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GENERAL REPORT.

OFFICE OF THE STATE BOARD OF HEALTH.
October 26, 1886.

HON. J. M. RUSK, Governor of Wisconsin:

SIR: In obedience to the requirements of law we present this, the tenth report of the State Board of Health, showing so far as we are able to do so, the sanitary condition of the state during the year. For the details we respectfully refer you to the accompanying report of the secretary.

During the whole of the past year, though contagious disease in some form has been more or less constantly prevalent, the state as a whole has been notably free from any very serious or extensive outbreak of such disease, and the power of judicious and intelligent effort to prevent its spread has been very clearly demonstrated in numerous places.

In our last report it was remarked that in a certain sense Preventive Medicine was upon trial in this country, both in the prolonged effort that was being made to avert the march of Cholera hitherward, and in the active measures which were then being taken to prevent the introduction of Small Pox, from places in which it was exceedingly prevalent, and with which we were in more or less constant communication. Of the former disease we are glad to say that, we believe wholly as a result of the effort made to prevent it from doing so, it has not yet appeared in any part of the United States, and of the latter though it was repeatedly brought to this state as also to others, it nowhere obtained more than a temporary foot-hold. Seven times during the past year has Small Pox been reported in Wisconsin, brought hither most frequently by immigrants, and each time by the prompt and efficient action of local boards

General Report.

of health, co-operating with the State Board, it has been controlled and restricted either entirely to the household wherein it first appeared, or at most to the households of those who had been exposed to the contagion before the true character of the disease was known. With possibly a single exception the above statement is literally exact, and when we consider the pecuniary expenditure both as regards individual communities and the state, that would have resulted from the spread of this disease from any one of these centers, under inefficient management, we believe that in this single experience the expenses of a very large proportion, if not of all the Health Boards of the state have been saved. We believe also that the state may justly be congratulated upon this result, and, that it may further be congratulated in that at no previous time in the history of this Board has there been either the ability or the readiness that now exists to cope with any formidable disease that may come to us in any way.

While speaking of the introduction of disease by immigrants, it seems appropriate to refer specifically to a series of resolutions relative to the inter-state notification of the existence of contagious diseases, first adopted at a conference of State Boards of Health, held at Toronto in connection with the meeting of the American Public Health Association at that place during the present month, and subsequently discussed and adopted by that association also, which is the most influential body of sanitarians in the country, embracing as it does in its membership representatives from nearly all, if not all the states in the Union, and also from the provinces of Canada.

It will readily be seen upon reading these resolutions that the leading idea is that of enabling the several states to guard the avenues of travel and commerce by having them promptly informed as to the existence of contagious disease in any commonwealth, and thus to render it possible for each state to protect its own citizens directly and those of

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other communities indirectly by preventing the spread of such disease. The full text of the resolutions is as follows:

1. "Whereas it is necessary for the protection and preservation of the public health that prompt information should be given of the existence of cholera, yellow fever and small pox: Be it resolved, that it is the sense of the National Conference of Boards of Health that it is the duty of each state, provincial and local Board of Health in any locality in which said diseases may at any time occur, to immediately furnish information of the existence of such disease to the Boards of Health of neighboring and provincial states, and to the local board in such states as have no state boards.

"2. Resolved, That upon rumor or report of the existence of pestilential disease, and positive definite information thereon not being obtainable from the proper health authorities, this conference recommends that the health officials of one state shall be privileged and justified to go into another state for the purpose of investigating and establishing the truth or falsity of such report.

"3. Resolved, That whenever practicable, the investigations made under the preceding section, shall be done with the co-operation of the state or local health authorities.

"4. Resolved, That in accordance with the provisions of the foregoing resolutions the Boards of Health of the United States and Canada, represented at this conference, do pledge themselves to an interchange of information as herein provided.

"5. Resolved, That in cases which present symptoms seriously suspicious of any of the foregoing pestilential diseases, they shall be reported as provided for in the case of those deemed actually pestilential.

Of the more commonly prevalent forms of contagious diseases in this as in other states, viz., diphtheria and scarlet fever, there has been neither the number of cases or the fatality in the year covered by thisr eport that there has been in corresponding years in the past, although these diseases continue to be the ones from which the greatest amount of child mortality results in this state. It has been and will be the constant effort of the board to disseminate correct views as to the nature of these and other preventable diseases, believing that a correct knowledge of their character must underlie all intelligent action for their

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control. Circulars giving suggestions for the prevention and restriction of diseases of this kind have been widely and gratuitously distributed, and we are glad to say that they have been frequently reprinted by the press of the state, thus enormously increasing their circulation and their influence.

Typhoid fever has shown marked severity in a few places, notably in the newly opened iron regions in the northern part of the state, and at Waterford, in the south eastern part. In this latter place it assumed at one time an alarming aspect, and bade fair to become extensively epidemic, and this Board being called upon for advice and aid with reference to the restriction of the disease, the President and Secretary visited the village. The results of their investigation are given at length elsewhere in connection with this report, and will be found suggestive to all who will heed the teachings conveyed by them.

The diseases most extensively prevalent during the year have been those of diarrhoeal character, including diarrhoea, dysentery, cholera morbus and cholera infantum. The existence of one or more forms of these diseases has been reported from 487 different localities during the year, and from quite a large proportion of these the reports have been to the effect that the tendency to sickness of this kind was a very notable one. No such extensive prevalence of these diseases has ever before been reported. Concerning the fact of such prevalence, there is no question whatever among the gentlemen who have made report, although there is great diversity of opinion concerning the causes to which it was due. It may be that, as some suppose, this wide-spread tendency to diarrhoea, etc., was wholly due to some atmospheric, telluric, or meteorological influences, existent during the past year and not likely again to recur, but it is not unwise to remember that a very general tendency to diseases of this class has been frequently noted prior to periods of cholera, and no injury can follow even an excess of caution in preventing

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