The port medical officer states:

"The well-known malarial centers of the East and West African coasts and of India will afford instances of malaria which have occurred during the voyage on every incoming ship from ports situated therein.

"The questions have only to be pushed to arrive at the case, which is generally reported as 'now well.'

"On the other hand, many febricula are reported as 'malaria' by way of definite diagnosis where definition is clearly impossible. 'Malaria' and 'influenza' share the misdiagnoses of febrile cases with 'cold' and 'chill.'

"The definitely malarial invasions of a ship are mostly detected, and temporary cure of symptoms is effected by means of quinine. The masters and stewards of ships which trade in infected regions are usually quick in detecting malaria, from long experience. This does not always apply where the Protean forms of subtertian malaria are concerned, though in this disease quinine is usually given a successful trial on instinct.

"My impression is that the seafaring community which goes into the Tropics is far more infected than appears from any record. *

ILLUSTRATIVE SHIPS.

*

The following illustrative ships are cited by the port medical officer as examples of the amount of infection on some of the vessels, the nature of the masters' reports, and the manner in which the disease is frequently viewed on shipboard.

The S. S. Hunstanworth, from Rufisque, West Africa, arrived at the mouth of the Medway on November 16, 1922. The master declared 8 cases of malaria, 3 of pneumonia, and 1 case of peritonitis. The ship left Rufisque on November 5. The malaria came on after the vessel had left Las Palmas, Canary Islands. Every man of the crew of 24 had been ill; and only about four men were fit to man the ship at the time of arrival. The vessel had taken on cargo up the river and among swamps. Four of the crew had been taken on at Las Palmas, where they had been in hospital, from another ship, which had also been at Rufisque. One of these four men subsequently came into Denton Hospital. He had the subtertian. parasite in his blood and was severely ill upon his admittance to hospital.

The vessel had proceeded to Rochester before details could be fully learned, but four men who were sent into Denton Hospital from Rochester, one with delirium, showed the subtertian parasite-ring forms only.

The case of "peritonitis" (severe vomiting) died, as did also another patient.

The S. S. Hesione, from Bombay, arrived at Gravesend December 4, and reported 42 cases of malaria as occurring when the ship was at Bombay, and subsequently up the Malabar coast. The type of the disease was apparently not severe. The cases were treated as they occurred, at the various ports. The last case had occurred 15 days before arrival. The crew was free from fever; but upon examination, several members were found to be anemic and "below par." The master reported a good deal of malaria on Bombay ships. The S. S. Chama, arriving December 14, had visited every port of importance in the Bight of Benin, coast of West Africa, and had been "coasting" since September. There were two cases of malaria on board on arrival, and a total of six eases in all had occurred. Five grains of quinine was given daily to all hands from September 3 to November 20 as a preventive measure. It was stated that the health of the crew appeared to show the value of this treatment. The S. S. Hortensius arrived from Beira at Rochester July 21 with a report of about 22 cases of malaria, all well now," indicative of the unimportance attached to the disease. The medical officer states: "A subsequent single notification of malaria from the Seamen's Hospital, in a case which came from this ship on July 22, is at once a commentary on the report and a clear indication in one case of the condition of infection which possibly exists in nearly all the cases.” The S. S. Caledonia reported 77 cases of "influenza" during the voyage from Bombay, October 7-27, the latter date being the date of arrival at the port of London. Subsequent notifications were made from the ship and from the Seamen's Hospital. The subtertian parasite was found in the blood of the patients at the Seamen's Hospital, and the port medical officer had notice of two similar findings in two patients landed from the vessel at Marseille and a further notification of a benign tertian case on December 12. The report of the medical officer goes on to state that "the outbreak was almost entirely confined to those of the crew occupying quarters on the starboard side of the ship. The passengers were not affected. Most had 'recovered' at the time of arrival. Those who were still ill were the cases notified as malaria, and suggest, together with the fact that the starboard side of the ship was alongside the quay in Bombay, that the majority of the cases, if not all, were malaria."

MEETING OF THE AMERICAN PUBLIC HEALTH ASSOCIATION. Fifty-Second Annual Meeting to be Held In Boston, October 8-11, 1923. The American Public Health Association extends to the public health profession and other interested persons a cordial invitation to attend its fifty-second annual meeting, in Boston, Mass., October 8 to 11, 1923.

The annual meetings of this association are always important events in the public-health world, but the meeting this year is of more than usual interest, since it ends the first 12 months of the new program adopted as a result of the reorganization of the association in 1922.

Two general sessions and 26 meetings of the scientific sessions will be held this year. In addition, many trips of technical and general interest have been planned around the historic city of Boston as part of the entertainment and educational program. On Monday evening, October 8, the formal opening session will be held, followed by a reception. On Wednesday evening, October 10, Sir Thomas Oliver, distinguished English industrial hygienist, and Dr. George E. Vincent, president of the Rockefeller Foundation, will address the second general session. The scientific program, embracing all branches of public health, will be held according to sections as follows: Public health administration, laboratory, sanitary engineering, vital statistics, child hygiene, food and drugs, industrial hygiene, public health nursing, health education and publicity.

Among the important subjects scheduled for discussion are food inspection, growth of children, full-time health officers, mental hygiene in the school program, nutrition work, the effect of so-called "moonshine" liquors, standards for schoolhouse construction and sanitation, epidemiology, better birth registration, organic heart disease, the etiology of common colds, water supply and purification, and mosquito control.

An important report of the committee on municipal health department practice will be presented in the public health administration section. At this time the announced plan for the awards to cities for distinctive community service will be discussed. The problems of health officers in small communities will be specially considered at a round-table discussion scheduled for Wednesday morning. The clinic on printed matter, which has proved valuable in past years, will be held again this year by the section on health education and publicity. At this clinic, samples of public health publicity will be examined and criticized by experts. Of special interest also is the report of the committee on health problems in education, of the child hygiene section.

In the September issue of the American Journal of Public Health will be found the preliminary annual meeting program arranged by sections, and the October number of the Journal will contain additional information.

Members of the association traveling by rail to Boston may secure a reduction of one-fourth the regular round-trip rate. Headquarters will be at the Copley-Piaza Hotel.

STATE AND INSULAR HEALTH AUTHORITIES, 1923.

DIRECTORY, WITH DATA AS TO APPROPRIATIONS AND PUBLICATIONS. Directories of the State and insular health authorities of the United States for each year from 1912 to 1922 have been published in the Public Health Reports for the information of health officers and others interested in public-health activities. These directories have been compiled from data furnished by the respective State and insular health officers and include data as to appropriations and publications.

Where an officer has been reported to be a "whole-time" health officer, that fact is indicated by an asterisk (*). For this purpose a "whole-time" officer is defined as "one who does not engage in the practice of medicine or any other business, but devotes all his time to official duties."

ALABAMA.

Board of censors of the State medical association,
acting as a committee of public health:

W. W. Brandon, governor, ex officio chairman,
Montgomery.

S. W. Welch, M. D., Montgomery.
W. D. Partlow, M. D., Tuscaloosa.
J. N. Baker, M. D., Montgomery.
V. P. Gaines, M. D., Selma.

S. G. Gay, M. D., Selma.

E. S. Sledge, M. D., Mobile.

A. N. Steele, M. D., Anniston.

II. S. Ward, M. D., Birmingham.

B. L. Wyman, M. D., Birmingham.

R. S. Hill, M. D., Montgomery.

Executive health officer:

*S. W. Welch, M. D., State health officer,

Montgomery.

Registrar of vital statistics:

*H. G. Perry, M. D., Montgomery.

State laboratory:

*L. C. Havens, M. D., director, Montgomery. State sanitary engineer:

*G. H. Hazlehurst, C. E., M. C. E., Montgomery.

Assistant sanitary engineers:

*II. G. Menke, B. C. E., Montgomery.

*C. C. Kiker, B. C. E., Montgomery.

*J. C. Carter, E. M., Mongtomery.

*E. B. Johnson, C. P. H., Montgomery.

*E. M. Craig, Montgomery.

*N. II. Rector, Montgomery. *W. D. Wrightson, Montgomery. Epidemiologists:

*K. F. Maxey, assistant surgeon, United States Public Health Service, Montgomery.

*T. H. D. Griffitts, assistant surgeon, United State: Public Health Service, Montgomery.

County organization:

*D. L. Cannon, M. D., director, Montgomery.

1 Reprints Nos. 83, 123, 190, 268, 344, 405, 488, 344, 605, 703, and 775 from the Public Health Reports.