REPORT OF THE SECRETARY.

STATE BOARD OF HEALTH AND VITAL STATISTICS OF THE COMMONWEALTH OF PENNSYLVANIA.

Hon. SAMUEL T. DAVIS, M. D., President of the State Board of Health and Vital Statistics of the Commonwealth of Pennsylvania :

SIR: I have the honor to submit the following report of the work of the Board and of my official acts during the past year. The Board has held three regular and eight special meetings.

The regular meetings took place on November 12, 1891, May 13, 1892, and July 11, 1892. The special meetings were held on February 22, March 28, June 29, August 13, September 3, September 16, September 21 and September 22, 1892.

At the first of the regular meetings, held November 12, 1891, a communication was received from the trustees of the University of Penusylvania, announcing the approaching opening of its new

LABORATORY OF HYGIENE.

Whereupon the following resolution was adopted:

Resolved, That this Board has received, with sincere satisfaction, the formal announcement of the approaching opening of the Laboratory of Hygiene, of the University of Pennsylvania, considering that this event marks an era in the progress, not of science only, but of civilization,

in this State.

Resolved, That the Secretary be instructed to communicate with Dr. William Pepper, Provost of the University, and with Dr. J. S. Billings, Director of the Laboratory of Hygiene, suggesting a conference for the purpose of formulating a plan by which this Board may avail itself practically of the facilities to be afforded by the Laboratory for the investigation of diseases, and of the meaus for its prevention, for the analysis of foods, water and other beverages, and for bacteriological studies.

Resolved, That in a definite co-operation between the University and the State Board of Health in the prosecution of such researches, this Board recognizes an opportunity, not only for mutual aid, but for advantage of the greatest moment to the entire Commonwealth.

In accordance with the above resolution such a conference was held, and your secretary was requested to take part in the opening exercises of the institute, which took place on the 22d of February, and which were formerly attended by the Board, called in special session for the

purpose.

The necessity of a laboratory of hygiene to the State Board of Health has been urgently felt, and arises out of the duties imposed upon the latter by section five of the act of assembly establishing it, which reads as follows:

"The State Board of Health and Vital Statistics shall have the general supervision of the health and lives of the citizens of the Commonwealth, and shall especially study its vital statistics. It shall make sanitary investigations and inquiries respecting the causes of disease, and especially epidemic diseases, including those of domestic animals, the sources of mortality, and the effects of localities, employment, conditions, habits, food, beverage and medicine on the health of the people. It shall also disseminate information upon these and similar subjects among the people. It shall, when required by the Governor or the legislature, and at such other times as it deems important, institute sanitary inspections of public institutions or places throughout the State."

Now, to carry out in any adequate degree the purposes of the law with regard to investigating the causes of disease, and the effects of foods, beverages and medicines on the health of the people, two things, among others, are absolutely essential: first, that the Board should have means and opportunities for making or procuring chemical analyses; and, secondly, that it should have means and opportunities for prosecut. ing what are now known as bacteriological examinations-the study of the germs of disease. And it goes without saying that where the interests of the health and lives of five million people are concerned, these means and opportunities should be on a generous scale, and should conform to the most recent developments of scientific hygienic research, both in this country and in Europe. It does not at all meet the intention and requirements of the statute, that the secretary of the Board should spend a few cents on test-tubes and chemicals, or press his old Dolland microscope, handed down from a previous generation, into the service of the State. Nor is it fitting that this great Commonwealth, with its millions of revenue, should be depending, as it has done, on the charity of private chemists, who have, in a spirit of generous patriotism, placed their services at the disposal of the Board in order to enable it, in some slight degree, to meet the claims that are constantly and prop

erly made upon it for the analyses of suspected waters and foods. It is hoped, therefore, that the trustees will see their way clear to allowing the Board to refer applications of this kind to the laboratory for investigation. The Board, for its part, should make every effort to obtain from the legislature a reasonable appropriation for such purposes, distinct from its general appropriation, which will enable it to meet, at least, the cost of all work done for the State.

Further, section nine, of the act creating the Board, instructs it, "from time to time, to engage suitable persons to render sanitary service, or to make or supervise practical and scientific investigations and examinations requiring expert skill, and to prepare plans and reports relative thereto." Observe the phrases: "suitable persons," "expert skill." Heretofore the Board has been compelled to call to its aid for these objects simply medical men, intelligent, educated, sound practitioners, but without that special training and equipment which would render them "suitable persons" in any strict, technical construction of the expres sion, or would furnish them with "expert skill." Here, again, the laboratory will prove the right hand of the Board, giving just that instruction which a sanitary inspector needs to fit him for his special work. And, on its side, it should be the purpose of the Board to pursue more persistently, even, than it has in the past, its purpose of obtaining a thorough sanitary organization of the State under legislative sanction and compulsion, the result of which will be to create a constantly increasing demand for just such trained, practical sanitarians as this school will graduate. In this view of the case it might be the part of wisdom for the trustees to place a certain number of scholarships at the disposal of the Board.

Finally, it is desirable that publicity should be given to the important work which will be carried on in this Institute, which your secretary risks nothing in saying, after a careful inspection, and after comparison with other similar laboratories, will be in advance of any in this country and the peer of any abroad, it is highly desirable that this work should be frequently brought to the notice of the legislature, the medical profession and the public; and I, therefore, suggest that its director be requested to present a stated report quarterly, or at such other intervals as may be deemed expedient, to the State Board of Health, of all investigations here prosecuted directly in the interest of the public health, which report shall form a portion of the Annual Report of the Board, to be transmitted to the Governor, and of which a certain number of reprints shall be furnished to the trustees for general distribution, as well as for preservation in the archives and various

libraries of the university.

EPIDEMIC AND CONTAGIOUS DISEASES. During the year there has been rather an unusual prevalence of preventable diseases. Small-pox has appeared at several points but has

been carefully isolated either by the State Board or by local boards, and thus prevented from becoming epidemic. Scarlet fever has been unusually prevalent, but of a mild type. Diphtheria, however, has been widespread and extremely fatal. It is safe to say, comparing the mortality returns of our cities with those of previous years, that this disease has been at least five times more prevalent than ever before. During the past weeks in the city of Philadelphia, it has reached at least ten times its average death rate. It is evident that the only way to deal with this virulent contagium, is to adopt the same rigid restrictions with regard to isolation, disinfection and destruction of fomites. that we have long insisted on for repression of small-pox.

The manner in which the board deals with that disease in rural districts, which are unfortunately denied the protection of local health authorities of any kind, is fairly illustrated in the management of an outbreak of

SMALL-POX AT POINT PLEASANT.

Small-having been reported at Point Pleasant, Bucks county, on the 15th of November, 1891, Prof. Wm. B. Atkinson, M. D., medical inspec. tor for the Delaware district, was at once dispatched to make an investigation. Under instructions from the secretary, he placarded the house in which the disease existed, called a public meeting of the residents and with the assistance of Dr. A. M. Cooper, a resident physician, appointed sanitary, quarantine and finance committees. Day and night guards were established, and Dr. A. M. Cooper was commissioned by the Secretary, Deputy Medical Inspector of the Tinicum sub-district, including the townships of Tinicum, Badminster, Plumstead, Buckingham and Soleberry, with full authority to inspect and enforce quarantine. Dr. Alexander, of the Lancaster County Vaccine Farm, was notified to send two hundred points of virus to Dr. Cooper and other physicians in the neighborhood.

The disease was confined to the first case, an Italian who had come from Trenton, N. J., and an infant in the same house. The authorities of Doylestown were communicated with and recommended to urge the citizens to have vaccination performed.

The chairman of the directors of the poor of the county was notified that it was their duty to provide for the necessary expenses of nursing and quarantine, and should new cases occur, to have them quarantined in the county pesthouse.

The following is the letter of instructions to the Medical Inspector: Dr. WILLIAM B. ATKINSON,

Medical Inspector Delaware District.

SIR: In making your inspection at Point Pleasant your first step will be to see Dr. Cooper, if possible, then to visit the house and placard it after verifying the diagnosis. The more influential citizens should then