which the court considered indicated the intention of the legislature to exclude occupational diseases from its provisions. (Public Health Reports, May 19, 1916, p. 1269.)

Dizziness caused by disease.-In Rhode Island compensation was awarded to a hack driver for injuries caused by a fall from the seat of his hack, although the evidence showed that the fall was at least partly" due to dizziness or unconsciousness induced by a disease from which he was suffering." (Public Health Reports, May 5, 1916, p. 1147.)

Typhoid fever.-In Wisconsin it was held that death resulting from typhoid fever, caused by polluted drinking water furnished by , an employer, was within the terms of the Wisconsin workmen's compensation law. (Public Health Reports, Feb. 11, 1916, p. 329.)

Hernia. The Supreme Court of Michigan has reaffirmed a previous decision that occupational diseases are not included within the terms of the Michigan workmen's compensation law, but the court has also decided that an employee who suffered from hernia, which was discovered shortly after severe muscular exertion and strain, was entitled to compensation, on the ground that the hernia was the result of an "accidental injury." (Public Health Reports, Sept. 1, 1916, p. 2375.)

Frostbite-Erysipelas.-The Connecticut Supreme Court of Errors decided that a widow is entitled to "compensation" under the Connecticut workmen's compensation law for the death of her husband, which resulted from erysipelas that developed after frostbite. He was an insurance solicitor and his duties required him to endure exposure to severe cold, which the compensation commissioner decided was the "proximate cause" of his injury. (Public Health Reports; Aug. 25, 1916, p. 2299.)

FOODSTUFFS.

The Illinois law held to be valid.-The Supreme Court of the United States decided that a statute of the State of Illinois prohibiting the use of boric acid in food was valid, and the construction placed upon the law by the Illinois Supreme Court was followed by the Supreme Court of the United States. (Public Health Reports, Jan. 14, 1916, p. 79.)

The Federal law. The United States Circuit Court of Appeals of the Second Circuit decided that when a question arises under section 7 of the Federal pure food and drugs act, whether an article of food contains substances which are injurious to health, this question. should be submitted to the jury for decision. (Public Health Reports, Mar. 3, 1916, p. 550.)

Liability of manufacturers.-The Supreme Court of Tennessee was called upon to consider the question of the liability of a manufacturer for injuries caused by poisonous substances contained in foodstuffs. The conclusion reached was that the manufacturer owes a high duty to the public and that he is liable for a failure to properly perform that duty, but "negligence is a necessary element in the right of action" and "there is no logical basis of liability for personal injury without some negligent act or omission." (Public Health Reports, Apr. 21, 1916, p. 1022.)

Trichino in pork. The Supreme Court of Pennsylvania held that a meat packer was liable for damages for deaths resulting from eating

pork which contained trichinæ. In New York a dealer who sold pork which contained trichinæ was held liable. In both of these cases it was contended that the seller was not responsible for the condition of the pork because it had been inspected by a Federal inspector, but the courts held that this did not relieve either the manufacturer or the dealer from responsibility. (Public Health Reports, June 23, 1916, p. 1646; July 7, 1916, p. 1793.)

Cold storage.-Section 337 of the New York public health law prohibits the storage of foodstuffs in cold-storage warehouses for more than 10 months. This law was upheld by the appellate division, first department, of the New York Supreme Court. The city court of Buffalo, however, decided that the section is unconstitutional, holding that its purpose and effect are not to protect the public health but to prevent the owners of foodstuffs from holding them for long periods to force up prices. (Public Health Reports, Aug. 18, 1916, p. 2235.)

Unwholesome fish-Damages.-The Supreme Court of North Carolina decided that a packer who negligently puts upon the market unwholesome fish is liable for damages for injury caused by eating such fish. The defendant knew before the fish were sold by the retailer that other fish from the same lot had caused illness, but he failed to give notice promptly. (Public Health Reports, Aug. 25, 1916, p. 2302.)

PROTECTION OF WATER SUPPLIES.

The Supreme Court of Errors of Connecticut granted an injunction against the continuance of a pleasure resort located on a reservoir which was the source of water supply for a city. The proprietor of the resort was awarded damages. (Public Health Reports, July 28, 1916, p. 2031.)

In Pennsylvania it was decided that a water company was not entitled to payment during the time that the water furnished by it was impure and unsuitable for the purposes for which it was to be used. (Public Health Reports, Mar. 31, 1916, p. 859.)

POLLUTION OF STREAMS BY SEWAGE.

The right of a municipality to discharge sewage into nonnavigable streams in sufficient quantity to cause pollution of the water was considered by the courts of Oregon, New York, and Virginia. (Public Health Reports, Feb. 25, 1916, p. 465; Jan. 7, 1916, p. 29; Apr. 14, 1916, p. 970.)

USE OF SECOND-HAND MATERIAL IN MATTRESSES.

In 1915 the Illinois Legislature passed an act prohibiting the use of second-hand material in making mattresses, quilts, or bed comforters which were to be sold.

The supreme court of the State decided that the law was unnecessary for the protection of health, as disinfection of the material would effectually safeguard the public. The law was declared unconstitutional. (Public Health Reports, Apr. 21, 1916, p. 1019.)

MARINE HOSPITALS AND RELIEF.

RELIEF STATIONS.

During the fiscal year ended June 30, 1916, the service operated 21 marine hospitals, all of which are owned by the Government, and maintained 125 other relief stations where hospital and out-patient relief was furnished patients. In addition, the service maintained. a sanatorium at Fort Stanton, N. Mex., for the care and treatment of patients suffering from tuberculosis. Because of the decrease in the number of patients the marine hospital at Cairo, Ill., was closed during the year and a contract made with a local hospital for the care of patients at that place.

RELIEF TO SEAMEN AND OTHERS.

There were 68,458 patients treated at the various marine hospitals and relief stations of the service during the year, including the patients treated at the tuberculosis sanatorium at Fort Stanton, N. Mex. Of this number, 17,524 patients were treated in hospitals a total of 484,408 days, and 50,934 patients were treated at dispensaries a total of 97,263 times. During the same period 467 seamen employed on foreign vessels received hospital treatment a total of 6,843 days. In addition to the foregoing, medical officers detailed for duty on board various vessels of the Coast Guard furnished a great deal of medical relief during the year to members of such vessels, to seamen employed on fishing vessels, and to natives of Alaska. The following is part of a report made by Asst. Surg. W. F. Fox, United States Public Health Service, on local health conditions, etc., observed during the Alaskan cruise of the Coast Guard cutter Unalga, which left Seattle, Wash., on April 20, 1916, and returned to that port on August 18, 1916:

GENERAL REPORT ON LOCAL HEALTH CONDITIONS AND OTHER MATTERS OF SANITARY INTEREST OBSERVED DURING THE CRUISE.

KODIAK.

On the way to our headquarters at Unalaska we stopped for several hours at Kodiak, Kodiak Island. It is well protected by the mountains, some of which are 2,500 feet in altitude. The climate is stated to be milder than to the westward. It has a population of about 500, mostly natives. They are of the Aleutian type of native, hard to teach and not overinclined to work. Their chief occupation is that of fishing.

Their general health is good, outside of the ever-prevailing cases of tuberculosis and syphilis. The last epidemic, one of measles, was 2 years ago. Last year there were several cases of typhoid fever on Woody Island directly across from Kodiak.

UNALASKA.

Unalaska was our next stop. It is well protected by the mountains surrounding it. It has a very damp climate, the rainy seasons being the spring and the fall. The average temperature for the winter is about 30° F. and for the summer about 60°. It has a population of about 300, with more males than females.

. The natives are lazy and uncleanly. Personal hygiene is sadly lacking. They universally have poor teeth, numerous missing teeth and cavities, and often pyorrhea alveolaris. Babies were seen with not a single healthy tooth. There are between 60 and 70 buildings in the village. The chief occupation of the natives is fishing and working in near-by canneries and for the Alaska Commercial Co.

The general health of the village is fair. During the year ending December 31, 1915, there were 9 births, 15 deaths, and 11 marriages. There are no special prevailing diseases outside of a goodly number of tuberculous cases. Syphilis is undoubtedly present to a great degree, although no active cases were seen. The last epidemic, one of la grippe, occurred last winter and affected the entire village. This was preceded by an epidemic of whooping cough. The last epidemic of measles was in 1900. The only case of typhoid fever known of by the local physician occurred over 15 years ago. One case of trachoma was found in a boy 2 years old from Dutch Harbor, which is about a mile from Unalaska. Although examinations were made, no other case was observed in Dutch Harbor or Unalaska. Tapeworms are said to be common, but the natives do not apply for treatment. Numerous cases of diarrhea from eating dried fish and turnips are reported quite frequently.

Natives come here from all parts of the Aleutian Islands for treatment. Unless the local physician is a surgeon also, in many cases no relief is afforded them. The local physician, Dr. A. W. Newhall, who has been with the Jesse Lee Home for several years, has left and will not return for a year or more. His place had not been filled when we left and it was stated that there would be no physician or trained nurse there during the coming winter.

The water supply comes from various sources. The majority of the natives obtain their water directly from the creek behind the village. This creek. is the outlet of a lake to the eastward and behind the village. The Jesse Lee Home pump their water directly from this lake. The Alaska Commercial Co. have a reservoir in the hills behind the village. This reservoir supplies the company store, schoolhouse, the marshal's home, and one other. The reservoir has a muddy bottom and appears to be nothing more than a stagnant pool. It is, however, good drinking water, although at times it is full of small red bugs and is slightly cloudy. Bacteriological examination using lactose peptone broth in culture tubes as media was negative. Chemically, chlorides were not in excess. There is also a pipe down to the wharf from which vessels obtain their supply of water. The Coast Guard cutters and a few natives obtain their water from this source. The collector of customs and six other families get their water from a spring just to the eastward of the company's reservoir. There is still another spring near by that supplies three families. Three of the natives have wells.

Fish is, of course, the natives' chief article of food. It is stated that they are very fond of raw turnips and eat them to excess.

A letter relative to the use of Crede's method in the new born for the prevention of ophthalmia neonatorum was sent to the local priest, the marshal, and the chief of the village. A bottle of the 1 per cent silver nitrate solution was also furnished to each. The priest was requested, by letter and in person, to translate the instructions into the native tongue in order that the native midwives would understand. The midwives were also seen personally and through an interpreter the method was explained.

It would seem as though a medical representative of some department of the Government should be stationed here for not more than a year at a time, or, if not this, that the local physician should be a representative of the Government, even if he only received a small salary.

It is suggested that a dental surgeon in the employ of the Government make an annual visit to this and other villages.

ATKA.

The next village visited was Atka. This is on Atka Island, one of the Aleutian Islands, about 300 miles from Unalaska. The climate is damp-raining or

snowing most of the time. The average extreme temperatures are: For the winter, 16° F.; for the summer, 65° F.

The total native population is 48, of whom there are an equal number of males and females. There are usually two white school teachers here. The natives are said to be industrious, but have no morals. There are 8 wooden buildings, 5 having three rooms and 3 having two rooms, and 7 barabaras. Their occupation is trapping and basket weaving.

The general health of the village was fairly good. During the past year there were 2 births, 8 deaths, and 3 marriages. Tuberculosis is present to quite an extent-physical examinations demonstrated this. Syphilis is said to be present, but no active cases were seen. The last epidemic, one of whooping cough, occurred last fall. There is no physician or trained nurse for the village, and the nearest one is at Unalaska.

The water supply is from a creek behind and also running through the village. Some of the water drains through a cemetery situated on a hill above, the creek. The chief food of the natives is fish and ducks. Canned goods may be obtained at the Government store.

Most of the buildings and barabaras are not in a sanitary condition.. They are crowded and not ventilated. Personal hygiene is sadly lacking. Most of the natives, and many of the children especially, have very poor teeth.

While the school teachers here seem to do all in their power to help the natives in a medical way, their medical knowledge is of course limited. A letter relative to the use of Crede's method in the new born was sent to the teacher, and a bottle of the silver nitrate solution was also furnished.

ST. GEORGE.

The next village visited was St. George, on St. George Island, one of the Pribilof Islands. For the winter the average extreme temperature is 10° below and for the summer 55° above zero. It rains all the year and is usually foggy and windy.

The native population numbers about 121, of whom 58 are males and 63 females. This was for the year ending June 30, 1915. There are seven white people on the island. The natives are stated to be of the better type but immoral. There are about 25 dwellings. Their chief occupation is sealing and fox hunting. The natives are wards of the Government.

Their general health has been good. During the year ending June 30, 1915, there were five births, one death, and one marriage. Tuberculosis is quite prevalent. The majority of the deaths since 1870 has been from tuberculosis in some form. It is stated that syphilis or venereal disease in any form is not prevalent. The last winter there were epidemics of whooping cough and gastroenteritis. The local physician, Dr. H. P. Adams, of the Bureau of Fisheries, states that he has not seen any cases of trachoma or typhoid fever on the island.

The water supply is from two surface wells. One supplies the Government buildings, which the white people occupy, and the other supplies the natives.

ST. PAUL.

The next village visited was St. Paul, on St. Paul Island. The climate is very much the same as that of St. George. The native population numbers 191, of whom 90 are males and 101 females. There are 11 white people on the island. The natives are of the better type, although personal hygiene is lacking. There are about 40 or 50 buildings. The natives are wards of the Government, and their chief occupation is sealing and fox hunting.

Their general health has been good. During the year ending June 30, 1915, there were 11 births, 5 deaths, and 2 marriages. A small building was recently turned into a hospital and equipped. A native nurse is on hand all the time, and there is a class in training of young native women. It is stated that venereal disease is not prevalent. Last winter there was an epidemic of la grippe.

UNGA.

A brief stop was made at the village of Unga, Unga Island. The population appears to consist chiefly of whites. There is a cannery near by. Their chief occupation is fishing. The people all seemed to be healthy. The buildings are mostly well located and well kept. There is no physician here. Recently after