and not subject to any existing executive department, but which should not have the rank of a department. It was proposed to transfer to the new establishment the following existing organizations: (1) the Public Health and Marine. Hospital Service; (2) the Bureau of Chemistry of the Department of Agriculture, or that part of it charged with the investigation of the adulteration of foods, drugs, and liquors and with the execution and enforcement of the act for preventing the sale or transportation of adulterated, misbranded, poisonous, or deleterious foods, drugs, medicines, and liquors; and (3) the Division of Vital Statistics of the Bureau of the Census. It was further proposed to grant authority to the President to transfer to the new establishment, the whole or part of any existing government organization engaged in work pertaining to the public health, with the exception of the Medical Department of the Army and the Bureau of Medicine and Surgery of the Navy.48

Congress did not see fit to pass any legislation creating a new department or establishment or consolidating any of the national agencies doing health work. The act of August 14 1912 (37 Stat. L., 309), the latest general act relating to the service, did not go further than to change the name of the Public Health and Marine Hospital Service to the Public Health Service, to give the service definite statutory authority to make extensive investigations in the field of public health, and to increase the salaries of the commissioned officers.

The act of August 14, 1912, expressly provided that all laws relating to the Public Health and Marine Hospital Service should apply to the Public Health Service, and it extended the field of activity by the provision that the Public Health Service "may study and investigate the diseases of man and conditions influencing the propagation and spread thereof, including sanitation and sewage and the pollution either directly or indirectly of the navigable streams and lakes of the United States, and it may from time to time issue information in the 48 62 Cong., 3 Sess., H. Doc. 1252, pp. 909-915.

form of publications for the use of the public." Under this law the service has ample authority to make any studies relating to health and diseases for which funds are available.

The law of July 1, 1902, had provided that the salaries and allowances of the commissioned officers of the service should continue as fixed by the existing regulations of the service. The act of August 14, 1912, which was the first law in which the salaries were stated, fixed them as follows: Surgeon General, $6000; Assistant Surgeon General, $4000; Senior Surgeon, $3500; Surgeon, $3000; Passed Assistant Surgeon, $2400; Assistant Surgeon, $2000. The grade of senior surgeon was a new one; the number being limited to ten. Provision was also made for longevity pay for officers below the rank of surgeon general, at the rate of ten per cent. of the annual salary for each five years' service, but the longevity pay was not to exceed forty per cent. of the basic salary, and total of the basic salary and longevity increase was not to exceed $5000 for Assistant Surgeons General, $4500 for Senior Surgeons, and $4000 for Surgeons. Compensation was at the rates given above until January 1, 1920.1

49

New Activities in 1913 and 1914. Duties in connection with the law imposing a tax on matches made of common poisonous white or yellow phosphorus were imposed on the service by regulations issued by the Commissioner of Internal Revenue on May 10, 1913, in accordance with the provisions of the act of April 9, 1912 (37 Stat. L., 81),50 The purpose of this tax was to prevent the manufacture of matches made of common poisonous white or yellow phosphorus, the Commissioner of Internal Revenue being authorized to make the necessary regulations. As the officer had no administrative machinery for making the scientific examinations required by the statute, he delegated that portion of the work to the Public Health Service. The regulations provided that

49 See page 54.

50 United States Internal Revenue Regulations No. 32. May 1913. Regulations governing white phosphorus matches under internalrevenue law.

each manufacturer should furnish samples of his product and material for examination whenever deemed necessary. In addition the Surgeon General was authorized to buy matches in the open market in order to determine whether poisonous material was being used. If the Surgeon General found that white or yellow phosphorus was being used in any form he was to make an examination of the factory and materials, as well as of the persons employed. The results of these examinations were to be reported to the Commissioner of Internal Revenue as a basis for determining whether the factory was subject to the tax.51

The Indian appropriation act for the fiscal year 1913, approved August 24, 1912 (37 Stat. L., 519), appropriated $10,000 to enable the Public Health Service to report on the prevalence of contagious diseases among the Indians of the United States. Fourteen officers were assigned to this work, and over 39,000 Indians were examined.52 The results of the survey were published.53

The deficiency act approved March 4, 1913 (37 Stat. L., 915), provided that the Director of the Hygienic Laboratory should receive the pay and allowances of a Senior Surgeon.

Increased Field Investigations in 1914. The sundry civil act for the fiscal year 1914, approved June 23, 1913 (38 Stat. L., 25), contained for the first time an appropriation for field investigations reading as follows: "Field investigations of public health matters: For investigations of diseases of man and conditions influencing the propagation and spread thereof, including sanitation and sewage, and the pollution of navigable streams and lakes of the United States, including personal services, $200,000." This appropriation resulted from the increase in the activities of the service incident to the passage of the act of August 14, 1912.

During the fiscal year ending June 30, 1914, the additional

work authorized by the act of August 14, 1912, and made possible by the increased appropriations, was conducted along two general lines, (1) diseases of man and sanitation and (2) investigations of water supplies and sewage disposal.54 Among the general diseases of man investigated were beriberi, diptheria, endemic goitre, hookworm disease, leprosy, typhoid fever, malaria, pellagra, trachoma, tuberculosis, and typhus fever. The following studies of occupational diseases were made: (1) Health of garment workers in New York City, (2) tuberculosis in Cincinnati as related to certain industries, (3) sanitary survey of Indiana industries employing woman labor, (4) trachoma among steel mill workers, (5) mine sanitation studies, and (6) metallurgical plant investigations; the two last being in coöperation with the Bureau of Mines. 55 In addition, systematic investigations of rural sanitation, school hygiene, industrial hygiene, and health organization and administration were taken up and enlarged. The investigations of water supplies and sewage included three distinct lines of research, (1) pollution of rivers and coastal waters, (2) disposal of sewage, and (3) treatment of industrial wastes. All the work undertaken had a direct bearing on the protection of water supplies and the shellfish industry, and the sewage studies were of practical benefit to householders and small communities in the prevention of disease.56

Medical Aid to Deep Sea Fisheries, 1914. Medical aid to crews of American vessels engaged in the deep sea fisheries was authorized by the act approved June 24, 1914 (38 Stat. L., 387), which provided that the Secretary of the Treasury might assign a revenue cutter (Coast Guard vessel) to this work and detail such surgeons and other persons of the Public Health Service as might be necessary.

Inoculation of Government Employees, 1915. In order to protect government employees against typhoid fever and smallpox, the Secretary of the Treasury on February 12, 54 Surg. Gen., Annual Report, 1914, p. 16.

55 Ibid., pp. 46-52.

56 Ibid., p. 17.

1915, issued an order directing medical officers of the service to perform vaccination against typhoid fever and smallpox for all civil employees engaged in interstate travel or regularly engaged in handling mail or other material to be carried in interstate traffic.57

Fumigation of Forecastles, 1915. The seamen's act of March 4, 1915 (38 Stat. L., 1166), provided that the forecastles of merchant ships should be fumigated at such intervals as may be provided by regulations of the Surgeon General of the Public Health Service, with the approval of the Department of Commerce.

Studies of Rural Sanitation, 1916. Studies of rural sanitation had been undertaken soon after the enlargement of the activities of the service resulting from the passage of the act of August 14, 1912, but the first specific appropriation for this work was made in the deficiency appropriation act approved February 28, 1916 (39 Stat. L., 21), which made $25,000 available for this purpose. An appropriation has been made for this work in each subsequent annual appropriation act.

Control of Biologic Products, 1916. The sundry civil act for the fiscal year 1917, approved July 1, 1916 (39 Stat. L., 279), contained the first specific appropriation for expenses of regulating the propagation and sale of viruses, serums, toxins, and analogous products required by the act of July 1, 1902.58 Up to this time the expenses of this work had been paid from the appropriations for traveling expenses and for the maintenance of the Hygienic Laboratory. 59

National Home for Lepers, 1917. As early as 1902 the service had recommended the establishment of a home for lepers, but this institution was not authorized until February 3, 1917 (39 Stat. L., 872). The Secretary of the Treasury was authorized to obtain a suitable site and erect necessary

57 Ibid., 1915, p. 277.

58 See page 27:

59 Sundry Civil Bill 1917. Hearings before subcommittee of House Committee on Appropriations, p. 129.