Sanitary Association has also had two papers before it, in which the subject has been well examined, and other facts adduced to which reference may be had. The State Board of Health is carefully considering the whole subject, and will necessarily recommend some change in the present inoperative law.

The report on the duty which the States owes to children in families, schools and workshops, will this year deal only with the home and the school, reserving the relations of the State to children in factories for another year. This report recognizes the child as, to no small degree, the ward of the State; since from five to eighteen years, he is taken under the charge of the State for education. It is all important as a great public and social interest, that we should avail ourselves of such information as to methods and surroundings as will fully carry out the object of free school training. This report seeks to present some of the various evils to which the child is exposed, in order that the attention of parents and citizens may be directed thereto for their abatement. Some of the more important means by which improvements are to be effected are stated. Also some of the readier tests are given by which unsanitary conditions of air, water, heat, etc., may be detected. The whole subject is one of such vital interest to the growing population of the State, that it will commend itself to your careful thought and inquiry.

The report as to the "More common domiciliary influences and surroundings productive of disease," does not attempt to consider all household conditions hazardous to health, but in this, the first report, fastens attention on the evils of defective ventilation and impure water supply, as introductory to a fuller consideration of methods of improvement and of other sources of ill-health which are very apt to occur in household administration, and especially in the close vicinage of cities. It deals with subjects of practical interest to all that dwell in ceiled houses, and thus addresses itself to the consideration of every citizen.

The report on endemic and epidemic diseases in this State since May, 1869, is a summary of all the best information that can be obtained upon the subject. In the absence of any State Board of Health, or of any reliable system of vital statistics, the only dependence has necessarily been upon the reports of medieal societies. These are of great value so far as they go, but as

in all purely medical reports more attention is given to the detail of symptoms, to the ways in which separate organs are affected, and to the methods of treatment, than to causes and the methods of prevention. It was, however, thought best by the board to collect all information possible as to endemics and epidemics for the last septennary period. This is introductory to that more strictly sanitary study of causes, of surroundings, of the laws of infection and contagion, which is so important in order to ascertain the most feasible methods of prevention or limitation. The details here given have, therefore, interest for future comparisons, and as points of departure for systematic sanitary analysis. It will be found in the report that soil moisture or imperfect drainage is well recognized as causing fevers and other diseases of an intermittent or miasmatic type. The malignant malarial fever localized in a certain suburb of Trenton in 1871, is instructive as showing how a miasmatic influence may be so intensified as to produce a type of the fever almost as pernicious as the yellow fever of the tropics.

The decline of intermittent and remittent fevers in Camden and its vicinity, as the result of effectual drainage, has been so marked as to corroborate manifold experiences of the same kind in other States.

The report discusses the sanitary effect of salt marshes, and the subject is one needing further inquiry. It will be seen that this report does not deal with developmental diseases, or those dependent on imperfect nutrition, but chiefly with zymotic dis eases. These usually depend upon outside contagions rendered. active by unhealthy surroundings, and by the susceptibility of the persons affected, both of which we believe can be greatly modified. It will be noticed that the chief endemics or communicable diseases confined to some one locality have been typhus fever in 1870 in Jersey City, and one each of cerebro-spinal meningitis, puerperal fever and erysipelas Typhoid fever while endemic mostly, has at times almost seemed an epidemic.

Epidemics of measles, mumps, whooping cough and influenza have from time to time occurred. But the three prominent pestilences in the State for the period since 1870 have been diphtheria, small-pox and scarlet fever. Diphtheria has been epidemic in at least twelve counties of the State in a single year (1876), and has at other times prevailed more or less in various

localities. It is as much under the control of preventive and sanitary as it is of purely medicinal treatment.

Small-pox, in the same period, has numbered as many as one thousand cases in a single year in one city. Most of our larger cities on lines of public travel have had it prevalent or epidemic at various times. In Camden it preceded the fearful scourge of Philadelphia in 1872. A mortality of 37 per cent. among those not vaccinated is stated. It is a disease often met with in country localities, as well as in larger cities. A distinguished writer, who is not a theologian, has said that the perversity of mankind in neglecting vaccination, which is so sure a protection against fatal attack, is the most available argument in proof of original sin. Now that vaccination directly from the calf can always be secured, the old excuse of the possibility of catching skin diseases from other people's children, which has been greatly magnified, has to be laid aside. Our State is so much a highway of travel that it is greatly important that all proper means be used to secure the vaccination of adults when the epidemic prevails. The contrast between such cities as Providence on the one hand, and Philadelphia on the other, shows what a difference in the prevalence of the disease can be made by an efficient system of vaccination. It seems to us, it is one of the rights of the citizen to be protected from such exposure. When, as in our State, the child has the gratuity of the free school, it is scarcely a question but that his vaccination should have been attended to before he is placed in a position by which he may unnecessarily become the conveyer of a disease which jeopardizes the rights of all the rest of the school.

Scarlet fever, which is so often epidemic in different parts of the State, is greatly influenced as to its spread and malignity by hygienic conditions, and is, therefore, very much under the control of sanitary jurisdiction.

In reference to this and all other diseases known as zymotic, the bearings of the pollution of air, of water and of habitations and of personal cleanliness thereupon is so definite that our highest authorities agree in calling them filth diseases; not that they may not occur amid good sanitary conditions, but if so, it is because they have been warmed and nurtured into virulency amid favoring circumstances. Even where these diseases occur, we greatly modify them by well applied hygiene. It is

maintained, too, by some of us that in the case of persons exposed to these contagions, much is to be done by their preventive treatment in advance of the time for the manifestation of any symptoms.

The paper on miasmatic diseases in Hudson county clearly presents the atmospheric and telluric influences in the county, which seem to favor the prevalence of intermittent and remittent fevers and to give to other diseases a miasmatic type. While all of us may not attribute the result so entirely to the extreme moisture, yet this is no doubt one of the factors in the causation of miasmatic disease. The views presented will aid in the study of that large class of disease which has its origin outside of the body, and which therefore is to be searched for with eagerness, either that it may be abated or that exposure thereto may be avoided.

The board also requested from Prof. Geo. H. Cook, the State Geologist, a brief statement as to any extended localities in which geological structure or surface conformation gives rise to imperfect drainage, or to any other circumstances which might jeopardize the health of the individual.

The study of the earth's surface, both as to its topography and its geological structure, is telling us much as to the conditions which favor heat or cold, moisture or dryness or sudden changes that may take place both in telluric and atmospheric conditions. Great water basins dependent upon impervious rock below the surface, while the crust of covering soil seems high and dry, sometimes account for intermittents in localities apparently free from miasmatic causes. Minerals in the water or the soil and the character of vegetation have much to do with normal or abnormal decomposition and decay. Water supply for drinking purposes is greatly involved in questions as to clayey, gravelly or humus soil. So, very many other questions as to health, require a knowledge of the earth's structure. The study in this State is all the more inviting because faithful and able service has so well defined its geological structure, and because the great geologic formations are so distinct. Perhaps in no State of our Union is there such encouragement to the study of population as affected by location. The triassic or red sandstone formation occupies nearly the whole of 9 or 10 counties. The cretaceous formation, including the green sand marl beds,

has its long and narrow belt adjoining, giving character to consecutive parts of eight counties more. The tertiary or more recent formations of Southern New Jersey cover six counties and parts of four others. Thus, in all but a small portion of the State, geologic structure can be studied in its bearings on air and water, moisture, disease, et cetera, without the complications which occur from frequent overlappings and intersections. The azoic and paleozoic or primitive formations, including the iron ore and limestone districts, in the northwest portion of the State, intermingle, but the other three formations already noted "are so entirely distinct from one another that they can easily be drawn in separate maps." Our geology, our locality, our minglings of city and country, our distinct sea and mountain districts and all as related to disease and climatology, so invite attention. and investigation, that an eminent American sanitarian recently said to us that he considered New Jersey as the best locality in our Union in which to study those sanitary problems which most concern the civic welfare of the American people. This year as preliminary we have only asked such indication of localities especially needing attention as have been brought to notice in the course of former surveys. We commend this paper to the notice of all interested in questions of drainage and public health, as indicating an important State interest.

Akin to this will be found a report upon the climatology of a part of the State for the last five years, as will be needed for reference when we come to secure future records, and to associate them with reliable statistics as to the progress of disease, and the ratio it holds to heat, moisture and to telluric and atmospheric conditions.

In this report it was not found feasible to make such comparisons, as so few even of our cities have attempted mortuary tables, and as other essential factors are absent, so that the data are insufficient in details and in extent of observation.

It had been the intention of the board to have furnished a careful statement of the diseases of animals for the last five years in this State, in order to show those to which experience had indicated us as most exposed, and for the purpose of pointing out methods of isolation, precaution or prevention. As there have been only sporadic cases of such diseases, as no one seems to have tabulated with accuracy the number of cases, and as the exact