BOARD OF HEALTH REPORT.

To His Excellency, HoN. A. G. Porter,

Governor of the State of Indiana:

SIR-In accordance with the law establishing a State Board of Health, approved March 7, 1881, I have the honor herewith to transmit to you the Annual Report of that Board for the year ending October 31st, 1883, the same being the Second Annual Report of that Department.

This report consists of a statement of the expenditures of the Board during the year, an inventory of the property belonging to the Board, a list of books and publications in the Library of the Board, a list of circulars, pamphlets and papers issued by them, an outline of their work, a series of articles upon Sanitary Hygiene and kindred subjects, by professional gentlemen of high standing; also, a series of statistical tables of the returns of deaths, births, marriages, epidemic and contagious diseases, arranged to exhibit as large an amount of facts and convey as much intelligence concerning the hygienic condition of our State as is practicable; a list of health officers, physicians and accoucheurs in the various counties in the State, and throughout the entire report such remarks, suggestions, deductions and observations as the Secretary of the Board deemed of sufficient importance to include. The Secretary regrets that the very short time since he assumed the duties of his office, precludes the possibility of his presenting you with as complete a report as the importance of the Health Department of the State government demands.

A series of sanitary investigations have been inaugurated, which it is confidently expected will render the work of the Bureau for the next year more manifestly in the interests of the public than heretofore.

The formative period of the existence of the Board having passed, it now remains to demonstrate its great value to the individual taxpayer. No axiom is truer than this, "Public health is public wealth," yet it is only when the work of the sanitarian is brought to the fireside of the individual, that the truth of the proverb is properly appreciated.

The ordinary layman entertains a very inadequate conception of the laws of health. In all other sciences he may be well versed, but the science of hygiene is to him a "sealed book.” His religion and philosophy, his social and political beliefs, are predicated upon the result of his own reasoning powers. Yet strangely he trusts the consideration of the laws that control his health, well-being and physical happiness, to others. The result is, that the vast majority of the commonwealth need instruction in the plainest precepts of self-preservation. Their dwellings and their surroundings, their school houses and churches, their business and occupations, their food and drink, their clothing, bedding, sleeping and repose; their work and their rest, and all their surroundings and attachments, need sanitary supervision. To do this, to point out the errors, to collect the results of the violations of the laws of health, to collate the facts, to make the proper deductions therefrom, and to present them to the public, impress them upon the minds of the people, to suggest the necessary methods of relief, and prevent the continuance or repetition of the errors, is the province of the State Board of Health. How well it will be done, and the effectiveness of the work, depends upon the intelligence, industry and capability, the efficiency and opportunity of the members of the Board, aided and abetted by the cheerful cooperation of the local health officers, the physicians, accoucheurs and citizens of the State.

State Boards of Health are a modern institution and the outgrowth of the demands of a modern civilization. Fifiteen years ago Massachusetts organized the first State Board of Health in the United States, since which time twenty-seven other States have followed her example, so that we now have twenty-eight Boards of Health constituting departments in that many State Commonwealths. Besides these, those forming a part of the local municipalities are numbered by thousands, and sanitary science is now placed high among the most important objects of modern research.

It is not a reflection upon the intelligence of our ancestors that this outgrowth of the science of hygiene belongs to our age. Their thoughts and labors were engaged in solving the problems of providing subsistence for themselves and families; preparing their homes, draining the swamps, removing the dense forests and laying the foundation of the great prosperity that now blesses this land. Besides, living as they did, isolated, with no cities or large towns, they were free from many of the diseases that advancing civilization introduces.

The aggregation of human beings almost inevitably produces a vitiated condition of air, water and earth, in, around and upon which they congregate, hence the rigid regulations laid down by the “Divine Mosaic Law," given to the Hebrews upon the beginning of their journey to the "Promised Land."

The dangers to society resulting from human accretion are many, and require constant vigilance to protect against them. Nor are any exempt. In a large degree, each man is his brother's keeper. One person may be the essence of care and cleanliness, but if his neighbor violates the law of hygiene the punishment often falls alike upon the innocent and the offender.

A filthy homestead or surroundings invites disease into a neighborhood, and it falls upon the helpless by preference. An. undrained pond or cess-pool is a centre of infection, and a source of poisonous exhalations to all within the circle of its baneful influence. An imperfectly sewered house or a polluted water supply, affects alike the young and the old. These dangers lurk in the most unexpected places, and among all classes. The hovel of the pauper and the humble home of the plebeian are frequently not less healthy than the palace of the affluent. The gross hygienic errors of the first two are often less dangerous than the insidious poisons which lurk in the imperfectly. sewered apartments of the third.

Manufacturing interests, commercial pursuits, and the busy struggle for bread, tend to crowd population into smaller limits. The advance in the price of real estate necessitates the economizing of space and area. Tenement houses supplant the cottage and residence; the necessaries of life become more costly, and the tendency is to a violation of the laws of health from sheer necessity. Sunlight, fresh air and pure water, become more and more reduced in quantity and quality, and the supervision of executive authority becomes necessary to prevent the outbreak of slumbering disease.

The value of legally organized boards of health has been amply demonstrated and their utility is recognized in all wellinformed communities, where they have been established.

London formerly had a death rate of over forty per thousand. Since the organization of her Health Department the mortality has fallen to less than twenty-five per thousand. That of England and Wales, from 35.4 per thousand, in 1860, to 20.5 in 1880. Denmark, from 31.2 in 1860, to 20.4 in 1880. Sweden, from 31.2 in 1860, to 18.1 in 1880. Austria, from 39.6 in 1860, to 29.6 in 1880. Prussia, from 38.6 in 1860, to 25.5 in 1880. Switzerland, from 31.6 in 1870, to 29.9 in 1880. Italy, from 37.2 in 1870, to 30.5 in 1880. The German Empire, from 39.8 in 1870, to 26.1 in 1880. In all these countries, sanitary science has been fostered during the periods named.

In our own country, the death rate has been largely reduced, as demonstrated in Boston, New York, Philadelphia and many other cities, where observations have been carried on. No State has, so far, abolished its Board of Health after once fairly establishing it.

The following is a list of the State Boards of Health and other sanitary bodies and authorities in the United States, and various sanitary associations and authorities throughout the world:

SANITARY AUTHORITIES AND ASSOCIATIONS.

UNITED STATES OF AMERICA.

NATIONAL.

National Board of Health, Col. Geo. E. Waring, Jr., C. E., Secretary, Newport, R. I.

United States Marine Hospital Service, Dr. John B. Hamilton, Surgeon General, Washington, D. C.

American Public Health Association, Dr. Irving A. Watson, Secretary, Concord, N. H.

Sanitary Council of the Mississippi Valley, Dr. John H. Rauch, Secretary, Springfield, Ill.