SPECIAL REPORT > OF THE BOARD OF HEALTH - OF THE z * STATE OF LOUISIANA. SESSION OF 1875. NEW ORLEANS: PRINTED AT THE REPUBLICAN OFFICE, 94 CAMP STREET. 1875 SPECIAL REPORT OF THE BOARD OF HEALTH OF THE STATE OF LOUISIANA. SESSION OF 1875. NEW ORLEANS: PRINTED''ATfTHE REPUBLICAN OFFICE, 94 CAMP STREET. 1875. REPORT. Office of the Board of Health, State of Louisiana, New Orleans, December 31, 1874. To the Governor and General Assembly of the State of Louisiana : The Board of Health respectfully submits a special report. This report exhibits the receipts and expenditures of the Board of Health during the year 1874, its liabilities at the present date, the considerable decrease during the present year of the revenue which supports the quarantine system and the Board of Health, and the probable total annihilation of that revenue in the near future, with some recommendations for legislative action for its relief and future support, and for such modifications of existing laws as will give to the Board of Health that permanent, efficient and scientific organization, which is necessary to a body charged with the respon- sible duty of protecting the city and State from preventable disease and death. The Treasurer of the Board of Health, in account with the State of Louisiana. Dr. To cash on hand January 1, 1874 $157 02 To quarantine drafts on hand January 1, 1874. (uncollected) ... 276 45 $433 47 TO MISSISSIPPI STATION. To cash received from fees on vessels via the station$19,237 60 To hospital charges on sick at quarantine hospital 43 00 19,280 60 TO ACHAFALAYA STATION. To cash received from fees on vessels via the Station as per rolls $277 50 277 50 TO RIGOLET8 STATION. To cash received from fees on vessels via the station as per rolls $347 80 To cash received from fees on vessels via the station, collected at the basins 97 35 445 15 TO OTHER SOURCES. To cash received for medicine $2 00 2 00 Total sum received $20,438 72 4 BY MISSISSIPPI STATION I Or. Paid balance of salary of resident physician for 1873, at $5000 per annum $311 66 Paid salary of resident physician from Jan- uary 1 to April 10, and from October 14 to November 19, 1874, at $5000 per annum, in full. 1,888 77 Paid on account of salary of resident physi- cian from April 10 to October 13, and from November 20 to December 31, at $3500 per annum ($221 07 unpaid) 1,956 65 Paid salary of assistant physician (1874), at $2000 per annum 755 49 Paid salary of assistant physician (1874) at $500 per annum 236 16 Paid salary of assistant physician (1874) at $900 per annum 34 10 Paid wages of employees at Station, during the year 1874 3,234 54 Paid for groceries and supplies furnished Sta- tion in 1873 698 72 Paid for groceries and supplies furnished Sta- tion in 1874 1,023 89 Paid for fresh meat purchased at Station in 1874 168 71 Paid for paints, oils, etc., furnished Station in 1874 19 50 Paid for drugs and medicines furnished Sta- tion in 1874 37 55 Paid for disinfectants furnished Station in 1873 48 50 Paid for disinfectants furnished Station in 1874 10 90 Paid for lumber purchased for repairs at Sta- tion, 1874 83910 Paid for atomizer for Station 48 30 Paid for Sturtevant's exhaus. fan for Station 79 00 Paid for fumigator for Station 19 00 Paid for iron pipe for Station 10 00 Paid for belting for Station 11 90 Paid for sheet iron for Station 4 50 Paid for stationery for Station 27 60 (Paid for bunting for Station 21 10 Paid for freights on supplies, etc., to Station 102 30 Paid for making coffins for Station 12 50 Paid for hardware sundries for Station 12 29 Paid for medical thermometer for Station ... 3 00 Paid telegram to Station 2 90 Paid for one dozen chickens for Station.... 5 50 Paid for one keg nails for Station 5 75 Paid for boat hooks 1 45 5 Paid for sundries purchased at Station during the year 106 05 Paid resident physician's bills for sundries purchased at Station during the year 1874 318 72 $11,557 10 by rigolet'b station: Paid on account of salary of resident phy- sician at the station for 1874 $353 85 Paid resident physician's bill for incidental expenses at station 18 95 Paid for disinfectants for station 4 00 Paid for paints for boat at station 4 05 $380 85 BY ATCHAFALAYA STATION: Paid on account of salary of resident phy- sician for 1874 $190 00 $190 00 BY SANITARY INSPECTOR'S OFFICES: Paid sundry expenses for sanitary inspector's offices $13 60 $13 60 BY OFFICE EXPENSES: Paid balance of salary of president for 1873, at $2000 per annum $1,166 72 Paid on account of salary of president for 1874, at $2000 per annum 333 32 Paid balance of salary of secretary and treas- urer for the year 1873, at $2000 per annum. 833 38 Paid on account of salary of secretary and treasurer for 1874, at $2000 per annum.... 666 64 Paid balance of salary of attorney for the year 1873 500 00 Paid salary of clerk for the year 1874 1,650 00 Paid wages of porteress for the year 1874... 240 00 Paid wages of messenger for the year 1874.. 144 00 Paid rent of board rooms for the year 1874.. 900 00 Paid for vaccine virus supplied physicians 1873 and 1874 177 26 Paid for books purchased for library in 1873 and 1874 150 83 Paid New Orleans Gaslight Company for gas supplied office and laboratory 1874 130 90 Paid for lithographing one thousand charts yellow fever at Shreveport for the annual report of 1873 85 00 Paid subscriptions to city papers 40 20 Paid subscriptions to foreign scientific journ- als and periodicals 26 25 Paid subscriptions to domestic journals and periodicals 17 00 6 Paid insurance on microscopical and meteor- ological instruments 21 25 Paid for barograph papers for barometer.... 14 00 Paid for gas fixtures for office and laboratory 6 25 Paid for repairing barometer clock 10 00 Paid for printing one thousand death certifi- cates, to order 7 50 Paid for emptying vault 8 00 Paid for kindling wood 6 50 Paid for six zincs for battery 6 00 Paid for blue stone for battery 7 50 Paid rent of Postoffice box 1874 9 35 Paid for box for official records 5 25 Paid for lamps for experiments in coal oil. . 4 00 Paid for framing charts. 5 80 Paid for fixtures for office windows 1 65 Paid for coal for office 3 75 Paid for postage and postage stamps, and in- cidental expenses at office during the year 133 30 7,311 50 Total amount expended $19,453 05 By quarantine drafts on hand uncollected... $783 95 By cash on hand 201 72 985 67 $20,438 72 New Orleans, January 19, 1875. I have this day examined the books, vouchers and papers of the Board of Health, State of Louisiana, for the year ending December 31, 1874, and have found the same correct in every detail. CHARLES HILL, Examiner, State Auditor's Office. Approved: Charles Clinton, Auditor. 7 STATEMENT OF LIABILITIES Of the Board of Health of the State of Louisiana on the thirty-first day of December, 1874. MISSISSIPPI STATION. For groceries supplied Mississippi Station in 1874 $251 63 For disinfectants supplied Mississippi Station in 1874.. 213 16 For one sulphur furnace purchased for Mississippi Sta- tion in 1874 86 25 For hose purchased for same 106 40 For paints, oils, etc., purchased for Station, 1874 37 45 For freight on supplies, etc., to Mississippi Station, 1874, (estimated) 75 00 For balance of salary of resident physician at Mississippi Station (certificate given) 221 07 ATCHAFALAYA STATION. For balance of salary of resident physicians, 1874, (cer- tificategiven) 710 00 RIGOLETS STATION. For balance of salary of resident physician, 1874, (cer- tificate given) 146 15 For balance of wages of employes at Station, 1874, (cer- tificates given)' 295 00 For sheriff's fees removing vessel to Quarantine Station, 1874 119 00 OFFICE EXPENSES. For salary of President of the Board of Health, ten months at $2000 per annum 1,666 74 For salary of Secretary and Treasurer of the Board, eight months at $2000 per annum 1,333 36 For salary of Attorney of the Board for the year 1874.. 600 00 For office furniture purchased in 1874 139 00 For subscriptions to city papers 42 00 For towing steamboat " Belle Lee" to Milan street and return, 1873 80 00 For vaccine virus purchased, 1874 18 90 For subscriptions to scientific journals and papers 50 00 For printing a thousand copies of annual report of 1872, 900 00 For lithographing two thousand charts, mortuary and meteorological, 1872 500 00 For printing, blanks, blank books, stationery, etc., etc., for office, Quarantine Stations, and Sanitary Inspec- tors' offices, 1873 926 00 For printing a thousand copies of annual report for 1873 900 00 For lithographing two thousand charts, mortuary and meteorological, 1873 500 00 For printing, blanks, blank books, stationery, etc., etc., for office, Quarantine Stations and Sanitary Inspectors' offices during the year 1874 909 25 Total liabilities $10,826 36 8 The causes of the large indebtedness of the Board shown by the statement of the secretary are: First-The deficient appropriation by the General Assembly at its session of 1873, which left debts of the Board unliquidated amounting to two thousand five hundred dollars. Second-The Legislature at its session of 1874 made no appropri- ation whatever for the relief of the Board, which consequently began the year with the burden of seven thousand dollars of debts. Third-The receipts at the Mississippi Quarantine Station have decreased from twenty-five thousand dollars in 1869 to nineteen thousand dollars in 1874. Fourth-The cost of carrying on the operations of the Board is somewhat enhanced by the increased price of supplies in general, whilst quarantine dues not being as formerly paid in gold or its equivalent their purchasing power is to a corresponding extent diminished. Fifth-While the revenues of the Board have thus seriously de- creased, its expenses, even with constant effort at economy, have decidedly increased. The General Assembly is respectfully reminded that previous to its Act of March 11, 1870, increasing the powers of the Board and consequently its duties, this body was in effect merely a Quarantine Board, and its duties and powers as a Board of Health practically nothing. Previous to that date there were no meteorological or other ob- servations made, no extended or systematic or continuous recording of the facts of epidemics and epidemic disease, no laboratory work or expenses, no vaccine furnished to physicians of the city and State, no purchase of scientific instruments or use made of them, no house- to-house inspection with its attendant expenses. Whatever reports were made to the Legislature consisted of a few pages containing some valuable facts, but no way comparable with the accurate, ex- tended and complete repoits which are now annually presented, and whose value is distinctly recognized by all experts in sanitary matters throughout the United States. An examination of those items which cause the increased expenses of the Board at the present time as contrasted with the past, will show that they are in the main necessities of the increased and increasing work accomplished by the Board of Health. 9 As has been stated, the Board of Health began its fiscal year with a debt of seven thousand dollars. To increase its financial difficul- ties, Charles Morgan and other New York steamship proprietors, procured in the United States Court an injunction, forbidding the Board to collect quarantine dues from vessels belonging to the be- forementioned persons. The diminution of the revenues of the Board from this cause during the year just closed, amounts to the sum of twenty-six hundred dollars. In April, upon the recommendation of this Board, Dr. Alfred W. Perry was appointed quarantine physician at the Mississippi station. Dr. Perry introduced a system of disinfection of vessels, more thorough than had been before attempted, requiring the aid of new appliances, which, however, by his mechanical and inventive skill, his personal industry and supervision, were furnished and put in working order, at an expense which, though very moderate, was yet an addition to the ordinary current expense of the station. Dr. Perry made a contract with the Board to accept salary at the rate of thirty-five hundred dollars per annum, instead of five thousand dollars, and to furnish an assistant at five hundred dollars per annum, instead of two thousand as salaries are allowed by law. In addition to these reductions, he brought down the pay roil of the station by the discharge of employes not required by the neces- sities of the station, and by reduction in supplies used, so that the expenses of the Mississippi station were reduced from about twelve hundred, to seven hundred and thirty dollars per month; and at the date of his removal had laid before the Board a proposition, whilst increasing the salary of the assistant physician, to bring the total expenses of the station to six hundred and ninety dollars per month, being at the rate of say eight thousand five hundred dollars per annum, instead of fourteen thousand six hundred dollars, as under his predecessor. Much to the regret of the Board of Health, on the fourteenth of October Dr. Perry was superseded by Dr. Howe, who held the po- sition about five weeks, during which period all attempts at economy were disdained and the expenses brought up to the former rate of about fifteen thousandjdollars per annum. At the request of the Board of Health, made in consequence of this official extravagance and also because of disobedience to posi" 10 tive instructions of the Board directing disinfection of vessels from infected ports, Dr. Howe, on November twentieth, was superseded by Dr. Julius S. Clark. By Dr. Clark the plans of the Board for the economical manage- ment of the Mississippi Qirantine Station are cordially and com- pletely carried out, the rate of expenditure at the present time being about the same as under the administration of Dr. Perry. It is evident that the receipts of the Board have therefore been so managed that had the action of the courts not deprived it of a por- tion of its usual revenue they would have very nearly provided for its expenses. The indebtedness of the Board December 31,1873, seven thousand, dollars, and its loss of revenue by injunctions, two thousand six hundred dollars, appproximate closely to the ten thousand dollars indebtedness of the Board December 31,1874. This debt will require an appropriation by the General Assembly equivalent to ten thousand dollars in cash. As was suggested in the opening sentences of the report it is almost certain that all revenues of the Board will be taken away very early in the year. If the maintenance of quarantine and the continued existence of the Board of Health be esteemed desirable by the Legislature, action to that end is necessary. The amount of appropriation necessary for the support of quar- antine and the Board of Health during 1875 is twenty-six thousand dollars. The small amount of three hundred dollars for nails and paints are necessary to prevent rapid and serious deterioration of the quarantine buildings. The work of repair could be done by the employes of the station. Partially to meet its expenses, the Board of Health recommend that it be constituted Registrar of Births, Marriages and Deaths for the parish of Orleans, and in support of this recommendation re- spectfully sets forth that the study of vital statistics is the founda- tion of the science of hygiene, and the accumulated facts of vital statistics are only valuable, interesting and fruitful of conclusions, in the degree that they are truly and fully recorded, faithfully pre- served, scientifically analyzed, published and acted upon. As at present kept, the records of births, marriages and deaths 11 are seriously deficient in the accuracy and completeness which give to such records sanitary and legal value. Properly to perform the duty of Registrar, the preliminary train- ing and experience of the vital statistician are absolutely necessary. Therefore, to place the Board of Health in charge of this duty is to secure accurate record, careful preservation, scientific analysis and use of these vital statistics. In all other cities where Boards of Health are organized, such board is the Registrar of vital statistics; the experience of other communities confirming the statement just made. The deficiency of the present Registry of Deaths would be much greater than it even now is, were it not for the voluntary aid of physicians in affording information, and for the blank certificates of death furnished gratuitously to all physicians by the Board of Health. The community, the State, and the student of vital statistics of this and other countries derive the facts for study from the publica- tions and from the office of the Board of Health, and not from the office of the Registrar. The Registrar for the Parish of Orleans has never made any pub- lication of the facts accumulated in that office, and for sanitary and scientific purposes the office is utterly useless. The Board has been assured by legal authority that the deficiency in the manner of the registration of deaths is so serious, that, were the legal point raised, the whole registration would be pronounced hivalid by reason of this incompleteness. The funds of the Board are exhausted as shown by the accom- panying exhibit. To transfer the registry to the Board of Health would be to fur- nish the Board with means to pay about one-third of its annual expenses. The transfer of the registration and the fees therefore, as before recommended, will relieve the taxpayers of an annual, unnecessary expense of, say, eight thousand dollars. The Board, therefore, urges its request as a matter of scientific and hygienic importance, and as a matter of political economy and reform. Another advantageous amendment of the Quarantine Act, sug- gested by the opinion and practice of other similar bodies, and con- 12 firmed by its own experience, would be to increase the duration of the time of membership in the Board of Health. Terms of from three to six years, and their consecutive expiration, would secure to this body, thus organized, extensive knowledge of the science of hygiene, practical experience, continuity of ideas, and improving methods. Addition to existing laws should be made giving the Board of Health ample power in the presence of disease contagious in char- acter, or in presence of threatened epidemic, to take all needful measures, and expend the moneys necessary to prevent the preva- lence of contagious or epidemic sickness. The want of funds has seriously embarrassed the board in its attempts to limit the spread of small pox. Not unfrequently cases occur in which it is desirable to destroy infected personal property, to move all inhabitants from an infected house, and to provide temporary quarters for the indigent, or to remove vessels or steam- boats from an infected locality. These necessities, and others arising unexpectedly, in spite of careful prevision, require command of funds and adequate powers. The health of the inhabitants of New Orleans being most directly benefited by such measures, the expense arising therefrom should properly be borne by the treasury of the city. The project of a bill reorganizing the Board of Health, properly enlarging its powers, making it the registrar of the parish of Orleans, and containing other comparatively unimportant modifica- tions of existing health laws, will be prepared by the board and sub- mitted for your consideration and adoption. Although thinking it unnecessary to make extended and formal defense of quarantine measures, the board deems it proper in this connection to express its strong and increasing faith in the value and necessity of a thorough system of quarantine and disinfection of vessels from infected ports. During the past five years, the Board of Health has made rigorous and continuous effort, by thorough and timely disinfection to pre- vent or delay the progress of yellow fever. During thib period experience has been acquired in the use of disinfectants, facts accu- mulated as to the apparent modes of progress of the disease, and improved methods of securing information of the early appearance of the disease. In 1870 New Orleans suffered with yellow fever. As an epidemic 13 it was confined to a portion of the Second District, twelve blocks by four. The same year, about six weeks later, yellow fever appeared in Mobile, and ravaged every part of that city. In New Orleans great efforts were made by sanitary operations to arrest the progress of the disease. No efforts whatever were made in Mobile. In 1871 yellow fever appeared in New Orleans. Efforts were made by the Board of Health to limit its spread, and with apparent success, while all other Southern cities, towns or villages in which it appeared that year suffered with it in its epidemic form. In none of these communities were intelligent, persistent efforts made to control the disease. In 1872 yellow fever was again present in the Fourth District of New Orleans. Disinfection was again practiced with apparent success. In 1873 yellow fever appeared in all the Districts of the city, and was epidemic in limited localities in the Third, Fourth, Fifth and Sixth Districts. Disinfection apparently confined the disease to the vicinity of the spots where it appeared, and the city altogether escaped general epidemic, whilst Shreveport, Memphis, and numer- ous other Southern communities passed through the terrors of a general and fatal yellow fever epidemic. In 1874 a few cases of yellow fever appeared in this city, but in those localities where they manifested themselves sufficiently early in the season to be considered a test of the value of disinfection, the results of that process may be considered satisfactory, more espe- cially as our unfortunate neighbors of Pascagoula and Pensacola suffered from epidemic yellow fever, showing that the exemption of New Orleans was certainly not owing to favoring dissimilarity of meteorological conditions. During the time that Dr. Perry was resident physician of the Mississippi Quarantine Station, April 11 to October 14, 1874, several vessels, which had yellow fever on board, either whilst in West Indian ports, or during the voyage to this port, were disinfected under his supervision. In not one of these did yellow fever make its appearance after the vessel arrived in this city. Two days after the Station passed into the charge of Dr. Perry's successor, and contrary to the explicit instructions of the Board of Health, a vessel from Cuba was passed without disinfection. A week after the vessel 14 was laid to wharf, and the contents of her hold discharged, yellow fever broke out on the vessel. This may be only a coincidence, but bears strongly the apparent relation of cause and effect. The result of the labors of the Board to secure the State against the introduction of yellow fever, and the city of New Orleans itself against its introduction and spread, appears therefore highly en- couraging. From its present vantage ground of experience and accumulated facts, the Board of Health, as an official duty of great importance, expresses its opinion that the failure of the General Assembly, by suitable legislation, to provide for the future maintenance of the Board of Health and the Quarantine system of the State, would be a public misfortune. In behalf of the Board of Health, C. B. WHITE, M. D., President.