Produced by the University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan Library

Influenza Encyclopedia

ï~~ LOS iANC,:ELFS 1)EPARTMNT CF H tHi -. which required midwives to secure State license will raise the standard of qualifications of a midwife and thereby reduce accidents and criminal practices Comnmiicable Diseases* Tuberculosis: Our records for the year ended June 30th, 1917, show 2710 cases of tuberculosis reported, which includes all forms of the disease. Each month of the year shows an approximate equal in cases reported-variation not being large enough to be considered important. There was a total of 991 deaths, classified as follows: Pulrmonary 859, acute miliary 14, tubercular meningitis 57, conditions classed as white swelling 4, desseminated 1, and all other forms 56. Three hundred ninety-five of the cases were not reported until filing of the death certificate. Twenty-one deaths were under 2 years of age and 23 were between 2 and 5 years. Based on the generally accepted method of estimation (multi plying the death rate by ten) we should have had approximately 10,000 cases reported, 2000 of which would be so advanced as to require hospital care. Although no accurate survey has been made of advanced cases (especially of those outside the hospitals) anyone at all acquainted with our tuberculosis situation will realize that such an estimate is approximately correct. A study of our reports shows that cases from the well-to-do are fairly truly reported through private physicians and private sana toria. Cases among the very poor are detected by the free clinics and visiting nurses. The advanced cases, especially, are detected by the County Hospital. This leaves us a large number of patients from among the working classes, who are able, in many instances, to perform only sufficient work to keep themselves going. These are steadily drifting towards the helpless classes-untreated, un reported. Largely they occupy the cheap lodging houses or crowded homes, and even when they are quite intelligent and well meaning, find themselves so situated that it is impossible for them to take the necessary precautions to prevent the spread of infection. No measures have been taken by the Municipality for the housing or care of these patients, and even the private sanatoria of *See page 17 for tabulation as prepared by Mr. E. C. Moritz, contagious

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