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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
