ANNUAL REPORT OF THE SURGEON GENERAL OF THE PUBLIC HEALTH SERVICE. TREASURY DEPARTMENT, BUREAU OF THE PUBLIC HEALTH SERVICE, SIR: In accordance with the act of July 1, 1902, I have the honor to submit for transmission to Congress the following report of the operations of the Public Health Service for the fiscal year ending June 30, 1915. This is the forty-fourth annual report of the service, in the one hundred and seventeenth year of its existence. Administrative supervision of the work of the service is conducted through the seven divisions of the bureau, and operations for the fiscal year are herein reported under the titles of the divisions, as follows: (1) Scientific research. (2) Foreign and insular quarantine and immigration. (3) Domestic (interstate) quarantine. (4) Sanitary reports and statistics. (5) Marine hospitals and relief. (6) Personnel and accounts. (7) Miscellaneous. The administrative personnel of the bureau throughout the year has consisted of the following: Surgeon General Rupert Blue. Assistant Surgeon General A. H. Glennan, in charge of Division of Personnel and Accounts. Assistant Surgeon General W. G. Stimpson, in charge of Division of Marine Hospitals and Relief. Assistant Surgeon General L. E. Cofer, in charge of Division of Foreign and Insular Quarantine and Immigration. Assistant Surgeon General J. W. Kerr, in charge of Division of Scientific Research. Assistant Surgeon General W. C. Rucker, in charge of Division of Domestic (interstate) Quarantine. Assistant Surgeon General J. W. Trask, in charge of Division of Sanitary Reports and Statistics. Chief Clerk D. S. Masterson. 15 SCIENTIFIC RESEARCH. The scientific investigation of public-health matters and routine studies relating thereto have been carried on during the year in increasing degree through the Division of Scientific Research, in charge of Asst. Surg. Gen. J. W. Kerr. This was made practicable by reason of continuance of appropriations and enlargement of the organization begun the preceding year. In conformity with the provisions of law and for purposes of administration, the investigations of the division have been classified and conducted under several broad heads as follows: (1) Diseases of man, including hookworm disease, malaria, pellagra, trachoma, typhoid fever, and tuberculosis; (2) industrial hygiene, including occupational diseases; (3) school hygiene; (4) mental hygiene; (5) rural sanitation; (6) sanitary organization and administration; (7) viruses, serums, toxins, and analogous products; (8) pollution of navigable waters; (9) surveys of coastal waters, including shellfish areas; (10) treatment of industrial wastes; and (11) disposal of sewage. In order to carry on the above lines of work, it has been necessary not only to increase the number of scientific workers but to provide additional office and laboratory facilities at places in the field. For this purpose existing stations, such as marine hospitals and quarantine premises, have been utilized wherever possible. Some of them have been made the regular field headquarters for different lines of work. For instance, malaria studies are carried on from New Orleans, the headquarters having been transferred from Mobile, Ala., within the year; pellagra studies from Savannah; industrial hygiene studies from Pittsburgh; rural sanitation studies from St. Louis; and studies of the pollution of navigable waters from Cincinnati. At these places it has been practicable to conduct the work and to enlarge it with little or no additional overhead charges. Necessary laboratory facilities have been provided or added to. Temporary laboratories have also been installed at the Fishermans Island, Va., and Mobile, Ala., quarantine stations for studies of the pollution of coastal waters with special reference to the shellfish industry. The hospital and laboratory authorized for special studies of pellagra at Spartanburg, S. C., has been equipped and put to the use for which it was intended. As in previous years, the technical and purely laboratory studies have been carried on at the Hygienic Laboratory. The studies of leprosy have been continued at the leprosy investigation station. Advantage has been taken of the location of this station near Honolulu to cooperate with the chief quarantine officer in the enforcement of the quarantine laws and regulations by examinations of specimens on request and with the Territorial board of health by examinations of public health specimens in the prevention of the spread of infectious diseases. 16 With the providing of laboratory facilities at a number of the stations above referred to, arrangements have been made for cooperation also with the Bureau of Indian Affairs, this cooperation consisting of the examination of clinical and public health specimens as aids in diagnosis and in the control of diseases. Studies of the sanitation of convict_camps were carried on in behalf of the Office of Public Roads, Department of Agriculture, by means of the detail of a commissioned medical officer. Medical officers were likewise engaged in studies of mine sanitation and the sanitation of the steel industry in cooperation with the Bureau of Mines, Department of the Interior. Reference is made in detail to all these studies under appropriate headings. As the scientific work of the service proceeds, its importance becomes more and more apparent. It is safe to say that the results obtained from one line of study alone have been of many times greater value than the entire appropriation for studies of public health matters for the year. There is justification therefore for recommendations for enlargement of this work. As previously stated, detailed mention is made of the several activities of the field stations and laboratories under separate appropriate heads. Many activities of the Hygienic Laboratory also are thus given special mention, the facilities of this station having been freely made use of in the development of the field investigations. STUDIES OF HOOKWORM DISEASE. For five years past the service has cooperated with the Southern State boards of health and the Rockefeller Commission in the movement for the eradication of hookworm disease, carrying out in general the plans of investigation that were inaugurated prior to the formation of the Rockefeller Commission. This commission went out of existence on December 31, 1914, but the service will continue its cooperation with the State boards. Soil pollution.-In the sanitary survey to determine the degree of soil pollution in rural districts the State boards have now accumulated the following statistics: Of a total of 250,680 farm homes, scattered over 653 counties in 11 States, 125,584 homes (50 per cent) had no privy of any description, so that a theoretical maximum of soil pollution was occurring around these homes. The details for all the homes are as follows: 1,360 homes with type A privies, at 100 per cent-842 homes with type B privies, at 75 per cent. 965 homes with type C privies, at 50 per cent_. 8, 247 homes with type D privies, at 25 per cent_ 113, 682 homes with type E privies, at 10 per cent. 125, 580 homes without any privy, at 0 per cent__ 250,680 homes give total score of__. Average privy index, 6.3 per cent. Points. 136,000 63, 150 48, 250 206, 175 1, 136, 820 0 1,590, 395 These figures (6.3 per cent) show a slight improvement over the average (5.8 per cent) for the 189,586 homes for which statistics had been accumulated up to the preceding report.1 1Annual Report, 1914, United States Public Health Service, p. 22. 10435°-15-2 |