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Measles.-The number of deaths caused by measles was smaller than during any previous statistical year since the records of vital facts have been preserved in New Jersey, only 60 having been reported.

TABLE 20.-SHOWING DEATHS IN NEW JERSEY FROM MEASLES FOR THE

TWENTY-THREE YEARS ENDING JUNE 30TH, 1901.

Year.....

1879. 1880. 1881. 1882. 1883. 1884. 1885. 1886. 1887. 1888. 1889. 1890.

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ENDING JUNE 30TH, 1901. CHART SHOWING DEATHS IN NEW JERSEY FROM MEASLES, FOR THE TWENTY-THREE YEARS

Small-pox.—The number of cases of small-pox reported during the year ending June 30th, 1901, was 225, and the number of deaths was 5—a fatality of only 2.2 per cent. The small fatality is in accord with the experience which has been recorded in other States during the past five or six years. The rate of the occurrence of the cases of small-pox was, by quarters, as follows: July, August, September, 2; October, November, December, 13; January, February, March. 36; April, May, June, 174. New Jersey has been fortunate enough to escape with comparatively few cases of small-pox during the recent general prevalence of this disease in other portions of the United States, and this fact has doubtless been due to the intelligent, prompt and energetic measures which have, in almost every outbreak, been applied for its eradication. But reference to previous reports of this board shows that a very large number of the inhabitants of the State are without the protection afforded by vaccination, and, when we consider the increasing number of new centers of infection, which is shown by the table of reported cases of communicable diseases, there is little room for expectation that we are longer to go free from numerous widespread outbreaks of this disease, and preparations should everywhere be made by the local sanitary authorities for the prompt isolation of the first case and the immediate vaccination of suspects. Domestic quarantine is uncertain and unreliable in all infectious diseases, and, in dealing with small-pox, all accumulated experience shows that outbreaks can only be restricted with certainty when the patients are removed to a hospital which is controlled by persons who have been trained in the measures which should be taken to prevent communication between infected and non-infected persons. Economy and efficiency are both promoted by the removal of small-pox patients to a hospital, and the public interests cannot be well served in any community where the persons affected with this disease are of necessity kept in their own homes. Co-operation between sanitary districts in the removal and isolation of cases of small-pox, and the erection of one hospital for the reception and care of patients from several neighboring townships and municipalities has important advantages, and such an institution, conducted under the supervision and control of the health board of one of the interested communities, would render far better service in protecting the entire district from infection than could be secured by the maintenance of one hospital in each of the municipalities and townships.

Vaccination. The appearance of small-pox in numerous localities

in New Jersey during the past year has led to the vaccination of a large number of persons, and discussions among medical men as to the most reliable sources of vaccine and the best modes of vaccination have been renewed. Reports received in the office of the State Board of Health show that in some instances no subsequent examination has been made by the physician to learn if the resulting pustule is protective, and in too many cases there has been accidental infection and consequent annoyance to the patient, which is altogether needless. There is no excuse for careless vaccination, and local boards of health are morally bound, and should be legally held, to guard this operation when it is conducted under their supervision or by their direction, against failure by reason of inert virus or because of uncleanly or unskillful manipulation. The examination of the arm on the eighth day, and re-vaccination in cases where failure has occurred, is as much a part of the duty of the vaccinator as it is to perform the primary operation. The fancied security now enjoyed by many recently-vaccinated persons is liable to a rude awakening in the course of some future outbreak of small-pox, because of the negligent manner pursued by some practitioners in conducting the operation. Carelessness of this character should be condemned by every true friend of vaccination, and all should insist upon asceptic precautions and the use of fresh, glycerinated lymph. The following standard rules for vaccination are recommended :

Site.—The insertion of the deltoid in the left arm is to be preferred in children who are old enough to walk, and in adults. The outer side of the thigh, below the junction of the lower and middle thirds, is a site frequently chosen in women and infants; sometimes, also, the junction of the middle and upper third of the leg on the outer side.

Asepsis.—The hands of the operator should be thoroughly scrubbed with soap and water before undertaking this operation. Wash the part to be vaccinated thoroughly with a brush and soap and water, then with plain water. Dry with sterile cotton.

Scarification.-Scrape a surface not over three-eighths of an inch in diameter, so as to bring a little blood or serum.

An ordinary cambric needle is the best scarifier. It should be passed through a flame or be boiled before using.

Virus.—Use glycerinized virus; rub it thoroughly into the scarified area with a small piece of wood which has been previously boiled.

The hand of the operator should not touch that portion of the instrument which is to come in contact with the wound. Allow the part to dry in the air; no dressing is necessary.

Cancer.—This disease caused 1,001 deaths in New Jersey during the past year. The number of deaths recorded as being due to cancer for the previous year.was 921, and the average number for twentythree years

has been 652. The excess of deaths from this cause for the year ending June 30th, 1901, above the average, was 349.

TABLE 21.-SHOWING DEATHS FROM CANCER, PER 100,000 POPULATION, FOR

THE TWENTY-THREE YEARS ENDING JUNE 30TH, 1901.

Years..

1879, 1880. I 1881. 1 1832. 1883. 1834. 1885. 1886. 1887. 1888. 1889. 1890.

Deatbs per 100,-)

000 population

37.0 37.5

88.6

33.7

38.1

88.7

88.9

41.5

42.1

44.6

41.1

44.2

Years

1891. 1892. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901.

Deaths per 100,-)

000 populations

48.4

45.5

46.9

46.3

46.0

47.1

48.3

47.0

51.0

48.4

52.0

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