "  Keep  Well,"  "  Anti  Alcohol,"  "  Fresh  Air  "  and 
'•  Car  Placards." 

Lectures — Health  lectures  are  given  before  schools,  colleges,  clubs,  churches  and 
settlements.     Most  of  the  lectures  are  illustrated  with  stereopticon  pictures. 

Noon-day  talks  have  been  given  to   factory  workers. 

In  its  lecture  work,  the  Bureau  has  had  the  assistance  of  qualified  lecturers  from 
the  Bureaus  of  Child  Hygiene.  Bureau  of  Food  and  Drugs  and  the  Bureau  of  Pre- 
ventable Diseases. 

Exhibits — In  addition  to  the  permanent  exhibit  at  headquarters,  traveling  ex- 
hibits dealing  with  various  phases  of  public  health,  have  been  shown  m  various  parts 
of  the  city,  usually  in  schools,  settlement  houses,  etc.  Among  the  more  important  of 
these  were  general  health  exhibits  shown  at  the  Y.  W.  C  A.,  Russell  Sage  Founda- 
tion, the  Henry  Meinhard  Memorial  and  Zion  A.  M.  Church,  and  at  the  Brooklyn 
Branch  of  the  Y.  M.  C.  A.,  a  child  welfare,  including  a  food  exhibit  at  the  Washing- 
ton Irving  High  School,  a  patent  medicine  exhibit  at  the  Women's  Municipal  League, 
a  child  hygiene  exhibit  at  the  Lincoln  House,  a  tuberculosis  and  patent  medicine 
exhibit  at  the  Julia  Richmond  High  School,  a  food  exhibit  at  the  Grand  Central  Palace, 
in  connection  with  the  Bureau  of  Municipal  Research,  a  tuberculosis  and  patent 
medicine  exhibit  at  the  John  Hall  Memorial,  a  food  exhibit  at  the  22nd  Regiment 
Armory  and  at  the  School  of  Modern  Cooker>',  conducted  by  the  "  Forecast  "  Maga- 
zine. 

Motion  Pictures — Continuing  its  policy  of  the  previous  year,  the  Bureau  has 
loaned  motion  picture  reels  to  a  large  number  of  motion  picture  theatres  in  the  city. 
The  usual  free  moving  picture  shows  given  in  the  parks  and  playgrounds  in  past 
J  ears  were  abandoned  because  of  the  epidemic  of  poliomyelitis. 

Nezvspapcr  Publicity — A  large  part  of  the  Bureau's  educational  work  is  carried 
on  through  articles  published  in  the  newspapers.  The  Department  keeps  a  record 
of  the  amount  of  space  accorded  items  relating  to  its  activities.  During  1916,  there 
were  published,  2,898  newspaper  articles,  representing  approximately  170.000  square 
inches,  or  about  460  square  inches  of  space  daily.  While  much  of  this  publicity  re- 
sulted from  interviews  solicited  by  reporters  of  the  various  papers  con- 
cerned, the  major  part  of  it  came  in  response  to  the  126  press  bulletins  sent  out  in 
the  form  of  multigraphed  notes  to  all  the  newspapers.  In  1915  the  total  space 
amounted  to  approximately  110,000  square  inches  or  about  300  square  inches  of  space 
dailv. 


85 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


ift^**'*!^?!''" 


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A<-^ 


hc^ 


-r««»-'Hiss'"' 


DEPARTMENT 


MONTHLY  BUIXETIN 


f;; 


ARTMENT  OF  HEALTH  j.fT'^,     ^L?.    -^ 


POLlOMYKLlllS 


•H^rjvEjr 


£6 


BUREAU    OF     LABORATORIES. 


BUREAU  OF  LABORATORIES 


DIPHTHERIA 


LABORATORY 
EXAMINATIONS 


1138!! 


TUBERCULOSIS 


CASES  SHOWING     $521 
BACILLI  7k 

LABORATORY 
EXAMINATIONS 


€s^ 


59707 
$4605 


TYPHOID  (wIDAL) 


CASES  SHOWING    ,3377 
BACILLI  "*^^ 

LABORATORY       21452 
EXAMINATIONS    »7*6» 

CASES  SHOWING    2078 
REACTION  118? 


WASSERMAN 
MILK  SAMPLES 
RABIES 


LABORATORY      50969 
EXAMINATIONS    -^^^'^ 


LABORATORY  DIAG. 
OF    RABIES 


67657 
74  S50 


954 
393 


TETANUS  SERUMilSifgg 


PRODUCTS 
PRODUCED 


MENINGOCOCCUS 
SERUM 


376100 
279530 


TYPHOID  VACCINE  9V1JJ8 

biPHTHERIA     ifjfjgg 
TOXIN 


)9I5 

:T€Xi9is 


1^1913 
1916 


Il7:i9«6 
(9lS 


I  r9i5 
-43X»S'« 


I9l€ 


I0:i9l5 
1916 


Ekkata— in  tlic  above  chart,  the  position  of  tlie  bars  representing  Typhoid  N'accine, 
1915  and  1916  should  be  reversed. 

Diphtheria   Serum   was   accidentally   omitted. 


.'<7 


BUREAU  OF  LABORATORIES. 

Changes  in  Procedure— A  card  and  letter  system  was  substituted  for  the  old  sys- 
tem of  office  records  at  the  serum  production  plant  at  Otisville.  Its  operation  has 
reduced  the  necessary  bookkeeping  by  at  least  one  third.  It  has  already  been  copied 
by  several  other  laboratories.  A  new  system  of  bookkeeping  is  also  being  instituted  at 
both  Otisville  and  the  16th  Street  Laboratories. 

In  April,  simpler  and  cleaner  methods,  for  injecting  horses,  were  devised,  re- 
sulting in  a  reduction  of  labor  and  mistakes.  The  horses  under  immunization  at 
Otisville,  were  removed  to  the  new  stable  where  a  larger  number  of  horses  can  be 
handled. 

A  change  has  been  made  in  the  manner  of  collecting  blood  for  antiserums.  In- 
stead of  recording  bleedings  a?  so  many  bottles  or  flasks,  the  containers  are  now  cali- 
brated and  the  exact  amount  drawn  noted.  Not  only  is  a  more  exact  account  kept, 
but  this  plan  makes  it  possible  to  control  the  efficiency  of  the  drawing-off  process. 

For  determining  units  cost,  the  work  was  divided  into  25  functions,  appropriately 
among  the  different  divisions. 

Concentration  Process — The  problem  of  preventing  the  jellying  of  plasma  and 
serum  after  separation  from  other  blood  constituents  has  been  studied.  Smaller 
quantities  of  blood  are  drawn  in  the  containers,  permitting  of  more  thorough  mixing 
of  blood  and  citrate  solution  and  the  installation  of  a  water  still  has  made  it  possible 
to  cleanse  the  containers  more  thoroughly  and  thus  obviate  the  salt  deposits  which 
frequently  followed  the  washing  of  glassware  in  the  hard  water.  By  systematizing 
the  work,  two  men  can  now  run  three  lots  of  plasma  (about  85  liters  in  each  lot).  As 
soon  as  the  concentration  room  in  the  new  stable  is  ready,  it  is  hoped  that  the  pro- 
cedure can  be  still  further  systematized,  with  an  additional  increase  in  the  output. 
There  were  also  economic  improvements  made  in  the  technic  with  an  appreciable 
reduction  in  the  loss  of  antitoxic  units  entailed  by  the  concentration  process. 

Forage  for  Horses — A  study  was  made  of  the  forage  requirements  of  horses, 
with  the  result  that  a  considerable  economy  has  been  effected.  A  new  dietary  was 
adopted  and  has  resulted  in  an  improvement  in  the  physical  condition  of  the 
horses,  a  less  number  of  digestive  disturbances  as  well  as  an  appreciable  saving  of 
money. 

Experimental  Animals — A  bookkeeping  system  has  been  installed  in  connection 
with  the  raising  of  experimental  animals.  Forage,  labor  and  other  expenses  are 
recorded  and  this  expense  is  divided  by  the  number  of  animals  produced. 

Horse  Immunizations — More  careful  observations  have  been  made  @f  the  horses 
immunized  with  meningococci.  Five  horses  have  been  treated  according  to  three  dif- 
ferent plans  of  dosage.  The  results  proved  the  superiority  of  the  Amoss-Wollstein 
method  in  producing  a  more  potent  serum  in  a  shorter  period  of  immunization.  A 
•■similar  procedure  is  now  being  carried  out  with  six  horses  under  immunization  with 
the  pneumococcus.  The  results  will  be  published  when  these  studies  are  completed. 
One  horse  has  been  immunized  with  the  gonococcus  by  the  intravenous  method. 
This  proved  that  the  intravenous  method  of  inoculation  is  decidedly  preferable  to  the 
subcutaneous  method  since  abscesses  are  avoided  and  the  physical  condition  of  the 
horses  remains  far  better. 

Media  for  Meningococcus  and  Gonococcus — A  study  was  made  to  find  a  better 
culture  medium  for  the  growth  of  meningococcus  and  gonococcus,  which  would  in- 
sure good  growths  of  these  delicate  organisms  and  obviate  frequent  transplanting. 
A  liver  medium  has  been  perfected,  based  on  a  medium  devised  by  Dopter,  which 
seems  satisfactory. 


BUREAU    OF    LABORATORIES. 


Nezi)  Blood  Media— An  attempt  is  being  made  to  utilize  the  blood  clots  and  cil- 
iated blood  sediments  for  media  in  the  place  of  beef.  Preliminary  experiments  seem 
to  indicate  that  such  a  medium  can  be  successfully  prepared.  The  saving  eflfected  will 
be  considerable. 

Ammonium  Sulphate — Experiments  were  made  with  a  view  to  recovering  the 
ammonium  sulphate  from  the  final  filtrate  in  the  antitoxin  concentration  process.  A 
simple  method  has  been  devised  and  this  ammonium  sulphate  is  now  being  used  at 
least  four  times  and  then  sent  to  the  Sanatorium  farm  for  fertilizer. 

Locfflcr  Scrum  Tubes— A  new  method  of  preparing  Loeffler  serum  tubes,  fol- 
lowed in  the  laboratory  of  the  Boston  Health  Department,  has  been  tried  in  the 
diagnosis  laboratory.  The  tubes,  containing  broth  and  serum,  are  placed  in  the 
autoclave,  and  heated  for  an  hour  at  15  pounds  pressure.  Coagulation  and  steriliza- 
tion are  thus  accomplished  in  one  process. 

Important  Activities — Media  Preparation — This  division  includes  the  media  prep- 
aration and  sterilization  for  the  whole  Bureau.  The  amount  of  work  is  indicated 
by  the  following  table  : 


1915. 
Liters. 

1916. 
Liters. 

Diphtheria  toxin  broth 

910 

1,222 

180 

'  2,448 
1,330 

291 
2,271 

602 

1,927 
9''1 

Tetanus  toxin  broth 

Tuberculin  broth 

112 

Mallein  broth 

108 

Stock  broth 

2,015 
'>  107 

Agar — for  milk  work 

for  typhoid  carriers 

803 

antigens,   vaccines,  stock  transplants  and  general  use .... 
Miscellaneous  media 

1,810 
720 

Total 

9,320 

10  583 

An  increase  of 

1,203 

275,700 

12,822 

817,275 

219,413 

Tubes  and  bottles  filled 

288,528 

An  increase  of 

Glassware  washed  and  sterilized 

1,036,688 

An  increase  of 

Oyster  Examinations — A  special  investigation  has  been  made  of  the  oysters  from 
Keyport,  N.  J.,  and  vicinity,  and  from  Jamaica  Bay.  Results  of  these  examinations, 
follow : 


Xr.MBER    OF 

Shf.ll  Fi.sh 
Examined. 

xumbek  of 
Ferment.ation 

Tubes 
Inoculated. 

Samples  Scoring 

Lots  of 
Shell  Fish. 

Below 

Fifty. 

Fifty. 

Above  Fifty. 

No. 

% 

No. 

% 

No. 

Sc 

299 

1,445 

4.335 

222 

76.8 

16 

5.5 

51 

17.6 

Bacterial  Diagnoses — Many  special  diagnoses  were  made  for  anthrax,  whooping 
cough,  blood  poisoning,  hookworm,  etc.,  in  adtlition  to  the  following  routine  exam- 
inations : 

89 


ANNUAL    REPORT    OF    THE    DEPARTMENT    OF    HEALTH. 


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BUREAU    OF    LABORATORIES. 
SERA  AND  VACCINES  PRODUCED. 


1916. 


Diphtheria  Serum  in  c.  c.  (average  units  estimated  300  per  c.  c.) 

Tetanus  Serum  in  c.  c.  (average  units  estimated  150  per  c.  c.) . . 

Anti-Meningitis  Serum 

Other  Sera 

Rabies  Vaccine 

Smallpox  Vaccine 

Typhoid  Vaccine  (Average  bacteria  1,000  to  c.  c.) 

Bacterial  Vaccine  (Average  bacteria  1,000  to  c.  c.) 


1,348,000 

2,386,-500 

279,550 
725,525 

31,073 

8,550 

95,600 

205,9.56 


Spinal  Fluids  examined — Due  to  the  poliomyelitis  epidemic,  the  number  of  fluids 
examined  at  the  main  laboratory  was  greatly  increased : 


Jan. 

Feb. 

Mar. 

Apr. 

May. 

June. 

July. 

Aug. 

Sept. 

Oct. 

Nov. 

Dec. 

Total. 

1915 

1916 

26 
.34 

18 
49 

64 

84 

73 
73 

67 
98 

58 
144 

52 
250 

58 
609 

27 
360 

43 
146 

20 
69 

32 

67 

5:is 

1,983 

The  Kingston  Avenue  Hospital  Laboratory  examined  678  fluids  making  the  total 
tor  the  year  2,661,  as  compared  with  538  in  1915. 

Poliomyelitis  and  Meningitis — Diagnostic  and   Preventive   work :    There   was   an 
increase  of  68  per  cent,  in  consultations  with  physicians  in  1916. 


Infl.\mmation  of  Meninges 

AND  DiSE.\SES    with    SYMPTOMS 

Simul.\ting  ^Meningitis. 

Consulta- 
tions. 

New 
Cases. 

Lumbar 
Punctures. 

Inocula- 
tions. 

Epidemic  Cerebro  Spinal  Meningitis.  . 
Polioinvelitis 

348 

822 

81 

164 

14 

51 

74 
365 

80 
175 

28 

32 

263 

345 

80 

167 

11 

54 

255 
11 

Tubercular  ^leningitis 

Other  Diseases  Simulating  Meningitis. 
Pneumonia  Simulating  ^Ieningitis.  .  .  . 
Other  Varieties  of  Meningitis 

3 

7 

0 

44 

Total 

1,480 

754 

920 

320 

Schick  Test — Over  10,000  inmates  of  12  institutions  were  tested  with  the  Schick 
reaction  and  1,200  were  immunized  and  gave  a  positive  test.  So  as  to  determine  the 
efficiency  and  duration  of  the  active  immunization  95  per  cent,  of  those  who  received 
the  full  treatment  of  three  doses  given  a  week  apart,  were  found  to  have  become  pro- 
tected. The  immunity  also  was  found  to  have  lasted  during  the  period  of  obser- 
vation, i.  e.,  12  months. 

The  Schick  Test  in  Polioniyelitis — During  the  summer,  1,6(X)  children,  having 
poliomyelitis  were  tested  with  the  Schick  reaction  and  85  to  90  per  cent,  showed  a 


91 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

positive  reaction.  This  pointed  to  the  probability  that  children  susceptible  to  one 
of  the  less  infectious  diseases,  like  poliomyelitis,  are  also  more  apt  toi  be  susceptible  to 
other  infectious  diseases.  Those  who  gave  a  positive  Schick  reaction  received  a  com- 
bnied  active  and  passive  immunization  against  diphtheria. 

Amebic  Mouth  Infections — The  conclusion  of  the  study  of  amebic  mouth  in- 
fections in  school  children  showed  (1)  that  children's  mouths  could  be  kept  in 
good  condition  by  school  clinic  supervision,  and  (2)  that  an  emetin  wash  had  no  last- 
ing effect  upon  the  number  of  amcl)as  present. 

Anthrax — The  examination  for  anthrax  bacilli  of  many  skins  and  bristle  brushes 
from  industries  in  which  cases  of  anthrax  had  occurred,  failed  to  show  any  anthrax 
bacilli. 

Pertussis  and  Influenza  Vaccines — Several  thousand  persons  having  whooping 
cougli  were  injected  with  the  pertussis  vaccine.  The  results  indicated  that  the 
vaocine  had  a  slight  favorable  efifect. 

Unusual  Sera — In  addition  to  the  production  of  diphtheria  and  tetanus  antitoxic 
serum,  anti-pneumococcic,  anti-gonococcic,  anti-meningococcic,  anti-streptococcic,  and 
normal  serums,  horses  have  been  immunized  against  bacillus  typhosus,  various  strains 
of  para-typhoid  B.  and  strains  representing  all  the  types  of  B.  dysenteriae.  The 
immunizations  liave  been  successful,  regular  bleedings  having  been  taken  and  the 
serum   obtained   has   been    stored   anticipating   possible   emergencies. 

Typhoid  .Intibodics  Transmitted  by  Cozvs'  Milk — An  experimental  study  has  been 
made  of  the  possible  transferrence  of  typhoid  antibodies  from  an  immune  cow  to 
human  beings  through  the  agency  of  milk.  The  results  showed  that  no  apparent  im- 
munity could  thus  hi  induced. 

Tuberculin — In  order  to  help  standardize  tuberculin,  a  study  is  being  made  of 
the  varying  conditions  constituting  the  most  favorable  method  for  preparing  old 
tuberculin. 

Glycobacter — A  detailed  study  is  being  made  of  the  glycobacter  peptolyticus,  a 
bacillus  advocated  and  used  as  an  auxiliary  to  the  bacillus  bulgaricus  in  producing 
"  lactic-acid  milk."  The  data  obtained  show  the  extravagance  of  the  promulgator's 
claims  and  have  been  communicated  to  the  Society  of  American  Bacteriologists. 

Paratyphoid — Investigation  of  the  paratyphoid  group  has  led  to  results,  espe- 
cially in  relation  to  identification  of  the  types  pathogenic  for  man.  One  result  was  a 
qualitative  method  for  the  dififerentiation  of  the  "  A "  and  "  B  "  types  found  in 
human    diseases. 

Streptococcus  Viridans — A  study  of  the  streptococcus  viridans  groups  showed 
that  cultures  from  various  pathological  conditions  had  no  immunological  relationship 
one  to  the  other.  Stock  biological  products,  therefore,  can  not  be  applied  for  spe- 
cific therapy. 

Vaccina  Virus — Work  on  the  addition  of  brilliant  green  to  vaccine  virus,  prom- 
ises to  give  a  method  which  will  quickly  reduce  to  a  minimum  or  kill,  all  the  bacteria 
in    this    product. 

Pneumococci — Work  on  the  pneumococci  in  common  colds  is  strongly  suggestive 
that  they  may  be  a  source  of  contagion   for  lobar  pneumonia. 

Laundries — A  study  was  made  by  means  of  microbiological  tests  of  the  laundries 
of  the  city,  with  a  view  to  showing  the  possibility  of  the  transmission  of  disease 
through  the  improper  handling  of  clothes.  The  results  showed  that  the  conditions 
existing  in  the  average  laundry  were  poor  and  that  there  was  a  possibility  that 
diseases  might  be  transmitted  through  laundry  contact  and  improper  methods,  and 
that  new  sanitary  laws  are  necessary  for  the  government  of  the  laundries. 

92 


BUREAU    OF    LABORATORIES. 

Condensed  Milks — The  study  of  condensed  milks  was  completed  and  published. 
The  survey  covered  the  sanitary  and  manufacturing  conditions  and  the  chemical  and 
microbiological  analysis  of  the  product.  The  unfinished  problems  are,  direct  micro- 
scopic examination  of  milk,  the  transmission  of  disease  through  butter  and  the  ef- 
fect of  cold  storage  temperatures  on  butter,  cream  and  ice  cream. 

Diphtheria  Toxin — Tests  made  on  diphtheria  toxin  after  the  mctiiod  of  Martin 
showed  that  French  strain  of  No.  8  B.  diphtheria  to  be  far  more  toxigenic  than  our 
strain  of  \o.  8.  when  grown  according  to  this  method.  Tiiis  test  has  confirmed 
all  previous  tests  along  the  same  line  with  the  result  that,  for  the  present,  when 
using  Martin's  peptone  bouillon  for  diphtheria  toxin,  only  the  French  strain  will  be 
used.     When  using  Witte's  peptone  our  strain  still  produces  very  strong  toxin. 

Tetanus — A  test  is  being  carried  on  by  inoculating  Martin's  peptone  bouillon  with 
three  different  strains  of  B.  tetani,  one  isolated  in  July,  1913,  from  a  war  case  and 
obtained  from  Lister  Institute,  one  used  at  Pasteur  Institute  for  toxin  i)roduction  and 
one  which  has  been  used  at  the  Research  Laboratory  for  the  last  nine  years  and 
which,  with  Witte's  peptone  bouillon,  has  given  an  exceedingly  high  toxicity. 

Goats  Milk — The  investigation  of  the  value  of  goat's  milk  in  infant  feeding,  is 
progressing  favorably.  Goat's  milk,  when  used  in  the  treatment  of  active  and  chronic 
pulmonary  tuberculosis,  was  found  to  be  apparently  of  little  or  no  special  value. 


TABLE  No.  L 
EXAMINATION  OF  WATERS. 


TOT.\L 

F.x.wii- 

N.^TIOXS. 

Good. 

U8.*BLE. 

SCSPICIOCS 

POLLCTED 

Speci.\l 

1916 

1915 

1916 

1915 

1916 

1915 

1916 

1915 

1916 

1915 

1916 

1915 

DrinkinK  waters,  supplies  in- 
cluding special  wells  and 

537 
480 
342 
116 

241 
34 

9 
4 
4 

1.050 
182 
110 
72 

80 
4 

11 

4 

317 

203 

37 

52 

525 

33 

28 

5 

29 
2 

4 

46 

36 

9 

3 

5 

154 

10 

6 

4 

22 
4 

103 
31 
58 
12 

'    2 

181 
22 
14 

8 

21 
2 

0 
2 

60 
210 
235 

49 

27 

190 

117 

62 

55 

8 

3 
2 

11 
0 
3 
0 

241 

9 
4 
4 

Before  enterinR  pool 

After  enterinK  pool 

Special  Waters — 

Oyster  beds  and  sea  waters. 

River  waters  (dairy  inspec- 

Wells  (dairy  inspection) . .  . 

93 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


< 
P^  CO 

M    1—1 

N 


P5 
H 

CO 

Ph 

Q 
;?: 

P4 

O 

CO 

O 
H 


Fermen- 
tation 
Tubes 

Ex- 
amined. 

•0 

4,008 
1.696 
1,223 
1,482 

05 
0 

oc 

to 

868 

1,250 

510 

367 

05 
C5 
(N 

Total  Agar 

Plates 

Examined  ALL 

Samples  and 

Controls. 

in 

23,794 
25,212 
20,219 
28,398 

CO 
C) 

CO 

C3 

CO 
05 

35,176 
41,490 
31,107 
33,938 

Samples 

of 

Ice 

Cream. 

10 
0 

.    .    .    .U 
....  1  0 

•     •     ■     •      CJ 

CO 

01 

rH 

•  CO  (N  0    1   lO 

•-^  — 00     0 
•coco-H     00 

Samples 

OP 

Condensed 
Milk. 

10 

....       CO 
....        ,35 

CO 
05 

00  CO  CO  in     cj 

050  t  05         f 

rt     1-1     ^ 

Samples 

— Water 

From 

Farms 

10 
05 

05  f  CO  0         1" 
rHOCOrt         0 
rHrH        .-c         ■* 

CO 
05 

0  in  1.0  in  1  in 
^t^o>o  1  t^ 

f-Cf-H                          »f 

Controls 

—Can 
Rinsings 
Examined. 

05 

•<j<  0 1^  00  1  0-. 

OJ'tt^CO    1  ■* 

rH                     CO 

0 
05 

CON'<»<>-C    1    CO 
i-l                   (M 

Samples 

Can 
Rinsings 
Examined. 

10 

OS 

(MINOOO        <N 

(Mincom     0 

C^(NrH             CO 

CO 
05 

eoo5            CO 

Raw 
Pasteur- 
ized 
Cream 
Examined. 

in 

OJ 

1,210 
2,024 
1,343 
2,258 

6,835 

to 

03 

3,141 
3,144 

1,982 
1,748 

10,015 

Samples 

Raw 

Cream 

Examined 

05 

r^oo>o  1  CO 

rfCOCOO        05 

rH          f-<          CO 

CO 
05 

•*001  C) 

t^Mcot^ 

OS 
CO 

Samples  of 
Pasteurized 

Milk 
Examined. 

10 
05 

10,953 

11,732 

8,913 

9,962 

3 

IC 

•* 

to 

05 

11,046 

12,126 

9,166 

7,526 

oo_ 
05" 

CO 

fa  M   Q 

0  -J  H 
%^  < 

in 

05 

oqcot^co 
IN  int^M 

rfTco'co'co" 

00 
CO 

CD 
0 

CO'*  MO 

■*  CO  CO  in 

00_Q0_O5_^O)^ 
t-"O5"t>-"05 

00 
0 
00 
■* 

CO 

First  quarter.  . . 
Second  quarter. 
Third  quarter.  . 
Fourth  quarter. 

"o 

c 

94 


BUREAU    OF    LABORATORIES. 


TABLE  No.  3. 
ANTIRABIC  TREATMENT. 


08 

H 

C 

tic's 

G    > 

:^  2 

on 

MoRTALITy. 

Gross. 

Corrected. 

1 

m 

o 

'.3 
a 
K 

a  ta 
85^3 

5   « 

Percentage  of 
Cases  in  which 
Biting  Animal 
Was  Rabid. 

15  Days  or 
More  After  End 
of  Treatment. 

Percentage  of 
Cases  in  Which 
Biting  Animal 
Was  Rabid. 

In  city 

528 
447 

373 
359 

70.6 
80. 

3 
1 

0.8 
0.28 

1 
0 

0.27 

1913 

Out  of  city 

Total 

0. 

975 

732 

75. 

4 

0.55 

1 

0.13 

1914 

In  city 

Out  of  city 

Total 

500 
343 

355 

258 

69.7 
75.2 

2 

1 

0.56 
0.39 

1 

0 

0.28 
0. 

852 

613 

71.9 

3 

0.49 

1 

0.16 

In  city 

220 
206 

124 
164 

56.2 
76.6 

0 

1 

0.0 
0.6 

0 
0 

0 

1915 

Out  of  city 

Total 

0. 

426 

288 

67.6 

1 

0.34 

0 

0. 

1916 

In  city 

Out  of  city 

Total 

Grand  Total . 

115 
131 

40 
114 

34.8 
87.8 

0 
0 

0. 
0. 

0 
0 

0. 
0. 

246 

154 

63.0 

0 

0. 

0 

0. 

2,499 

1,787 

71.5 

8 

0.44 

2 

0.11 

95 


BUREAU  OF  RECORDS. 

Changes  in  Staff — With  the  establishment  of  the  Division  of  Stenography  and 
Typewriting,  copyists  who  had  become  expert  in  the  clerical  work  of  the  Bureau, 
were   transferred  to   that  Division  and   replaced   by   junior   clerks. 

Changes  in  Procedure — Copies  of  birth  certificates  were  sent  to  parents,  following 
the  report  of  births  by  physicians. 

Important  Activities — The  Division  of  Statistical  Research  improved  and  aug- 
mented  its  output  during  the  year. 

The  Division  of  Searches  and  Transcripts  increased  its  output  by  approxi- 
mately 2,000. 

Action  was  taken  throughout  the  year  against  physicians,  midwives  and  others 
who  failed  to  report  births  within  the  ten  day  limit  allowed  by  the  regulations.  Dur- 
ing the  year  415  physicians,  168  midwives  and  35  undertakers  were  convicted  and  $929 
in   fines  were  levied. 

Achievements — A  monograph  was  prepared  and  published  on  mortality  in  speci- 
fied sanitary  areas  in  the  Borough  of  Manhattan. 

A  report  was  prepared  of  the  second  illness  census  in  health  district  Xo.  1. 

Tabulation  of  births  by  an  electric  machine  was  started  and  has  proved  satis- 
factory. 

STATISTICS. 
Population. 

The  population  of  the  Greater  City  of  New  York  on  July  1.  1916,  was  estimated 
as  5,602,841.  This  estimate  was  based  on  the  Federal  Census  of  1900  and  1910.  and 
was  arrived  at  by  the  arithmetical  method.  The  reasons  that  caused  the  Department  of 
Health  last  year  to  abandon  the  geometrical  method  of  estimating  the  population 
in  favor  of  the  arithmetical  were  detailed  in  the  last  yearly  report.  The  estimated 
population  of  the  Boroughs  on  July  1,  1916,  was: 

Manhattan.  Bronx.  Brooklyn.  Queens.        Richmond.  City. 

2,634,223  575,877  1,928,432  366,426  97,883  5,602,841 

Births. 

137,664  births  were  reported  during  1916,  an  actual  decrease  of  3,592  and  a 
relative  decrease  of  about  7.000.  Had  the  rate  for  the  year  1915  prevailed  in  1916.  there 
would  have  been  about  144,700  births.  The  crude  birth  rate  for  1916  was  24.57,  as 
compared  with  25.83  for  last  year. 

Two  causes  are  thought  to  be  responsible  for  the  lowering  of  the  birth  rate. 
The  first  was  the  decrease  in  the  foreign  element  of  the  population  of  the  City, 
brought  about  by  the  shutting  off  of  immigration  by  the  European  War.  The  fact 
that  foreigners  are  more  prolific  than  natives  has  caused  their  loss  in  the  population 
to  have  a  pronounced  effect  upon  the  birth  rate.  That  the  loss  of  immigration  was 
responsible  in  a  very  large  measure  for  the  decrease  in  the  birth  rate  is  borne  out 
by  the  fact  that  the  largest  decrease  in  the  birth  rate  was  experienced  in  the  Borough 
of  Manhattan,  where  the  rate  dropped  from  25.23  in  1915  to  23.17  in  1916.  It  is  in 
the  Borough  of  Manhattan  that  the  great  majority  of  immigrants  make  their  home 
upon  arrival  in  the  cit>'.  The  second  cause  was  the  low  marriage  rate  experienced  during 
the  first  year  following  the  declaration  of  war,  which  in  turn  was  probably  caused 
by  financial  depression,  and  non-employment  and  also  by  the  shutting  off  of  immi- 
gration, which  has  lowered  the  number  of  marriageable  persons  in   the  population. 

96 


BUREAU    OF     RKCORDS. 

During  the  past  year  the  births  were  tabulated  by  means  of  electric  sorters, 
and  the  Bureau  of  Records  hopes  in  the  very  near  future  to  issue  an  interesting 
bulletin  on  birth  statistics. 

Marriages. 

During  the  year  1916,  54,782  marriages  were  reported.  In  other  words,  109,564 
persons  were  married,  an  increase  of  almost  4.000  marriages  over  the  number  re- 
ported in  1915,  when  50,997  marriages  were  performed,  or  101,994  persons  were 
married. 

The  marriage  rate  for  1916  was  9.78,  as  compared  with  9.33  for  1915,  an  increase 
of  .45.  This  increase  in  the  marriage  rate  is  a  reflection  of  the  increased  prosperity 
during  the  past  year,  and  is  the  highest  rate  recorded  since  1912.  It  is  interesting  to 
note  the  close  relation  that  the  marriage  rate  of  the  City  bears  to  the  prosperity  of 
the  community.  We  find  that  the  marriage  rate  rose  continuously  from  1898  to  1907, 
when  the  financial  panic  occurred,  and  when  from  the  high  rate  of  11.84,  it  dropped 
to  8.39.  The  rate  again  gradually  rose  to  10.31  in  1912,  which  was  the  year  of  the 
Presidential  election.  In  1913 — the  first  year  of  the  new  administration — the  rate 
fell  to  9.86.  In  the  early  part  of  1914  the  marriage  rate  continued  to  rise,  but  with 
the  declaration  of  war  in  Europe  and  the  consequent  financial  disturbance,  the  rate 
for  the  year  was  only  9.95.     In  1915  the  rate  fell  to  9.33. 

During  the  past  year,  the  highest  marriage  rate  was  recorded  in  the  Borough  of 
Manhattan,  where  31.735  marriages  were  performed,  equivalent  to  a  rate  of  12.05.  The 
'owest  rate  was  recorded  in  the  Borough  of  Queens,  where  2,352  marriages  were 
performed,  equivalent  to  a  rate  of  6.42. 

The  low  marriage  rate  of  1915  is  reflected  in  the  low  birth  rate  of  1916. 

De.\ths. 

Notwithstanding  the  epidemic  of  influenza  and  infectious  colds  that  visited  the 
City  in  the  early  part  of  the  year,  and  the  epidemic  of  anterior  poliomyelitis  that 
visited  the  City  during  the  summer,  the  death  rate  for  the  year  was  the  lowest  on 
record,  to  wit:  13.89,  and  is  a  reflection  of  the  gradual  and  steady  reduction  of  the 
general  death  rate  that  has  been  accomplished  year  after  year,  as  shown  in  the 
following  table : 


Ye.\r. 

POPILATION. 

Deaths. 

Death  Rate. 

1900 

3.446,042 

70.872 

20.57 

1910 

4.794,935 

76.742 

16.00 

1911 

4,929,586 

75,423 

15.30 

1912 

5,064,237 

73.(X)S 

14  41 

1913 

5.19S,888 

73,902 

14  21 

1914 

5.333,.539 

74,S()3 

14.03 

1915 

5,46S,190 

76.193 

13.93 

1916 

5,602,841 

77,801 

13.89 

This  gradual  lowering  of  the  death  rate  has  been  accomplished  in  great  measure 
by  the  reduction  of  mortality  in  the  early  years  of  life.  Not  only  has  the  incidence 
and  the  mortality  of  the  acute  infectious  diseases  been  lowered,  but  the  mortality  of 
infants  from  the  diarrhoeal  diseases  has  been  reduced  tremendously,  and  a  material 
decrease  has  been  effected  in  the  mortality  of  the  other  diseases  of  early  life.  This  re- 
cluction   in  the  mortality  during  the   first  year  of   life  has   in  great  measure  compen- 

97 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 

sated  for  the  lower  birth  rate,  and  it  is  logical  to  suppose  that  if  the  mortality  of 
the  first  year  of  life  has  been  reduced,  the  morbidity  has  also  been  reduced.  There- 
fore, when  the  children  of  the  City  reach  their  second  year  of  life,  they  are  in  more 
robust  health  than  were  the  children  of  bygone  years  who  had  weathered  the  disease 
Ftorms  that  harassed  the  infants  of  former  years;  and  since  every  disease  con- 
tracted, even  though  recovered  from,  leaves  the  human  organism  perceptibly  weaker 
in  some  regard,  we  may  further  assume  that  the  children  of  to-day  who  have  es- 
caped many  of  the  ills  that  overtook  their  brothers  of  a  few  years  ago,  will  grow 
into  more  robust  womanhood  and  manhood  and  have  a  better  chance  of  reaching 
their  allotted  "  three-score  and  ten  "  years.  The  following  table  shows  the  reduction 
in  the  death  rate  of  infants  under  one  year  of  age  since  1910: 


Year. 

Births 
Reported. 

Deaths  Under 
One  Year. 

Rate  per  1,000 
Births  Reported. 

1910 

1911 

1912 

129,080 
134,544 
135,655 
135,134 
140,647 
141,256 
137,664 

16,215 
15,053 
14,289 
13,780 
13,312 
13,866 
12,814 

125.6 
111.9 
105.4 

1913 

102.0 

1914 

1915 

1916 

94.6 
98.2 
93.1 

Typhoid  Fever, 

Since  the  mortality  of  typhoid  fever  serves  as  a  very  fair  index  of  the  sanitary 
condition  of  the  City,  the  purity  of  our  water  supply  and  the  safety  of  our  milk 
supply,  it  is  logical  to  present  the  following  table,  and  it  is  encouraging  to  observe 
therein  that  the  number  of  deaths  and  the  death  rate  of  this  disease  has  steadily 
declined. 


Year. 

Number  of 
Deaths. 

Death  Rate 
Per  1,000. 

1910 

558 
545 
499 
362 
334 
332 
215 

.12 

1911 

.12 

1912 

.10 

1913 

1914 

1915 

1916 

.07 
.06 
.06 
.04 

Pulmonary  Tuberculosis. 

Pulmonary  tuberculosis  is  gradually  being  forced  from  its  place  amongst  the 
"  Captains  of  Death,"  not  by  spectacular  methods  or  by  specific  cure,  but  by 
perseverance,  ripened  experience  and  increased  efficiency  in  the  control  and  treat- 
ment of  this  disease  by  the  Department  of  Health  and  co-operating  organizations. 


98 


BUREAU    OF    RECORDS. 


Year. 

Deaths  From 

pulmoxary 
Tuberculosis. 

R.\TE. 

1900 

8,154 
8,692 
8,825 
8,406 

2.37 
1.81 
1.61 
1.50 

1910 

1915 

1916 

Acute  Anterior  Poliomyelitis. 

The  publicity  given  the  epidemic  of  Poliomyelitis  focused  attention  upon  this 
disease.  The  fact  that  almost  2,500  persons,  mostly  children,  died  of  this  disease 
during  the  last  epidemic,  amply  justifies  the  drastic  measures  that  were  taken  to 
combat  it.  The  disease  is  not  a  rare  one  in  this  City.  Cases  occur  endemically,  as 
is  shown  in  the  following  table : 

Number  of 

Vear.  deaths. 

1912 70 

1913 54 

1914 34 

1915 13 

1916 2,448 

A  thorough-going  and  scientific  study  of  this  epidemic  has  been  made  by  the 
Department,  and  the  results  will  have  been  published  before  this  report  reaches  the 
public.  It  is  interesting  to  note  the  secondary  effect  of  the  publicity  given  the 
epidemic  of  Poliomyelitis.  That  effect  was  the  lowering  of  the  death  rate  from 
all  causes  of  infants  under  one  year  of  age,  which  may  be  attributed  to  the  addi- 
tional efforts  of  the  parents,  supported  by  those  of  the  Department  and  co-operating 
organizations,   to   safeguard   children    from   disease. 

Respiratory  Diseases. 

While  the  mortality  of  the  respiratory  diseases  has  been  lowered,  the  reduction 
in  the  death  rate  of  this  group  has  not  kept  pace  with  the  reduction  in  the  fatality 
of  the  other  acute  diseases.  During  the  past  year,  the  mortality  of  pneumonia  and 
bronchitis  was  augmented  by  the  epidemic  of  influenza  and  infectious  colds  which 
visited  the  City  in  the  early  part  of  the  year. 


Year. 

Bronchitis. 

Pneumonia — Lobar  and 
Broncho  Pneumonia. 

Deaths. 

Rate. 

Deaths. 

Rate. 

1900 

1,964 

1,417 

928 

711 

814 

.57 
.37 
.20 
.13 
.14 

10.482 
9,783 
10,519 
10,922 
10,663 

3.04 

1905 

2.43 

1910 

2.19 

1915     

2.00 

1916     

1.90 

99 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

Organic  Heart  and  Kidney  Diseases. 

The  one  discouraging  feature  in  the  statistics  of  the  jear  was  the  continued 
increase  in  the  death  rate  of  the  degenerative  diseases.  The  death  rate  of  heart 
disease  and  nephritis,  taken  as  a  group,  has  steadily  increased  since  1900.  It  is  evi- 
dent that  in  the  future,  the  Department  of  Health  must  direct  its  efforts  against  these 
diseases.  The  acute  infectious  diseases  have  been  successfully  combated,  but  the 
mortality  of  the  chronic  diseases  of  later  life  has  received  but  scant  attention  from 
health  officials.  However,  their  increasing  mortality  has  directed  attention  towards 
them,  and  already  a  struggle  to  reduce  their  mortality  has  begun. 

Aside  from  the  fact  that  there  is  no  specific  cure  for  these  diseases,  there  are  two 
important  obstacles  to  their  prevention  and  successful  treatment.  The  first  is  the 
lack  of  public  interest  because  of  their  continued  presence  among  us.  In  other 
words,  we  have  grown  used  to  them.  Were  an  infectious  disease  to  become  epidemic 
and  claim  as  many  victums  in  one  year  as  heart  disease  and  nephritis  combined,  or  of 
either  one  alone,  the  population  would  be  on  edge,  and  the  most  drastic  measures 
would  be  taken  to  combat  the  disease.  The  second  is  that  these  diseases  are  in- 
sidious in  their  onset,  so  that  when  their  symptoms  become  sufficiently  marked  to 
cause  the  sufferer  to  seek  medical  advice,  the  disease  has  progressed  beyond  the 
stage  when  it  is  ameiial^le  to  treatment. 

Cancer. 

Both  the  actual  number  of  deaths  from  and  the  death  rate  of  cancer  have  in- 
creased since  1900,  and  while  it  is  true  that  this  increase  has  been  due  in  some 
measure  to  improved  diagnosis,  the  fact  remains  that  there  has  been  a  real  increase 
in  the  mortality  of  this  disease.  But  little  has  been  accomplished  during  the  past 
year  in  reducing  the  mortality  of  cancer.  There  are  probably  many  reasons  for 
this.  The  most  important  one  is  that  the  only  treatment  offering  reasonable  assurance 
of  cure  is  radical  operation.  To  be  successful,  the  operation  must  be  performed  at 
the  earliest  possible  moment  before  the  disease  has  become  disseminated.  Operations 
are  dreaded  and  consequently  are  postponed  until  all  other  methods  of  treatment  have 
been  tried  without  success.     The  possibilities  of  cure  are  accordingly  diminished. 


Year. 

Heart  Disease. 

Nephritis. 

Heart 
Disease 

AND 

Nephritis. 

Cancer. 

Deaths. 

Rate. 

Deaths. 

Rate. 

Rate. 

Deaths. 

Rate. 

1900 

1905 

1910 

1915 

1916 

3,858 

5,140 

6,870 

10,383 

10,682 

1.12 
1.28 
1.43 
1.90 
1.91 

5,352 
5,944 
5,638 
5,521 
6,547 

1.55 
1.48 
1.17 
1.01 
1.17 

2.67 
2.76 
2.60 
2.91 
3.08 

2,291 
2,875 
3,710 
4,647 
4,702 

.66 
.71 

.77 
.85 
.84 

Violent  Deaths. 

A  preventable  cause  of  death  that  has  claimed  more  victims  during  the  past  year 
than  during  1915  was  violence.  The  deaths  from  the  causes  grouped  under  this  heading 
rose  from  3,819  during  1915  to  4,235  during  1916,  the  respective  rates  being  8.7  and  9.0 
per   10,000.     The  majority  of  these  deaths   resulted   from  accidents  that   might  have 

100 


BUREAU    OF     KFXORDS. 

been  avoided.  A  large  number  of  them  were  due  to  accidental  burns,  and  of  these 
the  largest  proportion  occurred  amongst  children.  Had  the  matches  been  placed 
out  of  their  reach,  or  had  they  not  been  allowed  to  play  where  they  could  upset  hot 
fluids  or  play  with  fire,  the  lives  of  the  majority  of  these  children  would  have  been 
saved.  If  we  but  realize  that  less  than  10  per  cent,  of  the  accidents  prove  fatal,  we 
can  get  some  idea  of  the  enormous  economic  loss  from  this  cause — thru  disability 
that  does  not  terminate  fatally.  It  is  encouraging  to  note  that  public  opinion  is 
gradually  being  aroused  to  aid  in  the  reduction   of   deaths    from   accidents. 

The  mortality  of  the  following  diseases  was  lower  during  1916  than  during 
1915 :  Typhoid  fever,  malaria,  measles,  scarlet  fever,  whooping  cough,  diphtheria, 
other  epidemic  diseases,  pulmonary  tuburculosis,  tuberculous  meningitis,  other  forms 
of  tuberculosis,  apoplexy,  broncho  pneumonia,  other  respiratory  diseases,  diarrhoeal 
diseases  under  five,  appenditicis,  cirrhosis  of  the  liver,  puerperal  septicaemia,  other 
puerperal  diseases,  congenital  debility,  old  age  and  suicide. 

The  mortality  of  the  following  diseases  was  higher  during  1916  than  during 
1915:  influenza,  poliomyelitis,  cancer,  simple  meningitis,  heart  disease,  acute  and 
chronic  bronchitis,  lobar  pneumonia,  hernia,  nephritis  and  violence  (suicide  excepted). 


NoTF — Mktkokoi.ogic.\l  Sum mary. 

The  annual  meteorological  summary,  formerly  published  with  the  Annual  Report, 
can  be  obtained  from  the  Wcatbor  Bureau  of  the  United  States  Department  of  Agri- 
culture,  New  York. 


1U1 


ANNUAL.    REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


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BUREAU    OF    RECORDS. 


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103 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


CHART  III. 


DEATHS  1 9OO/JN0  ISIS 
BY  IMPORTANT   DISEASE  GR0UP5 


TyPHOID 


CONTAGIOUS 
DISEASES 

(SnAllPOX^HlA 

IXS.SCAHLCT, 

WHOOPINB  COUCH 

OirrHIRIA) 

oecAse  or  owkT' 

ivt  srrrcn  g«t« 

Tj;  CASTRO  CMERniSl 
APPENDiCITIiMtRNIfl 
OBSTRUCTION  AND 
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DEATHS  FROM 
VIOUNCe 

(SLnciDt  aczpjw) 


TUBEflCULOSIS 
All  rORMS 


RESPIRHTOBY 
DISEASES 

ACUTE  AND  CHRONICI 
BRONCHfTIS 
PNEUMON/fl 


AU  OTHCR 
CAUSES 


OEGENERXriVE 

{APOPLCXVARrERIOl 
5CL''R056  HCflKT 
AND   BRIGHT5  OlS 
EASCJ 


ZI6 

1137 


NOTE 
THIS  CHART  COMPARES  THE    NUMBER   Of 
DEATHS    THAT    OCCURRED    INI   1916  WITH 
THE    NUMBER    THAT     \*/0ULO     HAVE     OCCURR- 
ED   HAD    THE   RATES    OF   1900    PREVAILED 
IN   1910 


6026 


5136 
7098 


439a 


4701 


3634 


INOICATCS  rieuMCS   I900 


INOICATCSnSURES    191 C 


i)f   T/TLCS    lOJ   TO  "0  rNCL 


104 


BUREAU  OF  RECORDS. 


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t*STW)  CNTCT  POI  BirrHS 

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AU.    TBC     PCR   mOOO 
CONTAGIOUS  PCR  IQOOO 
(MSTRO-CNTIR  KH^^nt 

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ALL    TBC   PCR    10000 
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105 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


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107 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE 
BIRTHS 


Month. 

Total. 

White. 

Negro. 

Others. 

Native 
Parents. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

January 

February 

March 

11,226 
11,478 
12.475 
11,152 
11,295 
11,180 
11,126 
12,311 
10,997 
11,734 
11,029 
11,661 

5,664 
5,687 
6,220 
5,608 
5,714 
5,588 
5,583 
6,170 
5,548 
5,940 
5,514 
5,753 

5,378 
5,581 
6,002 
5,356 
5,397 
5,394 
5,304 
6,924 
5,235 
5,567 
5,279 
5,689 

83 
113 
139 

87 
102 
110 
119 
118 
102 
115 
136 
123 

98 
93 

110 
95 
79 
85 

112 
96 

110 

109 
91 
93 

2 
3 
2 
3 

1 
2 
4 
2 

2 
5 
2 

1 
1 
2 
3 
2 
1 
4 
1 
2 
1 
4 
1 

1,594 
1,539 
1.782 
1.572 
1,705 
1,571 
1,685 
1,738 
1.526 
1,778 
1,591 
1,682 

1.455 
1,485 
1,592 
1.501 
1,588 
1.539 
1.495 
1,644 
1,460 
1,508 
1,458 
1.864 

July 

August 

September 

October 

November 

December 

Total 

137,664 

68,989 

66,106 

1,347 

1,171 

28 

23 

19.763 

18.589 

108 


BUREAU    OF    RECORDS. 


No.  1. 
REPORTED— 1916. 


For 

EIGN 

Mixed 

Unknown 

At- 

At- 

Parents. 

Parentage. 

Parentage. 

tended 

tended 

Appar- 

BY 

Mid- 

BT 

Phy- 

ently 
Illegi- 

Twins. 

Trip- 

lets. 

M. 

F. 

M. 

F. 

M. 

F. 

wives. 

sicians., 

timate. 

3,502 

3,418 

619 

585 

34 

19 

4.053 

7.173 

142 

121 

1 

3,496 

3,513 

730 

650 

38 

27 

4,200 

7,278 

136 

108 

1 

3,695 

3.721 

827 

770 

57 

31 

4,308 

8.167 

173 

103 

2 

3,379 

3,257 

700 

667 

47 

29 

3,696 

7,456 

126 

90 

1 

3,333 

3,180 

735 

685 

44 

25 

3,867 

7,428 

136 

103 

1 

3,403 

3,281 

683 

637 

43 

23 

3,707 

7,473 

118 

108 

2 

3,292 

3,231 

695 

669 

34 

25 

3,901 

7,225 

105 

96 

3.747 

3,654 

761 

700 

44 

23 

4,175 

8,135 

140 

105 

2 

3,397 

3,209 

684 

658 

43 

20 

3,754 

7,244 

91 

103 

1 

3.480 

3,439 

763 

703 

36 

27 

3,305 

8.429 

101 

94 

3,365 

3,249 

675 

647 

24 

20 

3,959 

7,070 

92 

109 

2 

3,436 

3,245 

740 

656 

20 

18 

3,562 

8,099 

101 

106 

41,525 

40,397 

8,612 

8,027 

464 

287 

46,487 

91,177 

1,461 

1.230 

13 

109 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


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f-    o    ., 


<mm 


H    g    OS'S      :    «3    S    a,    o)    >r; 

11  il--iliiii 


£  ^ 
a 


110 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE 
MARRIAGES 


Total. 

White. 

Black. 

Chinese. 

Single. 

Widowed. 

Date. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

239 

288 
308 
231 
314 
366 
281 
271 
358 
383 
366 
476 

F. 

188 
252 
252 
194 
284 
285 
218 
196 
308 
375 
331 
506 

January 

February 

March 

3,836 
4,505 
4,241 
3,230 
4,347 
6,054 
4,254 
3,301 
4,706 
5,012 
4,999 
6,297 

3.736 
4,374 
4,128 
3,130 
4,220 
5,968 
4,182 
3,194 
4,560 
4,883 
4,852 
6,078 

3,737 
4,377 
4,132 
3,131 
4,221 
5,968 
4,184 
3,194 
4,560 
4,882 
4,854 
6,082 

100 

128 

107 

99 

125 

85 

70 

107 

146 

129 

145 

218 

99 
128 
108 

99 
124 

86 

70 
107 
146 
129 
144 
215 

"   3 
6 
1 

f 

2 

"    2 

1 

..  .  . 
■  ■    2 

i 
1 

3,559 

4,184 
3,892 
2,966 
3,990 
5,635 
3,932 
3,003 
4,289 
4,573 
4,591 
5,747 

3,607 
4,200 
3,935 
3,000 
4,001 
5,711 
4,004 
3,057 
4,337 
4,562 
4,612 
5,695 

July 

August 

September 

October 

November 

December 

Total 

54,782 

53,305 

53,322 

1,459 

1,455 

18 

5 

50,361 

50,721 

3,881 

3,389 

112 


BUREAU    OF    RECORDS. 


No.  3. 
REPORTED  1916. 


Divorced. 

Native. 

For 

EIGN. 

Religious 

Marriages. 

Civil 

Marriages. 

Pro- 

Ethical 

M. 

F. 

M. 

F. 

M. 

F. 

Catholic. 

testant. 

Jewish. 

Culture. 

38 

41 

1,594 

1,825 

2.242 

2,011 

1.297 

762 

1,209 

1 

567 

33 

53 

1,861 

2.062 

2.644 

2,443 

1.470 

916 

1,020 

1,099 

41 

54 

1,705 

1.889 

2,.536 

2,352 

1.178 

1.007 

1.206 

1 

849 

33 

36 

1,356 

1.547 

1,874 

1.683 

660 

743 

979 

,   3 

845 

43 

62 

1.703 

1.861 

2,644 

2,486 

1.284 

1.115 

956 

3 

989 

53 

58 

2,564 

2.927 

3.490 

3.127 

1.843 

1.746 

1.947 

1 

517 

41 

41 

1,905 

2,1.59 

2,349 

2.095 

1.414 

1,215 

1,381 

2 

242 

27 

48 

1,365 

1.517 

1,936 

1,784 

1.091 

796 

851 

1 

562 

59 

61 

2.047 

2.241 

2,659 

2,465 

1,509 

1,015 

1,158 

4 

1.020 

56 

75 

2,136 

2.344 

2,876 

2,668 

1,677 

1,307 

893 

2 

1.133 

42 

56 

2,010 

2,289 

2,989 

2,710 

1,574 

972 

1.378 

4 

1.071 

74 
540 

96 
681 

2,845 

3.115 

3,452 

3.182 

1,606 

1,065 

1,622 

4 

2.000 

23,091 

25.769 

31,802 

29.013 

16,603 

12,659 

14,600 

26 

10.894 

113 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

TABLE 
PARTICULARS  REGARDING  MARRIAGES,  BIRTHS, 

CITY  OF 


Total. 

White. 

Colored. 

Other. 

Native 
Parents. 

Foreign 
Parents. 

Parentage 

of 

Mixed 

Nativities. 

Parentaoe 
Unknown 
OR  Not 

Stated. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

Marriages.  . 

.54,782 

137,664 

77,801 

6,253 

53,305 

68,983 

41,434 

3,260 

53,. 32  2 

66,112 

33,650 

2,640 

1,459 

1,347 

1,394 

149 

1,455 

1,171 

1,234 

121 

18 
28 
85 

5 

23 

4 

Births 

Deaths 

Stillbirths.  . 

19,761 
9,126 
1,088 

18,591 

7,445 

897 

41, .521 

28,918 

1,852 

40,301 

24.041 

1,456 

8,612 

3,417 

334 

8,027 

2,779 

288 

464 

1.452 

135 

287 
623 
120 

Sex  undetermined,  83. 


BOROUGH  OF 


Marriages. 

Births 

Deaths.  .  .  . 
Stillbirths. 


31,735 

61,030 

35,822 

2,830 

30,580 

30,277 

19,145 

1,523 

30,595 

28,856 

14,863 

1,088 

1,139 

985 
929 
108 

1,135 

862 

808 

67 

16 
28 
73 

5 

22 

4 

6,712 

3,866 

387 

6,077 
2,949 

287 

20,797 

13,805 

1,026 

20,160 

11,142 

700 

3,436 

1,485 

141 

3,248 

1,182 

105 

345 
991 

77 

255 

402 

63 

Sex  undetermined,  44. 


BOROUGH  OF 


Marriages. 

Births 

Deaths.  .  .  , 
Stillbirths. 


4,080 

16,144 

7,675 

673 

4,041 

8,365 

4,149 

408 

4,041 

7,663 

3,434 

247 

39 

57 

50 

4 

39 

59 

41 

3 

"l 

2,372 
726 
133 

2,186 

589 

75 

4,817 

3,019 

192 

4,453 

2,525 

122 

1.217 

413 

68 

1,059 

331 

40 

16 
42 
19 

24 
30 
13 

Sex  undetermined,   11. 


BOROUGH  OF 


Marriages. 

Births 

Deaths. .  . 
Stillbirths. 


15,920 

48,590 

27,081 

2,234 

15,678 

24,384 

14,221 

1,041 

15,679 

23,753 

12,183 

1,094 

241 

253 

349 

32 

241 

199 

319 

49 

1 
"9 

1 

7,815 

3,424 

449 

7,579 

2,964 

438 

13,672 

9,737 

517 

13,445 

8,421 

550 

3,052 

1,094 

80 

2,927 
961 
117 

98 
324 

27 

2 

156 

38 

Sex  undetermined,   18. 


BOROUGH  OF 


Marriages. 

Births 

Deaths.  .  .  , 
Stillbirths. 


2,352 

9,453 

5,547 

416 

2,328 

4,729 

2,951 

232 

2,329 

4,654 

2.477 

169 

23 

38 

56 

3 

23 

32 

61 

2 

1 
"2 

2,356 

807 

97 

2.227 

718 

79 

1,715 
1,799 

87 

1,833 

1,547 

67 

696 

348 

39 

626 

248 

20 

55 
12 

25 
5 

Sex  undetermined,  10. 


BOROUGH  OF 


695 
2.447 
1,676 

100 

678 

1,228 

968 

56 

678 

1,186 

693 

42 

17 

14 

10 

2 

17 

19 

5 

Births 

Deaths 

Stillbirths.  . 

506 

303 

22 

522 
225 

18 

520 

558 

30 

510 

406 

17 

211 

77 
6 

167 

57 

6 

5 
40 

6 

10 

1 

Sex  undetermined,  00. 


114 


BUREAU    OF     RECORDS. 


No.  4. 

DEATHS  AND  STILLBIRTHS  REPORTED— 1916. 

NEW  YORK. 


Di- 

N 

OT 

Months  of  Utebo-oestation. 

Single. 

Married. 

Widowed. 

vorced. 

Stated. 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

o£ 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

M. 

F. 

25 

50.301 

50,712 

3.881 

3,389 

540 

681 

6 

26 

105 

317 

470 

557 

773 

718 

2,685 

271 

21.484 

14,730 

15.923 

10,493 

5,008 

9,559 

79 

54 

419 

52 

307 

MANHATTAN. 


29,154 

29,319 

2.205 

1,948 

376 

468 

6 

17 

67 

165 

241 

267 

327 

314 

1,043 

252 

10,416 

7,026 

7,242 

4,535 

2.175 

4.049 

44 

32 

270 

33 

131 

THE  BRONX. 


3,799 

3.848 

252 

192 

29 

40 

2 

7 

30 

53 

71 

66 

83 

336 

7 

1.930 

1,302 

1,790 

1,155 

467 

1,008 

5 

6 

8 

4 

18 


BROOKLYN. 


14,612 

14,697 

1.202 

1.082 

106 

141 

1 

18 

109 

138 

168 

316 

263 

1,053 

11 

7.215 

5.111 

5.420 

3.770 

1.814 

3.599 

17 

12 

113 

10 

139 

QUEENS. 


2.150 

2.197 

179 

133 

23 

22 

6 

11 

10 

34 

44 

46 

44 

201 

1 

1,433 

1.027 

1.169 

816 

385 

689 

8 

3 

14 

3 

19 

RICHMOND. 


646 

651 

43 

34 

6 

10 

2 

3 

4 

7 

18 

14 

S2 

.  490 

264 

302 

217 

167 

214 

5 

1 

14 

2 

115 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE 
MORTALITY  FROM  THE  PRINCIPAL  CAUSES 


Cause  of  Death, 

City  of  New  York. 

Jan. 

Feb. 

Mar. 

Apr. 

May. 

June. 

July. 
6,209 

Aug. 
7,011 

Sept. 
5,578 

Oct. 

Nov. 

Dec. 

Year. 

7,966 

6,723 

7,077 

6,791 

6,661 

5,723 

5,605 

5,792 

6,665 

77,801 

16 

1 

24 

14 

24 

120 

381 

2 

35 

793 

56 

42 

425 

32 

13 

'si 

11 

25 

122 

180 

'ii 

730 
57 

34 

416 
20 

7 

'si 

20 

39 

123 

100 

1 

■57 

805 

77 

50 

340 

37 

10 

98 
16 
40 
115 
47 
2 

"52 

837 

93 

52 

428 

32 

9 

'88 

7 

48 

123 

30 

1 

'32 

819 

83 

53 

412 

34 

11 

'  '3 

'48 
10 
48 

105 
13 
64 

'28 

671 

75 

64 

378 

40 

16 

'  'i 

'54 

4 

48 

77 

3 

777 

12 

581 

52 

52 

342 

36 

24 

■  'i 

'25 

2 

42 

41 

5 

1,078 

'i3 

.  591 

39 

43 
393 

41 

32 

'  '2 

"6 

1 

16 

35 

2 

364 

'ii 

584 
36 

41 

394 

21 

36 

'  '2 

"6 

4 

7 

36 

10 

122 

'ie 

613 
30 

37 

372 

20 

21 

"i 

10 
58 
21 
25 

'ie 

661 
37 

48 

385 

25 

21 

"i 
"9 

6 

2 

76 

61 

12 

is 

726 

48 

38 

416 

26 

216 

1 
10 

490 
96 

349 
1,031 

853 
2,448 

'326 

8,411 

683 

554 

4,701 

364 

2.    Typhus  fever  (Brill's  dis- 

4.  Small  pox 

5.  Measles 

7.  Whooping  cough 

8.  Diphtheria  and  croup.  .  . 

10a.    Anterior  poliomyelitis.  . 
10b.    Asiatic  cholera 

11.  Cholera  nostras 

12.  Other  epidemic  diseases. . 

13.  Tuberculosis  pulmonalis. 

14.  Tuberculous  meningitis.  . 

15.  Other   forms   of   tubercu- 

16.  Cancer,  malignant  tumors 

17.  Meningitis,  simple 

17a.     (of      which)       Cerebro- 
spinal meningitis.... 

9 

8 

19 

17 

17 

25 

23 

16 

12 

12 

10 

8 

176 

18.    Apoplexy    and    softening 

93 

1,125 

111 

25 

1,131 

594 

46 

35 

124 

66 

56 
53 

622 

25 
20 
51 

370 
36 

331 

76 

953 

97 

21 

648 
467 

42 

41 

139 

65 

56 
49 

582 

27 
27 
37 

354 

28 

309 

75 

1,037 

97 

13 

718 

478 

45 

42 

145 

60 

44 
59 

604 

37 
33 

44 

353 

29 

307 

63 

926 

74 

18 

591 
437 

49 

43 

131 

60 

50 
59 

554 

30 
24 
32 

384 
24 

307 

56 

958 

76 

20 

529 
439 

40 

47 

168 

50 

46 
41 

581 

32 
23 
39 

353 
35 

312 

72 

788 

59 

8 

339 
322 

28 

47 

173 

72 

33 
43 

511 

28 
20 
33 

308 
14 

350 

67 

687 

45 

9 

237 
308 

35 

34 

394 

52 

60 
40 

478 

24 
17 
29 

289 
23 

429 

64 

713 

37 

10 

221 
316 

25 

33 

782 

86 

45 
63 

451 

16 

6 

39 

403 

18 

399 

68 

707 

31 

8 

210 
221 

21 

36 

444 

49 

42 
59 

460 

18 
13 
40 

346 
20 

390 

57 

873 

44 

11 

334 
234 

22 

35 

279 

46 

47 
46 

526 

19 

8 

27 

311 
36 

379 

65 

899 

46 

17 

458 
232 

37 

34 

171 

42 

51 
57 

545 

12 
13 
26 

351 
27 

367 

62 

1,021 

96 

20 

714 
390 

57 

46 

103 

49 

65 
75 

632 

20 
17 
35 

367 
27 

344 

818 

10,687 

813 

180 

6,130 
4,438 

447 

473 

3.053 

697 

595 
644 

6,546 

288 
221 
432 

4,189 
317 

4,224 

19.  Organic  heart  disease.  .  . 

20.  Acute  bronchitis 

21.  Chronic  bronchitis 

22.  Pneumonia        (excluding 

broncho-pneumonia) .  . 
22a.    Broncho-pneumonia.... 

23.  Other      respiratory      dis- 

24.  Diseases  of  stomach  (can- 

cer excepted) 

25.  Diarrheal  diseases  (under 

5  years)    

26.    Appendicitis    and    typh- 
litis  

27.    Hernia      and      intestinal 
obstruction 

28.  Cirrhosis  of  the  liver.  ..  . 

29.  Bright's  disease  and  acute 

30.    Diseases  of  women   (not 

31.  Puerperal  septicaemia.  .  . 

32.  Other  puerperal  diseases. 

33.  Congenital    debility    and 

malformations 

34.  Old  age 

35.    Violent    deaths     (suicide 
excepted) 

a.  Effects  of  heat 

b.  Other  accidents 

c.  Homicides 

303 

28 

287 
22 

292 
15 

297 
10 

292 
20 

337 
13 

24 

374 

31 

32 
341 

26 

2 
362 

26 

353 

26 

349 

18 

323 
21 

58 

3,910 

256 

36.    Suicides 

86 
995 

6 

64 
938 

3 

65 
1,050 

5 

71 
1,038 

4 

83 
992 

2 

77 
839 

1 

51 
844 

2 

63 
876 

7 

62 
782 

6 

60 
893 

7 

87 
945 

2 

67 
1,002 

1 

836 
11,194 

46 

38.    Causes  not  known  or  ill- 

Under  1  year 

1,106 
253 
1,578 
1,904 
1,310 

1,054 

259 

1,533 

1,391 

996 

1.126 

334 

1,688 

1,433 

989 

1,082 

322 

1,659 

1,330 

910 

1,086 

334 

1,687 

1,249 

838 

881 
320 
1,509 
993 
685 

1,072 
506 

2,199 
881 
595 

1,614 
526 

2,823 
923 
643 

1,098 
263 

1.647 
912 
591 

889 

194 

1,260 

1,157 

830 

887 

110 

1,127 

1,292 

888 

923 

157 

1,257 

1,449 

1,023 

12,818 
3,578 
19,967 
14.914 
10,298 

1  year,  under  2  years 

Total,  under  5  years 

65  years  and  over 

70  years  and  over 

Males 

4,213 

3,753 

256 

8 

3,167 

3,039 

1,492 

84 

184 

3,702 

3.021 

197 

7 

2,758 

2,612 

1,142 

66 

145 

3,886 

3,191 

259 

10 

2,978 

2,752 

1,112 

78 

157 

3,711 

3,080 

220 

11 

2,883 

2,605 

1,081 

69 

153 

3,632 

3,029 

236 

9 

2,804 

2,608 

1,002 

59 

188 

3,173 

2,550 

209 

5 

2,533 

2,110 

846 

49 

185 

3,548 

2,661 

203 

2 

2,582 

2,426 

943 

47 

211 

3,981 

3,030 

230 

7 

3,109 

2,67C 

971 

55 

206 

3,149 

2,429 

209 

4 

2,535 

1,962 

849 

33 

199 

3,046 

2,559 

184 

3 

2,416 

2,055 

875 

55 

204 

3,182 

2,610 

202 

6 

2,500 

2,120 

942 

66 

164 

3,690 

2,975 

223 

7 

2,766 

2,543 

1,097 

92 

167 

42,913 

34,888 

2,628 

79 

33,031 

29.502 

12,352 

753 

2,163 

Females 

Institutions 

Dwellings 

Hotels,  etc 

Others 

Non-re.sidents 

180 

161 

158 

166 

161 

139 

138 

141 

120 

145 

165 

174 

1,848 

116 


BUREAU    OF    RECORDS. 


No.  5. 

WITH  AGES  OF  DECEDENTS,  YEAR  1916. 


Manhattan. 

Jan. 

Feb. 

Mar. 

.\pril. 

May. 

June. 

July. 

Aue. 

Sept. 

Oct. 

Nov. 

Dec. 

Year. 

3,570 

3,116 

3.343 

3.287 

3.143 

2,607 

2,606 

3,139 

2,626 

2,639 

2,685 

3.061 

35,822 

5 

5 

2 

5 

5 

3 

5 

'  'i 

10 

13 

16 

8 

10 

"i 

87 
"2 

21 

38 

65 

69 

58 

29 

'36 

'2i 

"e 

"5 

"k 

"356 

6 

3 

6 

9 

5 

7 

1 

1 

1 

3 

2 

44 

13 

16 

22 

25 

29 

32 

28 

17 

11 

7 

"4 

1 

205 

51 

49 

60 

55 

64 

49 

35 

23 

17 

18 

29 

32 

482 

137 

76 

35 

17 

13 

5 

2 

6 

10 

14 

315 

1 

7 

in 

356 

i64 

56 

13 

8 

726 

"20 

20 

33 

'26 

23 

'is 

"5 

"5 

"4 

"e 

"e 

"4 

'i76 

407 

385 

404 

431 

394 

333 

273 

274 

296 

321 

325 

348 

4,191 

29 

39 

41 

57 

51 

36 

29 

22 

21 

16 

19 

23 

383 

25 

22 

29 

32 

26 

39 

27 

22 

22 

23 

23 

17 

307 

193 

182 

172 

188 

190 

179 

175 

185 

178 

165 

181 

191 

2,179 

20 

12 

16 

19 

21 

21 

14 

18 

12 

11 

14 

10 

188 

5 

4 

9 

11 

10 

14 

11 

11 

9 

6 

5 

3 

98 

23 

20 

25 

19 

22 

23 

25 

19 

20 

17 

18 

23 

254 

463 

387 

435 

412 

407 

322 

269 

287 

301 

375 

386 

420 

4,464 

56 

42 

44 

36 

35 

24 

20 

16 

18 

21 

26 

53 

391 

13 

5 

7 

7 

7 

5 

4 

4 

4 

4 

5 

6 

71 

514 

327 

339 

312 

251 

150 

104 

102 

97 

141 

216 

303 

2,856 

254 

212 

234 

217 

198 

122 

118 

157 

110 

113 

112 

181 

2,028 

14 

10 

19 

16 

11 

12 

15 

8 

8 

8 

9 

21 

151 

14 

15 

20 

19 

24 

24 

14 

10 

18 

15 

13 

20 

206 

5S 

90 

77 

70 

95 

63 

185 

440 

228 

129 

79 

57 

1,571 

28 

30 

29 

26 

21 

36 

18 

40 

17 

24 

16 

24 

309 

29 

26 

19 

23 

21 

12 

34 

19 

16 

21 

19 

24 

263 

18 

20 

24 

22 

17 

22 

11 

34 

23 

26 

22 

38 

277 

254 

273 

274 

254 

277 

240 

230 

190 

206 

264 

257 

300 

3,019 

10 

17 

15 

15 

14 

9 

9 

7 

11 

10 

5 

7 

129 

10 

12 

7 

10 

12 

9 

9 

2 

10 

6 

5 

8 

100 

18 

11 

18 

12 

12 

17 

14 

17 

13 

8 

9 

14 

163 

178 

158 

174 

175 

179 

137 

139 

182 

159 

131 

164 

161 

1,937 

12 

11 

10 

10 

13 

5 

9 

8 

9 

14 

13 

13 

127 

165 

137 

151 

178 

162 

167 

201 

181 

198 

190 

190 

199 

2,119 

11 

13 

1 

25 

i48 

i25 

142 

174 

iso 

160 

172 

150 

186 

i76 

i75 

i85 

1,943 

17 

12 

9 

4 

12 

7 

18 

18 

11 

14 

15 

14 

151 

40 

35 

35 

39 

37 

42 

29 

34 

30 

30 

55 

33 

439 

469 

429 

499 

479 

449 

408 

399 

421 

381 

436 

433 

487 

5.290 

3 

2 

2 

3 

5 

4 

3 

1 

23 

532 

520 

549 

537 

559 

409 

491 

825 

542 

434 

406 

431 

6.235 

126 

132 

191 

177 

158 

135 

188 

225 

131 

93 

56 

77 

1.689 

759 

758 

838 

854 

841 

656 

838 

1,288 

815 

602 

515 

575 

9.339 

729 

552 

596 

573 

531 

397 

367 

377 

373 

482 

563 

588 

6.128 

505 

372 

410 

304 

347 

257 

243 

251 

238 

330 

373 

406 

4.096 

1.966 

1.746 

1.866 

1.856 

1,737 

1.478 

1,490 

1,805 

1,516 

.1,454 

1,519 

1.714 

20.147 

1,604 

1.370 

1,477 

1.431 

1,406 

1,129 

1,116 

1.334 

1,110 

1,185 

1,166 

1.347 

15.675 

163 

129 

183 

149 

149 

141 

121 

148 

145 

134 

132 

143 

1.737 

7 

6 

7 

8 

8 

,   5 

2 

6 

4 

3 

5 

6 

67 

1,752 

1.607 

1,729 

1,709 

1,629 

1(449 

1,461 

1,770 

1,453 

1,366 

1,414 

1.612 

18.951 

1,662 

1,365 

1,437 

1,364 

1.343 

.989 

1,039 

1,280 

1,038 

1,097 

1.109 

1,306 

14.929 

144 

116 

108 

108 

94 

71 

70 

65 

69 

79 

98 

106 

1,128 

71 

60 

64 

61 

41 

34 

32 

34 

29 

48 

50 

73 

597 

85 

69 

80 

81 

95 

102 

94 

102 

109 

98 

92 

90 

1,097 

119 

114 

110 

126 

118 

88 

84 

101 

86 

86 

114 

126 

1,272 

117 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

TABLE 
MORTALITY  FROM  THE  PRINCIPAL  CAUSES 


Cause  of  Death. 


Total,  all  causes. 


10a, 

10b 

11. 

12. 

13. 

14. 

15. 

16. 

17. 


Typhoid  fever 

Typhus  fever  (Brill's  dis 

easej 

Malarial  fevers 

Small  pox 

Measles 

Scarlet  fever , 

Whooping  cough 

Diphtheria  and  croup.  .  . 
Influenza 

Anterior  poliomyelitis.  . 

Asiatic  cholera 

Cholera  nostras 

Other  epidemic  diseases. . 
Tuberculosis  pulmonalis. 
Tuberculosis  meningitis.. 
Other  forms  of  tubercu- 
losis  

Cancer,  malignant  tumors 
Meningitis,  simple .... 


(of      which)       Cerebro- 
spinal Meningitis 


18.  Apoplexy    and    softening 

of  brain 

19.  Organic  heart  disease. .  .  . 

20.  Acute  bronchitis 

21.  Chronic  bronchitis. .  . 

22.  Pneumonia        (excluding 

broncho-pneumonia) . 
22a.    Broncho-pneumonia... 

23.  Other     respiratory     dis 

eases 

24.  Diseases  of  stomach  (can- 

cer excepted) 

25.  Diarrheal  diseases  (under 

5  years) 

26.  Appendicitis  and  Typhy 

litis  

27.  Hernia      and      intestinal 

obstruction 

Cirrhosis  of  the  liver.  . 
Bright's  disease  and  acute 

nephritis 

Diseases  of  women   (not 

cancerous) 

Puerperal  septicaemia.  . 

32.  Other  puerpearl  diseases 

33.  Congenital    debility    and 

malformations 

34.  0|d  age 

35.  Violent    deaths     (suicide 

excepted) 


The  Bronx. 


Jan. 


851 


28. 
29. 


30. 
31. 


a.  Effects  of  heat.  . 

b.  Other  accidents.  . 

c.  Homicides 


36.  Suicides 

37.  Other  causes 

38.  Causes  not  known  or  ill- 

defined 


Under  1  year 

1  year,  under  2  years. 
Total  under  5  years. . 
65  years  and  over.  .  . 
70  years  and  over.  .  .  , 


Males 

Females.  .  .  . 
Colored.  .  . . 
Chinese.  .  .  . 
Institutions. 
Tenements. 
Dwellings.  . 
Hotels,  etc. . 
Others 


7 

116 

1 

3 

114 

54 


Feb. 


13 
123 


121 
17 
165 
189 
131 


Non-residents . 


458 

393 

11 

376 

318 

171 

2 

10 


Mar 


9 

100 

1 

3 

68 
32 


89 


89 

15 

132 

147 

113 


363 

284 


302 

246 

103 

3 

9 


699 


1 

115 

3 

1 

70 
35 


Apr. 


653 


10 
119 


106 

32 

170 

135 

92 


399 
300 

7 

3i7 

257 

132 

1 

9 


4 

100 

5 

5 

49 
31 


May 
675 


2 
101 


10 
125 


91 

27 
142 
128 

93 


338 

315 

8 

1 

313 

262 

111 

2 

7 


7 
120 


June. 


105 

23 

165 

120 

77 


386 

289 

5 

3i2 

250 

120 

3 

16 


83 

20 

118 

106 

71 


289 
245 


273 
202 

79 
4 

14 


11 


Aug. 
Q67 


Sept. 


529 


76 


17 

140 

93 

56 


293 

230 

14 

276 

191 

79 


15 


Oct. 


576 


36 


6 
100 


28 
24 

2 

2 

55 

7 

5 
5 

43 

1 
2 


79 


123 

36 

217 

106 

69 


380 

287 
7 

349 
258 

86 
3 

13 


Nov.  Dec. 


620   701 


94 
26 
141 
96 
56 


298 

231 

5 

27  i 

197 

97 

12 


7 

107 

1 

3 

28 
24 

1 

3 

29 

1 

6 


30 


89 

20 

134 

121 

81 


290 

286 

6 

262 
230 

89 
2 

19 


Year. 


9 

106 

3 

2 

81 
30 


6 
103 


112 

13 

143 

129 


327 
293 

4 

260 

223 

110 

2 

14 


10 


108 


95 

23 

143 

160 

109 


379 
322 

7 

282 

272 

112 

2 

16 


7,675 


24 
1 

34 
9 

37 
105 

96 
173 


41 

891 

66 

46 

547 

41 


18 


83 

1,195 

19 

25 

609 
325 

57 

47 

238 

66 

65 
45 

548 

19 
33 
53 

480 
30 

334 


2 

318 

14 


106 
1,183 


1,197 
269 
1,810 
1,530 
1.046 


4,200 

3,475 

91 

1 

3,593 

2,906 

1,289 

24 

154 


101 


118 


BUREAU    OF    RECORDS. 


No.  5 — Continued. 

WITH  AGES  OF  DECEDENTS,  YEAR  1916— Continued. 


Brookltn. 

Jan. 

Feb. 

Mar. 

.\pril. 

May. 

June. 

July. 

Aug. 

Sept. 

Oct. 

Nov. 

Dec. 

Year. 

2,800 

2,335 

2,411 

2,273 

2,293 

2,082 

2,455 

2,461 

1,846 

1,874 

1.950 

2,301 

27,081 

8 

4 

2 

4 

2 

4 
3 

8 

7 

11 

12 
1 

7 

7 

1 

76 
6 

3 
3 
5 
36 
158 
1 

'  '7 

5 

5 

50 

66 

12 

8 

6 

41 

49 

19 
4 

8 
48 
20 

1 

i? 
1 

11 
44 

14 
1 

10 
2 

10 

38 
6 

36 

14 

2 

11 

29 

3 

498 

3 

'i4 

14 

3 

451 

'  3 

U 

2 

112 

i 

ii 
2 

30 

'  '4 

17 

6 

3 

"4 

1 

22 

37 

3 

"85 

30 

78 

361 

366 

1,156 

io 

226 
17 

16 

216 

14 

ii 

249 
20 

17 

247 

23 

'  "7 

250 

22 

4 

208 

25 

'  '7 

188 

13 

'  '4 

202 

10 

■  3 

179 

9 

"s 

182 
11 

'  '4 

217 

12 

■7 

229 

12 

"98 

2,599 

188 

11 
143 

8 

7 

139 

2 

18 

103 

14 

10 

160 

9 

17 

135 

6 

16 

128 

16 

15 

112 

15 

16 

135 

11 

11 

124 

7 

11 

127 

4 

13 

118 

6 

16 

128 

11 

161 

1,552 

109 

3 

2 

5 

5 

4 

11 

9 

4 

2 

2 

2 

3 

52 

46 

438 

45 

9 

41 

374 

50 

12 

38 

368 

47 

4 

30 

320 

31 

5 

22 
340 

38 

7 

29 

302 

33 

2 

23 

282 

20 

4 

32 

254 

19 

5 

26 

266 

11 

4 

28 

311 

18 

3 

29 

337 

17 

11 

25 

399 

33 

11 

369 

3,991 

362 

77 

388 
232 

198 
175 

245 
172 

189 
160 

196 
175 

145 
170 

97 
154 

69 
106 

66 
79 

136 

82 

163 
67 

270 
143 

2,162 
1,715 

21 

22 

18 

28 

18 

10 

15 

13 

10 

12 

14 

23 

204 

8 

10 

12 

12 

15 

15 

13 

15 

13 

14 

15 

13 

101 

41 

28 

47 

41 

55 

78 

144 

222 

144 

95 

64 

29 

988 

22 

23 

20 

23 

19 

28 

20 

33 

22 

16 

15 

20 

261 

16 
22 

15 
15 

19 
25 

18 
26 

14 
13 

15 
15 

15 
21 

17 
19 

13 

26 

18 
13 

22 
22 

26 
25 

208 
242 

248 

201 

210 

206 

207 

165 

172 

179 

173 

172 

188 

220 

2,341 

9 

5 

21 

9 
10 
18 

14 
19 
13 

13 
9 
12 

14 

S 

19 

14 

8 
9 

12 

4 

10 

7 

1 

14 

5 

2 

18 

9 
'  "9 

4 

1 
11 

10 

5 

14 

120 

72 

168 

113 
13 

123 

8 

114 
12 

134 
3 

99 
12 

99 
6 

84 
6 

136 
6 

110 
4 

108 
12 

98 
8 

112 
6 

1.330 
96 

112 

129 

112 

92 

108 

114 

147 

129 

119 

114 

124 

94 

1,394 

io? 

5 

119 
10 

109 
3 

86 
6 

162 
6 

lio 

4 

10 

126 

11 

14 

112 
3 

1 

108 

10 

105 
9 

122 
2 

89 
5 

25 

1,295 

74 

27 
335 

16 
320 

16 
353 

16 
334 

20 
360 

14 
284 

10 
286 

11 
302 

13 
249 

18 
284 

19 
314 

21 
323 

201 
3,744 

1 

1 

1 

1 

1 

2 

2 

1 

10 

335 
91 
518 
776 
520 

356 
92 
519 
534 
392 

3.86 
90 
561 
548 
378 

360 
107 
550 
472 
341 

347 
139 
577 
478 
320 

310 
150 
627 
386 
275 

385 
249 
980 
327 
231 

514 
197 
1,002 
339 
252 

365 
75 
518 
341 
218 

291 
69 
419 
428 
318 

285 
27 
355 
469 
322 

318 
50 
427 
545 
387 

4.272 
1,336 
7,053 
5,643 
3,954 

1,384 
1,416 

67 

807 

1,012 

815 

8 

69 

1,255 

1,080 

48 

1 

662 

888 

624 

46 

1,279 

1,132 

53 

3 

698 

949 

575 

5 

60 

1.208 

1,065 

56 

1 

656 

879 

572 

4 

48 

1,221 

1,072 

69 

1 

660 

910 

526 

8 

54 

1.133 

949 

54 

626 

828 

450 

6 

42 

1,403 

1.052 

55 

638 

1,071 

509 

11 

68 

1,368 

1,093 

65 

1 

749 

976 

487 

5 

55 

1,003 

843 

50 

618 

621 

416 

3 

48 

1,020 

S54 

36 

589 

608 

452 

4 

53 

1,046 

904 

52 

1 

607 

ti9S 

496 

12 

44 

1,259 

1,042 

63 

1 

684 

Sol 

590 

14 

45 

14,579 

12,502 

668 

9 

8,000 

10,341 

6.512 

82 

632 

43 

25 

31 

22 

26 

27 

26 

26 

16 

33 

27 

26 

328 

119 


ANNUAL    REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

TABLE 
MORTALITY  FROM  THE  PRINCIPAL  CAUSES 


Cause  of  Death. 

Queens. 

Jan. 

Feb. 

Mar. 

Apr. 

May. 

June. 

July. 

Aug. 

Sept. 

Oct. 

Nov. 

Dec. 

Year. 

578 

466 

458 

439 

424 

364 

470 

609 

450 

379 

420 

490 

5,547 

2 

'    2 

3 

11 

26 

'    2 
54 

1 

4 
35 

'   3 

1 

3 

8 

18 

'  'l 
42 

1 

4 
32 

1 

1 

'  'l 
4 
4 
6 
5 

'    3 

44 

5 

2 

22 

4 

'  i 

2 

1 

2 
6 

'58 
3 

1 

24 

1 

2 

'  '3 
1 

1 
3 

'53 

4 

5 

37 

3 

1 

'  '5 
1 
1 
6 

'  'i 

42 
5 

3 

29 

1 

'  i 

1 
2 

6 
'94 

38 
6 

1 

16 

2 

3 

'  i 

'  '5 
3 

i79 

'    1 

31 

1 

2 

24 

5 

2 

'  i 

'    1 
6 

'46 

'    1 

46 

3 

3 
33 

6 

'  '3 

1 
11 

32 
2 

1 

27 

2 

2 

■  's 

'    6 

'  '2 

47 

2 

6 
23 

1 

1 

"5 
3 

21 

'"2 

"'i4 
12 
21 
67 
59 
336 

2.    Typhus  fever  (Brill's  dis- 

7.  Whooping  cough 

8.  Diphtheria  and  croup.  .  . 

10a.    Anterior  poliomyelitis.  . 
10b.    Asiatic  cholera 

11.  Cholera  nostras 

12.  Other  epidemic  diseases.. 

13.  Tuberculosis  pulrnonalis . 

14.  Tuberculosis  meningitis. . 

15.  Other  forms  of  tubercu- 

'  i 

59 

5 

2 

34 
2 

i2 

546 

38 

34 

336 

21 

16.  Cancer, malignant  tumors 

17.  Meningitis,  simple 

17a.    (of  _     which)      Cerebro- 
spinal meningitis 

2 

1 

1 

1 

1 

1 

1 

8 

18.    Apoplexy    and    softening 

11 
83 

7 

84 
42 

1 

7 

6 

9 

6 
4 

52 

2 
1 
2 

29 
5 

22 

3 

61 

4 

1 

42 
36 

] 

6 

7 

4 

4 
4 

41 

1 
2 

1 

26 
3 

19 

5 

94 

2 

1 

46 
23 

2 

2 

7 

4 

2 
4 

51 

1 

1 
7 

24 
3 

11 

7 

73 

2 

1 

32 
22 

1 

5 

7 

1 

2 
6 

39 

2 

'    1 

37 
5 

12 

2 

70 
2 
2 

23 
29 

4 

2 

4 

6 

5 
6 

35 

1 
1 
4 

29 
2 

14 

9 

52 

2 

12 
17 

2 

3 

16 

4 

5 
3 

46 

2 
1 
2 

24 
17 

10 

46 

2 

14 
16 

2 

4 

38 

5 

3 

5 

29 

1 
2 
3 

21 
4 

32 

6 

59 

2 

17 

24 

1 

3 

54 

4 

3 

5 

26 

1 
1 
4 

31 
3 

41 

7 
52 

1 

15 
16 

1 

26 

7 

4 
7 

39 

1 

3 

32 
3 

25 

3 

48 

3 

19 
10 

1 

2 

21 

5 

2 
5 

41 

'  '4 

20 
6 

36 

7 

59 

2 

25 
18 

6 

3 

10 

5 

3 
6 

38 

2 
1 
2 

35 

4 

17 

5 
77 

6 
1 

46 
28 

7 

5 

5 

5 
10 

37 

2 
1 
4 

38 
1 

22 

75 

774 

35 

6 

375 
281 

29 

42 

201 

54 

44 
65 

474 

16 
11 
37 

346 
39 

268 

19.  Organic  heart  disease..  .  . 

20.  Acute  bronchitis 

21.  Chronic  bronchitis 

22.  Pneumonia        (excluding 

broncho-pneumonia. .  . 
22a.    Broncho-pneumonia.... 

23.  Other     respiratory     dis- 

24.  Diseases  of  stomach  (can- 

cer excepted) 

25.  Diarrhoea!  diseases  (under 

26.    Appendicitis  and  typhyli- 
tis 

27.    Hernia      and      intestinal 

28.  Cirrhosis  of  the  liver.  .  .  . 

29.  Bright's  disease  and  acute 

30.    Diseases  of  women   (not 

31.  Puerperal  septicaemia. .  . 

32.  Other  puerperal  diseases. 

33.  Congenital    debility    and 

malformations 

34.  Old  age 

35.    Violent    deaths     (suicide 

a.  Sunstroke 

b.  Other  accidents 

21 

1 

ig 

'    9 
2 

12 

'14 

'ie 

1 

2 
30 

4 
33 

4 

'24 

1 

'33 
3 

ie 
1 

'26 
2 

6 

247 

15 

6 
57 

2 

3 

83 

4 
62 

1 

5 

80 

11 

60 

8 
45 

6 
69 

9 
60 

6 
62 

1 

4 
62 

2 

4 

75 

1 

7 
71 

73 

776 

7 

37.    Other  causes 

38.    Causes  not  known  or  ill- 

Under  1  year 

80 

15 

110 

151 

108 

72 

18 

102 

106 

79 

62 
16 

88 

102 

71 

76 

10 

91 

115 

86 

61 
11 
84 
81 
64 

56 
9 
76 
82 
63 

85 
41 
189 
62 
41 

125 
59 

273 
67 

48 

75 
26 
138 
79 
61 

54 
12 
81 
85 
67 

71 
13 
95 
94 
65 

68 

5 

94 

114 

87 

885 

235 

1,421 

1,138 

840 

1  year,  under  2  years 

Total  under  5  years. 

65  years  and  over. 

70  years  and  over 

313 

265 

15 

1 

138 

127 

282 

1 

14 

5 

238 

228 

11 

'92 
100 
227 

1 
14 

10 

236 

222 

14 

iie 

100 
228 

5 
1 

224 

215 

6 

1 

110 

95 

219 

2 

13 

217 

207 

11 

ios 

101 
201 

4 
18 

193 

171 

6 

'95 
85 

178 

3 

15 

272 
198 

8 

iie 

106 

222 
2 

25 

345 

264 

9 

i38 

150 

287 

10 

26 

253 

197 

8 

ii5 

99 
202 

1 
21 

209 

170 

7 

iis 

64 
189 

'25 

229 

191 

12 

i49 

86 

169 

1 

10 

280 

210 

10 

ii9 

104 

232 

3 

14 

3,009 

2,538 

117 

2 

1,406 

1.217 

2.636 

33 

196 

72 

Females 

Colored 

Chinese 

Tenements 

Dwellings 

Hotels,  etc 

Others 

Non-residents 

8 

6 

4 

3 

6 

3 

5 

12 

3 

6 

120 


BUREAU    OF    RECORDS. 


No.  5 — Continued. 

WITH  AGES  OF  DECEDENTS,  YEAR  1916— Continued. 


Richmond. 

Jan. 

Feb. 

Mar. 

April. 

May. 

June. 

July. 

Aug. 

Sept. 

Oct. 

Nov. 

Dec. 

Year. 

167 

159 

166 

139 

126 

136 

155 

135 

127 

137 

117 

112 

1.676 

1 

1 

1 

1 

1 

1 

1 

1 

8 

1 
5 
6 

'  5 

'  i 

2 
3 

'  i 

3 

i 
"i 

'  i 

1 

1 

33 

2 
16 

'  i 

'  6 

'  i 
'  i 

'  i 

'  3 
2 

..  .^ 

1 

8 

16 

17 

57 

is 

2 

16 

1 

'  2 

24 

2 

i 

16 

15 

18 
1 

16 

15 
2 

ii 

1 

14 

is 

"i 

9 

"5 

184 
8 

'  8 

1 
11 

■  6 

1 

10 

1 
5 
2 

1 

8 
1 

1 
3 

12 

'  8 

1 
7 

"e 
1 

6 

87 

5 

6 

25 

2 

3 
31 

6 

25 

1 

3 

21 

3 
21 

1 

3 
19 

2 
23 

1 
13 

6 
14 

2 

32 

1 

1 

2 
20 

19 

1 

37 

263 

6 

1 

31 
12 

13 
12 

1 

18 
14 

9 

7 

7 
8 

1 

6 
4 

1 

3 

6 

1 

5 
5 

1 

5 
3 

1 

10 
5 

7 
5 

14 
8 

128 
89 

6 

2 

2 

2 

1 

1 

3 

2 

1 

I 

2 

17 

5 

1 

2 

1 

1 

8 

9 

11 

10 

5 

1 

1 

55 

2 

1 

2 

1 

1 

7 

"i 

2 
2 

■  3 

'  2 

2 
1 

■  '2 

2 

1 

1 
1 

2 

1 
1 

6 

15 
15 

19 

15 

19 

19 

12 

11 

10 

13 

9 

7 

16 

14 

164 

'  'l 

3 

'  i 

2 

1 
1 

1 

'  i 
4 

'  i 

'  i 

'  i 

'  i 

"i 

4 

5 

11 

6 
4 

10 
3 

4 

1 

10 
3 

6 
4 

9 
2 

5 
2 

9 

10 
2 

15 

8 
1 

4 
3 

96 
25 

6 

9 

10 

4 

2 

18 

15 

15 

12 

9 

4 

5 

109 

'  6 

'  9 

io 

■  4 

'  i 

1 

18 

is 

14 

1 

12 

"9 

"4 

■5 

107 
2 

ii 

2 

17 

17 

1 
20 

3 
26 

1 
13 

2 
17 

1 

1 
14 

2 

16 

1 

2 
18 

3 
20 

12 

17 
201 

2 

18 
4 
26 
59 
46 

17 
2 
22 
52 
40 

23 
5 
31 
52 
38 

18 
1 
22 
42 
26 

14 
3 
20 
39 
30 

23 
6 
32 
22 
19 

22 
11 
52 
32 
24 

27 
9 
43 
34 
23 

22 
5 
35 
23 
18 

21 

24 
41 
34 

13 

1 
19 
37 
30 

11 
2 
18 
42 
34 

229 
49 
344 
475 
362 

92 
75 

100 
59 

106 

60 

2 

85 
54 

1 

71 

55 

2 

80 
56 

90 

65 

5 

83 

52 

1 

79 
48 

1 

73 
64 

1 

61 

56 

2 

58 
54 

978 

698 

15 

94 

20 

80 

2 

6 

95 
13 
72 

■  i 

il8 

9 

69 

3 

7 

95 

5 

71 

'  '4 

'94 

4 

61 

3 

5 

■90 
6 

68 
2 

12 

91 

19 

63 

2 

9 

103 

6 

46 

3 

10 

78 

7 

65 

'  '9 

84 

6 

66 

1 
9 

70 

4 
69 

1 
4 

69 
10 
57 

■  2 

1.081 

109 

787 

17 

84 

6 

5 

1 

3 

6 

10 

7 

7 

6 

6 

11 

7 

75 

121 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE 
VITAL  STATISTICS 


o 

c 

1  ^  c 

I  i's  d 

o 
c 

o 
o 

o  ^ 
~  5 

U.2 

U.2 

«        03 

^ 

^ 

w  ->- 

Z  "^"3 

>  oS 

CITIES. 

a 
o 

ja 

01 

di  o 

JZ 

HI      . 

«.2 

L- 
S 

^1 

"is 

O  ra 

03 
P 

K-5 

m 

O 

03  C3 

o 

."So 

III 

+i      o 

w 

H 

Q 

H 

m 

H 

x 

H 

30 

Montclair,  N.  J 

25,029 

245 

9.79 

535 

20.90 

14 

.56 

8 

91,213 
152,534 

914 
2,013 

10.02 
13.20 

2,158 
3,577 

23.66 
23.45 

75 
175 

.82 
1.15 

11 
6 

2 

Syracuse,  N.  Y 

New  Haven,  Conn 

156,500 

2,307 

14.74 

4,417 

28.22 

193 

1.23 

17 

2 

Rochester,  N.  Y 

255,000 

3,486 

13,67 

6,766 

26.53 

6 

3 

Jersey  City,  N.  J 

308,774 

4,346 

14.07 

7,085 

22.95 

379 

i.23 

6 

4 

Buffalo,  N.  Y 

461,887 
500,000 

6,853 
5,739 

14.84 
11,48 

12,683 
8,141 

27.46 
16.28 

491 
174 

1 ,  06 
.35 

10 

7 

o 

2 

Los  Angeles,  Cal 

San  Francisco,  Cal 

500,000 

7,002 

14.00 

7,663 

15.33 

9 

1 

Pittsburgh,  Pa 

571,984 
584,609 

8,725 
10,002 

15.25 
17.10 

16,139 
13,634 

28.22 
23.32 

10 
22 

9 

Baltimore,  Md 

Cleveland,  Ohio 

657,300 

8,841 

13.45 

16,623 

25.29 

693 

i.Oo 

8 

11 

748,431 
1,683,664 

12,021 
26,287 

16.06 
15.61 

19,725 
40,849 

26.35 
24.25 

1,971 

i'.ii 

5 
6 

11 
2 

Philadelphia,  Pa 

2,447,845 

34,894 

14.25 

54,425 

22.24 

5 

3 

New  York  City— 1915.. 

5,468,190 

76,193 

13.93 

141,256 

25.83 

6,413 

1.17 

6 

5 

New  York  City— 1916.. 

5,602,841 

77,801 

13.89 

137,664 

24.57 

6,253 

1.12 

4 

2 

New  York  City— 1917. . 

5,737,492 

STATES. 

1,223,583 
2,246,761 
2,371,095 

18,247 
22,765 
31,324 

14.91 
10.13 
13.21 

32,734 
55,233 
75,545 

26.76 
24,58 
31,86 

1,190 
1,607 

.97 
.72 

12 

7 
31 

3 
6 
1 

North  Carolina 

2,824,237 
2,854,727 
2,877,532 
3,293,335 
8,383,992 
10,108,713 

35,416 
39,026 
39,435 
39,409 
115,284 
146,892 

12.54 
13.67 
13.71 
11.97 
13.75 
14.53 

61,916 
48,075 
66,476 
69,749 
219,061 
242,950 

21.92 
16.84 
23.10 
21,17 
26.13 
24.04 

2,051 
1,255 
3,054 

9.794 
10,485 

.73 

.44 
1.06 

1.17 
1.04 

15 
10 

7 
14 
12 

8 

4 
2 
3 

2 
4 
4 

New  York  State 

*Rate  figured  on  total  population  all  ages. 
♦♦Exclusive  of  hospitals. 


122 


No.  6. 
YEAR  1915. 


BUREAU     OF     RECORDS. 


Is  a 

is 

£?Co 

1  fed 

§  a  C. 
c  "~ 

E  C.O 

a  a  3 
_^   c 

■fl  0 

a  c. 

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1  t  s 

acj^o 

Q  a  a 

0   a 

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j  a  c. 

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a 

c. 
Q 

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a 

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cj  cS  0 

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i,  1  c 

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JO  »o 

c  1  ^ 

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1.   O'O 

0  1  _ 

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0 

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108 

40 

80 

8 

172 

60 

56 

65 

4 

$12,815 

$0.51 

7 

's 

91 

59 

66 

57 

60 

45 

21 

87 

19 

21.833 

.24 

19 

8 

83 

56 

88 

63 

184 

88 

48 

98 

22 

77 

210 

88 

55 

193 

130 

49 

88 

i7 

44,681 

^28 

■'27 

7 

101 

61 

96 

245 

113 

34 

84 

97,020 

.62 

46 

19 

142 

129 

70 

98 

127 

107 

17 

132 

86 

94 

95 

119 

94 

63 

108 

30 

**2i4,i74 

!46 

176 

7 

174 

46 

89 

26 

117 

80 

28 

69 

12 

134,258 

.27 

117 

23 

lo9 

117 

192 

115 

84 

16 

27 

101 

86 

120 

63 

12 

109 

'  427,666 

.'75 

278 

13 

187 

106 

85 

189 

153 

28 

120 

247,510 

.42 

178 

24 

109 

73 

98 

56 

41 

115 

43 

267.821 

.41 

230 

29 

138 

114 

63 

203 

105 

30 

104 

480,882 

.64 

186 

19 

158 

ioe 

80 

85 

197 

130 

34 

103 

28 

603.727 

.36 

28 

148 

85 

159 

87 

35 

114 

1,327,918 

.54 

"788 

23 

161 

111 

85 

72 

190 

93 

40 

98 

22 

3,322,426 

.61 

3,056 

18 

150 

109 

84 

55 

191 

109 

47 

93 

18 

3,275,841 
3,326,041 

.58 
.58 

3.087 
3,068 

16 

120 

88 

104 

9 

82 

'53 

79 

3i 

'9 

22 

141 

58 

40 

73 

'(58 

68 

6 

90 

13 

11 

122 

68 

82 

45 

149 

89 

24 

79 

13 

11 

166 

69 

97 

31 

168 

87 

50 

74 

14 

17 

133 

80 

81 

152 

107 

21 

106 

28 

19 

128 

63 

102 

19 

111 

6.5 

74 

9.5 

141 

94 

18 

109 

28 

17 

144 

99 

92 

64 

198 

105 

39 

99 

23 

123 


ANNUAL     REPORT     OF     THE     DEPARTMENT    OF     HEALTH. 


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12S 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


uajpiiqQ  JO  sm'B3Q 

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TABLE  No.  11. 


DEATHS  IX  INSTITUTIONS,  YEAR  ENDING  DECEMBER  31,  1916. 
Borough  of  Manhattan. 


Babies  Hospital 

Bellevue  Hospital 

Beth  Israel  Hospital 

Central  and  .Neurological  Hospital 

City  Hospital 

Columbus  Hospital 

Flower  Hospital 

Foundling  Hospital 

Frenrh  Hospital 

German  Hospital 

Gouverneur  Hospital 

Hahnemann  Hospital 

Har  Moriah  Hospital 

Harlem  Hospital 

Home  for  .\j!ed  (Little  Sisters  of  Poor) 

House  of  Relief 

Jewish  Maternity  Hospital 

Knickerbocker  Hospital 

Lying-in-Hospital 

^lanhattan  Maternity  Hospital 

Manhattan  State  Hospital 

Metropolitan  Hospital 

Misericordia  Hospital 

Mount  .Sinai  Hospital 

New  York  Hospital 

New  York  City  School  and  Hospital . .  . 


443 

3,870 
22.1 
826 
600 

53 
271 
700 
104 
362 
533 

67 

50 
941 
130 
105 

34 
230 
234 
6 
655 
1,830 
175 
643 
3S2 
138 


New   York    Infirmary   for   Women   and 

Children 34 

New  York  Nursery  and  Child's  Hospital.  197 

New  York  Polyclinic  Hospital 382 

Park  Hospital 41 

Post-Graauate  Hospital 414 

Presbyterian  Hospital 312 

Reception  Hospital 4 

Roosevelt  Hospital 265 

St.  Francis  Home 51 

St.  Gregory's  Hospital 79 

St.  Luke's  Hospital 352 

St.  Mark's  Hospital 78 

St.  Mary's  Hospital 66 

St.  ^■incent's  Hospital 490 

Skin  and  Cancer  Hospital 22 

Sloane  Hospital  for  Women 89 

Sydenham  Hospital 69 

Washington  Heights  Hospital 34 

Willard  Parker  Hospital 800 

Women's  Hospital 54 

Workhouse  Hospital 60 

Other  Institutions 1,451 


Total 18,951 


Borough  of  The  Bronx. 


Fordham  Hospital.  .  . 
Home  for  Incurables. 
House  of  Calvary. . . . 
Lebanon  Hospital.  .  . 
Lincoln  Hospital  .  .  .  . 
Montefiore  Hospital . 
Riverside  Hospital. . . 


532 
95 
98 
390 
541 
233 
364 


St.  Francis  Hospital . 
St.  Joseph's  Hospital. 

Seton  Hospital 

Other  Institutions  .  . . 


Total . 


268 
605 
318 
149 


3,593 


Borough  of  Brooklyn. 


Angel  Guardian  Home 14 

Bethany  Deaconess  Hospital 24 

Brooklyn  Hospital 317 

Bushwick  Hospital 160 

Consumptive  Home 42 

Cumberland  Street  Hospital 218 

Coney  Island  Hospital 175 

Eastern  District  Hospital 98 

German  Evangelical  Hospital 47 

German  Hospital 278 

Home   for   .-Vged    (Little   Sisters  of  the 

Poor) 45 

Infants'  Hospital 7 

Jewish  Hospital 388 

Kings  County  Hospital 1,802 

Kingston  .\ venue  Hospital 432 

Long  Island  College  Hospital 515 


Long  Island  State  Hospital 240 

Lutheran  Hospital 49 

Methodist  Episcopal  Hospital 286 

New   York   City   Home   for   .-Vged   and 

Infirm 329 

Norwegian  Hospital 166 

Samaritan  Hospital 37 

St.  Catherine's  Hospital 370 

St.  Christopher's  Hospital 75 

St.  John's  Hospital 139 

St.  Mary's  Hospital 352 

."^t.  Peter's  Hospital 216 

Swedish  Hospital 68 

Williamsburg  Hospital 166 

Other  Institutions 945 


Total 8,000 


Flushing  Hospital .  .  . 
Jamaica  Hospital.  .  .  . 
St.  John's  Hospital .  . 
St.  Joseph's  Hospital. 
St.  Mary's  Hospital.. 


Borough  of  Queens 

175 


233 

56 

113 


St.  .Anthony's  Hospital. 
Other  Institutions 


Total . 


566 
174 


1,406 


City  Farm  Colony. .  .  . 

Marine  Hospital 

Sailors'  Snug  Harbor. . 
Sea  View  Hospital.  .  .  . 
S.  R.  Smith  Infiirraary, 


Borough  of  Richmond. 


60 

50 

108 

382 

198 


St.  Vincent's  Hospital. 
Other  Institutions.  .  .  . 


Total . 


Borough  of  Manhattan 18,951 

Borough  of  The  Bronx 3,593 

Borough  of  Brooklyn S.OOO 

Borough  of  Queens 1,406 


RECAPITUL-^-nONS. 

Borough  of  Richmond. . .  . 
City  of  New  York . 


131 


149 
134 


l.OSl 


1,081 


33,031 


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133 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE   No.  14. 
DEATHS  FROM   ACCIDENTS  AND  NEGLIGENCE,  1916. 


Fractures  and  Contusions: 

Crushed  by  elevator 

Crushed  by  machinery 

Crushed  by  derrick,  stones,  etc 

Crushed  by  falling  bodies 

Not  specified  by  coroners 

Falls: 

Down  shaft,  hold  of  vessel,  etc 

Down  stairs 

From  buildings 

From  fire-escapes 

From  scaffolds 

From  windows 

From  wagons,  cars,  etc 

On  streets  and  sidewalks 

Other  falls 

Not  specified  by  coroners 

Street  Vehicles: 

Wagons,  trucks,  etc 

Automobiles 

Other  vehicles 

Railroads: 

Electric  surface 

Steam 

Elevated 

Subways 

Burns  and  Scalds: 

By  stoves 

By  lamps 

By  fluids 

By  steam 

By  playing  with  matches 

By  other  methods 

Not  specified  by  coroners 

Conflagration 

Wounds: 

By  firearms 

By  cutting  and  piercing  instruments.  .  . 

Drowning 

Poison: 

By  food 

By  alcohol 

By  wood  alcohol 

By  carbolic 

By  cocaine 

By  mercury  (bichloride) 

By  opium 

By  other  poisons 

By  unknown  poisons 

Illuminating  gas 

Chloroform  or  ether 

Coal  gas 

Not  specified  by  coroners 

Explosions 

Freezing 

Lightning 

Electric  current 

Foreign  body  in  larynx 

Sunstroke 

Criminal  abortion 

Animals,  injury  by  (not  snake  bites  or  hydro- 
phobia)   

Other  violence 

Tetanus 

Hydrophobia 


Borough  of 

CiTT  OF 

Man- 

The 

Brook- 

Queens. 

Rich- 

New 

hattan. 

Bronx. 

lyn. 

mond. 

York. 

23 

3 

26 

12 

4 

7 

23 

.5 

1 

13 

6 

2 

27 

35 

5 

19 

4 

2 

65 

48 

9 

43 

3 

3 

106 

53 

2 

41 

2 

1 

99 

107 

14 

62 

7 

4 

194 

88 

8 

25 

1 

122 

37 

6 

11 

54 

21 

6 

18 

2 

1 

48 

81 

14 

38 

4 

137 

32 

o 

20 

4 

3 

64 

56 

5 

31 

4 

1 

97 

133 

25 

92 

14 

5 

269 

33 

24 

4 

2 

63 

95 

4 

34 

10 

1 

144 

217 

45 

111 

20 

14 

407 

5 

3 

12 

4 

24 

50 

13 

40 

6 

1 

110 

15 

12 

10 

17 

8 

62 

9 

r> 

12 

2 

28 

13 

2 

6 

21 

32 

9 

30 

4 

1 

76 

4 

6 

3 

13 

82 

15 

45 

10 

3 

155 

2 

2 

4 

32 

5 

15 

2 

4 

58 

16 

9 

37 

2 

3 

67 

37 

14 

2 

2 

55 

41 

22 

12 

1 

76 

6 

o 

1 

1 

10 

12 

7 

i 

20 

220 

26 

161 

40 

35 

482 

12 

2 

5 

4 

23 

1 

2 

2 

1 

2 
2 

1 

1 

2 

3 

1 

5 

2 

11 

6 

1 

4 

11 

12 

3 

7 

o 

27 

6 

2 

8 

134 

21 

165 

20 

5 

345 

9 

2 

1 

1 

13 

9 

2 

2 

1 

14 

24 

8 

23 

2 

57 

4 

20 

1 

25 

3 

2 

1 

6 

2 

1 

3 

5 

10 

10 

3 

1 

29 

14 

3 

6 

1 

24 

25 

2 

25 

6 

58 

24 

5 

8 

5 

42 

7 

5 

5 

o 

19 

17 

2 

14 

7 

40 

6 

2 

10 
1 

4 

1 

23 
1 

134 


BUREAU    OF    RECORDS. 


RECAPITULATION. 


BoRorcH 

OF 

City  of 

Man- 
hattan. 

The 
Bronx. 

Brook- 
lyn. 

Queens. 

Rich- 
mond. 

New 
York. 

123 

641 

317 

87 

18 

205 

41 

220 

41 

134 

42 

24 

25 

19 
85 
52 
32 
2 
38 

"26 

8 

21 

10 

5 

2 

"    2 

10 

3 

7 

85 

362 

157 

68 

8 

149 

22 

161 

27 

165 

26 

8 

25 

1 

10 

10 

<•) 

41 

13 

42 

34 

25 

1 

23 

12 

40 

11 

20 

5 

5 

6 

"  '4 

3 

1 

12 

7 
17 
15 

9 

1 
13 

1 
35 

5 
1 

.... 

1 
"  '2 

347 

Falls           

1.147 

575 

221 

30 

428 

76 

482 

87 

345 

Other  gases 

Criminal  abortion 

84 
42 
58 

1 

6 

5 

14 

31 

23 

Electric  current 

Foreign  body  in  larynx 

Other  \-iolence 

29 
24 
93 

Total 

1.974 

322 

1.331 

257 

108 

3.992 

135 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


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137 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


TABLE  No.  16. 

DEATHS     OF     CHILDREN     UNDER     ONE     YEAR     OF     AGE    ACCORDING    TO 

NATIVITIES  OF  BOTH  PARENTS— DEATH  RATES  PER  1,000  BIRTHS 

REPORTED  BY  NATIVITIES  OF  BOTH  PARENTS— 1916. 


Austria-Hungary 

Bohemia 

England 

France 

Germany 

Ireland 

Italy 

Russia-Poland 

Scotland 

Sweden 

United  States 

Other  foreign 

Mixed  native  and  foreign 
Unknown 

Total 


Births  Reported 

BY  Nativities 

OF  Both 

Parents. 


10,613 

225 

443 

82 

1,764 

4,662 

29,011 

23,016 

191 

463 

37,590 

29,604 


137,664 


Deaths  Under 
One  Year  by 
Nativities  of 

Both  Parents. 


881 

21 

44 

8 

192 

534 

2,924 

1,734 

13 

46 

3,976 

2,445 


12,818 


Death  Rate 
1,000  Births 
Reported  by 
Nativities  of 
Both  Parents. 


92. 

93. 

99. 

97 
108. 
114. 
100.6 

75.3 

68.1 

99.4 
105.7 

82.6 


93.0 


138 


BUREAU    OF    RECORDS. 


TABLE  No.  17. 

DEATHS    OF    CHILDREN    UNDER    ONE    YEAR    OF    AGE    ACCORDING 
NATIVITY  OF  PARENTS  FOR  YEAR  1916. 


TO 


Country. 


]\Ian- 

HATTAN. 


The 
Bronx. 


Brook- 
lyn. 


Queens. 


Rich- 
mond. 


New  York 
City. 


United  States 

Ireland 

Germany 

Italy 

Russia 

England 

Austria-Hungary .  .  . 

Scotland 

British  America.  .  . . 

Switzerland 

France 

Bohemia 

Roumania 

Poland 

Syria 

Sweden 

Norway 

Denmark 

Finland 

Holland 

Cuba 

Other  West  Indies. . 

Belgium 

Spain 

Greece 

China 

Australia 

Other  Foreign 

Mixed  Foreign 

Native  Father 

(Foreign  Mother) 
Native  Mother 

(Foreign  Father) . 
Unknown 


Total . 


1,612 

366 

71 

1,475 

690 

27 

586 

4 

9 

1 

5 

16 

20 

24 

3 

10 

5 

3 

15 

4 
99 

2 
11 
53 


64 
191 

226 

372 
271 

6,2.35 


344 

38 

28 

250 

185 

4 

70 

9 


3 

10 
3 


2 
59 

56 

102 
16 

1.197 


1,484 

110 

74 

1,042 

640 

9 

177 

6 


14 
57 


23 
33 

7 
6 


o 

89 

131 

245 
59 

4,272 


434 

13 

15 

127 

75 

3 

31 

1 

1 

'     1 

1 

38 


3 
1 

22 
34 

72 

7 

SS5 


102 

7 

4 

30 

11 

1 

17 

"l 


11 

2 

1 
3 


3 

8 

16 
6 

229 


3,976 

534 

192 

2,924 

1,601 

44 

881 

13 

16 

1 

8 

21 

45 

133 

27 

46 

46 

11 

28 

"4 

129 

2 

16 
64 


71 
364 

455 

807 
359 

12,818 


139 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 

TABLE  No.  18. 

DEATHS  FROM  ALL  CAUSES  AND  DIARRHOEAL  DISEASES  UNDER  ONE  YEAR 

OF  AGE,  BY  WEEKS. 

City  of  New  York — Year  1916. 


All  Causes. 

DiARRHOEAL    DlSE.^SES. 

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0 

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January  1 

94 

24 

19 

49 

23 

24 

233 

3 

3 

7 

5 

1 

19 

January  8 

114 

27 

16 

36 

29 

27 

249 

3 

3 

'  '2 

6 

2 

3 

19 

January  15.  .  .  . 

110 

28 

20 

39 

21 

33 

251 

6 

4 

4 

7 

2 

2 

25 

January  22.  .  .  . 

119 

29 

19 

28 

30 

36 

261 

8 

4 

4 

6 

2 

1 

25 

January  29.  .  .  . 

107 

29 

16 

43 

34 

21 

250 

12 

4 

3 

10 

6 

2 

37 

February  5. .  .  . 

123 

18 

16 

33 

31 

19 

240 

4 

1 

3 

2 

1 

5 

16 

February  12. .  . 

109 

26 

23 

45 

31 

22 

256 

7 

4 

4 

8 

5 

1 

29 

February  19 . .  . 

111 

31 

13 

38 

33 

26 

252 

3 

8 

3 

13 

5 

3 

35 

February  26.  .  . 

105 

31 

27 

36 

32 

35 

266 

5 

12 

7 

5 

3 

4 

36 

March  4 

104 

20 

16 

?8 

36 

30 

244 

4 

3 

2 

11 

6 

26 

March  11 

120 

21 

16 

43 

35 

34 

269 

6 

3 

7 

7 

3 

'  i 

27 

March  18 

102 

25 

16 

30 

44 

32 

249 

5 

3 

2 

5 

6 

2 

23 

March  25 

112 

36 

19 

36 

37 

28 

268 

2 

7 

1 

9 

5 

3 

27 

April  1 

92 

14 

14 

41 

36 

32 

229 

7 

3 

2 

12 

4 

7 

35 

April  8 

120 

28 

21 

52 

34 

27 

282 

4 

6 

5 

11 

5 

1 

32 

April  15 

113 

16 

10 

20 

50 

36 

245 

2 

5 

2 

3 

7 

5 

24 

April  22 

113 

17 

23 

42 

40 

21 

256 

6 

1 

4 

8 

8 

27 

April  29 

102 

24 

10 

36 

38 

28 

238 

1 

4 

2 

11 

6 

'  i 

25 

May  6 

99 

29 

18 

39 

41 

37 

263 

6 

8 

3 

8 

4 

3 

32 

May  13 

104 

20 

11 

44 

42 

32 

253 

4 

6 

3 

7 

7 

2 

29 

May  20 

94 

21 

15 

28 

28 

44 

230 

4 

4 

5 

6 

3 

4 

26 

May  27 

101 

18 

16 

28 

44 

34 

241 

8 

3 

3 

6 

5 

5 

30 

June  3 

94 

14 

18 

42 

33 

40 

241 

5 

3 

10 

14 

6 

2 

40 

June  10 

93 

18 

27 

32 

26 

28 

224 

3 

5 

7 

7 

7 

3 

32 

June  17 

73 

15 

17 

24 

29 

24 

182 

6 

8 

1 

4 

5 

1 

25 

June  24 

78 

19 

13 

28 

28 

31 

197 

1 

5 

4 

.5 

5 

4 

24 

July  1 

71 

24 

13 

24 

30 

34 

196 

5 

8 

2 

1 

6 

7 

29 

July  8 

71 

15 

14 

47 

29 

44 

220 

4 

3 

4 

19 

3 

5 

38 

July  15 

89 

13 

17 

30 

37 

55 

241 

3 

8 

14 

12 

11 

48 

July  22 

84 

14 

17 

58 

45 

29 

247 

4 

'    3 

8 

24 

15 

8 

62 

July  29 

59 

25 

18 

66 

60 

55 

283 

1 

7 

8 

40 

29 

24 

109 

August  5 

87 

24 

22 

76 

84 

87 

380 

7 

10 

6 

41 

41 

41 

146 

August  12 

81 

31 

20 

73 

94 

52 

351 

3 

11 

12 

49 

43 

20 

138 

August  19 

109 

27 

23 

80 

82 

61 

382 

7 

11 

6 

51 

43 

24 

142 

August  26 

89 

30 

23 

68 

79 

57 

346 

6 

11 

6 

38 

41 

24 

126 

September  2.  . . 

80 

25 

17 

60 

67 

48 

297 

4 

11 

8 

25 

34 

13 

95 

September  9 .  . . 

92 

20 

22 

50 

50 

64 

288 

8 

6 

7 

29 

25 

21 

96 

September  16.  . 

75 

20 

20 

46 

42 

41 

244 

8 

9 

9 

23 

22 

19 

90 

September  23.  . 

90 

26 

21 

34 

29 

24 

224 

5 

10 

11 

15 

16 

6 

63 

September  30.  . 

84 

25 

20 

59 

30 

38 

256 

4 

5 

7 

34 

15 

16 

81 

October  7 

89 

13 

12 

36 

28 

25 

203 

2 

3 

6 

17 

14 

9 

51 

October  14.  .  .  . 

97 

19 

13 

23 

23 

21 

196 

4 

4 

6 

14 

9 

6 

43 

October  21.  .  .  . 

75 

18 

18 

34 

33 

27 

205 

3 

7 

5 

20 

20 

12 

67 

October  28 

88 

20 

11 

43 

33 

23 

218 

5 

4 

4 

19 

18 

10 

60 

November  4 .  .  . 

79 

11 

22 

34 

20 

18 

184 

4 

5 

5 

13 

6 

3 

36 

November  11.  . 

105 

26 

19 

34 

30 

20 

234 

5 

5 

8 

15 

8 

5 

46 

November  18.  . 

86 

17 

14 

27 

24 

20 

188 

4 

4 

5 

13 

7 

5 

38 

November  25.  . 

107 

23 

24 

26 

14 

14 

208 

5 

2 

4 

6 

5 

1 

23 

December  2. . . . 

94 

18 

17 

23 

18 

13 

183 

3 

3 

4 

5 

8 

3 

26 

December  9. . .  . 

106 

19 

19 

31 

20 

12 

207 

1 

3 

5 

5 

1 

2 

17 

December  16. . . 

92 

25 

15 

32 

17 

18 

199 

1 

4 

6 

5 

2 

18 

December  23. . . 

120 

36 

20 

35 

15 

9 

235 

■    3 

9 

5 

4 

2 

1 

24 

December  30. . . 

118 

17 

10 

31 

18 

15 

209 

1 

1 

3 

6 

2 

1 

14 

Total,  53  weeks 

5,123 

1.179 

930 

2,130 

1,936 

1,695 

12,993 

234 

276 

259 

744 

573 

365 

2,451 

Year  1916 

5,061 

1,158 

916 

2,093 

1,919 

1,671 

12,818 

231 

273 

259 

738 

570 

364 

2,435 

140 


BUREAU     OF    RECORDS. 


TABLE  No.  19. 
DISPOSITION  OF  THE  DEAD  AND  STILL  BORN  INFANTS— 1916. 


Cemeteries. 


Number  of  Interments. 

Borough  of  Manhattan — 

Marble 10 

Marble  Vault 1 

St.  Marks 1 

St.  Marks  Vault 1 

Trinity  Church 85 

St.  John  the  Divine  (Crypt) 1 

Total 99 

BorouKh  of  The  Bronx — 

City 5,848 

Pelham  Bay 23 

St.  Peters 29 

St.  Raymonds 3,098 

West  Farms 9 

Woodlawn 2,549 

Total 11,556 

Borough  of  Brooklyn — 

Canarsie 59 

Cypress  Hills 681 

Evergreens 823 

Flatlands 22 

Friends 25 

Gravesend 13 

Greenwood 4,002 

Holy  Cross 6,320 

Holy  Trinity 1,724 

Maimonides 132 

Mount  Hope 122 

National 117 

New  Lots 8 

New  Utrecht 6 

Salem  Fields 201 

United  Jewish 69 

Washington 2,060 

Total 16,384 

Borough  of  Queens — 

Acacia 259 

Bayside 338 

Bethel 127 

Calvary 19,816 

Cedar  Grove 530 

Cypress  Hills 911 

Evergreen 3,199 

Flushing 340 

Fresh  Pon<l 906 

Linden  Hill 1  gj3 

Lutheran 51436 

Macpelah 125 

Maple  Grove 013 

Montcfiore 1,401 

Mount  Cnrmel l!o75 

Mount  Hebron lio41 


Cemeteries. 


Number  of  Interments. 

Borough  of  Queens — Continued. 

Highland  View 559 

Mount  Neboh 213 

Mount  Olivet ...'...'.'  2  247 

Mount  St.  Mary .'.'..'.  '407 

Mount  Zion , . .  . .  2  795 

Prospect '     0 

Springfield 42 

St.  Johns 2  668 

St.  Michaels 2593 

St. Monica [[[  '   ^7 

Union  Fields ,  \  413 

Ahawath  Chesed 49 

Mount  Lebanon 281 

Hungarian 32 

Grace  Church  Yard  (Jamaica) 5 

Total 50.333 

Borough  of  Richmond — 

A.  M.  E.  Zion e 

Baron  Hirsch 508 

Bethel 45 

City  Farm  Colony 3 

Fairview jqq 

Fountain 2 

Hillside .[  12 

Lake '  46 

Moravian 404 

Mount  Loretto 6 

Mount  Richmond 1,191 

New  Springville '     6 

Ocean  View 70 

S.  S.  Harbor 126 

St.  John's  Lutheran 1 

St.  Luke's 5 

St.  Mary's,  3d  Ward 44 

St.  Mary's,  4th  Ward 113 

St.  Peter's 363 

Silver  Lake 23 

Silver  Mount 90 

Staten  Island 46 

Sylvan 4 

West  Baptist 1 

Woodland 144 

United  Hebrew 369 

Sacred  Heart 1 

Total 3,729 

Summary — 

Borough  of  Manhattan 99 

Borough  of  The  Bronx 11,556 

Borough  of  Brooklyn 16,384 

Borough  of  Queens 50,333 

Borough  of  Richmond 3,729 

City  of  New  York 82,101 


141 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE 

DEATHS  FROM  ALL  CAUSES 

DEATH  RATE  PER  1,000  POPULATION 

CITY  OF 


Estimated  Population 
1916. 


White. 


Males. 


Females. 


Both 

Sexes. 


Males. 


Fe- 
males. 


Both 
Sexes. 


Total  De.\ths 

All  Causes. 


White. 


Males. 


Fe- 
males. 


Both 
Sexes. 


Under  1  year.  .  .  . 

Under  5  years . . .  . 

5  to    9  years .  .  .  . 

10  to  14  years. . .  . 

15  to  19  years. . .  . 

20  to  29  years 

30  to  39  years 

40  to  49  years. .  . . 
50  to  59  years. . .  . 
60  years  and  over 

Total 


*68,990 


*66,105 


*135,095 


*1,347 


*1,171 


*2,518 


6,922 


5,404 


12,326 


296,300 
254,900 
245,000 
250,500 
577,500 
474,100 
331,170 
184,370 
122,930 


291,600 
253,750 
245,500 
279,800 
599,950 
442,200 
306,950 
178,200 
142,840 


587,900 
508,650 
490,500 
530,300 
1.174,450 
916,300 
648,120 
362,570 
265,770 


3,816 
2,825 
2,627 
3,122 
14,075 
12,737 
6,344 
2,527 
1,336 


4,080 
3,206 
3,089 
4,255 
18,477 
13,232 
6,706 
3,030 
2,039 


7,896 

6,031 

5,716 

7,377 

32,552 

25,959 

13,050 

5,557 

3,375 


10,726 
1,027 
506 
780 
2,782 
4,356 
5,650 
6,037 
9,570 


8,537 

864 

462 

726 

2,416 

2,809 

3,541 

4,171 

10,124 


19,263 

1,891 

968 

1,506 

5,198 

7,165 

9,191 

10,208 

19,694 


2,744,700 


2,743,392 


5,488,092 


49,560 


58,290 


107,850 


41,434 


33,648 


75,082 


*  Total  births  reported. 


142 


BUREAU    OF    RECORDS 


No.  20. 

BY  SEX,  AGE  AND  COLOR. 

ESTIMATED  AT  DIFFERENT  AGE  GROUPS 

NEW  YORK. 


Increase  in 

Total  Deaths 

E 

EATH  Rate  per 

1,000  Population 

Mortality 

DF 

All  Causes. 

Estimated 

AT    DiFFEREXT    AGE    GrOUPS. 

Negroes  Over 

White. 

Negro. 

White. 

Negro. 

Fe- 

Both 

Fe- 

Both 

Fe- 

Both 

Fe- 

Both 

Males. 

males. 

Sexes. 

Males. 

males. 

Sexes. 

Males. 

males. 

Sexes. 

Males. 

males. 

Sexes. 

271 

218 

489 

100.3 

81.7 

90.9 

201.0 

186.1 

194.2 

-1-100.7 

+104.4 

+103.3 

375 

325 

700 

36.1 

29.3 

32.7 

98.3 

79.6 

88.5 

-1-62.2 

+50.3 

+55.8 

29 

28 

57 

4.0 

3.4 

3.7 

10.3 

8.7 

9.5 

+  6.3 

+  5.3 

+  5.8 

22 

17 

S9 

2.0 

1.9 

2.0 

8.4 

5.5 

6.8 

+  6.4 

+  3.6 

+  4.8 

29 

30 

59 

3.1 

2.6 

2.8 

9.3 

7.0 

8.0 

-f-  6.2 

+  4.4 

+  5.2 

177 

163 

340 

4.8 

4.0 

4.4 

12.6 

8.8 

10.4 

+  7.8 

+  4.8 

+  6.0 

250 

203 

453 

9.2 

6.3 

7.8 

19.6 

15.3 

17.4 

4-10.4 

+  9.0 

+  9.6 

210 

160 

370 

17.0 

11.5 

14.2 

33.1 

23.8 

28.3 

-i-16.1 

+  12.3 

+  14.1 

151 

127 

278 

32.7 

23.4 

28.1 

59.7 

41.9 

50.0 

+27.0 

+  18.5 

+21.9 

151 

181 

332 

77.9 

70.8 

74.1 

113.0 

88.8 

98.4 

-1-35.1 

+  18.0 

+24.3 

1,394 

1.234 

2,628 

15.1 

12.2 

13.7 

28.1 

21.2 

24.4 

+  13.0 

+  9.0 

+  10.7 

143 


ANNUAL     REPORT     OF     THE     DEPARTMENT     OF     HEALTH. 


TABLE  No.  2L 
DEATHS  OF  NON-RESIDENTS  FROM  CERTAIN   CAUSES  FOR  THE  YEAR  1916. 


Cause  of  Death. 

Man- 
hattan. 

Bronx. 

Brook- 
lyn. 

Queens. 

Rich- 
mond. 

City  of 
Nev\ 
York. 

Typhoid  fever    .... 

4 
66 
25 

172 
8 

135 

111 

55 

25 

7 

18 

116 
77 
18 

435 

"41 

"9 

11 
6 

"5 

2 

27 

3 

17 

6 

22 

1 

44 

29 

5 

4 

1 

5 

4 

88 

2 

97 

3 

IS 

1 

3 

'"8 
7 
1 
2 

"1 

1 

"27 

2 
15 

'"4 

"9 
3 
1 
1 

"1 

10 

3 

26 

12 

Pulmonary  tuberculosis 

Other  tubercular  diseases 

Cancer 

157 

32 

210 

Alcoholism 

9 

Heart  diseases 

207 

Acute  respiratory  diseases .... 
Diarrhoeal  diseases 

156 
62 

Appendicitis 

32 

Cirrhosis  of  liver 

8 

Diseases  of  women 

23 

Congenital  debility 

122 

Accidents 

181 

Suicides 

25 

Other  causes 

612 

Total 

1,272 

101 

328 

72 

75 

1,848 

Under  5  years 

261 
89 
319 
422 
181 

2 
16 
34 
31 
18 

24 
38 
119 
87 
60 

3 

8 

31 

19 

11 

1 

7 

26 
19 
22 

291 

5  to  25  years 

158 

25  to  45  vears 

529 

45  to  65  years 

65  years  and  over 

578 
292 

Total 

1,272 

101 

328 

72 

75 

1,848 

Institutions 

940 
243 

89 

78 
13 
10 

161 

86 
81 

53 

17 
2 

62 
6 

7 

1,294 

Houses 

365 

Other  places 

189 

Total 

1,272 

101 

328 

72 

75 

1,848 

144 


ANNUAL    REPORT    OF   THE    DEPARTMENT    OF    HEALTH. 


TABLE 

REPORT  OF 

FOR  YEAR  ENDING 


Borough  of — 

Manhattan. 

The  Bronx. 

36,702 
13.93 
13.60 

7.966 
13.83 
13.33 

Death  rate 

Corrected  by  redistributing  deaths  according  to  borough  of  residence. 


Estimated 
Population. 

Certificates  Receii 

'ED  AND  Tabulated. 

Marriages. 

Births. 

Deaths. 

Stillbirths. 

Manhattan 

The  Bronx 

2,634,223 
575.877 

1,928,432 

366,426 

97,883 

31,735 
4,080 

15,920 

2,352 

695 

61,030 

16,144 

48,590 

9,453 

2,447 

36,702 

7,966 

25,567 

5,488 
2,078 

2,830 
673 

2,234 
416 
100 

Queens 

Richmond 

City  of  New  York 

5,602,841 

54,782 

137,664 

77,801 

6,253 

Borough  of- 


Manhattan. 


The  Bronx. 


Number  of  deaths  in  institutions 

Number  of  deaths  in  tenements 

Number  of  deaths  in  dwellings 

Number  of  deaths  in  hotels 

Number  of  deaths  in  streets,  rivers,  etc. 


18,949 
14,931 

1,128 
597 

1,097 


3,593 

2,906 

1,289 

24 

154 


146 


BUREAU   OF   RECORDS. 


No.  22. 

BUREAU  OF  RECORDS 

DECEMBER  31,  1916. 


Borough  of — 

CiTT  OF  New  York. 

Brookljn. 

Queens. 

Richmond. 

25,567 
13.26 
14.04 

5,488 
14.98 
15.14 

2,078 
21.23 
17.12 

77,801 
13.89 

Rate  Per  1,000. 

Tr.^nsit 
AND  Disin- 
terment 
Permits 
Issued. 

Coroners' 
Cases. 

Searches 
Made. 

Transcripts 

Marriages. 

Births. 

Deaths. 

Stillbirths. 

Issued. 

12.05 
7.08 
8.26 
6.42 
7.10 

23.17 
28.03 
25.20 
25.80 
25.00 

13.93 
13.83 
13.26 
14.98 
21.23 

1.07 
1.17 
1.16 
1.14 
1.02 

1,404 

105 

1,299 

1,298 

84 

5,987 

1,032 

3,530 

S06 

255 

110,817 

14,788 

66,215 

7,639 

3,397 

35,971 
6,443 

22.974 
4.364 
1,167 

9.78 

24.57 

13.89 

1.12 

4,190 

11,610 

202,856 

70,919 

Borough  of — 

CiTT  OF  New  York. 

Brooklyn. 

Queens. 

Richmond. 

8,002 

10.339 

6,512 

82 
632 

1.406 

1,217 

2,636 

33 

196 

1.081 

109 

787 

17 

84 

33.031 

29,502 

12.352 

753 

2,163 

147 


ANNUAL    REPORT    OF   THE    DEPARTMENT    OF    HEALTH. 


TABLE  No.  23. 
SEARCHES  MADE  AND  TRANSCRIPTS  ISSUED— YEAR  1916. 


Borough  of 

City 

Man- 
hattan. 

The 
Bronx. 

Brook- 
lyn. 

Queens. 

Rich- 
mond. 

OF  ■ 
New 
York. 

Free    searches   of   birth   records   for 
school  and  mercantile  purposes,  etc. 

Paid  searches  of  birth  records 

Paid  searches  of  marriage  records. . . . 
Paid  searches  of  death  records 

66,553 

11,005 

5,147 

28,112 

9,184 
405 
143 

5,056 

42,594 
4,218 
2,502 

16,901 

4,084 

276 

77 

3,202 

2,273 

170 

41 

913 

124,688 

16,074 

7,910 

54,184 

Total  free  and  paid  searches .... 

110,817 

14,788 

66,215 

7,639 

3,397 

202,856 

Transcripts. 

Paid  transcripts  of  births  issued 

Paid  transcripts  of  marriages  issued. . 
Paid  transcripts  of  deaths  issued .... 

6,532 

2,676 

26,763 

360 

71 

6,012 

2,123 

1,607 

19,244 

225 
52 

4,087 

135 

19 

1,013 

9,375 

4,425 

57,119 

Total  transcripts  issued 

35,971 

6,443 

22,974 

4,364 

1,167 

70,919 

148 


BUREAU   OF   RECORDS. 


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160 


BUREAU    OF    RECORDS. 


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and 

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120 

Hright's 
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Simple 
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X 

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110 

Diseases 
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S 

X 

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M 

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115 

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X 

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30 

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5  to  9  years.  . 
10  to  14  years 
15  to  19  years 
20  to  24  years 
25  to  29  years 
30  to  34  years 
35  to  39  years 
40  to  44  years 
45  to  49  years 
50  to  54  years 
55  to  .59  years 
(iO  to  04  years 
(15  to  (>9  years 
70  to  74  years 
75  to  79  years 
80  to  84  years 
85  yrs.  and  ov 

161 


ANNUAL   REPORT    OF    THE    DEPARTMENT    OF    HEALTH. 


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134 

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127 

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126 

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15  to  19  years 
20  to  24  years 
25  to  29  years 
30  to  34  years 
35  to  39  years 
40  to  44  years 
45  to  49  years 
50  to  54  years 
55  to  59  years 
60  to  64  years 
65  to  69  years 
70  to  74  years 
75  to  79  years 
80  to  84  years 
85  y'rs  and  ov 

162 


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165 


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15  to  10  years 
20  to  24  years 
25  to  29  years 
30  to  34  years 
35  to  39  years 
40  to  44  years 
45  to  49  years 
50  to  54  years 
55  to  50  years 
CO  to  04  years 
65  to  09  years 
70  to  74  years 
76  to  70  years 
80  to  84  years 
85  y  rs  and  ov 

167 


ANNUAL  REPORT  OF  THE  DEPARTMENT  OF  HEALTH. 


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171 


INDEX 

A 

PAGE 

Accidents  and  negligence,  deaths   from    (tables) 134,  135 

Achievements  in  health  protection  during  the  year 26 

Activities,    new    25 

Advisory    Board,    Medical 15 

Advisory   Council,   committees   of 22 

Age  groups,  deaths  by 171 

Age,  sex,  and  cause,  deaths    (table) 150 

Air,  content   of   soot  and  dust  studied 43 

Ambulances,    nurses    on 11 

Amebic   mouth    infections    study 92 

Anatomical  exhibit  to  combat  quackery 83 

Animal    diseases     (table) 63 

Anthrax,  in  connection  with  brushes 59 

Anthrax,  investigation  of  a  supposed  source  of  infection 57 

Anthrax,  laboratory  examinations  of  skins  and  brushes  for 92 

Antirabic   treatment  work    (table) 95 

Antiserum    preparation    modifications 88 

Associates  in  Public  Health 21 

B 

Babies  and  children  under  supervision   (table) 53 

Bacterial    diagnoses   made    (table) 89-90 

Bathing  establishments,  control  of 19 

Births     96 

Births,  by  nativity  of  parents   (table) 110 

Births,   particulars    regarding    (table) 114 

Births,  reported  by  months   (table) 108 

Board  children,  permits  to   (table) 52 

Board   of   Health 14 

Business  block,  typical,  sanitary  survey  of 25 

Butter,    pasteurization    of 68 

c 

Cancer,  and  tuberculosis,  pulmonary,  deaths  and  death  rates,  etc.  (table) 132 

Cancer,   deaths    100 

Cancer,  tuberculosis,  pulmonary,  and;  deaths,  15  years  and  over,  by  sex,  age  and 

civil    condition     (table) 133 

Cause,  age,  and  sex,  deaths  (table) 150 

Cause  of  death,  annual  rate  per  1,000,  age,  meteorology,  and  deaths  in  institu- 
tions, by  weeks    (table) ■  128 

Causes,  all,  and  diarrhoeal  diseases,  deaths  under  1  year  of  age  by  weeks  (table)  140 

172 


INDEX. 

PAGE 

Causes,  all,  deaths   from,  by   sex,  age  and   color;   flcatli   rate   at   diflfcrcnt  age 

groups    (table)    142 

Cerebro-spinal  meningitis  cases  and  deaths  reported   (table) 60 

Chickenpox  cases  reported  (table) 60 

Child  Hygiene,  Bureau  of 47 

Child  Hygiene,  Bureau  of,  changes  in  organization 47 

Child  Hygiene,  Bureau  of,  changes  in  procedure 47 

Child  Hygiene,  Bureau  of,  changes  in  staff 47 

Child  Hygiene,  Bureau  of,  chart  of  work  performed 46 

Child  Hygiene,  Bureau  of,  infant  mortality  reduced  by  work  of 51 

Child  Hygiene,  Bureau  of,  important  activities 47 

Children  and  babies  under  supervision   (table) 53 

Children,  permits  to  board  (table) 52 

Children,   school,   physical  examinations    (table) 52 

Children  under  1  year  of  age,  deaths  according  to  nativity  of  parents,  by  bor- 
oughs   (table)     139 

Children  under   1   year  of  age,  deaths  and  death   rates,  death   rates   i)er   \fiOO 

births,  by  nativities  of  both  parents  (table) 138 

Clinics  for  school  children,  work  of    (table) 54 

Condensed  milk  samples   examined    (table) 94 

Conjunctivitis  found  in  school  children  (table) 54 

Consultants,   honorary    15 

Contagious  diseases,  cases  of,  treated  in  department  hospitals   (table) 78 

Contagious  diseases  contracted  by  hospital  employees 77 

Contagious  diseases  found  in  school  children,  at  home  (table) 53 

Contagious  diseases  found  in  school  children,  in  schools  (table) 53 

Contagious  diseases  (minor),  skin,  eye,  etc..  found  in  school  children   (table)..  54 

Contagious  diseases,  inspections,  removals,  etc.    (table) 61 

Contagious    diseases    (tables) 60-63 

Conveyances,   public,   inspections   of 43 

Cost  of  Department  of  Health,  per  capita,  reduced 27 

Cream   samples  examined    (table) 94 

Cyanide    fumigation    prohibited 19 

D 

Day  nurseries,   permits   issued    (table) 52 

Dead,    disposition    of    (table) 141 

Deaths    97 

Death  rate,  crude   (chart) 103 

Death  rate  of  infants  under  1  year  of  age  (chart) 12 

Death  rate,  reduction  in 26 

Deaths,  by  principal  causes,  with  ages  of  decedents   (table) 116 

Deaths,   particulars  regarding    (table) 11-* 

Defects,  physical,   found  in  school  children   (table) 52 

Departmental   procedure,   advances   in 23 

Diarrhoeal  diseases,  and  all  causes,  deaths  uniler  1  year  of  age.  by  weeks  (table)  140 

Diphtheria  antitoxin  immunizations  performed    ( tal)le) 61 

Diphtheria  cases  and  deaths  reported   (table) 60 

Dii)htheria.   minimum   (piarantine   period   established 56 

Dii)lithcria.   reduction   in -'' 

Diphtheria  toxin,   tested 93 

173 


INDEX. 

PAGE 

Disease  groups,  deaths  by  important    (chart) 104 

Diseases,  certain,  deaths  from,  and  contributing  causes   (table) 136 

Diseases,  infectious,  cases  and  deaths  (table) 60 

Disinfections  performed    (table) "1 

Dog  muzzling,  enforcement  of 44 

Dogs,   muzzling   of -^ 

Dogs,  unmuzzled,  census  of 5° 

Drainage  of  mosquito  marshes 25 

Drugs,  miscellaneous  activities  affecting 68-73 

Dust  and  soot  in  the  air,  studies 43 

E 

Educational  leaflets  85 

Educational  public  health  work 83 

Employes,  classes  and  numbers   (table) 18 

Employes,  number  and  time  service 23 

Employes,   physical   examination   of 23 

Employes,    ratings    of 23 

Employment  certificates  issued    (table) 52 

Examinations  of  school  children   (table) 52 

Executive  staff   18 

Exhibits,    educational    - 83,  85 

Expenses   of    department    (table) 38 

F 

Favus  found  in  school  children   (table) 54 

Fire  and  Fire  Hazards  Committee,  Bureau  of  Hospitals 76 

Food  and  Drugs,  Bureau  of,  changes  in  organization 66 

Food  and  Drugs,  Bureau  of,  changes  in  procedure 66 

Food  and  Drugs,  Bureau  of,  changes  in  staff 66 

Food  and  Drugs,  Bureau  of,  chart  showing  activities 65 

Food  and  Drugs,  Bureau  of,  important  activities 67 

Food  establishments,  inspections  of    (table) 7Z 

Food  handlers,  examination  of,  by  private  physicians 21 

Food,  pure,  regulation  violator  heavily  fined 71 

Food  regulation  violations  prosecuted   (table) 74 

Food  show  exhibit   .- '0 

Foods,  public  health  education  in  economical 83 

Foodstuffs,  chart  showing  main  lines  of  flow 64 

Foodstuffs    condemned    (table) '4 

Foodstuffs,  miscellaneous  activities  affecting 67-73 

Food  supply,  protecting  public " 1" 

Free  lunch  counters  inspected 68 

Fresh   air  campaign °4 

G 

General    Administration,    Bureau    of 36 

General  Administration,  Bureau  of,  changes  in  organization 36 

General  Administration,  Bureau  of,  changes  in  staff '. ^^ 

General  Administration,  Bureau  of,  important  activities 36 

General  contagion  in  schools    (table) 53 

174 


INDEX. 

PACE 

German  measles  cases  reported   (table) 60 

Glanders,    reduction    in 27 

Glasses,  cleansing  of,  work  to  secure  proper 67 

Glycobactcr  studied   92 

Goat's  milk,  value  of,  in  infant  feeding,  and  in  tuberculosis,  studied 93 

Gonorrhoea  cases  and  deaths  reported   (table) 60 

H 

Health  administration,  history  of,   published 83 

Health,   Board   of 14 

Health   district   plan   extended 23 

Health  Districts,  achievements 30 

Health  Districts,  changes  in  organization 28 

Health  Districts,  Division  of 28 

Health  Districts,  changes  in  procedure 28 

Health  Districts,  changes  in  staflf 28 

Health  Districts,  important  activities 29 

Health  Districts,  work  performed    (table) 31 

Heart  and  kidney  diseases,  deaths 100 

History  of  health  administration  in  the  city  published 83 

Home  visits,  school  nurses  and  inspectors  (table) 53 

Honorary    Consultants     15 

Horse-shoeing    shops    sypervised 43 

Horses,  methods  of  immunization  tested 88 

Hospitals,  Bureau  of,  activities   (chart) 75 

Hospitals,  Bureau  of,  changes  in  staflf 11 

Hospitals,  Bureau  of,  medical  procedure,  improvements  in 76 

Hospitals,  Bureau  of,  new  buildings 76 

Hosf)itaIs,  Bureau  of,  patients  treated,  etc.  (table) 78 

Hospitals,  Bureau  of,  per  capita  cost  of  food 76 

Hospitals   (Department),  infections  acquired   within   (table) 82 

I 

Ice  cream,  bacteriologic  examination  of,  begun 69 

Ice  cream  samples  examined   ( table ) 94 

Impetigo   found  in  school  children    ( tal)le) 54 

I  ndustrial  hygiene  activity 57 

Industrial  hygiene  work   (table) 63 

Infant,  birth,  death  and  survivors'  rates  (chart) 107 

Infant  mortality  reduced 51 

Infant  mortality,  reduction  in 26 

Infants,  death  rate,  under  1  year    of  age  (chart) 12 

Infants  under  1  year,  deaths  of,  last  7  years  (table) 98 

Infections  acquired   within   Department   hospitals    (table) 82 

Infectious  diseases,  cases,  deaths,  etc.   (table) 60-63 

Infectious  disease,  cases  of,  treated  in  Department  hospitals  (table) 78 

Infectious  diseases,  deaths,  Brooklyn  Borough,  by  wards   (table) 125 

Infectious  diseases,  deaths.  Manhattan  Borough,  by  wards  (table) 124 

Infectious  diseases,  deaths.  Queens  Borough,  by  wards   ( table) 126 

Infectious  diseases,  deaths,  Richmond  Borough,  by  wards  (table) 126 

175 


INDEX. 

PAGE 

Infectious  diseases,  tables  of  inspections,  removals,  etc 61 

Influenza  vaccine  tested 92 

Inspections   (visits)   by  scbool  nurses  and  inspectors   (table) 53 

Inspectors,  School,  visits  by   (table) 53 

Institution  Inspection,  Division  of 31 

Institution  Inspection,  Division  of,  changes  in  staff 31 

Institution  Inspection,  Division  of,   functions 31 

Institution   Inspection,  Division  of,  important  activities 32 

Institution    Inspection,   Divison   of,   organization 31 

Institution  Inspection,  Division  of,  personal  effort  improvements 33 

Institutions,   deaths   in    (table) 131 

Introduction    19 

K 

Kidney  and  heart  diseases,   deaths 100 

Kingston  Avenue  Hospital   Medical   Board 16 

L 

Laboratories,    Bureau    of 88 

Laboratories,  Bureau  of,  changes  in  procedure 88-89 

Laboratories,  Bureau  of,  chart  of  activities 87 

Laboratories,  Bureau  of,  important  activities 89 

Labor   camps    inspection 42 

Laundries    studied    bacteriologically 92 

Law  Division    38 

Law  Division,  changes  in  organization 38 

Law  Division,  changes  in  procedure 38 

Law  Division,   important  activities 39 

Law  Division,  results  accomplished    (table) 39 

Lectures   on   public  health 84-85 

Letter    of    transmissal 13 

Library,  municipal,  establishment  of  branch  of,  in  the  Department 25 

Little  Mothers'  League,  attendance  and  enrollment    (table) 53 

Lodging   houses    inspected 43 

M 

Manure    transportation    supervised 41 

Marriages    97 

Marriages,  by  months    (table) 112 

Marriages,  particulars  regarding    (table) 114 

Marshes,   mosquito,   drainage   of 25 

Measles  cases  and  deaths  reported   (tabic) 60 

Media  for  gonococci  and  meningococci 88 

Media,  Loeffler,  new  method  of  preparation  tested 89 

Media,  new  blood 89 

Media,  table  of  amount  prepared 89 

Medical   Advisory   Board 15 

Medical  Board   Kingston   Avenue  Hospital 16 

Medical  Board,  Willard  Parker  and  Riverside  Hospitals 16 

Meningitis    laboratory   diagnosis    (table) 91 

Meteorological    summary    101 

176 


INDEX. 

PACE 

Midwives'  permits  issued    (table) 52 

Milk,  condensed,   laboratory   study   of 93 

Minor  contagion   found  in   schools    (table) 54 

Milk,  cow's,  typhoid  antibodies  transmitted   by 92 

Milk  handlers,  physical  examination  of 67, 69 

Milk  samples   examined    (table) 94 

Milk  sold  by  milk  stations  (table) 53 

Milk  stations,  milk  sold  by  (table) 53 

Molluscum  contagiosum  found  in  school  children    (table) 54 

Mortality,  diseases  in  which  it  increased  and  those  in  which  it  lessened 101 

Mosquito,    anti,    work 42 

Mosquito  extermination  educational  work 83 

Mosquito  marshes,  drainage  of 25 

"  Mosquito  week  "   22 

Motion-picture  theatres,  inspection  of 43 

Moving  pictures  of  food  control  activities 70 

Moving  pictures  used  in  public  health  educational  work 83-84 

Mumps,  cases  reported    (table) 60 

Muzzling  of  dogs 22 

Muzzling  of  dogs  enforced 44 

N 

Nativity  of   decedents    (table) 127 

Newspaper  publicity  in  public  health  educational  work 85 

New  York  City's  vital  statistics  compared  with  those  of  other  cities  and  states 

(table)     122 

Non-residents,    deaths    (table) 144 

Notable  accomplishments  and  new   activities 25 

Nurseries,  day,  permits  issued    (table) 52 

Nurses  on  ambulances 11 

Nurses,  School,  visits  by   (table) 53 

O 

Occupational    hygiene    activity 57 

"  Open    Window    Week  " 84 

Organization  of  Department  of  Health   (chart) 17 

Oysters  from  certain  areas  barred  from  city 68 

Oysters,  laboratory  examination  of 89 

Oysters,  new  regulations  affecting  the  sale  of 67 

P 

Patent    medicine    campaign 23 

Patent    medicine    exhibit 83 

Patients  and  patient-days,  Department  hospitals   (table) 80 

Patients  treated  in  Department  hospitals   (table) 78 

Peddlers  examined    58 

Pediculosis  found  in  school  children  (table) 54 

Per  capita  cost  of  Department  of  Health  reduced 27 

Pertussis   vaccine   tested 92 

Physical  examination   of   employes 23 

Physical  examinations,  school  children    (table) 52 

177 


INDEX. 

PAGE 

Physicians,  course  in  contagious  disease  for 83 

Piggeries    supervised    43 

Pneumococci  studied    92 

Poliomyelitis  cases  and  deaths  reported  (table) 60 

Poliomyelitis,  deaths,  last  5  years   (table) 99 

Poliomyelitis  epidemic   •. . . .  24 

Poliomyelitis  laboratory  diagnosis    (table) 91 

Poliomyelitis,  new  procedure  in  control  of,  authorized 20 

Population    (chart) 102 

Population,  death  rate  per  10,000  (chart) 106 

Population,  deaths,  death  rates  by,  1898-1916   (table) 149 

Population,  density  and  death  rates  (chart) 105 

Population    of   city 96 

Preventable  disease,  general  considerations  in  regard  to  work  against 28 

Preventable  Diseases,  Bureau  of,  changes  in  staff 56 

Preventable  Diseases,  Bureau  of,  changes  in  organization 56 

Preventable  Diseases,  Bureau  of,  changes  in  procedure 56 

Preventable  Diseases,  Bureau  of,  important  activities 56 

Preventable  Diseases,  Bureau  of,  work  of  (chart) 55 

Preventoria,  for  tuberculosis,  admission  to 59 

Private  schools,   inspection  of 43 

Procedure,  departmental,  advances  in 23 

Publications,    educational    84 

Public  Health  Education,  Bureau  of 83 

Public  Health  Education,  Bureau  of,  important  activities 83 

Public  health  education  campaigns 22 

Public  health   lectures 84-85 

Q 

Queensboro   Hospital   opened 23 

Queensboro  Hospital  visiting  and  Consulting  Physicians  and  Surgeons 16 

R 

Rabies,  anti,  educational  work 58 

Rabies,  reduction  in 27 

Ratings   of    employes 23 

Receipts  of  Department    (table) 38 

Records,  Bureau  of 96 

Records,  Bureau  of,  changes  in  procedure 96 

Records,  Bureau  of,  changes  in  staff 96 

Records,  Bureau  of ;  general  summary  (table) 146 

Records,  Bureau  of,  important  activities 96 

Refuse  dumps  inspection 42 

Research  and  Efficiency,  Division  of 34 

Research  and  Efficiency,  Division  of,  changes  in  staff 34 

Research  and  Efficiencj',  Division  of,  functions 34 

Research  and  Efficiencj%  Division  of,  important  activities 34 

Respiratorj-  diseases,  deaths,  last  5  years  (table) 99 

Restaurants  inspected  and  graded 25 

Ringworm  found  in  school  children  (table) 54 

Riverside  Hospital  Medical  Board 16 

178 


INDEX. 
S 

PACE 

Saccharine,  use  of,  as  a  sweetener  not  allowed 69 

Sanitary   Bureau    41 

Sanitary  Bureau,  changes  in  procedure 41 

Sanitary  Bureau,  changes  in  staff 41 

Sanitary  Bureau,  chart  of  work  performed 40 

Sanitary  Bureau,  important   activities    41 

Sanitary  Bureau,  table  of  work  performed 45 

Sanitary  survey  of  typical  business  block 25 

Sanitary  surveys    41 

Scabies  found  in  school  children  (table) 54 

Scarlet  fever  cases  and  deaths  reported  (table) (A) 

Schick  tests   91 

School  children,  clinics  for,  work  of  (table) 54 

School  children,  examination  of,  by  private  physicians 21 

School  children,  examination  of,  by  teachers 21 

Searches  made  and  transcripts  issued   (table) 148 

Sera  produced    (table) 91 

Sera,  unusual,  produced 92 

Sewerage  system  study 41 

Sex,  age,  and  cause,  deaths   (table) 150 

Skimmed  milk,  sale  of 67 

Smallpox  cases  reported  (table) 60 

Smoke,  dense,  activity  against 43 

Sneeze,    anti-,    campaign 22 

Social  agencies,  co-operation   of 22 

Social  service  work  in  connection  with  infectious  diseases 57 

Soot  and  dust  in  the  air,  studies 43 

Spinal   fluids  examined 91 

Spitting  crusade  22,  42 

Stables  inspected   41 

Staff,   executive    18 

Stillbirths,    particulars    regarding    (table) 114 

Streptococcus    viridans    studied 92 

Suicides    (table)    130 

Summer   resorts  inspected 44 

Syphilis  cases  and  deaths  reported   (table) 60 

T 

Tenement    house    nuisances 41 

Tetanus  toxins  studied 93 

Trachoma  found  in  school  children  (table) 54 

Trades,   dusty,   supervised ■ 44 

Traffic  conveyances,  sanitary  control  of 19 

Transcripts  issued,  and  searches  made  (table) 148 

Trial  block,  sanitary  survey  of  a 44 

Trichinosis,   outbreak   of 57 

Tuberculin,  study  of  preparation  of 92 

Tuberculosis  cases  and  deaths  reported    (table) 60 

Tuberculosis  Clinic,  work  for  year  (table) 62 

Tuberculosis,  preventoria   for,  admission  to 59 

179 


INDEX. 

PAGE 

Tuberculosis,  pulmonary,  and  cancer,  deaths  and  death  rates,  etc.  (table) 132 

Tuberculosis,  pulmonary,  and  cancer;  deaths,  IS  years  and  over,  by  sex,  age  and 

civil  condition   (table) 133 

Tuberculosis,  pulmonary,  deaths    98 

Tuberculosis,  pulmonary,    deaths    (table) 99 

Tuberculosis,  reduction  in    26 

Tuberculosis  statistics  and  work   (tables) 62 

Tuberculosis,  statistics  of  Department  institution  care  of  cases  of  (table) 81 


Typho 
Typho 
Typho 
Typho 
Tj-pho 
Typho 
Typho 
Typho 
Typho 
Typho 
Typho 
Typho 


d  antibodies  transmitted  by  cow's  milk 92 

d,  anti,  educational  work 58 

d  "  carriers,"  discharge  from  hospital 56 

d  fever  cases  and  deaths  reported  (table) 60 

d  fever  deaths  (table) 98 

d  fever,  forcible  removal  of  certain  cases  instituted 56 

d  fever,  new  procedure 59 

d  fever  work  (table) 61 

d  fever,  reduction  in 26 

d  fever,  release  from  quarantine  requirements 56 

d  outbreak  traced  to  milk  supply 58 

d,  patients,  removal  authorized 20 


V 

Vaccinations   performed    (table) 61 

Vaccines   produced    (table) 91 

Vaccine  virus   work 92 

Venereal  disease  cases  admitted  to  Department  hospitals 11 

Venereal  disease  supervision,  activities  of  committee  on 59 

Violence,    deaths    from 1(X) 

W 

Water,  bottled,  analyzed  and  frauds  detected 44 

Water  samples  examined    (table) 93 

Water  supply,  sanitary  surveys  of 44 

Weeds,    noxious,    removed 43 

Whooping  cough  cases  and  deaths  reported   (table) 60 

Willard  Parker  Hospital  Medical  Board 16 

Wood  alcohol  poisoning,  study  of 57 


18U 


•vm 


