October 31, 1888. Hon. J. M. RUSK, Governor of Wisconsin:

SIR:-In accordance with the provisions of the statute, we have the honor to present the following, the twelfth report of the State Board of Health.

While we have again to congratulate the people of the state on a year of general good health -- in some marked particulars better than preceding years - it is nevertheless true that contagious and other forms of disease that are, in great measure at least, preventable are never wholly absent from the state. We believe it to be equally true however, that such diseases have been generally better managed and more successfully controlled during the past year than ever before in the history of the state, and that in an increasing number of cases, by the intelligent use of proper precautions, such diseases have been prevented from spreading in many communities where they have obtained an entrance, and where, in the absence of such precautions and of the necessary authority for their enforcement, they might have extended to epidemic proportions.

Both local boards of health and the people are gradually becoming better informed concerning the principles ar:d limitations of preventive medicine, and we have evidence that we cannot doubt to the effect that during the year covered by this report, sickness has been diminished in this state and the death rate lowered by the intelligent application of these principles.

The secretary's report will refer more in detail to instances of the control of outbreaks of Diphtheria,

General Report of the Board.

Scarlet Fever, Typhoid Fever, etc., by the vigilant action of local boards of health, though the familiarity with these diseases produced by their more or less constant prevalence among us tends often to make the work of the health officer difficult, and makes us to a considerable extent oblivious of the good that has been accomplished thereby. Nothing that is apparent to the public probably illustrates so fully the power of preventive medicine in its practical application as the simple statement that on five distinct occasions during the year Small Pox made its appearance in the state, and that on each of these, through the discreet and vigilant action of local health authorities it was so controlled that in no case did it spread beyond the household in which it first appeared. Action like this has not only saved the communities in which the disease was thus brought from an amount of sickness and death which cannot be estimated in money value, but it has also saved the whole commonwealth froin a pecuniary loss of which the amount has been doubtless far in excess of the whole sums expended on boards of health of all kinds in the state.

It is not necessary, however, to enter into arguments concerning the value of efficient health boards, or to give undue praise to the boards now in existence. It is but just to say that some of them — many of them, indeed — have done

good work, work that fully justifies the wisdom of the law requiring their organization in every township. The health organization is the one that touches the people most nearly and most vitally in their homes and in their families. It is the organization above all others which should never be deprived of its place or powers from considerations of economy, so called. It is the earnest desire of this board to uphold the local boards by every practicable means, and to render all possible aid in making them more efficient, and in our efforts in this direction we solicit the aid and co-op

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General Report of the Board.


eration of the press, the pulpit, the school and, in a word, of every agency that can advance the interests of the state, and of those who love their fellow men and value the prosperity of the commonwealth.

For several years this country has faced the probability of an invasion of Asiatic Cholera, and the legislature of Wisconsin, in common with the legislatures of many other states, provided a contingent fund which should be available in case of need therefor becoming apparent to both the governor and this board. This action was taken for each of the two biennial periods beginning with the legislative sessions of 1885 and 1887, but happily no occasion arose during either of these periods for drawing upon the fund so provided. We recommend, however, as a matter of ordinary prudence, the continuance of a special contingent fund, to be available under similar conditions to those hitherto laid down, should such an emergency arise as would make its use necessary for the protection of the state. In such an emergency the state would in all probability act in co-operation with other states for the common good of all; this: would be but a practical extension of the co-operation which now exists for the notification of contagious diseases through a compact which took form in a National Conference of State and other Boards of Health, which has for its object the mutual exchange of information whenever a dangerous form of contagious disease appears in any part of the country. The advantages of this system, and of practical co-operation for the control of any wide-spread epidemic needs only to be stated to be appreciated.

As a part of this co-operation for mutual protection, we may refer also to an effort that is being made to secure uniform rules for the transportation through contiguous states of the bodies of persons dead from contagious disease. It is often desired to transport such bodies from one state to General Report of the Board.


another, and while it is evident that safety to the living must be the paramount consideration, it is manifest as well that such safety, as also the convenience of all parties concerned, would be much promoted by uniformity of the regulations under which the transportation is effected.

In connection with, and as forming a part of this report, there are presented several papers on matters of practical sanitary interest. Among them is one that has been prepared for the report by Prof. Rɔberts Bartholow, of Philadelphia, at the request of Dr. S. C. Johnson, on “The

• Preventable Causes of Typhoid Fever," a topic of immediate and very practical interest to the people of Wisconsin, inasmuch as Typhoid Fever is a disease of exceptionally frequent occurrence over a large part of the area of the state. In this instance the board has departed from its usual custom of obtaining papers only from members of the medical profession or other well qualified writers on sanitary topics, resident within our own state. The opportunity, however, of obtaining a contribution from a writer of so extended and well deserved reputation and high ability as Prof. Bartholow was not one to be passed by unimproved, particularly when the subject was one affecting us so closely. The disease is treated by Dr. Bartholow from the advanced stand-point of modern discovery, and many things in connection with its occurrence are set in the clear light thrown by the investigations of our own day, the deductions from which are shown to be quite impregnable.

The marked increase of this insidious disease in Wisconsin within late years gives this paper a special interest and value at present, while the high standing of the writer as an authority justifies the board in calling particular attention to it.

Another article, from the pen of Dr. J. L. Kaine, of Mil. waukee, treats of a matter of much practical importance

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