either the township board of health would be concerned or the county board of health in case the territory where the camp is located is not organized as a township. Town boards are not in a position to handle this problem satisfactorily, except, perhaps, in the larger cities. The best plan would be for the county health officer to assume responsibility for sanitation of all tourist camps in the county. This new duty would necessitate a special arrangement with the county board of health, which has "jurisdition over all unorganized towns * and such other powers and duties in reference to the public health as the State board shall, by its published regulations, prescribe."

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THE DEMAND AMONG SANITARIANS AND PRACTICING PHYSICIANS FOR SUPPLEMENTAL ACADEMIC TRAINING.

In 1920 the Public Health Service conducted a venereal disease institute extending over a period of two weeks of intensive study. The following year 16 general public health institutes were held at various geographical centers, in cooperation with State departments of health. At the venereal disease institute there was an attendance of fully three times the number expected, and a large number were present at the general institutes.

These experiences have led the Public Health Service, at the suggestion of the Advisory Committee on the Education of Sanitarians, to send a circular letter of inquiry to members of the staffs of health departments, to public health nurses, and to practicing physicians in various parts of the country to determine what their interest might be in one or more institutes covering a period of six to eight weeks. Letters were mailed to approximately 3,500 employees of health departments, to about 6,000 public health nurses, and to the members of State medical societies in five States (approximately 9,500 practicing physicians). They were asked to express their opinions regarding (1) the need for supplemental academic training, (2) the season of the year at which they considered it would be wisest to hold public health institutes, (3) whether it would be more desirable, in their opinion, to have several institutes at various medical centers or one at Washington, and, finally, whether they could probably attend, would endeavor to attend, or wished additional information.

The accompanying table gives a summary of replies received to August 1, 1923. It will be observed that there were over 6,000 replies to 20,571 letters, and that of this number 5,746 express a belief that there exists a need for the type of public health institute proposed.

It is especially interesting to note that approximately 1,000 employees of health departments, 1,000 nurses, and 2,000 physicians, a total of over 4,000, say "I could probably attend an institute if it is not held too far from my home." The 1,970 physicians so expressing themselves represent the responses from only five States. Maine, Virginia, Ohio, Colorado, and Washington were chosen both because

they are well separated geographically and because mailing lists were easily available. It will be observed that a majority recommend the summer season in preference to other seasons of the year.

The deans of medical schools and leaders in the medical profession generally will doubtless be interested-and perhaps some will be surprised to learn that there is so marked an interest in preventive medicine on the part of practicing physicians as the responses of the physicians of five States indicate.

Announcement will be made later of plans for public health summer schools to meet the demand for supplemental academic training revealed by this inquiry.

Tabulation of replies from employees of health departments, nurses, and certain physicians to an inquiry regarding the advisability of establishing one or more public health

institutes.

DEATHS DURING WEEK ENDED AUGUST 18, 1923.

Summary of information received by telegraph from industrial insurance companies for week ending August 18, 1923, and corresponding week of 1922. (From the Weekly Health Index, August 21, 1923, issued by the Bureau of the Census, Department of Commerce.)

Deaths from all causes in certain large cities of the United States during the week ended August 18, 1923, infant mortality, annual death rate, and comparison with corresponding week of 1922. (From the Weekly Health Index, August 21, 1923, issued by the Bureau of the Census, Department of Commerce.)

1 Annual rate per 1,000 population.

33

13.5

13.8

5

8

89

10.6

9.5

17

12

79

* Deaths under 1 year per 1,000 births-an annual rate based on deaths under 1 year for the week and estimated births for 1922. Cities left blank are not in the registration area for births.

Deaths for week ended Friday, Aug. 17, 1923.

Deaths from all causes in certain large cities of the United States during the weck ended August 18, 1923, infant mortality, annual death rate, and comparison with corresponding week of 1922. (From the Weekly Health Index, August 21, 1923, issued by the Bureau of the Census, Department of Commerce)-Continued.

PREVALENCE OF DISEASE.

No health department, State or local, can effectively prevent or control disease without knowledge of when, where, and under what conditions cases are occurring.

UNITED STATES.

CURRENT STATE SUMMARIES.

These reports are preliminary, and the figures are subject to change when later returns are received by the State health officers.