therefore, a uniform plan of action adopted for the entire country which greatly facilitates the object in view, namely, the most complete limitation of epidemic disease with the least possible interference with travel and traffic. This plan contemplates the inspection of moving trains coming from infected places or suspected of transporting infected persons or goods, by competent physicians; the instant removal and isolation of any found to be affected with contagious disease, and the furnishing of such passengers as are considered to be free from the danger of carrying the infection with a certificate to that effect. The formal regulation authorizing the Secretary to instiute such inspections and isolate such passengers, on which the order of the Board to transportation companies was based, was adopted by the Board during the first six months of its existence. It will be found upon page 320 of the first annual report of the Board. This system has received the endorsement of the most eminent practical sanitarians, and has been already in successful operation in several States of the Union. Its introduction will necessarily entail considerable expense. The inspectors must be intelligent, well educated physicians, of such age, standing, practical experience and knowledge of affairs as to command general respect. Their number must be sufficient to enable them to do their work thoroughly without serious interference with travel and traffic. As a rule there are no considerable aggregations of population, and hence no boards of health, at points where railroads enter the State. It may, therefore, be necessary for the Board to establish camps of observation for suspects at several points near the State boundaries. As the people in the townships in which such camps would be located would be in no way responsible for their presence, and as they would be intended not for the protection of the people of these townships but of the entire State, simple justice would seem to indicate that the expense of maintaining the same should fall not upon the scanty populations of the townships but upon the entire state. However, that might be, the management of such camps should not be left to the people of the township, any more than that of a military camp should be in case of riot. Public safety demands that they should be under the direct supervision of this Board. Guards would be needed to enforce quarantine. It might be an open question whether they should be furnished by the sheriff of the county or the Adjutant General of the State. All experience shows that little dependence is to be placed upon the raw material of a posse. Should the necessity of such precautionary measures arise it is manifest that the Board would need a sum of ready money greatly in excess of its ordinary appropriation. It would be necessary to open a branch office with a staff of assistants solely for this work, in order that the routine work of the Board, which under the circumstances would materially be augmented, might go on interrupted. The protection of the streams of the Commonwealth from choleraic pollution might also require a considerable outlay. The Board cannot too strongly urge upon the Legislature, therefore, the importance of making permanent provisions for future emergencies, by the establishment of an emergency Board, composed of the heads of certain of the departments, of which the Chief Executive of the State should be the chairman, and the appropriation of an adequate sum to be disbursed by said Board under proper restrictions and on the requisition of the proper authorities. The only point at which such inspection was actually inaugurated by the Board, was Cumberland, Maryland, on the Baltimore and Ohio road, where Dr. J. S. Hackney, Medical Inspector of the Southern Tier district was stationed for a week, with the approval of the railroad company, and the consent of the Secretary of the State Board of Health of that State. LEPROSY. The leper who has been domiciled at the Delaware county pest-house at Lima for the past two years has recently made excursions into the neighborhood which have caused much anxiety to the inhabitants. It is a question whether this is a matter for interference on the part of the Board. of the local courts or of the sheriff of the county. Two new cases of this disease have been discovered lurking in the city of Philadelphia. One of these had been for months acting as cook in a small hotel kept by Dr. Paine of bogus diploma notoriety, who was promptly fined by the City Board of Health for this criminal infraction of sanitary law. Both cases are now confined in the Municipal Hospital, on the grounds of which a separate building is being erected for the permanent reception of cases of this disease. Thus the prophecy on which your Secretary ventured a few years since, that unless stringent precautions were adopted, and a retreat for such unfortunates was provided by the national government, every city would need its leper house, is entering at this early date on its fulfillment. INVESTIGATION WITH REGARD TO LEPROSY IN THE UNITED STATES. Copies of the resolution adopted with regard to the spread of leprosy in the United States, and the necessity for national provision for the care of sufferers from that disease have been sent to the President of the United States and the Supervising Surgeon-General of the United States Marine Hospital Service. The Secretary also visited Washington and conferred personally with the latter official on the subject, who will recommend it to the attention of Congress in his forthcoming report. Circulars on this question have been sent to all State Boards of Health and to all prominent specialists in skin diseases, and numerous replies have been received showing that very general interest is being awakened in the matter. NOTIFICATION OF ARRIVAL OF INFECTED SHIPS AT THE PORTS OF NEW YORK AND PHILADELPHIA. On the 16th of February the Secretary addressed a communication to the United States Commissioner of Immigration at the Port of New York, Hon. John B. Weber, requesting that immediate notification should be given this Board of the arrival of any vessel having infectious disease on board, on which were immigrants destined for points in this State. On the 18th of February a courteous reply was received acceding to the request. The first list was received February 21st. Since then notifications have been received regularly. It will convey some idea of the immense tide of immigration which is pouring into this Commonwealth when it is stated that the steamer "Darmstadt," arriving March 24th, brought 400 immigrants for Pennsylvania alone. Information thus received is at once sent to the local authorities, who thoroughly appreciate the vigilance of the State Board in thus warning them of the possible approach of infection. A similar arrangement was made somewhat later with the Hon. John J. S. Rogers, United States Commissioner of Immigration for the port of Philadelphia. List of steamships arriving at the ports of Philadelphia and New York, either on which were cases of infectious disease or from ports infected with cholera, of which the State Board of Health was notified by the United States Commissioner of Immigration, and by Dr. John H. Rauch, surgeon in charge at the United States Quarantine Station at Camp Low. From February 22nd, 1892, until June 28th, 1892, notifications were received in thirty-three instances, and were sent to towns and villages. Subsequent to that date, the notifications were as follows, and were sent to the authorities of towns to which the immigrants were destined, as indicated below: July 12th, smallpox on S. S. "Indiana," notifications sent 45. sent 29. August 31st, cholera on S. S. "Sorrento," notifications sent 19. September 2nd, scarlet fever on S. S. "Friesland," notifications sent 34. September 24th, cholera on S. S. "Normannia," notifications sent 8. September 25th, cholera on S. S. "Moravia," notifications sent 8. September 27th, cholera on S. S. "Rugia," notifications sent 2. THE PREVENTION OF BLINDNESS. The Board will remember that its attention was once called by the Sydenham Medical Coterie of Philadelphia to the alarming increase of blindness and to the fact that much of it was preventable. A communication was presented early during the present year from a special committee of the Philadelphia County Medical Society, urging the same subject upon the consideration of the Board in the following terms: Resolved, That the State Board of Health be requested to memorialize the Legislature of this State to pass a law, or to itself adopt a regulation, requiring that all cases of inflamed or reddened eyes of the new-born shall be reported to some health officer, or legally qualified practitioner of medicine within twelve hours of the time the disease is first noticed. In response to this request, the following preamble and resolutions were adopted: WHEREAS, It has been brought to the attention of this Board by two important medical societies of the city of Philadelphia, representing a large portion of the medical practitioners of that city, that from onefourth and one-third of all cases of blindness are due to ophthalmia of the new-born, which is a preventable disease; therefore, be it Resolved, That the following regulation be and is hereby adopted: REGULATION IV. Whenever in any city, borough, village or place in this State, having no health authority of its own, any nurse, mid-wife or other person, not a legally qualified practitioner of medicine, shall notice inflammation of the eyes or redness of the lids in a new-born child, under his or her care, it shall be the duty of such person to report the same to a legally qualified practitioner of medicine, within twelve hours of the time when the disease was first noticed. Resolved, That this Board recommends the passage of a similar ordinance by the councils of all cities and boroughs, having health authorities of their own, or the adoption of a similar regulation by such health authorities. A circular upon this subject giving the reasons for the adoption of the regulation and indicating the means to prevent blindness from the cause referred to has been issued by the Board and circulated among hospitals and training schools. CONSUMPTION. Acting under instructions from the Board, the Secretary has transmitted copies of the circular on consumption to the superintendents of all penal institutions throughout the State, with a letter calling their at tention to the necessity for adopting certain precautions to prevent their institutions from becoming infected with the germs of this disease, and asking for statistics of the prevalence of this disease among the inmates. Replies received up to the present time indicate that it is a rare thing for a case of consumption to be found in the smaller county jails. Returns have not yet been received from the State penitentiaries. PENNSYLVANIA ASSOCIATION FOR THE PREVENTION OF TUBERCULOSIS. As indicating the general diffusion among the people of a belief in the doctrine of the contagious and infectious character of consumption, it is interesting to note that a society has been formed in the city of Philadelphia, having for its object the prevention of the spread of this most prevalent and fatal of all diseases. THE FLOODS AND FIRES OF JUNE 5, 1892. Intelligence of the terrible destruction to life and property at Titusville and Oil City on the 5th of June, reached the Secretary at Detroit on June 6. He at once telegraphed to his Excellency the Governor inquiring whether the information in his possession led him to consider that the interference of the State Board of Health was necessary or desirable, and to the mayors of those cities inquiring whether tents were needed. A medical inspection of the regions affected was also ordered, and the Boards of Health were asked whether they needed assistance to meet the emergency. The replies of the Governor and the other officials indicated that the local Boards of Health and authorities were able to cope with the emergency. This was shortly afterwards confirmed by the report of Medical Inspector Woods. On the 10th of June, the Secretary visited Oil City and conferred with the mayor and Board of Health. Accompanied by the President of the City Board of Health a careful inspection of the entire district was made, and every provision was found being made for the prevention of nuisances and care of the injured. A similar inspection of the Titusville region affected was also made a few hours afterwards in the company of the President of the Board of Health of that city. Much admirable work had also been done here by the local Board, but the immense area involved, and the low lying character of the district presented considerable difficulties in the way of abating the nuisances. About four hundred men were actively at work in the removal of débris, application of disinfectants, construction of drains and the opening of thoroughfares. The efficient manner in which these two Boards of Health had met such an overwhelming disaster afforded a convincing proof of the need of the compulsory establishment of Boards of Health throughout the entire State. After carefully examining the causes of the disaster by fire in both of these instances, the Secretary was impressed with the fact that oil tanks or refineries should no longer be permitted in exposed positions on the |