252. Public Health Administration in West Virginia. A study of the health laws and public health administration of the State of West Virginia. By Taliaferro Clark. January 22, 1915.

253. Biological Products. Establishments Licensed for the Propagation and Sale of Viruses, Serums, Toxins, and Analogous Products. January 22, 1915. 254. The Purity and Strength of Household Remedies. Variations in Purity and Strength of Widely Used Drugs and Preparations a Possible Source of Danger to the Patient. By Martin I. Wilbert. January 29, 1915. 255. Public Health Administration in the State of Washington. By Carroll Fox. February 5, 1915. 256. The Limitations to Self-Medication. Uses and Abuses of Proprietary Preparations and Household Remedies. By Martin I. Wilbert. February 12, 1915. 257. Impounded Waters. A Study of Such Waters on the Coosa River in Shelby, Chilton, Talladega, and Coosa Counties, Ala., to Determine the Extent to which They Affect the Production of Anophelines, and of the Particular Conditions which Increase or Decrease Their Propagation. By J. A. A. Le Prince. February 12, 1915.

258. Malaria Control. Drainage as an Antimalarial Measure. By J. A. A. Le Prince. February 19, 1915.

259. Rat Proofing the Public Docks of New Orleans. A Report on Its Possibility and Cost. By H. P. Letton. February 19, 1915.

260. Control of Malaria. Oiling as an Antimosquito Measure. By J. A. A. Le Prince. February 26, 1915.

261. Hypochlorite Treatment of Water Supplies. Portable Plant and Field Equipment for Its Administration. By H. A. Whittaker. February 26,

1915.

262. Venereal Disease. Its Probable Prevalence.

An attempt to reach a definite

basis of statistical value. By Charles S. Banks. February 26, 1915. 263. Trachoma. A Survey of Its Prevalence in the Mountain Section of Eastern Kentucky. By John McMullen. March 5, 1915.

264. State Laws and Regulations Pertaining to Public Health Adopted During the Year 1913. Reprint from the Public Health Reports, 1913 and 1914. 265. Interstate Migration of Tuberculous Persons. Its bearing on the public health, with special reference to the States of North and South Carolina. By A. D. Foster. March 12, 1915.

266. Interstate Migration of Tuberculous Persons. Its bearing on the public health, with reference to the State of California. By P. M. Carrington. March 19, 1915.

267. Efforts to Curb the Misuse of Narcotic Drugs. A Comparative Analysis of the Federal and State Laws Designed to Restrict or to Regulate the Distribution and Use of Opium, Coca, and Other Narcotic or HabitForming Drugs. By Martin I. Wilbert. March 26, 1915.

268. State and Insular Health Authorities. April 2, 1915.

269. Interstate Migration of Tuberculous Persons. Its bearing on the public health, with special reference to the States of Texas and New Mexico. By Earnest A. Sweet. April 9, 16, and 23, 1915.

270. Bubonic Plague. A Menace to American Seaports. By W. C. Rucker. April 16, 1915.

271. Typhus Fever. Its Etiology and the Methods of Its Prevention. By John F. Anderson. April 30, 1915.

272. Anopheline Surveys. Methods of Conduct and Relation to Antimalarial Work. By R. H. von Ezdorf. April 30, 1915.

273. Municipal Ordinances, Rules, and Regulations Pertaining to Public Health. Adopted during 1914 by cities of the United States having a population of over 10,000 in 1910. August 7, 1914, to April 16, 1915, inclusive. 274. Plague. Its Geographic Distribution and Its Menace to the United States. By W. C. Rucker. May 14, 1915.

275. Public Health Administration in Illinois. By S. B. Grubbs. May 21, 1915. 276. Interstate Sanitary Districts. Their Establishment by the Secretary of the Treasury in Connection with the Enforcement of the Interstate Quarantine Laws and Regulations. May 28, 1915.

277. Malaria in the United States. Its Prevalence and Geographic Distribution. By R. H. von Ezdorf. May 28, 1915. 278. The Migratory Habits of Rats. With Special Reference to the Spread of Plague. By R. H. Creel. June 4, 1915.

279. State Laws and Regulations Pertaining to Public Health. Adopted during the year 1914.

280. The Practicing Physician. His Relation to Public Health Administration. By John W. Trask. June 11, 1915.

281. Note on a Rodent Plague Focus. By W. C. Rucker. June 11, 1915. 282. Tuberculosis. The Municipal Care and Supervision of the Tuberculous. Report made by committee to the Monday Evening Club of Washington. June 18, 1915.

283. Interstate Migration of Tuberculous Persons. Its bearing on the public health, with special reference to the States of Arizona and Colorado. By A. J. Lanza. June 18, 1915. 284. Public Health Administration in Toledo. By Carroll Fox. June 25, 1915.

SUPPLEMENTS TO THE PUBLIC HEALTH REPORTS.

These supplements do not form a part of the Public Health Reports, but are printed as supplements thereto in order that a wider distribution may be had. They are popular in style and treat of various diseases and subjects of interest and value to the public. The aim of this class of documents is to present to the individual in nontechnical language the cause, effect, and prevention of various conditions and diseases. The following numbers were issued during the

year:

17. Sanitary Survey of Indiana Industries Employing Woman Labor. By M. J. White. July 17, 1914.

18. Malaria-Lessons on Its Cause and Prevention. (For use in schools.) By H. R. Carter. July 17, 1914. 19. Yellow Fever: Its Epidemiology, Prevention, and Control. (Lectures Deliv

ered at the United States Public Health Service School of Instruction by H. R. Carter, Senior Surgeon, United States Public Health Service. Lecture No. 1, March 26, 1914; lecture No. 2, March 27, 1914.) September 11, 1914.

20. Leprosy: Its Treatment in the Philippine Islands by the Hypodermic Use of a Chaulmoogra Oil Mixture. By Victor G. Heiser. October 16, 1914. 21. Scarlet Fever: Its Prevention and Control. By J. W. Schereschewsky. November 27, 1914.

22. Resolutions Concerning Disposal of Human Excreta at Unsewered Homes. June 18, 1915.

MISCELLANEOUS PUBLICATIONS.

Only two publications were issued in this series during the fiscal year:

12. List of Publications, Public Health Service. June, 1914. Paper.

15. Organization Chart of the United States Public Health Service. January, 1915.

LIBRARY.

During the year the library of the bureau was materially enlarged by the purchase and donation of a number of valuable volumes dealing with medical and allied subjects. In addition to these volumes, the bureau was kept advised of the current advance of the profession by the subscription to 46 journals. Many of these journals were bound and made a part of the reference library.

ADDITIONAL COMMISSIONED OFFICERS. In the estimates ted to Congress for the fiscal year 1916 an item of $50 the pay of additional commissioned officers was included. T would have permitted of the appointment of 22 medical of the entrance grade of assistant surgeon. Favorable action estimate, however, was not taken by Congress.

The extension of service operations during the past two y been principally along the lines of public-health work. The of officers needed for service in the field has steadily increas the interest that has been aroused in public-health matters stantly growing. Requests received from State and local agencies for assistance in the solution of health problems have passed in number similar requests during any like period in tory of the service. It is through cooperation with such agend the most effective work for the betterment of health conditio eraly is to be accomplished. An effort has been made to assistance and advice wherever possible, but on account of the number of available medical officers the bureau has in some in been unable to take advantage of opportunities for the acco ment of valuable and beneficial scientific work. In the investi of diseases of man, the pollution of navigable streams, lak coastal waters, the sanitation of interstate carriers, and the e tion of epidemic diseases the lack of a sufficient number of officers has been a problem throughout the year. Additional have been imposed upon the service by the extension of relief to the newly created Coast Guard, and the physical examina all American sailors applying for the rating of "able seama been undertaken on request of the Department of Commerce, the provisions of the seamen's act. The physical examination tain classes of applicants for appointment under the civil serv also been assumed, at the request of the Civil Service Comm It is therefore hoped that adequate provision will be made f important service need.

ADDITIONAL CLERICAL ASSISTANCE.-The need for increased o assistance in the bureau has followed the growth of service w the field. While certain additional employees have been pr during the past three years, the increase in the bureau force h been commensurate with the rapidly growing volume of ad trative and detailed routine work incidental to the developm service functions. The estimates that have been submitted f coming fiscal year represent the most careful consideration increases actually necessary to the proper conduct of the bu work.

RURAL SANITATION, TYPHOID FEVER, MALARIA. For studi rural sanitation and of malaria especially is there need of 1

facilities. With the possible exception of pellagra, there is no single disease which so vitally affects the Southern States as malaria and none which causes so great an economic loss. For example, in the State of Mississippi alone in 1914 there were over 116,000 cases of this disease. As a result of investigations during the year it has been shown to be highly improbable that hibernating mosquitoes carry the infection through the winter. It has also been shown that the disease can be eradicated from infected communities at comparatively reasonable cost. During the course of rural-sanitation studies it has been demonstrated also that in whole counties the number of cases of typhoid fever can be reduced to one-fifth of their former prevalence, and that the indirect results may be even greater. For these two large and promising fields of study, and in order to utilize these important discoveries, an additional sum of $100,000 annually should be made available. With such a sum the entire country could be made to feel the benefits of the work within a very few years.

OCCUPATIONAL DISEASES.-There is need also of enlargement of the studies of occupational diseases and the causes giving rise to them. As these studies proceed it is evident that the problems awaiting solution are complex. They require more than ordinary inspections of factories and statistical compilations. Highly technical laboratory studies are necessary, and methods and standards must be devised and their adoption encouraged to the end that the health of workmen shall be conserved and a better understanding on such matters arrived at between employer and employee. Funds for this work should be largely increased.

POLLUTION OF COASTAL WATERS.-As the studies of the pollution of shellfish-bearing waters have advanced it has become increasingly evident that the areas of undue pollution should be rapidly determined. For this purpose, surveys of all shellfish-bearing waters should be made without delay. An additional sum is accordingly being included in the estimates of appropriations for this purpose. No article of food, perhaps, enters more universally into interstate commerce than oysters. In recent years considerable misunderstanding has arisen as to the actual conditions under which they are grown and handled. As a result, this industry, involving millions of dollars, has suffered losses which can be saved. At the same time, the health of the country can be safeguarded.

REPAIRS TO PUBLIC HEALTH SERVICE STATION AT CINCINNATI, OHIO. With the development of river-pollution investigations at Cincinnati, that place has been found to be well suited for the field headquarters for such work. In order to conserve the property in which it is housed (formerly the marine hospital, and owned by the Government) and in the interest of the work now being conducted, an appropriation of $20,000 should be made to repair the main building and to demolish dilapidated wings of the structure.

MANUFACTURE OF VIRUSES, SERUMS, TOXINS, ETC.-On July 1, 1902, the law to regulate the propagation and sale of viruses, serums, toxins, and analagous products was approved, but no appropriation made for its enforcement. At that time, however, there were only 12 establishments to license, and less than 6 products for which license was required. Since then, the growth of the use of biologic

products in the prevention and cure of diseases has been so rapid that there are now 41 licensed establishments in this country and abroad, and over 60 different products propagated therein. There is need of closer supervision of these establishments, and examinations of a greater number of samples of their products, and an appropriation of $25,000 should be made available for the purpose. The manufacture of viruses, serums, toxins, etc., is surrounded by so many dangers to the public health, that every possible precaution must be exercised to supervise the various processes involved.

ADDITIONAL BUILDING FOR HYGIENIC LABORATORY.-It is desired to renew the recommendation, made for several years past, for an additional building for the use of the Hygienic Laboratory in Washington. Although the work at that institution has been greatly extended since the passage of the act of August 14, 1912, and the personnel increased, no provision in the way of additional laboratory or office space has been made. The scientific work of the laboratory in the past has been such that the results there achieved are accepted as authoritative throughout this country and abroad. In such an institution, where accuracy, precision, and systematic organization are so vitally important, overcrowding becomes a really serious condition. The estimated sum of $175,000 for the purpose of constructing a new building is again respectfully urged.

SEGREGATION AND CARE OF LEPERS.-It becomes more apparent each year that adequate provision must be made for the segregation and care of cases of leprosy in the continental United States. In 1913 an investigation conducted by correspondence by the Public Health Service definitely located 148 cases of leprosy in the United States. The bulk of these cases were persons native born. While leprosy is not classed as an acutely infectious disease it is considered by authorities on the subject to be communicable. The danger from this comparatively small number of cases, however, is that many of them move from place to place, remaining in one locality only until the nature of their malady is discovered and then removing to another section where, because their affliction is not known, they can for a time at least escape the isolation and ostracism due to the prevalent dread of this disease. In a few States homes for these unfortunates have been established; but the cases that are constantly moving constitute an interstate sanitary problem.

In the third session of the Sixty-third Congress a bill (H. R. 20040) was introduced providing for the national care of lepers. With slight amendments it was passed by the House of Representatives, but was not acted upon by the Senate prior to the adjournment of Congress. This bill had the approval of the department. It is hoped that the matter will again be considered by Congress, to the end that a solution of this problem may be effected.

NATIONAL QUARANTINE SYSTEM.

In section 8 of the act approved February 15, 1893, Congress gave sanction to the national control of quarantine by providing:

That whenever the proper authorities of a State shall surrender to the United States the use of the buildings and disinfecting apparatus at a State quarantine station the Secretary of the Treasury shall be authorized to receive them and to pay a reasonable compensation to the State for their use if, in his opinion, they. are necessary to the United States.