The Health bulletin [serial] - University of North Carolina at Chapel Hill

—
April 1927 The Health Bulletin 27
sion of this service. The advantages of
a generalized program in which a nurse
renders all types of service in a district
assigned to her are being repeatedly
demonstrated. Studies recently reported
by the East Harlem Nursing
and Health Demonstration indicate
again that the generalized type of visit
costs less, but insures more effective
service from the standpoint of the
family as a whole, than does the specialized
type of service.
Finally, a quotation from the Surgeon
General of the United States Public
Health Service may be appropriate
in indicating achievements, as well as
problems to be met.
"During the last quarter of a century
the death rate from typhoid fever in the
death registration area of the United
States has been reduced more than 80
per cent ; the death rate from tuberculosis
about 55 per cent ; and the rate
from diphtheria, 70 per cent. These
are some of the records which sanitarians
contemplate with pride, and from
which they receive courage for future
work. Other communicable diseases
show creditable reductions in both case
and death rates, but the official records
for some diseases are not so encouraging.
"The death rates from cancer, diseases
of the heart, diabetes, and other
diseases are increasing, while automobile
accidents, unknown a few years
ago, are taking a toll of human life
which is appalling. The steady increase
in deaths and disablements from this
cause each year is disheartening to the
person who sees the suffering and loss
of life as well as the saving of time in
transportation and the greater freedom
of movement which the automobile has
brought to our people." Neic Haven
(Conn.) Health Bulletin.
A recent writer has made the statement
that the struggle of the future
will be between man and insects. Some
such struggle has unquestionably gone
on since the earliest times, and the
non-habitability by the white man of
^many of the most fertile sections of
the world has certainly been largely
due to the presence of insects which
carry disease. The writer just quoted
had in mind more than diseases of man.
In fact, he was considering chiefly diseases
of food-producing plants, and the
question which is of such rapidly-growing
importance—food supply for the
race. We need only mention the ravages
of the Hessian fly, San Jose scale,
codling moth, and the cotton boll weevil,
which cause such tremendous losses
and so much anxiety to our agricultural
interests. Domestic animals on
which we are dependent are also victims
of insect pests and insect-borne
diseases.
As far as man himself is concerned,
we have grown accustomed to thinking
of the house-fly as a bearer of typhoid
fever and other intestinal diseases, the
ts tse fly as the carrier of sleeping
sickness, the flea as carrier of bubonic
plague, mosquitoes as agents in transmitting
malaria, yellow fever and dengue,
the louse as carrier of typhus and
INSECTS AND DISEASE
trench fevers, the tick as carrier of
Rocky Mountain spotted and relapsing
fevers, and more recently we have
learned of deer-fly fever (tularemia).
Indeed, the list is too long for mention
here, and additions are being made
constantly by new discoveries.
The insect responsible for the transmission
of Kala-azar is the most recent
addition to the list, a disease which
fortunately does not affect us in this
country, but which is none the less interesting
from this general standpoint.
A commission headed by Lieut.-Col.
Christophers, working in India since
1924, has concluded that the sandfly
(Phlebotomus argentipes) is the agent
of transmission in this disease. The
bedbug, which has been incriminated
in the past, has been excluded by careful
work, as has also the common louse.
The commission has arrived at this
conclusion, in spite of some facts which
speak to the contrary, most of the evidence
being so strong, that they "for
the present" hold that the sandfly is
the "probable transmitter." It was
proved that 25 per cent of sandflies
which bit patients became infected with
the parasite in spite of the fact that
they exist in very small numbers in
the peripheral circulations. The great