286. Zooparasitic Intestinal Infections.

An analysis of infections found among

1,287 school children (776 white, 511 negro) of the city of X. By

C. W. Stiles. July 2, 1915.

287. The Practical Use of Disinfectants. By H. E. Hasseltine. July 2, 1915. 288. Intestinal Infections. The school grades attained by 2,166 white school children (1,062 boys, 1,104 girls) in the city of X, classified by age, sanitation, and intestinal parasites. By C. W. Stiles. July 2, 1915. 289. Post-Vaccination. Studies on its relation to vaccine virus. By John F. Anderson. July 16, 1915.

290. Anopheles as a Winter Carrier of Plasmodium. The mosquito as a prophylactic indicator. By M. Bruin Mitzmain. July 16, 1915.

291. The Notifiable Diseases. Prevalence during 1914 in cities of over 100,000. Diphtheria, gonorrhea, leprosy, malaria, measles, epidemic cerebrospinal miningitis, poliomyelitis, rabies, scarlet fever, smallpox, syphilis, tuberculosis, and typhoid fever. Cases reported, case rates per 1,000 population, and fatality rates per 100 cases. July 23, 1915.

292. Embalming. Indefinite preservation of the body. By Edward Francis. July 30, 1915.

293. Methods of Destroying Lice. Abstract of article by J. Parlane Kinloch, M. D. August 6, 1915.

294. The Number and Kind of Drug Addicts. By Martin I. Wilbert. August 6, 1915.

295. Standard for Determining the Purity of Milk. The limit of error in bacteriological milk analyses. By H. W. Conn, Wesleyan University, Middletown, Conn. August 13, 1915.

296. The Trachoma Problem. By J. W. Kerr. August 20, 1915.

297. The Pharmacy of Useful Drugs. By Martin I. Wilbert. August 27, 1915. 298. The Notifiable Diseases. Reported prevalence during 1914 by States.

Dengue, diphtheria, gonorrhea, leprosy, malaria, measles, epidemic cerebrospinal meningitis, poliomyelitis, rabies, Rocky Mountain spotted fever, scarlet fever, septic sore throat, smallpox, syphilis, tuberculosis, typhoid fever, and typhus fever. Cases reported, indicated case rates per 1,000 population and indicated fatality rates per 100 cases. September 3, 1915.

299. Essentials of Swimming-Pool Sanitation. By Wallace A. Manheimer, Ph. D. September 17, 1915.

300. Public Health Administration in Chicago, Ill. A study of the organization and administration of the city health department. By J. C. Perry. August 20-September 24, 1915.

301. Tobacco and Snuff: Their use by white school children in the city of X. By C. W. Stiles and D. N. Richards. October 1, 1915.

302. Industrial Hygiene. A plan for education in the avoidance of occupational diseases and injuries. By J. W. Schereschewsky. October 1, 1915. 303. Heights and Weights of Children. Classification, by age and by sanitation, of 1,652 white school children (771 boys, 881 girls) in the city of X. By C. W. Stiles and George A. Wheeler. October 8, 1915.

304. An Efficient Liquid Disinfectant. A formula by which one can be readily prepared. By Albert F. Stevenson. October 8, 1915.

305. Cosmetics as Drugs. A review of some of the reported harmful effects of the ordinary constituents of widely used cosmetics. By Martin I. Wilbert. October 15, 1915.

306. Lung Capacity of Children. Spirometer tests of 1,618 white school children (751 boys, 867 girls) in the city of X. By C. W. Stiles and Floyd Graves. October 15, 1915.

307. The Prevention of Pellagra. A test of diet among institutional inmates. By Joseph Goldberger, C. H. Waring, and David G. Willets. October 22, 1915.

308. The Prevalence of Pellagra. Its possible relation to the rise in the cost of food. By Edgar Sydenstricker. October 22, 1915.

309. Tuberculosis: With special reference to its epidemiology transmissibility and prevention. By George M. Kober, M. D. October 29, 1915.

310. The Division of Sanitary Reports and Statistics. Bureau of the Public Health Service. November 5, 1915.

311. Experimental Pellagra in the Human Subject Brought About by a Restricted Diet. By Joseph Goldberger and G. A. Wheeler. November 12, 1915.

312. The Notifiable Diseases. Prevalence during 1914 in cities of 10,000 to 100,000. Diphtheria, gonorrhea, leprosy, malaria, measles, epidemic cerebrospinal meningitis, poliomyelitis, scarlet fever, smallpox, syphilis, tuberculosis, and typhoid fever. Cases reported, case rates per 1,000 population, and fatality rates per 100 cases. November 19, 1915. 313. Hydrocyanic Acid Gas. Its practical use as a routine fumigant. By R. H. Creel, F. M. Faget, and W. D. Wrightson. December 3, 1915.

314. Strychnine Sulphate. Its effect on California valley quail. By C. C. Pierce and M. T. Clegg. December 10, 1915.

315. Public Health Administration in North Dakota. By Carroll Fox. December 17, 1915.

316. Memory Tests of School Children. Memory span of 1,585 white school children (751 boys, 834 girls) in the city of X. By C. W. Stiles. December 24, 1915.

317. Public Health Administration in Nevada. By Carroll Fox. December 31, 1915.

318. Standards for Milk. Their necessity to the welfare of the dairy industry. By John F. Anderson. January 7, 1916.

319. The Practicing Physician. What he should know about the registration of births and deaths and the reporting of sickness. By J. W. Trask. January 14, 1915.

320. Pyorrhea Alveolaris. Preliminary report on treatment with ipecac and emetin hydrochloride. By John S. Ruoff. January 21, 1916.

321 Narcotic Drugs. Recent legislation designed to restrict their use. By M. I. Wilbert. January 21, 1916.

322. Mental Manifestations of Pellagra. By W. F. Lorenz. February 4, 1916. 323. Morbidity Registration in the United States. A suggestion as to the formation of a provisional registration area for morbidity. By John S. Fulton and John S. Fulton, jr., February 11, 1916.

324. Anopheles Punctipennis Say. Its relation to the transmission of malaria. Report of experimental data relative to subtertian malarial fever. By M. Bruin Mitzmain. February 11, 1916.

325. Vitamines and Nutritional Diseases. A stable form of vitamine, efficient in the prevention and cure of certain nutritional deficiency diseases. By Atherton Seidell. February 18, 1916.

326. Community Sickness Survey. Rochester, N. Y., September, 1915. By Lee K. Frankel, Ph. D., and Louis I. Dublin. February 25, 1916.

327. Rocky Mountain Spotted Fever. A report of laboratory investigations of the virus. By L. D. Fricks. March 3, 1916.

328. Demonstrations of Malarial Control. By R. H. von Ezdorf.

1916.

March 10,

329. Death Rates of the Colored Population. Their trend and significance in the United States. By John W. Trask. March 17, 1916. 330. Poisons and Habit-Forming Drugs. A digest of laws and regulations relating to the possession, use, sale, and manufacture of poisons and habit-forming drugs enacted during 1914 and 1915, now in force in the United States. By Martin I. Wilbert. February 18 to March 24, 1916.

331. Endemic Index of Malaria in the United States. By R. H. von Ezdorf. March 31, 1916.

332. The Notifiable Diseases. Diseases and conditions required to be reported in the several States.

333. Bread as a Food. Changes in its vitamine content and nutritive value with reference to the occurrence of pellagra. By Carl Voegtlin, M. X. Sullivan, C. N. Myers. April 14, 1916.

334. Biological Products. Establishments licensed for the propagation and sale of viruses, serums, toxins, and analogous products. April 14, 1916. 335. Statistics of Disability. A compilation of some of the data available in the United States. By B. S. Warren and Edgar Sydensticker. April 21, 1916. 336. Some Fallacies Regarding Phenol. A review with reports of observations on the influence of ethyl alcohol on the germicidal and on the toxic properties of phenol. By Martin I. Wilbert. April 28, 1916.

337. Tertian Malarial Fever. Transmission experiments with anopheles punctipennis. By M. Bruin Mitzmain. May 12, 1916.

338. State Laws and Regulations Pertaining to Public Health. Adopted during the year 1915. Published in Public Health Reports during 1915 and 1916.

339. Pellagra.

Laboratory examinations in connection with the disease. By J. R. Ridlon. May 19, 1916.

340. Public Health Administration in Florida. By Carroll Fox. June 2, 1916. 341. Health of Garment Workers. The relation of economic status to health. By B. S. Warren and Edgar Sydenstricker. With introduction by

J. W. Schereschewsky. May 26, 1916. 342. Court Decisions Pertaining to the Public Health. Published in the Public Health Reports previous to January 1, 1916.

SUPPLEMENTS TO THE PUBLIC HEALTH REPORTS.

These publications do not form a part of the Public Health Reports, nor are they sent out therewith. They are popular in style and treat of various health subjects of interest to the general public. The large demand for copies of these supplements attests their value and interest to the general public. The following were issued during the fiscal year:

23. Typhoid Fever. A report of a water-borne outbreak in Decatur and in New Decatur, Ala. By Paul Preble. May 7, 1914.

24. Exercise and Health. By F. C. Smith. May 7, 1915.

25. School Hygiene. Survey of schools in Manatee County, Fla. By J. A. Nydegger. July 30, 1915.

26. Public Health Administration in Richmond, Ind. A report of a survey to determine the incidence of tuberculosis. By J. C. Perry. October 8, 1915.

27. United States Public Health Service Exhibit at the Panama-Pacific International Exposition, San Francisco, 1915. By W. C. Rucker and C. C. Pierce. December 31, 1915.

28. Rocky Mountain Spotted Fever. Some points in its diagnosis and prevention. By L. D. Fricks. March 17, 1916.

29. The Transmission of Disease by Flies. By Earnest A. Sweet. April 14,

1916.

MISCELLANEOUS PUBLICATIONS.

In this series are published those documents of this service which can not properly be classified in any of the preceding series. Last year there were issued under this head the following:

12. List of Publications, Public Health Service.

LIBRARY.

July, 1916.

During the course of the fiscal year the bureau library received many valuable donations, which, with the volumes obtained by purchase, materially improved its character as a public health library. In addition to these volumes, the bureau was kept advised of the current advance of the medical profession by subscriptions to 42 journals, many of which have been bound and placed in the library.

NEEDS OF THE SERVICE.

Study and prevention of pellagra.-The results of scientific studies of pellagra conducted by the service during the past year have been notable, and the public health and economic value of this work alone will be many times greater than the entire cost of investigations of health matters during the year. As outlined in another portion of this report, experimental work has determined both a cause and a method of prevention of this disease, which within the past few years has become alarmingly prevalent in certain sections. There is need of extending this work to demonstrate the value of these results and to make further investigations as to the relation of pellagra prevalence and economic conditions in badly affected communities.

Rural sanitation.-One of the most important phases of service activity during the year has been the study of sanitary conditions in rural communities. In the counties selected for this work, marked betterment in sanitary conditions, with resulting decreases in the number of cases of illness from diseases due to insanitary surroundings, has invariably been accomplished. When it is considered that 53.7 per cent of the population of the United States is classed as rural, which includes towns and villages of less than 2,500 inhabitants, and that very few of these people have the sanitary safeguards in the way of protected water supplies and sewage-disposal systems afforded the urban dweller, it becomes clear that improvement in rural health conditions must be brought about largely by encouraging the individual along lines of sanitary progress. During the progress of these studies every home in the selected counties has been visited, sanitary surroundings observed, and advice offered wherever needed. Literature on communicable diseases has been distributed, public meetings have been held, and addresses made. The work has in all cases been conducted in cooperation with State and local health authorities, and the enthusiastic response on the part of the general public has been most gratifying. Effective work has thus been done in reducing typhoid fever, malaria, and other diseases of high incidence in rural communities, and it is believed that adequate provision should be made for extending this work to at least one or two representative counties in every State of the Union.

Industrial hygiene.-The investigations of sanitary conditions in certain industries such as have been carried out by the service in New York, Massachusetts, Ohio, Pennsylvania, and Wisconsin have done much to determine sanitary defects in the industries studied, and to suggest remedial measures applicable to such industries generally. This work has also been done in cooperation with State and local authorities. There are many problems connected with industrial sanitation which await solution, which are of Nation-wide extent and significance, and which should therefore be investigated by the National Government. It is hoped that appropriations will

be provided for the commencement of studies which have been planned.

Biologic products.-During the year Congress appropriated $10,000 for the enforcement of the act of July 1, 1902, which provides for the regulation of the manufacture and sale of viruses, serums, toxins, and analogous products. At the time of the passage of this law there were but 12 establishments engaged in the manufacture of these products. Since then the use of viruses, serums, and toxins in the prevention and cure of disease has increased to such an extent that in 1915 there were 41 licensed establishments in this country and abroad, and over 60 different products propagated therein. It is highly important to the public health that the preparation of these products be closely supervised, in order that their purity and potency may be safeguarded. More frequent inspections of the establishments and the purchase of a greater number of samples of their products for examination are extremely necessary, and it is hoped that this appropriation will be increased.

National quarantine.-During the past year Congress appropriated $150,000 for the purchase of the quarantine station owned by the city of Boston, which station had been conducted by the service under a lease since June 1, 1915. This leaves but two important stations which are not a part of the national quarantine system, i. e., those located at New York and at Baltimore. At present a service officer, on leave, is acting as health officer of the port of New York under appointment from the governor of the State, and at its last session the General Assembly of the State of New York passed a resolution authorizing the appointment of a commission to negotiate for the transfer of the New York quarantine station to the Federal Government. The city council of Baltimore has also recently signified its desire to transfer the quarantine function at that city to the National Government.

In former reports the many advantages of a complete system of national quarantine have been set forth. It is believed that present sanitary conditions throughout the world render doubly important the acquisition of these remaining locally administered stations at the earliest practicable time. At no time in recent years have plague, cholera, and typhus prevailed in such widely scattered territory as they do to-day. The European situation has interfered with effective sanitary administration, and national and international complications in Europe and elsewhere have disrupted the interchange of information as to the prevalence of epidemic diseases. It is also likely that the close of the European war will bring about a quickening of commercial intercourse and an increased tide of immigration, necessitating the greatest vigilance in the administration of maritime quarantine.

National care of lepers.-For several years past it has become increasingly apparent that some provision should be made for the care of lepers by the Federal Government. This question was discussed in the Annual Report of the Public Health Service for the fiscal year 1914, and again in 1915. A bill providing for a home for lepers was introduced in the Sixty-third Congress, but failed of passage. In the first session of the Sixty-fourth Congress a bill (H. R. 193) "To provide for the care and treatment of persons