authorities, and mail and cable reports from service officers and American consuls in foreign countries. At the end of the fiscal year 1921 weekly telegraphic reports were being received from thirty-six states, monthly mail reports from forty states, and weekly mail reports from 520 cities. Each agency reporting is supplied with cards on which to insert the statistics desired. The reports are reviewed in the Division of Sanitary Reports and Statistics and prepared for publication. In addition to the periodic reports state health officers and service officers report by telegraph any unusual occurrence of disease which may be spread through interstate traffic. In order to stimulate the collection of accurate statistics, collaborating epidemiologists and assistant collaborating epidemiologists are appointed for states and minor subdivisions respectively. These officers serve at the nominal salary of one dollar a year. Collaborating epidemiologists are state health officers and assistant collaborating epidemiologists are local officers designated by the state health department. At the end of the fiscal year 1921 there were on duty thirty-six collaborating epidemiologists and 3862 assistant collaborating epidemiologists, the number of assistants having grown from 459 in two years. The processes involved in the scheme of collecting morbidity data through collaborating epidemiologists and assistant collaborating epidemiologists are indicated in the following general outline: 1. Reports of the occurrence and location of individual cases of communicable diseases by practicing physicians to the assistant collaborating epidemiologists on duty at the local health office, where all the information becomes available for primary use by the local health officer for the control of disease within his jurisdiction. 2. Reports of cases of communicable disease and local health status by the assistant collaborating epidemiologists to the collaborating epidemiologist on duty at the State health office, where the information may be used, in turn, by the State health officer. 3. Reports of cases of disease and general health conditions within States by the collaborating epidemiologists to the Bureau of the Public Health Service.1 Statistics and statements on the prevalence of communicable diseases in foreign countries are received by mail and cable from Public Health Service officers and American consuls. These reports go first to the Division of Foreign Quarantine and Immigration, which makes note of any facts that may be of value in connection with the quarantine work or the medical inspection of immigrants. They are then sent to the Division of Sanitary Reports and Statistics, which prepares the material for publication in the Public Health Reports. Data of this character are obtained also from the official publications of foreign countries and municipalities. The compilation of laws, ordinances, and judicial decisions relating to public health is made in this division. These items. are published in Public Health Reports as received, and later state laws, municipal ordinances, and judicial decisions are brought together in separate compilations. This division also assists other divisions of the service in the preparation of statistical material needed in connection with general studies of the diseases of man. In this connection it operates a general statistical office which was established for the following purposes: I. To furnish, in connection with many other lines of service activities, the technical advice required in planning their statistical work and in the analyses of the results. 2. To conduct certain statistical studies independently but closely coördinated with other field and epidemiological studies carried on by the Public Health Service. 3. To provide a central plant, with experienced personnel and necessary mechanical equipment, for the tabulation of material collected in previous studies and reports of disease prevalence. 4. Surgeon General, Public Health Service, Annual Report, 1920, p. 205. The Section of Public Health Education of the Division of Sanitary Reports and Statistics distributes the publications of the service, particularly those designed for the use of the general public. Requests for specific publications are answered by this section, which also supplies information in reply to inquiries in the field of general medicine, sanitation, and hygiene. Technical inquiries on special subjects not covered by the publications of the service are answered by the division having supervision over the particular class of work. This section also prepares bulletins for popular use, and disseminates public health information by means of articles given to the press and question and answer columns in newspapers. The division is organized as follows: 1. Office of Chief of Division 2. Administrative Section 3. Editorial Section 4. Morbidity Reports Section 1. United States 1. Collaborating and Assisting Collaborating Epidemiologists at various places 2. Foreign 5. Legal Section 6. Section on Public Health Education 7. General Statistical Office The Division of Sanitary Reports and Statistics is in charge of an Assistant Surgeon General. The employees in the division number 20. Division of Scientific Research. The Division of Scientific Research has a more elaborate organization than any other division in the Public Health Service, as the work of the division is not confined to one or two specific purposes like that of the other units. Its duties are primarily to investigate the causes of disease and methods of treatment, while the work of the other divisions is primarily to apply the principles developed as well as those of general medicine and hygiene to the specific work committed to their care. The work of this division includes the indefinite field described in the act of August 14, 1912 (37 Stat. L., 309); namely, of 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." With such a wide range of potential activity, the work and organization of the division vary considerably from time to time, as problems are disposed of and new ones taken up. The outline below shows the organization of the work in progress at present. 1. Office of Chief of Division 2. Hygienic Laboratory 1. Divison of Zoology 2. Division of Pathology and Bacteriology 3. Division of Pharmacology 4. Division of Chemistry 5. Control of Biologic Products 3. Rural Sanitation 1. Office of Surgeon in Charge 2. Work in the Field 4. Malaria Control 1. Office of Surgeon in Charge 2. Work in the field 5. Child Hygiene 1. Office of Surgeon in Charge 2. Work in the Field 6. Industrial Hygiene 1. Office of Surgeon in Charge 2. Work in the Field 7. Pellagra Investigations 8. Sewage Disposal 1. Office of Professor in Charge 2. Work in the Field 9. Stream Pollution 1. Office of Surgeon in Charge 2. Work in the Field 10. Mental Hygiene II. Leprosy Investigations 12. Studies of Public Health Administration 13. Morbidity statistics 14. Rocky Mountain spotted Fever 15. Botulism 16. Influenza and pneumonia This division is in charge of an Assistant Surgeon General, and the general direction of all field investigations is from the Washington office of the division, but in many studies headquarters are established in the field and the details of the work are directed from field headquarters. The Hygienic Laboratory is located at Washington. The laboratories of marine hospitals and quarantine stations are utilized for field investigations, but the Division of Scientific Research does not exercise any control over the routine work of these laboratories undertaken in connection with medical treatment. |