Biennial report 1929-1930 [1931]

STATE BOARD
of HEALTH
OFFICIAL BULLETIN
ON
BIENNIAL REPORT
STATE BOARD OF HEALTH 1929-1930
T. F. ABERCROMBIE. M. D.
COMMISSIONER OF HEALTH ATLANTA

al ,~~-;, -:~~---;~~~E ~~~;~D

i',. 0~!

\'fJ

of HEALTH

1~---~-
OFFICIAL

BULLETIN

ON

BIENNIAL REPORT

T. F. ABERCROMBIE. l\1. D.
COMMISSIONER OF HEALTH ATLANTA
l

STATE BOARD OF HEALTH

lkmbers

Robed F, Maddox, Atlanta:;__ -------------- --------------------------------- ----- Fifth District President

James H, tkDuffie, M,O,, Columbus -- ------------ --------- ----------------- ---- Fol.il"'th District Vioe-President
T, F, Abercrombie, r,I.O,, Atlanta ---------------------------------- ---------- -- ?Ex-Officio
Secretary

Walter R. Neal, Savannah----------------------------------------~-- -- ---First District

Arthur Q, Little, t',D,, Th001asvi lie -~- ------------------------------- ----------Secord Distriot

J, G, Dean, t.i, D,, Dawson----. -------. . ---"""'---------------------------- Third District

C, L. Ridley, til, D., Mlcon ----------- ----

Sixth Distr-ict

;q, C. Shamblin, M, 0, 1 Cartersvi lie----------- --~---------------------------- Seventh District D. M, Carter1 M. D., Ired i son ---------------~------------------------------------ Eighijl Oi str i ot J, G, \'li II iams, 0, D, S., Buford --------------------------~--- ----------------- Ninth District John A, Rhodes, M. D., Crawfordvi I le ---------------------------------~-----~---- Tenth District M. M, Parks, D. D. S,, Valdosta------------------------------------------------ Elsventh Oistriet

M. S, Brown, M. 0., Fort Valley ------------------------------------------------- Twelfth District M. L, Ougg;m, State Superintendent of Schools, Clayton -------~----------------- Ex-Officio
v. J. M, Sutton, 0,_ M State Veterinarian, Sylv'ilster ---~----~--~---- -----------Ex-Offici"

2

STATE BOARD OF HEALlH Personnel of Departmental Staff

T, F. Abercrombie, M. D,, -------------------- ---------------- Cemmissioner of Health and Secretary Director of Pub! ic Health Education

Joe P. Bowdoin, M, D., ------------------.--------------------Deputy Comnissioner of Health Director of 01 i ld Hygiene Dir~otor of Venereal Disease Control
Mi liard E. Winchester, t.,, 0., --------------------------------Director of County Health VJork
Thomas Fort Sellers -- ----- ---- ----------------~-----------Director of Laboratories

Butler Toombs-------------------------------------------------- Director of Vital Statistics

Lee Massey Clarkson -------------------------------------------- Director of Sanitary Engineering

INST ITUTI ONS

Marvin F, Haygood, M. D.,

--------------------------- ----Super inte,..nt, State Tubercu Ios is $anatorium at Alto

,loh,-, ;v, Oden, M. D., ----------- -------------------------------Superintendent, Training School for
Manta! Defectives at Gracewood

3

l
LETTER OF TRANSMITTAL

To His Excellency, Han. l. G. Hardman, The Governor of Georgia,
Dear Sir1

Atlanta, Georgia, June I, 1931,

have the honor to present to you the biemial report of the State Board of Health for the years 1929 and 1)')0.

You wi II note fran the detailed reports that the work of this department is increasing from ye.ar to year, The interest and cooperation manifested by the medical profession and the public during this period has been particularly gratifying. The eagar-ness with which the public is seeking health information and protective masures indicates that the fuhre of public health work in Georgia is very bright,
The repOI"ts of the divisions are set forth in the following order:
County Hea Ith Work laborat or ios Sanitary Engineering Child Hygiene Venerea I 0 iseascs Pub I ic Health Educat ion Vital Statistics State Tub::rculos is Sanatorium Training School for t.b'ltal Oefsctives

...--.---z.....~
T. F, Abercrorrbie, f.',O., Secretary, Georgia State Board of Health,
4

A TON AND A HALF OF TUBERCULOSIS PREVENTION

pi ture shows the ve hi le t hat is aking the long-a\aited message of tube ulosis prevention into our count ry dist ric ts . It started only l st Jovembe r but t he dema nd for it ha s g own be yond ou greatest expe t at ions .

The lowe

an inte i o

the t u k, fitted

up as an X-Ray

labo atory, where

minute examina

of ube ula us-

e t s a e made on

the spot . C. H.

1 Roberts , te hniian , is explaining

1

i t o D . T. '

'

Abe ombi.e , .State t.

Comm i ss i one of

He a lth .

COUNTY HEALTH WORK

DIVISION OF OOUNTY HEALTH WORK
M. E.. Winchester, M. D., Director
The growth f county health werk in Georgi a can be better lrlderstood when we
realize that cro January 1, 1919,. only six Oolllties were maintaining health organizaticros IX1der
the Ellis Health Law. These counties were Floyd, Glynn, Troup, Hart, Thomas, and Sumter. On
January I, 1931, thirty-two co1.11ties were operating full-time health units.
Considering IJhe lbl counties in the state, and that only 32 of these counties have full-time health units, it looks as if we \'Jere making slow progress, but in these 32 counties
47.12 per cent of the state's entire populatioo lives.
Otring 1929, three counties began operatioo of health un-its, Jenkins Clinch and Jefferson, besides the addition of Fultoo County te. the Atlanta City Department 11f Health
annexing the outlying districts making Greater Atlanta.
In 1929 two counties passed the first grand jury approvals of the Ellis Health
Law, !lwinnett and Hancock, and two counties, Screven and Terrell, passed the second grand jury
appr.va I ef the Ell is Health Law.
Five new health officers were secured for tho rew counties and for o01.11ties al-
ready operating who desired changes. Three counties added to their persomel by employing public
health nurses, viz, Bartow, Oeoatur and Coffee, and there was also a new nurse secured for Emanuel County. One county, Spalding, increased its personnel by adding a clerk.
Due to economic conditions and the discootinuitflOO of the Sheppard-Towner Fund
on June 30, 1330, Wayre and Worth Counties were forced to abandon health work. However, the
grand juries of both these counties rooormunded that the wor'K be reestablished as soon as ecooomic
32 conditions improved. During the last six months of tho year, counties wore ~ating health
units despite tho poor eccroomic conditions in most of them.
On Septoober I, l:JJO, the ~!Mnuel Co1.11ty health officer resigred and since the county conmi ss ionors decidod that the county was lXlable to finance the work, only a nurse was employed during the last three tnOnths of the year. lhe board of health and tho county convnission-
ws voted- that the WOI"k l,xt reiiUI!Iild ;~s soon~ efXII)OIIIiC oonditions improved. On Oecembcr 31 1 IJ30, Crisp Coll1ty abandoned the work, bringing the teltal nuniJer of COllltios lost dwing 13'30
up to fovr. With tlie oxceptim of Emanuel County, which was able to continue the work, all
thesa counties aro havin9 difficulty in financing the various county departments and payin0 the heavy bonded indebtedness for road and othor c01.11ty improvements~ As soon as economic conditions improve, however, these counties will reS\AOO work, as public health work in each of these counties has bbon sold to tho citizens and they are already demanding that the work be reestablished.
5

During 1930, the two necessary grand jll)' reconmendati ens fur the Ell is Health Law wer$ passed in Treutlen County. In Toombs, Pulaski, and Oooly, the first reCOIM:endation for the Ell is Health law was passed and each of these counties desire to form health districb, as they are un'!ble to finance a health department alene.
After a complete study of the state, it was decided that there are too many counties in the state with insufficient taxable property to justify the necessary appropriations for the establishment of health units. The only practical plan for the expansion of county health work in Georgia is to establish health districts permitting two or more small counties to share the expense of the SUjl-. port of one healtr unit. Therefore, a p1111'l has been worked out whereby the state may be divided into
35 60 health districts, and with an average appropriation of cents per capita, adequate health work
can be established in every county in the state,
Upon inwstiJation, it was fOl.nd that some of the counties operating with full-time health commissioners had not formally adopted rules and regulations governing thE. tlOMtrol of ctlnlRUlicable diseases as prescribed by the law , A minillll.lll standard for county boards of health was prepared, and furnished the county health officers,
Olring 1930, malaria conferences were held in Millen, Cordele, Camilla, Dublin, Fitzgerald, Sandersvi lie, and Cuthbert. At each of these meetings ~~Y.Jch interest was shown by the citizens and comty malaria control programs were plamed. During the year every oounty health unit in the mlaria belt began a quinine program and thus reduced considerably the price of quinine, This work, no ~oubt, caused a large number of individuals to take tho standard quinine treatroont thus reducing 411ater.ially the number of cases of malaria in the state.
Every teacher attending the 12 A. clo M. Sumner Schvols was given a physical examination dLring the summer sessions and health talk;; were made at each of these schools,
On June lj, 1330, an epidemic of s.;ptic sere throat occured in South Georgia, where mare
{han 75 cases were. found. Tho cause of this epi~~ic was tr&ced to a local dairy. Pro o;:>idemic of typhoid fever occurred on July 31, 1930, in a middle G~ia county. An investigation was made of
this epidemic and 12 cases found, The cause of this epidemri: was net determined, but no doubt the insanitary conditions in this community played an important part in the sprea~ of the disease.
During the month of July 1930 a few eases of typhoid fever were found in a South Gtlorgia county, and tho health officer from a neighboring county made the investigation, An epidemic of typhoid occur-red in a t'crth Georgia county at this time, also, the hoalth officer of an adjoining county making
th4t investica!im. An e;pid<Jmiaaf typhoid also occurred in a North Georgia county during July 1)30, the i.w~stig~t:an btin:J ~.adc by the h;alth officer there, A number of cases of undulant fever, diph-
theria, sGar:et fever, and ~f'lallpOI< were investigated during this yoar.
On September II, !9JO, an epidemic of malaria occurred in a North Georgia comty. This epidemic was caused by an incomplete drainage canal and more than 60 cases wore found.
In every epidemic occurrin;J in the state, an invostigation was made either by a hea-lth offioer or a menber of the State Board of Health, The usual investigations were made and

With the loss of two cm.nty hfJaHh departments in June 1930, and on0 in September 1730, it would seem thd the general health work in the state would show a decided decrease,
but, en tho ccntrary, tho statistical repcrt shows a larJc inCI'oase in almost ,;very important phase of hca Ith work over I ast year.
A program has boon worked out whGI'eby all th.;; counties in the state wi II be visit-
ed by members of the staff in their spare time in an effort to oP"ganize the county boards of health
in the counties not 1perating under the Ell is Health Law. Information has been prepared for these
counties that will assist themin protecting the health of their people until arrangements can be made for full-time health 11ork.
Asummarized report for the work accomplished in tho state for 1}29 and 1930
is included in the accompan) ing table.
RespecUu II y Submitted,
tv\.E.llilNU-~~ n., .t.:J
(M. [. Winc;hester, M. D.) DIRECTOR.
7

\>UM't'W"{T ur Wl.n'il1 nt.f\Lt-n Vf\1\ run 1nt::. oc.n.nvm c.a'lun~ ua..v1..n''--"-'' ..J', .,t..r"'l

EDUCATIONAL:

ACTIVITIES

Pub! ic rreet ings addressed Attendance School tal~s given Attendance Bulletins distributed Newspaper art i c lcs

COMMUNICABlE DISEASE CONTROL: Number new cases
Total nuaber visits Cases lf carriers isolated Contacts Quarantined

MATI:~Al, INFA~JT At.'O OliLD HYGIENE:
Prenatal Number new cases Home visits Office consultations Number midwives receiving 1st instr. Total number midwife instructions given NI.Ailbor midwiv(;s in col.llties Postnatal Number oow cases Number visits Infant and Preschool New preschoo I cases Vis its to preschool cases Group conferences with f!lOthers Office consultations with mothers
~
Number schools in col.lltics Number visits to schools Nunber chi Idran examined Number defective chi Idren Total number defects found Follow-up visits Nutritional Classes Cases attending Number weighed and measured l.k"Kkrrwe i rj1 t Gases improved
8

~RAND TOTAL FOR YEARS

I~

13}0

703

1,48}

48,133

80,216

3.546

6,~

147,018

241,015

127,336

110,024

1,286

1,304

l2 ..) ( l j
15,7)0 2,683 1,865

II ,514 24,340 5.116 2,314

3.533
II ,874
~.477
512 3,o6o I' 743
2,]08 12,533
7,036 14,833
904 5,671
353 5,483 104,163 54,604 88,017 24,665
tl, 197 20,617
1~~~~

3,805 16,178 7.913
217 3,234 1,017
2,537 14,117
7,048
13,3~
4,9(>4 8,170
359 14,550 !()(,, 773 56,')84 81,812 27,714
12,3')3 50,511
'~.9~44

;:;unmary ot Gounty Health \1ork for the Bionnium Ending December 31, 1130.
(cmhnu;:,d)

4. IM\iUNiZATIONS:
Completed antityphoid oaccinations 'three injections) Completed toxin-antitoxin treatments (throe injections) Protective antitoxin, cases Curative antitoxin, cases Antismallpox vaccinations (successful) Pers;.;ns ~iven e.ntirabic treatment (complete)
5. VENER,\l DISEASE CONffiOL
Suspects examined Number ne-.Y cases trcated Tota I number tn,a tmonts
6, I NTESW~AL PARf.S I TES'
Number of examinations N,_mber of cases hook~<orm found Number casos cth,.r intestinal parasites found Numbor comp Iobd trea trocnts
7 LIFE EXTENSIONr
Number of examinations
B. SANITATION CF FOOD SLJpPLI'S: Phys'cal exam. of food handlers and dairy employees lnsp.. ctions r:>f dairios and milk distributing places Cc.,s lLoercul in tr;sted Cc~s t.._sL: for abortus fovor Nuc,1b-Jr c~,.-c:sscs ccndcmnod Slaugh cur hou~os inspwcted Numtc;' C'ccassus approved Mcorl,;ts, : Jtuls, eating plaoos inspected o+.he~ i nsr,~ct! ons
9 W,URIA:
Pon<L and marshes dra inod Pond:: and marshes oi lud Pon~s '\fld m?.rshes .:!usted with Paris green Quin:n'J rJistributcd, grains Homes >creened

GRA:o TOTAL "OR YEARS

l J29

1)30

70,479

90,858

1;,sso

17,943

4:1

436

278

520

28,343

26,741

126

334

8,207 2,310 28,445

1],187
3,980 90.707

12,406 4,698
8,081

25,805 7,901
447 9,;J36

2,022

1,397

4,782 3,703 15,431
21,838 7558

II ,516 6,958 22,001
3,139 1,289 1,289 72,711 31,130 8,686

~~

331

3,8]5,417 yds

204

156 4,]20,160 ),481,548

647

333

9

J, OI..Wmlary or lloun y Healtn norK Tor t:ne -1ennu.m ~rx11ng ~cemOtlf

)JV

( cCiltinued)

GENERAL SAN I rATION : Inspect i ins of pr i vato premises Inspections schools and other pub I ic bui !dings
Inspect i c,ns of camps
Inspections of swi1m1ingpools Other inspections

GRANO TCTAL '"R YEARS

1929

1330

212,858

24o,2GI

2,158

1,595

220

448

288

344

22,470

3g,947

LASORAT~RY:
Specimens ex'll!lined
Specimens sent to State Laboratory
Milk samples examined Water samples examined l'iater samples sent to State Laboratory Others

66,542
3.2~7
8,473 1,387 1,312 14,585

87,633 15,225
II ,434
I ,595 1,466 43,262

SANITARY PRIVIES ltiSTALLED:
Concrete Vault (dry)
Water tight vault Box and Can Pit
Other types

9

5

2

2

224

35

3,248

990

65

12)

, PRIVIES RESTORED TC SANITARY TYP": Rural Urban

5JO

354

555

1,000

, SEPTIC TANKS INSTALLED: Rural Urban

304

131

76

';2

NEW 11ATER AND SHII:R CONNECT! ~S' Water Sewer

I ,964

1,266

1,976

I 1 Ill

, WELLS N\0 SPRINGS IM'ROVE01
Wells Springs

117

133

%

(4

FOOD HANDLING ESTABLISHMENTS:
Dairies improved Stores improved Eating places improved Other improvements

bll

728

6;6

647

414

551

361

711

10

SlA!mary of C01..nty Health 1'/crk for the Biennium Ending December 31, 1930, (continued)

GRM<D TOT .L FOR YEARS

18. CHILD HYSIENE:

1929

cl930

Infant and Preschool

Cases imprcvcd Defects corrected ~ Cases improved Defects corrected

I ,015 927
11,882 15,873

955 1,126
12,844 18,660

19, GENERAL SANITATICN:
Premises improved School improved Other pub I ic bui Iding improved Camps improved Swimming pools improved Nu isanccs abated Ordinances passed Convictions for violation of laws

16,057 258 219
71
62 ;, 737
21
63

17,847 2'/o 126
67
38 ),2.'fl
13 103

11

FULL-TILE cm.;r;TY HEr.LTH :;:>EP.n.RTMENTS 1930

-- . /
r-...... ~~_(

-~l'\-..

';

17

I
j\

\,---

,.- ......\..

/-

)

\ 16 .

\ \

\/ 'V"

',\,,_f_-.'I.

I. \:alker 2. Floyd ). Bartow 4., Hall
5 Cobb
6. ClarKe

7. OeKalb
8. Spalding
3 Richmond
I0. Troup II. Bald,in 12. 1"/ash ingtm

13, Jeffersm 14, Bibb 15. Jenkins 16. Laurens !],Sumter 18, Chatham
12

19. Dougherty 20. Coffee 21. !.1itchell 22, Colquitt
23. :!are
24. Glynn

25. Decatur
26, Grady
27. Thomas
28, 3rooks 2), Lowndes 30. Clinch

6ooo f-
5000

SCHOCL T.'.Li\S

~

~ 4000

0

0

25

"~ '

6

w

!if
:,.:;

g

<,_ 3000 -
~

a:
:;
~ z:

,23- 65

...24-0-0-

2000 r-

- 1000
0

1928
13

-
1930

COl!TI,lJlliCABLE DISEASE COHTROL

TOTAL NlJUR OF VISITS

1-

20000

-21100

'5 0

- 15000

en
I-

en

>

~

r:r

lJ_O
~

.E!1.!...

=z:>

10000 -

I
I I

5000 j; I
~il i
iI 0 I

-lj28
14

-
24 40
1930

SPECHIENS SENT TO ST~.TE LABOR.i.TORY

20,000

- 15,000

r-

10,000 1-
"!11'
u
LL'
&,

15

a:

If!

- z~ :

5,000

.....--

0
1927

.--
-
1928

-
1930

15

.,
- 4,000

48

! 3,000 1-

~

~ ;fZ:

~

~,...
!

2,000 ~

i
0

ffi CD ~

1,000 ~

1514
~

-
-
-115-5 -

1928

1929

1930

16

~------------------HOOKuORlvl TRE.c~.TlVIENTS

10,000

8,000

~

C5

6248

~ ..:c
~

6,ooo -

I.U 1-
~


!:'
~
2: 4,000 ~

9j13
~
-8081

____;,;;
-

-
~".
0
1927

-

1929

1930

TOXIN-.aNTI TO~(IN

25,000

. 2100:1 ' . I_ _;_

I'I!- 20,000 i :1

~

~I I I

zw ~
<[
a.U...:J.

II I

r~ 15,000

I I

-

l

X
.0.... ;:I:
~

hI
~I I I

.w....
w
..J
8
0
0w::

f. I'

~

10,000

:< ~~--

1I
\

I
i
!
I

rD
::::E:z>

~ I l1') I
l! I

~- Iil

5,000

I

It I

li I

Jj
~
'i~

j I
i

L0 i-. - ..

l'l2/

-2049;.:.'
1928

. . ..
- -158BO


-
17948
r----.
-

-

-

1929

1~0

18

TY:E-HOID V.b.CCIN.'"TIONS

- 100,000

80,000 i-

(/)

t5

;::
<C

69559

!!':

,.-

(..)

~

>

9
0
~

6o,ooo 1-

1-
:f

~

UJ

~

i

- 40,000

z

20,000
""

b')]bo
,-

70578
,...;-__

~
-90873
-
-

-

...

0

1927

1928

1930

19

l
1\iiATRrlN.B.L, INFANT .h.ND CHILD HYGIENE
PRENATAl HOME VISITS

20,000

15,000 1-
~
:">'
~
C)
:I:
15 ffi 10,000 f-
~
-7265-
5, ~00 1-

.--1:2-7=9-4-

16178 r--
~
-

0

I'Jt!-/

!J&

I

I0

20

LABORATORIES

DIVISION 0~ LABORATORIES T. F. Sellers, Director

Submitted herewith is the oonsel idated report for the years 1929 and 1930 of the division of Laboratories:

Specimens examined in Bacteriological Laboratory

T~rculosis

1929

Total

2,36&

Positive

488

Diphtheria

Total

919

Positive

103

rlidal tests for Typhoid (Dried specimens)

Total

873

Positive

160

Agglutination Reactim (Liquid specimens)

Total

2,003

Positive for Tjphoid

816

Paratyphoid

64

Sri IJls disease

97

Undulant Fever

29

Tularemia

59

Blood Cultures

Total

1,942

Positives- total

187

Typhoid

175

Paratyphoid

3

Undulant

6

Other Organisms

3

Stool and Urine Cultures

Total

467

Posilives - total

44

Typhoid

30

Paratyphoid

I

Dysentery

13

Other Organisms

0

Gtnocoocus Total

1;615

Positive

364

Malaria

Total

3,228

Positive

486

Intestinal Parasites

Total Positive

II 1 172 3.720

21

1930 2,623
485
1,268 185
631 144
2,950 I, 133
202 244
40
58
2,569 333
322
4 4 3
636
41
33 I 6
1,705
415
4,527
392
13,098 4,298

Rabies Total Positive
Miscellaneous Tota I for year Wassermam tests
Total Positive

Specimens examined in Bacteriological LaboratQf"y (continued) 1~29
656
290 457 25,]60
36,768
],622

1~0
1,072 515
4~7
31,576
4~.328
10,.803

The foil O'ling table canpares the growth of the laboratory work during the past

five years1
Bacteriological specimens Wassermann tests 1'/ater analysis Total

1~26
15,370 26,307 6,608 48,285

1927 15,]50 31,376 Z,12Q 54,316

1928 19,195 32,760 81 122 60,107

192~
25.760 36,768 8,}22 70,%

1~30
31,576
4~,328
~.042 8M4~

Our ing 19)0 there was an increase of 23.2 percent over 1;2~. For the two year ~riod of 1929-1930 the increase over the preceeding two years was 40 percent.

There is considerble variation in the amou1t of work required for each type of specimen. Certain specimens arc subjected to a number nf separate tests Vlhich are called procedures. For example--the average specimen to be examined for diphtheria requires two procedures, while a specimen .,f I iquid blood requires about five procedures in examining the serum fraction and four for Gxamining the clot fraction which, incidentally, is regarded as a separate specimen. If the 11assermam test is also desired, ~ portion of th& serum is rsferred to th~ flas;;;ermam Laboratory and is also Col.1ted as a separate specimen. As shOI\f\ by the following table, the total number of procedures for 192~
is 242,222 and for 1930 311,117, or an average of 3.4 procedures per specimen.

Types of specimen

Number of procedures per specimc.n

Tuberculosis Diphtheria ~~ida! s A99lutinations Blood Cultures Stool and Urine fultures Gonococcus Malaria Intestinal Parasites Rabies Miscellaneous Wassermann Ylater
Tota 1 number os procedures
Average number of procedures per specimen

2 2 2 5 4 3
2
2 3 3
4
3.4
22

Number of procedure~ for eaoh

type of specimen

1929

1930

4, 736

5,246

1,838

2,536

I, 746

1,262

10,015

14,750

7,768

10,276

1,401

1,900

1,675 6,456 22,344

I' ](Jj
~.054
27, 1}6

1,%8

3,201

1,371

I ,491

lt,7,0?2

137,312

__31,32

36,180

242,222

311,117

SPUTLt.l EXAMINATIONS

The following table compares the sputum examinatim results in the past five

years:
Number specimens examined Number pes i t i ve Percenta8e positive

1~26

1~7

1928

1929

1930 Average

2,074

2,208

2,261

2,325 2,556

2,712

436

459

463

484

482

465

21.0

20.7

20.4

20.8

18.8

20.3

EXAMINATICt-! OF C~U!I:-l FOR DIPHTHERIA

Diagnosis Release from quarantine Detecticn of carrier Vir,lence test Total

1929

T~tal Positive

753

83

93

18

43

0

4

2

919

103

1930

Total Positive

823

123

170

46

235

10

II

6

1,268

18)

While there was a slight increase in the number of positive diagnostic cultures during 1330, the general trend is downward, as indi~ted by the following table1

1926 Positive diagnostic cuttures

317

1927 Positive diagnostic cultures

219

1928 Positive dia!1'ostic cultures

182

1)29 Positive dia!1'ostic cultures

83

1930 Positive diagnostic cultures

123

SEROLOGICAL AGGL"TINATION REACTIONS (Liquid Ellood)
This work is steadily increasing. 2,350 liquid blood specimens were handled in 1930, as compared with 2,003 during 1929. The new blood specimen blank enclosed in every keidel tube
outfit is so arranged that the physician can easily indicate such special tests as he may desire. This no doubt was an important factor in the increase above indicated.

An analysis of the positive agglutination tests shows the following:

1929

Typhoid and Paratyphoid

880

Bri II Is {Typhus)

97

l.Odu Iant fever

29

Tularemia

59

1930
1,335
244
40
58

TYPHOID AND PARAffPHO!O

Since previous vaccination, or a previous attack of typhoid or paratyphoid fever, or certain "ther septic ccnditions wi II produce typhoid and paratyphold agglutinins in the blood, the above figu-es are not indicative of the actual number of cases involved, The above tabulation also includes a number of dupl icatior,s.
23

u arem1a 1s sprea
rabbits. There were 19 cases reported in January 1930. It is possible that the sn'ws in December and
Januvy which greatly faci I itate the ki II inJ of rabbits had something to do with this sudden increase. Since then as average of two to three cases monthly have been reported.

Bl"00 CULTURES

Number positive for B. typhosus
Number positive for B. paratyphosus
Number positive for Br. abortus Number positive for other organisms

1929

1930

175

322

3

4

6

4

3

3

Note that 322 were positive for typhoid in 1930, but only four- for paratyphoid.
This shows very well the r~lative incidence of these two infections in Geor;ia. Vital statistics for
the year will also show that typhoid fever increased during 1930, thus accounting for the increase in
positive blood cultures.

STOOL Af'.ll URINE Clll TlJRES
Number positive for B. Typhosus Number positive for B. paratyphosus
Number positive for B. dysentery
Number posit ive for other or~an isms

1929

1930

30

33

I

1

13

6

0

Five typhoid carriers were located by stool cultures. Two of these give a history of previous positive cultures. One had typhoid four years previously, l'lhi IG the oth.;r, a woman thirty years old, had typhoid during childhood. The carrier is a great pub! ic health menace and it is pr.,bable that a large majority of all typhoid cases criginate from such.

MALARIA

The following table shows the positive malaria for the past five years:

1926

1927

1928

1929

1930

130

163

281

486

392

Worms for Identification Hookworm Dwarf tape worm Round worm Pin worm l'l~;p worm Amoob ic dysentery F is,, h!1e worm R, ~ tape worm Nd included in above Total

INTESTINAL PARASIT"S Single Infestation
25

1929 6
3t364 99 90 28
8
6
0
2
2
3,605

1930 6
4,019 107
50
18 14
15
I
0
2
4,232

DOUBLE INFESTATION (Two kinds of worms in same patient)
Hookworm and dwarf tape ~rm Hookworm and pin worm Hookworm and whip worm Hook~orm an:! round worm Hookworm and rat tape warm
Round worm an:! dwart tape worm
Round worm and whip worm Total
TRIPLE INFESTATION (Three kinds of worms in same patient) Hookworm, dwarf tap~ warm and round worm Hookworm, whip worm and round worm Hookworm, round worm and p in worm Hookworm, dwarf tape worm and whip worm Hookworm, dwarf tape worm and rat tape worm
Tota I hookworm Total dwarf tape.worm Total round worm Total pin worm Total whip worm Total amoe<Jic dysentery Total rat tape worm Total fish tape worm
MISCELLANEOilS EXAMINATIONS
Oark fiold Urines (bacteriolo:~ical) Differential blood counts Vincent's angina {hancro id B. Ducrey MisceHaneous . cultures Type of organism Spinal fluids for meningitis Unclassified Total

192~
45
10
5
47
0 2 0
to~
2
3,477
14~
142
39 16 6 3
0
19 70 53
122
3
21
103
20
46 457

1930 35 5 5
14
3
0 2
I
I
0 0 0
4,083 143 66 23
22
15 3
f
I
25 76 71 94
22 2
80
55 72

2G

1 ------------------------- ----------
ANIMAL HEADS EXAMI"'EO FOR RABtr.s

Number heads examined Number positive Percentage positive

1926

1)27

1928

1929

mo

825

1'29

621

652 1,050

353

262

210

289

507

42.7

359

33.8

44.3

48.2

Kind of lonimal Total

CLASSIFICATION OF ~IMAL HUllS EXAMINED FOR RABIES

1929

Dog

258

Cat

24

Cow

6

Hog

0

Horse

I

~9

Positive
1')30 45~
29
16 2
I
507

Year
1')26 1927 1928 1929 1930

Human
1,852
I' 723
I ,260 1,474 2,466

IMNUFACTURE Af'il DISlR I BJTION OF ANTIRABIC TREATMENTS

klima!

Total

Hc.man deaths from rabies during or -after treat-
ment

310

2,162

2

233

1,')56

2

212

1,472

2

168

1,642

I

196

2,662

2

Canine Vaccine distributed

1929

1930

201

866

As indicated by the above tables, rabies increased greatly during 19)0. Positive
animal brain examination$ increased from 289 in 1929 to 507 in 1930, a rise of 75 percent. This is
the largest n1..111ber since 1)24 Vlh ich showed 509 positives.
Antirabic treatments increased from 1,474 in 1929 to 2,566 in 1930, a ~fse of 67 per~
cent. The increase in the Statll at large was not so marked as in Fulton Co~X~ty and ccntiJUOUS co\%1tles, 1,038 treatments were distributed to Fulton Cot.nty, including Atlanta, This is 42 percent
of the total for the State. Also 50 percent of the positive animal heads were from Fulton County,
In Marc:h and Apri I the situation became so bad in Fult'ln CoU'ity that the City Comcil of Atlanta and the County Board of Health passed ordinances requiring inoculation of all dogs. These laws went into effect in June, During the last six months the incidence of rabies in animal$ gradually subsided, as did .also the demand for treatment. Just how much effect vaccination of dogs had in bringing about the decline it is hard to determine Even l'lithout ,interference rabies tut-
breadks usually decline after a few months, Fl.t'thermore, enly a small rJ~rticn of the total dog

27

... --~----------
population was inoculated. The laws are not enforced; in fact, neither the City and Cot.tlt)' authorities, nor the people have shown very much interest lately.

There were three cases of human rabies during 1929 and five in I:JJO. Two of the three
1929 cases were not treatEd, One of these cases was remarkable in that the patient claims that he
was not bitten. Ab ut three weeks before the onset of the disease he treated a dog which dies supposedly of rabies, Evidently the bite, if any, was ve y slight, or he ma) have gotten sal iva into an open abrasion. \ihi le we are accustomed to regard exposure .,f this kind as possibly dangerous, this is the first instance in mr ex~erience of infection resulting from other than an actual bite of the infected animal, The other untreated case was in the person of a negro boy whose father had gotten the treatment for him, but in spite of our instructions to carry the treatment to the hospital for adminIstration, took it home and applied it dti ly direct to the wound with a rag poultice. The treated Case received prompt mild treatment for an ordin~/ puncture wound on the wrist, Intensive treatment was not indicated, Twenty-six days after treatment was begt.n the first symptoms appeared, The treatment was completed, except for the omission of the fifteenth dose, four days before symptoms began.

Three of the five 1)30 cases did not take treatment. Two children developed rabies d..ring treatment. Both were severely bitten about the face, In both cases the attending physician failed to notify the laboratory regarding the location and severity of the wounds until several days after ordinary mild treatment was be~-JUI1

One typical case of treatment paralysis was studied. The patient recovered completely after ruming a severe course. Another case of doubtful diagnosis was reported1 but the evidence pointing to treatment paralysis is too weak to warrant further cansideraticn,

In 1329 a new form of treatment was instituted to take care if severe laceraticns about
the face, This treatment was inspired by the failure of the intensive treatment to protect two children in 1)28 who werebadly bi~n around the mouth. It consists of three injections daily of material of increasing strength continue~ for fifteen days, then fallowed by six daily injections of the usual strength, It i~ called dras:i, treatment, Q,.ring 1929, nine cases were so treated and all were successful. ln1930, ten were so treated. (he of these did nQt begin drastic treatment unti I several days after being bi Hen, This case died,

No untoward reactions have been reported from drastic treatment and we are confident that it is justified and that in several instances it saved I ives.

TYPHOID VACCINE Typhoid vaccine distributed 1926 Typhoid vaccine distributed 1927 Typhoid vaccine distributed 1928 Typhoid vaccine distributed 1929 Typha id vaccine distributed 1330

243,629 c. c. 348,135 c. c. 320,705 c. c. 317,802 c. c.
39(),645 o. c.

The increase in demand for typhoid vaccine during 1)30 was in keeping with the increas-
ed incidence of typhoid fever.

A ~tudy of a number of cases of typhoid fever in persons who had previously been vac cinated seems to indicate that ~accine cannot be rei ied upon to protect people who have opporhnity

to ingest massive doses of virulent typhoid bacilli. Data on sueh cases is buing accumulated and the study will be continued.

l.hfortlrlately three injections of typhoid vaccine, oven if properly administered, wi II not produce adequate irrrnlrlity in every instance. A considura.)lc portion of the porulation has at SOIOO time boen inoculated, hence the number of reports of unsuccessful vaccination has ooruespondingly increased. A study of these apparent fai li..res is now being made. The majm.. ity of the Colrlty health officers have reported no cases of typhoid among tho vaccinated, but somo have reported from one to as many as n inc.

belowt

The distribution of vaccin0 to health officers both county ard municipal is tabulated

TYPHCIO VACCINE DISTRIBUTED TO COUNTY HEALTH OF~ICERS

County Baldwin Bartow Bibb Brooks Chatham Clarl<e Clinch Cobb Coffee Colquitt Crisp DecattiOeKalb Dougherty Emanuel Floyd Glynn Grady Hall Jefferson Jenkins Laurens LO'M'ldeS Mitchell Richmond Spalding Sunter Thomas Troup Walker

Total Number c. c. distributed during

1~29

1930

I, 100

3.900

6,635

5,000

~.5~9

6,270

2,?00

3,166

3,100

5.100

763

9,900

2,~40

1,430

7.140

10,822

6oo

7,400

3,500

5,610

4,200

6,300

7.1~ 1,~0

2,167 2, ]62

800

2,000

5,250 6,452

9,263 ~.316

2j 100

1,120

330

4,000

3,515

6,942

3,042

5,520

6,600

8,014

8,100

2,000

3,000

7,50~

2,500

6,165 4,118

5,v55 4,022

2,000

4,800

4,830

4, 742

~.500

5,452

4,~00

8,150

29

Colllty 'Hare ~!ash in,:;ton !layne la-th City of Atlanta City of Coh.mbus Total

Typhoid Vaccine Distributed to Colllty Health Officers

(cuntinued)

Tot~l Number c.c. distributed during

1929

1~0

4,275

4,400

3.150

II ,550

4.755
?,Ot'O
1.,895 Bz3Z2 153,846

1,350 5,000 3,240 2,000 17 ),201

DIPHTHERIA ANTITOXIN
1926 Nunber mits diphtheria antitoxin distributed
Ni.mber mits diphtheria antitoxin distributed 1927 ~i.mber units diphtheria antitoxin distributed '1928 Nunber units diphtheria antitoxin di str i:Juted 1929 Nunber lllits diphtheria antitoxin distributed 1930

57,296,000 49,334,000 35,3)3,000 3o,6;J6,ooo 29,924,000

The demand for diphtheria antitoxin was slightly under that for 1;129, and is the lowest since 1)20. Incidentally the diphtheria mortality rate for 1930 is 4.6 per 100,000 popt.>lation1 as compared with 6.3 for 1~9. Thus both the death rate and the demand for antitoxin indicate that dip-
htheria is steadily dec I ining,

!926 Toxin-antitoxin dlstri'1uted
Toxin-antitoxin distributed 1927 Toxin-antitoxin distributed 1928 Toxin antitoxin distributed 1929
Toxin-antitoxin distributed 1)30

TOXIN-ANTITOXIN

76,555 c.c. 72,392 c.c. 39.710 c.c. 104,768 c.c. 49,074 c.c.

The demand for toxin-antitoxin was considerably less during 1930 as compared with 1929.
This is partly due to the dedrea~d incidence of diphtheria, and partly to the campaign of free dis-.
tribution. The above table refers only to antitoxin sold at 3oard of Health price, In additicn,
33,050 doses were distributed free, making a grand total of 84,124 doses in 19)0~ There was no campaign of free distribution in 1929.

The advantages of toxoid over toxin-antitoxin have been satishctori ly demonstrated and we are now recomtnending its use in place of toxin -antitoxin,

The advantages of toxoid are:
I. Two doses of toxoid will immmize 90 porce11t of those rbcoivl,..g it, while throo doses of toxinantitoxin will immunize only 75 percent.
2. Toxoid contains no animal scrLI!I and will not prorJucs sensitization,
3 Toxoid produces ifmlunity 111\.Jch m.cre qc.ickly than toxin-antitoxin,
4, The cost per immmiz.. ticn of toxoid is less than that fer txifl!"antitoxin.

SQiiCK MATERIAL

Schlck material distributed 1326 Schick material distributed 1327 Schick material 4listributed 1328 Schick material distributed 132~
Schick materia I distributed 1930

7,650 tests 7,300 tests
7,840 tests II ,400 te:sts 13,490 tests

SMALLPOX VACCINE POINTS Smallpox vaccine points distributed 1~26 Smallpox vaccine points distributed 1927 Sma II pox vaccine points distr iouted 1928 Smallpox vaccine points distributed 1929
Sm~llpox vaccine points distributed 1930

54,820
73.198
32,400 2?,160
27,710

SILVER NITRATE AMPULES Silver nitrate ampules distributed 1~26 Silver nitrate ampules distributed 1927
SilvGr nitrate ampules distributed 1328 Silver nitrate ampules distributed 1929
Silver nitrate ampules distributed 1930

23,345
26,890
34, 79
41,883
3),767

1326 Tetanus antitoxin distributed
Tetanus antitoxin distributed 1927
Tetanus anti toxin d istr i0uted 1928
Tetanus antitoxin distributed 1929
Tetanus anti tax in distributed 17.30

T.rANUS ANTITOXIN

739,000 units 1,411,000 units
713,000 units 2,562,000 units
2,8M,OOO units

CARBON TETRAOiLORIDE-OiENOPOOILt.l MIXTURE

Carbon tetrachloride mixture distributed 1926 Carbon tetrach I or ide mixture distributed I)27

16,500 c,c, I ~,485 c.c.

Carbon tetrach Ior ide IIi xture distributed 1928 Carbon tetrachloride mixture distributed 1929

II ,685 c.c. 21,280 c.c.

Carbon tetrachloride mixture distributed 1930

23,230 c.c.

Scar let fiJVer antitoxin distributed Scarlet fever antitoxin distributed Scarlet fever antitoxin distributed Scarlet fever antitoxin distributed Scar let fever antitoxin distributed

SCARLET FEVER ANTITOXIN
1926
1927
1928 1929
1930

88,000 units
135,500 units
67,500 units
432,500 units
193,000 Lnits

WASSERMANN DEPARTMENT

Unti I more technical assistance can be provided, it is recCl!TITlWded that the present policy regarding the Kahn precipitation test for syphilis be continued- namdy, that the :~assermann
test be the efficial test and the the Kahn test be made only upon request. During 1930 there r.ere
31

8,637 Kahn tests made in addition to 49,328 assennann tests!
C(JJCLUS ION The constantly increasing demand on the laboratories for service is a :Jood indication that the physicians and people of the State value very hidhly this phase of public health wcrk. The api I ity to take care of the increased demands is largely due to the efficiency and loyalty of the personnel and to tho fine spirit of cooperation coming from th,, vario s oth(,r divisions of the State
Board of Health, end especially from our Chief, Dr. T. F. Abercrcmbi~ and from GoVL~nor Hardman.
'"'"~..)~~'L.--v--"Q
( T. F. Sellers) Director
32

SANITARY ENGINEERING

Engineering'

----~-- ---------~----~----------
Sl'TIT:'BY -r:~r UTT"~T)VTG

L. ].~. Cl ~rkson, Director

\ ....

The followihg items represent service rendere: by the Division ff Sanitary

Pub! ic and semi-pub! ic water supplies; Cooperative work with the \.hi ted States Pub I ic Health Service on Interstate
carrier water supplies; Domestic water supplies: Swimning Pool Sanitation; Sewage and industrial waste disposal; Privies and home sewage disposal; Malaria contra I; Rural school sanitation; Genera I sanitary scrvoys; Emergency sanitary work.

It wi II be noted that the above items of service may be classified under urban
and rural. In rendering such service, we must consider the fact that the 1330 census shows that a
majority of the total inhabitants of the state I ive on farms and in unincorporah;d towns and villages.
It is also true that populaticns without tho faci I itics of municipal governments and sanitary regula-
tions are in conside,-a lo need of assistance to improve sanitary onvironments,

RURAL '.CORK STRESSED- -Although recog"lizc;d as the 1110st difficult problem, the objective of the division has been to increase each year assistance to the rurc.l population, which is considerably more than the urban.

In counties with health officers, the problem is less difficult than in colllties without organiz~;d r1ealth work, Rural inhabi ants, or persons I iving on farms or in ~solatcd commlrlities generally suffer m.,st from insanitary conditions and are in nc;ed of sanitation, Consequently, as much assistance as possibl& Is being rendered tho rural inhabitants, especially through malaria control, domestic water supplies, privies, home and school sanitation and other strictly rural sanitary necessities, with the object in view that eventually such rur<tl service may proccod in lrliformity with the now more highly developed service rt.--ndered those I iving in tov.ns and citivs through municipal administrations.

Protection of public water supplies, proper tredment and disposal of sewage and general municipal sanitation represents a service which is progress in~ vary satisfactJri ly. Rural sanitation, especially privy construction, so necessary for the rural homes, cannot proceed as it should U'lti I oounty health Lnits include sanitary personnel, thus making avai Iable proper fi&ld contacts for this division.

DIFFICULTIES OF CONTACT---In counties having hualth officers, the rocotm~enda tions usually are made jointly by the health officer and the divisim representativo. In rural se.ctims of cOU'lties having no organized health units, it is necessary to contact the individual family in matters relating to home sanitation. These contacts must be largdy by corrcspondt;nce following inquiry for assistanoo on some particular home sanitation probtem.

33

SUPERVISION I!F POOUC '':ATER SUPPLIES---For the purpose of considering pub I ic water supply, the topography and geology "f the state naturnlly divide it into two separate arca:u

SOUTH GEORGIA WATER SUPPLIES: The Southern half of the state lying in the coastal plain is underlaid with strata bearing water in satisfactory quantity, Deep wells furnish water to all municipal suppl ios in this section of tho state, and the water is generally satisfactory in bacteriological quality, A good many exceptions oxis to this general condition due to fissures and sub-st.rface channels, Sov<:.ral supplies have wells t1ith defective casings and top S<-als, Anumber of pervious brick storage reservoirs built below tho ground surface receive water from deep wells. The pervious conditioo of reservoir sidewalls and bottoms permits entrance of surface water. The work of replacing those wells with defects and loaky reservoirs nocessari ly wi II require a loog time,

Continuous chlorination provides the only practical sanitary safeguard on

these suppl i<:.s1 but has the disadvantage of being dependent to a large extent upon the persa10l ele- 1

ment.

I

NORTH GEORGIA fiATER SUPPLI~Sr In the Northern half of the state, the great majority of the mlllicipal population depends up01 fi ltercd surface stn;am supplies. l'.'ell over half of the state's l.f"ban population having water from public supplies dopond upon riv<.rs, creeks, and storage basins on small streams. A fov1 large springs in tho northwest oorner of the state have ade-
quate flows to supply several towns and industrial villages,

"!ATURE OF PROOLEM--Even with tho proper mechanical equipment and structures,
the maintenance of tho safety of a public watur supply is oro of constant vigilance on the part of
those In loca I control. .lmoog such a large group of suppl ics, there are many persons ~o arc not train.;d for the specific work involved.

The rate of depreciation of certain types of purification equipnent is high and dangers due to obsolescence arc constantly mounting, It is, therefore, apparent that this division's efforts must be directed, not only to promoting initial improv001ents, but in bettor operation of purification equipment already installed and replacing worn-out and obsolete material,

The problem of instructing in wator purification is campi icated by the chemical and bacteriologic~! prinicplcs involved and the fact that many of those locally respoosible for the safety of the public water supply aro not technically trained,

TRAINING OF PLANT OPERATORS, LAB<JlATORY A.rf) RF'O <TS---To moot th<- require100t1ts fer instrvcting in the e.lemcnts of water purification, tho divisi01 has undertaken to teach local personnel by having a representative stay at tho water plant as long as nocossary to demonstrate the use of tho plant c01trol laboratory and to apply the bst rosults to tho daily operation of tho plant.

i.'hen this work was started about the bcgiming of this biennium, ooly two cities.--the largest and the fifth largest in tho state--werEJ using a plant laboratory for c01trol of tho
purification process, Sinco the instructional service has been made avai Iable, nino additional fi Itor-
ad supplies have provided the laboratory equipment and taken advantage of thEJ increased efficie-ncy and safety resulting from an application of basic principks superseding the uncertain ''rule of thumb11

A simple, yet detailed, report form has boon prepared upon which is kept a com-
34

pleto record )f each day's physical, chemical and bacteriologicat tests made by thu plant operator.
lhcso reports are submitted to this divisiQn vach month ~nd ar~ equivalent to daily contact with oach plant so controlled. It has been d~~onstrated that this r~liablo typv of filter pl1nt control can be
aFJpl ied in the smallest as well as the largest towns. The II fi Iter plants now controlled by local laboratorivs represent each major type of or ,ani zed community in the. state serv0d by a conmon water supply. In the I ist ar(; municipal, industrial vi llagc and pub! ic institution watc.r suppl ios, Tho population served by those II laboratory controlled filter plants is 36~,577.
PLAIH IMI"ROVEMENTS- -Majer improve;munts had boon completed on 30 wah,-r supplies at the end of 1930. Nineteen of tbose were improved in 1923 and the rumaindor in 1930. The pop-
ulation of this group of towns is !87,550. The 30 maJor improvements included soven now filter plants, 14 chlorinators on deop wei Is and springs in towns not previously supplying stori I izod water, c.ij1t old chlorinator plants replaced with new units and ono installation of a largo cast ircn main tor<..place a leaky underground brick gravity conduit. Ono new filtration plant replacing an obsolete plant
was under construction at the end of 1930.
INTERSTATE CARRIER WATER SUPERVISION---All field inspections, laboratory and clerical work for the United States Pub! ic H,.,lth Service, certification of drinking water on vossds and rai !way trrain coaches is done by tho division. During 1~9 fifty-six suppl ios wore usod on jntcr state carriers for dr-inking and cui inary purposes. As a result of inspoctions and bactcri()logical ro.. cords of those; suppl ics, 45 rc.cEJived favorable certification. Pending improvements, under way or cont~plated, permitted seven provisional C<;rtificates. Four supplies received prohibitory cortitlcati~o
At the beginning of 1330, the surgeon-genoral of the U. s. Pub! ic Heiilth Ser-
vice enunciated the pol icy of withholding full favorablu certification from supplies permitting tr~ap proved cross-connections with nonpotablo sourc~s or by-passes around purification plants. Tho estab1ishmont of this definite pol icy required intensive work in se~~eral cities to permit full certification.
Accordingly, thosE> having such cross-connections wore nd if iod and two ci tics el iminatod dan,urous connections ,:ith cotton mit! ponds by instal I ing approved safety devices. Two
cities eliminated by-passes around their fi Itor plants. Of the 53 supplies used on interstate car-
riers for drinking purposes, 44 received favorable, eight provisional and one prohibitory c<..rtifica.ion.
DOISTIC \lATER SUPPLf!?S---Approximately 65 purc(flt of the population of the
state during tho biennium took drinking and domestic wat()r from private h01rostoad suppti<,s. Shallow wells and springs are th& chief sources. In 192~ bacteriological analyses wer0 made on 744 sample$
%a as compared with sampks in 1930. Ro arts of N.boratory findings, together with spuciHr,recom-
mendations for improvements based on tho oM16r 1s description, were mailed on each of tho samp,c,s
This contact serves more than the single purpose of a bacteriologicc"l are.lysis. In renclering this servic<- to the; rural rusidunt, a qucstionnair<- is sent requiring not onl1 a full description of thL water supply but also dutai Is of privy or sewage disposal faci I ities. This serves as secondary to a fiold inspection and results in furnishing of propor recommendations in le\ter and in bulletin form for a sanitary homestead.
PRIVIES Aij) HOI/ SE~:I,GE DisPOSAL---1\'hf.ll'lover county personnel is avai lablo urder organized county health work, this division coopbr'atLs in promotion of privy construction and
35

hano sewage disposal. tlowovc..r, such county personnel is so I imited that an opportunity is not afforded to rendor tho service due the public a'l this typo of work. PrD11isi01 of such co~..nty personnel is urgently needed and is noccssi'.ry in order thd state-wide sanitation may prooced ~s it should.
Recently, due to addec person111.-l to this divisicn, ccntact is being m~de, ith t<l'ms and cities in an effort to promote this type of sanitation. Thoro is, however, an urgc;nt need for sanitary personnel in counties to special izo on this work which wculd result in more adequate service to th~ rurcl inhabit~nts.
SVII!.tt.lr-JG POCL SANI ~ATI'''- -Tho need for impro ed swinming peal sanitation has boon md tnrou;,h contact with municip<'-1 itios and org.c.nizations during tho stage of planning tho pool prior to construction. By ro;;vic,ing and a;proving submitted swimming peal plcns, many improvements in design md public hoc:Jth and comfort protective devices have been secured. Tho division has bam able to suggest ways for the improvement of operation of sew,ro.l old peels not properly constructed or equipped.
SEWERAGE Ai<D SE:'AGE DIS OSAL---Tho division's primary interest in stream pollution improvomcnt through treatment of domestic ~nd industrial sewage is due to the effect upon existing publ ie wcter suppl ics and future demands upon stre<:ms for water supply purposes. Secondary interests include elimination of local nuisance conditions and impaired recreational use of streams be-
cause of excess i vo sewage carriage.
Progress in meeting existing stream pollution probkms is retarded by lack of specific legislation and statutory limitations to municip.}l improvement financing. Inability to plan for future growth and expansion of disposal plants results from the pol icy of financing permanent improvelllJOts by current r ov!)nuc. This makes frequent abandonment of cost Iy structures necessary and induces poor operation during tho temporary I ife of tho phnt. Eleven sowage disposal plants bui It during 132~ received the approval of the division.
A survey of all the sewerage systems in Georgia was undertaken in 1;30, The survey of each town gives information which is v"ry important in guidinJ the future wcrk in sanitation. While the survey is only partially completed, it shows clearly that in a largo lkJmber of towns having sewerage systems, only a relatively small m.mber of houses adjacent to the sewers are connected.
In these towns, sanitar} protection hc.s bocn providodat considerable pub I ic expense but is not accepte<l by many adjacent property holders. It is in these. towns that permanent sanitation can be accommodated most economical! y. Tho pr()ssing nood for extending sewer I inos into t.l'lsewerod sections of many towns is rovcded by the survey. The routine inspection of se;wage disposal plants, together with special investigations of certain proposed now proj<;cts, have 'been carried on.
RURAL S0100l St.NITI\TION- --This probk.m is one of combined sanitary and educational importance. Tho;; consolidation of rural schools has led to rapid ~struction of larger school buildings and larger school pop'.,lations. The larger schools have indoor toilets requiring water supply ll'lder pressure and safo se11age dispos;l plants. A number of school architects have been contacted with the; result that thuy submit plans for school sewage disposal plants before construction begins. In counties having Health Officers thG rural schools are in general w11 equipped with sanitary privies where indoor toilet facilities are not available.
36

GENERAL SANITARY SURVEYs---General sanitary sl.ir.eys of mLOieipal ities contemplat!ing sanitary imf:t"ovements or proposed industrial vi II age sites are made, R6ports and "ec011111erldt.ti~ are f:t"&pared and submitted to the officials concerned., Recreational and sumner camps receive this service, Pullman cities at major attended athletic contests were included,
EMERGeNCY SANITARY ':OHK---Several periods of storms and f locds created inundated pot"tions of the state with consideral;lle damage, and interrupUon to public water supplies and sewage systems. The emergency chlorinating equipment f the division was installed and kept in operation on endangered water supplies during both major 1;1mergencies of the year,
;IAWi AND SE::A~E DISPOSAL PLANT AT ALTO SANATtllii..IM--A water treattllnt plant
compr1s1eg a 12,000,000 gallon storage lake, 'Aration, coagulation, filtration, and sterilizing units
has been completed and put in operation, Laboratory9quipment has been supplied by the institution thus completing alI details for making it a model typical plant for its portion of the state, Therebui It sewage disposal pl&nt comprising C'larse bar wrems, Imhoff tank and trick I ing fi Iter treatment has also been completed and put in operation at the Alto Sanatorium.
MALARIA CONTROL---
DRAINAGE: The past year ha.:o been a year of exceptional progress tn malaria
t:onb-ol, ehiefly through drainage promotitn. Unti I 19281 there was ptectically no drainage of conse-
quence for malaria control, The extremely high malaria incidenceexperienced in 1928 and 1929, togeth-
er ~ith concerted efforts in promotion of drainage, has brought about a state wide inter~st for malqria control by drainage projects, Today, there ar& in the State 24 cot..nties in which, ring the past fiV1:1 years, drainage for malari<1 control has been accomplished. The size and impedance of these project. range from single ponds for t:onm.n ty control to county dde drainage. Some of these counties have made definite annual appropriations fer county drainage systems. Some counties have ebtained drainage machinery for canal construction, and others are now considering similar plans for next year. Drainage is recognized as the most effective and most permanent method, even though initial cost may often be ronsiderable. It is exp~oted that during the present year it. least five counties will initi-
ate drainage projects of considerable magnitude and preliminary drainage surveys are now baing made
in el\oh Such projects require drainage plans, profiles and cost estimates by this Division, foiiM!Ied by inspections and limited supervisicn while work is in progress.
IMP!ll.MJEO lATER c.ntr.:>l of hydro-ellilctric impounded areas still constitute
00$ of DUr chief activities , Wo have in the state approximately 36 hydro-electric impounded area$ oaD-
prising approximately 150,000 acres. Nearly half of these are of recent development and .-perating t.nder permits issued by the State Board d Health. These permits require, first, complete cle~ins of
all V!lgetation before the water is i~Lilded ar:ld larvacidal contrel during mosqt.~ito pr<uction saaS<lnS af~r the ater is raised to the maximum elevation. Power companies today are cooperating in a commendable way with the State Board of Htliilth. There is considerable expansion l!f hydro--electric develo~t in the State and the large areas of hydro-~lectric impcunded areas nc'essitate close and con-
stant supvvisicn. Populations in approximately 20 col.llties are being protected against malaria by im-
pounded water regulations,
There is. of ccurse, no conflict whatsoever between h~"dro-electric development and health conservation. Rather, the two arq workers together for the common good, water power f:t"OII!Otins industrial and social ft"ogress, and pub I ic heulth providing an atmosphere in which enter.
37

prise can live and move. That the south is n-W in the mtdst of an ilmexampled increaso in induatrics makes it the more essential that health be safeguarded,. since there is an ~ver,-growing nllft'ber of people as well as an ever-mocnting capital investment to protect. Thus it is largely in the interest of industrial progress that appeals are made for the prevention ,f disease-tarrying mosquitoes\

There follows a tabulation of counties in which populaticns have been protect~d under Impounded Water Regulations since same became effective, counties during same period assisted by the Division in drainage and a I ist of Power Companies cooperating with tho State 'Board of Kealth in malaria centro! of impounded waters.
l. Counties with populations protected under Impounded Water Regulations.

Baker Baldwin Coweta Crisp Decatur

Dougherty Fannin Floyd Gilmer Harris

Jasper Jones Laurens Loo Macon

Putnam Sumter Troup Seminole Worth

2. Counties assisted in drainage.

Baker
01atham Colquitt

OeKalb Dougherty Fulton

fbuston Jenkins Moriwether

Richmcnd Sumter Rockdale

3 Power companies cooperating with State Board of Health in malaria control
of impounded waters.

Columbus Electric & Power Cofll'any Crisp Col.nty Power Ccmpany Georgia Power Company Pub! ic Uti I ities Georgia Corporation South Georgi a Power Company Tcocoa EIectr ic & Power Company And Recreational Devol opments :
t.t.JNICIPAL AND COUNTY \~'ORK---Community ard town malaria control was well estab1ished during the early period t'lf promotion work ard today as the result malaria is chiefly a rural problem. lt\nicipal administrators more fully realize the great eccnomic valut> of malaria control for insurance of industrial expansion. There is a continued stimulus in malaria work in counties with full time county health officers. Tho need for malaria control in counties has resulted in certain ceu1ties establishing county health units. In many instances valuable malariu control projects have resulted from joint promotion by cooperation between the county health officer ard this Division. Several counties without organized health work have adopted plans for county drainage with the work under supervision of this Division.

SPECIAL MALARIA WORK---Of considcnble interest during 1929 in connection with county malaria control is tho selection of Dougherty County by the United States Public Health Service for field study and demon$tration of malaria control_ by use of Paris Green as a larvacide. The Divi-
38

sim and the County Board of Health are cooperating in this demonstration. This is the mly colZ'Ity in the lklited States which has adopted such a plan and results are, being watched with great lntorost. The work is being financed by Dougherty County I.Zlder a special appropriatim, <dth perscrincl of field director, laborers and elaborate field equipment. An epidemiolo~ist with thG United st~tes Public H~lth Service is located at Albany in Dougherty County observing this domonstration.
In three counties special work has boen cmductod in colkction of blood s~i !OOflS in order to determine the population percentage with malaria infection. Three counties have taken advantage of our impounded water regulations, using same as a local instrurrent in order to include regulations of nu<dy constructed ponds for fishing and recreational purposes,
MAL.l.iiiA TREN6---Tnrough a 10 year period the malaria mortality tr~nd has boon decidedly doonward with the exception of a two year period, 1928 and 1929, when there was unprecedented rainfall in portions of the state where malaria is most r.revalent. Tnere has boon a uy decided reduction for the yoar 1930 in countic.s lt1ore malaria is endemic. It is, though, with cmsidorablo CQF\ siderable concern that we are now discovering tpidemic malaria in sections of the state where it has not previously been a serious problem~ It, therefore, bec0100s necessary that we stiiii.Jiato interest and institute control measures in such sections in order to ctrb endemicity as far as possibl&,
Respectfully Submitted,
(~y.rQ~v
(l.t M, Clarksm)
Director.
39

RECAPITULf.TION OF WATER SUpPLIES Wll'H ESTIMATED POPULATI()'IS
I~)

Supplies r-~:cciving iiltration
~nd c!.loriru~ticn
Ooep Mllls and springs recciviog chlorinati:n Deep vJC II s anci :.pr inus not reccivinJ cnlorination Tot~l ~blic water suppli6S ;";atcr fran pr ivatc suppl ics Tota I for State

Population

5) b')o,or:o

)~

16C,ooo

14G

)gi 1ZIO

2f.O t,l37, 710

2,132,~

),2]0,000

Pcrca1tas'Q of:
flap.~ Iat ion u:.ing Public Supplies

;Jcrocntaoe Toti!l Stato Papulation

)].2

1).~

g,6

).I

20.2 100.0

~.8 I
)4,8
bS.2
100,0

f\blic water suppli.s accopting ~tate LaJ<Jrator-) scrvico l'wl ic v1~tcr suppl i,:s not acccr;ting State l.a:x;rabry savice
Total Pub I ic v.atcr supplies m<:k ing ~ajor i~ovCI11Ults to ;;lants

2')2 I, 120,)20
..1_ _ _17, J;O __ 26o 137,]10

13

4),200

~8.5
I 100,0
).8

40

RECAi-' IT! !LATl fli Of PIJll I~ .. .',Ti'cil SUi.>f'LtE:>
1)30

Suppl ius receiving fi ltre::. in

and chlorination

:'leep wells and :>prin:JS receiving

chlorination

Deep wei Is ill'ld 3t-:rinns net receiving

chlorination

Total pu!JI ic water supplies

roo ~later

priv~~e suppl ics

T~hl for State

!<umi:lef'

Pcpi..tion

55

G<j0,40'j

Go

2J0,?87

142

?.i~a Z:, I

2G4

l,lll,(]j3

1.121.4):1
2,308.506

Percentage PO:A Iat i .en usinu public suppl ics

PeroontajC total state population

1_.6.5

22.4

18.1

(,.;

2].4

8~

100.0

38.2

(,1 8

too.o

!\.obi ic supplies aeeuptin<J State LaOOr-atur; service l'ubl ic suppl i:'s not acoov ing Stato Laboratory service Total Public water suppl ios making ~:~ajor ii1J'"OIICIOO!ltS to plants Filtor phnts under local chemical and bactcriolo:Jical laboratory control

227

1,ocs,)07

2Z

22.244

264

I, 1111(]j3

II

144,350

12

3&~.577

~.o
2!0 100.0
13.0

41

l
SACllR IOLOG ICAL Public ~ater Supplies Pri~ate Water Suppl iss
Swinming Pool
cHEMICAL Pub I i c Water Supplies

WATI!R LABOOATORY ANALYstS

I~
j,620
744 88
6

FIELD INSPECTIONS, CONFERENCES AND ENGINEERS PLANS APPROVED

P\Jb~ ic Water Supplies

264

Sewage Disposal

25

Malatia Control

148

Swlnming P"'()ls

4

Genera I and Mi see II aneous Surveys

15

Engineers Plans for Water Supplies Approved

8

Engineers Plans for Sewage Dispesal Appl"oved

II

BULLETINS DISTRIBOTEO

Ha. Sewage .Oisposal Pit Privy leaflets Mosqvitoes and Malaria Control Farmstead later Supply Switlllli~ Pool

408
ISJ6 2,144
818
37

MAlARIA DATA

NuRber cOU'lties, including 1930, furnished engineering ser~ice for investigaticns, drainage plans and supervision
Nuli:ler towns and eities fvmished same service
Total nllllber hydn>-electrt-c developntents meeting impoiXlded water requirements
Total acreage under hydr~lectric areas
Nunber hydro-electric developments using larvaecides for mosquito con-trol
Total nunber acreas Lnder lar~a&-Cide central

I~
?.m
%!!
132 '
6
303 38
156
2
25 6
374
4,103
613 641 29
22 62
36
150,000
7
2t,OOO

42

CHILD HYGIENE

,,
DIVISION OF CHILD HYGI~~
Joe P. 3owdoin, :.!. D., Director.
Y:hile in the main, the program of the division of child hygiene has been cast almg the I ine of the preceding years, we are of the opinim that the work has been w0ll worth whi Ie. Never in the history of the divisiqn have ve had better or more wholeheart~d cooperation of all division of the State Board of ~eaHh, the medical sociFJties and the general pub! ic.
The work that tho divisicn is attempting to do for the prospective mothers, mothers and babies of Georgia has met with splendid reaction in all women's organizations. This is evidenced by the many calls upon the division for literature and for help in community planning of health work and for speakers to address the people on many occassions.
The work of the Hea 1thmob i Ie has been we 11-recc ived. The work Jone seems s Iow but
it is thorough and if properly followed up, would no doubt be of much more practic~l worth. This
work is made possible by the Phi t.\.1 fraternity and to it Georgia owes a great debt of gratitude.
Our nurses, who are constantly in the field, are always in direct touch with the people. They are the outposts of our work and the teachers to the people in prop.;r hygiene and sanitation. M.lch of the reduction in infant mortality is due to them and a great deal of the good work
;one for and with mothers is their work.
The result of this work has raised Georgia in the estimatioo of all thinking people Two yo.:rs ago, we stood 47th in deaths in child-bed; today we are 42d. Only fi vo states in the Lni ted States last year showed a reduction in infant mortality. Georgia was one of the"'.
We ask the public to read our entire report and then~tudy the tables that follow.
POST-GRN>UATE CO'!flSES FOR DOCTORS---We are inc! ined to think that the most outstanding work of the biennium has been the post-graduate schools for physicians of the State in obst()trics. These schools have been made poss ibIe by a spec i a I appropriation mado by the federa I department of labor, Children's Bureau. Dr. J. R. McCord, professor of obstetrics, Emory University, who has been
4ln the advisory COITCTiitte.:; of thL children's b.reau for a m..mocr of )ears, kno~:ing of the high mortality ~ate in the southland, has beun very much interested in this important qU()stion. It was really thro-
wgh his study of conditions that the qv::.stion of intensive education of physicians was considered for Georgia.
Every one. knows that Dr. McCord is a very busy man, and only by the. sacrifice of his f!Orsonal practice was it made possiblo to giv<e our physicians this opportunity. Se1en schools of five days each have been held. The physicians have rospooded wondurf~lty, W40Y mon driving 100 miles
a day to attend. ::u are under lasting obi igations to organized medicine in thE: State for the uniform
support and help in each district and "specially to the officials of th"' Modica! Association of Goo rgia. A more detai I rGport of those schoc>ls >~iII be . ivcn under a special head.
WHITE HOUSE CONF!:::\ENC'E--It was a great pleasure and inspriation to serv.:. on the committee of Or. Fred L. Adair of the Yth ite House Confcrenc'; on 01 i Id Ht.a Ith and protection, the subcommittee being headed by Dr. J. R, McCord of Emory ltlhiorsity oo "Pre-natal and Maternal Care"
43

l

Three or four meetings were held; I had the honor of attending twa of th~111, one. in Detroit and tho

other in Washington City. We have been plaqed on the continll'ling eommittee to make final repo<'t to

President Hoover and requested to road a paper in \'.'ashin;:~ton on "The !.'ulace of tho Untrained Midwife",

Doctor Abercrombie and l were present at the three-day meeting of the Vlhite House ConfOf"ence held in 'i.'ashington on Navenber 1)-22, '.';e had over 3,000 interost\ld pt;ople participating, (
The problems of maternity, infancy, and childhood were gone into by experts in every line and phase of
the 110rk. More than 30 Georgia citizens attended, and the State was accorded splendid representation on eommittees at the many hearings,

MAY DAY- -The advancement of May Day has been more universal tha.1 any previous year,

. Many cornnitteea did no~ stop with a flay Oay but put on a complete weeks program~ The Georgia Con-

grass of Parents and Teachers in 1929 put on its preschool child sumner-round -up in connection with .

this work and the result was splendid Other organizations participated. Several mayors issued

j

proclamations and Governor Hardman was enthusiastic in his cooporation and issued a strong proclama- 1 1
tion. The crystallization of sentiment of May Day in the health of the child has been a wonderful

thing. Mrs. C, A. VerNooy, of Athens, chairman of tho executive eommittee did splendid work and waB

of (Teat assistance,

At the request of the American fllild Health Association, the Director of the Division of Child Hygiene took over the campaign for flay Day in 1930 and directed it fran this office, A special stenographer was employed for this fl.II"PPs~;, aoout three months of her time be in:] devoted to May
Day work,

I do not think there is any question that the program as put on this year was more universal in its adaptation and adoption than we have previously. M enormous amoll'lt of I iterature was distributed, including complete programs for cOI!llllmity organization. lrbny letters were received from every section of the State, alI of them having inrnediate attention and assistance in organizing their ~ities.

continuance,

HEALTHMOBILE---The Healthmobile !.hit has given us a (Teat deal of anxiety ~s to its

It Ill be recalled that this truck was a gift from Phi 1\\.1 fraternity and we felt
hCJ'IOI" boLnd to pro11ide in some way for its regular visitations, at least dcring the best of out weather. fie had no avai lablo flllds and was at sea for a time as to how vJO could keep up the work, As a happy soluticn to our problem Dr. E. ;'/, Glidden came to our rescue by offering to assist us if we could arrange to do some spechl work in tuoorculosis,

This exactly fitted into our program and consequent!) this valuable unit was continued right along. This specicd work will be deaft with in the report of the H;,althmobile, The work has been of unusual value and of decided aid w;o hopt.: in giving a real picture of the problem of tuber culosis in childnood,

The Phi Mu frdernity has continued this splendid work for the mothurs and babies,
The contribution besides the Healthroobi le was an appropriation of $1,500 for its maintenance. It is
also raising an endoMOent fund of $50,000 to perpetuate the work .

44

-Th-e t~yp-e -of-w-ork~d-on~e -by~t-he-H-ea-lth-mo-bi-le-in--I~-' -wa-s -qu-it-e d-if-fe-re-nt-fr!om!111 that done in 1~8. In 1928 the work was confined to the preschool child and prenatal cases, Whereas d<ring 1;29 an attanpt was made to reach all chifdrett, from infancy through school age, in each county visited. A great deal more ground was covered in 1928, 20 counties, against four com ties in 1929, while only 3,021 were examined in the 20 cOLnti<-s the year before.
In 1928, the work consisted of physical examination of the child, conferences with the parents distribution of literature, health mvies and talks. The same type of work was done in 1929 with the addition of further investigation and more complete examination, including the Von Pirquet test, of all children who gave any indicati<tl from history or physical examination, that they might be tuberdulous.
The counties visited in 1929 were McDuffie, \\'hitfield, Towns, and Milton. Three are almost entirely rural. The other, Whitfield, has a considerable mi II popula ion but sti II by far the larger percent of the children examined were rural. In 1928 the children examined were &l so largely rural or lived in small towns.
In the group of 3, 021 infants and preschool children examined in 1;328, two percent had no defects; in th-o group of 5,576, 91 percent of which were school dli ldrcn, thi'Jre were only
0.62 percent no-defect children folrld. In the 1928 group of children under school age 2,5 defects were
found per child; in the 1929 group, lar8cly older children, 3.04 defects per child were fev1d. The per-
cent of defects of vision, hearing, teeth, throat, g~ands, and nutrition was much higher in the older (I .329) group.
In brief, tho principal defects found in the 5,576 children examined in 1929 were;vision, 498; hearing, 121; teeth, 412]6; throat, 4,451; lungs, 122; heart, 85; glands, 3,808J
orthopedic, 305; anemia, 241; skin, 315; nutrition, 1,588; 84 speech. There were also defects of the
nose, gastrointestinal tract; genitalia, nervous system and habits.
The most striking compariscns in figures for the two yevs aro those in regard to teeth and nutrition. The group of yolrlger children (1928) show 44 percent defective teeth and 10.
8 percent undernourished. The older children (1929) show -,6.6 percent defective teeth and 28.4 \1'\der-
no<r ished. Of course many of the younger children examined in 1928 had no teeth or good baby teeth just through. However, the rural child of school age shows an alarming lack of ~sonal care of the teeth and of dfntal care. lhe matter of malnutrition was still more striking and alarming and many schools had 40 to 50 percent of the 0ldcr d1 i ldren (fourth to ninth grades) badly undernourished, Many of these d1 i ldren ate no breakfast, or a ver;r early and hurried breakfast; most of them had cold, inadeql.(ate lunches, Fatlgye from lcng school h~urs and lack of tho proper amount of sleep were also evident factors. 111-c:hosen dieU, of course, had an important part in this conditicn.
Tho tuberculin skin test was given to 805 children. Seventy-one were positive,
indicating a tuberculous condition, active or latent. The children had X-rays of the e.'l<::st m!lde and those who had indications of pulmonary involvement wwe advised to make application for admis.ion to the Sanatorium at Alto. lllunbers of the colored children have been admitted, and one of the white ones. The others who net;d hospitalization are on the waiting I ist.
Eighy-four health talks were made to 7,995 persons and 159 health films were shown to 7,455 persons. These films on malaria, hookworm, smallpox, diphtheria, tuborculesis, the
45

l

care of the tooth, tho yearly h&alth examination and other subjects carry their messages of health

and sanitation in a most effective way, Everywhere tho movies meet with enthusiastic reception and

approval.

Individual conferences with parents to the number of 935 were hE-ld. Practi-
cally &II these parents seemed eager fer information concerning tho health of th0ir children, but parents of older children were found much harder to convince cf the necessity or proper feeding and health habits for these children than vrero the parents of babies, Although a few parents objected to the tuberculin test, many more wuro found who were anxious to have the test made on their children whether thoy were in the suspected group or not, This it is felt, is a very encouraging attitude of the parent,

The longer stay of tho Heal thmobi le in a county, from one to three; months, gave time to begin seeing results, It was most gratifying to note the large number of corrections of defects, especially of vision, teeth, and ton~ils, Many parents are pathetically anxious to have their children's defects corrected, bwt economic conditions make it seem impossible, It is to be de-' plored that after having stressed tho importance of ccrroctions, that we have no moans of helping the parent to have it dono,

Many years of health education and agitation are before us before the masses wi II hall() that vision of good health, kecp_ing woll, personal and community hygibl1o, which wi II make for us a new race of healthy, happy people, throughly awakened to the importance of prevention rather than cure of disease and i 11-health.
The Hea Ithmob i Ie unit was organized in 1330 wi th the samo size porsonne I as
last year; to wit, a physician, a nurse, and a director of visual education, and with the same motor conveyance as for 1;)28,

It began work in Douglas County on March l, examining th'- chi ldrcn from in. fancy through the third grade of coomon school, this being a change frcm tho prouram previously conducted~ Owing to demands of the service of this unit, anc! after thorcu:Jhly consid<Oring tho advisabil-
it~ of discontinuing the examination of the older childrbn, we decided that the defects of the child-
ren, after they had roached the third grade, wore not so essential as the defects in the younger child reo and consequently the yOl.figer child was the most pressing problem,

Tht> truck we hav<o been using was overhauled and put in as good condition as possible with a I imited expenditure of mono: 1-kwcver, it was not possible. for us to continue the work with this outfit after the 1;30 werk "'''s co,oc~:et.,d. The t;uck n'ls done good survi<;o and has seen pretty hard usage, consequently it ;s q'-'; lc I ikuoy a""'" convc~ancc. l'li II havo to be bought.. The Phi Mu Fraternity sent us a contri:cution oi $1,)00 cac-ly in tho year to help finance the operation of the unit.
The Hcalthmobi le remained in the field until NovombE.r 15. The truck was
stored, as usual, and efforts are being made to dispose of it, It has beon ir. service for three years without a great outlay of monoey for a new body and complete over-hauling of the engine and chassis, and it i not suitable for another season, This condition has bee;n roport~od to the Phi Mu Frah:rnity, which has nade this unit possible. I recOITJOOnd, in this connection, when a new outfit is purchased that if~ as ligM as possible,
46

Literature for distri:Jution and small suppl it,s togethc;r with the I i9hting plant an; all that is necessary to carry. The. trur.k is used rarely for an examining room for the physician. Th8 extra expc;nse in operating the, heavy truck 1i II not justify its use as slueping quarters for tho dr i vcr.

During 1930, it visited Douglas, Pickws, Cherokee, Fannin1 and Jackson CoLtlt ies, and in each accanpri shed splendid results.

The unit for the first time in yE;~rs has been kept intact. A two t~eeksl vacation w:s taken by the employt.cs at the, closo of tho s0ason, anJ the physici:m and nurse returned to dut~ with the tuberculosis clinic. hich was ready for tho first week in December.

herewith.

A complete report covering activities of the unit (statistical) is submitted

TOXIN-ANTI-TOXJ:.; fNO TOXOIO---Aftor a poroid of investigation and study1 it was decided by our laboratories that we should discontinue the official rocomnondation toxin- antitoxin and substitute the more recent Toxoid. This is in line 11ith tho best intcrost of our work for children. The chango, we foe!, wi II be v._ry beneficial.
Wu had good results from our toxin--antitoxin campaign in 1923. ~usual we
had tho splendid assistance of the physicians of tho State as well as the; women's organizations and espeo ia I Iy the Parent-T<;;ach-r s Associ d ion.

~.o had tho pleasure of participating l'lith the Parent-Teacher .\ssociation in tho distribution of free toxin-antitoxin to tho chi~dron of th6 various countius in the Statf:l along tho same I incs as years previous. ~:e offered 200 complete. inmunizations to each coLtlty in the State. As in previous seasons the. request for this treatment was very urgc,nt in some COLtltks, v.h i lo other counties did not take advantage of tho offer.

Tho statistical report of tho laboratory will show tho distribution~

It is the opinion of the director that if it could possible be done toxoiJ, should be distributed frco to the people of tho State ihrougoout tho year. This could be dono through the organization of the Parmt-Toachcr and other associations, and a splendid, worth-~>ni lo program put on.

COOPERATIO!': OF OOCTOi<S---1 am quite sura that never boforo in tho histQt'y of
the division of child hygiene have r1c had a more pleasant suason with tho doctors. :;a have never had
as general and widespread splendid cooperation of the physicians of our State as we have had this period, although in the past it has been good. To thu doctors of Georgia WG arc Ltldcr many and lasting obi igations.

COOPERATIVE AGENCIES --Tho Oivisicn of Child Hygi0no has had wonderful cooperation from evory organization that is interested in tho welfare and bdtonnont of conditions of the State. The report would be too long should we attempt to enumerate and canment upon thomo To each and evory one bo~h individually and collcctivoly, 11e acknorilcdge our debt of gratitude ,,nd obll gat ion.
47

'lhe Director of the Divisim of Child Hygiene has beet'\ made vi{:e-president of the Georgia Cmgress of Parents and Teachers, object being to I ink the work of the health department more ccmpletely 11ith the work of the association.
P''ERPt:R.<L DEATHS---c:e decided to try to place the responsibi I ity for our hig,: death rate in mothers, so fe.r as it was possible., and to this end w~ selected certain coll1ties l'lith I full time commissioners of health, located in different parts of the State, sendinJ them copies of death certificates, and where possible the birth certificates of the babies. With the help of the ilirector of the Bureau of Vital Statistics and Dr. J. R. McCord of Emory University, we prepared a questiomaire which was sent to each of the cm.nties selected.
~:a h:Jpe that this can be of service in the future. The few COt.nties, of course will not 4ive us a picture of the real conditions, but we do believe it 111ill be a faidy good index of/ the real situation in the State. I am convinced that this study wi II give us the key to a further lo~ ering of our death rate in mothers.
J'.lFfiNT MffiTALITY --~'le have been made to rejoice in tho past few weeks by a statement released by the Census Bureau that Georgia was one of the five states in the United States that showed a reduction in infant mortality last year. ::e really show 41 deaths less than the previous year, and this would increase our rate in the savin9 as we had the normal increase in births.
NURSES - -The ye~r 1929 was cr1e of our be5t as well as most unfortt.r~ate. It
saw the complctitrl of our contacts with c.very one of the 161 counties in both Hcalthmobile clinic work and the contacting of every known midr~ife. The work has been satisfactory in this respect.
Every assis~ant ]ave loyal support and eo.m has done hGr i'Jest to make the
1929 the best ye~r, knowing that tho ontir() organizatim would be dissolved July I because of there-
peal of th~ Sheppard-Towner Law and the consequent discontinuation of the Federal appropriation that has enabled us to do 'tho oducat: onal l'lork throu9hout the State.
The 27 nurses had been notified early in the year that their servicos would
have to be dispensed with and consequently each one followed out the; plans 11ith zeal and made it possible for us to complete our program. That each me might have a better Ul'ldcrstanding, and that all 01.r work might be coordimted along the same intensive I incs, ;~e cal led the nurses in and hdd a two
day conference March 7 i!nd 8.
This cmtact yave both the office and the fiold worker an opporhnity to better understand each othtJr and consequently to do better 01ork. It was more of an cxporionco mooting than an)thing else, and tho round-tablo discussion was of gn;at value to the work. These nursos have
emtacted 6,381 midwives and 1'10 have issued, on their reCOI!m3ndation1 3,67{) certificates and refused
to certify 2,711 midwives as grossly incompetent.
NURSES-- The work that 110 begun in counties whore cooporat ive nurses ''ore employed must have been satisfactory and the da~onstration considered of such value that at tho expiration of our cooperative period the coUltios took over the nurse and continued her "ork, with the exception of two cot.r~ties. ":e hope that this wcrk will become permanent In each caUlty wher~ the demonstration was made. The: five itinerant nurses, workinJ out from our offi<o, wore. discontinued July 1.
48

After discussi ao ard conferenoo, we have come to the conclusion that we may be able to ronder better service by distriQting the ~ate ard placing a nurse in a givon territory,
holditlg her rosponsibl~; for such territory. ihis CI!IW\ot, hO'.ev<ilr1 be done at once. ~s we hwo 27 COIA'Itics that have not been visited since 1928. ::c now plan to contact those countiGs as quickly as pos-
sible and 1.hen we have thuo up to 1929, Wll wi II carry out our district plan.
Owing to no avai lablt. funds, 1!0 have only five nursos for 13:)1. Therefore,
the Stab wi II b<:l divided into five districts of a'">out 26 counties Lach, \"ie arc not including in the
work the midvdv!'ls of countios that ha~~U full time comnissioners of health, but wi II act as best we can in cooperating with th~ health officer,
If we follow tho usual progrBm in our work in these districts, it wi II require about two years to cover one of the districts. ~e hop!'l to adopt the district plan of prooedurv about Ap-i I I.
r:e are constrained to bel ie\16 our midwives are doing better o:ork than in any time in the past. There has been a gradual elimination of the lX1fit1 thu old, md the decrepit,
SILVER Nl TR\TE---The manufacture and distribution of si lv.r nitrat, has beef\ continued and we f<.:vl sure that wo have gotten a batter distribution than in former ye::rs. We bel i<:lve that perhaps more attention is being given tho eyes of tho new-born than any time in th~ history of the division. The actual distribution of this preventi~ measure will be found in the statistical ropert of the laboratory.
EDUCATIONAL---Tho demand for child health I iterature has been constant and we have distributed a grec.t deal of it, I am sorry we only have one original pamphlet-The GeorJia Baby Book, This book has continued to bo vury popular, It is only distributed on request and oonsequ(;lltly we think none of th~ are lost so far ~s service and interest are concerned,
This ~k was entirely r.:,writtun and 81 new cuts 11\aoo. The food rc.cipos wwe all rearranged and brought up to c;latc. Tho book i tsdf is a spkndid prod\.1Ct1 dono in crLam, blue,
96 and broVKl. It has pages besides tho cov<-r. A MW avenue of distribution has been opened by the
placing of tho Baby Book in the infant and chi ltlr1l 1s dop::dments in tho leading stores of the State. Tho Baby Book in this way gains, not only th~ attention of the visitors in tho stores, but has boen advertised in the display advertisements of tho merchants, It has also been used in window ~ssi~ to eu- advantagu.
The deman;1 upon tho division, have stl:adi ly increased unti I now requests for
litor:-ture are more than we can r~ally fi II. I m<:lan by this we ha>~t. l enlarged scope of demands for
which no literature has been pr11parcdj and so far as t have be<lliab.te to find out, is not supplied by any other agency in the Stat~.
I think there is a very ferti lo field for us in thu pr6paration of educational mabrial to be furnishvd the Parunt-T<.achcr Association and teachers in the schools. This material ihould be of such nature :ts can bo used in teaching in the school end by the mother in planning school lunchos <!nd nKnus for tn.:; h0100. ThorG is a demand for such help from tho Statu Board of Health and I hope scmcthing can be <Jone to enablv us to mt:.et it.
49

l

If we could only meet this damand with Goorgia prepared and Georgia printed

material instead of having to usc just whatever we can get, it would be~ more satisfactory, Much

of the material furnished is most excellent, but it boars the stamp of organizations foreign to Geo-

rgia.

been cant inued,

All other publ icaticns that we have distributed in the past few years haw !
'

lie prepared a nunber of articres for the press, a series of six on the child for tho Masonic Messenger. Request has been received for a continuation of this work,

The educational work amcr~g tho school girls knoWn as Little Mother's Leagues has continued to h~vo the cooperation of our public health officers, teachers, and nurses. Tho name of this organ i zat i cr1 has been changod to Mothers t He Ipers'1 Lc;ague,

I am inclined to think thoro has been a slight increase in public health talks, Many speake-rs have been suppl ic;d and many addresses have been made in all S\Jctions of the State,

Respectfully Submitted,

Joo P. Bowdoin, M, D. ) Director.

50

T
CONSCX..IDATICN OF HEALTHMJBILE ':!ORK
1929

Number examined Preschool :School Defects Vision Hearing Teeth Eyes
Ears
Throat Nose Lli'Igs Heart Glands Orthopedic Anemia Skin Genital Hernia Nutrition Rickets Tumor Motor Lan,uage Adaptive behavior Personal-social Thyroid Total

McDuffie
173 I ,641i
154
I~
I, I)5 76 37
1,388 67 59 37
1,023 103 75 98 18 21 393 16
6 20 3
II
16 4,800

\Vn itfietd

Towns

220

58

I, 760

903

177

104

50

37

1,614

835

105

45

45

22

I,658

798

82

87

35

18

26

18

1,446

745

85

84

78

51

io6

69

17

17

12

3

707

287

17

6

8

3

35

II

22

18

I()

8

2

6,344 3,266

Number chi ldren with no defects
Number hea Ith ta i ks in above comt ies
Number present at heelth talks Number pr<,sent at movies Conferences wit!t parunts

36
84
7.9"15 7,455
935

Mi Itan
29 787
63 20 672 36 23 607 50 9 8 588 33 37 42 4
3 201
3
2 18 23
2 2,445

Totaf
480
5,o96
49B 121 4,276 262 127 4,451 286 122 89 3,808 305 241 315 s6 39 1,588 42
II
10
84
66 23 35 16,855

51

Number Examined' Preschool School Pb;x:s i ca I defects Vision
~earing
Teeth Eyes Ears Throat Nose
Ll.llgS
f!eart
Glands
Orthopedic Anemia Skin Nutrition Genital Hemia Rickets Posture Motor Language Adaptive Behavior Persona 1-Soc ial Thyroid Tumor Total Number no defects
Health Talks NIAI\ber Number presont films Number films Number present
Conferences with Parents ;,hite
~lored
Total

HEALTHMOBILE REPORT
1?')0 Douglas Pickens Cherokee

254

m

481

778

499

421

122 30
733
35 28
7'J3
59 17 17 730 26 14 87 149 25 26 9 195
14
23
15 4
3,116

82 15 634
37
23
636 55 16 12 627
37 21
'
154 76 19 20 128 2 20 64 6 2
I 2,]41

43
5 576 42
12 bal 29
9
5
~58 58 13 80 147 103 10 32
90
9 15
67
7 2 6
2,699

fannin
364
1,098
87 32 1,051 76
23
I, 103 73 19 20
1,089 58 37 94 270
75
6 51 127
I 34 92 4 14
4,441

Jackson Total

201 1,69'}
:m 3, 7'fJ

to6
25
'J37
121 29 904 66 18
25 947
53 28 80 312 40 II 28
85
2 19 55 3 6
3,901

440
IOl
M3~ 311 115
4,082 282
79 79 4,051 232 113
395 1,032
319 72 140
b25
14 102 301
35 28 I 16,898 103

29
2,340
57
2,34G

20 1,515
40 1,515

19
1,8]0
38 1,870

25 2,000 .
50 2,000

21 1,800

114 9,525

42

227

1,800 9.525

178

272

_91

6z

269

339

338

30)

30

2

368

311

222 1,319

95

225

257 1,544

52

McDuffie Whitfield TOWI'IS Milton Total
January february Mirch Apri I May Jt.re July August September Octob.,r NoV$11ber December Total
January February March Apri I !thy JlnG July August Septel!ber October November December Total
Grand Total

TUBERCULIN TESTS MIIOE BY HEAlnMl"ILE UNIT

1929

m,ite

Neg. Pos.

113

8

,, Colored

Neg.

Pos.

118

182

32

91

II

200

2

0

0

28

5

2

0

523

47

m

24

Total

Neg.

Pos.

231

21

273

43

200

2

JO

5

734

71

LITERATURE DISTRI'3l.1TE2

1929

Prenatal

Preschool

I ,323

2,223

I ,602

4,165

432

4, 019

944

4,183

1,?99
682

3.353 4,361

IQ9

I ,349

222

827

250

1,826

251

1,279

65)

1,521

)48

1,004

8,885

30,]10

School 5,152 13,840 12,329 2,000 2,300 1,050 1,000
128 3.~3 5,586 2,661
(l2 50,461

Misee IIaneous Total
215 8,913 741 20,348 128 16,968 245 7.J72
7,41)
4 6,097 2,458
7 I, 184
328 6,397 l3b 7,252
19 4,854
,,an13 ~.~n 91,93)

Ll TE'1ATUR~ DISTR 18UTEO 1930

Prenatal
535 838
679 639 354 575 472 296
368
453 152 28) 5,6,;4

Preschool 4,004 ~. 113 3,098 3,339 2,247 1,629 I, 151
3,22~
2,640 3,266 2,601
1,3Z8 32,6'Jj

School 2,853 2,']20 1,056 1,000
6oo 0
1,250 l,o67 4,822 4,183 4,966
lz II~
2],636

Miscellaneous
79
451
313 580 1,950
625
438 565
723
800 620
46
7,190

73.165

53

NURSES' ACTI VITIES

1929
{Six Mmths)
5 Itinerant -
22 County - Nurses

1930
{Twelve Months)
4 Itinerant Nurses

Nunber COll"lt i es v is i ted Little hbthers Classes Organized
&Teal ment in CIasses Mothers Classes ()-ganized
Nl.lllber Attending Midwife Classes Held
Midwives Attending Number Vaccinated Against Smallpox Total Field Visits Made Literature Distributedt
Prenatal Infant Presch,ol Other Total pieces of Literature Distributed

77 269 6,26o
38
I, 155 121
5,291 2,929 30.5"72
3, 703 9,o69 7.129 12,969
32,870

73 85 2,593
10 174
273 3,279
561
1,573
I ,210 2,248
763 1,424 5.645

organizations

The nurses made many talks before clubs, Parent-Teacher Associations, and civic

The result of the employment of 27 nurses as against four is evident frcm the above table, All nurses had to be discontinued July I, 1929 owing to the repeal of the federal law
which gave aid to states in maternity and infant welfare.

54

VENEREAL DISEASE .

\

\

DIVISION OJ!, VZ~'L:lc-:_;;.AL DIS ~i~S~~ C01ITROL

Joe P. Bowdoin, ;\t.:J., Di:rector

There has been no change in the general program of the Venereal Dis~ase Con~ trol Division during the past two years. l!e have made no decided pro<Jress so far as we can determine;
onthe other hand, we are quite confident that there has been no retrogression. It is one of the most
difficult problems that we have ever dealt with.
Fmdamentally we feel that the ultim:1te solution of the many problems of the 1~ork is the education of our young people, which education "iII necessarily have; to come from the parent. Progress has been made along this most constructive I ine, in our judgement, Several of our schools, notable among them i:Jeing Georgia Tech, the State A, and M. Schools, and Mount Berry, have requested us to talk to their classes, The talks ha,'e apparently been well received by the student body, and the members of the faculty who have attended have expressed thems.:olves as being well pleased 11ith the presentation of the sex question and venereal diseasei.
This is good work, of course, and we are delighted to be of service in this way; at the same time we fed that the a~e group is a I iHie lata for the best results, In other' words, we are convinced that sex education should begin at the mother's knGe and around th.c fireside on the first inquiry of the imocent chi I d. The conclusi m is therefore rea<'hed that we must first educate the parent as to the nect>ssity of bll ing th.~ story of I ife in the right way, at thu right time, ard only in sufficient amount to give the child com;-;rui1ensively c011'pl;ote knowl~;;dge of its. If by tho time it is old enough to really need such kncw.lcdge for its protection,
Along this line we have made progress, and alons this line wo hope to continuo, This cvenue of appro.1.ch was made possibk throu:jl tho farseeing progressive administration of the Grand Master of Masons, the Honorable Raymund Danicl, Hs requested th.lt we supply a speaker for tho district and county conventions of 'he ~lasms, who would present the probkm to the Masons _of the state, We had the honor of addressing many such assemblies dur ir] ths sc.r.mer and fall of 19'29, and oQ,.eaoh oc cas ion the address so far as we could determine was l'lc.: I reroived. This campaign on his ~r~ ard his interest in pub! ic health reoult"d in 'he creation by tho Gnnd Lodge of Freemasons of the stinding conmittee on pub! ic questions involving health ard citiz.:;nship. If this conrnittee is active ard a pro gram is prepared that is practicable as well as popular, the potentialities for good cannot be estimated, even by those of us y,;,o are longing for just such opportunities.
!!e are kd to bel iove that this interest in plbl ic hl;alth by this, the largest as well as the oldest fraternity, w~s no doubt born of the campaign among them to raise the fllld for
the building and equipping of tnc Children's Tuberculosis Sanatorium at Alto,
We were invited and spoko to the ho~ demcnstrdion agoots at their annual meeting at the University of Georgia, 1'/o found this group of fine women cooperative, ''nd they have the intere<;t of the sever1l counties in which they work at heGrt. They have been of spkndid service to our nurses and the Heal thmob i Ie.
Venere31 d iseaso contra I 11ork for 1930 was a Ieng genera 1 educa tiona I I ines, with a II'IJCh broadened opportunity insofar as roaching the young men is concerned, The year was mark-
ed by new opportmities brought about by a letter of cr. Abercrombie to tho boy's schools of the state.
55

.1
We had never done this bofore in so general a way. The response to the offer to furnish a speaker
tor_. schools was accepted by seven, and arrangements were made at off times to meet the student
bodies.
The social hygiene talk for boys was delivered to 1,690 young men. In each
instance the talk was apparently well received and the heads of the schakls expressed themselves as being under obi igaticns to the State Board of Health for having brought tho message to their students. The student bodies seemed to be eager to I isten tu the infonmation given.
KEIDEl TUBEs--1 would also I ike to call attention to the Keidel tube distribution, and to urge every one who takes a speciamen of blood to use this vacuun tube; it is always ready; it is sterlized, and in fact is very satisfactory in every respect. The price is very reasonable, being only 1.50 per dozen in separate mailing cases.
WASSERMANN TEST~--In 1930 the total in lfassermam and Kahn test was only a
few less than 50,000. The exact number wi II be foll'ld in the laboratory report. w., are st i II doing
both tests in a large number of cases and "hen requested by physician to do so. This does not begin
to represent the tota I nunber of tests made, as very many are made in privah laboratories, and a--
bout 10,000 are made in ol inio laboratories that are reported to us.
ARSPHENAMINE--Many of the manufacturers of the arsphenamines have advocated their own brands under copyrighted trade names, oodeavoring to get the State Board of Health to stock their particular brand. We have constantly refused to stock all tne brands, and tho result has been that some of th!llll who did not succeed in securing an order have gone into the field with detail men and the usual propaganda, with a sharply lowered price to the health officers and doctors.
We wish to cal I the ~attention of the hoalth officers to the fact that all
arsphenamines have to reach a set standard before they can 0e sola. This standard of our United ~tates Pub I ic Health Service makes them all safe, and in our opinion one brand is just as good as an other in the results obtained.
We would also I i ke to call attention to the fact that had the Stab~ Board of Health not hand!~ and continued to handle this remedy for syphilis, the prices paid would more than likely be two or three times higher than they are today. Fer 12 years we have carried this reiOOdy .for our physicians, manufactured uy two leading firms of our country.
CLINIC AT EMeRY---On invitation of the professor of public health of Emory University we had the ploosure of spa."lking on vener3al diseases l:o the third yoar medical men of the university.
The tenth amual venereal disease clinic in cooperation with Emory thivorsity
was held Jll'\e 3-81 1929 Tho entire week was devoted to il'ltensive study. Tho>e clinics are a oontin~
uing source of great benefit to the medical men of the state. Their appreciation is manifest in the large attendance year after year. The probability is that thGy will be continued in the future.
BIOLOGICAI.S--The concentration of tho mai I ing of all tho vaccillGs, biologicals and various romedies sent out by the State Board of Health into the hands of one individual was decided upon, and the transfer of the detail of filling orders for Keidel tubes and the arsphenamines was
56

.. -----~----------.,..----------------
made from this division to that of the baloratories on September 30, 1329. The demand for these suppi ies has continued am quite I ikely wi II be increaS6d as the years go by. For detai Is you aro _re-
fei'TOd to thG accompanying statistical repOrt.
HEALTH NEVIS----Newspaper articles have been furnished and reference to the venereal diseases in Georgia's Health have been made a number of times. Tho larg6r dailias do net take this kind of publicity very well; in fact, they do not call the diseases by their names at all, but refer to them as "social diseases", How l<:ng before we can get away from this prudery I do not know 1 but I am thoroughly convi-nced that these diseases should be as fre'Biy discussed by name as tuberculosis, typhoid, whopping cough 1 etc. The diseas<;s tht;mselvcs arc common enou~h and the problem serious enough not to be camouflaged by meaningless terms. \'le are convinced also that if informatim of the right kind is given to tho children of today the better for all it r1ill be, especially sex education to our yomg oh i ldren,
It might be well to fl16ntion that the t.bsonic Massengcr, a monthly magazine
pt.bl ished by tho Board of Trustees of th':l Masonic Orphans' H01re, requosted in 1929 that _a column of
health advice be furnished it for each issue. This invitation was accepted and the articles have been appearing oach month,
These articles were continued in 1930, as well as others contributed to the Journal of the Modica! Association of Georgia and the Bulletin of the Georgia Congress of Parents and Teachers, The Journal of the GeOI"gia State Dental Society made request for special artides, and many other articles for newspapers have been written,
~-e had a reqUElst for the showing of the nevereal disease film in Atlanta. This is the first time this film has been used in some time.
\'le have cant inued our rad i~ braodcast through the courtesy of fiSB, appearing
once a week 15 minutes being assigned us,
GE~GIA'S HEALTI-1---The publication of Georgia's Health on tho 15th of each month hai continued, fie try to use origiml matter, and its preparation has involved tho writing of about 68,000 words during the ye;ir,
The circulation has been put on a basis of requC;sts. :e had to increase o..r
order for it twice in 1929. Oocembor 1s order was for 6,000 topics,
The same type of publicity w:s usud in 1930, but owing to insufficient fund$ this material is necessarily I imitod, Georgia's Hc,alth reached a circulation of about 9,000 in 1930.
It is pOpular with a gr-eat many people, am its articles have been reproduced by many popular as well
as scientific publications,
It might be advisa'llc to arbitr~rily increase this circulation to at luast 10,000 by thu seiGcticn of certain men and womGn as well as institutions who ~ould be interested in the problems it~iscusses, This could~ done at a nominal expense.
PlATE MATTER---Through this division as in the past tho popular medical articles for the weekly newspapers of the state have been prepared and furnished. Eighteen colurrns of
57

--1 sutfl matter were sent out in 1929 to lob of the best papers in the State, making a tobl of 1,900
coiUIIf'ls set up ard ready for inmediate use. So far as we have been able to juclgc this mat.ter was H"
recc ivod by the papers.
We did not have the funds to get out as much pi ate matter in 19_;0 as we usu- !
ally do, but continued to supply it to 108 weekly papers. l'le think most of it w.:cs used, \1" have just:<'
revised our mai I ing I ist for this material, and during 1~14 wi II send it mly to such papers as re- !
quest it, Just how rrueh of this material is being used we cannot say positively, We
discontinued our clipping buruau service as a matter of economy, and instuad requested to be placed on the exchange I ist, Some of the newspapers so sol icitcd were kind eough to respond, but, comparatively speaking, very few are sending their papers with regularity, ard recently the clippings have been very few,
CASE REPORTIMJ---Thc one outstanding defect in OLr work is the. failure of physicians to report their cases, and to those loyal physicians who do report we arc under deep obi igat ions. None of our reports, hmvever, are as fu II as they shou Id be to enable us or the Iega I authorities to take any decided or definite stops towards quarantine and proper treatrocnt of the prostitute.
Respectfully Submitted,
~~
(Joe P. Bowdoin, M.D.) Director,
58

1

---

--~--~~~

Jatl!Jary February March Apri I
May
JLne July
AUJUst
September October November December
Total Gr!l)d Tota I
JatV.Jary February March Aprl I
May
Jt.ne July
August
September October' November Deoeraber Total

SUMMARY OF 'BJERAl 0-ASE CONTROL V-tMK 1329

Syph i I is



F,

103

44

220 163

242 226

611 453

290 284

2'!)

273

217 175

388 287

176 178

430 342

462 275

330 201

3,764 2.,')0]

6,671

Gcnorrhea

M.

F.

101

50

148 61

239 26 481 200

244

72

217 74

211

67

249 101

193

78

251

82

218 68

I4Z 3Z

2,699 916

3,615

Chancroi4

M. F.

00

36

II

0

9

0

9

I

0

I

I0

II

0

0

0

70

6

I

10 0

b7

9

76

Arsphenam inc
3,.283 3,159 3,155 4,687 5,038 4,353 4,232 3,613 4,o65 3,917 ),848 2,67'3 46,029

Ylassermams
3. 727 3,896 4,467
4,968
5,065 4,658 4,501 4,269 4,309 4,947 4,073
3z2~Z
52,177

Smears
'Z27 163 189 188 210 112
15~
163
It)
152
150
141 2,020

Pamphlets
348 0
1,326 738 393 242 220 250 410
570 970 425 5.%2

Lectures 0 0
483
813
245 170 450
1,~
550 1,075
1,1~
240
6,478

59

'l
January February
Match
Apri I t.b.y JU'\e July August Septem'>Elr October Novelllber Oecember Total Grand Total
J<W~uary
February
Match
Aj:t"il t.b.y June July August Septetrber October Nowllber Oeoember Total

SUMMARY OF VE~ERC:Al D!SEASE C:1NffiOL ':QRK 19)o

Syphi I is

M.

F.

422 260

317 2)5 314 214

66; 570
527 441

367 311

194 210

485 324

561 396

36G 305
326 255

3'2 211
4,869 3,738

8,607

Gmorrhea

11'1.

F.

207 62

276 88

344 112

290 86

254

78

261

82

133 45

213 77 402 127

329 rJ> 250 75 22z 68

3,186 996
4,182

Chancroid

M.

F.

60

8

0

12 0

13

I

10

0

10

0

9I

23 0

12

0

15

I

II

0

50 134 3
137

Arsl!lhenam ine
3.523 3,883 3,806 4,641
5,833 4,561 5,069 3,684 4,]30 5,203 3,6b6 2,951 51,550

v:assermams
4,305 4, 734 4,971 5.943 6,162 4,914 4,}64 4,823 6,485 4,976 3,842
3a6Z3 59,872

Smears
150 138 !62 144
178 156 213
177 236 201
165
~~
2,114

Pamphlets
965 825 710
I,Oil
I ,319 233 517 509 828 830 657 3ba
8,778

Lectures
147 185 662
804
I, 100 6ao
1,757
0
593 1,620
435
61~
8,598

60

PUBLIC HEALTH EDUCATION

T .iF. Abercrombie, L't. D., Director.
Activities of the Division of Public Health Education dur:ng 1930 may be cla,ssified under the follo~.ing II mz.jor headings, which will be taken up in sequence:
I. :Oirth :.eyistration Promotion. 2. nealth Con:x;rvation Contest Promotion.
3, Jenkins County Engineer in~ Project.
4. Health Education ':eek.
5 Heal thcade. 6. Autcmobi le Tag Cooperative Activity. 7 Aid Rendered Mouth Health Activities.
8. Compilation of History of Public Health in Georgia.
9. General Pub! icity.
l'l Printing. II. Stockroom Installation.
ll1RTI1 REGISTRATION PROt.~OTION ---lnsuffici~y of birth registraticn throughout the state, early in the year, inspired an intensive statewide campaign to bring about a more thorough registration of births, In cooperation with the director of the oureau of Vital Statistics this division formed contact with and obtained cocperation of the fo~.r leading women's or_;anizations in the state of a statewide character: The Geor)a Federation of Women's Clubs, the Georgia Congress of Parents and Teachers, the Georgia league of '''omc>n Vot.,rs and the Georgia Fedontion of Colored VI omen.
Addresses were prepared for delivery by sclectud speakers in audienct:.s composed of members of each of the named oraan izat ions. These addresses wen; distributed free Iy during thG year and were delivered in scores of women's organizations throughout the state, 1\hilo all of them rendered valiant S6rvice to the registration effort, yeoman sorvice was performed by the Gcor)a Federation of Women's Clubs throuj1 Mrs. Alice P, Trenary, of Atlanta, wh'l was appointed birth n;s;istration chairman by tlrs, A. H. Brenner, of Augusta, then president of the organization. This federation called on this division to furnish the principal speaker at the state federation meeting in Macon in May. This was done by the pr<'>curement of Or, T. F, 11\.rphy, chief statistician -,f the federal bureau of the census,
Through inquiry blanks carried with automobile tags, interost in birth registration reached a peak in the early part of the year, There was a veritable avalanche of inquiries by parents to ascertain if their children were legally re3istered,
Car cards were prepared and through cooperation with the Georgi a Power Company, were placed in the str0et cars of Atlanta further call in;J attention to the value of proper registration.
61

HEAllH CONSERVATION CONTE'T PR0!-,10TION--- This divisim coop"ratcd to the fullost extent with the insurance section of the United States 01adJer of CO!!Illc.rcc in endeavoring to persuade as largo a number of Georgia cities as possible to enter the health conservation contest sponsored by the national organization.
JENKINS COUNTY ENGINEERING PROJECT---In March, the divisio of sanitary engineering Ll'ldertoak a major engineering project in Jenkins county, near Mi lion, draining a lake of approximately 700 acres, restoring that area to cultivation and rendering the entire surro.nding territory inhabitable by white people throujh elimination of a mosquito pest-hole of throe-quarters of a century standing.
This project, while not as Iarge as others projected in the state, assumed certain spectacular aspects which was felt would capture the fancy of the public. Accordingly, a number of Georgia newspapers and press associations W<re invited to send reporters and photographers to Mi lien to witness the dynamitinJ of this ditch.
The resultant publicity was nation-wide in its scope, accoc.nts and pictures of it appeared in several foreign publications.
The publicity increased interest tremendously, as evidenced by receipt of mai I, and evidence of int.Jrest of the general public in drainage as a means of removing the malaria menace.
HEAL1H EDUCATION WEEK---The six leading organizations in Georgia interested in public health the Medical Association of Geor,ia, the Georgia State Dental Society, tho Goorgia Tuberculosis Association, Emory lhiversity Medical College, the University of Georgia Medic<d College,
and the State Board 01 Health combined to launch an intensive campaign duriny the we<:.k o+ May 5 to 12,
calculated to direct the attentia'l of the 3cneral public to the value. of pcbl ic health education.
The campaign was directo! from thE- modi cal viewpoint by the. toodic~l Association of Georgia, while the State Board of Health, through this division, essayo~ to perform thu ckrical and mechanical detai Is incident to the occasion.
HEALTHCADE---In June, the department thre-ugh cooperation of the S(-veral divisions, arranged Lr a motorcade of nEWSpapermen and roprvsentatives of the department to vi:.;it uach county maintaininj a full-time health officer.
This "healthcade" oocupiod three and a half we<;Ji<s and traveled approximately 3,000 miles. The department furni$hed transportation, each nuwspaper pay inj tho expenses of its representative. The extra cost to the departmE.nt was no~l igible, as each departrr.ont representative ar-
ranged his routine trips over this territory to coincide, thus making up the motor train.
In addition to the publicity obtained, the healthcade was responsibk for drawing the attention of the people in the respective hualth officer co'"nt1es to cub I ic hi.-alth endeavors in those col.l1ties. In many instances, the interest and active cooperation of infi:.Jential citiwns, who theretofore, had taken no co~izance of pub! ic h8alth 0ndeavors, was drawn to the county health units.
AUTOMOBILE TAG COOPERATIVE ACTiviTY---Through cooperatim cf the secrGtary ot state
62

l'
and motor vehicle commissioner, the department was permitted to hav& inserted in envelopes containing the 1930 automobile ytags a small slfp, Qne side bearing a message stressing tho i~tance of birth registratim, the other having a blank for the inquiry as to registration of the children of the recipient. The nunber distributed was 400,!00 and the rcspcnse was such as to almost swarrp the force of the .bureau of vital statistics in looking up birth records. However, every inquiry received was responded to and the desired information given.
Broadening this activit;, in 1930, the soerdary of state allowed the department the privilege of inserting, in additicn to a birth registration slip, a circu.ldr to replace the wax paper behrecn tho tags in the envelope to prevent scratching. ())(' sido of this circular was devoted to malaria an<J the other to pE-llagra. Each side contained an inquifY blank perrnitting therecipient to sign and send to the department for further I itorature on the subjectr The birth regis tration card in the 1931 tags was made to promote the sale (at cost) of the souvenir birth certificate projected by the department, These circulars and cards wcro prepared and the negotiations with the secretary of state conducted by this division.
AID TO MOUTH HEALTH ACTIVITIES--.arly in the year, the Guorgia State Dental Society called on the departlll".-nt for certain assistance in a mouth health campai!1', statewide in character, it was developing. This division was called upon to render this assistance, which was done by editing and distributing to newspapors throughout the state certain articles on dental science prcparod by members of the dental profess ion,
At various times during the year, the divisim was called upon to give some specific aid to this profession in the promotion of this and other altruistic campaigns.
HISTffiY OF PUBLIC HEALTH IN GEORGIA--The 1/Qdical Association of Georgia, in com-
pi I ing its History of Georgia Madicine, requested the department to furnish a history of public
health movement in the stato from inception to date. The task of compiling this history was performed through the enthusiastic ~Joperation of tho various chiefs of divisions of the department. Each furnished the data relative to his own activity, and from these date the history was compiled, using as aneuclous a meritorious work of prior days by Or. Mi liard E. Winchester, of the department,
GENERAL PU6LICITY---'ilhile other special activities have been carr-ied on, it has been the task and aim of this division to promulgate, at all times, through the newspapers of Georgia, news of the activities of the department, as well as timely and seasonable cautions. The success of this endeavor is attested by the free use of the department's pronouncements by the newspapers
Finances rrf the department h~ve not permitted subscriptions to all the nowspapers of the state, consequently nothing like a completo file of clippin_;, has been obtained. However, the evidence tbhined from receipt of a comp~ratively few campi imentary copic,s, mostly of weGkly newspapers, show that this activity has been profitable,
PRINTii,G---Lats in 1)29, the departroont installed a multigraphing outfit designed to do a major portion of the printing required. In addition, other similar machinery Pwned by the department was coordinated under this division. Tho other machinery included a mimeograph machine, an addressograph, and a graphotype, the latter for cutting the plates used in the addressograph.
63

The net results are that the department has been able to produce from five to seven times the amount of printing usually available without increasing to any great extent the annual outlay for printing, At the present time, virtually all the forms used by the department are Printed by this division and in most instances the cost of production is less than half the cost of c011100rcial printing. The standard set by conmercial printers, has been maintained in tho production of forms, and in many instances improved through intillk~te knowledge of tho p.:cd iar needs of the department, The mag1itude of this accompl ishmont can hardly be comprc,honde' unless the character of tne printing produced is takt-'0 into consideration. In addition, hundreds of thousands of sheets were produced on tho mim.sograph.
STOCI<RO ~: INSTALLATION---1/hon the department was ord~red by the governor to remove its quarters from No, 4 Capitol Square to the newl) finished quarters on the ground floor of the capitol adjacent to the laboratories, the physical task of moving and install inJ the department in the new quarters devolved upon this division, This was accomplished with the least possible confusion.
Ther<.J became avai I able with this move, a conrnodious room in which tho large store of supplies could be installed and kept in a systematic fashion, This division installed the supplies in an orderly manner, and developed a system of requisitions from the divisions through which a check could be kept on the quantity of supplies on hand. A perpetual invontory was put in use, after an accurate inventory of the suppl it:s on hand was mado. As new supplies are added, the cost of tho now supply is noted in the perpetual inventory book, so the department may ascertain the cost to date of any article of supplies used by the department.
Another valuable pt.rposc this system serves is that it provides a check on the suppi ies, The supply of one item begins to run low, the affected division is notified and may replenish it in timo to prevent a break in the steady flow of activities, Before this system was installed, it was a constant source of irritation and embarrassment to division heads to find a cer-tain necessary item had become exhausted,
("i('i:"'~rdombtpe,Z~. D~,) ~L
DIR"CTGR,
64

VITAL STATISTICS

BUREAU OF VITA.L STATISTICS
Butler Toombs, Director

BIRTHS- For the calendar year 1)30 there were registered 60,318 live births, correspur.ding to a birth rate of 20.7 per 1,000 popuhtion, This represents an increase of 1,804 over the number (58,514) of births regist<:""ed in 1329. !n the last ten years the annual average nunber of births registered was 61,940, representing an annual average birth rated 21.3.

Although the birth rate for 1930 shows an increase of 2.9 percent over the rate for 1929, tho annu~.l avorag& rates for thE: past ten years show dec Iine of 0.3.

DEATHS- Tho total m;rfber of deaths reported for the calendar year 1930 was 35,188, corrcs~onding to~ death rate of 12,! per 1,000 population. This rate represents a slight decrease of 0,8 percent over the rate (12,2) recorded in 1929. The annual average number of deaths reported in the last ton years was 32,981, representing an annual average death rate of 11,4.,

Death rates for the past ten years show an annual average increase of 0.1,

Following are shown the number of births and deaJ.s with corresponding birth and death rates per 1,000 porulation for the years 1921 to 1)30:

YEAR
1921 1922 1923 1924 1925 1326 1927 1928 1929 1930

BIRTHS

Number

Rates

?0,630

24,4

65.753

22.?

63,681

22,0

63,386

21.8

62,2~

21.5

53.959 ~1,636

18.6 21.2

59,228

20.4

58,514

20,1

60,318

20,7

DEATHS

Nu!rber

Rates

29,552

10.2

31 '714

10.9

34,082

11.8

34,797

12.0

31,278

10.8

29,906

10.3

31,869

11.0

36,085

12.4

35,340

12.2

35,188

12. I

STILLBIRTHS- In the year 1930 there were registered 3,796 sti II births, corresponding to a ratio of 6,3 per 100 live births, This is an increase of 255 over the number (3,541) registered in 192;:;, and the ratio per 100 live births is 3.3 percent higher than the ratio (6,1) shown for 1929

l~fANT MORTALITY--The number of deaths under I year of age registered in 1930 was 41 713, corresponding .to an infant mcrtal ity rate of 78.1 per 11000 I ive births, This is 244 more than the rumber (4,469) registered in 1929, and the rate per 1,000 I ive births is 2,4 percent higher than the rate 76.3) recorded in 1929.

The amual average infant mortality rate for the last ten years shows an increase of

Following are the nunboraf deaths under I year of age and the infant mortality rates
65

per 1,000 live births for tho years 1921 to 1930:

Year

Deaths Lhder I Year

1~1

4,974

1922

4,366

1923

5,629

1924

5,875

1925

4,724

1%

4,323

1927

4,5]8

1928

4,875

1929

4,464

1330

4, 713

Rate Per I ,000 Births
]0.4 6~.4
88.4
927 75-8 80.1
743 82.3 ]6.3
]8.1

Tables 8 and 8X show deaths under I year of age and infant roortality rates, by cer-
tain causes and month of death; Tables 9 and 9X show deaths under I ye'lr of age and infant lll()rtal ity
rates, by certain causes and color.
AVERAGE AGE AT OE,\TH - Table 6 sh(YfjS the average age at death by sex and color for the years 1926 to 1930. Comparing the average ago of death in 1930 with 1929, the averago ago 42.3 in 1930 represents a gain of 1.1 years. Tho average age of white males shows a gain of 1.4 years,
and the white females I year. The colored males average age shows a gain of one-half a year, and the
col <;>red fema los 1.2 years.

MONTH OF DEATH - Tables 4 and 4X show deaths and death rates per 1001000 population, by specified causes and month of death for tho years 1929 and 1930, respectively.
In 1929 January had the highest rate due principally to the high incidonco of influenza and pncl.!!IOnia. In 1930 June shows the hi ghost rato, All causes show higher rates than recorded in 192), except scarlet fever, diphtheria, influcnza, poliomyelitis, tuberculosis and malaria.
Following arc shown the death rates per 1001000 population from specified causes for the years 1921 to 1930:

Typhoid Fever
19~ 1929 1928 1927 1926 1925 192: 1923 1922 1921 17.2 II. 7 13.9 ~o.G ~~-5 21.8 22.2 19.9 2M 2].0

Malaria

15.2 233 18.2

9-3

9.2 'j.?.

14.4 16,2 19.6

15.8

Diphtheria
4.6 6.3 7-5 8.6 a.o G.o

75 9.1 13.8 lt. .I

Tuberculosis (all forms)
74.6 753 74.1 72.8 ]2.6 789 e;.5 8?.4 89.9 857

1930 1397

1929 126.9

1928 103.2

Diseases of the Hoart

1927 924

I'J2b 1925 77.4 74_,0

1924 79-0

1923
J9.0

Po llagra

24,5 30,0' 26.4 '95

13.5 11.8 11.0 14.7

Automob iIe Ace idents

lj.4 18.3 14.8 '37 . 11,8 11,2 16..2

8,8

Accidents (exclusive of automobile accidents)

49-0

49.8 44.6 44.1

387 43.0 47.6 43-3

1922 66.9

I~ I 599

17.7 17-3

6.8

35

437 45.8

.Respectfully Submitted,
/ ~)..A2t.;_/'-d7;\.l--zl-..~
(Butler Toombs) Oiroctor

67

I Table 1- BIRTHS and DEATHS (exclusive of stillbirths) and

I

Rates Per 1,000 Population, In Each County: 1929 and 1930

COUNTY

MJM3ER BIRTHS

DEATHS

RATE PER I, 000 POPULAT1 ON

BIRTHS

DE'THS

Tlltal Appling Atkinson Bacon
Baker
Baldwin

1929 !930

1929 1930

1929

1930

58,521 60,318 35.340 35,188 20.1 20.7

207

278

15)

164

163

212

88

77 15.8 20.8

33

29 22.9 23-7

7'J

82 23,2 30.0

159

17')

58

64 20.3 22.3

278

263

663

~4 12.3 11.5

1929
12.2 6.7
4.7
10,7 7.4 2).3

1930
12,1 5.8 4.2 11.6 8,2 25-9

Banks
I Barrow Bartow Ben Hill Berrien

.264

239

289

241

564

556

249

282

396

452

125

10/ 26.8 24.5

12.7 11,0

129

143 23.2 19.4

10.4 11.5

298

287 22.) 21.9

I 1,8 11.3

168

164 18.) 21,6

12.8 12.6

137

137 27.1 307

9-4

93

Bibb Bleck ley Brantley Brooks Bryan

1,467 224 167 410 132

1,452 235 198 501 115

1,222 I,246 1).1 18.8

120

125 24.2 25.7

71

b9 24.2 26.6

229

2~,2

19.0 23.4

66

80 22.1 19.3

15.) 16.2 13.0 13.6 10.3 10.0 10,6 11.3 11.0 13.4

Bulloch Burke Butts Calhoun Camden

603

674

535

552

152

121

226

223

135

151

234

218 22.8 25-3

8,8 8.2

363

390 18.2 18.9

12,4 1).3

132

131 '57 12.9

13.8 14._0

134

127 21.4 21.0

12.] 12.0

93

122 21.2 23.8

14.6 1].2

Campbell Candler Carroll Catoosa Charlton

110

121

210

2cb

b73

741

173

161

110

119

84

81 11.0 12,2

8,4

8.2

100

87 23-3 22.8

11.1

9.6

323

338 1').6 21.6

9.4

98

66

88 l8,8 l].O

72

93

45

41 25'' 27.1

10.4

93

Chatham Chattahoochee Chattooga Cherokee Clarke

1,89'2 1,849 2,04; 1,940 18,0 17-5

132

119

41

55 15.3 13-3

351

4~2

165

162 22.9 28.6

486

503

153

163 24,l 253

44)

522

401

392 17.5 20,4

19.5 18.4 4,8 6.2
10.8 10.5 7 7 8,1 15.6 15-3

68

Table 1- BIRTHS and DEATHS (exclusive of stillbirths) and

II

Rates Per 1,000 Population, In Each County: 1929 and 1930 (continue&)

\----.

i

I

NU!~Bt'""R

RATE PER I, 000 POPULf,TION

I

I

COUNTY

!

BIR111S

QEI'.THS

BIRTI1S

DEATHS

I
I! Clay j Clayton
I Clinch

1329

1930

1929 1330 192)

1930 1329

1930

155 182

I121

85

158

95

42 114

22.2 17,4 17,6 15.4

12.1

6.o

92 11.1

122

152 i 32

31

1?.6 21.6

4,6 4,4

Cobb

667

678 363 371

19.0 19.1

10,4 to.s

lJI Coffee Colquitt

445

475 134 147

22.6 24,0

6,g

7.4

560

623

244

259

18.3 2G.3

8,0 8,4

I1 Columbia Cook

179

207

79

64

'99 235

8.8

7-3

2'/>

26o

90

107

20.9 22.9

8,0 9.4

I1 Coweta CraiYford

403

486 228 263

159 19.3

9.'0 10,4

190

153

106

93

26,6 21,7

14.8 13.2

ICrisp

395

397 255 239

22,6 22.8

14,6 13.8

Dade
j Dawson
III Decatur DeKalb

121

95

40

44

61

74

31

24

541

56?

305

294

I, 158 I, 101

657

662

29.3 22.8
17.1 21.1
t6.t 239
1'~9 15.6

97 10,6 8.7 6.8 9.1 12,4 96 9.4

IDodge
i Dooly
Dougherty

507

555

215

193

23.4 251,

9.9 8.9

407

443

253

207

22..4 24.5

13.9 11.5

398

350 356 318

18.0 15.7

16.1 14,2

Douglas Early

208

187

97

104

21.8 19.?

10,2 11,0

4<Yj

"74

216

196

22.1 259

11.8 10.7

j Echols
i Effingham
I Elbert
I Emanuel
Evans
I
1I Fann1.n
j Fayette
II Floyd Forsyth
Frankl in

i

.

II

16

12

8

214

116

110

113

l 348

329

202

233

486

502

2'.!8

255

I I 130

143

51

62

378

I426 133

124

128

20t,

59

86

1,073 I,100 66o 549

291

299

I371 Jbl

II I .. I

90

68

181

160

I

l

I

69

39 5.8 21.1 16.3 18,( 1?.8 20.1 20.8 18,4 20.1
29.3 327 14.4 23.5 22.3 22.5 27.2 28.0 22.9 22.6

4.3 2,9 10.8 11.1 10.7 12,6 94 10,6 72 8,]
IC,3 9.5 6.7 99
13-7 11.3 8.4 6.4 11,2 10.0

T!lble 1- BIRTHS and DEATHS (exclusive of stillbirths) and Rates Per 1,000 Population, In Each County: 1929 and 1930 (continued)

i' U!.18ER

RATE PER 1,000 POPULATION

COUNTY

BIRTHS

DEf,THS

BIRTHS

DEATHS

1929

1930 1329 1930

1329

1930 1929 1930

Fulton
Gi Imer Glascock Glym Gordon

5,518 5,696 4,691 4,?54

'77 '73 15.0

14.9

211

190

71

51

28.4 25.7

9.6

6.9

69

74

18

34

15.8 16.8 4.I

77

432

405

323

333 22.3 20.8 t6.7

17.1

399

393

160

171

23.6 23.2

95

10.1

Grady Greene Gwimett Habersham Hal I

410

390

18.3 203 21,3 20.3

95

10.5

223

270

174

177

17.0 21.4 13.3

14,0

541

586 287 251

'93 21,0 16.2

9.0

282

308

105

107 22.4 24.1

8.3

8,4

731

702

301

325

24.3 23.1 10.0

10.7

Hancock Haralson Harris Hart Heard

258

328

136

124

19,2 2).0 10,1

95

257

252

98

134

'93 18.9

?.3

10.1

213

2(Jj

118

122

18,6 18.4 10.3

10.9

400

354

138

153

26.0 2J.2

9.0

10.0

199

232

67

72

21.5 25.4

7-2

7-9

Henry Houston trw in Jackson Jasper

317

317

172

158

19.5 19.9 10.6

9-9

160

I~

139

138

14.2 17.6 12.3

12.2

253

284

112

107 20.7 23.2

9.2

8.7

404

407

176

210

18.5 1n.8 8.1

9~7

170

199

112

107

18.6 23.1 12.2

12..4

Jeff Davis Jefferson Jeri<in:s Johnson Jones

120

139

52

48

14.9 1].1

6.4

59

362

331

185

159

1].4

'59

8.9

7-7

272

308

187

196 20.9 23.8 14.4

15.2

288

314

156

132

22.6 2q 12.2

10.4

202

218

101

83 21.7 24.2 10.9

9.2

Lamar Llll'lier Laurens lee Liberty

194

212

119

127

1)..9 21.7 12.2

13.0

66

85

29

36

12.7 16.3

5.6

6.9

703

719

448

3'JJ

21.2 21.9 13.5

12.1

165

191

127

127

19.4 22.9 14.9

15.2

178

145

127

141

21.7 17.8 15-5

17.3

Lincoln Long

176

164

29

38

22.1 20.8

36

4.8

]0

71

41

29

16.7 17.0 9..8

6.9

70

I - ----~---- -~----~---~----------~---~!'o.ble 1- BIRTHS and DE.4-THS (ltxc1usive of stillbirth8) and Rates Per 1,000 Population, In Each County, 1929 and 1930 {continued)

I COUNTY
Lowndes Lumpkin Macon Madison Marion

NUM3ER

BIRTHS

DEATHS

1929

1930 1929 1930

618

624

103

128

281 I 263 360 I 339

161

157

346 347

~3

55

183 177

167 159

87

79

RATE PER I,000 PCPULATION

BIRTHS
1929 1930
20.9 20,8 20.8 259 16.8 15.8 23.7 22.6 23.0 22,5

DEATHS
!929 1930
11.7 11,5
8.] 11.1
10,, 10.6 11.0 10,6 12.4 "3

McDuffie Mcintosh Meriwether Miller 11\i Iton
i
I Mitchell
I lienroe t,~o,tgomery
I toorgan
I Mu-ray
I
I Muscogee
N.wtcn Oconee Oglethorpe Paulcl ing
Peach Pickens Pierce Pike Polk
Pulaski Putnam Quitrran Rabun Randolph
Rich100nd Rockdale

181

174

103

I 123

163

498 I 4)2

104
264

222

212

80

103

126

45

b21

620

2E.4

3C'5

294

193

202

236

92

219

220

149

219

218

79

rn

9!3

&~2

333

337

2;9

1~2

131

75

312

320

146

309

316

116

183

15?

1':6

217

2)1

65

2")8

3f:0

139

218

2)3

139

452 I 5H8

2)0

I

1)9

15G

q

2Gb

174

116

115

Ill I 34

130

144

49

300

326

163

1,3~2 [1,374 1,281

I 83

127

91

--~-

118

'97 1).3 11.2 13.1

121

21.5 28,3 18,2 21.0

274

21.9. 13.2 11.6 12.2

80

24,41 23-3 8.8 8.8

36

15.3 1 18.7 6.7 53

I

323
I6.;
85 154
65 I

~2-5.'4I
20.3 16.81 23.7 1

26.2 12,0

I25-3

IS.~

2).)

Q/-~

i 76 :03.6

I
I

'6'.'6'

13.6 14.1 8.5 12.3 7-0

820

i I 1f.9 I 15.) 14.9 14,2

2().;
77

I I j 19.2

}'0 )"

I~ .I

17 .I I !6,2

9.0

11.8 95

I I 144

23-2 . 2.1.7 10.8 11.1

90 I
I
I 125
{,.;

24,81
1].8
22.~

2).5 i ;.3

I

I 15-3 14.2

23.8

I
I

6.8

7-3
12.2 6.6

I137
157
276 1

24.2 19.8 I
i 18.2

I I 2fl.7 11.3 10.9
23.3 I 12.6 14.4
23.3 i 9-3 11.0

I
t (lr".
_;u
116
I36 I}l

i
1731
2J.z I
3o.4 I 20.7 i

1].)

9-5

I 20.] 1).1

I 28,9 I 9.0

I 22.7 ?.8

10.0 13.8 94 54

I 178

17.5 . 18.9

95

10.3

I

1,~18,6 18,8 17.7 18.]

84

11.2 17.5 12.3 11.6

71

I

I
I
l:

Table 1- BIRTHS and DEATBS (exclusive of stillbirths) R~tes Per 1,000 Population, In Each Couutyt

and

l
!
I

1929 and 1930 {contiuued) -

i

i<UI:'WR

RATE PER I,000 POPlJLATI<Ji

I
l

CO~TY

BIRTHS

DEATHS

BIRTHS

DEATHS

f
!

1~9 1930 1929 1930

1929 1930

1929 I 1930

!' Schley

'f, 117 58

72

18.0 21.8 10.9 13.4

Screven Seminole

497 489 159 203

144 148

79

63

24.0 23.8

7-7 99

19-5 20.0 10.7 8.5

Spalding

421 435 378 350

18.0 18.5 16.2 14.9

Stephens

II Stewart
I Sunter

I Talbot Taliaferro

I Tattnall

II

Taylor Teffair

Terrell

283 248 101 126

273 246 143 131

580 543 428 379

240 210

103

97

135 140

84

83

2)3 305 114 114

182 213

93

80

307 389 149 167

342 450 246 242

24.2 21.0
24.4 22.1 20.7 20.2 27.7 24.7 21.2 22.6 19.1 19.7
17.0 20.0 20.4 259 18.6 24.6

8.6 10.7
12.8 11.8 15.3 14.1 11.9 11.4 13.2 13.4 ].4 ].4
8.7 7-5 99 11.1 13.4 13.2

i Thomas

7rf, 701 456 489

21.6 21.5 14.0 15.0

Tift

308 286 184 202

19.3 1?.8 11.5 12.5

I Toonbs Towns Treutlen Troup Turner

352 37'l Ill

138

129 122

50

32

l4'o

187

65

68

792 801 508 487

'L~7

290

89 102

20.5 21.6
29.9 27-9
1~).5 24.9 21.6 21.8 ~7 25.8

or.or

8.0

11.6 ].3

8.7 9-1

13.8 13.2

M 9'

Twiggs Union Upson Walker
W~lton

221 204

83

94

178 176

60

57

400 417 235 219

584 562 269 250

487 493 239 237

25~ 24.3 28.0 2].6 2[}.';) 21.3 22.5 21.4 22.9 23.3

97 11.2 9.4 8.9 12.3 11.2
10.3 9-5
lf,2 11.2

Ware farren Washington Wayne Webster

550 621 )81 373

247 254 Ill 114

4f,8

456

294

290

291 3[}6 151 149

107 100

62

68

20.6 233 22.0 22.6
'77 18.2
2'_3.1 24.1
21.2 19.8

14.3 14.0
99 10.2 11.6 11.6 12.0 "7 12.3 13-5

--
72

I T:A.ble 1- BIRTHS a.nd DEATHS (exclusive of stillbirths) and

i

Rates Per 1,000 Popuiation, In Eaoh County:

I

1929 and 1930 (continued}

I

NUI'.~BE:<

RATE PER I, 000 POPULATION

COUNTY

BIRTHS

OE!.THS

BIRTHS

DEATHS

1929 930 1929 1930 1929 1930 1929 1930

Wheeler White llhi tf ie Id
IIi Icox
l'li lkes

216

185

72

86 23.5

20.1

7.8 94

188

174

64

55

31~0

28.6 10,6

90

523

553 209 22j 25.5 26.5 10,2 10.7

270

261

145

lob

19-9

19.4 10.]

M

249

237 177 175 15..0 1\,8 10.7 II .o

Wilkinson li'crth

177

214

102

142

16.3

197

94 13.1

535

526 247 237 25 .. 1 24.9 11.6 11.2

I

I

I

I

II
I
I

I
I

I
I

I
I

I

I

I
I

I

I

i

I

I

I

I
I

I

! __L_

73

I I

I
I

I

I

I
I

Ta.ble 2: BI!tTHS {<.:XOlusive of stillbirth), By Month, Sex aud Color: l929 and 193~

MONTH Am YEAR
Total
1)29 1930
January
1929 1930
February
1929 IJ30
March
1929 19)0 Af:r i I 1929 1930
May
1929 1930
June
1929 1930
July
1929 1930
August
1929 1930
Septerrber
I,,,.. 1929 1930

Doth Sexes
58,521 60,318
5,104 5305
4,494 4,374
5,043 5,430
5.161 5.175
4,751 4,914
4,351 4,525
4,691 5,o68
5,1?8 5,288
4,786 5,427

TOTAL Males Females

Both Sexes

WHITE Males Females

Both Sexes

COLCR0
Males Females

29,870 28,651 35.151 18,357 17.394 22,770 11,513 11,257 30,?47 29,571 3?,o64 19,015 18,049 23 254 II, 732 II ,522
2,590 2,514 3,201 1,634 1,567 1,903 95; 947 2,6~5 2,,Ao 3,265 1,626 1,63) 2,040 1,039 1,001
2,370 2,124 2, 783 1,448 1,335 I, 711 922 789 2,537 2,337 3,035 I,581 I,454 1,839 956 883
2,601 2,442 3,043 1,569 I ,474 2,000 I ,032 968
2,752 2,678 3,301 1,681 I ,620 2,129 1,0]1 1,058
2,679 2,482 3.189 l,b,S I ,431 1,972 981 991 2,(,76 2,4)9 3.133 1,642 1,491 2,042 1,034 1,008
2,392 2,359 2,893 1,468 1,425 1,858 924 934 2,517 2,397 3,015 1,56o 1,455 1,899 957 942
2,247 2,104 2,672 I,410 1,262 I,679 837 842 2,308 2,217 2,853 1,484 I ,369 I,672 824 848
2,338 2,353 2,866 I,433 I,433 1,825 905 920 2,597 2,4?1 3,183 1,~38 1,545 1,885 959 926
2,653 2,525 3,156 1,596 1,560 2,022 I,057 %5 2,750 2,538 3,244 I ,703 1,541 2,044 I,047 997
2,412 2,374 2,872 1,439 1,433 I ,914 973 941 2,?22 2, 705 3,259 1,640 1,619 2,168 1,082 1,086

1)29 1930
November
1929 1930
Oecerrber
1929 1930

4,884 2,527 2,357 3,013 1,587 1,426 1,871 5,127 2,555 2,572 3.118 1,~ 1,556 2,009

940 931 993 1,016

4,885 2,494 2,391 2,966 1,526 1,438 1,919 966 953 4,569 2,2)0 2,279 2,817 1,411 1,4o6 I,752 87'3 873

I 5. IJ3 2,567 2,626
i 4,616 2,378 2,238

3,097 2,841

1,547 I,487

l1,550 2,09f
I,354 I, 775

I,020 I 1,076 e91 I 884

74

-~~-- ~--~-~~-------------------

[

Table 3- l)~;:;.th Rates Pur 100,000 Po:;?Ulation From

Specified dauses (1929 and 1930) r->..-..d Aiuua1 A"'l~:::tage

Ro.tes {1921 to 1925) :6nd (1926 to 1930)

I
I

CAUSE OF DEATH

rI All causes

Typha id fever

Malaria

Smallpox

Measles

Scarlet fever

11hoop ing cough

Diphtheria

Influenza

Dysentery t
I Tuberculosis (all forms)
I Oancer

I Pellagra ()i abetes me II itus

Cerebra I hemorrhage, softening

I Heart diseases

lI

8rmchitis Pnel..lll0'1 ia (all

forms)

Diarrhea, enteritis- 2 years

Appendicitis, Typhi Iit is

Cirrhosis of I iver

Nephritis

Puerperal septicemia

Other puerperal

Early infancy

I Suicide Homicide

I
I

Automobile aqcidents

I Other externaI causes

Un-known, 111-def ined

I All ether caus()s
L

DEATH RATES PER 100,000 POPULATION

ANNUAL AV'RA~E

1921 to' 1926 to

1929

1330

1925 1930

I, 113.2
239 15.6
5 6.9
1 9' 10.4
37.8 54 89.1 44,1 15.1 8.2 s:;.t 75.0 4,9
9<J.O
40.4 10.6
73 104.6
6.3 15.4 91.1 6,2 18.2
8,]
46.5 50.2 216.0

I, 158.7 16.9 15.7 ,2
3.2 1.0 7.4 7.4
55' 8.9
779 49.9
239 10.1
73'
113-2 3.6 84.3 25.2 11.3 4.1
130.1 5.2
14.7
63.1 8.1 17.3 16.3 47,6
58.7
199.4

I ,215,4 II. 7 23.3
.I
1.1
1.4
9.6 6.3 87.5 7.0
753 50.1 30.0 10.4
799 126.9
2.3
797 18.1 11.3 4,tl
1377 4,6
14.3 54.3
9.9 18,0 13.3 49.6 68.9 203.5

1,207A
lb,?
15.2
4.4
8'.8'
4.6 33.1 10.5 74.6
533 24.5 12.1 87.0 140.? 32 88.5 24.7
11.4
4.6
1299 55
1].1
585
10.2
195
19.4 4,.0 78.8 200.2

l

l

75

'

Table 4- DEATHS (exclusive of stillbirths) From Specified causes, By Month

Of Death: 1929 and 1930

~

CAUSE OF o~ATH Nf.J YENl

Total

Jan,

Feb.

Mar,

~r.

May

June July

Aug. Sept.

.Oct,

Nov,

Dec,

All Causes TyPhoid Fever Smallpox i.'!:lasles Scarlet Fever Whooping Cough Diphtheria Influenza

I~ 35,340 4,9JI 2, 742 2,815 2,6';7 1~30 35,188 3,246 2, 9131 3.23~ 3.107

1~29

340

1~30

492

6

6

~

15

5

10

13 13

2,830 2,7~1 2, 7j6 2,648 2,587 2,87J 2,586 3.126
2,989 3,309 2,~ 2,551 2,485 2,8f3 2,]22 2,756
I

26

41

50

62

45

43

15

22

26

55

91

83

78

57

39

22

I~

2

0

0

0

0

0

I

I

0

0

0

0

0

1930

0

0

0

c0

0

0

0

0

0

0

0

0

~

1:'-

1929

31

5

6

6

6

5

I

I

0

0

0

I

0

1~30

128

8

7

37 22

23

15

8

3

I

0

I

3

1~2~

40

5

4

I

3

1930

38

4

2

I

4

I

0

0

5

5

6

3

7

I

2

3

4

2

3

7

5

1929

280

13

II

18 15

1930

257

13

24

20

24

19

32

49

33

29

24

14

23

28

38

37

23

13

13

9

15

1929

183

24

2

5

6

1930

135

17

13

3

1

6

7

6

23

25

34

26

19

3

I

6

13

15

26

23

14

1929 2,543 1,594

311

175

82

1930

j64

185

180

162 127

55

22

13

II

27

48

70 135

56

22

15

)4

II

31

57

104

Table 4- DEATHS (exolusive of stillbirths} From Speoified causes, BY Month Of Death: 1929 and 1930 (oontinued)

I

CAUSE OF DEATH AND YE.IR Total

Jan.

Feb. Mar. Apr.

May

June July

Aug.

Sept.

Oct.

Nov,

Dec.

Oystlntery

1929

204

2

5

2

16

34

45

38

18

II

16

6

II

1930

305

12

9

7

l4

67

77

40

31

20

13

13

2

Acute Anterior Pol iomye Iit i ~

1929

21

2

I

I

2

I

I

I

4

4

I

2

I

1)30

31

8

0

4

2

2

I

I

I

4

4

3

I

Lethargic Encephalitis

...... _

1929

5

0

0

0

2

0

0

0

I

I

0

0

I

1930

9

0

I

I

2

I

0

0

0

2

I

0

I

M3ningococcus Meningitis

1:-

1929

55

5

4

10

6

6

3

I

0

I

5

5

9

r:-

1930

93

II

16

II

II

9

4

3

4

2

4

4

14

Tuberculosis (all forms)

1929 2,190

208

154

192

208

217

2o6

196

!50

166

153

156

184

1930 2,175

196

183

216

177

220

187

178

161

152

163

168

174

Malaria

1929

677

19

13

6

24

29

49

82

113

123

135

48

36

1930

442

22

17

19

23

29

39

65

42

69

62

39

16

Cancer

1929 1,456

116

Ill

129

Ill

131

117

124

112

130

146

115

114

1930 1,5:)2

128

104

129

141

125

145

142

98

152

141

136

Ill

Diabetes Me IIi tus

I 1929

302

l1930

352

40 37

21 31

27 25

15 37

22 37

24 14

24
23

24
30

23
19

3J

19

32

I I 32

32

35

...... ----------~

Table 4- DE.ATHS (exclusiYe of stil::.2irt:.sj F_;,o;n Specified Causes, By Month

Of I:e:~. t~~.. :1::.: G~.' -:.::_:_,: ~ : ~:(' ~ :-~~:.ti. .....-~~~~r.!

- ---. _- . r~--~- -~

---i -- .. -__ --~- ..;. ---~~----; --, -~-- -;-~-T-~-.

CAUSE OF DEf,TH MD YEAR

Tota~

Jan.

Feb.

I j.

.- - - ,

, ,. _

-{- ----. -- -.r-- .-1- -.u-

--~1--- "--.-:------i:-

.. uQ.

"";:>t.

Oct.

Nov, Dec.

Pellagra

1929 1930

871

59

m 42

34 37

6o 52

I1
7~ '

:
Bo

Ii
111 .I 115

'fJ

65

7'3

9-1 ' 88

62

65 50

61 58

53 45

56 .:2

Cerebra I Hemorrhage ard

Softening

1929 2,323 1930 2,536

203 231

202 225

213 225

177 217

I 196 I 175 175

154

2'09 2-:5 221

:]o

180
I~

225 235

t%
190

223 200

Heart Di se'ases

Pneumonia

1929 3,691 366 239 3C5 JOB 321 328 319
1930 4,099 370 353 360 3(,2 346 Jb8 329
1929 2,316 614 224 220 173 131 121 68
1930 2,580 366 348 349 300 197 143 93

269 274 319 273 370

310 313 355 328 305

rro-

6o

'fj

135 179 2%

85

85

132 237 245

Diarrhea &Enteritis,

urder 2 ~ears 1929

526

1930

721

5 18

21

32

80 105 79

16

15

15

18

91 184 101

67

37

33

:

15

85

79

62

39

16

Cirrhosis of Liver

i

1329

128

12

12

10

15

II

10 14

12

8

5

7 I 12

Nephritis

1930

134

9

II

II

12

II

14

7

12

15

II

I 14 I 7 I

1929 4,003 420 338 331

322 322 323 290

309 312 328 331

377

1930 3,787 1'4 331 409 357 325 365 282

260 239 28{; 271

298

Diseases of Puerpera I

State

1929

416

52

33

42

33

40

25 31

33

-+5

32

24

26

1930

498

31

41

45

41

48

45 52

45

36

42

36

36

-

Table 4- DEATHS {exclusive of stillbirths) From Specified Causes, By Month Of Death: 1929 and 1930 {continued)

C~SE OF DEf.TH 00 YE/,R

Total Jan.

Feb. Mary Apr.

May

June July

Aug,

Seot. Oct. i ~<ov.

Dec,

Puerperal Septicemia 1925 1930
Malformations & Diseases of Ear Iy Infancy I)29
1330 I

134 160
I, 742 1,890

13
21

8

9

7

16

15 13

~ I 10 12

I10

12

14

10

I

167 .. 137 131

144

141 1 ~133

142 1 158

175

177

160

. 159

148

192

151 I 154

17

14

II

21

16~ 135 ,.

I

I135

174

I6 I
14
I141
134

~~ I I
I149 .
,3,

Suicide

1929

287

24

28

32

1930

2%

24

25

21

25

I21

15

I29

30

39

28

22

17

15

26 21071 25

I
~I I18 1
27

Homicide

1329

523

48

39

43

1930

569

44

45

33

33

I43

38

I62

49

42

29

I 43

I ()l

54

I:-

49

39

41

49

55

Go

5b

45. '

I53

Auto Accidents 1929 1930
Other Externa I Violence 1929 1330
Lrknown or II I-de f ined 1929 1930
All Other Causes 1929
1930

531

39

564

50

1,4471' 134

1,~28

II'

2,002 215

I 2,297

220

6,071

521

5,943

518

34

31

40

36

102

I{)]

117 123

43

I25

40

41

37

44

I 1461 146

94

110

106

123

I51

48

. 49

56

I141

134

187

9b

172

148

138

177

163

I 141

147

185

212

220

IB'j

198

174 I 150

473
427

531 II 524

i46{ 5~5,1
5o6 5ch

541 619

55003~ II

515 479

48

54

64

54 1

42

I I 55

56 1 58 I

94
85
154 165

"03 I
115
I 192 I 194

I 100
119 1
I 172
I 180

138 ,.
128 .
I
I 183 1
21:.

47,; 442

I ! 509

457

I I )02 . 456

54b 1 4bC

,L..-----,___,...,-

I

I

I

!

1

1. __l___...t___ __:_.

1

Table 4X- Death Rates Per 100,000 Population, From Specified Causes, By Month of Death: 1929 and 1930 (Annual Basis}

CAUSE OF DEATH AND YEAR

Total Jan,

Feb.

Mar.

Apr.

May

JI.Ol July

Aug.

:ept

Cct.

Nov. i)ec.

fd I Causes

1929 1,215,4 2,001.2 1,226,0 1,142.4 I, 114.8 1,148.5 I, 171.1 1,118.5 I ,074 .6 1,085.5 I, 165.2 I,005.1 1,268.7 1930 I,207,4 1,314.3 1,329.8 I,311.4 I,300.6 1,210,2 1,385.2 I,186.3 1,0329 I,040,2 I, 163.2 I, 139.4 I, 115.9

Typhoid Fever

1~29

II.7 2.4

2.]

36

1930

16.9

2.0

4.5

52

6.} 10.6 1?.2 20.3 25.2 18.9 17.4 6.3 8.9

55 10.5 23.0

3.9 33-b 32-7

23.1

16.3

9

Sl!llllpox

1929 1930

.I

0

0

0

0

0

0

0

0

0

.4

0

0

0

.4

0

0

0

0

0

0

0

0

0

0

0

Measles

1929 1930

I, I

2.0

2.7

2.4

4.4

32

31 15.0

2.5

2.0

,4

92 93 6.3

,4

0

0

32

1.2

,4

0

0

0

0

0

.4 1.2

(1)

Scar let Fever

1929 1]30

1.4 2.0 1.8

1.3 1.6

9

.4 ,4

1.3 1.7

,4

0

,4

.8

0 2.0 2.1

1.2

1.6

,8

2.4

1.3 2,9

1.2 2.9 2.0

Whoop i ng Cough
1929 1930

9.6

53

4,9

73

6.3

77 13.4

'99 13.4 12.2

e.8

5.2 10,7

8.1

10.1

II.) 15.9

15.0

93 55

97 59 93

5.2

38 6.1

Diphtheria Influenza

1929

6.3

97

9 2.0

2.5

2.4 2.9

1930 1929

4..; 6.8 5.8
8).5 6<b,j IJ:),I

I1.2

,4

)1,0

)4,4

1,2
"3

.4 9.2

1930

33.1 749 8o.3 65.6

53.2 22.7 92

2.4

93 10.5

13.8 10.9 77

2,4

52 6.3

10.5

97 57

53

4.5 11.3

19.5 29.4 54.8

6.1

57 4.6

12.6 23.8 42.1

--. - - - . --- ... ------- --------

r-

'

)

Table 4X- Death Rates Per 100,000 Population, Fram Specified Causes,

By Month of Death: 1929 and 1930 (Annual Basis, continued)

GAUSE fJf DEATH A~ YEAR Total Jan,

Feb.

Mar.

:p--.

ltty

June

July

Aug.

Sept.\ Oct. Nov,

Dec.

Dysentery

1529

1930

/\cute Anter ior Po Iio-

myel it is

1929

1930

Lethargic Encephalitis

1929

1930

Meningococcus ~eningitis

1929
mo I
f~;} TuberCI...... :dl

Malaria Cancer Diabetes Mel Iitus

19301
1929 1930
1929 1930
I19291
193G
I

].0 .8 10.5 4.9

.]

.8

1.1 . 3-2

.2

0

-3

0

1.9 2.0 3-2 4.5

753 84.4 74.6 79-4

23-3 77 15.2 8.9

50.1 4].1 533 51.8
10.4 !6,2 12.1 15.0

2.2

.8 6.] 13.8 18.9 15.4 7-3 4f6

4.0

2.8

59- - 27.1 32.2 16.2 12.6

94

I

I

.4

.~

.8

.4

.4 ' .4 1.6

1.7

0 1.6

,8

.8

,4

.4

.4

I. 7

0

0

.8

0

0

0

.4

.4

,4

.~

.8

.4

0

0

0

.8

1.8

4.1

2.5

2.4

1.3

.4

0

.4

].1

4.5

4.6

36

'7

1.2 I.6

.8

68.9 77-3 87-3 88,1 8b.4 796 60.9 69.6
81.6 8].5 74.1 8).1 78.3 721 65.2 63.6

I

5-8 2.4 10;1 11.8 20.6 333 45.8 51.6

7-6

].8

9-6 " 7 t6.3 26.3 17.0 28.9

49.b 52.3 46,6 53-2 49.1 50.3 l5.5 54.5 46,4 52.2 59-0 50.6 60.] 57-5 39-7 63.6

94 11.0

6.3

8.9 10. I

97 '17

97

13.8 10,1 15.5 15.0

59

93 (2.1

8,0

6.5 2.5 4.5
52 5-5 .8

,41 .8

.4

1.6

1.3

.4

0

0 .4

.4

0

.4

rl

2.0

2.1

3-6

([)

1.6

'7 57

62.1 65.4 747 66.0 703 ]0.4

'"'' 54.8 20.2
2).1 16.3 6.5

593 48.3 46.3 57' 56.9 45.0

12.6 13.0

I 8.0
13.4

1IJ4..O2

I

Table 4X- Death Rates Per 100,000. Population, From Specified causes, By MenU: of Deo.:ch: l929 and 1930 (Ar.Jtual Basis, continued)

CAL5E Cf CEATH AI-D YEAR

Total

Jan. Feb.

Mar.

Apr. May

JlJ'"le

July

Aug. Sept.

Oct.

Pellagra

1929
1~0

Cerebra I He1110rrhage and

~ftening

1929

1~0

Heart Oisea~~

I:P9
1930

Pneumonia

1929

1930

Diarrhea and Enteritis

ll"lder 2 years

1929

1930

Cirrhosis 4f the Liver

1929

1930

Nephritis

1929 1930

Diseases ,f the Puerperal

State

1929

1330

30.0 23.9

15.2

24,4

31.~

325

49.1

46.]

38.6 273

24.8

24.5 1].0 r6.) 21.1 27.2 31.6 39.4 35.6 2').1 20.9 435

75' 799 82.4 90-3 86.4 743 79.6

]1.0 62.5 755 91.3

8].0 ~.5 100.4 91.1 ~.8 84.6 102.6 89.5 68.8 70..3 '15.2

126.9 148.5 lob.9 123.8 129.2 1303 1376 129.5 10').2 115.0 1295 140,1 149.8 1575 145.8 151.5 140.1 154.1 J33.2 12').5 131.0 1437

191 249.2 100.2 89.3 ]2.6 53.2 )0.8 2].6 24.4 1.7-9 54.8 88.5 148.2 155.2 141.3 125.6 79.8 599 37-6 34.4 35.6 535

16.1 2.0

a.o

B.5 13.4 325 44.1 )2.1 2].2 15-5 13-4

24.] 6.5

6.]

6.1

].5 369 7].0 40.9 344 330 25.1

4.4 4.9

54

4.1

6.}

4.~

4.2

5-7

4.9 34

2,0

4.,6 36

4.9

4.5

50

4.5

59

2.8

4.9 6.3

4.5

1371 17o.5 151.1 1343 135.1 130.7 1355 129-~ 14].4 147-7 16).6 149.4 131.6 152.8

117.7 r26.4 1309 (33.1 114.2 105.-3 100.1 115.8

14.' 21.1

14.8

1].1

139

16.2 10.5

l].l 12.6 18.3 18.2 1].2 19.4 18.8

12.6 13.4 18.9 13.0 21.1 18.2 15.1 1].0

Nov. Dec.

22.3 22.] 18.8 1].0

82.2 90.5 795 81.0
114.6 150.2 13].3 123.5
('J
"}5.1 120.1 co 99.:?. 99.1l

14.3 6.1

~-3

6.5

2.9 4.9 59 2.8

1389 1530 113.4 120.6

10.1 10.6 15.1 14.6

Table 4X- Death Rates Per 100,000 Population., From Specified Causes, By Month of Death: 1929 and 1930 (.Anuua.l :&.l.sis, continued)

CAUSE OF DEATH /\NO YEAR

Total

Jan. feb.

Mar.

Apr. May ..Me

I July

Aug.

Sept.

Oct.

Nov.

Dec.

Puerperal Septicemia

1923

~.6

53 36

3-6

1530

55

8.5 3'

6.5

Mal fa-mat ions & 0 iseases

of ar ly Infancy 1929 1930

599 67.8 61.3 53.2 ...? 70-9 ]9.0 b4.8

SuicidE!

1929

99 97 12.5 13.0

1930

10.2

9.7 11.2

8.5

bicide

1925

18.0 19-5 17.4 17.4

1930

15.5 178 20.1 133

Auto Accidents
1929 1930

!8.: ' 15.8 15.2 12.6 19.4 20.2 1].8 14.6

other External Violence
1929 1930

49.8 54.4 45.6 43.4

4).0

48.2 ~2.2

49.8

Unknown cr 111-def ined

1929

68.9 8].3 ]6.9 6o.l

1930

7&.8 89.1 82.5 85.9

AII Other Causes

1929 208.8 211.4 211.5 215.5 1930 2039 209-7 190.5 212.2

------

.----

6.J 36 4.2 4.1

4.5

7-1

I 57 1 2.5 4.5

55 32 5-0 5-7

4.0

4.6

8.51 55

52
I

6o.4 57.2 66.6 599

558
80.4

57.6 61 .. 1

64.1 62.3

56.6 56.5

66.6 70.4

l 59--2 6o.5 .
%.1 53-0

10.5 8.5 6.3 11.8 {2.2 71 10.6 7..6 8.9

16.3 11.3 92 6.9

6.1

8..4 10.1 11.3 13-3

t'J

135 17.4 16.o 2').2

19-9 17.6 11.8 lB. I 21.9

C)

20.5 15.8 1].2 19.8

22.3 2').1 22.7 18.1i 21.4

18.1 10.1 16.8 20.]

19.5 20.2 21.9 26.9 21.5

1].2 15.0 18.4 19.8 1 22.] 1].6 22.3 23.4 235

61.3 59-3 394 57-2 46.o 42.9 51-5 757

54.4 394 41.8 45.3 56.o 389 356 46.6 ;.9.8 51.8

579 71.8 68.4 572 52.1 749 82.9 70.4

597 64.6 7M ]2.2 743 6o.] 69.1 78.5 754 86.6

1955 21].1 22].0 204.1 211.8 204.9 259-1 204.1

20}.0 198-9 206.6 191.7 221.6 1539 185.0 2633 190.9 186.)

l
I

Table 5: DEATHS {exolusive of stillbirths), From All CG.U!:>CS' By A:;~, sex a.nd Color: 1'029

AGE
All Agea;
t..nder I year
I I Year 2 years 3 years 4 years
5 - 9 years 10-14 years 15-19 years 20-24 years 25-29 years
30-34 years
35-39 years
40-44 year$ 45-49 years 50-54 years
55-59 years 60-64 years 65-t;7 years ]0)4 years 75-79 years
80-84 years 85-89 years 90-94 years 95-99 years 100 years and over lJnknt>Vl Age

TOTAL Both &!xes Males Females

Both Sexes

I-itlE Males

Females

COLoRED Both Sexes Males

Females

35,340
4,464 837 448 270 211

18,6~
2,509 460 223 129 108

16,647
1,955 377 225 141 103

.18,245
2,34) 465 256 165 112

9,8]4 8,371 17,035

1,324 237 130 81 57

1,019 228 !26 84 55

2,121
372
I~
105 ~

8,819
I, 185 223 93 48 51

8,2]6
936 149 ~ 57 48

731
573 1,271 1,654 1,646

412

319 389

229 160

342

183

159

319 254

264

163 101

309

156

153

Wj

666

491

269 222

780 336

444

782

872

568

273 295 1,086

509

577

775

871

5G1

280 281 I,085

495

590

1,472

711

761

611

304 307 861

407 454

1,812

854

958

710

377 333 I, 102

477

625

1,853

94~

909

733

4o6 327 I, 120

538

582

2,085 1,097

988

864

494 370 1,221

603

618

2,504 1,462 l,a.:.2

'137

581 4o6 I,517

881

636

2,0~3

1,200

893 I, 101

659 442

992

541

451

2,102 I 1,243

859 I, 122

684 438

980

559

421

2,163 1,222

941 1,463

842 621

700

380

320

2,261 1,232 1,029 1,66] 884 783 594 348 246

2,oo6 1,051

955 1,502

7?' 726

504

275

229

1,569
]66
296
~

756

813 1,129

513 616

440

243

197

358 408 529 225 304 Z37 133 104

124

174

157

59 9S 141

65

76

45

47

23

II

12

69

34

35

97

37

6o

9

I

8

88

36

52

62

35

27

24

15

'I 38

20

18

I
84

-----------------------------
r-
Table 5::1.: DEATHS {exolusi"Ve of stillbirths), From

All C:iuao::s, By Agu, sex and color: 1~30

AGE
All Ages
Under I year I year 2 years 3 years
4 years
5 - 9 years I0-14 years 15-19 years 20-24 years 25-29 years
30-34 years 3539 years 40-44 years 45-49 years 50 54 years

r

TOTAL

1 Both i I Sexes I Males Females
I
II 35,1881 I8,6QI 16,587

Both
Sexe~

I'M ITE
I
Males 1 Females

Both Sexes

18,036 9,812 8,224 17,152

COLORED Males females
8,789 8,363

I 4,713

I 928

I 446

I 243

I
I

191

l 639

6c6

I 1,223 1,675

I 1,592

2,622 2,091 530 398 230 216 120 123 too 91
357 282 322 284 560 663 800 875 719 873

2,468 1,356! 1,072 2,245 1,226 1,019

50( 2911 209 428 239 189

2~ 132 116 198

98 tOO

146 67 79 97 I 53 44

100 62 38

I91

38

53

33! 195 143 301 t62 139
28C 159 121 326 !63 163
438 223 209 785 )31 454
592 317 275 1,083 483 600
56: :<63 305 I,024 456 ')68

I ,413 I, 766

66~
838

7471
928

53~
690

257 345

278 878 345 I,076

409 493

469 583

1,843 96o 889 72'; 387 342 I, 120 573 547

2,013 1,059 954 1>7 4l2 325 I,246 617 629

2,504 I,.~64 1,040 1,015 631 384 I,489 833 656

55-59 years 6o .64 years 65-69 years 70-74 years 75-7') years

2, 15~ 1,258 898 I, II< 705 414 1,037 553 484 2, 19i 1,265 925 I,244 728 516 946 537 409 2, lb( 1,218 942 I,444 810 634 716 408 300 2,341 1,305 1,043 1,694 925 769 654 380 274 I,81 972 8!.0 1,37' 714 659 439 258 181

80-84 years 85-89 years :;J0-94 years 95-<JJ years 100 years
and over
Unknown Age

1,43 697 740 l101l 482 536 4191 215 204

73 325 407 I 511 208 303 221 117 104

2'f. 113 182 i 157 50 107 138 63 75

to;

42 6o

31

"I 25

66

31

Jj

8 711

27 32

I57

It

39

15

2

9

4 II

73 56

25 28

48 28

I

I

I
I

I

85

Table 6: Avur<:.:::e A'~l,j At D~i:i.tht From All Cn.ust~st By Color and Sex: 1926 to 1930

TOTAL

WHITE

COLORED

YEAR

Both I

Both

I

Both

I Sexes Males Females Sexes Males Female Sexes Males Females

1926

41.2 40.9 41.1 44.7 437 45.8 377 )8.6 )6.6

1<)27

41.3 41,2 41.3 44,7 43.8 45.7 37.7 38.3 37.1

1<)28

41.7 41.8 42.2 45.0 43.9 46.3 )8.8 39-5 38.1

t:29

42,8 42.7 42.7 46.3 45.6 47.1 390 3).5 38.4

1930

42.3 42.3 42.3 459 45.1 46.8 385 39' 3?.8

--

I

I

86

'I

---~-~~~~-----------------

T'lble 7-De'l.ths (exclusive of stillbirths), By Det'li led Ll~t

r..P ~fll,.,A~ nnn l"'r.11"\l" 19'9 -.nt'l 19~1"1 "

I
I--
!

CAUSE OF DEt1TH All Causes

I. Typhoid and paratyphoid fever

Total

1929

1)30

35,340 35,188
340 500

1\h ite

Colored

1329 19.)0 1929 1930

18,245 18,036 17,075 17,152

140 207

200 293

2. Typhus fever

I

9

0

8

I

I

3 kelapsing fever

0

0

0

0

0

0

4. Malta fever

I

I

0

I

I

0

5 Malaria
6. Smallpox

677 442

2

0

322 186 355 256

I

0

I

0

7 Weasles 8. Scar let fever

()
.1'

Y:h oop ing cough

31 128

40

38

280 257

26 94

33

33

171 121

5 34 75
109 136

10, Diphtheria

183 135

139 102

44 33

II a Influenza (with pulmonary campi ications) lib Influenza (other and LnSpecified) 112 Mi Iiary fever

1,527 503 1,016 4~1

0

0

317 284

533 248

0

0

biO 219

483 213

0

0

13 t.~ps

2

+

0

+

2

+

14 Asiatic cholera

0

0

0

0

0

0

15 Cholera nostras
116 Dysentery
l 17 Plague

5

IO

204 3(1)

0

0

3

7

99 158

0

0

2

3

105 147

0

0

118 Ye II ow fever

0

0

0

0

0

0

Srirochetal hemorrhagic jaundice 119
i20 Leprosy 21 E.-ys ipdas 22 Acute pol iomyel it is
23 Lotharg ic encepha I it is 24 Mbningococcus meningitis
25 Other epidemic_and endemic diseases
26 Glanders
27 Anthrax 28 Rabies
29 Tetanus 30 Mycoses
T!IBEROt!LOS IS (tota I)
31 Of the respiratory system
32 Cf tho meninges, contra! nervous system
33 Of the intestines, peritoneum 34 .Of the vertebral column 35 Of tho joints 36 Of other organs 37a Disseminated {acute) ~ 37b Disseminated (chronic)
+ lnohwd in Other Infcct ious 0isoasos

I

0

0

0

48

48

21

31

5

Q ,I

55 93

0

0

0

0

0

0

2

7

63

56

5

2

2,190 I 2,175
I ,973 I I ,)76

40 31
62 62

18

19

3

7

28

26

59 50

7

4

l_.

0

0

I

0

0

0

0

0

46

4(j

12 25

3

8

23

48

0

0

2

8

9

6

2

I

32 45

0

0

0

0

0

0

0

0

0

0

I

5

33

31

I

2

30 25

I

2

4

0

742 774 1,448 1,401 666 697 I ,307 1,2-rJ

17

19

26

19

23 12 36 43

6

II

12

8

2

3

q >

8

16

16

ol I
I

I

4

19

18

43 34

73

I

87

Table 7-De~ths (exclusive of stillbirths} By Det~iled List of C'1Uses 11nn r.olori' 1129 'lnd l9.MOJ'"',ontinu3d)

CAUSE OF DEATH
.
. 38 Syphi I is
39 Soft chancre

Total
192"3 mo

461

429

0

0

'llhitc

1929 1930

82

77

0

0

Colored

1929 1930

379 352

0

0

40 Gonococcus infection 41 Purulent infoction, septicemia 4;! Other infcct ious discases
CANCEfl A. D OTHER tlALIGNANT TUtl<iRS {tota I) 43 Of the bvccal cavity 44 &

15 'Jj
7 1,456
52

19 69 23 1,552 80

4

4

60

39

6

14

988 1,1~

42

61

II

15

35

30

I

9

:.68 447

10

19

45 Of the digost iIIEl track arid peri toncum 46 Of the fomalc genital organs
47 Of the breast
48 Of the skin 49 Of other or unspcci fiod organs 50 Tumors, benign and unqual ifiod 51 Acute rheumatic fever 52 Chronic rhoumat ism1 osteoarthritis1 gout 53 Scurvy 54 Pellagra 55 Beriberi 56 Rickets
157 Diabotos :re II itus

577

578 414

418

163 160

327

35' 159

208

168 148

129

134

91

92

38

41

72

72 67

68

54

299

334 215

258

31

33

16

15

25

39

15

20

55

53

26

33

0

0

0

0

84 75

15

18

10

19

29 20

0

0

871

713 334

255

537 458

I

0

0

0

I

0

17

13

6

2

II

II

302

352 201

240

101 112

5Ba Anomia, pernicious
58b Anomia ~59 Oiscasos of tho pi.tuitary gland ., 60a Exophthalmic go itor
6ob Other d iseascs of the thyroid and

51

57

36

41

15

16

12

19

5

10

I

0

0

0

7

9

I

0

24

16

15

9

57

61 Parathyroid gIands

24

2]

14

18

10

9

62 Discasos of tho thymus gland

7

14

5

13

2

I

63 Diseases of the adrenals {All ison1s disease

2

3

2

2

64 Di scascs of the sp loon

2

3

2

2

65a lcukomi a

30

38 26

26

0

I

0

I

4

12

6)b Hodgkin's di scasc

9

75

6

4

I

66 Alcoholism (acute or chronic)

44

52

26

32

18

20

67a Chronic load poisoning

5

0

2

0

~

0

67b Other chronic mineral poisoning

0

2

0

I

(

I

68 Chronic poisoning by organic substances 69 other genera I disoasos 70 Encophal it is ]Ia Si""le meningitis ?lb Nonepidomic cerebrospinal meningitis

9

5

8

5

I

0

77

73 44

43

3~

30

62

43

48

25

I~

18

90

53

57

29

3~

24

~

41

28

20

IE

21

72 Tabos dorsa I is (I ocorootor ataxia) 73 other diseases of tho spinal cord

13

II

12

7

4

52

56

28

34

2

22

88

'!

- - - - - ......... ---~--------------

..

..

T::t.blo 7-De'.:l.ths (ux.clusive of stillbirths) By'])et'liled List

nt' ~f11H~As ~nn f'lnlnl"t l 1~9 !:'lnrf 1Q~:'\ l 11nntinn.~n 1.

CAUSE Of DEATH

Total

19~

1930

'lf1ite 1929 1'930

Colored 1929 1930

74a Cerebral hemorrhage

2,262

74b Cerebral thronbosis and cmbol ism

37

75 Paralysis without specified cause

594

76 General paralysis of the insano

62

77 Other forms of 100ntal alienation

27

78 Epilepsy

74

79 Convulsions (nonpuerperal)-5 yrs, &over-

15

80 lnfanti le convulsions (under 5 years)

52

81 Chorea

3

82 Neuralgia and rouritis

7

83 Softening of the brain

24

84 Other diseases of tho nervous system

84

85 Discases of tho eye and .anroxa

2

a6a Diseases of tho oar

35

!l6b Diseases of the mastoid procoss

40

87 Per icard it is

39

88 Endocarditis and myocarditis (acute)

121

89 Angina poetor is

304

90 Other diseases of heart
91a f.reurysm

3,227 46

91b Other diseases of tho arteries

235

92 Enbolism and thrombosis (not cerebral)

46

93 Di soases of the vc ins

10

94 Diseases of the lymphatic system

7

95&

% Other diseases of tho circulatory system

42

97a Diseases of the nasal fossilQ

I

97b Diseases of tho nasal fossae annexa

14

98 Disoases of the Iarynx

9

99a Acute bronchitis

20

99b thronic bronchitis

28

99c,d Bronchitis (undefirod)

20

IOOa Bronchoproumoni a

706

IOOb Capillary bronchitis

5

lOla Lobar proumon ia

914

IOib Pneumonia (undefined)

691

102 Plour isy

51

1(13 Congestion &hemorrhagic infarct of tho

lung

50

IL4 Gangrene of the lung

l1

IG5 1\sthma

57

- I Included in other diseases of tho circulatt"Y systo

2,483 40 637 78
30
% II
67 0 8 13 83 0 19 27 29 1% 352 3,495 42
~8
6 13 4
68
0 19 19 27 24 42 745 4 1,145
686
70
52 0 43

1,228
29
275
32
7 28 0 23 2
5 19 63
I 25 31
17
51 228 1,627
17 127 36
6
5

1,2~
23
337 48 16 49
I
34 0
3 7 52
Q
14 20 10
72
276 1,]28
16 171
5 8 2

1,034 8
319 30 20 46
~5
29
I 2
5 21
I 10
9 22 "";)'
]6
1,6oo ~ 108 10 4 2

1,189
17 300 30
14
47
I 33
0
5
6
31 0
5. 7 19 124
76
1,]6]
26
127 I
5 2

17

34

I

0

IO

15

6

14

5

13

16

14

6

21

392 394

2

I

435 547

336 298

26

31

25 34

0

0

4

4

3

5

15

14

12

10

14

21

314 35;1

3

3

47') 598

355 388

25

'J)

42

37

I

0

19 25

8

15

I

0

38 18

89

.Table 7-DGnths {exclusive of stillbirths), By Det~iled List

..

of r.~l~A!'I n.nd color 1 ~29 ~w'J 1CI!l:n inn....H ..., ~"~ \

CAUSE OF DEATH

Total
1~29 1930

M-1 ita 192~ 1930

Colored
1~9 1930

1\l; Pu1monary ewphysema i07 other diseases of the respiratory system .108 Diseases of the mouth and annexa 105a Adenoid vegetations
IQ9b other diseases of the pharynx, tonsi Is
tiO Diseases of the esophagus
lila Ulcer of the stomach
(lib Ulcer of the duoderum tl2 other diseases of the stomach 113 Diarrhea and enteritis (under 2 years) 114 Diarrhea ard enteritis (2 years and over) 115 Mkylostomiasis 116 Diseases due to other intestinal parasites ll7 Appendicitis and typhlitis
liSa Hemia
ll8b lntost ina I obstruction 119 Other diseases of the intestines 120 Acute yellow atrophy of the I iver 121 Hydatid tumor of the I i ver ""122 Cirrhosis of tho I ivor
123 Biliary calculi i24 other diseases of the 1iver
125 Diseases of the pancreas
126 Peritonitis without specified cause 127 Other diseases of the digestive system 128 Acute nephritis 129 Chronic nephritis 130 Chyh.r ia 131 other diseases of the kidneys and <lmeXa 132 Calc:ul i of the urinary passaiij&S 133 Diseases of the bIadder 134 Diseases of the urethra, etc, 135 Diseases of the prostate 136 Nonvenereal discases of male genital
organs
137 Cysts, other benign tumQrs of the ovary
IJJ Salpingitis and pelvic abscoss
139 Benign tumors of the uterw 140 Nonpuerporal uterine hemorrhage 141 other diseases of the fellllle gonital orgar 142 Nonpuerperal diseases of the breast

3 21 48
0
100 0
96
30
318 526 300
9 II
330
6e
145
59 10 0 128
33 131 13 74
0 436
3.567 0
103 12
43
33
88

4 41
37 0 88
3 101
32 285 721 321
4
3 333
6e
181 44
13 0
134 24
109 4
52
0
375
3,412
0
74 18
27
16
93

72

10

12

55 39 58 57

7

0

31 .30

I

4

2 8
26
0 63 0 50 19 129 292 163
9
6
228 29 78 31
7
0 74
26 90
13
32
0 189 1,997
0 54
9 18
9 51
2 4 23 13 2 17 I

2
17 19 0
4~
2
50 26 122
453
tn
3 0 211
30
93 18 6 0
80
18
69
3 25
0
139 1,921
0
50
14 10
2 52

I 13
22 0
37 0 46 II 189 2)4
137 0
5 102
39 67 28
3
0 54
7 41 0 42 0 247 1,569 0 49
3
25
24
37

0

5

9

6

8 32

9 45

05

16 14

I

0

2 24 18
0
39
I 51 6 163 268 144
I
3 122 38 88
26
7 0 54 6 40
I
27 0 236 1,491 0 24 4
17 14 41
2
3
31 48 0 14
3

90

------------------.-----------
I -:- -~ -pT-'lble 7-Da'lths ( ~lusive of stillbirths) By Detn.iled List

.

of nn.u!=:es and Color 1929 ~d 1930 (oontinuedl

CAUSE OF DEATH

Total I~ 1930

~ite
I~ 1930

Colored 192~ 1~0

THE PUER"ERAL STt'.TE (total)
"' Accidents of pregnancy
144 Puerperal hemorrhage

550 658 284

80

63

51

49

49

29

jl45 other accidents of labor

70 87 30

146 Puerporal septioomia

134 159 6o

147 Puorparal phlegmasia alba dolons, eabolus,

14

15

.7

148 Puerperal albuninuria and convulsions

20G 274 lOS

149 Other conditions of the puerperal state

2

II

2

150 Puerperal d iseascs of the breast

0

0

0

151 Gangrene 152 Furuncle 153 Acute abscess 154 other d iseases of the skin and ameXa
155 Diseases of the bones IS,' Disoasos of the joints

43

37

17

18

19

12

33 33

19

23 18

7

30

16

17

I

I

I

157 ~tat ions

0

0

0

156 other diseases of the organs of locomotion

I

3

I

15~ Hydroeopha)us

33 33 24

15~ Congenihl malformations of tho heart

66 89 51

15~ other congenital malformations

65

62

45

16o Congenital debi Iity, icterus, solerema t61a Premature birth

2ob 216 101
I, 107 1,218 67)

t61b Injury at birth

128 144

82

162 other diseases peoul iar to early infancy

129 128. ]2

163 Lack of eare

8

0

0

164 Old age (senility) SUICIDE (total)

649 613 269
287 296 268

165 & Solid or I iquid poisons or by absorption

t66 of corros ive substanoos

56 66 52

167 By poisonous gas 168 By hanging a- strangulation

15

3

15

15

18

13

169 By drowning 170 By firearms

9

15

7

175 176 166

171 By cutting or piercing inst.rumants 172 By jlJIIlling from high places
173 By crushing

7

9

6

6

7

6

I

0

I

174 By other means HOMICIDE (total)

3

2

2

523 569 149

197 By firearms

361 391 113

198 By cutting or piercing instruments

100 Ill

14

199 By other means

6o 67 21

200 Infanticide

2

0

I

361 266 297

34

29

2~

30 20 19

48 40 39

81 74 78

8

7

7

153 15 121

7

0

4

0

0

0

14 26 23

13

6

6

15

14

18

9

16

9

12 13

4

0

~

I

0

0

0

I

0

2

21

9

t2

74

15

15

51

20

II

102 IC5 114
757 432 461

~~

46

35

71

57 57

0

8

0

231 380 382
273 19 23-

61

4

5

2

6

I

18

2

0

10

2

5

165

9

II

8

I

l

7

0

0

0

0

0.

2

I

0

158 374 41!

126 248 265

~ 86 102

23 39 44

0

I

0

91

Table 7-De~ths (exclusive of stillbirths), By Det~iled List
of' l1:1.11l':Al'! n_..,t'l l'!nl \,.. 1Q!)Q !'l'l'il ~9!'10 t~nt-in,;~t'l\

CAUSE OF DEATH ACCIDENTAI. OR l 'NDEF ItED (tota I)

Total
192';) I ')30
I
1,9]8 1,992

White
i92) I 19-30--
i, 113 I, 164

Colcrod :923 1930
865 828

175 Poisoning by food 1]6 Poisoning by wnomous animals
177 Other acute poisonings (gas ~ccpted)
178 Conf Iagrat ion 179 Bums (conflagration excepted)

54

43

7

2

50

46

31

27

201

213

23

20

31

23

5

0

2

2

27

27

23

19

10

12

21

15

66

87

1)5 126

180 Meehan ica I suffocation

45

40

23 18

22

22

181 Absorption of irrespirable or

poisonous gas 182 Oroilrling

10

II

116 114

6

8

6o 47

4

3

56

67

183 Trurratism by firearms (except in war) 184 Traumatism by cutting or piercing instr. 185 TraUma.tism by fall 186 Traumatism in mines & quarries 187 Traumatism by machines

114

118

II

15

2)5

269

3

I

40

43

56

45

4

10

187 211

2

0

24

20

58

73

7

5

48

58

I .I

16

23

188a Railroad accidents

131

143

75 83

56

6o

188b Street-car accidents

12

10

9

8

3

2

188c Automobile accidents

531

564 335 391

1% 173

188c, f Injuries by other vch icles 188d Aeroplane and balloon accidents 188g Lands! ide, other crushing

22

I'

II

8

II

II

3

3

3

3

0u

58

38

34

20

24

18

189 lnjl.ries by animals (not poisoning)

19

33

190 Wounds of war

0

0

192 Starvation (deprivation of food <x- water

8

0

12

20

0

0

4

0

7 13

0

0

4. 0

193 Excess iw cold

12

12

4

2

8

10

194 Excessive heat

4

46

2

21

2 25

195 Lightning
l;lb Other accidental electric shocks

34

26

17

13

17

13

29

II

24

II

5

0

201 &

202 other accidents
. 2(8 other external violcnoo (net SJX-Ci ficd) . 204 Sudden death

139

89

58 56

126 137

66 45

24

34

52 72

73

44

34

22

74 65

205a Ill-defined 2Qijb Not spec if ied cr url<nown

501

421

1,375 1,739

190 16o 489 526

311 261
886 1,213

92

1

7X-Death R.?..te:; P~r 100,000 Pon. <l11.i~u,, By Detailed li~t of '

C"!w.1ses and n.olol ~ 1929 and 1930

.

CALSE OF DEATH

Total ~ 1930

V'h ito
1929 mo

eo1cr-~
I~ 1m

ALL CAUSES I Typhoid and paratyphoid fevor 2 Typhus fever
3 Rc Iaps ing fever 4 Malta fovor
5 Malaria 6 Small pOll
7 Measles
8 Scar lot fovor 9 l'tlooping cou~ 10 Diphtheria I Ia Influenza {with pulmonary complications) lib Influenza (other and unspecified) 12 Mi I iary fovor 13 ~s
,,14 Asiatic cholera
15 Cholera nostras Dysentery
17 Plague 18 Yellow fever
19 Spirochetal hemorrhagic jaundice 20 Leprosy 21 Erysipelas 22 Acute pol ianyol it is
23 Lethargic oncophalitis
24 Meningococcus meningitis
25 Other epidemic and ondamic diseasos
26 Glanders 27 Anthra~~ 26 Rabies
29 Tetarus
30 Myccses TUBeRCllLOS IS (tota I)
31 Of the respiratory system
32 Of the mon inges, contra I nervous system
33 Of tho intestines, peritoneum
34 Of the \edobral colum 35 Of the joiots
'!> Of tho other organs
37a Dlssominatod (aouto
37b Oissominatod (chronic) + .Included in othor infectious disoasos

1,215.4 1,20?.,4

II, 7 17.2

c 3

0

0

0

0

233 15.2
.I e

1.1 4,4

1.4' 1.3

96 8.8 6.3 4,6

525 1'7-3

349 15.8

0

0

.I

+

0

0

.2 .3

7.0 10.5

0

0

0

0

0

0

0

0

1.7 1.6

1 1.1

.2 .3

1.9 32

0

0

0

0

0

0

.I

.2

2,2 1,9

.2 ,I

753 74.6
6].9 67,8

1.4 1.1

2.1 2,1

.6 >~7

.I

.2

1.0 9
2.0 ~-7
-.2 .I

99~1
7.7 0 0 0
17.6
,(
1.4.
1.8 94.
7-6
50.2
29.2
0 0.
0 .2
54 0 0 0 0
2.5
1
.2 1.3
0
0 0 .I
1,8
'
40.6
365
9
1.4
.3 .I
. 5
9
.0

j795
11.2 .4 0 .I
10.1 0
5-1 1.8 6.6 5-5 15,4
13.5 0 + 0 .4
8,6 0
0
0 0 2,2 . 1.4 . ,4 2,6 0 0 0
.3 1,7
'-
42.0.
3M 1,0 1.0
.6
.2'. .4
9 .I

l;580.a J.5987

!5 ,, 2].3

1

.I

0

0

.I

0

J2.6 . 23-9

.I

0

.-5 . 32
.6_ .5

10.1 12,7

4.1 J.l

5&4 20.4

44,7 19.9

0

0

.2

+

0

0

.2_ 3

97 13-7

0

0

0

0

.. I

0

0

0

.2

1

.a. .6

,2

.I

3.0. 4,2 '

0

o.

0.

0

0

0

.I

.2

2.8 2.}

.4 0

1339 130~
120.9 lli.2

2.1

1~1

33 4,0

1.1

7

.I

.4

1.8 1.7

4&1 ).2

.6

.3

93

~-- , ... - ....... - ............. .
7X0Den.th Rates:Per 10p,ooo Pop'tl.l.'l.tion, By :Detn.iled List of . G:mses and" Col6r..,-l.S29 Md 1930 aontinued

,
J .-: CA~E OF OCA~ :"~-- ..

Total 1929 lJ30

Whit\l

Colorod

1]2;1 1?30 1929 (930

bo~~~-.~--~~~~~--~-. ~~--~--;-~~~~~~~~~~~~~~~~

.. JB S.yjlhHis ' .

.JI!

.,

''

<;
.~.~-"l'

. - --.4

J9.:..So,ft .cllancr,c -. . -; ~--

15.9 14.] 4.5 4.2 35.0 )2.a

C O.

0

0

0

0

;4~ G~occus;i~fcction

.5 7

.2

.2

1,0 1.4

"' 4!' ~ul<nt infocti<n,:sopticcmia

3.3 2.4

33

2.1

3.2 2.a

42 Other infc!)tious di~oasos
.-: .~ ~~ AID:O'f!'iER t.IAiJ~NANT TUMffiS {total

.21 .a

3

.a

.I .a

50.1 533 54.1 6o.o 43.3 41,]

~3 Oij th,!l buccal cavitx.



1.8 2,7 2.3 33

.9 l.a

44 & i

'.

45. of! th~- diJst.ivo tr~ck & por,itoroun

.46 Of th~ f~lo. genital 'organ5 .

4]. 0~ t~ !To~s~
48. ot tho skin

;. : 7 , ,



I

..

: :,

~

'\ -



49 0~ other ci- LnSpoc if iod organs

50_ T~~. bori~ and ;~ual if_i111d

51 Adut-o rhcutn<ttic fo~

.

52 Chronic rhoumat ismi _osteoarfhr it is, gout

5.3 Self"":)'



:

~4 Ptill~gra . .

55 Beriberi
I Sb Rickets
57 ~tabctos n:o11 itus

58a Aromia, p~nicious;

,

5ab Aromia .

,



;



l ' ..

. ., '

:

~9 Djsoe.ses qf :tl}o pitl'itary ~land

:. ...

...

l,.

Oa Ef.oe~thal~i!l-.goitor _

. ~.O...b

$. .~.. -d isaase...s

of

t.tJo

thyroid '

61 ai-d parathyroid glands -

62 o'isoasc.s of tho thynus gland

63 O;iscasos of tho adi-enals (Allison's disease

64 o;soasos of tho spleen

65a ~~ia .



65b H;in's,di~\laso

66 A'lco;ol ism (;cute ~: olronic;)

~za cpr~io load_poisoni~

~7b Qthc~. chroni? lllin:ra} pbiscnjng..

_

~ OhrQ!)iC poi~~lng 'by, a-ganio substances ...

9 Other gcncra.l disoa~s

]0 ehoe~a litis_

jla Si11fJJo,~i"lJitis

71 b :Nooopidomie corobrospinal.moningitis
. ]2 Tfbe~ dorsaIJs ( ~o;rotor ataxia)

73 dthor djsoasos oftho spinal cord_

19.8

12.2
4.6

2.5
11.5
1.1

1.3 1.8

{}

30.0 24,5

0

0

.6 .4.

10.4 1.2.1

1.8 2.0

.4 7
0

.8 . 5

.8 9 .2 5
.I .I
,I .I
1.0 1.3
3 .2
1.5 1.8 .2 0 0 .I
3 ~, 2 2.6 2.5
2.1 1.5;
3.1_ ).S
1.6 1-.4
.4 ..4
1.8: '9

22.7 22.].

8.] 11.3 50 5..0

37 37

11.8

1~.0

.'j

.8 .1.1
1.,,4. I.e

0

0

18.3 13.8

0

0

3

.I

11.0 1).0

2.0 2,2

3 5

0

0

.a 5

,8

1.0

3 .]
.I

.I

.,

1,4

1.4

3 3 1.4 1.]

.I

0

.I

~4

3

2.4 2.3

2.6 1.4

31 1.6

1.5. 1.1

7 '
'5

15.1 14.9

15.5 13.8
35 3a 5 .4
].8 ].0

1.4 1.7
9 1.8
2.] 1.9 00

4),] 42.7

.I

0

I.G 1.0

93 lo.4
1.4 1.5
.6 .a

.I

0

.B 1

.a

.2 .I

0 .I

0 .I

.4 1.1

.4 .I

1.9

0

.I

.I

0

).I 2.8

1.3 1.]

31 2.2
'7 2.0
.I .4

. 2.2 2.1

94

7X-Death Rates Per 100,000 Population,- By Detailed Li ~;t of . -
~:q,,.,.,.., .<'!.nil ~n1n .... lQ!i!:Q~nd lq!'lo (,..,.,.,.,+~ ....,,"", \

CAUSE OF DEATH

Total

1~2~

1330

'Illite 1929 1;)30

Colored 1')29 t~o

74a Cerebral hemorrhage
74b Cerebral throrrbosis and embolism
75 Paralysis without specified cause
76 Gereral cpar~lysis of the insane
77 Ofuer forms of 100nb.l alienation

7?.8 &<j.2

1.3

1.4

20,4 21.3

2.1

2.7

r9

1.0

78 Epilepsy

2.5

33

79 Cmvulsions lnonpuerperal) -5 yrs, & over-

-5

H

80 Infantile convulsions (under 5 yee.rs)

1.8

2.3

81 Chorea .

,I

0

82 Neuralgia and neuritis

.2

.3

83 Softening of the brain

.8

.4

84 Other diseases of the nr.rvous system
85 Diseases of the eye and amexa a6a Disoasos of tho ear
abb Disc1ses of tho mastoid proco~s
87 Pericarditis
68 Endocarditis c;nd myoc~rd it is (acute) 8} klg ina pectoris
JO Other d iseasos of heart

2.9 .I 1,2 1,4
1.3 4,2
lo.5 111.0

2,8 0
7
9
1,0
6.7 12,1
119.9

9la Arourys111 ~li:>,c Othor diseases of tho e. rtories

1.6

1.4

8.1

10.2

92 Enbol ism and thrombosis (not corclral)

1.6

,2

93 Diseases of tho veins
34 Diseases of the lymphatic system 95&
96 other diseases of tho circulatory system
I97a Disoascs of tho nasa I fossae 97b 0 iseases of tho nasa I fossae annexa
98 Diseases of the larynx
99a Acute bronchitis
;J9b Chronic brooch it is

3

,4

,2

,1

1,4

2.3

0

0

.s 7

-3

7

7

9

1,0

,8

99c,d Bronchitis (undcfired) IOOa BronchopneutOOO ia

7 1,4
24.3 25.6

IOOb Capillary bronchitis

.2

.I

lOla Lobar pneumonia l:lb Prolll!l;)nia (undofired)
!C2 Pleurisy

31.4 253

23.& 235

1.8

2.4

103 Congastkn & hemorrhagic infarct of lung

1,7

1.8

104 Gangrcro of the Iung

.I

0

105 t'\sthll'il

2.0

1.5

lo6 Pulmonary oaphysema

.1

.I

6 Included in othor diseases of tho circula cry syst m

67.2 1.6
15.1 1,8 ,4
1.5 0
1.3 .I
3 1.0 ).4 .I 1.4 1.7
9 2,8 12.5 89.1
9
7.0 2.0
3 3

70.3 1.2
18.3 2.6
9
2.7 H
1.8 0 .2 ,4
2,8
0
.a
1,1
.5
3-9
15.0
93-8
9
93 .3 ,4
.I

9 1,8

.1

0

5 .a .3 .a

3 7
3 .a
.3 1.1

":;I 21.4 .I

23.8 29-7

18.4 16,2

1.~ . '7 2.3 2.0

.I

0

1,() 1.4

~I

.1

I

956 100.8

-7

1,6

295 28.0

2.8 2.8

1.8 1.3

4,3 4.4

1,4

I

2.7 31

.I

0

.I 5 .5 .6

1.9 .I
9
.a
2.0
6.5 7-0
148,0

' 2.9 -0
.5 7
.1.8
11.6
7.1 164.7

2.7 2,4

10,0 11.8

' 9
,4 .5

,2

,2

2.2 3.2

0

0

,4

,4

.3 5

1.4 1.3

1.1

9

1.3 2,0

~.o 327

3 3

44.3 557

~.8 3b.!

2.3 3.6

7 1,4

.I

0

35 1.7

.I

,2

95

r

7X-Death

.
Rates Per

100,000

Population,

By

Detailed

List

of

Causes 'l.Il.d Color 1-;29 and 1930 (continued)

C,'.USE OF DEATH

Tota I 1929 1930

r.tlite 1929 1930

Colored
t929 1930

107 Other diseases of the respiratory system
JOB 0 iscascs of tho mouth and annexa
'99a f.donoid vegetations
I09b other diseases of tho pharynx, tons i1s 1.10 Diseases of tho esophagus Ill a UIoer of tho stomach llib Ulcer of tho duodenum 112 Other diseases of the stomach 113 Diarrhea and enteritis (under 2 years) .114 Diarrhea and enteritis (2 years and over} 115 Arl<ylostomias is 116 Diseases duo to other intestinal parasites
117 Appendicitis and typhlitis
ll8a Hernia 118b lntcstina I obstruction
lt9 other diseases of the intestines
120 Acute ye II ow atrophy of tho I iver 121 Hydatid tumor of tho Ii ver
122 Cirrhosis of the I ivor
123 Biliary calculi t24 Other d iseascs of the Iivor 125 Discasos of the pancreas 126 Peri toni tis without specified C<1.USC
127 Other diseases of the digestive system 128 Acute rophr it is
129 Chronic nephritis
130 Chyluria
of 131 Other diseases tho kidneys and amexa
132 Ca IcuI i of the ur inary passages 133 Diseases of the bladder
134 Diseases of the urethra, etc, 135 Diseases of the prostate 't36 Nonvenereal disoasos of male genital organ 137 Cysts, other benign tuners of tho ovary 138 Salpingitis and pelvic absooss 139 Benign tumors of tho uterus 140 Nonpuorpera I uter inc hemorrhage 141 Othor diseases of the fomalo genital organ 142 Nonpucrperal disoasos of the breast
THE PUERPERAL ST.'.TE (tota I ) 143 (,cc idents of pregnancy 144 Puerpera I hemorrhage

7 1.7
0 3.4
0
33 1,0 10.9 18,1 10.3
3 ,4
11.3 2.3 5.0 2,0
3 0 4,4 1.1 4.5 ,4
2.5 0
15.0 122.7
0
35 .4
'5 t,I
30 ,2
3 1.9 2,0 .2 1.1
0 18.9 2.8 1.7

1,4 1.3
0 30
'
35 1.1
98 24.7 11.0
.I .I 11,4 2.3 6.2 1.5 ,4 0 .:.6 ,8
37 .I 1.8 0
12.9 117.1
0 2.5 .6
9 5 32 ,I ,4
1.3 2,0
0 1.0 .I 22.6 2.1 1.?

.4 1,4
0
34 0
2.7 1,0
7,I
t6.o 8,9
5 3 12.5 1,6 4,3
'7 ,4 0 4,1 1,4 4,9
7 1,8
0 10.3 IQ9,4
0
30
5
1,0
5 2.8
.I ,2
1.3
7 ,I
9 .I 15.6 2.8 1.6

9 1.0
0 2,7 .I 2,7 1,4 6,6 24.6
j.6
.2
0 11.5 1.6 5.1 1,0
.3 0 4.3 1.0
37 .2 1.4 0
7-5
104.3 0
2,7
.B
5 .I 2.8 0
5 .4
5 0 ..9 .I 19,6 1.8 1.6

1.2 2,0
0 3.4
0 r.,3 1.0 17.5 21.6 12.7
0
.s
94 36 6.2 2.6
.3 0 5.0 .6 38 0
39 0
22,8 145,1
0 4,5
.3 2.3 2.2
34 .5 .6
30 4,2
5
1.3
0 24.6 2.7 1.8

2.2
1.7 0
36 .I 4,8
.6 15.2 2').0 13.4
,I
-~
11.4
35 8,2 2.4
7
0
50 .6
37 .I
2.5 0
22.0
139-0 0
2,2 ,4 1.6 1,3
3.8 .2
3 2.9 ~~5
0 1.3
3 277 2o] 1.8

96

7X-De'lth Rates

Per

100,000

Population,

' By Detailed

List-of

k

r.nuse_S and r.olor 192.9 -a- nd 1930
Total

CAUSE OF OEf,TH

1929 1930

continued
ltl ito
1923 1930

Colored
1329 1330

145 ether accidents of labor

2.4 3.0 1.6 2.6 37 36

lt,6 Putrpera I sopt icomi a

4.6 54 33 4.4 6.8 ].3

147 Puerperal phlegmasia alba dolonst embolus 148 Puerperal alrumin~.ria and convulsions

5 6.9

5 .4 34 57

.4 8.3

.6 1
a.a ll.3

114) Other conditions of tho puerperal state

.I

.4 ,I

.4

c .4

1'50 Puerpera I diseasos uf the !:roast 151 Gangrene
152 Fu-unole
1153 Acute abscoss
! 154 Other dist;ases of the skin and annexa

0

00

1.5 1.3 5
.6 1 1
1.1 1.1 1.0

.a .6 .4

0

00

.a 2.4 2.1
' 1 .6
.a 1.3 1.7

5 1.5 .8

1155 Dlseasos of the bonos
!,;;'It;I Diseascs of the jo-ints Amputa t iens

1.c 5 3 .6 1.2 .4

0

0 .I

0

0 .I

0

0

0

0

00

1158 Other diseases of the organs of Iooomot ion

c

!157a Hydr,;coph~l us
I!:i9b Cons;::nital malformaticns of th~; heart

1,1 2.3

.I
1.1 31

.I
1.3 2.8

.I
1.1 4.0

0 .2
.a 1.1
1.4 1.4

J'53c Oth~;r oorrJOn ita I ma Iformations

2.2 2.1 2.5 2.8 1.8 1.0

ijiG.~ Cmgonital debility, icterus, solorema
lbi~ ?~emature birth

55 ].I ].4 55

97 10.6

38-1 41.8 370 41.1 3~1-9 43.0

(16:b Injury at birth

4,4 4.3 4.5 53 4.3 33

'162 Other diseases pocul iar to early infancy

4.4 4.4 35 35 53 53

llb3 Lack of C.lr"O
1164 Old age (seni I ity)
I SUICIDE (total)

3

0

0

0 7 0

22.3 21.0 14.7 12.5 351 356

9.a 10.2 14.7 14.8 1.8 2.1

1165 Solid or liquid poisons or by

166 absorption of corros i110 substances 1167 By poisonous g:~s 168 By hanging or strangulation 169 By drowning 170 By f iroorms 171 By cutting or pLrcing insti"IJIII()tlts
1172 By juoping from high plaoes '173 By crushing
1174 By other mears

'9 2.3 2.a 33

5

.I .a

.l

5 .6 7 1.0

3 .5 .4 5

6.o 6.0 91 90

.2

3 3

.4

.2

"' 3

.4

0

0 ,I

0

.I

.I

,I

.I

,4 5 0 .I

.I

0

.I .5
.a 1.0

.I .l

0

0

0v

.I

Q

H1MICIOE ( total)
1)7 By firearms 198 By cuH ing or piorcin:J instruments 199 By ether means 200 Infanticide
,~CCiuEtmL OR UNDEFINED (total)

18.0 19.5 8,2 a.6 34.6 ~-l

12,4 13.4 6.2

I 34 2.1 ,I

3~

.8

2.3 1,1

0 .I

.6.8 22..;! 24.1 .~ , a.o 95

1.2 36 4,1

0

.I

0

68.0 68.4 60.9 63.2 ao.o n.2

175 Poisoning by food 176 Poisoning by venomous animals

1.9 1.5 1.3 1.1 2.9 2.1 .

.2

.I 3

0 .2 .t

97

---

7X-Death Rates Per 100,000 Population,



{!,,.u~A~ Ani! ~nln10o 1Q?C nnn 1Q?fl

By Det1iled List
t"-Ont'innAn

of

CAUSE OF OEAll-l
lm Other acute poisonings {gas excoptad
178 Confla!Tation
m Btrns (cmfla!Taticn cl<copted)
!80 Mechanical suffocation l81 Absorpticn of irrespirable or poisonous ~s
'i62 Drowning
183 Trt.lllatism by firearms (excc;;t in war) 184 Trauna.tism by cutting or piercing instr,
I!Jj Trauma.t ism by fa II
lab Trauma.t ism in mines and quarries
187 Traunat ism by mach inos 188a Railroad accidents
l88b Street-car accidents
IB8c llutomob i le accidonts
188o,f Injuries by other vehicles
IB8d Aeroplane and balloon accider;1ts
188g Lands! ido, othor crushing 189 lnjtries by animals (not poisoning) 190 ltolllds of war 192 Starvation (deprivation of food or ~ter) 193 El<cassive cold
I94 El<ccss i vo hoat 11) Lightning
I~ Other a ccidcntal eloctic shocks
201 &
2Q2 Other ace idcnts 2(8 Other O)(tornal violcncc (not spocifiod) 2b4 Suddon death 2C5a Ill-defined 2t5b Not spec if ied or lri<nown
..

Total
I~ 1930

1.] 1.6

1,1

9

6.) ].3

1.5 !.4

3

.4

4.0 39

39 4.0

.4 -5

8.1 92

.I

.o

1.4 1.5
4.5 4.9

.4

.3

18.3 19.4
.a .6

.I

.I

2.0 1.3

7 1.1

0

0

3

0

.4

.4

.I

1.6

1.2

9

1.0

.4

4,8 2.0

3'9'

4.3 4,7

1].2 14.4

4].3 597

rrtlite
192) 1)30

1.5 1.5

5 1
3.6 4.]

'3 1.0

3

.4

3.3 2.6

3' 2.4

.2

5

10.2 11.5

.I

0

1.3 1.1

4.1 4.5
.s .4

18.3 21.2

.6

.4

2

.2

1.9 1.1

.] 1.1

0

0

.2

c

.2

.I

.I 1.1

3 7 1.3 .6

Colored

1929 I~

2.1 1.8
'9 1.4 12.5 rt.]
2.0 2.1

.A

3

5.2 6.2

54 6.8

.6 .5

4.4 54

.I

.I

1.5 2.1

52 s.6

.3

.2

18,1 t6.1

1.0 1.0

G

0

2.2 1.7

.6 1,2

0

0

.4

:J

7 9
.2 2.3

1.6 1.2
.s 0

3.6 2.4 6.] 4.1
1.3 1.8 31 2.1
2.6 39 6.a 6.1
10.4 a.] 28.8 24.3
2b.B 28.6 81.9 ~ 13.1

98

Table 8- nEl\.Tt!S Under 1 y.33r O'f' ...'\ge { excl:usi ve of stillbirths), By Oausa of D.Jath

and Month, In G.-o~gi~t 1929 and 1930

CAUSE OF OEAlH Ai-lO YEAR

Total

Jan. Feb.

r.hr.

Apr.

May June

July

I Aug. Sept. Oct. Nov.

Dec.

All Causes

1~29 4,464 1930 4,713

558 449

392
413

378 422

325 389

355 '360

352 491

342 393

356
36a

323
325

348

334

I 379

353

401 371

Measles

1929

2

1730

22

0 2

0 2

0 5

2 2

0 4

0 2

0 I

0 I

I~

0 0

0 0

0 2

Scar let Fever

1929 1930

I
6

0

0

0

0

0 0

0 0

0 0

0 0

0 0

0 0

0 I

0

0

I2
2

I I

ltloop i ng Cough

1929

164

1930

128

5

6

II

8

II

II

9

10

17

30

20

I15

16

10

15

18

16

14

4

7

9

16

~

5

9

(J'>

Diphtheria

1929

28

7

0

2

3

3

I

2

I

2

3

I

3

1930

22

I

4

0

0

0

0

0

4

3

2

5

3

Influenza

1929

263

157

46

18

5

7

2

I

0

2

2

10

13

1930

102

24

20

20

10

3

6

0

3

I

4

2

9

Dysentery

1929

45

0

I

I

2

7

13

9

2

3

5

I

I

1930

90

3

3

2

3

16

22

14

ll

6

4

5

I

Erysipelas

1929'

13

I

3

3

0

0

0

I

0

4

0

I

0

1930

18

2

2

I

'0

3

I

0

2

3

I

2

-~----

Table 8- DE~THS under 1 yc~r of Age (exclusive of stillbirths), By C~use of Death

and Month. In G~orgia: 1929 and 1930 continuedl

CAUSE OF DEA lH AND Y~AR Total

Jan.

Feb,

Mar.

~r.

May

June

July

Aug.

Sept.

oct.

Nov.

Meningococcus Meningitis

1929

12

0

2

3

0

I

I

I

0

~

0

2

1930

8

2

0

I

2

I

I

0

0

0

0

0

Tetanus

1929

II

2

0

0

0

2

2

2

I

I

0

0

1930

4

I

0

0

0

I

0

I

0

I

0

0

Tuberculosis (all forms)

1929

12

I

I

I

I

I

I

2

0

3

0

I

1930

16

2

2

3

2

0

0

I

2

0

3

0

Syphi I is

1929

80

5

5

5

~

6

9

9

6

7

7

6

1930

63

4

4

5

7

7

10

"~

5

I

6

6

Ccnvulsions

1929

'jj

6

2

2

3

3

I

6

0

4

3

I

1930

~I

2

4

8

4

3

7

5

5

2

I

5

Bronchitis

1929

9

I

0

5

I

0

I

0

I

0

0

0

1930

19

2

I

4

4

0

0

2

2

0

0

2

Broncho-pneumonia

1929

237

46

29

31

23

12

9

8

II

1330

252

32

28

33

24

23

14

13

II

8

10

20

~

14

21

Pneumonia

1929

217

50

26

28

10

12

4

7

5

16

13

16

1930

265

41

25

30

36

12

19

II

12

5

15

31

-

-

Dec.

I I

I 0

0 I

10

0 0

r-1

3

4
5

0 2

30 30

30, 2e I
I

.,

Tt:t;ble s~ DEATHS Under 1 ye'3.r of' Age ( e~clusive of stillbirths(, By Cause of Death

anQ.Month. InGeor~ia: 192S n.nd 1930 lcontinuedl

,.

I

cAUSE OF DEA lH AND YEAR

Total Jan.

Feb.

l!.ar.

Apr.

May

. June

July

AliJ.

Sept. I Oct. Nov.

Dec.

Stomach 0iseases

1~29

34

IJ30

34

Diarrhea and Enteritis

2 2

2 3

4
I

0

2

2

.4

3 2

3

5

3

5

6

J

I5 II

l4
4

I 3

Lnder 2 years

1~2~

329 ' 4

12

15

20

42

62

44

42

30

22

25

II

I~

450

Congen ita I Ma Ifa-rna t ions

1~29

144

1~30

158

12
12
13

ll
13 II

II
II
16

6
~ 12

41
10 10

~7
10 17

66
II
~

57

5~

I~

17

15

II

43
II 17

34
I15
II

I13
16 16

Congenital Debi Ii ty

l 192~

2o6

17

17

10

18

II

24

[8

16

15

22 i 24

14

rl
0

1930 I 216

22

21

17

17

20

28

16

13

13

21

10

[8

rl

Premature Birth

1929 I, 107

107

88

88

~

1930 1,218

113

116

10<1

103

% 85

~

~

123

106

98

73

Ill

~I

87

lo6

82

95

% 75

Injury at Birth

I 1929

121'

13

7

12

9

8

7

10

12

16

12

1930

144

15

10

12

II

10

13

14

17

12

12

7

15

7

II

Other Diseases of Ear Iy

!

Infancy

1923

137

14

10

8

14

15

7

12

21

12

7

10

7

Externa I Causes

! 1930

125

1329

)6

1930

7~

12 6 7

15

10

13

0'

12

8

5

10

4

9 9 4

8 6
3

4
7 10

15

10

7

7

3

4

15

5

i7 I 5

7

13

9 16
9

AII Other Causes

I 1~9~2390 '

1,154 1,223

102 127

116 115

108 118

89
116

98
79

87
98

69
95

~

84

81

~

~2
96

94

116

88

120

._..L

-
Table BX- Inf'lnt J.:ortality R:lte, Deaths Under 1 Y8'1.r of Age Per 1,000 Live Births, By C'2.use of Death and Month, In Georgia: 1929 and 1930

CAUSE OF OEA TH t1ND YEAR

Total

Jan.

Feb~

Mar. IV

May

June July

Aug.

Sept. oct.

Nov.

Dec,

All Causes

.1~9

]6.3 '093

8].2

749

62.9

]4.]

80.9

729

68.]

6].4 ]1.2

1930 ]8.1 84.6 84.] 77-7 75.2 733 108.5 77-5 69.6 599 739

M9asles

1929

0

0

0

0

3

0

0

0

0

0

0

1330

.4

.4

.4

.9

.4

.8

,4

.2

.2

.2

0

Scar let Fever

1929

0

0

0

0

0

0

0

0

0

0

0

1930

.I

0

0

0

0

0

0

0

0

2

.4

\\'hoop i ng Cough
1929 1930

2.8 2.1

I 1.3

1..5j

2.3

I 2.1

1.7

2.0

1.9

2.1 31

39 4,0

6.) 32

38 31 32

2,k.

7 1.4

Diphtheria Influenza Dysentery Erysipelas

1929

.5 1.3

0

.3

.5

.6

.2

.4

.I

.4

,6

1930

.4

.:;.

~8

0

0

0

0

0

.8

.6 I .4

1929 4.5 30.7 10.2 3-5

9

1.4

.4

1930

1.7 4.5

4.1

37

1.9

6 1.3

.2
0

0
'

I.4

.4

.2 .a

1929

.a

1930 1.5

0 .6

.2 .6

I.I

3

.6
.4

1,4 33

2.9 4.9

1.9 2.8

3 2.1

.6 1.0

1.1

.8

1929

.2

1930 :
I

3

I'

' ' I

,4

,4

II-5

0

.2

.2

l

I0

0

1

IQ

.2 .2

0

.8

0

0

.4

.6

68.3 77-2 77-3 80.4

0

0

0

,4

0

.I

,4

.2 .

1.8

C\l
30 0

1.1

1.9

r-t

.2

5

1.1

.or

I 2~0

2~5

.4 . 1.9

.2

.I

1.1

.2

'..2

0

.2

.4

CAUSE OF DEATH /,i{) YEAR

Meningococcus Meningitis

1~2~

,2

0

1930

. 1

.4

Tetanus

1~29

.2

-3

1930

.I

.2

: I .5 .2

0 ,4

.2 .2

.I .2

.2 0

0 0

I

0

0

0

0

0

.4

.4

.4

.I

0

.2

0

.2

0

Tuberwlosis (all forms)

1925

.2

.I

1~30

.3

.4

.2

,I

.I

.2

.I

.4

0

.4

.6

.4

0

0

.2

..4

Syphi Iis

1329

1.4

9

1.1

.~

9

1.2

2.0

1.9

1.1

1~30

1.0

.8

,8

.~

1.4

1.4

2.2

1.0

.)

Ccnwlsions

1929

.6

1.1

I~

.8

.4

Bronchitis

1)29

.2

.I

1930

'0
"-'

,4

Bronchc-pneumonis

1929

.~.o

~.o

193C 4.2

6.0

.4

.3

-5

.6

,.I

1.2

0

.8 '5

.8

.6

1.5

1.0

.J

0

-~

.I

.2 7

. 8

0

.l

0

.I

0

0

.4

.4

6.4 6.1

4.4

2.l

2.0

1.7 2.1

57 6.1

4.6

4.]

31

2.6 2.1

Proumonia

19231 1930 1

37
.:.4

,_, I 5' 97 1 57
17 I

I 55 I

~-~

2.5

70 2.4

-~
~.2

1.4

-~

2.2 2.3

I
I

I

By
I I Dec,

.2

0

,4

.I

0

0

0

.2

.2

0

0

.I

.2

0

0

0

.6

0

,2

0

0

.6

0

.2

1.4

1.4

1.2

1.~

Kl

.2

1.2

1.3

.6

0 r-i

.8

.6

.2

7

.4

.2

1.1

1.1

0

0

0

0

0

0

.4

.4

1.6

2.0

4,0

57

1.7 2.7 4.6 6.5

33 2.6 32 57

-~

2.~

6.8

6.1

Tnble ax- ~~fant l.Iortalit~ Rates, Deaths U~~~~-~'~j,;::..~~- ~?0-~~t~,u~t~~~~~~~~ ~-~-~~~~~By _]



CAUSE OF DEATH "I'D YEr\ll Total

Jan. Feb.

Mar.

Diarrhea and Enter it is

I


ropr.

I Ma2._

~'--~~~:_::___jI

~ul~

_

I
!___

~. -~~

--~; -~-~.:.. :.

~I -

cod,

JI-~''-::.:.__i1 ~~::.:__-

" l I I r I

,n' I,

i ,J I

'
,J

I

I,:

,8

1

I \. .4

.6

1

.6 I "

.9

.6

I I 1

under 2 years

1929 ),6 1930 75

.] 2.6 2.3 2.3

2.9

38

2.0

1.2

8.8 14.2

93

8.3 21.4 I' 13,0

8.1 6.2 I 0,8 10.9

4.~

5.1

8.4

J.4

I 2,1
2.8

Cct1gon ita I Ma Iformations

1929 2.5

2.3 2,8

2.J

lo]

1930 2.6

2.5 2.3

2.9

2.3

2,1

2.2 1 2.3

2.0 3.8 I 1.8

I I,( 35
2.8 l 2.o

. 1

2,2
33 I

I 3.0 3o0

2.4

35

Congenital Debi Iity

Premature Birth

1929 35
1930 36
192:7 18.9
1930 20.2

33 37 4.1 4.)
20.9 195 21.3 23.8

1.9

3~

3' 33

1?.4 I 8.2

19.2

'99

2.3 4.1

i 55

).8

6.2

32

I 20.2 19.5 19.1

tM 27.2 1 20.~

30 3'

2.5

2.4

I 18.9 15.2
J7,'. 1 a6~o

4.5 4.9

2.6

4,1

2.2

39

22.7 20.]

l 16.?

18.2

21.0

16.2

<;II 0 ....-1

Injury at Birth

1929 2.2

2.5 I .5

2.3

1.]

1930 2.4

2.8 2.1

2.2

2.1

I 1.6 H6

2,1

2.0 2.9

2.8

I
2.3 3.3
32 2.2

2.4 1.4

2.8

2.3

1.~

2.4

Othel" Diseases of Early

Infancy

192~

2~3

2.7 2.2

1.5

2.7

1930 2.1

2.3 31

1.8

2.5

3.1

1.6

25

4.0 2.5

1.8 1.8

.8

2.8 1,8

1.4

2.0

lo3

2.9 1.1

1.9

External Causes

1929 1.6

I. I 1.3

2.3

1.5

I 1930 1.3

1.3 r.o

1,8

.8

AII Other Causes

' 1929j 197

199 25.?

21.3

17.2

~~--------IJ_30_L_!03

24.0. 2.3.6

1:

'

21.]

22.4

1.8 1.3

I l.t.

1.3.

1.4

.8

7 I 2,0

.6 7

2o.5
lo.l

I I 19o9 14.6 19.1
I 21.7 1a.7 1 15.3

17-5
16.6

1.4

1.0

30

1.4 2.8

1.9

18.8 19.2 22.2 18.7 19.3 26.o

~~-~~~----------------
Table 9w DEATHS Under 1 year of A.ge, From Specified Causes By Colt'lr: 192') and l930

C.WSE OF DEATH All Causes

Total ~,464

1929
White
2,343

Colored
2,121

Total
4,]13

1930
l',l,ite
2,468

.
Colored
2,245

Measles Scarlet Fever Whooping Cough

2

2

I

I

164

39

0

22

0

6

65

128

14

8

6

0

6o

68

Diphtkeria
lnflue~a
Dysentery

28

17

263

140

45

19

II

22

123

102

26

90

17

5

53 4'

39

51

Erysipelas Meningococcus rlen ing it is Tetanus

13

13

12

5

II

5

0

18

7

8

6

4

18

0

4

4

3

I

Tuberculosis (all forms) Syphi I is Conwlsions

12

7

80

12

35

18

5

l6

68

63

17

51

8

8

17

46

24

27

Bronchitis Broncho-pneumonia Pneumonia

9

5

237

122

217

107

4

19

115

252

110

265

14

5

118

134

io6

159

Stomach Diseases

34

20

Diarrhea and Enteritis under 2 years 329

172

Congen ita I Ma Ifoma t ions

144

109

14

34

157

450

'fj

158

16

18

275

175

127

31

Congenital Debility Premature Birth Injury at Birth

2o6

101

I, 107

675

128

82

105

216

432 I1218

46

144

102

114

756

462

109

35

Other Diseases of Early Infancy ExternaI Causes Unknown, ill-defined

137

72

'1>

43

843 308

65

125

53

79

535 955

70

55

3B

41

311

644

AII Other Causes

311

189

122

268

163

IO'j

105

!rable 9X- Infant Mortality Rates, Deaths under 1 year Per 1,000 Births, By Specified causes and Color: 1929 and 1930

CAUSE O' CEATH , All Causes

Total
-,6.3

192~ Ylh ite
65.5

Colcred
~3.1

Total
78.1

1930 White
66.6

Colorod ~~5

Measles Scarlet Fever Whooping Cough

0

.I

0

.4

0

0

0

.I

2,a 2.8 2.9 2.1

.4 .3

.2

0

1.6 2.9

Diphtheria Influenza Dysentery
Erysipelas Meningoococus Meningitis Tetanus

5

5

5

.4

4,5

3~

54

1.7

.a

-5

I ,I

1.5

.2

,4

.2

.l

.2

.I

0

3

.3

.I

.3

.I

-5 .2 1,4 2.1
1,1 2.2

.5

0

.I

.2

.I

0

Tuberculosis {all forms) Syphi~ is Convu Is ions
Bronchitis 8rondo-pneumon ia Pneurronia

.2

,2

.2

3

1,4

.3

).0

1.0

.6

5

.7

.a

.2

,I

,2

3

4.0

34

51

4.2

37

3.0

4.a

4,4

.2

3

5 2.0

.6 1.2

,4 ,2

3-2 58

2.~

6.8

Stomach Diseases
Diarrhea and Enteritis under 2 yrs, Congen ita I Ma Ifonnat ions
Congenital O&bi I ity Premature Birth Injury at Birth

.6

.6

.6

.6

5.6

4.8

6.9

?.5

2.5

3.0

'5

2.6

3.5 2.8 4.6 36 Ia.~ 18,9 19.0 20.2 2,2 2.3 2.0 2,4

,4

.8

7.4 7-5

34 1.3

2,8 4.9 20,4 1M 2.9 1.5

Other Diseases of Early Infancy
Externa I Causes
Unkn011n, iII ~defined
AII Other Causes

2,3 2.0 2.9 2.1

1.6

1.2

2,3

1.3

1~.4

8.6 23.5 15.8

5.3 53 5.4 4.4

1.~

2.4

1,0 1.8

8,4 277

4,4 4.5

106

l
!
Dia3:;.~am il.- Birth and Death Rates Po:r 1, 000 Population 1921 to 1930

2b

24

22

20

18

lb

14

c
0
+'
""'i 12
a0..
8
0
h
.L, 10 a..,.
+'
a":'

-~

4

2

I_j__ _ o ~----~--'--__.__ _ ___.__i___L_ _

l _ _l_

1921

1922

1~3

1928 1)29 1930

107

Dia~,ram B- 'l.'yphoid Ft:ver })E:c.th Rate Pfr 100,000 Population and Pate T:renc: 1921 to 1930
28

16-
!i 14
.... "a'_
/?. 12

8 .f 10
8
6-
4
2
0
1921

.!
1924 1925
108

. . < ..
Dia;;;;:-m G- Ma1&-ria 'JEoath Rates Pbr 100,000 I'opu1ation and Hatu T~end: 1921 to 1930

:~ I
20

18

16
c 14
0 +'
"g:J'
~ 12
0 0
8~

TREND

2
0 L._--~..--_~...-_--~.-1_ _L_____,~I'----.J...---L----1---'

1921

1922 1923

1925

1927 1928 1929 1930

109

Diagram D- Diphtheria Death Rates Per 100,000 Population and Rate Trend: 1921 to 1930

t6

14

12

10
.~..
.!!
6..
, 8
0
8
8
!6
~
&
4

....... ....... ~fl1()
......
.......

t
0

'~_j

--

1921 1922

1923

1924

1925

1}~

1927

1928

1929 1930

110

Di~zram E- TubP.rculosis Death Rstes PP.r 100,000 Population ond Rete Trend: 1921 to 19~0

?1, 84
82 --

1}1-
"'
'' '

80

78
..~.. 76
~
:J 0.
- - 0
Q..
0 74
0 0
0
~
.l..'.[-,. 72 a"::'
70

''

'

--

~

'

1921 1922

1924

1925 1926

1927 1928

111

Dia rem F- Hsc.:t Dist c. SloS T)8c:th Hates P'c ::.' 100,-00-0- - - - - -
Po;:n1<-tion end :Rat' T::.'end: 1921 to 1930

100 -

/

/

/ / 70

/

/


....

6o

:";'
a.
0
~

g"':::>
0

50

- - L
,f 40
Q)
~
30 -

/ /
----

20

10

0

_j_

- -I

1921 1922

1923

1724

1925

1926

1927 1)28

1929

1930

112

Diagram G- Pellagra Deeth Rates Per 100,000 Popu1~tion ~nd Rate Trend: 1921 to 1S29

28
26-

24-

22

,

20

/

18

5

/

+' lb

"g' .

a..

0g 14
g

i'12

10

1921 1922

1)24

1926

1928

113

Diagram H-Automobile Accidents Death Rate Per 100,000 Population and Rate T~~nd: 1921 to 1930

22 20

18

16

14

c
0

12

.....

""a3'.

~
8

10

0

8

.r.'.f.-.,.. "'0::

6

4

2

0

1921 1722 1923

1924

ST~TE TUBERCULOSIS Sli.NATORIUM ALTO
rv: ..rvin F. Haygood, M.D., Su!Jerintendent
PERSQI'JNEL---On August 9, 1930, Dr. ~.~arvin Fletcher Hay:1ood, formerly of Knoxvi lie,
Tenn., became superintendent of the Sanatorium, replacing Dr. Edson l'i, Glidden II, resigned,
Dr. Glidden had been superintendent of the Sanatorium continuously sinee 1319 and un-
der his directi<n great strides were made in treating tuberculous patients in Georgia as well as in creating a consciousness of the danger of tuber.ulosis to the conmll'lity and to the State.
The medical staff of the Sanatorium consists of the followingt F. C, r.'helchel, M.D., lredical Director: H. C, Schenck, M.D., Chief Physician of the Field Clinic Servicet Kell ie Joseph, M. D., and H. E. Crow, M.D.
A corps of 29 nurses is an important part of the Sanatoriuns persor.nel. Thirteen of this number are graduate registered nurses and the remainder, although undergraduate, are especially trained for sanatorium service. In the colored unit of the Sanatorium there are two graduate registered colored nursss and five others,
The meals and their P'-eparation are supervised by an expurienced dietitian,
Labcratory work is done bot a graduate bacteriolo;;y technician.
The clerical work of the Sanatorium is performed by a staff of five.
Other employees, classified variously 1.11der the heading of building superintendent, carpenters, electricians, fireman, cooks. and kitchen help, waiters, bus boys, la1.11dry employees, maids and janitors on the inside; and truck drivers, dairy workers, farm employees and miscellaneous laborers
for outs ide work number sane 86.
HISTORIC,~L- -Although not going into great detai I nor attempting to namt; all those citizens of the State who were instrumental in the dt:.velopnent of the Sanatorium, a very l:r ief acco1.11t of the history of thu institution i~ 3iven below.
The first State Sanatorium for the Tuberculous in Georgia was provided for by the Legislature of 1)08-09. The leading figuro in the fi1lt against tuberdulosis in Georgia at that time was
the late Capt. R. G. Raoul of Atlanta, and his infl~ce was an important factor in securing this leg~
islation.
The Sanatorium was n:Jt ready for u:,;.,, however, 1.11ti I 1311. It canprise<l wtnt is now known as the "Old San11, the present negro division of the State Sanatorium.
In 1918, afLr a thorough insplction of the Sanatorium and careful study of circl.lllstanc<SS by members of the Raoul Fo1.11dation, it was rEicorrme;nded th1t the instotution be turned over to the managemtlllt of the State Board of Hea Ith. This reco11100ndat ion was ~ccepted by the Legis Iature, which
passed a bi II effecting the transfer. The exceuti<e secretary of the; Raoul Foundation sti II retained an
115

advisory connection with thc. Sanatoriun, howevL~, ll1til 1921, At that time he volt..ntari ly withdrew.
In 1320 a bi II, calling for the appropriation of $500,000 for the bui Iding of a now sanatori~..n, was introduced in the Legislature and received the approval of the Governor, the budget
committee .nd the appropriations c01rrnitteo of tho Hou,o of Representatives, but it Wils not pushed further because it depended on a tax m-:.asure which failed to pass, A similar bi 11, which provided, further, that tho necessary money should be raised by a tax on cigars ond cigarettes, was proposed in tho
1923 session of tho Legislature. This bi II was passvd and was approved by tho ~overnor. The; new
bui Iding was cornpldcd and opened to occupancy on March 10, 1927.
In the sping of 1330 the next greu.t addition to i:hc Sanatorium was opened when the
bui Iding for the housin3 of chi ldr.,;n and th<. tn.Htment of childhood tuberculosis W"!S occupied, This infirmary was bwi It and furnished by the. lthsonic fraternity anC: th,:, Ordor of Eastern Star of Georgia and preSEcnted to tho St<>.te as a unit of the Sanatoritm,
In tho follor1ing pages there is given a brief description of the. various t..nits .W.ich go to make up tho Sanatorium,
LOCATION- -The San~torium is locat(;d in tho mot..ntains of northeast Georsia, 18 miles abo~~~: Gaincsvi I Ie. Tho property or the SaniJ.toriun I ius partly in Habersham County and partly in Banks Cocnty. It is on the main I ine of tho s.~uthem Railway b.ctwcm Atlanta and Washington, D. C., and on
Stata Highway mrnbu- 13 (United States Interstate Highw~y numb<.r 19) Contrary to popular bel icf the
Sanatorium is not in tho town of Alto, although Alto is its postoffic~ It is away from any town, being nearly two miks south WC3t from Alto. Local trains stop at the Sanatorium, as do fast trains, by .crrangetr6nt, to take on or disch~rgc patients as passengers, Thr; Sanatorium station was origi:oally called 11Sanatcrium" but tht; name was lder changed to 11Raoul" in momory of Capt. II, G, Raoul, the pioneer of tuberculosis work in Georgia.
The S:1.natorium propc,dy comprises ~orne throe hundred acres, part of which is woodland and part under cultivation. Located in this montainous suction of G"orgia the Sanatorium has a high elevation, but it commands a vi of! of sti II ~:i :>wr n.ount::iros, for to the north and north was> the hig~ er lllOU')tains of G(;or,)ia's Blue Ridge r .. a,- trhc;r rc.1jsstic bulk ::nd from th-..rn come cool in~ brc~zcs during the hot weather of the SllllllOr. AI: a':>oJt the ~anaL,rium arc farms, applo and peach orchards, and forests - a pleasin3 panorama i'l all dir,dl Jns.
MAIN l~FiR!o!I,RY ---The ilain Infirmary was Arected and opened in 1927. This building
is four stories in height and of fire-proof con:>':ru~tion throughout, It is built of sand colored brick and is modern in ,;esisn, ccnstrv:;tion anrl equipment, In addition to furnishing accomodations
for 150 adult white patients, this c.Ji id!:g hcCJses the administrative offices, physicians' offices and
.,xamimtion rooms, X-Ray laboratoriJs wi',~ mdern radiosraphic and flouroscopic faci I ities, laboratcry for bacteriological tests, operating roorn, auditorium, dining room, kitchen, laundry, etc. At present a part of this bui !ding is having to be used as a nurses' home unti I more suitable accorr.odations can be furnished the nurses,
There are no patients' wards larger than 10 beds, Cn each floor of the building there are two of these wards. There arc two five bed r:ards an>l one four bed ward on both th~ second
and third flo:rs, and the remainder of the accomodation5 for pativnts consist of single and double ra.ms, The double rooms are arranged in p~irs ~ith a sol>rium between. There is no partiality shor.n
116

in the allotment of rooms, the single ro0111s being rss!.rvod for the sickest patients, the dot.bls rooms for tho!ie in better condition and the wards for tr.ose patients who aro butter able to take car01 of themselves in the. matter of attending to th(Jir wants and noods.
The main dining room on th'" first flee-r is for the patients who are consider:d by the physician to be able to go there for their meals. On each floor there are diet kitchens for the preparation of tray service for bed patients, and dining rooms for those pati0nts who do not need tray service but arc not, in the physicians' opinion, abk to make the trip to the mian dining room. Tho arrangement and furnishings of tho bui !ding were dt-sign(jd with thu comfort and convenience of the patient in mind and the dcsignurs succeded admirably on their purpose.
CHILDREN'S INFIRfMRY---Prior to 1';)30 as many child pati(>()ts were accomodated in' tho main building of the Sanatorium as could be taken care of, This arrangelllUlt was not ideal, for they had to be thrown, more or less, in contact with the adult patients whose disease differed, of cC~Tso, from the. ir own.
Children arc now housed in a hospital of their own which was built and furnished by the Masonic fraternity and Order of Eastern Star of the State.
The bui !ding itsdf is -of companion architocturo to tho main infirmary which It flanks. It is of fireproof construction throughout Qnd is completely modern in design and construction. There are two floors devoted to dormitories for the I ittle patients and a third floor which is designed for isolation cases. This floor serves also as 'lrl ebservation ward for now p~tients ao that infectious diseases may be detected be. fore the rew chi id is ~.I lowed to come in contad "'ith the patients already in the SanatoriLrn. Th's ::r.cccuo~ is '.n i~.port.n+_ p.ccau~ion in pr.vcnt;..,g epidemics. The building is so situated on the side nf a hi I i that onu sirk of i.hr. kscmr,r,t is really 2. ()round floor. This floor is fitted out as a dining roJm for th d1 i ldren and opt;ns into the bui Iding and also into the outdoors.
In additior, to b~ing a hom:J f01 child patients, tho chi ldren1s bui !ding provides quarters and offices for a physician and for nuq;es.
Tho equipment of the hospibl is as modern as the bui !ding itself. All fittings wcre designed with the canfcr'.: of the chi I.J us +he; d<'minating idea. There is not the sf ightost lack of com-
fort and convenience for ;,ny chiid ,:w is so unfJrtGnato as to have tulxrculosis and so fortunate as to
be a patient in t~''" new Masonic Chi ld:c.n's Sui IJing.
SevJnty-fivc chi lo:lren :v-c c~red for in this unit of the Sanatcriun and given the best care that a physician and a sbff of nurses in con..tant attc.ndancu can offer.
SCHOOL---Mli le minister ina to tho phy~ical n0eds of the. children who arc patients at tho Sanatorium it should not be assumed that th~ir mont~! dcv~lormont has boun wholly neglected. It should not be oxpoct<.d th:t these chi ldron can keep up with their school work in its entirety, that would be looking for too groat a p-.rformancc from sick chi ldron, or chi ldrcn whose health is below par and threatened wi ~h tho d~;voloprrcnt of more serious trouble. Nev(rtheless classes are being conducted for them in an effort to givu them as much as possible of the schooling they would receive as well children in the public schools.
117

Up to and at the present time school for the children is held in temporary quarters in the Sanatoriul'l, They wi II, howevor, soon have a modern school bui Iding. Tho State Dcpartrent of Education has long been interested in the project of bui !ding a school for them, During 1930 tho plans wore definitely forl!l.llatod, the monoy raised, and tho building is now in procc.ss of erection.
The school oui !ding is being placed betYJen, and slightly to the rear of, the main bui !ding and tho Chi ldren1s Bui Iding, Its architecture is companion to that of those two bui Idings. It is of fireproof construction -concrete, brick and ti to. The bui Iding wi II furnish adequate space for the instruction of all children of school age, who are patients and able to attend classes.
The old ideal of a sound mind in a sound body is a very desirable goal and the Sanatorium authorities desire to give these chj ldren every possible advantage in attaining this ideal,
Of the child pat ionts in tho Sanatorium an avorago of 80 per cent aro of school age and all of this f'll.llli:lcr havo been able to attend school regularly.
THE "OlD SANII-The "Old San", as its name imp I ics, was tho original unit of tho Sana-
torium. Since the completion of the new Sanatorium building in 1927 tho older buildings have been
tho Negro unit of the Sanatorium. TI1is unit was completed and ready for use in 1~)11 and consists of a group of ten buildings. Tho main ouilding contains offices, store rooms, dining room, etc., in addition to its being an infirmary for patients, The other bui Idings in the group are cottages, each designed to care for ten patients. At present not all 'he cottages arc used for patients, however,
s0100 of them have to be used to house the negro h~lp employed in tho Sanatorium. Nevertheless 68
negro patients arc takun caro of in the institutim. They have their own nurses, and a physician assigned solely to minister to thuir needs and direct their trcntmont.
The buildings of th; "Old San" are of wooden construction and arc located in a beautiful setting, surrounded by forest trees. Tho grounds ar-c very attractively landscaped to preserve the natural wi ldnoss of the forest location and are, at the same time, planted to lawns, flowors and shrubbery,
WATER SUPPLY-Tho water supply of tho Sanatorium is very carefully supervised and
guarded from all sources of pollution, Early in 1928, in order to provide adequately for the greater
demands made on the water supply system by tho opening of the new bui !ding which had boon completed the previous year, a new dam was bui It impounding a larger lake, and an adequately largo and efficient purification plant was erected. This installation is canpldely modem and might well be coveted by many a larger co11111unity. It has a daily capacity of 250,000 gallons. Tho State Sanitary Engineer says that it wi II supply sufficient water fOI" a conmunity of two thousand people and is modern enough in owry respect to serve as a model for others concorned with the installation of a water supply system of similar capacity.
rlator is pumped from a spring-fed lake. It is aerated, then treated with I itro and alum and allowed to stand in coagulation basins long enough for the sediment to flocuhte. It is then filtered and chlorinat0d and, after being tested as to its purity, is passed to the storage tank from which it is drawn directly for usc as needed.
DAIRY--The Sanatorium owns its dairy and produces its 0\'l'l milk. The dairy herd con-
36 sists of holstc in cows, in nUflber and a pure bred holstdn bull. Every effort has always been made
118

1 to protect the milk from all pollution and tho succoss of the effort has boon marked. Only tested
cows, proven to be free of tuberculous infection, have over boon allowed in the herd.
~ average daily production is worthy of note. Throughout the year tho por diom, por cow avorage ylold exceeds throe gallons.

Tho main bui Idings of tho dairy arc ami Iking barn, a sleeping bam, two silos ard a recently completed milk house which will provide modern and adequate cold storage facilitis and pasteurization equipment.

Patients now received milk from healthy, woll kept arrl clean cows, which has been carefully handled to avoid pollution and wi II finally be given tho double assurance of purity which pasteurization and adequate cold storage provide.

NQt only does tho dairy furnish milk for tho SanatoriUil, it also contributes sorro veal to tho I ardor.

PIGGERY--Praotically all of the fresh pork and lard used in our dining room comes from our own piggery.

Tho operation of a piggc.ry provided a means of utilizing the surplus food that is always associated with a kitchen of tho size of tho oro necessary for the Sanatorium. These food scraps arc thus turned to profit and nothing is lost, since they proviJe the solo feed for the piggcry and thus rna~ it a by~product activity.

Although tho number of hogs on hard at any time varies within wide I imits, the average number might be placed at <fj.

REHABILITATION---Mmy patients who leave the Sanatorium with apparently arrested cases are faced with tho problem of finding, and training thomsolvos in, a new occupation, since, for them, tho occupation that they had before having tuberculosis is unsuited to tho changed condition of their
health and strength. A rohrn to former occupations rreans, for many, irovitably another breakdown. Thus tho question of rehabilitation and the fitting of those patients for a suitable remunerative occupation when the return to I ifo outside tho SanatoriUil is seen as one of great importance. If these patients return to their unsuitable occupations ard suffer another broakdown as a result, the moroy and time spent by the State on their cure is an irreplaceable loss.

Plans are now being formulated looking toward tho introduction into the Sanatorium regime of some forms of occupaf.ional training which wi II rehabilitate tho patient economically as the stay in tho Sanatorium has rohabi I itatcd him physically. Thus it is hoped that a great saving to the State wi II be effected in time, monoy and man power, arrl that many wi II be able to completely conquer tuberdulosis who were faced before with the probabi Iity of repeated recurrence of tho disease.

Tho present pla!1s call for courses in poultry raising, rabbitry and floriculture. It is hoped that work cen be oogun a Iong these I i11s in the near future,

~;.~!ZED REPORT OF B.JILDING Nil !AAIN IPr.IRING ACTIVITIES 1930

L. Tho interior of tho Main Infirmary was complcte1y repainted and refinished. New

stained c,Joor facings wore put on the doors, thus relieving to some extent the hospital atlllosphcre of long

unbroken e1panses of white walls~

119

2. The Chi ldronts Building, donatod to the State by the Masonic Frat::rnity and .Clrder of the East\lrn Star of Georgia, was completed.
3. The Schoo I House was begun.

4. A con<rete tt-iveway was laid fran the newly paved highway to the main building of the Sanatorium, This was obtained through the courtesy and generosity of the S~de Highwa}' DopartJ~ent and the Habersham County Officials, which IV(; gratefully acknowledge.

roan entrance.

5 A concrete dr'1ve was laid in the rear of the Chi ldron1s Sui lding, to the dining

6. A new garage was eroded, each unit being fireproof in itself, constructed of
metal on a concrete floor. This garage provides separate ~pace for ten automobi los and contains a gasoline fi I I ing station and ci I room.
7 Dairy &:ildings
a, A now and modern milk house was added to tho dairy, providing adequate cold storage and pasteucization equipment.
b. A modern and rodent free foed storage bin was erected.
c, A roofed bin, with concreto floor and walls, was bui It for the storage of manure and its conservation for use as forti I izers.

FIELD CLINIC SERVICE-~Briefly stated, the Field Clinic St..rvice is a travel I ing unit for the examination of those who have had known contact with tuberculosis or l'ilo have symptons which
are suspicious indications of the disease. The Field Clinic Sbrvice goes only into those counties
into which it is invited by tho Medical and Public Health Authorities. It makes no attempt to practice redicine, Rather it makes an effort to cooperate with physicians to the end of decreasing disease and giving to many an opportunity that they might never have had otherwise, of being cured of tuberculosis.

The hope for victory in tho fight against tuberculosis I ios to a groat oxtont in early diagnosis of the.disease and subsequent treatment for it. The most desiroable goal in all diseases in prevention ard, in the case of tuberculosis, prevention and early diagnosis are, in a sense, synonymous, Because of its infect ions nat.rc there can be no groat success in the prevention of tuberculosis unt i I thosQ who have the disease arc discovered and tmated, thus removing them from the unconscious rcle of being a oonace to others and a danger to tho conmunity. For every case of tuberculosis that is cured them is a potential decrease in the feeling of panic for others who might be diagnosed as tuberculous; and, since the chances for clTc aro proportional to the earliness of diagnosis ard subsequent beginning and perseverance in the treatment for ~}~disease early diagnosis also collbats tt\tese fool ish fears which are some of the most powerful al t'ies of tuberculosis. The case which is not discovered in its early ard easily curable stage becomes a greater and greater danger to society as it progresses into a moderately and then a far advanced condition; it destroys attempts at prevention along other I inos that may be tried, by spreading tuberculous infection braodcast.

The war on tuberculosis must call out all the forces of society. There must be cooperation b$tll!len physicians, all publ io and private health associations and societies, schools and
120

private citizens. It is toward the establishment of such a partnership that the Fietd Clinic Servie$ is laboring. The Clinic Service is not trying to replace the private physician but to be a
supplement and a help to him. It is diagnostic in intent and makes no attempt to enter the field of the physician, that of treatment of disease,
The Clinic Service is free of SQI118 of the restntints of the practicing physician, Since it is unethical for the private physician to solicit patronage, it is necessary for scme society or organization to t.n:lertake the finding of early cases of tuberculosis ard place them l.rlder medical care and treatment. The Clinic Scrvi<:<: and the local health departments, being free of the restraint of ethics in this relation, endeavor to accomplish this task. ltlen a case of active tuberculosis is discoverod by the diagnostic clinic it is then the province of the private physician to institute treatllk)nt~ Tho service of a physician especially trained in the diagnosis and treatment of tuberculosis is offered by this brandt of the State Board of Health and the State Tuberculosis Sanatoril..lll, both for the diagnostic work of the clinic and as a consultant when dosired,
The Field Clinic Service is now equiped with the most modern of facilities, embodied in a traveling X-ray outfit, The name IIA Ton ,6rd A. Half Of Prevention" has boon most apprQpriataly applied to this unit. On a I ight automobile truck chasis is mounted a body which houses the most modern of X-ray equipment. Not only is this laboratory completely outfitted far the takmg of Roentgenograms, it is also providod with a dark room for the de<ieloprent of the exposed films, and facilities for their examination and study. It derives its power by plugging into tlole regular
current outlet of the toiM"I in which it happons to bo in use. No more modern mobile X-ray unit can
be found in use today. Through oaployrront of this outfit complete examinations can be made in those COI!InUnitic-s far from a hospital and its standard X.;ray faci I ities.
Respectfully Submitted~
h11i~J9 II 00~--- M. F. Haygood, M.D.
121

STATISTICAL REPORTS

Patients discharged from January through December 31 for the years indicated in the left hand

colunn

Adults
w. c.

Children

VI

c

Sub~tota I

\'!

c

Total
w&c

1929

373

102

4!)

1930

247

86

56

34

303

120

423

Patients in the Sanatorium December 31 of the years indicated:

1929

101

45

59

31

160

76

236

1930

117

48

74

15

191

63

254

TOTALS A~ AV~Rt~F:S GRAPHICALLY RO:PRESENTED

Total number treated

I

711

L----------------------------------------------~

1)30

Average da i Iy censua

1929

220.97

1930

____ _ _j
________-_-_-,,!

r - - - - - 1929 'i -------------------------

J

I- - - - - 1930

i]4.83 days

122

BUILDINGS AT ALTO SANATORIUM dmi i strati o

01 AGRAMATIC REPRESENTATIO'! OF PAT I ~NT Of,YS BY I.'ONTHS TOTAL - BOTH Rf,CES
----------

80

Legend

I )29

1)30

',

I\

I
I I

'''

I

I

I \
v
123

59

OIA<;RAIMTIC COM>ARISON ~ PATIENT DAYS 1Y 'ONTHS

Legend

fiJ "'0 Q)
l
..,
>..
0"'
..c...
Q)
.....
"'Q..
43

,' '
I
''
I I

/

'

/

'''

/-- -\
' ' . --

''
I I I

Jan Feb,
COLORED
------ 1929
24 1930

M!y JtXle

-

I --
I
I

' ''\
''- -

/-
/
'
/"
/

.,

!

~

I

...s
>.. 0
.....

I
I
-- ,- ....

..!...

Q..

--/



14

Jan, Feb, M!r. Apr. M!y

J~.ne July Aug. Sept. Oct, Nov. Dec,
124:

CL'SS IFIC,\T ION Of PATIENTS

~.

1929

Q!i_MJM ISS ION

ON DISCHARGE

App-

Un-

Not

v.h ite

Arrested Arrested Ouie9Cent Improved improved Died Clas!:ified Not T. B.

6hi ldhood T.B. 28

0

20

4

4

0

0

0

0

l.linim;l

52

I

29

14

4

00

0

lt>d. f.dv.

107

0

21

44

28

3

0

II

0

far f'IJv,

158

0

14

78

38 16

II

0

~m T.B.

26

0

0

0

19

0

Q

7

0

Not Classified 2

0

0

0

0

0

0

2

0

Total

373 I

71

76

133

41 16

35

0

'Colored

Chi Idhood T,8. 5 0

2

Minimal

13 0

2

Mod. Mv.

15 I

0

Far fv:Jv.

b6 0

2

Non T.B.

I0

0

Not Classified 2 0

0

Total

102 I

6

Grand Total

475 2

77

5

9 )

3 8

0

I

0

2

10

22

86

155

0

0

2

0

3

I

16 37

0

0

0

0

21 38

62 54

0

0

0

0

2

0

0

0

0

0

4

_o_

39

0

Clt.SSIFICATIO': OF P.\TIENTS

1330

ON A!Jvll SS ION

ON DISCHIJlGE

App-

lh-

NOt-

White

f.rrested arrested Quiescent Improved improved Died Classified Non T.B.

Chi ldhood T.B, 51

25

lb

Minimal

40

5

22

Mod, Adv.

76

12

Far Adv.

116

0

0

Non T.G,

16

0

0

Not classified 4

0

0

4

I

00

7

2

30

24

I

0

3

I

II

58

23 14

0

0

0

0

0

0

0

0

2

3

3

0

5

0

10

0

0

16

4

0

Total

303

31

50

52

85

27 15

24

19

Gc-lored

Gh i ldhood T.e. 15

0

I

Minimal

14

0

3

MOO. /v:Jv,

24

0

0

Far Adv.
f'lan T.e.

67

I

0

0

0

0

!':len Classified 0

0

0

Total

120

I

,,
0

2

7

2 ' 10

2

II

0

0

0

0

6

40

0

0

8

3

21 30

0

0

0

0

31 '33

0

0

0

0

2

0

0

0

0

0

4 ~-0-

Grand Total

423

32

54

58

125

58 48

28

19

1~5

Abscess of I1Xl9 Aort.ic Aneurism Arterio-sclerosis Adenitis 8ronch iectas is Bronchial Asthma Card io Rena I Discase ChrQnic Appendicitis Chronic Nephritis Chronic Foil icular Pharyngitis Chronic Rhinitis Chronic Sinusitis Chronic Tonsil it is Cryptic Tons i Is Diabetes Mall itus Epilepsy Goiter, Exopthalmic Gastro-intestinal ?tosis Hock worm Hypertrophied Tonsi Is Hyperthyroidism Inguinal Hernia Malaria Menta I de feet ive Mitral stenosis Myocard i t i s Nephrolithiasis Otitis media Ovarian Cyst txyuris Paralysis, Infantile, Residual Pellagra Perforated Septum Pleurisy with effusim Pott1s d isease Pyelitis Scabies Sigmoid diverticulosis Spontaneous Pneumothorax Syphi I is Tapeworm Tenia Tuberculous Otitis Media Tuberculous enteritis Tuberculous epiglottis

COMPLICATIONS

Mlite

1929

1930

I

0

5

3

0

I

8

3

0

I

0

0

0

2

3

9

0

4

0

4

3

0

22

7

0

7

0

2

0

0

0

9

7

0

3

6

0

2

0

4

2

0

0

I

0

0

0

2

0

0

2

0

0

0

4

4

0

12

5

2

0

I

0

2

I

0

3

2

2

2

0

4

2

0

8

2

16

II

2

I

126

Colored

1929

1930

0

I

0

0

0

0

0

5

0

0

0

0

5

0

0

0

0

I

0

0

0

0

0

0

0

0

0

0

0

I

0

0

0

0

I

,oO

0

I

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

I

0

0

0

0

2

I

0

0

0

0

0

0

0

3

0

14

21

0

0

0

0

0

0

10

12

0

0

Tubercu Ious Laryngitis Tuberculous meningitis Tubercu Ious nose Tubercu Ious pericarditis Tuberculous peritonitis Tuberculous fistula in />no TlJI!lif abdominal Umbilical hernia Various neuroses

C~.'Pl1 CAT IONS (cant inued) r.hite

19<'9

1330

63

33

0

0

0

0

0

10

5

0

0

4

0

ME GROUP I - 10 years II - 20 years 21 - 30 years 31 - 40 years 4f -50 years
51 - 6o yoars
61 - 70 years 71 - 80 years Total
January February March Apri I May June July August Scptonbor October November December Total

ME ,\NO SEX OF Pf,TI"NTS (80TH RF,CES)

1929

M.

f.

T.

14

37

51

36 80 lib

62 102 164

28

52

80

13

21

3~

16

10

26

2

I

') )

0

I

I

171 304 475

PATIENT DAYS BY MONTHS

1hite

1929 1930

4,675

4,945

4,348

4,344

4,838

4,411

4,700

4,210

4,823

5,o67

4, 721

5,218

4,007 4,883

5.579 5,828

4,685

5,673

4, 711

5,881

4,983 t 7J.8 57.072

5.755 5~43 62,850

Coljred

1929 1,482

1930 2,208

1,477

1,928

1,612 1,637 I, 704

2,256 1,~3 2,054

1,962 2,281

1,822 1,930

2,329

1,743

2,177 2,197 2,336 2!382 23,-583

1,675 I ,BOO 1,9_30 2,ob5 23,632

Colored
1~29
14 0 0 0
5
0 0 0 0

1930 21 0 0 0 0 0 0 0 0

1930

M. F, T.

17 44 61

28

63 91

46

90 136

31 45 76

22 16 38

II

5 16

3

4

I

0

I

158 2b4 423

Total

1929 6,247 5,825 6,450

1930 7,251 6,272 6,667

6,337 6,527

6,173 7,121

6,683

7,040

7,168 7,212

7.509 7.571

6,862

7,346

6,908

7,681

7,319

7,743

n.1tz 80,655

8.oo8 86,482

127

Appling Atkinson Baker E!aldwin Banks 8arnJir Bartow Ben Hi II tlibb Bleck ley Brooks Bryan Bullock Burke Butts Camden Campbell Candler Carroll Chatl'lam Cherokee Clarke Clay Cobb Coffee Colquitt Columbia Cook Coweta Crisp Decatur OeKalb
Dodge
Dooly Oou,;.erty Douglas Early Effingham Elbert Emanuel Fayette Floyd Forsyth Frankl in Fulton

COUNTIES FRO!, 1\H!Cfl P,\TIENTS Ct.ME (BOTH RACES)

1929

1930

2 Glascock

2

2 Glym

2

2 Gordon

3

0 Gwinnett

3

2 Habersham

4

I tla II

4

3 Haralson

2

3 Harris

16

20 Hart

0

2 Henry

2

I Houston

0

I Irwin

7

3 Jacksen

2

2 Jasper

0

I Johnson

0

JGnes

4

0 Lamu

I

0 Laurens

5

2 Lowndes

40

37 Lumpkin

3

4 Macon

18

4 Madison

3

3 lt:Duffie

24

8 Meriwether

2

2 Mi Iton

I

Mitcl\);11

4

0 Monroe

I

I Montgomery

I

5 Morgan

7

7 lU-ray

3

4 r.Lsoogee

8

5 Newton

I Oconee

4

I Oglethorpe

3 Paulding

0

Peach

0

Pickens

I

Pierce

I

2 Pike

5

3 Polk

0

2 Pulaski

II

5 Putman

I

4 Rabun

10

3 Randolph

67

50 Richmond

128

1929

1930

0

4

3

0

6

4

16

7

4

10

3

3

0

0

0

I

3

2

0

I

0

0

0

I

I

I

3

3

II

9

0

2

2

2

4

10

I

2

2

2

3

4

I

0

2

2

2

18

17

2

0

I

3

0

0

2

3

~

0

3

6

0

I

I

3

0

2

I

2

6

13

C vn.c. lYIIL..n. I"'U'UJ
Vie w of the at er Reservo ir Lake Plant
Dai v Barn and Pa t of He d

Rockdale Seminole Schley Screven Spalding Stephens Sumter Talbot
Taylor Tal iaferroe Telfair Terrell Thomas Tift Towns Troup lhion
Ups<n Walker Walton Ware Washington Wayne Webster Wheeler White Whitfield Wi Icox l'li lkes Wilkinson \orth

COUNTIES FRl'J.: WHICH PATIENTS CI'J (BOTH RACES) (cmtinued)
1929
0
0 I 4
7
3
2 I 0 2 4
12 2 2
5
2 4
3
2 I 0 I 12 I 2 I 0

1930
0 I I
7 5
2 0 0 0 I 0 8 0 1
Z3
7 5 9
8
0 0
3
13
2

129

OCCUPATIONS (BOTH RACES)

AccOLntant Adults, no occupat~ Baker {wrapper) Bank Clerk Barber Bell Boy Bookkeeper Bootblack Broker (bond) Brick Mason Cabinet maker Cafe Manager Car Inspector Carpenter Chauffeur Children, no occupation Cigar Maker Civi I Engineer Clerk (CRR) Clerk (drug) Clerk (grocery) Clerk (marchand ising) Clerk (office)

1929

1930

2

0

12

0

2

') )

I

3

0

4

3

0

0

I

0

0

0

3

2

0

6

0

3

2

0

8

0

I

0

0

4

3

I

I

2

7

4

6

2

Clerk (shipping) Clerk {soda) Clerk (telegraph Cook Craneman (steam shove I )

2

0

0

2

0

8

9

0

Dairyman

0

2

Editor

I

Electrician Elevator Operator Farmer Filling station attendant Gran ite cutter

2

0

I

I

36

43

0

0

Hair dresser Hatter House maid

0

I

0

12

2

House wife Insuranee agent Interior decorator Janitor Laboratory hdpor

112

74

I

0

I

0

0

I

laborers Laundry workers Lawyers

20

12

3

5

2

130

t~ach inist Mail carrier M:lat cutter M:lchanic M:lchanical Engineer M:lrchant lleter reador fl'edical student Mi II iner Minister Musician Nurse (Graduate) Nurse (Student) Painter
P~ctographer
Physician Plasterer Pol iceman Porter Prohibition Officer (colored) Ra i Iroad agent Ra i Iroad section boss Reporter (newspaper) Rug repairer Sales people Salesman (traVfll ing) Saw mi II hand School child
Schoo I teacher Seamstress Shoemaker Shop superintendent Stenographer Student {college) Telegraph operator Telephone opertor Text i le worker
Theatre Manager Truck dr i ver Undertaker Vulcanizer Waiter and Waitress Watchman Waterworks aHEJ"Idant Yle Ifare worker

OCCUPA Tl ONS (BOTH Rt.CES) (continued) 1929 (, 0
0 I 0 0 2 I
4 (,
0 I I 0
0 2 I 0 0
6
4 I 119 II
5
0 II 4
3
2 22
0 0
0 4 I 0 I
131

1930 4 I 0 4
2 0 I 2 6
3
0 0 I
0 0
8 I 0 110 6
5
2 I
6
0 0 0
33
2 0 I
4 I
0

FIELD CLINIC SERVICE

CLASSIFICtUIC'N OF CASES 'XI\t,:INEO BY THE "IELD CLINIC SERVICE FROM THE orE OF ITS BEGirt-liNG October 13, cnt i I December 31 1 1930

Col.nty Coffoc Crisp {iougherty Emanuel Glynn Lowndes Ware Washington Total Grand total

Positive

Suspicious

Negative

Total

II

10

24

45

14

10

50

74

8

~

6

3

30

'f>

II

28

17

26

46

112

13

16

55

84

3

2

3

8

14

19

14

25

88

94

231

413

132

STATE TRAINING SCHOOL for
MENTAL DEFECTIVES

SCENES AT OUR GRACEW. .O OD I~N.STITUTION .
Ad i nis trati on Buildi ng t he Child en
A portion of t he Dairy Herd

... Jo~m

. ::..) '

\'ie h:1ve jud closed what I consider tk most sc.ccessful two :rurs in the history of the instituticn, bA as the pcopL. of G8crji:1 ar,, rapidly awak<Joir.g to tho value of the service this instihotion is mdeavoring to rcn<kr, I Cln foo-~see many yNrs to cornv, each one of wi' ich i II
grow 'flare successful than the; year prc.cudin3. Dt.ring 1929 Ne dischor;ed 19 children and had on pa-
role Janu.1ry I, 1;:.3Q fiv-e righ-grade boys th:1t ar0 self-supporting, and the indications arc that they wi II continUE. to sup;:od thcmsclvGS rei ievinJ the institution entirely of their care, rr.aking a paSliibiG tobl of disrhar-JCS of 24

. hm we are ir. a ?Osition to complet~ the t. aonin3 ~; a feeble-minded child and send it back into the COCI'fl'unity oS aro assd, we fool that our work means o great deal !o He state. '.'1~ also feel that the hurr.aroe and intcll igent care that is given the cases that ne must handlE: ascustodial on,,li moans much more than thu figures in dollars and cents could possibly sho..

i:e hod a >~a it ic;g I ist of abod ;30 when the Log is Iature md in 1923. :le added during 132~ to this alrudy lonj ''~it in:] i ist, 135 roartc> of very urgent c.1sss. As the ir.stituticn
and its work b~comcs better kr<olon, ito' co~rsc is r.aiJrJI for -s to receiv~ more: appl icdions for J.~mission. Ev~ry availacle space in thG ir.siit .tion h~s b(.o.;n filled, besides 'lie have built from nur ml.ir.:~nanc~ flrld a cotta~~ tor the c.1re of l0w-:rade c.stodi:J.I c;,scs which has cost c sl i:f.tly more th:m ~~,0':-C. n-~j:; oui ~dins is sh. am heated, ~.:..~s SCW'J,r.'!~~~ system, <.md hot and cold ~a.tvr, and a kit-
chen oro.: dinina roo"' alt ,cf,.,d Sl that tfc:;se l01: grade children 11i II not corte in c:,ntact wit'' th<.hi~h;r type; cs~s rr.akin:J a sc~~ratc, LJlit hr those .Jlfcrt<.-n.Jt.. s, :oithir. th<.- past four yur:. I have boon called upon to .~xarr!r.e th::: cr.i ldrcr. and par(nts of many fanci I i~s. With this 1'<-mbcr .Js a basis,
I ;,m wi II in'; to make th,; sbhment that 30 p rc:r:t of all cases Jcrefldent on or ..~rity that arc not
har.dis1,nd 1hysically ars dCi)03r>~cd bc<'a '"; tl-cy are dcfinit)ly fccblc-minded, ThesL fcc lie-mind-
:o ed parcds codinue j,., brir.J in+o the wori:J childre'l ot thc.ir own type. The app.2ls th<.- diffo:;r,_nt :,cJ ch.tritil'JI'. orJanizatio'ls ov_r tk slate an car.sLrotly increasing, and yoc.r sup~rintcr.der.t iGves
thd o_,r departm,_nt sho-ld be0in now to m<:kc a ddormir.cd fijht for laws gov~rninJ tho marriag" of
deicdivc. individua!s, either monbl or physical.

I rccer.tly saw a fa'llily in an adjoining cOL<lty that had been dJpt:ndent on charity for a roumber of years, lh, tath._r w~s suffo;ri'J from an extmsivL cancer involving the ldt side of th,; faco. H- had ocero rr.ar,-ivd tilicc, was the fathv.- of oight children by tho two marriag8s, All tho children by the tirst rr.arriagr.; v;cm evidently iou~lc.-rrinded from the history obtaino)d from the father: two d his daughters are I ivin:J tho I ivos o' prostitubs. HE. has foc;r children at rr._sent in his I itt!~ caJin home tl-at are badly inf,~stc.d wi lh hookworm, and from all indicdions the father and the chi ldrcr, ar., feeble-mindud. Th- fatf,,:r's brothcrJ and sisters have be~:n nc'or-dc-w-.,lls, none of them have ever been sc-I f-s<.pport in~. My former rep0rts wi II show that th() orjJhar:agvs, a lmshouscs, state farms, reformatari.s, pub! ic schools, :md hoc;so::s of prostitdion show a large percent of feebiG
minded por-ulation. Our r~cords ir. this instituti:Yl wi II st,ow that more. tf,~r. ;o percent of our admis-
sions arc children of ddinit,lt fccblc.-minded pe.runts, St:vcntJ-two thousand five hundred dollars was ;,ppror;ri~tLd for maintenance of thG instit;tion ~or I)JO. &vcnty-five thousand del Iars was appr~priated for the purposu of buildings or the purchase of land and th~ erection of a rtsidonce fo~

133

yovr SI.Jperintendcr.t, over~ period of two years. for the futJre growth of the instit-tim it w~s decided that a portion of the moh-
ey appropriafod fer the purchase of property, de., could b0st be used by buyin; the old Circvlar Cm.rt property, which is coo.poscd of nsarly :)00 acres of the most terti lc lend in the. Stated Georgia. This property is well known to a great many p~oplc in the state, it being the home of th~ !at~
Jacob Phinizy. It cor.sists, as above, cf nearly )00 ac.~s ,f lilr1d, a 12 rean house, 1'- tenant houses
of two and three rom~ each, two larJ<- bams, hoi house, wagon shelt.>r, wagon scales, a large. garage with I iving quJrkrs ebove, and two cow shelters. Tho first payment on this property wa: rr.adc in
Janu~ry 1730, th~ second payment is to be made this yE>ar. After paying for this property, we will have approximately ~25,000 for bui ldin8 purposes out cf this apJ:ropriation. Our plan is to move the higher grade pop.. latio:-. to the Circ~Jar Coi.JI"t prop.;rty 1S rapidly as f<.Ods for bui Idings can be ob-
tained. Th prcs.:;nt property at Srac.wood, we hop<. to usE> as a cvstodi.:d department.
ENL:.rlSEficNT --It i5 very evident that the institc.tion must be materally enlarge<J if we are to r.,ceivc tbe most urge:ot cases of the vicious and idle types and thosr, cases whose home surroc.ndings are not of the kind to raise even normal children. Lhen a mentally defective child has to be h1nd ic;;pped furthr by an :.nwho Iesorr.e home surroundings, it adds t~ the ser i ousn~ss of the s i tuat 1::n.
Yoc.r superintend~nt does not believe that it will ever be possible to instituti~~
al ize all oi the cases rr,.,king appl iotion, n~ither does he <xi ie1e that a! I ca~es making appl icatirn sho. ld be admitteJ to th~ institution. Thf;re are homes in which a rocntally defective child is able
to receive a high typt of traininJ with some advice from one r~ho is farr.iliar with this type of individ.al.
have attempted to inv~stiyate as many as possible of the cases applying for ad-
mission, and arr. no. only placing the names of the most urgc"f1t types on nur '"aiting I ist, which at the present time amounts to mJre than 700. ;/e rE.ceive practically every day the most pitiful app<ials from fami I ics asking a~ission for their Ll1fortcr.at~ rolatives. Wo tin~ that qtnte a few of these cases em be kept at r.cmc with proper advice from time to time. A numb~Jr .-f cases arc. bei"<J cared for in th;_,r haws 'lft(;r gdting advice from the personn..,l >t tho institvtil'f1, The bLTde'l'l of this lon3 >aiting I ist c,~nnot be pl,ced on the shouldlrs of the Statu Board of Health or the superintEndent of the institution.
At every meeting of the le8i.Jature th<- crmded conditions heru and the l<r9e waiting I ist has bem pieced t>t.forc tht; proper authOrities and rul id has been urgently request~d. We lre using every avai lablu space and sti I I 1.<- are not a!:lle in a small way to nold down this moc.nting list that has boon eccurr~dating no11 for SfN<:ral )'0ars. 'lie m~.Jst have a sJffici,.nt number of buildings and equipment to care for the casas th~t need i~diate institution~! car~.
I heve c~l led your attenti0n and the attention of the legislatvre to the fact that
we haven't the type of equipm,;n' nor sufficient eq~ipment to trair. the inrr.~L5 a:, th~:y shoLid b~. I
oo urge that 1nother dfort ~1de to get sdficier.t fc.'1ds for a building and facilities cr manual
training.
As in forrrer years, the: '.hivusit} Hospital has bE;en c.>rin3 for our acutely sick, and while it has rend.-,red ~xcel knt service, it is umbarra5si.-.g for the institution to contiml! to
134

as,, for its support wht;n a hasp ita I and equipment for same is so bad Iy ne,,ded d the inst i tut ion,
You realize th~t unless we Jet sufficient funds for buildings for the housing of children, ''e cannot hope t~ meet the rlemar.ds made upon us for admission, It simply means that the only vacancies that we wi II haw from now on wi II be du,_ to deaths, discharges, 65capbs, and removal by parents, Judging th6 future by the past, this will be very few, I again call your att&ntion to the fact that we have never been able to even fenr.e our pastures, in fact thure isn't a fence on the tracewood property. It is the desire of your superintendent to mana~ the affairs at the institution as intelligently and efficiently as pos~ible, We are wasting money every year by not being able to fence ?ur fields arld p~sturos,
EXTRA-MJRAL ACTIVITIES- -During 1~0 practically every portion of the state has
been covered in visits by your superintendent. There ha$ been examined at the institution more than
50 cases for the Juveni I~ Ccurt of Augusta and th~ local Orphanage; besides this work we have visitsd
and examir.:.d patients and advi$ed as to their care in the hane, in the following counties of the state I Elbert, Clark, Butts, Spalding, M.Jscogee, Bibb, Houston, Pulaski, Chatham, Pierce, Ware, LONndes, Berrien, Cook, DecJtur, Habersham, Floyd, ()winnett, DeKalb, Meriwether, Troupe, Oau_;herty, and Fulton,
During thest: trips 165 inhll igo>nce tests, physical, psychiatric anJ neurolovical
examinations ~ave ~~n given, A partial survey of two schools in Fulton County has been made, a partial survey of two schools in Muscogee County has ~en made, talks have been made along the I ines f mental deficiency and mental hygiene whtln requests ~a'l6 been made for 0<.r services,
During the past year the State Board of Health in cooperation with the University of Georgia, gave a post graduate course to the physicians in soroo of the srr.aller medical cmters, the towns visited were a3 follows1 Waycross, LaQ-ang<-, Rane, Ccrncl ia, Cordcl.;, and Fainbridgc.
Frid(ly afternoon wa:; designat-.d for mental hygien& and discussions of the feeblemiMed problem. Ol.f'ing thes.o meetings the local phy~icicns were r&qucst~d to coop,~rate by bringing in for clinical use any 1"16rvous, rnGr.tal rr feeble-minded c~so,s tr-1t they IT'i:;ht b<; in~erested in, These cases were used as subjeds for discussi .... E.-a .inaLon and advics wac. aiso given the local physicians and the relatives reJ~rdine, t;-,e ca:'c o t-oec'; cc;<:3S-. I have a.Hcrdd du~:nJ the year the State Social Conference which was hu~:i ..:.t ~.;Lar.n al--.o tn(~ ln+orr.atlona~ ~enLd Hy)bne Association held at l'lashington, D. C., in M!). Fr ycx- ir,'.0rrr.Jtion I wi II sbt~ that the Association for the Study of the Feeblc-m inded was in session :n '/1,:;~ inyton at th. sarre t i mo of the lnt<;mat 1ana I Menta I Hygiene meeting,
MEDICAL WORK---From January I, 1929 to Septerrbcr I, 1930, I kad associated with me, [)-, H, H, Blanchard, He was giv:::r. a le'!ve ot afJsenre tor one year for special study, and since that dat~ it has been necessary for me to ~arr) on t~.e fll(;dical work besides my othor dc;ties. With a popu-
lation of 231 children oosices th,J Oll'.f>ICyecs, I find that it is practically impossible for met() give
each nf my many dut i '~s the thC>~ght that they deserve,
We hJ.ve for the past year, as in previous years, given a thoruugh physical examination to 11! new admissions, They have been vaccinabd against small pox and typhcid f~.;ver, the Schick test has been givc;n and these cases n ..-acting h:Jve i'lOen ir.1munized agaii"\St diptheria.
135

\'/e h;:vc h~d dc.ring the year anoth~r epidemic of influenza which was not as exten-
sive or as serious as the one in 1929. No other epidemics have occurred, neither has there been any
evidence of pellagra or cth~ nu:ritional diseases,

attached,

Three deaths have occurred dtring the year, the causes i II je shown in the tabks

During the year we have given intell i3encc test an, have made neurological and physical examinations on all casus in the instotution, Their intelligence level, n0urolc3ical, physical findings, and diagnosis has been record~d on all case:> rerraining in the institv!oon.

RELIGIOCS )<P.VICES- -According to plans made at the beginning of the year IJ30, reI igiuus services naJe been held d the institution by the local Methcdost minister on the second and fourth &..ndays and each llednesday l!'orning. Beginning December I, the rei i3ious services were taken
over by the Baptist minster, and the same program will be carried out during 1931 as in 1930. All
children who arc physically able, and have sufficient mental capacity are required to attend these
services, All of the service> havu been well attended and enjoytd by the employees as Nell as the
ihmates,
SC:-1 OL ::oRK --As stat~d previous!}, it was necessary d"ring 1)30 to reduce our personnel if w~ wcr~ to functiOfl at all, consequently since Apri I it has been impossible for us to keep
our school work and occc.pt icnal therapy dep'lrtment up to the standard of former ye~rs. \'ie have had numerous cntertairJr.er.ts during the year; rr.e of the r;est features of this has been in the form of dinner parties given the ldter part of each mc<1th for the children whose birthdays have occurred on any dab. of th~t particGiilr month. 80sid!es th~ enjcym,;nt of the3e occasions, it is, we consider a very deiinitc form nf lninin3 by teaching the girls that wcrk in the kitchen how to sur\Kl and also allOI!ing the boys and :Jirls to com: in contact with each other en these occasions. Th~su dinner parties have ~e~n und8r the surervisicn of the head teacher and stewarde-ss, The Woman's Le;,guc of Augusta has givr.n seJeral cntcrhinmcnts during the year, thes~ having been arrangod through the kindness of h'rs. 'li. ii. Gattey who is the ch'' irman of this work,
The annual barbeau~ was given c:. Jul) 4, which was also a very delightful occasion.

O<..ring the hoi idcys ev.:.ry cottaue had a Christmas tree for tho children of that particular group. A play wa~ al3o staged by th~ school 9roup. Tris play w-}s givc;c on two occasions, on0 for visitors and again for ell ths chi ldroo; of toe i:-.stitution that were capable of enjoying it. The Exchange Club also gaw a Christrr.c:s tr0c fvr :II trc children of th0 institdi<Yl, -:.~they have been doing in former yt:ars. Tk or:Jani;,Hior: c f '1o) s~ods of Acogusta fo.rntshcd a large nt-~nbcr of toys, and M--s. Battey ga10 a ChriAmas ir '" hr t! ., 11.~1-. Jroup. C/">ristm"s dinner- ,;,s SIved to all the children in the instituticn, ti:e :r.c:.u u ...c i~t "~! cf t~;r~cy, oystLr dress in;, c;,nJied yams, pea~, mask0d potatoes, cranberry jelly, cc:fu,:, ~rr ""'" ., :;r<J cake.
I mi)lt state under lei:, sam: r.~aJir.'j that~ rccvrd i~ kepi of ~v-;ry me.P.I served the children in each dinin0 rc.orc C"i~cry cky. \":~ic"t ch-:rts 'oavc also been rcn r~gul~rly. A gain in weight in '~very c"s~ hc~> beer. shcl'in whcrc tho cri ld rc.:cainci in the instituticn as long cS two months,
FAilM Ai~D !JAIRY---Tr= iH"t yecr was CL\usually hard alcng this line of activity on account of the prolonged drJught that str"ck ~.;s during the spcino .)nd surrmer, r.ur garden was practi-
136

cally a fai lyre, but tha other crops were much better, and as you know, ou- production of cotton, com, and hay was far above the average of any farm in the neighbor-hood. We have sufficient corn on hand to carry us well into 1932 unless we increase our I ivestock materially as we anticipate doing. The proceeds from our farm will show a good profit, besides it hos furnished employment for our boys.
We plan a very difinite change in our farming operation for 1}31. We hope to materially increase our acreage for garden, furni~hing an abundant supply for the institution and I hope a sufficient amount to sell on the local market to take care of at l8ast a portion of the extra colored labor we have hired, and our guano. Our cotton acreage will be just enough to give the smaller boys employment in ohoppin;; and picking same, the other portion of the land to be used for corn and forage crops.
Our dairy has also paid us a good profit, we having increased our herd by saving the heifer calves from the highest producers. ~ithin four years we havo raised from our best cows,
17 outstanding individual heifers. fo'hil6 those are ;rade stock, we hope to continue to use them until
our registered stock is old enough to take its plac6 in the dairy barn. VIe recently purchased five registered Jersey cows whose breeding ar~ second to none. With this as a nucleus, r!o plan to eventually have all registered cattle. i'lo have produced enough milk during the year to give all ef the children in tho low-grade cotta"e milk three times a day and a great deal of the time wa have been in a position to serve milk to all the population of the institution. For our milk production and farm produce, I refer you to the monthly reports.
We wen; unfortunate during the year to lose two of our very best mules which wi II have to bb replaced before spring. We also lost a very valuable saddle mare. While we had two veterinarians from the city, aM one from the Department of Agriculture, no definite cause of their deaths were ever de ermined.
We will have for slaugher during 1931, about 80 head of hogs unless something out of
the ordinary happens to them. We have vaccinated them against cholera, and have sufficient com't' carry them through the -year.
OUR NEEDS---As statt--d previously in this report, we cannot hope to further increase our population unti I more funds for bui Idings are secured. We should have at the present time suf-
ficient bu~ Idings to care for 500 extra patients, and whi I& it would not take care of our long wait-
ing I ist I feel that by 110eding out some of lhe older ones and some that could probably be kept at home by giving the relatives advice as to their care and training that this building pr~--would be sufficiont fer the present. I estimate at the very least that it would n16an anoutlay of atoout ~300,000.
We are obligtJd to have a building for hospital purposes apart from the other buildings
which would cost approximately $15,000. equipped; a laundry at an estimatod cost of $7,000; and industrial department and school building at an estimated cost of $15,000; increase in ice plant and rofrgerating facilities estimated cost of $5,000; bakery and equipment estimated cost of $2,500. Considering our present population of 231 plus an increase of 500 urgent cases that should oo institutionalized immediate!~, we would require approximately $200,000, for maintenance. You of course recognize
that our per-capita cost VlW-Id be lowc;rod as our pepl.llat ion incrsased.
As discussed with you previously, o~e should haVf; at least three more teachers, a
137

full time psychologist, a full time social worker, a trained nurse, and an assistant physician1 re.. .;:g!J1izing the fact that if our populatin increases that o\A"" personnel must also increase but not il'l
puoportion to the population.
FINANCIAL REPORT---As to our finances I refer you to the accountant of the State Board of Health. Whil,; we have had a material reduction in our maintenance as rlell as in our other appropriations, wo are going to closo th~ year l'lith a very little deficit, if any, and with an increase in population. Had it not be<:n for your timely advice and the advice of yotr acco~ntant, tr~ C! L. Tinsley, and with the cooperation that I hav:o gotten fran my staff and other employees, we. could. not have made showing that we have. It has ooen my desire as wei I as the desire of every one connected with the work to I ive as oconomically as possible.
I want to <..xpruss my appreciation to you, the mem.crs of the State Board of Health, and others connected IV i th the work. I wou Id I ike to make pub I ic acknowl edgmont of the wonderfu I '1/0rk and the sacrifices that have been made by those connected with the institution, such fidelity as
tne employees have shown in such a year that has passed needs notice by those in authority. Every position held by every employee on the place has been filled in such a way that the superintendent owos thorn his gratitude. Tho finances of the institution as you know, wore roduced which necessitated a decrease in the persol'll'l61. The employetJs thut have remained accepted their extra burden without cooment, and have canplet<;d th(; year sti II loyal to tho institution.
Respectfully Subm;~
'-t-7. ~~i-~ "'--
Oden, M. D.} Superintendent.
138

SCENES AT OUR GRACEWOOD INSTITUTION
Hi gh - Grade Girl s ' D r it ory Typical Sle ep ing Quar t ers

~-------------
GENERAL INFORIJ.AT: ON.

I. Date ef opdning as an institution br feebleminde~-2, Type of instit~tion--
3 Institution plant--

July 5, 1921.
State

Va Iue of institution property' Real estate and b.ildings Perscnal property Total acr6aje of main institution property
Owned
Rented

1329 $99,665.10 14,38).36
325 0

1930 $149,665.10 14,389.36
m.
0

Colonies Tota I acreap under Cl-1 t iva t ion 4. Actually in servijle at end of year--

0

0

190

400

Officers and emp Ioyees

l.i,

F.

T,

M,

F.

T.

Superintendents

0

0

I

Assistana superintendents

0

0

0

0

Patho Iog ists

0

0

0

0

0

0

Other staff physicians

0

0

0

0

0

0

Psychologists

0

0

0

0

0

0

Resident dentists

0

0

Q

0

0

0

Principal of school

0

Q

0

0

0

0

Teachers of jrade subjects

0

1

0

I

Teachers of special subjects

0

0

0

0

0

0

Socia I workers

0

0

0

0

0

0

Stewardess

0

0

I

I

Graduate nurses MatrvnS All others Total-

0

0

0

0

( 0

6

6

8

14

8

16

24

0

0

0

0

5

5

!L 2

12

14

9

23

1930

M,

F,

T.

114 102 2lb

0

0

0

114 102 2tb

21

13 34

135 115 250

13

4

17

0

2

2

2

I

120 108 228

139

C1\\S!JS OF PATIE!H POPULATION AT END OF"Vii.R IN r::STITUTIGr-1

Feeble-minded ( not epileptic ) Feeble-minded epileptics Epileptics (not feeble-minded) others ( specify ) Total
Enrol led but absent from institution There are no colored patients in the institution,

1929

I .~
'"

F.

T.

112

99 211

2

3

5

0

0

0

0

0

0

114

102

216

None

1930

M.

F.

118 102

2

6

0

0

0

0

120 108

None

T. 220
8 0 0 228

r.ENTAL STATUS Idiot ll!beci le Mer on (Exclude epileptics Not feeble-minded Under observation Total

ftNTAL STATLG OF FIRST AOMISSIGrJS ANO REAWISSinNS 1929

Total

1st Admissions

M,

F,

T, r:i. F. T.

9

9 18

9 9 18

83 65 148 83 65 148

22 28 50 21 28 49

0

0

0

0

0

0

114 102 216

000 000 113 102 215

Readm iss i ens

M, F, T.

c

0

0

0

0

0

I

0

I

0

0

0

0

0

0

0

MENTAL STATUS OF FIRST ADMISSIONS AND READMISSIONS 1930

MENTAL STAT'.'S Idiot lmbeci le Moron { Exclude ep i I ept i cs Not feeble-minded Under observation Total

Total

M. F, T.

II

9 20

89 ]I 160

20 28 48

1st Admissims
t:. F, T. II 9 20
89 70 159 20 28 48

0

00

0 00

0

00

i)

0

0

120 108 228 110 JO] 227

Readmissions

M.

F. T.

0

0

0

0

I

I

0

0

0

0

0

0

0

0

0

.0

I

140

- ~----~--------------------
AGE OF FIRST All~ISSIGNS CLASSIFIED 'TIH Rr:FERENCt TO MENTAL STATUS

Total

Idiot

1929 lmbeci le

Moron

"lot Feeble-minded

AGE GROLP

~1. f', T,

lklder 10 years 13 12 25

10 to 14 years 53 27 80

M? f', T, 448 448

M. F, T, 8 6 14
38 14 52

M. F, T. I 23
II 9 20

M. F. T. 000 000

15 to 19 years 35 49 84

0 I I 2B 34 62

7 14 21

000

20 to 24 years I0 9 19

0 0 0 I 0 6 16

0 33

0 00

25 to 2) years 2 5 7

0I

I4 5 0

000

___ 30 to34 ~ars ~~-0~~~--~o~~o__~o

l~~o---~-~o~~o~~o_ _~o-~o--~o

Total

114 102 216

9 9 18 86 64 150 19 29 48

000

AGE OF FIRST MJI.IISSIONS CLASSIFIED '111-l REf'ERENCE TO ''tENTAL STATUS

Total

JI.GE GROUP

F, T.

Under 10 years 13 II 24

I0 to 14 years 46 30 76

15 to 19 years 43 44 87

20 to 24 years 15 16 31
25 to 29 years 2 7 9

1930

Idiot

lmbeci le

~~. F, T, fl, F, T.
4 3 7 9 5 14

' 4 I0 29 17 46

2 3 33 30 63

0 0 0 15 13 28

0 00 26 8

Moron M, F,
03
II 9
9 12
03
0

Not Feeble-minded T M. F. T. 3 000 20 0 0 0 21 0 0 0
30 0 0
I 000

30 to34 years ~~--~0~-'~--~0----~0--~0~~~--~0~~~---0~-~0--~0--~0-~0--~0

Total

120 108 228 II 9 20 89 71 16o

20 28 48 0 0 0

ENVIRONMENT OF FIRST ,&.OMI~'SI<l'lS CLA8SIF18l VIITH REFE~:;cE TC MEfllTAL ST.~TIJS

ENVIRONMENT Urban Rural Total

Total
,!. F. T.
73 62 135
41 40 81
114 102 216

1929

Idiot

lmbeci le

M, F, T, M, F. T,

5 5 10 57 35 92

4 4 8 29 29 58

9 9 18 86 64 150

M, F, T.
II 22 33
8 7 15
19 29 48

DISCHA~ES CLASSIFIED :'ITH REFE:ENCE TO f~S'JTAL STATIJS AND Q-IR~NOLIGICAL

Total

1929
Idiot

lmbeci le

Moron

Others

AGE GW'tiP

M, F. T. M. F. T. M. F. T. M. F. T. M. F. T.

Under 10 years 10 to 14 years 15 to 19 years

000 8 2 10
72 9

0 0 0 0 0 0 0 0 0 000

2 0 252 7 I 0

000

0I

2 0 2 4 I 4 I I2

20 to 24 years

I0I

Total

16 4 20

0

0

0

0

0

0~___..;0::.__....;0::.__..;::0~0

3

4 7 2 9 5 0 5I

2

ENVIRCtlMENT OF FIRST ADMISSIONS CLASSIFIED .1111 RE'ERE"iCE TO MENTAL STAnJS

EWIRONM!:NT Urban Rural Total

1930

Total

Idiot

lmbeci le

Moron

M, F, T. M. F. T. M. F. T. M, F. T.

78 7? 155 5 5 10 57 51 108 16 23 39

sL-__ _4~2--~~~9--~n~~6~_4__~1~o--~3~2--=2o::..-~5~2--~4____

~9.

120 108 228 II 9 20 89 71 160 20 28 48

14!1.

DISOi\RGES ClftSStFIEO ~ilni R!:cERENCE TO MENTAL STATUS AND (}IROIIOLOSICftl AGE

AGE GROUP lklder I 0 years IO to 14 years
15 to 19 years
20 to 24 years Total

Total

t~. F. T.

022

10 3 13

3

4

2

2

15 7 22

15',30

Idiot

lmbeci [e

M. F, T. M. F, T..

0I

000

2 000

7I 8
2

0 0. 0

2

:2

2 3 10 3 13

MorOI'I

Others

1.1. Fi T, M. F. T.

0

I 000

2

3 000

2 0 2 000

0 0 0 000
4 2 6 000

142

Page
State Board of HeaIth ..... , .......... , .. , ......................... ., .. .. .. 2
Staff of State Health Department............................................... 3
Letter of Transmittal.......................................................... 4
Division of Colrlty Health rlork,................................................ 5
Division of Laboratories ................_....................................... 21
Division of S~itary Engineering............................................... 33
Divistctl of Child Hygier.e...................................................... 43
Division of Verereal Disease Control........................................... 55
Oivision of Public Health Education ....... ,.................................... 61
Btreau of Vital Statistics................................... , .................. 65
INSTITUTICIIS
State Tubercull).$iS Sanltcr it.Mn .................... -., , , , 115
State Training !ldlool for Mental Dafect ill8s, , ,, , ...... ., ..... , .............. 133
ILLUSTRA.TIJNS
Facing Page
A Tan and a Half 1f Tuberculosis $'revention......... ... ....... ................. 4 lidallr\istration !Wi ldiliQ, AI to...................... , ............................ 122 0\i Jdr"''s euiJding, Alto.................. 122 Sd\ooi Sui tding1 AI to ............................................................. 122 Reservoi,.lake, AJto.. . 128 Filter Ptarlt., Alto...... , ....... , .......... 128 Dairy Barn and !V;rd, Alto........................................................ 128
Acitinistration Buildi""G, Gracowood. 132 Play,.-~, Gra.oewcxxi, , . 132 Dairy Herd, ~a.cewoad.~ ..... ... . t32
GirIs1 Oci"cn1 tory, Graoe'WOOd ............................................... , , 138 Typical Sleeping. Quarters, Gracewood , , .. )~