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An official method for lessening heart disease
AN
OFFICIAL
?IIETHOD HEART
JOHN
D. M(sL~ax,
FOR
LESSEKING
DISEASE” M.D.,
PIIILADELPRIA,
Pa
P
REVENTIVE medicine has been one of t,he principal functions of the medical profession, in the sick room, in the laboratory, in the medical schools and in all health agencies. This is very clearly and forcefully demonstrated by the efforts to control communicable diseases. We have so impressed the law-making bodies as to the wisdom of preventive medicine that laws have been passed giving physicians great powers over those ill and t,hose who have been in contact with these diseases. Health departments-international, national, state, county, and those of districts, cities, boroughs and organized communit,ies-have been created by law giving to those department,s powers which are far reaching. “Protect the masses” might well have been the slogan of the profession when these laws were urged. How great are these powers might well be illustrated by a procedure in my own state. The legislatnrc of 1919, at the request of the Department of Health passed the follow of Health may, when it deems it ing amendment : “The Department necessary to safeguard human life and health, declare as communicable, diseases additional to those herein sl)ecifically so declared. ” Jmmedintely syphilis and tuberculosis were declared communicable diseases. 111 a crntral city of the St,ate, in a genitourinary clinic a number of men reported suffering from syphilis ; from iuformation gained from each the source of infection was determined as coming from a certain house; this house was raided, the inmates arrested and placed in prison, mly to be released within less than one hour by a court order. The inmates returned to the lIoust\, which wa.s then placarded ” syl)hilis”; they immediately fled the house, only to be arrested and put in prison. Xucli to t,lie surprise of the lawyer interest,ed, a court ortlt~r, \vhich called for their release, could not be obt,ained as the inmates now were in jail not because of being taken out of a raided house, but because they had broken quarantine. l:nder these laws and regulations communicable diseases are subjec,t to quarantine, which has been defined by the Attorney-General as meaning confinement in a room in a house, confinement in a house, or remova. to an institution provided for the care and treatment of those suffering from the disease in question. This 1a.w can be enforced as it has been tested in court. We have succeeded in decreasing the number of those suffering with *Rt,acl
before
the
Rmcrican
Haart
12ssociation. 107
May
26,
1025,
Atlantic
City.
typhoid fever altd tLtbercdosis ; typlioitl. bf3CilUSC the sottree of ittfwfion has been controlled; ttlbcrdosis, bwmtsc of education of thr public on prevention. Part, of ottr efforts in tire past have hit to C~lllCiltC, Urge and force the atltdts, l)arrnts and ,g~ardians, to protect iIIli1 @tart1 tile children; in this we llil\.(’ failctl to consider tllose n:hotll Ire wisli tn protect. We seem to forget that in il vrry few years tllv;-, tllr children, mill be the ones who \vill 11av-c~I Iw l)ower to tlo this: that. they will \w filtllcEi and mothers anti sltottltl 1)~trainetl to protect their own, ilS we arc now traitiitt, (r thciv I’ailtvrs iltltl ntotlicrs. ‘1%c cotttmunicablc diseasesthat, have not been materially lessened are clipIttlic~ria. scarlot fever, mraslw, ntttmps ant1 whooping cotlyh. We liave accoiitplisliccl little, 8s TV<’have aircv~tly shown b>- out morbidity reports. This plan leas hcclt far frortt il success. If TYt’ have, therefore, failed in reducing the number of those sufferiitg with these diseases, wotdd it not he \vell to vltattpv ottr method and bltiltl ttlt sucll it rcsistattcc within the body of’ each caltild its will lessen tttr number of fertile fieltls for their cle~clolttttrttt .’ This XSSOciittiOlt has t\v0 Objects : (1 I tll(l ~~r~c.rcntiolt Of Ilcilrt dist’aS(‘. and (2) tllc? Citl't! Of tllOW 1lO\V siltft~tGg ftY)Itt tlC’ill+ disease. Tllt~w are one Irttntlrcitl ant1 six rttilliolt l~cwltlc in tlte United States. \vit h ahout fifty-eight tltillintl o\.or tncJn1 y-ollr illlcl forty-eight million itttdcr twenty-otiv ; of this nnrtiber ithltt fo71v million are school cltiltlren, with thrw million itndrr t~vclrc J~cars ot’ age. ,Igilill using ltt? “ The medical itispecown state as an illltstritti0tt. tllc law I)rf)vitles: tors sliall, at least oti?e ewh year, inspect and c~arc~fnll~-test alld Csamine all pupils in the pnhlic~ scliools of their. tlislric+s, girittg S]JCc+iitl attention to defective Sipltt, ltearittg, twtlt or r/f//it’ diwl)i/itic.s f/red t7cfcct.s specified by the (‘omtnissioitcr of’ IIcwlt It itt his tlirectiotts anti rrqitirenicnts for medical inspection of schools, illl~l shall makC SltCll HdditiOttill inspcctiotis atttl csaitiittatioits ilS S2lilll hc! prnviciecl fOr iI1 said dircctioits or reqniretl by the Cotritttissiotter of Ilewltll, the j)rittciltal, or the district, suI)critttettdertt of sc~lrnols. IGirt meclical jtistwc*tar shall gire CilrCfUl tlirectiniis cottccrltili~ tllcl (‘arc of CIilCh prtl)il ~110 needs special care \vllilc iit scliool. ‘1’11r1cac*lter, priticipl or tlistricbt, supc‘ritttrttdent Sll;tll c;lrry 0ltt HS c:nrt?f’Ully ilS [m:sihl~ the IllPtliCil1 itispector’s clircctioiis concerttin, 0. tllo SlWcaiil (‘iI1’C Of ltttl)ils wliilc in
sclionl.
”
~1 mctlrotl for ittcreasirig rvsistntic~t~ to tlicsc cottimt7tiicable tliseases, w1tic.h are rwl)onsible itt man\- ittst;tttcc,s for heart disease, is RS follows : First, a thorough medical exaniinat~ion pearly of all children between the ages of six ittttl twelve. I’ntler the law jwt quoted it is dertiatttlrtl ; i1nClit can, tllereforr, be dour. Srco~id, pay special attelltinn to those of six vC?;ltJS jrlst wttcring scJtto01, noting Cdilr(‘fllll?ant1 fllll) all i~l~normitlities and nonimmttttitics. Tliirtl, follow vaclt child yearly, carefully noting conditions found atic1 correct,iotts m;de as the rCdt
110
THE
111. A list (a) (b) (c) (d) IV.
of all State completed.
properties
IIEART
on which
JOURNAL
construction
has been
started
but
not
To what use is each to be put. List of Commissioners in charge. Amount of money appropriated. Bed capacity.
Influence
V. New
legislation make them
lis t of properties heart patients.
on a selected available for
legislation directing that the ings for the care of heart INFORMATION
I. Name, (‘a) (b) (c) (d) (e) (f) II.
AMERICAIf
Name
VALUABLE:
FOIL
and number of membership, cluding Commissioners of Name and address Name and address Amount of present What if any active What organizations Find in each district toward a health
State purchase patients. Local
and
institutions,
a site
aud
COMAIUNITY
of each Health the Poor.
construct
buil~l-
SERVICE
or Welfare
of the person most active in of the Executive OtIicer. finances. fzcnctiolk now. are anxious to do SOMETHING one person financially able improvement program.
so as to
each
in-
organization.
if and
organization
properly charitably
advised. inclined
and location of each hospital and institution which might care for acute or chronic heart disease patients, with number of beds that could be made available. (For discussiot~ see page 117.j
OFFICIAL
?IIETHOD HEART
JOHN
D. M(sL~ax,
FOR
LESSEKING
DISEASE” M.D.,
PIIILADELPRIA,
Pa
P
REVENTIVE medicine has been one of t,he principal functions of the medical profession, in the sick room, in the laboratory, in the medical schools and in all health agencies. This is very clearly and forcefully demonstrated by the efforts to control communicable diseases. We have so impressed the law-making bodies as to the wisdom of preventive medicine that laws have been passed giving physicians great powers over those ill and t,hose who have been in contact with these diseases. Health departments-international, national, state, county, and those of districts, cities, boroughs and organized communit,ies-have been created by law giving to those department,s powers which are far reaching. “Protect the masses” might well have been the slogan of the profession when these laws were urged. How great are these powers might well be illustrated by a procedure in my own state. The legislatnrc of 1919, at the request of the Department of Health passed the follow of Health may, when it deems it ing amendment : “The Department necessary to safeguard human life and health, declare as communicable, diseases additional to those herein sl)ecifically so declared. ” Jmmedintely syphilis and tuberculosis were declared communicable diseases. 111 a crntral city of the St,ate, in a genitourinary clinic a number of men reported suffering from syphilis ; from iuformation gained from each the source of infection was determined as coming from a certain house; this house was raided, the inmates arrested and placed in prison, mly to be released within less than one hour by a court order. The inmates returned to the lIoust\, which wa.s then placarded ” syl)hilis”; they immediately fled the house, only to be arrested and put in prison. Xucli to t,lie surprise of the lawyer interest,ed, a court ortlt~r, \vhich called for their release, could not be obt,ained as the inmates now were in jail not because of being taken out of a raided house, but because they had broken quarantine. l:nder these laws and regulations communicable diseases are subjec,t to quarantine, which has been defined by the Attorney-General as meaning confinement in a room in a house, confinement in a house, or remova. to an institution provided for the care and treatment of those suffering from the disease in question. This 1a.w can be enforced as it has been tested in court. We have succeeded in decreasing the number of those suffering with *Rt,acl
before
the
Rmcrican
Haart
12ssociation. 107
May
26,
1025,
Atlantic
City.
typhoid fever altd tLtbercdosis ; typlioitl. bf3CilUSC the sottree of ittfwfion has been controlled; ttlbcrdosis, bwmtsc of education of thr public on prevention. Part, of ottr efforts in tire past have hit to C~lllCiltC, Urge and force the atltdts, l)arrnts and ,g~ardians, to protect iIIli1 @tart1 tile children; in this we llil\.(’ failctl to consider tllose n:hotll Ire wisli tn protect. We seem to forget that in il vrry few years tllv;-, tllr children, mill be the ones who \vill 11av-c~I Iw l)ower to tlo this: that. they will \w filtllcEi and mothers anti sltottltl 1)~trainetl to protect their own, ilS we arc now traitiitt, (r thciv I’ailtvrs iltltl ntotlicrs. ‘1%c cotttmunicablc diseasesthat, have not been materially lessened are clipIttlic~ria. scarlot fever, mraslw, ntttmps ant1 whooping cotlyh. We liave accoiitplisliccl little, 8s TV<’have aircv~tly shown b>- out morbidity reports. This plan leas hcclt far frortt il success. If TYt’ have, therefore, failed in reducing the number of those sufferiitg with these diseases, wotdd it not he \vell to vltattpv ottr method and bltiltl ttlt sucll it rcsistattcc within the body of’ each caltild its will lessen tttr number of fertile fieltls for their cle~clolttttrttt .’ This XSSOciittiOlt has t\v0 Objects : (1 I tll(l ~~r~c.rcntiolt Of Ilcilrt dist’aS(‘. and (2) tllc? Citl't! Of tllOW 1lO\V siltft~tGg ftY)Itt tlC’ill+ disease. Tllt~w are one Irttntlrcitl ant1 six rttilliolt l~cwltlc in tlte United States. \vit h ahout fifty-eight tltillintl o\.or tncJn1 y-ollr illlcl forty-eight million itttdcr twenty-otiv ; of this nnrtiber ithltt fo71v million are school cltiltlren, with thrw million itndrr t~vclrc J~cars ot’ age. ,Igilill using ltt? “ The medical itispecown state as an illltstritti0tt. tllc law I)rf)vitles: tors sliall, at least oti?e ewh year, inspect and c~arc~fnll~-test alld Csamine all pupils in the pnhlic~ scliools of their. tlislric+s, girittg S]JCc+iitl attention to defective Sipltt, ltearittg, twtlt or r/f//it’ diwl)i/itic.s f/red t7cfcct.s specified by the (‘omtnissioitcr of’ IIcwlt It itt his tlirectiotts anti rrqitirenicnts for medical inspection of schools, illl~l shall makC SltCll HdditiOttill inspcctiotis atttl csaitiittatioits ilS S2lilll hc! prnviciecl fOr iI1 said dircctioits or reqniretl by the Cotritttissiotter of Ilewltll, the j)rittciltal, or the district, suI)critttettdertt of sc~lrnols. IGirt meclical jtistwc*tar shall gire CilrCfUl tlirectiniis cottccrltili~ tllcl (‘arc of CIilCh prtl)il ~110 needs special care \vllilc iit scliool. ‘1’11r1cac*lter, priticipl or tlistricbt, supc‘ritttrttdent Sll;tll c;lrry 0ltt HS c:nrt?f’Ully ilS [m:sihl~ the IllPtliCil1 itispector’s clircctioiis concerttin, 0. tllo SlWcaiil (‘iI1’C Of ltttl)ils wliilc in
sclionl.
”
~1 mctlrotl for ittcreasirig rvsistntic~t~ to tlicsc cottimt7tiicable tliseases, w1tic.h are rwl)onsible itt man\- ittst;tttcc,s for heart disease, is RS follows : First, a thorough medical exaniinat~ion pearly of all children between the ages of six ittttl twelve. I’ntler the law jwt quoted it is dertiatttlrtl ; i1nClit can, tllereforr, be dour. Srco~id, pay special attelltinn to those of six vC?;ltJS jrlst wttcring scJtto01, noting Cdilr(‘fllll?ant1 fllll) all i~l~normitlities and nonimmttttitics. Tliirtl, follow vaclt child yearly, carefully noting conditions found atic1 correct,iotts m;de as the rCdt
110
THE
111. A list (a) (b) (c) (d) IV.
of all State completed.
properties
IIEART
on which
JOURNAL
construction
has been
started
but
not
To what use is each to be put. List of Commissioners in charge. Amount of money appropriated. Bed capacity.
Influence
V. New
legislation make them
lis t of properties heart patients.
on a selected available for
legislation directing that the ings for the care of heart INFORMATION
I. Name, (‘a) (b) (c) (d) (e) (f) II.
AMERICAIf
Name
VALUABLE:
FOIL
and number of membership, cluding Commissioners of Name and address Name and address Amount of present What if any active What organizations Find in each district toward a health
State purchase patients. Local
and
institutions,
a site
aud
COMAIUNITY
of each Health the Poor.
construct
buil~l-
SERVICE
or Welfare
of the person most active in of the Executive OtIicer. finances. fzcnctiolk now. are anxious to do SOMETHING one person financially able improvement program.
so as to
each
in-
organization.
if and
organization
properly charitably
advised. inclined
and location of each hospital and institution which might care for acute or chronic heart disease patients, with number of beds that could be made available. (For discussiot~ see page 117.j