believe that our state has a duty to perform in the matter of caring for our tuberculous poor. She provides for her insane, epileptics, and moral degenerates, and surely they are of no more value than those who suffer from tuberculosis; besides the chances for cure and restoration to society as useful men and women are infinitely greater. Moreover, the educational value of such institutions in the matter of prevention is beyond computation, and, as it seems that the final solution of this problem must be that of education in methods of prevention, the useful purpose which such an institution would serve is beyond question. Almost every state east of the Missouri river has one or more institutions erected or in course of erection for the care of their tuberculous poor, and the results obtained thus far are more than were hoped for.

The German empire, which is always in the lead in scientific medicine, has over 200 such sanatoria, some for the treatment of the indigent and others for the treatment of those who can pay for the actual cost and care.

Your Excellency's attention, no doubt, has been called by the Board of Control to the urgent necessity of separate buildings whereby tuberculous cases in the state institutions can be isolated from the well. This must appeal to you as being particularly important in institutions for the insane and feeble-minded, where the patients have not the mental ability to understand the necessity of proper care of their expectorations or secretions, and the danger to others of infection by carelessness on their part.

Pam

The State Board of Health has inaugurated an aggressive campaign along the line of prevention of this dread disease and are at the present time engaged in gathering a tuberculosis census of this state, that the information derived may be used for the purpose of providing preventive measures, by forwarding to each case reported a pamphlet on modern prevention, in which detailed instructions. are given concerning the care of the patient and his expectoration, and up-to-date information as to hygiene and outdoor life. phlets have also been placed in the hands of every family in which a case of tuberculosis has died during the last year, which information was gathered from our files of reported deaths. County health officers have been instructed to thoroughly disinfect and fumigate every house in which a case has occurred. It is thought that in locating the points of infection of the cases now in existence and the places and things previously infected, in which disinfection and a general cleaning up will be inaugurated, a great step will be taken in the prevention of new cases. In addition to this, our pam

phlet on prevention has been placed in a great many of the public schools of the state, and is being used as a text-book, whereby these means of prevention are studied, and the information thus disseminated must be of inestimable value in the control of this preventable disease.

REGISTRATION OF BIRTHS AND DEATHS.

It is impossible under our present law and system to collect complete and accurate statistics of births and deaths in this state, and as accurate statistics must be the underlying basis of a proper interpretation of sanitary conditions, it follows that such an interpretation cannot be accurate and complete nor appropriate preventive measures applied until such time as exact data can be secured. The Bureau of Commerce and Labor, Department of the Census, Division of Vital Statistics, is making an effort throughout the United States to have uniform registration laws passed this winter in such states as are not already classed as registration states, and I believe that there are only sixteen states in which the government is willing to concede that the statistics are properly and accurately gathered and of sufficient value for the United States Census Department. In the accomplishing of this purpose Congress recently passed a joint resolution in which they express approval of the movement of the Bureau, and request favorable consideration and action of the state authorities to the end that the United States may obtain a complete and uniform system of registration.

Aside from the sanitary significance of accurate vital statistics, they are of great importance from a financial standpoint as giving accurate data and certified copies of records of deaths and births in the settlements of estates and the collection of pensions.

STATE OF THE PUBLIC HEALTH.

The general health of the citizens of Kansas for the years 1905 and 1906 has been fairly good. There have been no unusual epidemics or calamities that have befallen the people of this state. The general death-rate has been approximately the same as in former years. Smallpox has been notably on the decrease as compared with the two years previous, and the average mortality from contagious and infectious diseases has been notably lowered. The following comparative table of infectious and contagious diseases for the past two years will at a glance indicate the mortality as well as show that during the past year there has been a notable diminution in deaths.

The following counties have reported no deaths from consumption or typhoid fever during the past two years: Typhoid feverBrown, Lane, Morton, Wabaunsee, Wallace, and Wichita; consumption-Grant, Haskell, Logan, and Wichita.

Following is the rate of mortality for 1906, per 100,000 population, of counties reporting the following diseases: Consumption, 56.7; cancer, 33.32; typhoid fever, 25+; diphtheria, 22+; cholera infantum, 22 +; dysentery, 14.7; measles, 11.11; scarlet fever, 8.8; smallpox, 2.8.

There were 924 deaths reported in 1906 due to external violence, of which number 112 were due to suicide. The different methods chosen for self-destruction were varied, but preference seems to have been given to poison, shooting, and hanging. The various methods chosen were as follows: Suicide, by poison, 51; shooting,

26; hanging or strangulation, 15; drowning, 8; cutting instruments, 6; crushing, 3; asphyxia, 3; methods not classified, 13.

The number of deaths from external violence during 1906 has increased over that of 1905, as indicated by the following table:

The following table gives the number of deaths at various periods

Of the 11,029 deaths reported of which ages were given, 4366 were above 50 years, or 30.5 per cent. of the people had attained an age beyond the meridian of life. In 1905 six reached an age of over 100 years, and in 1906 eight were between 100 and 110. Two who died in 1905 had reached an age of over 110 years, and one in 1906 had reached an age of over 110.

Of the 12,257 deaths reported for 1906 the following occupations of deceased were given: Attorneys, 19; bakers, 7; blacksmiths, 22; bookbinders, 3; bookkeepers and clerks, 88; bricklayers, 19; butchers, 28; carpenters, 86; cigar-makers, 3; drivers, 32; druggists, 18; editors and writers, 8; electrical workers, 10; engineers, 31; engravers and artists, 10; farmers, 1426; firemen, 21; housewives, 2056; insurance agents, 16; jewelers and watchmakers, 8; laborers, 718; laundry employees, 9; linemen, 7; liquor dealers, 9; machinists, 44; merchants, 150; miners, 114; ministers, 24; molders, 4; nurses, 6; oil and gas-well workers, 8; painters, 30; paper-hangers,

6; planing mill workers, 1; physicians, 41; policemen, 4; printers and pressmen, 11; real-estate agents, 25; seamstresses, 38; steamrailway employees, 25; railway employees, operating department, 68; stockmen, 52; street-railway employees, 4; shoemakers, 11; stenographers, 3; stone- and marble-cutters, 12; servants, 164; tailors, 14; tinners, 5; teachers, 34.

The death rate per 1000 population for 1905 was 7.5 per cent., and for 1906 7.5 per cent.

Respectfully submitted.

S. J. CRUMBINE, M. D., Secretary.