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. Ridion. 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. Health Reports previous to January 1, 1916, Published in the Public 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 economie 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 andi to make further investigations as to the relation of pellagra prevalence and economie 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 337 per cent of the population of the United States is classed as rural, which includes towns and villages of less than 2,500 inhabi tants, and that very few of these people have the sanitary wifeguards 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 encourag ing the individual along lines of sanitary progress During the progress of these studies every home in the ∞lected counties has been Visited, sanitary surroundings observed, and advice offered wherever needed. L terature on communicable diseves has been distributes, public meetings have been held, and addresses made. The work has in all cases been conducted in cooperation with State and local hexith authorities, and the enthus istic response on the part of the general publie has been most gratifying Effective work has thus been dot e in reg typhoid fever, malaria, and other doseves of high m cidence in rural communities, and it is believed that adequate pro vis on should be made for extending this work to at least one or two representative counties in every State of the In on. Ilustra Therone, - The investigations of sanitary cond trons in certain and tries such as have been carried out by the service in New York, Massachusetts, Oro, Pennsylvania, an. 1 Wisconsin have dote much to detern...ne sanitary defects in the it. listries stolesi. and to ggt reme-l, al measures it plicable to » 1 h and estries gåter ally Ty's work has also been done in cooperation with State and local author t ́es There are many problems corrected with ind ́s trial war tation w), -h awit so'ition, which are of Nation w le extent at 1 g, haber, atd which should therefore be it vest gate! by the Natior al 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 po tency may be safeguarded. More frequent inspections of the estab lishments 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 appropri ated $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 nego tiate 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 immigra tion, 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 afflicted with leprosy and to prevent the spread of leprosy in the United States" was passed by the House of Representatives on May 4, 1916. A similar bill (S. 4086) has been favorably reported to the Senate by the Committee on Public Health and National Quarantine. It is hoped that this important measure will be enacted into law, and a means thus afforded for segregating these unfortunates, many of whom by the very nature of their affliction are forced to become wanderers from place to place, and are therefore a menace to the public health. Additional building for the Hygienic Laboratory.-Efforts to secure an additional building for the Hygienic Laboratory, made for several years past, having proven unsuccessful, it is desired to again invite attention to the importance of providing adequate quarters for this institution. The expansion of the work of the laboratory has kept pace with the increased activities of the service in the field. The personnel has been increased as the work necessitated, and this has resulted in a condition of overcrowding which seriously interferes with important scientific work. An estimate of $175,000 for an additional building has again been submitted, and it is hoped that favorable action will be taken on this very urgent need. Bureau personnel.-Increases in the clerical force of the bureau have been made from time to time within the past several years, but have not been sufficient to handle efficiently the growing volume of work. Overtime work has been necessary on numerous occasions, and much additional work that could have been undertaken has been postponed. Estimates submitted to Congress for the next fiscal year include several additional employees. These estimates have, however, been held to the lowest minimum consistent with actual needs, and their favorable consideration is earnestly urged. Publications.-Although the number of publications distributed during the past year was considerably larger than in 1915, it was impossible to comply with many requests for literature on publichealth subjects because of the limited size of editions. The increasing demand for printed information on health topics evidences the growing interest and activity of the public along such lines. It is believed that in no way can the Federal Government more effectively encourage this tendency than by endeavoring to supply every request for such information. The good accomplished in this manner should be worth many times the increased cost of printing. Repairs to annex of Butler Building.-An estimate has been submitted for the remodeling of the one-story annex to the Butler' Building, which provides for the erection of an additional story and improvements to the walls and interior. This additional space is greatly needed for the working force of the bureau, and for the purpose of accommodating the steadily growing library. It has been necessary to erect shelves in the hallways for books, and the library of the bureau, containing many valuable reference books and reports, is separated in several divisions and on several floors of the building. The improvements covered by the estimate would render available a considerable amount of additional space at a moderate cost. RUPERT BLUE, Surgeon General. APPENDIX. FINANCIAL STATEMENT. Receipts and expenditures, Public Health Service, for the fiscal year ended June 30, 1916. 1 Includes $1,400 transferred to "Contingent expenses, Treasury Department, stationery, 1916." NOTE. For expenditures by stations under marine hospitals and relief, see Statistical Table 2. APPROPRIATION: "PREVENTING THE SPREAD OF EPIDEMIC DISEASES, 1916." 1 Includes $200 transferred to "Contingent expenses, Treasury Department, stationery, 1916." NOTE.-Payments amounting to $91,106.42 were made from pay items of appropriation "Public Health Service, 1916," account of epidemic duty. 63887°-H. Doc. 1493, 64-2-- -24 |