ELEVENTH ANNUAL REPORT

OF THE

Secretary of the State Board of Health

OF

PENNSYLVANIA.

PRESENTED BY THE

Secretary, BENJAMIN LEE, M. D.,

November 14, 1895.

To Pemberton Dudley, M. D., President of the State Board of Health and Vital Statistics of the Commonwealth of Pennsylvania: Sir: It again becomes the duty of your Secretary to make full report of his official acts for the space of one year. During this period the Board has held three regular and five special meetings. The former took place November 8, 1894, and May 1, 1895, at Harrisburg, and July 11, 1895, at Marietta, Lancaster county, and the latter, January 12, and January 30 (adjourned meeting), February 26, May 29, all at Harrisburg, and August 29, 1895, at the Executive office, Philadelphia.

Appointments.

Since the last annual report was presented, his Excellency, the Governor, has commissioned the following named gentlemen as members of the Board, Dr. James H. McClelland, Pittsburgh, Hon. Samuel T. Davis, M. D., of Lancaster, and Mr. Richard Y. Cook, of Philadelphia, whose terms had expired, to succeed themselves, and

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Mr. John Fulton, C. E., of Johnstown, to succeed Mr. Howard Murphy, C. E., whose term expired last year.

At the regular meeting held May 1, 1895, the following resolution was unanimously adopted:

"Resolved, That in view of the discontinuance of the relations between this Board and its former engineer member, Mr. Howard Murphy, C. E., we desire to express our appreciation of his eminent abilities as a sanitary engineer, and of the great value of his labors during his long official connection with us."

While the members of the Board congratulate themselves on being privileged to continue to enjoy the wise counsels and valued companionship of a majority of their old associates, the assurances which your Secretary has received from many sources of the high standing in the community and the professional ability of its new engineer member do not permit of a doubt that his relations with the Board will be equally profitable and harmonious.

Sanitary Legislation.

Inasmuch as the year 1895 was that of the biennial session of the State Legislature, the first and one of the most important duties confronting the Board was that assigned to it by law of "suggesting any further legislative action or precaution deemed proper for the better protection of life, and health."

Acting in conjunction with the Committee on Sanitary Legislation, your Secretary drew up and submitted to the Legislature the following bills, viz:

An act to remove limitations on the appropriations to the Board; introduced in the Senate by Senator Penrose, of Philadelphia, January 1, and in the House by Mr. De Velin, of Philadelphia, January 9.

An act to remove restrictions on the binding of the annual report of the Board; introduced in the Senate by Senator Penrose, January 1, and in the House January 9, by Mr. Pennewill, of Philadelphia.

An act to constitute school boards in townships boards of health; introduced in the Senate by Senator Penrose January 1, and in the House by Mr. Riter, January 9.

An act making an appropriation for the current expenses of the Board; introduced in the House by Mr. Stineman, of Cambria county, January 9.

An act to establish a laboratory of hygiene and bacteriology at the Capital of the State; introduced in the House by Mr. Lytle, of Huntingdon county, January 10.

An act to authorize the employment of a registration clerk in the Central Bureau of Vital Statistics at the State Capital; introduced in the House by Mr. Crothers, of Philadelphia, January 10.

An act instructing the State Board of Health to make a special investigation into the sources of pollution of the water supplies of the State; introduced in the House by Mr. Culbertson, of Allegheny county, January 10.

An act to continue the Emergency Fund of $50,000.00, introduced in the House by Mr. Fow, of Philadelphia, January 9.

The Board also gave its hearty support to the "Act to provide for the more effectual protection of the public health in the several municipalities of this Commonwealth," and to the "Act to confer the right of eminent domain on the sewerage companies."

It will be observed that all of these acts were introduced early in the session. Special meetings of the Board were held, and the members of the Board, as well as the Secretary, both at Harrisburg and at their homes were incessant in their efforts to urge upon committees and upon individual members of the Legislature the importance of the measures suggested. Unfortunately, the newly elected State officers had found the finances of the State in a somewhat depleted condition, so much so that the Governor considered it his duty to transmit a special message to the Legislature, shortly after his inauguration, calling the attention of that body to the fact that owing to the prevailing financial distress there had been a shortage in the revenues of the Commonwealth for the past two years, and therefore urging the exercise of the closest economy in the matter of appropriations. As several of the bills introduced by the Board necessarily involved the expenditure of trifling amounts of money, the condition referred to was considered to warrant their rejection. The only bills of all those referred to above which received legislative and executive sanction were, that to establish or continue the Emergency Fund, and that for "the better protection of life and health in the several municipalities of this Commonwealth." With regard to the latter, it is not too much to say that if the Board and the friends of efficient sanitary administration in this State can succeed at each meeting of the Legislature in securing as important a concession as this, they need not feel that their labors have been in vain.

This alone is a sanitary triumph of the greatest possible moment. I should disregard the promptings of my sense of justice did I fail to note here that this law owes its inception to the present energetic and efficient superintendent of the Bureau of Health of the City of Pittsburgh, Mr. Crosby Gray, one of the best equipped practical sanitarians in the State, and a faithful co-worker with this Board in its efforts to promote sanitary reform. Mr. A. M. Beitler, Director of Public Safety of Philadelphia, as Chairman of the Committee on Legislation of the Associated Health Authorities of Pennsylvania,

to which the bill was referred for revision, also gave its provisions much careful thought. It traces its origin, therefore, not to medical theorists or sanitary visionaries, but to men of affairs and action. Its value consists in the fact that it constitutes in reality

The Sanitary Code of Pennsylvania.

for the restriction of communicable diseases.

Heretofore every community big or little, has adopted its own ordinances for the control of contagious disease. It followed that in many places the regulations were utterly inefficient, and that in very few places were they alike. It is true that the State Board of Health in its Model Ordinance had attempted to guide local boards and borough councils in their efforts at legislation on this important matter, and thus to induce the uniformity which is so essential to efficient administration throughout the State; but, owing to the deplorable ignorance and ironclad obstinacy of a great majority of the latter it had met with but trifling success.

Statute law and not municipal ordinance is now supreme, in every city, borough and township in the State. The language of the law is mandatory throughout leaving nothing to the discretion of local authorities, save in one particular only, that of placarding houses in which infection exists. This question is left to local option.. The Secretary suggests that the Board adopt a regulation making this measure obligatory in all places having no local health authority of their own. In rural districts and small villages, where it is usually impossible to enforce quarantine by police officers, this precaution is even of more essential value than in cities. Its educational value is immense, and it is astonishing how quickly communities not only cease to resent its enforcement, but actually demand it.

Another strong point in this law is that the payment of the penalty for its violation may be enforced by imprisonment. But its most important feature consists in its recognition of local boards of health as co-ordinate branches of municipal government with the councils, and not dependent upon the latter, as heretofore, for endorsement of their regulations in order to give them validity in these particulars. More than this, any board of health finding it desir able for any special reason, or in any emergency, to adopt more stringent regulations than those prescribed in the law, can do so, and these regulations will have equal force and authority as though embodied in the law itself. *

Apart from this, the retrospect of the legislation of the recent session is not encouraging. The Board is still expected to have a general supervision of the interests of the health and lives of five millions of people scattered over an area of forty-five thousand square

miles with the paltry expenditure of six thousand dollars annually, including the Secretary's salary of two thousand. A comparison of this amount with those appropriated to this work in other states, even those having not one-third our wealth or population, is enough to bring the blush to the cheek of every thoughtful, patriotic Pennsylvanian. The following tabular statement needs no further commentary:

STATEMENT Showing Usual Amount of Appropriation to Several of the State Boards of Health in the United States in the Order of Comparative Amount of Appropriation.

NOTE. These appropriations are solely for internal sanitation and not for external or sea-board quarantine.

Illinois. This state has a special fund of $40,000 for emergencies. Pennsylvania. This State has a special fund of $50,000 for emergencies, only to be used at the discretion of the Governor.

Not less mortifying to those who would fain see evidences of intellectual growth in our Commonwealth and of breadth of statesmanship in the chosen representatives of the people, is the entire failure of the Legislature to appreciate the importance of a

State System of Registration of Vital Statistics.

It is a matter of profound astonishment to all intelligent foreigners visiting this State, as well as to residents of neighboring states, that the great and venerable Commonwealth of Pennsylvania is entirely without such a system. Your Secretary is in receipt of frequent communications from various official and private sources, both within and without our own State, and also from European countries, seeking information which can only be afforded by a complete system of registration of births, marriages and deaths; but, with annoyance and mortification is compelled to explain that there are