He' m rfi P4l7r 1885 PENNSYLVANIA. STATE 13D. OF HEALTH REPT. OF'ORGANISATION AND MINUTES WA P417r 1885 HHnnnmi NLH D5130fi3D b NATIONAL LIBRARY OF MEDICINE 'A "N '»»<»>ojAs JA -' Ull IVNOIIVN IN 1310 3W JO ABV.BIT IVNOIiVN 3 N I 3 I 0 3 W J O A II V a a II 1 V N O 11 V N 3NI3IO 1"\ i /s& l °,W JO A«V««H IVNOIIVN 3NI3I03W JO A II V II a I 1 IVNOIiVN 3NI3I03W JO A a V a a II IVNOIiVN 3NI3I03 i x l£%w ? TO? s v., NAl LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATION/ „„,, IVNOIiVN 3NI3I03W JO AHVaBII 1 V N O I i V r« PRm.'e ce^ COMMONWEALTH OF PENNSYLVANIA. 4 • i STATE BOARD OF HEALTH: REPORT OF ORGANIZATION ^ AND MINUTES OF FIRST AND SECOND MEETINGS, JULY 3 AND .NOVEMBER 11, 1885. EDWIN K. MEYERS, STATE TKINTEK, HARKISBLUG. l/V/} iref LIBRADV nr ■■------ NATIONAL LIBRARY OF MEDICINE BETHESDA 14, MQ. RECOED OF ORGANIZATION AND ABSTRACT OF MINUTES OF THE BOARD. Pursuant to a summons from the Honorable the Secretary of the Common. wealth, the following-named members of the State Board of Health and Vital Statistics of the Commonwealth of Pennsylvania, established by act of Assembly approved by His Excellency, the Governor. June 3,1885, met in the office of the Secretary of the Commonwealth on. Thursday, July 2, 1885, at 12.30 o'clock, as required by section 2 of the act, viz : Dr. Pem- berton Dudley, of Philadelphia ; Dr. Edward William Germer, of Erie ; Dr. J. M. McClelland, of Pittsburgh ; Mr. Rudolph Hering, of Philadelphia . Dr. Benjamin Lee, of Philadelphia, and Dr. J. F. Edwards, of Philadelphia; The oath of office, required by section 1, article VII, of the Constitution of the Commonwealth, was administered by the Honorable the Secretary of the Commonwealth, and under his supervision the members proceeded to draw lots for their respective terms of service, with the following results : Dr. Edward William Germer, six years ; Dr. Pemberton Dudley, six years ; Dr. J. F. Edwards, four years ; Dr. Benjamin Lee, four years ; Mr. Rudolph Hering, two years ; Dr. J. H. McClelland, two years. The Board then proceeded to organize by the election of Dr. Pemberton Dudley as temporary chairman, and Dr. J. F. Edwards as temporary sec- retary. The Chair announced the first business in order to be the election of a president, in accordance with section 2 of the act. On motion, it was resolved that the election be by ballot. The Chair ap- pointed Dr. McClelland as teller. Dr. Edward William Germer, of Erie, was declared unanimously elected. The appointment of a secretary was next in order, and Dr. Benjamin Lee, of Philadelphia, was unanimously elected to fill this position. On motion of Dr. Dudley, the President having taken the chair, it was Besolved, That the temporary secretary be instructed to at once notify His Excellency, the Governor, that the Board has organized [by electing Dr. Edward William Germer, of Erie, to be president, and appointing Dr. Benjamin Lee, of Philadelphia, as its secretary, and that it is ready to re- ceive communications from him on any subject pertaining to the protection of life and health, or other matter within the range of the duties by law as- signed to, it. Besotted, That the temporary secretary likewise notify His Excellency that, in Consequence of the election of Dr. Benjamin Lee, of Philadelphia, a member of the Board, to the position of secretary, a vacancy now exists upon the Board, which it will be the duty of His Excellency to fill. 4 At the request of the temporary secretary,Dr. McClelland was instructed to act with him as a committee to carry out the foregoing resolutions. The committee having reported that they had accomplished the duty prescribed, and conveyed the assurance of His Excellency's interest in the objects of the Board and his earnest wishes for its successful administrationi the Board adjourned to meet in the same room at 2, p. m. Minutes of Second Session. Pursuant to adjournment, the Board met at 2, P. m., in the office of the Secretary of the Commonwealth. All the members present. Dr. Germer, the President, in the chair. Dr. McClelland moved that a committee be appointed to draft by-laws for the government of the Board, and report at a special meeting to beheld for the purpose of considering such by-laws. The Secretary stated that, in order, if possible, to avoid the necessity for a special meeting at an early date, he had taken the liberty of drafting a set of by-laws, founded on those of the most successful Boards in other States, and, if it pleased the Board, he would submit them. Permission was accorded, and, on motion, the law establishing the Board was declared to be the Constitution of the Board, and the Secretary was instructed, in having the by-laws printed, to preface them with a certified copy of the act, as such constitution. The by-laws were then read, and, on motion, considered seriatim, amended and finally adopted as a whole, as the by-laws of Board. On motion, the Board then adjourned to meet at the same place at 8, p. m. Minutes of Third Session. Pursuant to adjournment, the Board met at 8, p. m., in the office of the Secretary of the Commonwealth. The President in the chair, all the mem- bers present. On motion of Dr. Dudley, the Secretary was instructed to obtain the opinion of the Attornej' General of the State as to whether section 27, article III, of the Constitution is in any way prohibitory of the right of this Board to order inspections of food, drugs, etc. Dr. Dudley then moved that the Secretary be authorized to purchase such scientific and other works,and to subscribe to such periodicals as,in his judgment, the Board may need for the use of its members in the discharge of their duties. Carried. The Secretary announced a donation of an entire set of annual reports from the State Board of Health of New York, for which he was ordered to return the thanks of the Board. The Secretary then offered the following resolutions, which were carried, viz : Besolved, That the Committee on Sanitary Legislation, Rules and Regu- lations be, and is hereby, directed to report, at its convenience, upon the 5 laws of the Commonwealth so far as they affect the necessary action of the Board, and also to prepare and print such portion of the existing laws as may, in its judgment, be useful to the public and to this Board. Besolved, That Committee on Epidemic, Endemic, and Contagious Dis- eases be, and is hereby, directed to prepare, and, with the approval of the Executive Committee, to publish and circulate a brief circular upon the subject of epidemic cholera, containing plain, practical instructions as to the most important measures to be adopted and rules to be observed, both by local boards of health and by private citizens, to prevent the invasion and spread of that disease. Besolved, That the Secretar}^ be authorized to request Dr. L. H. Taj-lor, of Wilkes-Barre, to prepare, for the use of the Board, a complete history of the existing epidemic of typhoid fever at the town of Plymouth, Luzerne county, with accurate maps, showing the various sources of water-supply, and their relations to the spread of the disease. Also, to request Dr. E. 0. Shakespeare, of Philadelphia, to furnish, for the use of the Board, full and complete records of the autopsies made by him at Plymouth, in order to determine the precise nature of the epidemic. Also, to request Dr. Morris Stroud French, of Philadelphia, to prepare a brief history of the establishment of the temporary fever hospital at Ply- mouth, under the auspices of the Citizens' Relief Committee of Philadel- phia. Also, to request Dr. Morris Stroud French, of Philadelphia, to prepare a statement of the expenses incurred in the treatment of the sick, whether in their homes or in hospital, in providing food and other necessaries for the destitute, and in disinfection ; and an estimate of the financial loss to the community and State from the epidemic. Besolved, That the Executive Committee be authorized to use its discre- tion as to the amount of compensation to be allowed for each of the above- named reports. Besolved, That the Committee on Sanitary Legislation, Rules, and Regu- lations, be, and is hereby, directed to prepare, and, with the approval of the Executive Committee, to circulate a simple plan for the organization of local boards of health. Besolved, That the Executive Committee be, and is hereby, authorized to communicate with the Honorables, the Secretary of Internal Affairs, the Treasurer, and the Auditor General of the Commonwealth, in regard to the proper forms to be observed in obtaining, for the use of the Board in meeting its current expenses, the moneys appropriated for this purpose in section 2, of the act establishing the Board. Besolved, That the Committee on Registration and Vital Statistics be, and is hereby, directed to prepare the necessary methods and forms for ob- taining and preserving records of births, marriages, and deaths, of preva- lent diseases, and of practitioners of medicine and surgery, in accordance with the requirements of section 7 of the law establishing this Board. 6 Besolved, That the Secretary be, and is hereby, instructed to inform all local boards of health in the State of the organization of this Board, and of the time and place of its regular meetings, to call attention to the pro- visions of the law, and to request copies of their reports and publications, in conformity with the requirements of section 8 of the law. Besolved, That the State Board of Health desires to express its hearty approbation of the energetic measures now being carried out by the Boards of Health of the cities of Philadelphia, Pittsburgh, and Erie, in order to avert the threatened invasion of cholera during the present summer. Besolved, That in house to house inspection, faithfully and fearlessly per- formed, it recognizes the only reliable means for discovering the actual sanitary condition of a city ; and that the appointment in Philadelphia of an officer, who shall devote his entire time to the work of disinfecting such premises as are reported by the inspectors to be a source of danger to the public health, affords reasonable grounds for the hope that, with proper pecuniary support from councils, these efforts will be crowned with success. Besolved, That the State Board of Health regrets the suspension of the order of Board of Health of Philadelphia directing the disuse and filling up of wells for drinking purposes in built-up parts of the city, believing that all such wells, if not already polluted, must shortly become so, thus constituting a constant source and menace of disease. Besolved, That the State Board of Health pledges to the boards of health or health commissioners of Philadelphia, Pittsburgh, and Erie, its hearty cooperation in all measures designed to avert pestilence from and maintain a high standard of public health in the ports of the Commonwealth, and will unhesitatingly use for this purpose whatever powers the Legislature may have conferred upon it, and will also avail itself of such advantages as may accrue from its relations to the National Board of Health and to the boards of health of neighboring States, to the same end. Besolved, That in view of the lateness of the season,and the threatening character of the news from Europe in regard to the progress of Asiatic cholera, the boards of health of the cities referred to be notified to send at once to the Secretary of this Board copies of their regular reports, together with such other information as, in their judgment, it may be important that this Board should be in possession of, without waiting for the preparation of blanks by this Board. Besolved, That the Secretary be, and is hereby, instructed to notify His Excellency, the President of the United States, the Secretary of the National Board of Health, and the secretaries of all State boards of health now existing, or which shall hereafter be created, of the establishment of this Board, and of its readiness to cooperate with them in the work of pro- tecting the health of the entire nation. Besolved, That the Secretary be instructed to communicate with the sec- retaries of the State boards of health of all contiguous States with refer- ence to devising a plan of inter-State supervision of travel and traffic in 7 order to prevent the importation of infected goods or persons from one State into another. Besolved, That the Secretary, acting in connection with the Committee on Travel and Traffic, be instructed to address a circular to the presidents of all railroad companies running lines on the territory of this State, urging them to adopt rules for the conduct of their employes in the event of the discovery of infected persons or goods on their trains, and also to deter- mine upon refuges, at safe distances from centers of population, to which such persons may be transferred for medical care and isolation, and such goods for disinfection, and calling for reports from such railroad officials as to the plans adopted by them in accordance with these suggestions, as well as in regard to the means taken by them for keeping their premises and lines of travel in good sanitary condition. Besolved, That no papers shall be published in the annual report of this Board except such as are approved for purposes of such publication by a majority of the members of the Board, and that any such papers shall be published over the signature of the writer, who shall be considered as en- titled to the credit of its production, as well as responsible for the state- ment of facts reported and opinions expressed therein. On motion, the Board then adjourned to meet at 9, a. m., the day follow- ing, July 3, in the same place. Minutes of Fourth Session. Pursuant to adjournment, the Board met at 9, a. m., July 3, in the office of the Secretary of the Commonwealth, the President. Dr. Germer, in the chair. Present, Doctors Germer, Dudley, Lee, and Mr. Hering. On motion, the reading of the minutes was dispensed with. The Secretary then read an " Address to the State Board of Health and Vital Statistics of the Commonwealth of Pennsylvania to the people of Pennsylvania," which, with some modifications, was, on motion, adopted. On motion of Dr. Dudley, the Secretary was authorized to have as many copies of the address printed as in his judgment was necessary to secure the objects of the address in giving information to the people of the ex- istence and objects of the Board. Dr. Dudley moved that the Secretary be authorized to transmit copies of the address to all mayors of cities, burgesses of boroughs, and supervisors of townships, and to the newspapers of the State. It was carried. Also, that the Secretary be, and is hereby, instructed to issue a postal card or circular to all physicians in the Commonwealth, notifying them of the establishment of the Board, and inviting their friendly and active co- operation in the work of organizing sanitary effort, and procuring sanitary statistics throughout the State. It was carried. Also, that the Secretary be requested to furnish each member of the 8 Board with complete lists of the standing committees, and the members composing each. It was carried. Also, that the Committee on Epidemics and Contagious and Infectious Diseases be authorized to confer with the State Board of Agriculture in reference to the subject of the prevention and control of contagious and infectious diseases in domestic animals, and to report at the next regular meeting. It was carried. A short recess was then taken, and the Board re-assembled at the Lochiel Hotel. On motion of Dr. Dudley, thdt portion of the by-laws which referred to the appointment of standing committees, viz: Article VII, section 1, was reconsidered, and a re-arrangement of the original committees was agreed upon, by which their number was reduced from ten to eight, as already re- ported in the minutes. This necessitated a change in the chairmanships of certain committees, so that by the new arrangement the committees stand as follows : 1. Executive Committee.—Chairman, Pemberton Dudley, M. D., Rudolph Hering, C. E., J. F. Edwards, M. D., Secretary, Benjamin Lee, M. D. 2. Committee on Begistration and Vital Statistics.—Chairman, Benjamin Lee, M. D., Edward William Germer, M. D., J. F. Edwards, M. D. 3. Committee on Preventable Diseases and Supervision of Travel and Trofftc—Chairman, J. F. Edwards, M. D., Pemberton Dudley,M. D., Ben- jamin Lee, M. D. 4. Committee on Water-Supply, Drainage, Sewerage, Topography, and Mines.—Chairman, Rudolph Hering, C. E., J. H. McClelland, M. D. 5. Committee on Public Institutions and Places, and School Hygiene.— Chairman, J. H. McClelland, M. D., Rudolph Hering, C. E. 6. Committee on Adulteration of Foods, Beverages, and Drugs. 7. Committee on Explosives, Poisons, and other Special Sources of Danger to Life and Limb.—Chairman, Pemberton Dudley, M. D. 8. Committee on Sanitary Legislation, Bules, and Begulations.—Chair- man, Pemberton Dudley, M. D. On motion, the Board then adjourned sine die. Minutes of Special Meeting. A special meeting of the Board was held on Wednesday, October 21, at 12 m., at the executive office, on the call of the President; Dr. David Engel- man in the chair. Present, Dr. Pemberton Dudley, Dr. David Engelman Dr. Benjamin Lee, and by proxy, Mr. Rudolph Hering. The reading of the minutes was,on motion, dispensed with. The Secretary stated the object of the meeting to be the consideration of the general subject of the powers of the Board as regarded the abatement of particular nuisances. The ques- tion was now a pressing one, since complaints of a very serious nature had 9 been made to the Secretary of nuisances existing in the immediate vicinity of Philadelphia, imperiling the health of not only the inhabitants of the vil- lages in which these nuisances existed, but of the entire city. Three cases were instanced : that of Spring Mill, Montgomery county, where small-pox had been introduced by infected rags at a paper-mill; that of Rosemont, whera typhoidal and malarial fevers of obscure type had been caused by filthy hog-pens, and cow yards, and defective drainage ; and that of Fern- wood, Delaware county, where tjphoid fever had been caused by neglected drainage. In the case at Rosemont, the Secretary, as executive officer of the Board, had twice given the offender formal notice, and personally ex- torted from him a promise to abate the nuisance, but neither warning nor promise had been respected. It had, therefore, become necessary for the Board to act, if it wished to preserve its self-respect, and the respect of the community. The Secretary had obtained a formal opinion from an attor- ney on the powers of the Board, and also an expression of opinion from Attorney Bickel, district attorney for Montgomery county, in which the nuisance referred to existed, both of which were read to the Board. That of Attorney Bickel contained a recommendation that the Board adopt a regulation similar to the following : Regulation. Whenever a complaint is made in writing to the Secretary of the Board of the existence of a nuisance, he shall forthwith, as executive officer of the Board, investigate the matter, and shall determine whether the alleged nuisance is detrimental to the publie health or the cause of any especial disease or mortality ; and in case he shall so find, then he shall notify the owner, agent, or occupier of said premises in writing of such finding, and the executive officer shall, thereupon, order and direct the abatement and removal of the same within ------days ; and in the event of the failure of said owner, agent, or occupier of said property to abate and remove the nuisance, then the executive officer shall proceed to abate and remove the same, and shall employ all the force necessary to do so, and shall proceed, by warrant, arrest, and indictment, to convict the party failing to obey said order of abatement and removal. On motion, the regulation, as read, was adopted as a regulation of the Board to be entitled, " Regulation No. 1, on Abatement of Nuisances," and the Secretary was instructed to proceed, with such dispatch as in his dis- cretion was warranted, to remove and abate the said nuisances. On motion, the Secretary was authorized to fill the blank number of days in the regulation as in his judgment the conditions of removal and the requirements of the public health might require in each instance. On motion of Dr. Dudley, he was instructed to obtain the opinion of the Attorney General as to whether the courts would probably sustain him in the removal and abatement of nuisances in accordance with the regulation as at.opted. On motion, the Board then adjourned. 10 MINUTES OF SECOND REGULAR MEETING. First Session. The Board met in the Supreme Court room in the capitol at Harrisburg on Wednesday, November 11, at 12, m., the President in the chair. Present, the President, Dr. Germer, Dr. Dudley, Mr. Hering, Dr. Engel- man, and Dr. Lee. The minutes of the last regular meeting were read and approved. The minutes of a special meeting held in Philadelphia, October 21, were read and approved. The Secretary then read his annual report, which was received, and, on motion of Dr. Dudley, was ordered to be included in the annual report of the Board to the Governor. On motion of 'Dr. Dudley, it was ordered that the substance of the min- utes, as read, be also incorporated in the annual report. On motion, the Board then adjourned to meet at 2.3 \ p. m. Second Session. Pursuant to adjournment, the Board met at 2.30, P. m., the President in the chair. « Present, Dr. Germer, Dr. Dudley, Mr. Hering, Dr. McClelland, Dr. En- gelman, and Dr. Lee. The Secretary reported that, in obedience to the instructions of the Ex- ecutive Committee, he had given an order for the execution of the seal of the Board to the Harrisburg Stencil Works, by whom a seal and press had been furnished at an expense of thirty dollars. Copies of the seal were presented for inspection. A slight variation had been made from the design prescribed in the by-law, in order to give greater prominence and distinctness to the motto, Salus populi suprema lex, which had been placed on the face of the seal above and below the State arms, instead of on the circumference. The seal, as presented, was approved. The Secretary then presented the report of Dr. Lewis H. Taylor, of Wilkes-Barre, prepared in accordance with a resolution of the Board, giving a complete history of the epidemic of typhoid fever at Plymouth' Luzerne county, during the spring and summer of the present year. On motion, portions of it were read by the Secretary, and it was referred to the Executive Committee for publication, after condensation by the Sec- retary, if he deemed it necessary. Dr. Dudley then presented a report on the sanitary condition of the 11 house and neighborhood in Philadelphia where the individual had lodged and boarded who had been supposed to have originated the Ptymouth epi- demic. On motion of Dr. McClelland, it was accepted and referred for publica- tion. The Secretary then presented the report of Dr. Morris Stroud French, of Philadelphia, who was one of the physicians sent to Plymouth by the Citi- zens' Relief Committee of Philadelphia, on the financial aspect of the epi. demic. This report had been also pre'pared in accordance with a request from the Board, and a large number of the local relief committees of Ply- mouth had been engaged to make a house-to-house visitation in order to get exact facts and figures. It contained the names of every individual at- tacked with the disease, and would be a very valuable addition to the litera- ture of typhoid epidemics. It was, on motion, adopted and referred for publication. The Secretary stated that Dr. Shakespeare, to whom he had applied, as instructed by the Board, for a report on the pathological appearances re- vealed in his autopsies of patients who had died during the Plymouth epi- demic, had been sent abroad by the President of the United States on a sanitary mission of much importance before he had finished the desired re- port, but had promised to finish it while crossing the Atlantic and transmit it in time for the annual report. The Secretary was authorized to incorporate Dr. Shakespeare's report in the annual report when received. The Secretary then stated that, soon after entering upon his duties, com. plaints were made to him of nuisances existing in the districts contiguous to the city of Philadelphia, but out of reach of the jurisdiction of the Board of Health of Philadelphia, one of these being nothing less than an outbreak of small-pox, originating from infected rags at a paper-mill. He proposed, both in writing and personally appearing before the city board, to enter into an arrangement by which, in such cases, he could have an expert inspector placed at the disposal of the State Board for the emergenc}-, the State Board to bear the expense of the inspection. The matter was referred to the sani- tary committee of the city board, who decided that there were legal and technical obstacles to such arrangement which could not be gotten over- At the same time, they most courteously undertook the work of inspection in several instances until the State Board could make its own arrangements for the inspection and abatement of nuisances. Feeling that the State Board could not continue to accept gratuitous services in this way, the Secretary had assumed the responsibility of appointing Dr. William B- Atkinson, of Philadelphia, as special medical inspector for the district in- cluding all the counties immediately adjacent to the city of PhiJadelphiai viz: Delaware, Chester, Montgomery,and Bucks,and requested the Board to confirm the appointment. On motion, Dr. William B. Atkinson, of Philadelphia, was appointed spe- 12 cial medical inspector for said district, it being understood that there was to be no salary attached to this or any similar inspectorship, but that each inspection would be properly compensated at the discretion of the Secre- tary. The Secretary then presented a report of an inspection of the United States Marine Hospital Service quarantine station at Lewes, at the mouth of the Delaware bay, made in company with a delegation of the Philadel- phia Board of Health, and Dr. Marshall, a member of the Delaware State Board of Health. Dr. Hunt, the secretary of the New Jersey State Board of Health, had also promised to take part in the inspection, but was pre- vented by a sudden outbreak of typhoid fever in that State. On motion, the report was accepted and referred for publication. The President then presented a number of circulars from the Treasury Department of the United States, addressed to him as health officer of the port of Erie, on the subject of lake quarantine, etc. They were referred to the Committee on Travel and Traffic. The Secretary presented a report on the occurrence of cases of typhoid and malarial fevers at Rosemont, Montgomery county, attributed to bad drainage and filthy pig-styes, etc., detailing the steps which he had taken for the abatement of the alleged nuisances, involving much correspondence with legal officers of the State and county, in order to determine the exact powers of the Board in such cases, and the most expeditious and certain mode of procedure for the removal and abatement of nuisances in general. The report was accepted, and referred as in previous instances. A similar report was presented by the Secretary on cases of t3Tphoid fever occurring at West Fernwood, Delaware county, attributable to de- fective drainage. In this case, as in the previous one, inspections had been made by Dr. J. Howard Taylor, medical inspector of the Philadelphia board, by Disinfector Kennedy of the same board, by Special Medical In- spector Atkinson, and by the Secretary himself. The report was accepted and referred. Mr. Hering, as chairman of the Committee on Water-Supply, Drainage etc., read a report of an inspection made by himself, Dr. McClelland, and Dr. Lee, of certain nuisances existing in townships immediately contiguous to Allegheny City, but outside of the jurisdiction of the board of health of that city, with recommendations for an improved system of sewerage; also of an inspection of the Allegheny river as a source of water-supply for that city, with recommendations. The report was accepted and referred. Dr. McClelland reported, in reference to the subject of the report just read, that the system of sewerage for Butcher's Run, recommended in the committee's report, had already been adopted by the councils of Allegheny and that the nuisances on Spring Garden Run had been abated by the county courts. The Secretary read a communication from the ck k of Allegheny City 13 stating that a survey of the Allegheny river had been commenced in ac- cordance with the suggestion of the committee. A telegram was read from Dr. Edwards stating that he would be present at the evening session. The Secretary stated that it was made evident by the inspection at Alle- gheny City that one of the most pressing duties of the Board was the adoption of regulations by which the proprietors of slaughter-houses, bone- boiling establishments, soap factories, and other similar industries outside of city limits, could be compelled to conduct their business in such a way as not to create or maintain nuisances prejudical to the public health. He had, therefore, drawn up a set of regulations for this purpose, which he submitted for the consideration of the Board. Dr. McClelland, while expressing his approval of the general tenor and object of the regulations, thought that they might be open to objection as affixing definite penalties to certain offenses, which the law creating the Board did not, in so many precise words, authorize. The Secretary explained that, in his view, this was merely an expression of the judgment of the Board as to what the appropriate penalty would be, and not intended at all to overrule the discretionary power conferred upon the judge by the law. On motion of Dr. McClelland, the regulation was adopted, with the ex- ception of the clauses affixing penalties, and the Secretary was instructed to obtain an expression of opinion from the Attorney General of the State as to the propriety of retaining such clauses, and not to circulate the regu- lations, as they stand, unless an affirmative decision had been rendered. Dr. Dudley then made a report on the inspection of Camp Muhlenberg, near Media, Chester county. General Snowden commanding First Brigade, Pennsylvania State National Guard. The inspection was made in the com- pany of the Secretary, and the report was highly commendatory of the sanitary condition and police of the camp. The report was accepted and referred. The President then presented a report of an inspection of Camp Gal- lagher, at Conneaut Lake, Major General Beaver commanding Second Bri- gade, Pennsylvania State National Guard. The location of the camp was good, and general sanitary precautions excellent, but considerable sickness was caused by the want of proper meat inspection, leading to the use of tainted beef. The report was accepted and referred. The subject of precautions to be adopted against small-pox being next in order, the President reported that since the commencement of the pre- sent epidemic in Canada, he had caused two thousand vaccinations to be made in the citj' of Erie. The Secretary then read a circular, which he submitted for the approval and adoption of the Board, entitled " Precautions against Small-pox." On motion of Dr. McClelland, the circular was approved and referred for publication in the report, and it was also 14 Besolved, That the Secretary be instructed to send a copy of the same to every physician, clergyman, board of health, health officer, and school superintendent and principal throughout the State, certain alterations and amendments being first made. On motion of Mr. Hering, the Secretary was instructed to inspect, or cause to be inspected, the various vaccine farms in this State or elsewhere in this country and report at his convenience. The Secretary then presented an elaborate report of the sanitary com- mittee of the Board of Health of the city of Philadelphia, made in response to a letter of inquiry addressed by him to the board, on the " provisions made for the disinfection of infected clothing, bedding, etc.," in that city, accompanied by illustrative cuts. The report was accepted and ordered to be printed in full. On motion of the Secretary, it was Besolved, That the State Board of Health earnestly recommend to the councils of the city of Philadelphia the establishment, in other parts of the city, of disinfecting stations similar to that connected with the Municipal hospital. Besolved, That the thanks of the Board are hereby tendered to the sani- tary committee of the Board of Health of the city of Philadelphia, and to its chairman, Dr. Ford, for the full and satisfactory replies made to the inquiries of the Board, and for the valuable information afforded. Besolved, That the municipal disinfecting station of Philadelphia is re- commended as a model to the councils of all cities in this State, and that the State Board of Health urges upon said authorities the importance of making similar provision for the treatment of infected material during the present winter, in view of the possible invasion of Asiatic cholera with the advent of warm weather, as well as of the present existence of an alarming epidemic of small-pox in a neighboring country. The Board then, on motion, adjourned to meet at 7.3D, p. m. Third Session. Pursuant to adjournment, the Board re-assembled at 7.30, p. m., at the same place, the President in the chair. Present, Dr. Dudley, Dr. Germer, Mr. Hering, Drs. Lee, Engelman, Mc- Clelland, and Edwards, constituting the entire Board. The Secretary reported having made a brief inspection of the new drain- age system of the State Lunatic Hospital at Norristown, which had been resorted to in consequence of the previous system having resulted in the contamination of a stream running through the borough of Norristown. On motion, the subject was referred to the Committee on Water-Supply, Drainage, &c, for consideration, observation, and subsequent report. The Secretary then presented a report on the sanitary condition of To- wanda, Bradford county, signed by the most prominent physicians of 15 the place, and requesting advice in regard to the proper means of remedy- ing serious defects of drainage. The report was accepted and referred for publication. On motion of Dr. Dudley, the Secretary was authorized to appoint a special medical inspector for a district of which Bradford county should be the center. A report on the sanitary condition of Millerstown, accompanied by a similar petition, was read by the Secretary, accepted and referred for pub- lication. On motion of Dr. Dudley, the Secretary was instructed to communicate with the authorities of Millerstown, insisting on the adoption of certain sanitary reforms. A similar report from Warrior Run was read, and a similar resolution adopted. A report from Dr. Lewis H. Taylor, of Wilkes-Barro, on the sanitary condition of Sugar Notch, Luzerne county, was then read by the Secre- tary. As showing what could be done by an intelligent and energetic bor- ough council in stamping out a threatening epidemic of typhoid fever, this report was in striking contrast to the majority of those received, and is earnestly commended to the consideration and imitation of all borough au- thorities. Accompanying this report, was a valuable history of the epi- demic, contributed to a local paper by Dr. Davis, of Wilkes- Barre. This was, on motion, adopted as a part of the report, and the whole was then ac- cepted and referred for publication. The next business in order was the consideration of the subject of " In- fected Rags. " The Secretary gave a brief history of the cargo of the bark Lucy A. Nickels. Having received private intelligence that this cargo of five thousand bales of rags from Japan, which the port physician of New York had decided against admitting to that port without disinfection, were to be brought to Philadelphia, he considered it his duty to notify the health officer of Philadelphia of the fact, and to ask to be allowed to appear be- fore the city board of health and present his protest against their being passed. This was courteously granted, but the Board nevertheless permit- ted the rags to be landed in bale and placed in a bonded warehouse. It was for this Board to decide whether it was necessary to take any action in the premises. Much discussion followed, and the President,calling Dr. Engelman to the chair, gave his experience as to the dangerous character of infected rags as disease carriers. On motion of Dr. McClelland, it was then Besolved, That the executive officer be instructed to forbid the removal of the Japanese rags constituting the whole, or a part, of the cargo of the bark Jjucy A. Nickels, from Philadelphia into the rural districts, until they have been disinfected in a manner entirely satisfactory to the Board of Health of Philadelphia. In this connection, the Secretary stated that, just before leaving Philadel- 16 phia to attend this meeting, he had been waited on by a gentleman, who claimed to have discovered a method of disinfection by chlorine, of much superior effectiveness to any process at present in use. Other chemists and manufacturers had also called his attention to proprietary disinfectants, requesting a competitive trial of their products. It was a subject to which the Board might appropriately turn its attention. Dr. McClelland moved that the whole subject of disinfection and the comparative value of various disinfectants be referred to the Committee on Preventable Diseases. It was carried. The Secretary then presented the following communications, viz: From Prof. George G. Groff, of Lewisburg, offering to dispose of a large collection of health charts, etc., to the Board. The Secretary was instruct- ed to examine said charts, etc., and purchase such as appeared available for distribution. From a large number of Clerks of Orphans' Courts and Prothonotaries throughout the State, to whom application had been made for returns of registration of marriages, and of practitioners of medicine and surgery, in- quiring to whom they were to look for compensation for the service re- quired. Dr. McClelland moved that it was the sense of this Board that the said county officers should apply to the county commissioners of their respect- ive counties for compensation. It was carried. From the United States signal officer at Philadelphia, in reply to a re- quest from the Secretary that he would furnish meteorological data for the annual report of the Board, giving the names of a large number of private observers throughout the State. Mr. Hering suggested that the water department of Philadelphia was in possession of data of this nature in reference to the rainfall for eastern Pennsylvania, and he had no doubt would cheerfully furnish them to the Board. The Secretary was authorized to make application to the chief of the water department of Philadelphia for such data in the section referred to. From Mr. R. K. Buehrle, city superintendent of public schools of Lan- caster, calling attention to the fact that it is not an unusual thing for con- sumptives to be teachers in public schools, and suggesting the risk of in- fection to the pupils. On motion of Dr. Dudley, the communication was referred for publication and also referred to the Committee on School Hygiene for consideration. Reports of committees being now in order. Dr. Dudley, chairman pre- sented the report of the Executive Committee, which was accepted and re- ferred for publication. On motion, the Board then adjourned to meet at the same place at 10 a. m., November 12. 17 Fourth Session. Pursuant to adjournment, the Board re-assembled at 10, A. M., Thursday November 12. All the members present. President Germer presiding. Reading of minutes was, on motion, dispensed with. The first business in order was the report of the Committee on Registra- tion and Vital Statistics. Dr. Benjamin Lee, the chairman, presented for the approval of the Board, a blank form of registration of marriages for the use of Clerks of Orphans' Courts in making theirreturns to the B jard, which, after discussion as to whether provision should not be made in it for the registration of marriages between parties of different colors, was approved and ordered to be printed and distributed to the appropriate officers. The Secretary was also authorized to prepare blanks upon the same gen- eral plan, having the medical registration law and the portion of the act creating the State Board of Health bearing upon the subject conspicuously printed upon a cover to be attached to the same, for the registration of practitioners of medicine and surgery, and to have the same printed and to distribute them to the appropriate county officers. On behalf of the Committee on Preventable Diseases and the Supervision of Travel and Traffic, whose report was next in order, Dr. J. F. Edwards, chairman, reported that, in accordance with a resolution of the Board, he had, in connection with the Secretarj', prepared a circular containing " Pre- cautions against Cholera, " which was presented for the consideration of the Board. On motion, the circular was adopted, referred for publication in the an- nual report, and also ordered to be printed and distributed at the discretion of the Secretary. Dr. Edwards further reported that, as instructed by the Board, he had issued a circular letter to the officers of railroads in the State urging the adoption of precautions to prevent the spread of epidemic and infectious diseases, and that he had received satisfactory replies from the Pennsylva- nia Railroad Company and the Baltimore and Ohio Railroad Company, conveying the assurance of their desire to cooperate with the Board in such measures, and reporting the precautions already in use in the form of print- ed circulars for the instruction of employes. The report was accepted, and the circulars referred for publication in the annual report. Dr. Edwards also stated that he had received from the Executive Com- mittee the following letter of instructions : 2 18 State Board of Health, Executive Office, 313 South Fifteenth Street, Philadelphia, September 28, 1885. Joseph F. Edwards, M. D., Chairman, Committee on Preventable Diseases and Supervision of Travel and Traffic. Dear Sir: At a meeting of the Executive Committee held Saturday, September 26th, you were instructed to make a careful investigation into the sanitary condition of the mining populations of this State, including in your inquiries the subjects of habitations, food, beverages, water-supply, habits of life, character and effects of labor, and sanitary condition of mines. Said investigation is expected to cover a period of about three weeks, and to be made at such a time that a full report thereon may be presented to the Board at the regular meeting on the second Wednesday in November. You are authorized to draw upon the Secretary for the sum of one hundred dollars, or as much thereof as may be necessary to meet the expenses of such investigation. (Signed,) Benjamin Lee, Secretary. In obedience to the above instructions, Dr.. Edwards had paid repeated visits to a number of points in the mining regions, and had gained much information that would be of value to the Board, but the field was so wide, and the range of information asked for so extensive, that it would be folly to attempt to make a report at this stage of his investigation. On motion, the action of the Executive Committee was indorsed,and the investigations were ordered to be continued. Dr. Lee, Secretary of the same Committee, reported that, in obedience to the resolution of the Board, he had communicated with the Secretary of the Board of Agriculture, suggesting that the two Boards should cooperate in the effort to prevent the introduction and spread of infectious diseases among our native stock, and had received from Secretary Edge, of that Board, cordial assurances of a desire to maintain an efficient concert of ac- tion for the purposes alluded to. Having learned through the President, Dr. Germer, of the existence of an epidemic of Texan fever among cattle at and near the city of Erie, he had commissioned Dr. Bryce, veterinary surgeon of the Board of Agriculture, to prepare a report of the epidemic for the use of this Board, which, if it pleased the Board, he would read. Permission was accorded, the report was read, and referred for publication, as a part of the report of the committee. A letter from Secretary Edge of the Board of Agriculture, to President Germer upon the same subject was then read, and similarly referred. The report of the Committee on Water-Supply, Drainage, Sewerage To- pography and Mines was then presented by Rudolph Hering, Esq. C E chairman. This consisted of, first, two elaborate maps, prepared under instructions from the Executive Committee, to serve as a basis for future statistical work, in reftrence to the distribution of diseases throughout the State 19 The first map indicated the "distribution of population," by means of a system of colored circles, readily seized by the eye and appreciated by the mind; and the second, the " intensity of travel," on all lines of railroad in the State, by a similar graphic device. On motion of Dr. McClelland, the thanks of the Board were tendered to Mr. Hering for the labor bestowed and ingenuity displayed in the execu- tion of these very valuable maps, and they were referred for reduction and publication. Mr. Hering then, secondly, presented a report on the general subject of the pollution of rivers, with special attention to the pollution of the Schuyl- kill, in the immediate vicinity of the city of Philadelphia, but outside of the jurisdiction of the board of health of that city. This subject had been referred to his committee, by the Executive Committee, in consequence of a communication received from the Board of Health of Philadelphia, call- ing the attention of this Board to the existence of these evils, and request. ing that steps be taken for their abatement. Appended to the report, were the report of the water department of Philadelphia, upon the same subject, and the charge of Judge Thayer, on the subject of the pollution of waters used as a source of water-supply for cities. On motion, the report was adopted, and, together with the addenda, or- dered to be published. The report of the Commiteee on Public Institutions, Buildings and Places, and School Hygiene, Dr. J. H. McClelland, chairman, was then presented as follows : To the President and Members of the State Board of Health of Pennsylvania : Gentlemen : Owing to the brief time which has elapsed since our or- ganization, 3Tour committee can report no special investigations, but, at this time, will offer certain recommendations for adoption by the Board, looking to effective work by the committee during the coming year. Your com- mittee would, thereupon, ask your consideration of the following resolu- tions : Besolved, That the Committee on Public Institutions and School Hy- giene, in connection with the Secretaiy, be instructed to issue a circular addressed to the authorities or proprietors of all hospitals, asylums, public halls, and places of amusement, and churches in this State, requesting them to furnish information as to the sanitary condition of the buildings under their care or in their ownership, with special reference to ventilation, heat- ing, air-space per individual, and water-closet arrangements, and that the portion of the act establishing this Board which refers to this subject be printed on the circular. B solved. That the Committee on Public Institutions and School Hy- giene acting in connection with the Secretary, be instructed to issue a cir- cular addressed to all school authorities throughout the State asking for specific information as to the sanitary condition of the several schools un- der their care or supervision, with special reference to methods of ventila- 50 tion and heating, the amount of air-space provided for each pupil in the school-rooms, mode of lighting, character of water supplied for drinking, and water-closet accommodations, and that the portion of the act creating this Board bearing upon the subject be printed upon the circular. Besolved, That the Executive Committee of this Board be authorized to employ inspectors of schools and other public buildings, who shall be fur. nished with instructions in detail, and clothed with official :, p. m. Presented a draft of by-laws for the govern- ment of the Board, which, with some modifications, was adopted. The Board adjourned at 6, p. m., to meet again at 8, p. m. At the evening session, offered a series of resolutions, looking to the establishment of relations between the different branches of the State government, the National government, and the Boards of Health of other States, and this Board, and outlining the initiatory work of the Board, which were approved by the Board. The Board adjourned at J 0.30, to meet at 9, a. M.,the day following. Friday, July 8. Attended the meeting of the Board at 9, a. m., in the office of the Secre- tary of the Commonwealth. Presented a draft of an address of the State Board of Health and Vital Statistics of the Commonwealth of Pennsylva- nia to the people of Pennsylvania, which was adopted by the Board with modifications. The first duty of the Secretary upon the adjournment of the Board at 12, 25 M., was to establish relations with the Auditor General's Department,which was done in company with the President of the Board. They were re- ceived with much courtesy by the chief clerk of the department, Mr. Thomas McCamant, who furnished the Secretary with blank vouchers and requisitions, and the information necessary for conducting the financial affairs of the Board. The Secretary then visited the Department of Internal Affairs, where, in the absence of the Secretary, he had a very satisfactory interview with J. W. Greenland, Esq., Deputy Secretary of Internal Affairs. The Board being, by the terms of the law, made dependent upon the De- partment of Internal Affairs for its apartments, stationery, etc., he at once made requisition for books, stationery, and desk furniture, necessary for the work of the Board. Owing to the fact that a change was at that moment being made in the department of public printing, the arrangements for the printing of the "Address of the Board to the People of the State" were obliged to be de- ferred. Saturday, July If. Wrote to Dr. E. 0. Shakespeare, of Philadelphia, requesting him to pre- pare a report of the pathological conditions observed in the autopsies made b}' him at Plymouth, Luzerne county, during the present epidemic of typhoid fever in that town; to Dr. Morris S. French, of Philadelphia, re- questing him to prepare a report of the financial outlay and loss, direct and indirect, resulting from the Plymouth epidemic, and Dr. Lewis H. Taylor, of Wilkes-Barre, requesting him to furnish a complete history of the epidemic at Plymouth, accompanied by a map indicating sources of water-supply. Tuesday, July 7. Issued call for special meeting of the Executive Committee. Trans- mitted resolutions of Board to Dr. J. F. Edwards, chairman Committee on Preventable Diseases and Supervision of Travel and Traffic, instructing him to prepare a circular in regard to Asiatic cholera, and to address a communication to the principal officers of all railroads in the State, urging them to adopt sanitary measures and formulate a system of sanitary su- pervision of their trains. Thursday, July 9. Transmitted resolutions of Board to the boards of health of the cities of Philadelphia, Pittsburgh, and Erie, calling for immediate reports. *> Friday, July 10. Attended meeting of Executive Committee, at executive office of the Board, No. 313 South Fifteenth street, Philadelphia. Sent resolutions of Board to the medical journals and the daily press. 26 Saturday, July 11- Received notification from Dr. David Engelman, of Easton,of his aP* pointment as a member of the Board to fill the vacancy caused by the ap- pointment of Dr. Benjamin Lee as Secretarv. Notified the other members of the Board, in writing, of the appointment. Monday, July 18. Received communication from the Board of Health of Philadelphia, con- taining a resolution calling the attention of the Board to the existence of serious nuisances existing on the west bank of the Schuylkill river, as well as at other points outside of the limits of the city of Philadelphia, affecting the purity of the city's water-supply, and requesting the Board to take steps toward their abatement. Went to Harrisburg. Devised forms for letter-book, library record, cash-book, letter-heads, etc., etc. Tuesday, July 14- Interviews with Secretary of Internal Affairs and Deputy Secretary Greenland. Made arrangements for a full set of books for the records of the Board. Interview with State Printer, Mr. E. K. Meyers; arranged for printing the act establishing the Board, the "Address of the Board to the People of the State," and forms of letter-heads, etc. Wednesday, July 15. Returned from Harrisburg, and attended regular quarterly meeting of the Executive Committee at the executive office. Reported favorable result of an interview with Attorney General Cassidy on the question referred by the Board for his decision as to its authority to order inspection of food and drugs. Thursday, July 16. Consulted all the members of the Board by letter as to the authority of the Board to create salaried offices. Friday, July 17. Received from the Committee on Health of Councils of the city of Alle- ghen}r, complaint of nuisances existing immediately outside of the city,with a request for an inspection. Saturday, July 18. Wrote to Harrisburg Stencil Works ordering seal and press. Tuesday, July 21. Wrote to Dr. L. H. Taylor, of Wilkes-Barre, requesting him to ascertain at what house in Philadelphia the individual lodged who was supposed to 27 have carried the seeds of typhoid fever from that city to Plymouth, with a view to instituting an inspection of the premises and neighborhood. Wednesday, July 22. Made application, in writing, to members of Congress for copies of United States census reports, and to the members of the Legislature for Pennsyl- vania geological survey reports for the library of the Board. Friday, July 24- Completed arrangements for ordering printed matter directly from the Superintendent of Public Printing instead of from the Department of In- ternal Affairs. Corrected proof of "Address of the Board." Monday, July 27. Forwarded lists of standing committees to all the members of the Board Tuesday, July 28. Telegraphed to Dr. Germer to make an inspection of Camp Gallagher, and to Dr. Engelman to make an inspection of Camp Sigfried. Wednesday, July 29. In company with Dr. Pemberton Dudley, made a sanitary inspection of Camp Muhlenberg, near Media, First brigade, Pennsylvania National Guard. Purchased works on sanitarj- subjects for the library of the Board. Friday, July 31. Wrote to General Snowden, commanding Camp Muhlenberg, transmit- ting report of inspection, for the information of his department. Monday, August 3. Received complaint of nuisance existing at Rosemont, Montgomery county, through the secretary of the Philadelphia Board of Health, with report of cases of fever attributed to the same. Thursday, August 6. Made an inspection of the quarantine station of the port of Philadelphia, at the Lazaretto, in company with Dr. John H. Rauch, secretary of the State Board of Health of Illinois, and Dr. Cleemann, of the Philadelphia Board of Health. Addressed a communication to His Excellency, President Cleveland, an- 2S nouncing the organization of the Board, and requesting recognition as re- gards the distribution of the national appropriation to meet epidemics, in case of the occurrence of a sanitary emergency. Friday, August 7. Applied to Postmaster General Vilas for post route maps of Pennsylva- nia, for the use of the Committee on Water-Supply, Drainage and Topo- graphy. Monday, August 10. Sent instructions to Dr. Pemberton Dudley to investigate the premises where the originator of the Plymouth epidemic contracted the disease in Philadelphia. Wednesday, August 12. Notified Daniel Kerrigan, of Rosemont, Montgomery county, to abate nuisance on his premises. Sent similar notice to William Moulden, in same village. Acknowledged donations to library from twenty-four sources. Monday, August 17. Obtained opinion from Attorney General Cassidy as to the proper pros- ecuting officer for the Board. Tuesday, August 18. Consulted " Purdon's Digest of Laws of Pennsylvania," in order to de- termine mode of organization of local boards of health, as at present estab- lished by statute. Wednesday, August 19. Went to Quakertown, and delivered an address before the Lehigh Valley Medical Association, on " Proper Organization of Local Boards of Health in Pennsylvania." Friday, August 21. Addressed a communication to His Excellency, President Cleveland on the importance of vigilant quarantine at Lewes, at the mouth of Delaware bay, and an appropriation for the National Board of Health. Wednesday, August 26. Attended special meeting of the Executive Committee, at the executive office, Philadelphia. Thursday, August 27. Transmitted financial report of Board, for the first quarter, to the Audi- tor General, with requisition for appropriation. 23 Wednesday, September 2. Notified by the Board of Health of Philadelphia of the existence of cases of small-pox at Spring Mill, Montgomery county. Requested said board to send disinfector and vaccinator to the place indicated, at the expense of the State Board. Subsequently, had a personal interview with the Board of Health of Pniladelphia on the question of cooperation between the two boards in dis- tricts lying outside of the city limits. Addressed letter of inquiry to Dr. Germer in reference to Texas fever among cattle at Erie, and preparation for small-pox. Wrote to secretaries of State Boards of Health of New Jersey and Del- aware, requesting them to take part in an inspection of the United States Marine Hospital Service quarantine station at Lewes, Delaware. Friday, September 4. Visited quarantine station of United States Marine Hospital service at Lewes, Delaware, in company with delegation of the Board of Health of Philadelphia, Surgeon Bailhache, of the Marine Hospital Service, and Dr. Marshall, of the State Board of Health of Delaware. Tuesday, September 8. Authorized Dr. J. Bryce, State Veterinary Surgeon, of Erie, to make a report on the recent epidemic of splenic fever at that place. Subscribed to Sanitary Monitor and Sanitarian for the use of the Board. Wrote to their Excellencies, President Cleveland and Governor Pattison, transmitting the "Address of the Board." Made arrangements for addressing circulars to all physicians throughout the State, announcing the existence of the Board, and claiming their active cooperation in its work. Thursday, September 17. Left for Allegheny City, with Mr. Rudolph Hering, of the Board, to investigate nuisances referred by the Board of Health of that city. Friday, September 18. Made a tour of inspection of the abattoir on Herr's Island, in the Alle- gheny river, of the Spring Garden district, and the Butcher's Run district, in company with Mr. Hering, chairman of the Committee on Water-Supply and Drainage. Dr. J. H. McClelland, of Pittsburgh, a member of the com- mittee, the health officer of Allegheny, and the Committee on Health of the Councils of the city of Allegheny, acting by virtue of a special act of legislation as a board of health. 30 Saturday, September 19. Inspected the water-supply of the city of Allegheny, examining the water works and point of in-take, and following up the river for a distance of eight miles, to a point above the sources of pollution from the almshouse and work-house, both of which institutions we visited cursorily, and were much pleased with their cleanliness and evidence of care in sanitary provi. sions. Left Pittsburgh at 11.30, p. m. Wednesday, September 23. Had an interview, by appointment, at the executive office, with Auditor Ely, of Whitemarsh township, Montgomery county, in regard to precau- tions against small-pox at Spring Mill. Thursday, September 24- Had an interview, by appointment, at the executive office, with residents of Rosemont, Montgomery county, in reference to nuisances in that village supposed to be prejudicial to the public health. Received information from Major Veale, health officer of the city of Phila- delphia, of the existence of cases of typhoid fever at West Fernwood, Dela- ware county, and of insanitary conditions at that place, supposed to be the cause of the same. Friday, September 25. Addressed a communication to the Board of Health of Philadelphia, allud- ing to the fact that the health of the city was constantly menaced by in- sanitary conditions maintained in the districts immediately outside of the city limits, and suggesting that some plan of cooperation might be agreed upon by which the trained inspectors and disinfectors of the city board could act under the authority of the State Board in investigating and re- moving such sources of danger. Correspondence with the complainants in regard to the nuisances at Rosemont. Saturday, September 26. Attended a special meeting of the Executive Committee, called to take action in regard to the method of procedure against parties maintaining nuisances. Had an interview with Dr. Taylor, medical inspector, and Mr. Kennedy, disinfector and nuisance inspector, of the Philadelphia Board of Health, and gave them instructions to make an inspection of the premises reported to be in an insanitary condition at Fernwood, Delaware county. Sunday, September 27. Visited Fernwood, and made a personal investigation of the house in 31 which the reported cases of typhoid fever were lying, and in which one patient had died of that disease. Met Dr. Roland, the attending physician, saw the patients with him, and recognized them as being ill with typhoid fever. Found very filthy conditions, both on the premises and in the road in front of them. Tuesday, September 29. Gave Dr. J. F. Edwards, a member of the Board, written instructions to make a sanitary inspection of the principal mining villages of the State, es- pecially investigating the modes of life, habitations, food, and habits of the inhabitants, drainage and water-supply of the villages, etc.. and to report to the Board at its next regular meeting. Wednesday, September 30. Appointed Dr. William B. Atkinson, of Philadelphia, to the position of special medical inspector of the Board, for the district including Phila- delphia and the adjacent counties, subject to the approval of the Board. From the foregoing statement of the work of the Secretary during the past three months, it is evident that the first and most pressing want of the State, from a sanitary point of view, is the organization of boards of health in the rural districts. What precise form this organization shall take, it is for the Board, in its wisdom, to decide, and to recommend it to the Legislature at its next meeting. The Secretary is strongly impressed with the belief, founded upon the experience of other States, whose health organization is of some years' duration and has been eminently successful, that the township will be found to be the unit of territory, and of official supervision, best suited for the maintenance of efficient and intelligent over- sight of the interests of the lives and health of its inhabitants. At the same time, he is prepared to acquiesce in any decision of the Board upon the sub. ject, and to do all he can to make the plan decided upon effective. He has been impressed, in his study of the political life of the people of the State, with the remarkable fact that the majority of the population are living en- tirely without local self-government. The town-meeting of New England, an institution which has done so much to maintain public spirit and promote good order and prosperity there, is entirely unknown here. The several township officers have each their several duties to perform, quite inde- pendently of one another, and never meet in council to consult upon the general interests of the town. The saying that " there is nothing certain in this world but death and taxes " is eminently true of this State, for as- sessors abound, and health is without protection. That the Common. wealth, generally, should have maintained so fair a reputation for good order, prosperity, and salubrity, with so loose a system of local govern- ment, speaks volumes for the capacity of its people for individual self- si government, their self-respect, and their respect for the rights and regard for the well-being of their neighbors. Should the officers of the townships, or such of them as might seem expedient, be by law instructed to asso. ciate in the protection of the public health, it would be a step in advance towards a more thorough organization of many other important interests as well. The next most urgent need is a proper appreciation, on the part of bo- rough councils, of the grave responsibilities devolved upon them by the laws of the Commonwealth as the conservators of public health. Every borough council in this State is, in point of fact, a board of health, pos- sessed of absolute authority for the removal and abatement of" nuisances " prejudicial to the public health, and the adoption of measures necessary to control and stamp out infectious diseases. Comparatively few of them appear to understand this fact in all its bearings, and it will be for the Board to furnish them with a brief compend of the enactments upon this subject, and urge them to take such measures as may be necessary to make them operative. The registration of vital statistics—a function of the Board of extreme importance—is delayed from the fact that the act establishing this bureau provides for no compensation for the officers to whom the Board would naturally look for returns, namely, in the case of the marriages, the Clerks of Orphans' Courts, and in that of* medical practitioners, the Prothonotaries. Many of these gentlemen have courteously responded to the request of the Board, but a large number protest, and properly so, against being compelled to do work without pay. The returns are, therefore, so incomplete that it will be unwise to attempt to present them at present. Copies of the forms issued by the Board for this purpose accompany the report. It is to be hoped that the Legislature, at its next session, will see the justice of remedy- ing this omission, and the Board should propose an amendment to the law for that purpose. Applications for relief from insanitary conditions have reached the Secretary from the most distant parts of the State, showing that the people were really waiting impatiently for the erection of a health de. partment, and wherever the Secretary has felt authorized to interfere, his decisions have been received with deference and regarded as final. The great epidemic of typhoid fever in Plymouth, Luzerne county, had entirely spent its force when the Board was organized, and it is a matter of congratu- lation that since that time no serious outbreak of pestilential disease has oc- curred in any part of the State. The threatened epidemic of small-p^x at Lafayette, Montgomery county, which might readily have extended to Philadelphia, was promptly nipped in the bud by the concurrent action of the Board of Health of Philadelphia with this Board. The introduction of Texan, or splenic, fever among cattle at Erie called for prompt interference on the part of the President of the Board Dr. Germer, the energetic health officer of Erie, who, with the aid of State 33 Veterinarian Bryce, succeeded in limiting the disease to a comparatively small number of cattle. As the Board announced in its "Address to the People," its aim is not to obtrude its work upon the public notice, or endeavor to create sensations, but quietly and understanding^ to make its influence felt in every portion of the State, in educating the people in matters pertaining to the promotion of health, and to stimulate and perfect sanitary organization, and it is a matter for congratulation that it has been able to devote the first few weeks of its existence principally to those ends without being called upon by any great emergency for the more public exercise of its powers. The number of written communications received and personally read by the Secretary has been one hundred and eighty. The number of commu- nications written by the Secretary has been three hundred and eighteen. The number of volumes purchased for the library of the Board is twenty- two : The Plumber and Sanitary Houses, S. S. Hellyer; Manual of Prac- tical Hygiene, Parkes, two volumes ; Filth Diseases and Their Prevention, John Simon, M. D., F. R. C. S.; How to Disinfect Our Homes, B. W. Palmer, A. M., M. D.; Ventilation and Heating, Billings; American Sani- tary Engineering, Philbrick; Sanitary Examination of Water, Air, Food, Fox ; How to Drain a House, Waring ; Public Health Reports and Papers, American Public Health Association, ten volumes; Brightly's Purdon's Digest, two volumes; Medical Directory, 1885, Philadelphia, and States of Pennsylvania, New Jersey, Delaware. The number of volumes presented to the Board is as follows : Reports of Boards of Health, National, State, and Municipal, the gift of the several Boards, sixtj^-nine; Pennsylvania Second Geological Survey, the gift of the Honorable Robert Adams, Jr., and of the Honorable David Engelman, fifty-eight; Annual Reports of Secretary of Internal Affairs of Pennsylvania, the gift of Honorable J. Simpson Africa, seven ; Reports of Pennsylvania Geological Survey, the gift of the Honorable James Gay Gor- don, fifteen ; Report of Board of Public Charities, gift of the Honorable Robert Adams, Jr.,; Report on Agriculture of Pennsylvania, gift of the Honorable Robert Adams, Jr.; two copies Smull's Legislative Hand-Book, the gifts of the Honorable Robert Adams, Jr., and Honorable James Gay Gordon, respectively ; Volume XI, Tenth Census of the United States on Mortality and Vital Statistics, and two volumes Compendium of the Tenth Census, the gift of the Honorable H. H. Bingham ; Annual Reports of the Water Department of Philadelphia, 1882,1883, 1884, ten copies each, the gift of Col. William Ludlow, thirty ; making a total of volumes now in the possession of the Board of one hundred and eighty-four. The number of pamphlets received has been one hundred and fifty-eight. Besides these, the Board is indebted to its President, Dr. Germer, for a number of volumes of the Sanitarian and many German periodicals on sani- tary subjects, as well as a large number of daily papers, from which cut- 3 34 tings have been made and filed for reference. The Secretary has subscribed to the Sanitarian and the Sanitary Monitor. The following circulars and forms have been sent out from this office, or are in the hands of the printer : Address to the people of the State of Pennsylvania. Circular to the cities of Philadelphia, Pittsburgh, and Erie, in reference to precautions against cholera. Circular to physicians in Pennsylvania. Circular to editors of newspapers in Pennsylvania. Circular to State and other Boards of Health. Form for registration of practitioners of medicine and surgery. Form for registration of marriages. Regulation regarding the abatement of nuisances. Regulations for slaughter-houses, bone-boiling, or other similar establish- ments. Form for complaints of nuisances. Form for notices to abate nuisances. Circular of precautions against cholera. Circular of precautions against small-pox. Regulations for the sanitary supervision of travel and traffic. Distribution of Act, Address, and Circulars. Copies of the " Act to establish a State Board of Health," and of the 'Address of the State Board of Health to the people of Pennsylvania," were sent to His Excellency, the Governor of Pennsylvania, and to all heads of departments at Harrisburg; to the mayors of all cities, the bur- gesses of all boroughs, and supervisors of all townships and villages in Pennsylvania; to the members of the Pennsylvania Legislature, to all judges, district attorneys, and prothonotaries, and to all boards of health in Pennsylvania; to His Excellency, the President of the United States, and all heads of departments at Washington. Copies of the act and of a circular letter to physicians were sent to all physicians in Pennsylvania. Copies of the act, of the address, and of a circular letter to editors were sent to six hundred editors in Pennsylvania. Copies of the act and of the address were sent to all County medical so- cieties in Pennsylvania; to all State medical societies in the LTnited States and Canada. Copies of the act, of the address, and of a circular letter to boards of health were sent to all State boards of health in the United States and Canada, to the boards of health or health officers of all large cities in the United States, and to the secretaries of National boards of health or health bureaus of all European countries. The following is a list of printed matter and stationery furnished to the Board by the Superintendent of Public Printing, Honorable W. Hayes 35 Grier, on requisition of the Secretary, and in accordance with forms devised by him : One record book for library. Five hundred half-sheet letter blanks for acknowledging receipt of books, etc. Ten thousand postal wrappers with arms of State and name of Board. Seven thousand circulars to physicians. Six hundred circulars to editors. Sixteen thousand complimentary slips. Five hundred sheets unruled letter paper with heading of Board. Two hundred and fifty postal notices of meetings of Board. Three hundred and fifty postal notices of meetings of Executive Com- mittee. Four hundred postal acknowledgments. Five hundred notices of nuisances. Three hundred complaints of nuisances. Five hundred addressed envelopes. Five hundred circulars to prothonotaries and clerks of orphans' courts. Two hundred circulars to boards of health. One thousand circulars, regulations for slaughter-houses, etc. Five hundred postal cards with heading. Two hundred postal cards addressed. Twenty thousand copies circular, " Precautions against cholera." Twenty thousand copies circular, " Precautions against small-pox." The following is a list of books, stationery, etc., furnished for the use of the Board upon the requisition of the Secretary by Deputy Secretary Green- land, of the Department of Internal Affairs : One book for minutes of the Board. One book for the minutes of the Executive Committee. One book for record of letters. One book for journal of Secretary. One book for casb account. One book for ledger account. Three scrap-books. Twelve maps of Pennsylvania. One letter-copying press. Four letter-press books. Ten thousand copies address of State Board of Health to the people of Pennsylvania. Ten thousand copies act to establish a State Board of Health. Two thousand letter-heads. Two thousand note-heads. Two thousand large envelopes. Two thousand small envelopes. 36 The following is a list of articles purchased for the use of the Board by the Secretary : One dozen document boxes. One piece rubber. One box rubber bands. One nickel blotter. One cyclostvle. One seal with press. Two tin signs. One fountain pen with pocket. One copying book. One bottle copying ink. REPORT OF SECRETARY AS TREASURER. The Secretary begs have respectfully to report: That there was received from the State Treasurer, July 3, 1885, the appropriation for the first quarter, . . . . $1,250 00 And September 3, 1885, the appropriation for the second quar- ter, ....................... 1,250 00 Making a total of receipts,................$2,500 00 That there have been expended, up to October 1, 1885, for traveling and other necessary expenses of members while on duty,.......... $193 85 For postage,................. 130 15 For books and maps,............ 29 05 For furniture, .............. 51 20 For clerical services,............. 8 00 For scientific report, .......... 10 00 For express, telegraph, etc.,.......... 14 18 For salary of Secretary,............ 750 00 ---------- 1,186 43 Leaving a balance in the treasury October 1, 1885, of ... . $1,313 57 Respectfully submitted. Benjamin Lee, CONSTITUTION. The Constitution of the State Board of Health and Vital Statistics of the Commonwealth of Pennsylvania is the act of Legislature establish- ing the Board, approved June 3, 1885. of which the following is the correct text: AN ACT To establish a State Board of Health for the better protection of life and health, and to prevent the spread of contagious and in- fectious diseases in this Commonwealth. Section 1. Be it enacted by the Senate and House of Bep- resentatives of the Commonwealth of Pennsylvania, in Gen- eral Assembly met, and it is hereby enacted by the authority of the same, That the Governor, by and with the advice Manner of appoint- and consent of the Senate, shall appoint six persons, a ma- men ' .,,... Number of mem- jority of whom shall be physicians of good standing, grad- bers. nates of regularly chartered and legally constituted medical colleges, and of not less than ten years' experience in the practice of their profession, and one of whom shall be a civil engineer, who, together with the Secretary, the mode of whose appointment is hereinafter provided for, shall con- stitute and be designated as the State Board of Health and Vital Statistics of the Commonwealth of Pennsylvania. Of the six persons first appointed, two shall serve for two years, Term of service. two for four years, and two for six years, from the first day of July next following their confirmation ; and the Gover- nor shall thereafter biennially appoint, by and with the ad- vice and consent of the Senate, two persons, of the same professions as those whose terms of office have just expired, to be members of said Board, to hold their offices for six years from the first day of July next following their con- firmation, and until their successors are appointed, except- ing the secretary, who shall continue in office as hereinafter provided ; but an}" member may be re-appointed. Any va- cancy occurring in said Board during a recess of the Leg- islature shall be filled by the Governor uotil the next regu- lar session of the same. 38 •ation?' °f °rgani" Section 2. As soon as possible after the appointment of the first six persons, as aforesaid, they shall meet in the of- fice of the Secretary of the Commonwealth, and shall pro- ceed, under the direction of the latter officer, to determine by lot which of them shall serve for the respective terms of two, font, and six years. Before entering upon the duties of the office, they shall take the oath prescribed for State officers by the Constitution of the State, and shall file the same in the office of the Secretar}- of the Common wealth,who, upon receiving the said oath of office, shall issue to each a certificate of appointment for his respective term of office determined as aforesaid ; upon receiving which they shall possess and exercise the powers, and perform the duties, of said Board as defined in this act. Immediately after having taken the oath of office, they shall organize, by electing one of their number to be president, and by appointing a proper person, who shall be a physician of good standing, of not less than ten years'professional experience, and a graduate Appointment of sec- of a legally constituted medical college, to be secretary of said Board, who shall hold his appointment until removed by the appointment of his successor or otherwise. The Board ma}' elect one of its own members secretary,in which case the vacancy thus created shall be filled by the Governor in the same manner as a vacancy caused in any other way. The president shall be elected annually. No member of the Board, except the Secretary, shall, as such, receive any sal- member^tob^plid! arv 5 Dut the actual traveling and other expenses of any member, while engaged on the actual duties of the Board, shall be allowed and paid on presentation to, and approval b}% the Auditor General of an itemized account with vouchers annexed. Duties of secretary. Section 3. The secretary shall be the executive officer of the Board, and shall have all the powers and privileges of a member of said Board, except in regard to voting upon matters relating to his own office and duties as secretary. He shall receive an annual salary of two thousand dollars, which shall be paid him in the same manner that salaries of other State officers are paid ; and such necessary expenses as the Auditor General shall audit, on presentation of an itemized account with vouchers annexed and the certificate of the Board, shall be allowed him. Time and place of Section 4. The said Board shall meet at least once ever> meetings. s^x m0nths, and may also hold special meetings as fre- quently as the proper and efficient discharge of its duties shall require, in the capitol building at Harrisburg (unless Salary of secretary. 39 otherwise ordered), and the rules and by-laws of the Board shall provide for the giving of proper and timely notice of all such meetings to every member of the Board. The Sec- retary of Internal Affairs shall provide and furnish such apartments and stationery as said Board may require in the discharge of its duties. A majority of the members of the Board shall, at any regular, called, or adjourned meeting, organize and constitute a quorum for the transaction of business. Section 5. The State Board of Health and Vital Statis- Duties and func- tics shall have the general supervision of the interests of nned.° 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 of epidemic diseases, including those of domestic animals, the sources of mortality, and the effects of localities, employments, conditions, habits, food, beverages 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 it important, institute sanitary inspections of public institutions or places throughout the State. It shall codify and suggest amendments to the sanitary laws of the Com- monwealth,and shall have power to enforce such regulations as will tend to limit the progress of epidemic diseases. Section 6. In cities, boroughs, districts, and places having powers of board. no local Board of Health, or in case the sanitary laws or regulations in places where boards of health or health of- ficers exist should be inoperative, the State Board of Health shall have power and authority to order nuisances, or the cause of any special disease or mortality, to be abated and removed, and to enforce quarantine regulations, as said Board shall direct. Any person who shall fail to obey, or shall violate, such penaity for vioia- order shall, on conviction, be sentenced to pay a fine of not tl(mornes,ect' more than one hundred dollars at the discretion of the court. Section 7. It shall be the duty of the State Board of Function of board Health and Vital Statistics to have general supervision of the in registration. State system of registration of births, marriages, and deaths, of prevalent diseases, and of practitioners of medicine and surgery, to prepare the necessary methods, forms, and blanks for obtaining and preserving such records, and to insure the faithful registration of the same in the several counties and in the Central Bureau of Vital Statistics at the capital of 40 the Slate. The said Board shall recommend such forms and amendments of laws as shall be deemed to be necessary for the thorough organization and efficiency of the registra- tion of vital statistics throughout the State. The Secretary of the State Board of Health and Vital Statistics shall be the superintendent of registration of vital statistics ; as su- pervised by said Board, the clerical duties and safe-keeping of the Bureau of Vital Statistics thus created shall be pro- vided for by the Secretary of Internal Affairs, who shall Secretary of Inter- im! Affair* to pro- vide clerical ;iev! business. 10. Adjournment. Section 3. At special meetings, the following shall be the order of busi- ness : 1. Registration of names of members present. 2. Reading of minutes. 3. Presentation of special subject. 4. Presentation of accounts. 5. Adjournment. Article V. REPORT OF THE SECRETARY. The Secretary shall, at the meeting in November, make a full report of his official acts during the year ending October 1 preceding, and accom- pany the same with recommendation of such measures as he shall deem necessary for the preservation of the public health and the faithful execu- tion of the law, and this report shall constitute the basis of the report of the Board to be presented to the Governor on or before the first Monday of De- cember in each year, in accordance with the requirements of section 10 of the act constituting this Board. Article VI. STANDING COMMITTEES. Section 1. The following standing committees shall be appointed by the President of the Board at the meeting in November : 1. An executive committee. 2. A committee on registration and vital statistics. 45 3. A committee on preventable diseases, disinfectants and supervision of travel and traffic. 4. A committee on water-supply, drainage, sewerage, topography and mines. 5. A committee on public institutions and school h\Tgiene. 6. A committee on adulterations, poisons, explosives and other special sources of danger to life and limb. 7. A committee on sanitary legislation, rules and regulations. Section 2. Such papers, communications, or other matter received by the Secretary, as he may deem proper for the purpose, he shall forward to the chairman of the appropriate committee, after filing the titles and memo- randa, which shall be recorded in the Secretary's office. Section 3. All reports of committees shall be in writing. Article VII. finances. Section 1. All accounts against th-e Board shall be filed with the Secre- tary, and may be presented at any meeting of the Board, when they shall be acted on in open session, and all accounts allowed shall be indorsed, " approved by order of the State Board of Health and Vital Statistics," and shall be indorsed by the President and Secretary. Section 2. The Secretary shall record, in a book reserved for that pur- pose, all accounts of expenditures ordered or made by the Board and its several members, and shall, before presenting any bill, account, or voucher to the Auditor General, cause a copy of the same to be recorded, and shall have stamped upon such voucher, account, or bill the audit and date as the Executive Committee shall provide. Article VIII. EXECUTIVE COMMITTEE. Section 1. The Executive Committee shall consist of not less than three members, including the Secretary of the Board, who shall be secretary of the committee. Section 2. It shall have the general supervision of the finances, pur- chases, expenses, and publications of the Board. Section 3. Its office shall be in the city of Philadelphia until otherwise ordered. Section 4. It shall hold meetings at least quarterly, and as much oftener as it shall deem necessary, and shall meet on the call of the chairman. Section 5. With the approval of the Board or of the Executive Committee, the Secretary shall make requisition upon the Secretary of Internal Affairs for such stationery, printed forms, clerical labor, apartments, and furniture as shall be needed for the use of the Board. Section 6. No purchases shall be made or expenditure incurred except 46 by order of the Board or of the Executive Committee, and the Executive Committee shall not have power to incur any indebtedness beyond the amount appropriated by law. Article IX. RULES OF ORDER. In conducting the business of the meetings of the Board, the parliamen- tary rules governing the Legislature of the State of I'ennsylvania shall be adopted so far as they are applicable to its deliberations. Article X. SEAL. The seal of the Board shall be circular in shape, bearing on the circum- ference the words, •' State Board of Health. Pennsylvania. 1885. Salus Populi Suprema Lex,'1'1 and in the center the coat of arms of the Common- wealth. Article XI. AMENDMENTS. These by-laws may be altered or amended at any regular meeting of the Board by a two-thirds vote of the members present. {State Board of pealfsh and Vital {Sfotigliicg Commonwealth of Pennsylvania. OFFICERS AND MEMBERS. President. EDWARD WILLIAM GERMER, M. D., of Erie. Secretary. BENJAMIN LEE, M, D., of Philadelphia. Members. EDWARD WILLIAM GERMER, M. D., of Erie. PEMBERTON DUDLEY, M. D., of Philadelphia. DAVID ENGELMAN, M. D., of Easton. JOSEPH F. EDWARDS, M. D., of Philadelphia. RUDOLPH HERING, C. E., of Philadelphia. J. H. McCLELLAND, M. D., of Pittsburgh. BENJAMIN LEE, M. D., of Philadelphia. Place of Meeting. Supreme Court-room, State Capitol, Harrisburg, (unless otherwise or- dered.) Time of Meetina. Second Wednesdays in May, July, and November. 48 EXECUTIVE COMMITTEE. Members, PEMBERTON DUDLEY, M. I)., Chairman. RUDOLPH HERING, C. E. JOSEPH F. EDWARDS, M. I). BENJAMIN LEE, M. D., Secretary. Place of Meeting, (Until otherwise ordered.) Executive Office, 1532 Pine street, Philadelphia. Time of Meeting. Third Wednesdays in January, April, July, and October. Secretary's Address. 1532 Pine street, Philadelphia. Bureau of Begistration of Vital Statistics. Department of Internal Affairs, State Capitol, Harrisburg. State Superintendent of Begistration of Vital Statistics. BENJAMIN LEE, M. D. 49 ADDEESS OF THE 'State Board uf Health and Vital Statistics of the Commonwealth of Pennsylvania. To the People of Pennsylvania: The kt State Board of Health," called into existence by the will of the peo- ple of this great Commonwealth, expressed through its representatives in General Assembly met, and approved by its chief executive, enters upon the discharge of its grave duties and the exercise of its important powers deeply impressed with the sense of the responsibilities which devolve upon it, and reverently invoking the blessing of the God of nations upon its la- bors. It desires at the outset so to define its position as to lead to the im- mediate establishment of those friendly reciprocal relations between itself and the public, which can be securely founded only upon a vigilant care for the well-being of the people by the State on the one side, and "a decent re- spect for the government by the people " on the other. It is not too much to say that the creation of this Board makes a new era in the history of the State, since it indicates the recognition by our legisla- tors of the truth, reflected from the minds of the people, once so well for- mulated by England's brilliant prime minister, Lord Beaconsfield, that " the health of the people is the first duty of the statesman." The " Dec- laration of Rights," which constitutes Article I of the Constitution of this Commonwealth, and is, therefore, a part of its organic law, proclaims that s all men have certain inherent and indefeasible rights; among which are those of enjoying and defending life and of pursuing their own happiness." It is the conviction of this Board that these necessarily include the inhe- rent right to the enjoyment of pure air. pure water, and pure soil, since with- out them life can neither be enjoyed nor successfully defended, and the pursuit of happiness becomes a cruel mockery. It further conceives one of its paramount duties to be to see that no man or combination of men, however rich or powerful, shall be allowed to trespass on these rights of the humblest citizen, whether from negligence, from greed or gain, or sim- ply from ignorance. It is no mere empty figure of speech by which we call disease a public enemy. It requires to be met with organized resistance, and this resistance must be directed by a responsible head. When pesti- lence invades our borders, that head must be clothed with powers analo- gous to those of a general when the foe is at the gates. Sanitary law, in 4 NATIONAL LIBRARY OF MEDICINE BETHESDA 14, MD. 50 place of martial law, is then proelaimed, and what are, in times of general health, recognized as sacred rights of person and property are sternly set aside. When such emergencies arise, as they inevitably must at some time, and as they possibly may at no distant day, the Board confidently looks to the sound sense and self-control of the people to lead them to sub- mit cheerfully to whatever temporary inconveniences it may be deemed necessary to impose. The abridgment of the license of the individual— nay, at times, even of his rights—for the sake of protecting the rights of the community, is the very foundation-stone of civilized life. Civil organ. ization cannot exist without it. Hence, restrictions are placed upon cer- tain kinds of business which threaten injury to human beings. We pro. hibit the merchant from exercising his right of unrestricted barter and sale and storage in the matter of explosives. He is not allowed to keep any considerable quantity of gunpowder, nitro-glycerine, or dynamite within certain limits, or within a certain distance of an inhabited house. Ever}* one acquiesces in the justice of this restriction of his rights. But if a pow- der magazine had exploded in the heart of Philadelphia on the first of Jan- uary, 1872, this calamity, frightful as it would have been would not have caused a tithe as many deaths, would not have produced a hundredth part as much suffering, would not have afflicted an approach to as great a pecu- niary loss as did the epidemic of small-pox which was then raging. Thou. sands of lives, tens of thousands of maimed, disfigured, or invalided persons, millions of money—such was the cost of that explosion of disease. Is it too much to insist that all our citizens shall submit to that slight infringe- ment of their personal rights, which an immense majority voluntarily un- dergo, in order that another such calamity shall henceforth, forever, be an impossibility within the borders of this Commonwealth ? Heretofore, it has been only a straggling, desultory warfare which has been waged against preventable disease within our borders. Isolated health boards and solitary sanitarians, here and there, have earned on a gallant fight, but against great odds, because lacking the element of intelligently combined action, which is essential to success. A prominent English med- ical review, speaking of our fragmentary and disjointed system of hygienic administration, if system it can possibly be called, says : " There is much good work done under a species of semi-authority and sufferance, and by volunteer exertion, but the plaint is the lack of a central authority and ad- ministrative power to make sanitary supervision an effective reality. The water-supply of a considerable portion of a great city is abominably pollut- ed, but no sufficient authority is found to remedy it; there are numerous and deplorable nuisances, but no effective inspectors ; there are many facto ries and work-shops, but no laws to secure their hygienic condition or the physical well-being of those employed in them ; there is evidence unmis- takable of the sale of unwholesome and adulterated food, but it is nobody's business to meddle with it and protect the public; there are on all sides complaints of building operations in defiance of sanitary laws, and no one 51 with authority to attend to them and take action against them ; and lastly, intra-mural interments stand condemned in all civilized communities, but the public authorities of the American cities have no power to stop them." It will be the business of this Board to see to it that this stigma upon our civilization is removed ; to collect and coordinate these scattered forces, marshaling them into a regular army of well-drilled sanitary troops, armed and equipped with all the appliances that modern science can suggest for stamping out pestilence and conquering contagion ; to strengthen feeble health organizations, and to establish new ones where none exist, until there shall not be a hamlet in the entire domain of the State without its regularly constituted health-officers in direct communication with the central head. Where the hygienic interests of different sections appear temporarily to conflict, the Board will use its best efforts to harmonize them. It often happens that the sanitary undertakings of one city prove the opposite of health-giving in their results in regard to another. The towns and cities which line the Schuylkill, for example, meritoriously wash themselves in that limpid stream, and so far do well, but unhappy Philadelphia, with the typhoid virus creeping through her veins, shudders as she unwillingly drinks their defiled washings. That they do this at their peril, the story of afflicted Plymouth only too clearly demonstrates, for let it not be forgotten that Philadelphia sowed the seed from which death has just reaped so fear- ful a harvest in that far-off mountain village. Hence, the necessity for the consideration on the part of the central sanitary authorities of the difficult problem afforded by "the pollution of rivers," in a broad, generous spirit, with a view to determining methods whereby one community may improve its own health conditions without impairing those of a neighbor. In an immense territory like our own, larger than that of most of the nations of Europe, with its great diversity of surface, its lofty mountain ranges, and its immense forests, wonderful opportunities exist for sanitary- engineering on an immense scale,determining in what direction water-sheds shall be encouraged and in what diverted ; to what extent private corpora- tions are to be allowed to jeopardize the health of large sections of the country by obstructing natural water-courses, for the purposes of manufac- ture or navigation ; deciding how far certain forests act as natural barri- cades against devastating winds, and should, therefore, be left untouched by the axe in order to maintain a permanent average rainfall, and thus avert droughts, cyclones, and floods—and how far others interfere with the circulation of healthful breezes, and may, therefore, be with benefit re- moved. With a rapidly growing population, and the frequent development of new centers of wealth and industry, much effective sanitation for the future can be accomplished in supervising the laying-out of new towns. No vil- lage must be allowed, from this time forth, to take the simplest corporate form without laying before this Board a carefully prepared plan of its sanitary provisions. Inquiry will be made into the character of the soil, 52 the quantity and quality of the possible water-supply ; the width and incli- nation of its streets ; whether its projected system of sewerage is wise and scientific; whether its surface drainage takes advantage of the natural water- courses ; its regulations in regard to habitations, the space of ground allowed to each, and the space required in each in relation to the number of occu- pants. All these are points which enlightened sanitary science demands should be arranged, with a wise prescience in advance, and not left to settle themselves hap-hazard as emergencies may arise, after fearful sacrifices of health and life, and at an immense outlay of money—as our older cities are finding out to their cost. The Board must also consider the relations of the country to the city as a purveyor. The supply of fresh vegetables and fruits, and pure milk and other dairy products to large communities is of the utmost importance, and every effort will be made to require and secure it. The transportation of live stock for food needs to be •, ery carefully watched and regulated, both that none but healthy, and, therefore, wholesome, meat may be exposed for sale, and that infectious and epidemic diseases may not be introduced among our native herds and flocks from other localities ; and although this subject has not been neglected by a coordinate branch of governmental supervision, the Board feels assured that any assistance which it may render in so im- portant a matter will not be considered as impertinent. But to attempt to briefly indicate even all the directions in which this organization hopes to add to the welfare and prosperity of the State would be to write a volume instead of carrying out its intention simply to speak a word. The intimate connection between a high standard of public health and material prosperity cannot be gainsaid. A human life has an actual cash value to the community as certainly as that of a horse or a cow. Fif- teen million dollars would not cover the loss to this State from preventable diseases in a single year. Hence, the money spent in sanitary precautions and improvements is repaid with compound interest in the longevity and productive capacity of the population. Its disbursement is economy of the wisest kind, worthy of the most sagacious statesman. But while it is true that the subjects confided to the consideration of this Board involve the profoundest problems of political economy and the most intimate researches of scientific investigation, it is not less true that every home and every hearth in the Commonwealth is deeply interested in the practical results to which it shall attain. Every vacant chair b\ the fireside, every empty place at the table, whose beloved occupant was snatched away by the ruthless hand of contagious or preventable disease, is a mute appeal for more searching inquiry into the causes and means of prevention of such diseases by the health authorities, and more general interests in their labors, and readier acquiescence in their decisions by the community at large and its individual members. The Board, therefore earnestly invokes the conscientious cooperation of every householder to the 53 extent of keeping his own home, and other buildings of which he may have supervision, in a healthful condition. Especially does it desire that the women of the State should take an active and intelligent interest in the practical solution of the problems of home hygiene and sanitation. The establishment of the first State Board of Health in the United States was effected by the efforts of women. Reference is made to that Board, whose work has been so effective and thorough that it has been looked to as a model by other similar organizations—that of Massachusetts—now in the sixteenth year of its existence. The ancients were right in making the divinity of health a goddess rather than a god, for woman, as wife, mother, nurse,has for her special function thatdaily min- istry to the bodily welfare and daily necessities of offspring and of hus- band, that constant presence in and care for the home which are such essen- tial promoters of health in the individual, in the family, and in the commu- nity. The Board is especially urgent, then, that the mothers of the land should attentively study the leaflets and tracts which if will from time to time issue, giving plain, practical advice as to the best methods of prevent- ing the spread of infectious diseases, and of making their homes the abodes of health, and therefore of happiness. The Board proposes to indulge in no display of sanitary pyrotechnics in order to dazzle the public and create for itself a factitious importance, but rather, by quiet, steady, carefulby considered work, to organize sanitary effort, to acquaint itself with the health conditions of every quarter of the State, and to diffuse information which shall develop an enlightened public sentiment in regard to both rights and duties from a sanitarian stand-point. Especially will it recognize the necessity for moving with caution where the interests of trade, manufacture, or commerce apparently conflict with those of public health, aiming always to protect the latter with the least possible interference with the successful promotion of the former. But, on the other hand, if the Legislature of this Commonwealth, acting with its usual wise conservatism, has been slow in establishing this safe- guard to the lives and health of the people, the latter may congratulate themselves that a much stronger law has now been enacted than could pos- sibly have been passed when the first application for such legislation was made. Instead of being only a statistical and advisory body, as must then have been created, the present Board has been endowed with ample powers to enforce its regulations for the protection of the public, and this grant imposes a responsibility which the Board recognizes and will not hesitate to assume if occasion demand. The Board cannot find more fitting language in which to conclude this address than that employed in a recent admirable circular issued by the Board of Health of the city of Philadelphia " for the guidance of citizens in the management of their dwellings and for personal application." It is as follows : " While the health of the community depends in great degree upon a rigid observance by officials of all the laws of public hygiene, it is no less 54 dependent upon the faithful applications of the principles of hygiene on the part of individuals. To accomplish the best results, the earnest and cheer- ful coiiperation of the people with the health authorities in all matters per- taining to the general health is absolutely indispensable.'1 ED. WM. GERMER, M. D., President. PEMBERTON DUDLEY, M. D. J. P. EDWARDS, M. D. RUDOLPH HERING, C. E. j. h. McClelland, m. d BENJAMIN LEE, M. I)., Secretary. Office of the Secretary of the Commonwealth, Harrisburg, July 8, A. D. 1885. 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