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 ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 REGULAR MEETING, JANUARY^, of ^ 
 
 JUN 25 1951 
 
 , The regular quarterly meeting of the Michigan fHHe^ Board oPllokftiP&u 
 held in the State capitol in Lansing, January 11, 1887. The members pres- 
 ent were as follows: Hon. John Avery, M. D., President; Prof. V. C. 
 Vaughan, M. D.; Prof. Henry F. Lyster/M. D.; Arthur Hazlewood, M. D.; 
 J. H. Kellogg, M. D.; and Henry B. Baker, M. D., Secretary. 
 
 Considerable business was transacted, and several papers were presented 
 of public interest. 
 
 Dr. Avery, the President of the Board, gave his annual address at this 
 time because this was the last meeting before the expiration of his term as 
 member of the Board. 
 
 # 
 
 ANNUAL ADDRESS. 
 
 BY HON. JOHN AVERY, M. D., PRESIDENT OF THE MICHIGAN STATE BOARD 
 
 OF HEALTH. 
 
 Gentlemen of the Board : 
 
 It would seem appropriate that we should pause at the beginning of the 
 new year to examine the work done in the past, and to forecast, as far as 
 possible, the duties of the Board in the future. 
 
 It is certain that the first and highest duty of the State is the protection 
 of the health and lives of its citizens. If health is luxury to the rich, it is 
 the poor man's capital; and the wages of each day’s work in the interest of 
 that capital pays its owner. The loss of a day’s work is a loss of interest on 
 invested capital. Any impairment of health is a loss of capital itself. Sick- 
 ness not only impairs ability to labor, but it entails expenses, and thus both 
 stops interest and encroaches upon capital. When this impairment of health 
 is the result of a preventable cause, it is evidence that a wrong has been 
 committed by some one. 
 
 , To prevent these wrongs so far as possible, and to protect the health and 
 lives of its citizens, the State has enacted public health laws, created a State 
 Board of Health, and a local board of health in every municipality in the 
 State. The duties of these boards are clearly defined in the laws creating 
 them. Those of the State Board are supervisory and advisory. It has the 
 “general supervision of the interests of the health and life of the citizens of 
 the State.’’ It has now been in existence thirteen years, a sufficient length 
 of time to warrant a brief review of the work it has done. 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Has it steadily approached the object for which it was created? Has it 
 faithfully endeavored to perform its duties? Has it met the expectations of 
 its friends and won the confidence of the people of the State? 
 
 Perhaps I can not better summarize the work of the Board in the past 
 than by quoting from an article read by me before the sanitary convention 
 held in Lansing last March: “ The State Board of Health has earnestly and 
 honestly endeavored to carry out every provision of the law creating it. It 
 has each year kept its expenditures within the amount appropriated for its 
 use, and covered back into the treasury an unexpended balance. It has 
 prepared, printed, and circulated among local boards of health, health offi- 
 cers, and the people, over 500,000 copies of monographs on different sub- 
 jects relating to public health; it has collected records of sickness and deaths 
 in different parts of the State and given the results back to the whole peo- 
 ple ; it has inquired into the causes of local epidemics and advised and warned 
 such communities of their danger. It has investigated special causes of sick- 
 ness, such as poisonous cheese, diseased meats, adulterated foods, and pol- 
 luted water supplies. The members of the Board have visited various places 
 in the State where nuisances have been reported to them by aggrieved citi- 
 zens, and advised as to the remedy in such cases. They have visited, at the 
 request otthe Board of Corrections and Charities, poor-houses and jails in 
 different counties of the State, called attention to their defects and pointed 
 out how they might be improved. They have visited the prisons and other 
 State institutions at the request of their officers or boards of control, to 
 advise how their condition could be bettered ; and their advice has generally 
 been kindly and courteously received, and often acted upon to the improve- 
 ment of such institutions. They have examined plans of public buildings 
 about to be erected, and suggested alterations as to heating, ventilation, 
 sewerage, drainage, plumbing, and lighting, and safety in case of fire, and 
 their suggestions have been kindly and thankfully received and acted upon 
 by architects and builders. And the results of these inspections of the plans 
 of public buildings is, not only that the State has buildings better adapted 
 to the uses for which they are designed, but more attention is being paid to 
 these details in building public halls, school-houses, churches, and private 
 residences, and in this way the comfort, safety, and health of the people are 
 better cared for. They are in direct and frequent communication with every 
 city, village and township in the State through their local boards of health 
 and health officers. They act as a sort of central signal station to which sig- 
 nals of alarm and danger are sent from every part of the State and from 
 which warning is sent to the endangered and advice to the afflicted.” 
 
 The Board has maintained pleasant and profitable relations with neighbor- 
 ing State Boards of Health, and with the National Board of Health, and its 
 work has been approved and commended by both. 
 
 There can be no question but that the practical exemption of the people 
 of this State from small-pox during the prevalence of an epidemic in a 
 neighboring province that paralyzed business and claimed more than four 
 thousand victims, in 1885, was due to the efficient immigrant inspection ser- 
 vice inaugurated by the Michigan State Board of Health, and afterwards 
 continued by the national health authorities. 
 
 There have been held under the auspices of the Board sixteen sanitary 
 conventions in as many different localities in the State. 
 
 These conventions have generally been well attended by local health offi- 
 
ABSTRACT OF PROCEEDINGS, JAN. 11, 1887. 
 
 3 
 
 ■cers, in their immediate vicinity, and by the public generally, with the effect 
 of bringing the local health officers and the State Board into closer relations 
 with each other, and of creating a morn general interest in all matters per- 
 taining to the public health. The papers read at these conventions and the 
 discussions elicited have been given to the people. 
 
 While it is true there are at the present time frequent outbreaks of com- 
 municable diseases, particularly of scarlet fever and diphtheria, it is also 
 true that these outbreaks are generally confined to the initial cases, and 
 owing to the better information of the people and more efficient action of 
 local boards of health, these diseases are not allowed to spread as in former 
 years. 
 
 This summary of work accomplished is also a forecast of the work to be 
 •continued by the Board. 
 
 Continue the education of the people by means of sanitary conventions 
 and the circulation of printed matter upon all subjects pertaining to public 
 health work upon which the public need to be informed. 
 
 Inaugurate and carry forward a vigorous and uncompromising campaign 
 against the ever present nuisance of the privy vault and cesspool. 
 
 Devise some practical method for the disposal of excreta and kitchen waste 
 in unsewered cities, villages and the rural districts, that the water supply 
 may not be polluted in these localities. 
 
 If possible, inaugurate a system of house-to-house inspection, in order 
 that each municipality may be informed of the sources of danger in its 
 midst. 
 
 Would it not be in the interest of public health for the Board to inquire 
 into the practical value of teaching the elements of hygiene in our common 
 ;and graded schools? 
 
 Would it not be of value to the people of the State, and in the interest of 
 public health, for the Board to make suggestions in regard to the construc- 
 tion, heating, and ventilation of common country school-houses, and per- 
 haps to furnish a few general plans for the same? 
 
 And now, gentlemen, fully impressed with the importance of the work 
 accomplished by the Board in the past, and with its value to the people of 
 the State, and with a firm belief that its usefulness will increase with each 
 year’s added experience, it remains for me to congratulate the Board that it 
 hae been its good fortune to have been at all times so ably represented by a 
 competent and efficient secretary, and to thank each individual member for 
 the uniform courtesy I have received from them during the time I have been 
 •connected with the Board. 
 
 CONDITION OF HEALTH, LAST QUARTER OF 1886. 
 
 In his “ Quarterly report of work,” the Secretary said : “ The office during 
 the quarter has received information of, and has taken action relative to, 
 48 outbreaks of typhoid fever in Michigan ; 63 outbreaks of scarlet fever, 
 and 111 outbreaks of diphtheria. To such localities there have been sent, 
 for distribution to the neighbors of those sick, about 480 documents on the 
 prevention of typhoid fever ; about 650 on the restriction and prevention of 
 scarlet fewer, and about 1,100 on the restriction and prevention of diph- 
 theria.” 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 SICKNESS AND METEOROLOGICAL CONDITIONS IN THE FOURTH QUAR- 
 TER OF 1886 COMPARED WITH THE THIRD QUARTER OF 1886, AND 
 WITH THE AVERAGE FOURTH QUARTER IN THE EIGHT YEARS 1879- 
 1886. 
 
 Contagious Diseases. 
 
 Compared with the preceding quarter (July, August and September), re- 
 ports received from all sources show the number of places at which diphtheria 
 was reported to have increased by an average of sixteen places per month, 
 scarlet fever to have increased by an average of fifteen places per month,, 
 typhoid fever to have decreased by an average of one place per month,, 
 measles to have occurred at the same ' number of places, and small-pox to 
 have decreased by an average of one place per month, in the fourth quarter 
 of 1886. 
 
 Sickness from all Causes. 
 
 A comparison of meteorological conditions of the fourth quarter of 1886 
 with the meteorological conditions of the third quarter shows the tempera- 
 ture to have been much lower, the absolute humidity to have been much less, 
 the relative humidity more, and the day and the night ozone less in the 
 fourth quarter than in the third quarter of 1886. 
 
 Compared with the preceding quarter (July, August and September), the* 
 reports received from regular observers indicate a marked increase of influ- 
 enza, bronchitis, tonsilitis, pneumonia, neuralgia, rheumatism, and diph- 
 theria, and a marked decrease of diarrhea, cholera morbus, cholera infan- 
 tum, dysentery and intermittent fever in the fourth quarter of 1886. 
 
 A comparison of the meteorological conditions of the fourth quarter of 
 1886 with the average of corresponding quarters in the eight years, 1879— 
 1886, shows that in 1886 the temperature was slightly lower, the absolute 
 humidity was slightly less, the relative humidity and the night ozone were 
 slightly more, and the day ozone was considerably more than in the average 
 fourth quarter of the eight years, 1879-1886. 
 
 Compared with the average for the corresponding quarter in the eight, 
 years, 1879-1886, the reports received from regular observers indicate that, 
 intermittent fever, remittent fever, typho-malarial fever, pneumonia, con- 
 sumption of lungs, typhoid fever, and diphtheria were less prevalent in the 
 fourth quarter of 1886 ; and that there was no disease that was more than 
 usually prevalent in that quarter. 
 
 EXAMINATION OF PLANS FOR PUBLIC BUILDINGS. 
 
 Preambles and resolutions were adopted as follows : 
 
 Whereas, Relative to sec. 7 of act 206, laws of 1881, (§ 418 of Howell’s statutes) which law requires 
 boards of charitable, penal and reformatory institutions to submit plans of proposed public build- 
 ings to the Board of Corrections and Charities, and to the State Board of Health, for examination 
 and opinion thereon,— certain State institutions have fixed the time and place for such examination 
 and opinion when it was impossible for members of this Board to attend, and have then adopted 
 plans without submitting them to the State Board of Health for its opinion ; and, 
 
 Whereas, The law does not give the boards of State institutions the power to fix absolutely the 
 time for the examination, by the State Board of Health, of plans for proposed public buildings ; and 
 Whereas, Because of previous engagements to attend Sanitary Conventions or other special 
 meetings of this Board, it is at some times impracticable for this Board to meet at short notice at a 
 given time or place ; therefore, 
 
ABSTRACT OF PROCEEDINGS, JAN. 11. 1887. 
 
 5 
 
 Resolved , That boards of control of State institutions having plans to submit to this Board under 
 «ec. 7 of act 206, laws of 1881, are respectfully requested to file such plans in the office of the Board in 
 the State capitol at such times as that they may be examined at one of the regular meetings of this 
 Board, which meetings occur on the second Tuesday of each January, April, July, and October; and 
 that when this is impracticable or inconvenient, the plans be filed and not less than ten days’ time 
 he given this Board to call a special meeting for the purpose of the examination of such plans, at the 
 office of the Board, at the place of the proposed building, or at the place of some sanitary convention, 
 as the circumstances may require. 
 
 Resolved , That it will facilitate the work of this Board in the examination of such plans and in the 
 forming of opinions thereon if boards submitting plans will have their architect, or other represent- 
 ative, present at the meeting of this Board, to explain the plans, the proposed location, etc. 
 
 Resolved , That a copy of these resolutions he sent to all State Boards of charitable, penal and re- 
 formatory institutions in this State. 
 
 PLANS FOR MODEL SCHOOL-HOUSES. 
 
 A committee of three (Drs. Avery, Kellogg and Hazlewood) was appointed 
 to draft plans for model school-houses, including plans for ventilation, sew- 
 erage and drainage, and diposal of excreta. The committee was author- 
 ized to employ an architect to assist them. School boards, or those having 
 in charge the erection of school buildings, are requested to submit plans. 
 
 ALLEGED POLLUTION OF DETROIT RIYER. 
 
 There was presented considerable correspondence from health officers of 
 cities and others on the Detroit river, below Detroit, concerning the alleged 
 pollution of the river by sewage and garbage from Detroit, and sickness 
 in consequence. This subject was discussed, and was made the special or- 
 der for the afternoon session of the next regular meeting, Tuesday, April 12, 
 1887. 
 
 LABORATORY OF HYGIENE AT THE UNIVERSITY. 
 
 Dr. Lyster, chairman of the committee appointed to confer with the 
 Regents of the University relative to the establishment of a laboratory of 
 hygiene at that institution, made the following report : 
 
 Your committee met with the Board of Regents, Dec. 7, 1886, at the Uni- 
 versity, each member of the committee individually presenting the subject 
 to them : — 
 
 Remarks by Henry F. Lyster, M. D. 
 
 Dr. Lyster, chairman of the committee, said substantially as follows : 
 
 Mr. President and Gentlemen : — We regard the position of the Board of 
 Regents as that of those having in trust the future prosperity of the University 
 of Michigan as well as of its present interests, and that the one is a complement 
 of the other. The time has come in this commonwealth when the people are 
 not satisfied to be the recipients merely of the original ideas and original 
 work of eastern minds and to appropriate the work of others. They recognize 
 the fact that the assimilation of the brainwork and handicraft of others does 
 not develop the strength and power th’at belongs to those who exercise their 
 minds and hands in labor. 
 
 The civilization, enlightenment and the environment of the people of 
 this State are such that it is perfectly competent for them to enter upon the 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 department of original research in the several branches of applied science* 
 and particularly in biology and all that pertains to the preservation of the 
 public health and the limitation of disease. 
 
 There is no institution where these branches of study should be pursued other 
 than a laboratory furnished and equipped with all necessary furniture and 
 machinery now approved and in use and to which such additional material 
 and supplies as required may be added. 
 
 This laboratory should naturally belong to the State University and have- 
 all the advantages of the association with the other departments of learning 
 and of the library. In union there is strength, and in the association of 
 these departments there will be felt an influence in the direction of scientific 
 thought and investigation which will redound to the interest of the Uni- 
 versity and of the State at large. 
 
 The University of Michigan after a history of 50 years, and with over 
 1,300 students, and after all the good it has done, and all the credit and 
 honor it has reflected upon the name of this State, must develop at once in 
 the department of natural science if it is proposed to keep it among the lead- 
 ing educational institutions in this country. 
 
 The University of Cambridge, England, has had a history of more than 
 nine hundred years, and has now about the same number of students in 
 attendance, and is still constructing new departments and new courses of 
 lectures to meet the wants of the times, and this is equally true of the Uni- 
 versity of Oxford, and of the universities of Berlin, Vienna, Strasburg, and 
 of other European cities and States, as well as of the University of Harvard, 
 and the Johns Hopkins University in this country. 
 
 Now if the members of this Board of Regents of the State University are 
 not merely governors pro tempore , but are in reality the wardens of the State 
 in whom are reposed the interests of its crowning educational institution in 
 trust, we ask as representatives of the State Board of Health, after 13 years’ - 
 study of the public health interest, that you ask from the State* legislature 
 such an appropriation as may be necessary to organize and equip a suitable 
 laboratory of biology and hygiene which in the opinion of the board which 
 we represent is absolutely essential to the best interests of the people of this- 
 State for their preservation and well-being. 
 
 Remarks by Victor C. Vaughan, M. D., Ph. D. 
 
 Dr. Vaughan spoke substantially as follows: 
 
 The degree to which a nation or community has advanced in civilization- 
 may be measured by the attention it gives to the protection of the health 
 and the prolongation of the lives of its citizens. In the dark ages people 
 lived in filth., were poisoned by their own excretions, and died by the thou- 
 sands. Between March and July, 1348, there perished in Florence alone- 
 more than 100,000 persons from the black death. Geneva lost 40,000 inhab- 
 itants, Naples 60,000, Venice 70,000, and in the brief space of four years 
 there perished in the whole of Europe not less than 40,000,000 of people 
 poisoned by the filth which they had accumulated about themselves. In 
 1665 the same filth disease swept from London more than 100,000 of its popu- 
 lation. By some attention to cleanliness the black death has been quite 
 banished from Europe; but other filth diseases still prevail in both hemi- 
 spheres. In our own State there are reported on an av'erage 500 deaths 
 
ABSTRACT OF PROCEEDINGS, JAN. 11, 1887. 
 
 annually from typhoid fever. There is reason to believe that this is actually 
 about one-half the true number, and we would be safe in saying that ther?, 
 are 1,000 deaths each year in this State from typhoid fever alone, and this 
 is much less than it was before the State Board of Health began its work. 
 For each death from typhoid fever there are on an average 15 persons sick. 
 This gives 15,000 cases of typhoid fever per year in this State, and if sani- 
 tary science was thoroughly understood by the people there need not be a 
 single case of this disease. This may seem to be a very strong statement, 
 but in one place its truth has been quite nearly demonstrated. From 1852 
 to 1859 the annual death rate from typhoid fever in Munich per 10,000 
 inhabitants was 24.2. After the establishment of the famous hygienic labor- 
 atory at Munich, and as a result of the investigations made at that laboratory, 
 certain municipal sanitary improvements have been made and the death rate 
 from typhoid fever has decreased until in 1884 it was only 1.4 per 10,000. 
 In a population of 250,000 this is an annual saving of over 500 lives, and 
 more than 7,500 cases of illness from this one disease alone. But typhoid 
 fever is not the only preventable disease. The list is a long one, and embraces 
 such dreaded scourges as diphtheria, scarlet fever and cholera. Can the educa- 
 tional facilities of the State be better employed than in giving instructions 
 in methods of preserving the health ? The State teaches the literature and 
 language of ancient Greece; should it not give some attention to the health 
 and lives of its own citizens ? It makes doctors who are to cure disease; 
 would it not be well to give a little attention to the prevention of disease P 
 It gives its students instruction in the means of preventing disease among 
 the lower animals ; shall it leave from its curriculum altogether the study of 
 the prevention of diseases which afflict human life ? Are the lives of its citi- 
 zens of so little value ? 
 
 Nearly every civilized country is now manifesting great interest in the 
 protection of the health and prolongation of the lives of its citizens. Ger- 
 many has established a number of hygienic institutes in connection with its 
 universities, and all students are instructed in sanitary science. 
 
 The already famous Imperial Laboratory of Hygiene at Berlin, under the 
 charge of Prof. Koch, has accomplished a great work. Here the contagious 
 nature of consumption (the most dreaded of all diseases in this latitude) has 
 been demonstrated, and the public is how being instructed in the methods 
 of procedure necessary to limit its spread, and the probabilities are that by 
 intelligent care in this direction the death rate from this disease will be 
 greatly decreased. 
 
 France has given much aid to practical hygiene, and the labors of Pasteur 
 on anthrax and hydrophobia are known and appreciated everywhere. 
 
 The municipal laboratory of Paris is maintained by the city, and for a 
 small fee anyone may have any sample of food or drink tested for adultera- 
 tions. In this way the people of Paris have become quite thoroughly posted 
 concerning adulterations, and from this knowledge the wisest and most 
 satisfactory enactments against food adulterations have been made and are 
 enforced. 
 
 England through its Local Government Board has carried on many im- 
 portant hygienic investigations, among which may be mentioned the recent 
 studies which have demonstrated the fact that scarlet fever may be transferred 
 from cows to children through milk. 
 
 In the United States much money has been spent in health work. Several 
 States have salaried analysts, milk inspectors, etc. 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 The Legislature of Louisiana two years ago appropriated $16,000 to enable 
 Dr. Holt, of the State Board of Health, to make some experiments in the 
 disinfection of ships. As a result of those experiments, which were success- 
 ful, yellow fever has been practically kept out of the State. The same State 
 maintains the disinfection of ships at the mouth of the Mississippi, and thus 
 protects not only itself but the whole of the Mississippi Valley. The State 
 of Mississippi appropriates $45,000 annually for health work. 
 
 The policy of Michigan in its health work, as in other departments of 
 State legislation, has been to educate the people. The Michigan State Board 
 of Health is not an executive body; its powers are wholly advisory, and it 
 has accomplished the great work for which it is universally given credit by 
 educational means; these it hopes to strengthen and widen by the laboratory 
 of practical hygiene which you have been asked to establish. 
 
 There is needed some place where every health officer of a town, village or 
 city can have samples of drinking water or articles of food tested for 
 impurities and adulterations. This could not be done for nothing, but at a 
 minimum fee, and the money obtained for work of this kind could be turned 
 into the laboratory fund ; this would give every locality in the State a direct 
 interest in the University, and all could see the practical benefit to be 
 derived from this department. Reflexly this would aid the University and 
 lead to its more hearty support by the people. 
 
 There are constantly being presented problems in the study of the origin 
 and spread of disease which can be solved only with the aid of a well- 
 equipped laboratory. One or two illustrations will serve to make this plain. 
 A grocer sells to fifty people some meat which is apparently all right, but it 
 makes everybody sick. What is the cause of the trouble ? This can be 
 ascertained only by careful and long study with all the aid that science can 
 bring to bear. The grocer can not be expected to pay for this investigation 
 because he is not to blame, and certainly those poisoned can not be asked 
 to pay for it. The State should do the work, should endeavor to ascertain 
 the cause and instruct its citizens against future similar calamities. Again 
 the question of the best method of the disposal of garbage is one in which 
 every householder in the State is directly interested, and which can be deter- 
 mined only by laboratory experimentation. The effects of slightly decom- 
 posed milk and the methods of detecting and preventing such decomposition 
 are questions which need solution. These and a hundred other problems are 
 of public interest and can be solved only by laboratory work. 
 
 Then this laboratory should be made an educational center in hygienic 
 subjects. The results of the work done in it should, through the State 
 Board of Health, be made known to the people. 
 
 There should also be carried on in such a laboratary original investigations 
 concerning the causation, nature, and prevention of disease. There can be 
 no question as to the duty of the State in protecting the lives of its citizens, 
 and no one can deny the fact that education in sanitary matters is one of the 
 most powerful protective aids that can be furnished any people. 
 
 Again, the instruction offered by such a laboratory to its students will 
 make them fit advisers in all sanitary matters to the various communities in 
 which they live. 
 
 The following is a proposed plan of study to be followed in such a 
 laboratory: » 
 
ABSTRACT OF PROCEEDINGS, JAN. 11, 1887. 
 
 9 
 
 SCHEDULE OF STUDIES. 
 
 I. The Air. — A. Physical Studies : (a) Observations on temperatures and 
 the influence of temperature on health, (b) Determinations of air pressure 
 and the effects of variations in air pressure upon diseases of the lungs and 
 heart, (c) Determinations of air moisture and the effects of climate as 
 affected by moisture, (d) Determinations of ozone and a study of its rela- 
 tions to disease, (e) Ventilation of houses. 
 
 B. Chemical Studies : (a) Analysis of air and determination of carbonic 
 acid gas. (b) Study of organic matter in the air and its effect upon health, 
 (c) Microscopical studies of the air. 
 
 II. The Soil. — A. Physical Studies of the Soil: — (a) Determination of 
 porosity, (b) Determination of the capacity of the soil for the absorption of 
 water, (c) Determination of moisture, (d) Determination of temperature. 
 
 B. Chemical Examination of the Soil : (a) Determination of organic mat- 
 ter. (b) Analysis of ground air. (c) Analysis of ground water, (d) Micro- 
 scopical examination of soil, (e) Diseases due to soil pollution. 
 
 III. Water. — (a) Physical properties, (b) Chemical analysis, (c) 
 Microscopical examination, (d) Diseases due to impure water. 
 
 IV. Foods. — (a) Nutritive value of foods, (b) Economical value of 
 foods, (c) Study of individual foods, (d) Analysis of foods, (e) Detec- 
 tion of adulterations. 
 
 V. Clothing. — (a) Physical properties of clothing, (b) Chemical prop- 
 erties of clothing, (c) Hygienic considerations of clothing. 
 
 VI. Healthy Homes. — (a) Sanitary locations, (b) Sanitary properties 
 of building material, (c) Study of air, space and ventilation, (d) The size, 
 arrangement and care of rooms, (e) Study of temperature and methods of 
 heating, (f) Water supply, (g) Disposal of waste. 
 
 VII. Contagious Diseases. — (a) The nature and history of contagious 
 diseases, (b) Study of germs, (c) Restriction of contagious diseases, (d) 
 Vaccination, (e) Disinfectants and disinfection. 
 
 VIII. Original Investigations. — I may state that the building should 
 be about 80 x 60 feet, two stories high, and with basement. It would require 
 furnishings and apparatus. There would be need for books and periodicals, 
 as the general library is almost wholly wanting in books on sanitary sub- 
 jects. 
 
 Abstract of Remarks by Henry B. Baker, M. D. 
 
 Dr. Baker said he wished to endorse the outline which had been presented 
 by Dr. Vaughan, and to emphasize the necessity of laboratory work as an 
 aid in teaching sanitary science. It was generally understood that for the 
 successful teaching of chemistry, laboratory work was essential, but he 
 thought it was not so well understood as it should be, that for successful 
 teaching in sanitary science a well-equipped, laboratory is essential. He 
 hoped the Regents would ask the Legislature for means to establish the lab- 
 oratory, not because it has been recommended by the State Board of Health, 
 but because it is right, and will make the University more useful in promot- 
 ing the welfare of the people. The University can do no nobler work. He 
 assumed that no elaborate argument was needed to convince the Regents of 
 the University that mental training in sanitary science was worthy to rank 
 higher than training in any science or art or literature. The question should 
 not be, why establish an effective system of training in sanitary science ? It 
 2 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 should be, why has this not been done long ago ? But mankind had to wait 
 centuries, until many universities and educational systems had grown old, 
 before the question was raised, “ What knowledge is of most worth ? ” What 
 sort of mental training is of most benefit to mankind ? He supposed that 
 all present had read Herbert Spencer’s work on education which started 
 with that inquiry, and which laid down a few propositions which seemed so 
 true as to require no proof. One conclusion was, “ That knowledge is of 
 most worth which tends directly to preserve life.” Another is, in effect, 
 that next in value is knowledge which tends indirectly to preserve life. And 
 compared with such knowledge and training in such directions, much that 
 has been taught in schools and in universities must be placed low in the scale 
 of immediate and prospective usefulness. 
 
 The University is charged with the noble duty of training the minds of 
 those who are to become the leaders of thought throughout this State and in 
 the nation. The State cannot afford to have those who are to be the leaders 
 in thought throughout the State untrained in sanitary science — ignorant of 
 that knowledge which is of most worth. He trusted that the Regents would 
 do all in their power to establish a laboratory of sanitary science, and a sys- 
 tem of instruction therein, and as rapidly as possible raise the system to that 
 high plane to which sanitary science is entitled by reason of its great useful- 
 ness to mankind. 
 
 The report of this committee was discussed, and the proposed laboratory 
 and system of instruction heartily supported by all present. In the course 
 of the discussion. Dr. Baker presented the following: 
 
 The highest education, and that of most utility, is that which best fits 
 one for right living, in every sense — that which has to do with the preserva- 
 tion of life and the perfection of physical and mental health. To supply 
 this higher education, in recent times, the several sciences have been laid 
 under contribution to form a science of hygiene, usually called sanitary 
 science. So long as the State University fails to supply this higher educa- 
 tion which is of most utility and vital importance to the people of this State, 
 or continues to give it a place inferior to the ordinary sciences, the Univer- 
 sity cannot expect more than half-hearted support by those who have at 
 heart the highest interests of the people. 
 
 The State Board of Health passed a resolution asking the regents of the 
 University to' consider the advisability of establishing a laboratory of 
 hygiene, in which original investigations should be carried on, etc. ; but it 
 was not considered that this was the only use for a laboratory. If it were, 
 the Board of Health itself might more properly ask the Legislature to grant 
 it an appropriation, so it could do what some other government boards of 
 health do, namely: Have original investigations made under its own direc- 
 tion. The cause of that disease which causes most deaths throughout the 
 world has apparently been discovered through such investigations under the 
 direction of the Board of Health in Germany. But this State Board of 
 Health had also in view, and its committee placed before the regents, the 
 idea of the great importance of such a laboratory, for the purpose of teach- 
 ing, in the best manner, at the University of Michigan, “ That knowledge 
 which is of most worth.” 
 
 In the Governor’s message it is shown that the regents have a willingness, 
 but not a great desire, to advance in this direction. In that case, it is pos- 
 
ABSTRACT OF PROCEEDINGS, JAN. 11, 1887. 
 
 11 
 
 sible that a laboratory of hygiene might be more enthusiastically supported 
 in connection with the State Agricultural College, in which great attention 
 is given to some of the sciences which lead up to and contribute to sanitary 
 science, and at the head of one department of which is Prof. Kedzie, an ex- 
 President of this Board and of the American Public Health Association, and 
 a sanitarian well known in Michigan and elsewhere. 
 
 The proposition to maintain such a laboratory at the University, however, 
 has come about because of recent valuable work done in the present imper- 
 fect laboratory at the University, by Prof. Vaughan, who lectures on sani- 
 tary science, in the school of political economy, at the University, and whose 
 original investigations into the nature of the cause of numerous cases of 
 poisoning in this State have resulted in learning, not only the nature of that 
 cause, but probably also of the cause of one of the most important diseases 
 of mankind. Prof. Vaughan’s important researches are already known and 
 acknowledged throughout the civilized world. It is a mistake, therefore, 
 to suppose that it is an entirely new scheme to establish a laboratory of 
 hygiene at the Michigan University. It is not an untried experiment. It is 
 a proposition to give proper room, opportunity and support to a laboratory 
 which has already made contributions of incalculable value for the promo- 
 tion of human welfare; and a proposition to provide for better instruction 
 in a subject now imperfectly provided for, but which is the most important 
 of all subjects which receive attention at the State University. 
 
 The following memorial was then unanimously adopted and signed : 
 
 To the Honorable the Senate and House of Representatives of the State of Michigan : 
 
 Your memorialists, the members of the State Board of Health, respectfully represent that : 
 
 Whereas, The highest education, and that of most use, is that which best fits mankind for right 
 living, that which tends directly to the preservation of life, and to the perfection of physical and 
 mental health and strength ; and, 
 
 Whereas, The teaching of such “knowledge of most worth” at the University of Michigan is not 
 yet well provided for ; therefore, 
 
 Resolved, That we earnestly memorialize your honorable bodies to take such action as shall lead 
 to the maintenance of a well-equipped laboratory of hygiene at the University of Michigan, and of 
 such instruction in sanitary science at that institution, as shall place that subject on a plane not 
 inferior to that of any other subject taught at the University. 
 
 The secretary presented to the board a very handsome and artistic “ Cer- 
 tificate of Thanks” (24x30 inches), which had been awarded to the Michigan 
 State Board of Health by the International Health Exhibition of 1884, in 
 London, England, for “services rendered,” and which was received through 
 the Department of State at Washington. 
 
 PRACTICAL RESULTS IN PREVENTING AND RESTRICTING COMMUNI- 
 CABLE DISEASES. 
 
 Dr. Baker reported his attendance, and much valuable information gained 
 at the annual meeting of the conference of State and Provincial Boards of 
 Health, at Toronto, Ontario, in October, 1886. Most of the States of the 
 Union and the Provinces of the Dominion were represented. The program 
 called for a discussion of the following proposition from Kentucky: 
 
 “ What have been the actual practical results secured, outside of large cities and towns, in pre- 
 venting the spread of scarlet fever, measles, diphtheria and typhoid fever, and how is the cooperation „ 
 of the medical profession and the general public best secured in such work ?” 
 
12 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 The discussion was opened by Henry B. Baker, M. D., secretary of the 
 Michigan State Board of Health, who, after preliminary remarks, presented 
 the following : 
 
 The Michigan State Board of Health was established in 1873. Late in that 
 year the board issued a circular to physicians stating the duties of physicians 
 and others under the law in dealing with “small-pox and other diseases dan- 
 gerous to the public health;” also showing the relative danger to the pub- 
 lic health from the various communicable diseases. The circular showed 
 that scarlet fever caused more deaths by far than small-pox, and it was urged 
 that if scarlet fever was properly restricted, the deaths from that disease 
 might be greatly lessened. The circulars were distributed to the physicians 
 throughout the State. From that time forward scarlet fever in Michigan 
 has been treated by the State Board of Health as a dangerous communicable 
 disease, and at present isolation and disinfection are quite generally enforced 
 by local boards. 
 
 Table 1. — Deaths from Scarlet Fever , reported to the Secretary of State, as having 
 occurred in Michigan during the five years , '1869-7 3, compared with the eleven years , 
 1874-84; 1873 being the year, in the latter part of which, the Michigan State Board 
 of Health was established and began its work. Also a comparison of the three years 
 1874-6, with the eight years, 1877-84 ; the Document on the Restriction and Preven- 
 tion of Scarlet Fever having been issued by the State Board of Health in 1877, and 
 distributed each year since that date . 
 
 Years. 
 
 (Five.) 
 
 Deaths. 
 
 
 Years. 
 
 (Eleven.) 
 
 Deaths. 
 
 
 Years. 
 
 (Three.) 
 
 Deaths. 
 
 
 Years. 
 
 (Eight.) 
 
 Deaths. 
 
 1869 
 
 252 
 
 
 1874 
 
 440 
 
 
 1874 
 
 440 
 
 
 1877 
 
 404 
 
 1870 
 
 852 
 
 
 1§75 
 
 423 
 
 
 1875 
 
 423 
 
 
 1878 
 
 429 
 
 1871 
 
 696 
 
 
 1876 
 
 399 
 
 
 1876 
 
 399 
 
 
 1879 
 
 418 
 
 1872 
 
 565 
 
 
 1877 
 
 404 
 
 
 
 
 
 1880 
 
 370 
 
 1873 
 
 580 
 
 
 1878 
 
 429 
 
 
 
 
 
 1881 
 
 383 
 
 
 
 
 1879 
 
 418 
 
 
 
 
 
 1882 
 
 592 
 
 
 
 
 1880 
 
 370 
 
 
 
 
 
 1883 
 
 673 
 
 
 
 
 1881 
 
 383 
 
 
 
 
 
 1884 
 
 326 
 
 
 
 
 1882 
 
 592 
 
 
 
 
 
 
 
 
 
 
 1883 
 
 673 
 
 
 
 
 
 
 
 
 
 
 1884 
 
 326 
 
 
 
 
 
 
 
 Sums 
 
 2,945 
 
 
 
 4,857 
 
 
 
 1,262 
 
 
 
 3,595 
 
 
 
 
 
 
 
 
 Averages.. 
 
 589 
 
 
 
 442 
 
 
 
 421 
 
 
 
 449 
 
 
 
 
 
 
 
 I submit a table (No. 1) in which the deaths from scarlet fever reported 
 to the Secretary of State as having occurred in Michigan during the five 
 years (1869-73) immediately preceding the organization of the State Board 
 of Health, is compared with the eleven years, 1874-84, the period of restric- 
 tion since the Michigan Board was established. 
 
 In table 1, I have also studied the effect of the circulation of a document 
 giving detailed information relative to the restriction and prevention of 
 scarlet fever. Such a document was issued by the Michigan State Board of 
 
ABSTRACT OF PROCEEDINGS, JAN. 11, 1887. 
 
 13 
 
 Health in 1877, and has been distributed thoroughly each year since. I 
 have compared the three years, 1874-76, just before the document was issued, 
 with the eight years, 1877-84, since it was issued. Although the average 
 number of deaths reported annually in the latter period is slightly greater 
 than during the three years immediately preceding, partly because the eight- 
 year period contains an epidemic year, there was not an increase but a de- 
 crease in the proportion of deaths to population. This is shown in the ex- 
 hibit (No. 1) in which allowance is made for the actual increase of popula- 
 tion, and it is found that during the time of the distribution of the docu- 
 ment there was a saving of 64 lives per year, or 512 lives during the eight 
 years compared with the three years in which the State Board labored to 
 prevent the spread of scarlet fever, but did not distribute a document con- 
 taining full directions how to restrict the disease. By exhibit 1 it will be 
 seen that during the entire period since the organization of the State Board 
 of Health the average deaths per year were 2.1 per 10,000 inhabitants less 
 than in the period previous to that time. The average annual population 
 during the 11-year period is estimated from the population as stated in the 
 Michigan manual to have been 1,609,023. This indicates a saving of 338 
 lives per year, or 3,718 lives saved from death from this one disease during 
 the first 11 years after the State Board of Health was established. (Statis- 
 tics for 1885 and 1886 are not yet available.) 
 
 Exhibit 1 . — A comparison of the Deaths from Scarlet Fever, reported to the Secretary 
 of State as having occurred in Michigan during the jive years (1869-73) just preceding 
 the organization of the State Board of Health, with the three years (1874-76) imme- 
 diately succeeding its organization, and those three years (1874-76) with the eight 
 years (1877-84), durinq which the document on Restriction of Scarlet Fever was dis- 
 tributed; also the jive years (1869-7 3) just before the establishment of the Board with 
 the eight years (1877-84) during the use of the document ; and finally a comparison 
 of the jive years (1869-73) just preceding the work of the Board, with the eleven years 
 (1874-84) since the State Board of Health was established. 
 
 Periods of Time 
 
 Compared. 
 
 Estimated 
 
 Average 
 
 Population. 
 
 Average 
 Deaths 
 Reported 
 per Year. 
 
 Total 
 
 Reported 
 
 Deaths. 
 
 Average 
 Reported 
 Deaths per 
 Year per 
 10,000 
 
 Inhabitants. 
 
 Decrease of 
 , Deaths 
 per Year per 
 10,000 
 
 Inhabitants. 
 
 Average De- 
 crease of 
 Reported 
 Deaths 
 per Year.t 
 
 Lives Prob- 
 ably Saved, 
 according 
 to the 
 Reports. *+ 
 
 j 5 years, 1869-73. . . 
 13 years, 1874-76... 
 
 1,215,230 
 
 1,384,515 
 
 589 
 
 2,945 
 
 1,262 
 
 4.85 
 
 
 
 
 421 
 
 3.04 
 
 1.81 
 
 252 
 
 756 
 
 J 3 years, 1874r-76. . . 
 1 8 years, 1877-84... 
 
 1,384,515 
 
 1,689,988 
 
 421 
 
 1,262 
 
 3,595 
 
 3.04 
 
 
 
 
 449 
 
 2.66 
 
 .38 
 
 64 
 
 512 
 
 (5 years, 1869-73... 
 
 ( 8 years, 1877-84. . . 
 
 1,215,220 
 
 1,689,988 
 
 589 
 
 2,945 
 
 3,595 
 
 4.85 
 
 
 
 
 449 
 
 2.66 
 
 2.19 
 
 370 
 
 2,961 
 
 j 5 years, 1869-73... 
 
 1,215,220 
 
 1,609,023 
 
 589 
 
 2,945 
 
 4,857 
 
 4.85 
 
 
 
 
 1 11 years, 1874-84.. 
 
 442 
 
 2.75 
 
 2.10 
 
 338 
 
 3,7i§ 
 
 * Probably not all deaths were reported before or since the organization of the Board, consequently 
 the saving is probably greater than is here shown, 
 t Allowing for increase of population. 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Table 2. — Deaths from Small-pox reported to the Secretary of State as having occurred 
 in Michigan during the five years 1869-73, compared with the eleven years 1874r-84 ; 
 1873 being the year, in the latter part of which the Michigan State Board of Health 
 was established and began its work. Also a comparison for the four years 1874-77 
 with the seven years 1878-84 ; the Document ou the Restriction and Prevention of 
 Small-pox having been issued by the State Board of Health in 1878, and distributed 
 each year since that date. 
 
 Years. 
 
 (Five.) 
 
 Deaths. 
 
 Years. 
 
 (Eleven.) 
 
 Deaths. 
 
 
 Years. 
 
 (Four.) 
 
 Deaths. 
 
 Years. 
 
 (Seven.) 
 
 Deaths. 
 
 1869 
 
 42 
 
 1874 
 
 18 
 
 
 1874 
 
 18 
 
 1878 
 
 6 
 
 1870 
 
 9 
 
 1875 
 
 26 
 
 
 1875 
 
 26 
 
 1879 
 
 6 
 
 1871 
 
 73 
 
 1876 
 
 76 
 
 
 1876 
 
 76 
 
 1880 
 
 3 
 
 1872 
 
 302 
 
 1877 
 
 102 
 
 
 1877 
 
 102 
 
 1881 
 
 82 
 
 1873 
 
 90 
 
 1878 
 
 6 
 
 
 
 
 1882 
 
 100 
 
 
 
 1879 
 
 6 
 
 
 
 
 1883 
 
 5 
 
 
 
 1880 
 
 3 
 
 
 
 
 1884 
 
 3 
 
 
 
 1881 
 
 82 
 
 
 
 
 
 
 
 
 1882 
 
 100 
 
 
 
 
 
 
 
 
 1883 
 
 5 
 
 
 
 
 
 
 
 
 1884 
 
 3 
 
 
 * 
 
 
 
 
 Sums 
 
 516 
 
 
 427 
 
 
 
 222 
 
 
 205 
 
 
 
 
 
 
 Averages.. 
 
 103 
 
 
 39 
 
 
 
 56 
 
 
 29 
 
 
 
 
 
 
 In table 1 it is seen that during the 11 years of the work of the State 
 Board of Health the deaths from scarlet fever, as reported to the Secretary 
 of State, were reduced in the aggregate about one-fourth, notwithstanding 
 the increase of population. Although this is an important reduction, table 
 H shows that small-pox was reduced about two-thirds. The greater success 
 in restricting small-pox is probably due to the fact that for small-pox we 
 have the additional advantage of vaccination in preventing and modifying 
 the disease. 
 
ABSTRACT OF PROCEEDINGS, JAN. 11, 1887. 
 
 15 
 
 Exhibit 2. — A comparison of the deaths from Small-pox , reported to the Secretary of 
 State as having occurred in Michigan during the five years ( 1869-73 ) preceding the 
 organization of the State Board of Health, with the four years ( 1874-77 ) immediately 
 succeeding its organization, and those four years (1874-77) with the seven years 
 (1878-84) during which the Document on the Prevention of Small-pox was distrib- 
 uted; also the five years (1869-73), just before the Board was established, with the 
 seven years (1878-84) during the use of the Document ; and finally a comparison of 
 the five years (1869-73) just preceding the work of the Board, with the eleven years 
 (1874-84) since the State Board of Health was established. 
 
 Periods of Time 
 
 Compared. 
 
 Estimated 
 
 Average 
 
 Population. 
 
 Average 
 Deaths 
 Reported 
 per Year. 
 
 Total Deaths 
 Reported. 
 
 Average 
 Deaths 
 Reported per 
 Year per 
 100,000 
 Inhabitants. 
 
 Decrease of 
 Deaths per 
 Year per 
 100,000 
 Inhabitants. 
 
 Average De- 
 crease 0 . 
 Reported 
 Deaths 
 per Year.f 
 
 Lives Saved 
 during the 
 Period, 
 according 
 to the 
 Reports. *t 
 
 j 5 years, 1869-73... 
 14 years, 1874-77... 
 
 1,215,230 
 
 1,409,758 
 
 103 
 
 516 
 
 8.48 
 
 
 
 
 56 
 
 222 
 
 3.97 
 
 4.51 
 
 64 
 
 256 
 
 j 4 years, 1874-77... 
 17 years, 1878-84... 
 
 1,409,758 
 
 1,696,034 
 
 56 
 
 222 
 
 3.97 
 
 
 
 
 29 
 
 205 
 
 1.71 
 
 2.26 
 
 38 
 
 268 
 
 J 5 years, 1869-73... 
 17 years, 1878-84... 
 
 1,215,220 
 
 1,696,034 
 
 103 
 
 516 
 
 8.48 
 
 
 
 
 29 
 
 205 
 
 1.71 
 
 6.77 
 
 115 
 
 806 
 
 j 5 years, 1869-73... 
 1 11 years, 1874-84.. 
 
 1,215,220 
 
 1,609,023 
 
 103 
 
 516 
 
 8.48 
 
 
 
 
 39 
 
 427 
 
 2.42 
 
 6.06 
 
 98 
 
 1,073 
 
 * Probably not all deaths were reported before or since the organization of the Board, consequently 
 the saving is probably greater than is here shown, 
 f Allowing for increase of population. 
 
 In order to ascertain the advantage of the distribution of the “ Document 
 on the Restriction and Prevention of Small-pox,” I have made in Exhibit 2, 
 a comparison between the periods of restriction without the document and 
 the period of restriction with the document; that is a comparison of the 
 period 1874-77 with the period 1878-84. This indicates that during the 
 time of the circulation of that document there was saved an average of 
 thirty-eight lives per annum, or 268 lives during the seven-year period. The 
 total number of deaths from small-pox reported to the Secretary of State 
 during that period was 205, which was 31 less than half the number which 
 would have been reported if the deaths from small-pox had continued at the 
 same rate as during the four years just preceding the distribution of the 
 document. 
 
 In exhibit 2 it may he seen that during the entire period since the State 
 Board of Health has been working, the average deaths from small-pox were 
 fi.06 per 100,000 inhabitants less than during the period of five years just 
 before the establishment of the Board. This shows a saving of 98 lives per 
 year, or 1,073 lives saved during the period of 11 years ; that is, there were 
 1,073 less deaths from small-pox during this period than there would have 
 been had the deaths continued at the same rate as before the work of the 
 Board commenced. 
 
 Thus, from the two diseases, scarlet fever and small-pox, there is indi- 
 cated by the statistics in the office of the Secretary of State to have been a 
 saving of nearly 5,000 (4,791) lives in Michigan during the eleven years fol- 
 lowing the establishment of the State Board of Health. 
 
 At this meeting, January 11, 1887, Dr. Baker added comments as follows: 
 
lb 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 The question may arise whether some part of the decline in the mortality 
 from small-pox and scarlet fever, shown to have occurred in Michigan, may 
 not be due to general sanitary progress rather than to the measures of 
 prompt notification, isolation, disinfection, etc., under the lead and direc- 
 tion of the State Board of Health. On this question as good evidence appar- 
 ently as is necessary is at hand. Wm. Squire, M. D., E. E. C. P., a promi- 
 nent member of the Epidemiological Society of London, England, has lately 
 said : “ Diseases propagated by personal infection, such as scarlet fever and 
 
 small-pox, have shown no diminution under our extensive sanitary works, 
 but require measures of isolation for their control ; they are not checked by 
 the great improvements in drainage and water-supply that have ‘proved so 
 efficacious against the prevalence of diarrhoeal diseases, and especially in 
 diminishing the amount of enteric fever. Both these points are proved in 
 the reports of the Eegistrar-General.” * 
 
 Except in certain districts, the law in England does not require as does 
 the law in Michigan that the householder or physician shall promptly notify 
 the health officer on the occurrence of a dangerous communicable disease. 
 Sanitarians in that country have now become convinced that those diseases 
 “require measures of isolation for their control” and at the last meeting of 
 the British Medical Association, after the discussion of a paper on the best 
 means for the prevention of scarlet fever, the public health section of the 
 association passed a resolution as follows : 
 
 “That the public health section, having considered the paper read and the 
 remarks made, are of opinion that the time has arrived when the protection 
 afforded by the powers for the compulsory notification of infectious diseases 
 should be extended to the population generally; and they therefore recom- 
 mend the council of the association to consider at an early date the advisa- 
 bility of endeavoring to promote general legislation with this object in 
 view.”* 
 
 In England, therefore, sanitarians are endeavoring to establish those 
 methods for the prevention of scarlet fever which have already been found 
 so successful in Michigan. 
 
 It should be understood, however, that something more is required than a 
 law compelling prompt notice of dangerous diseases. In Michigan such a 
 law had been passed many years ago, but not the slightest attention had ever 
 been given to it until the State Board of Health put life and system into that 
 as into other public health work throughout the State. 
 
 It is reasonable to believe then from the various lines of evidence, that 
 the decrease in deaths from small-pox and scarlet fever in Michigan during 
 the years when prompt notification, isolation, and disinfection in these dis- 
 eases have been attempted, has been due to those measures. Especially does 
 it seem true when we consider that these communicable diseases both tend 
 to increase with increasing facilities for travel and rapid communication 
 among the people by railroad and otherwise as has been the case in Michigan. 
 
 Irrespective of the cause, however, the fact is certainly a gratifying one, 
 that nearly five thousand (4,791) persons in Michigan are yet alive who 
 would have died from small-pox or scarlet fever if the deaths from those two 
 diseases had continued at the same rate as during the five years just preced- 
 ing the establishment of the State Board of Health. 
 
 ♦British Medical Journal, Oct. 30, 1886, page 812. 
 
0 *} 
 
 0*n. Ub. 
 
 THE LI3RARY OF THE 
 
 JUN 25 1951 
 
 UNWtKSUJf UF ILLINOIS 
 
 ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF 
 
 HEALTH. 
 
 REGULAR MEETING, JULY 10, 1888. 
 
 [139.] 
 
 The regular quarterly meeting of the Michigan State Board of Health was 
 held in the State Capitol in Lansing, July 10, 1888. The members present 
 were as follows: Hon. John Avery, M. D., President; Hon. C. V. Tyler, M. 
 D. ; Arthur Hazlewood, M. D. ; and Henry B. Baker, M. D., Secretary. 
 
 PROPOSED HEALTH LEGISLATION. 
 
 Besides the routine business, certain proposed bills for perfecting the 
 Public Health Laws of the State were discussed at the morning session and 
 referred to the Committee on Legislation. The objects of the Bills are as 
 follows: — 
 
 1. A Bill to prevent the use and sale of infected milk and infected milk 
 products; 
 
 2. A Bill to declare the least proportion of milk solids and of fat in unadul- 
 terated milk; 
 
 3. A Bill to require the labeling of all gasoline, benzine and naphtha sold 
 at retail ; and 
 
 4. A Bill to prevent the introduction and spread of dangerous communica- 
 ble diseases. 
 
 Relative to Bill No. 2, mentioned above, it may be said that a law in Michi- 
 gan prohibits the sale of impure or adulterated milk (Act No. 246, Laws of 
 1887), and provides for an inspection of milk in Detroit and other cities and 
 incorporated villages in the State. This law provides penalties for its viola- 
 tion, but it does not fully explain what is meant by pure milk. In each 
 prosecution it is necessary to go over the whole ground of proving^ what 
 
2 
 
 MICHIGAN STATE BOAlft^DF HEALTH. 
 
 should be taken as a standard, and why. If an unscrupulous chemist appears 
 for the defense, and gives it as his opinion that the standard is too high, the 
 offending milkman may escape because of this conflict of testimony. If the 
 law fixed a definite legal standard, such a result would not be possible. The 
 thousands of analyses made and recorded in the different states of the Union 
 supply a basis for fixing such a legal standard. In drawing the bill presented 
 to the Board at this meeting, the Secretary has corresponded with chemists 
 and milk inspectors in other states, and the bill is drawn in accordance with 
 the best information which he was able to obtain. 
 
 The object of Bill No. 4, mentioned above, is to punish any one who, know- 
 ingly affected with small-pox, scarlet fever, diphtheria, or any other danger- 
 ous communicable disease, shall willfully enter a public place ora public con- 
 veyance, or who shall willfully go into any other locality without a permit of 
 the Board of Health of that locality, or who shall knowingly and willfully 
 convey any child or irresponsible person affected with any dangerous com- 
 municable disease, or the corpse of a person dead from such disease, or who 
 shall, in any way, subject another to danger of contracting one of these dis- 
 eases. At present there is no statutory provision punishing those traveling 
 from place to place on the cars or in other public conveyance, knowing them- 
 selves to be affected with a dangerous communicable disease, and cases have 
 been brought to the notice of the State Board of Health which would be 
 covered by this proposed bill. 
 
 A letter was presented from a citizen of Branch county complaining that 
 incompetent practitioners were driven, by the stringent laws of Indiana and 
 other states, into the southern counties of Michigan, and asking the State 
 Board of Health to exert its influence to protect the state from charlatans 
 and quacks. The subject was discussed by the Board and referred to a com- 
 mittee with instructions to draft a proposed bill for presentation to the legis- 
 lature. 
 
 DIETARY OF STATE INSTITUTIONS. 
 
 The Secretary stated that replies had been received from seven different State 
 Institutions in reply to the request made by the State Board of Health for 
 information concerning dietary, as follows : — Michigan State Prison, Michi- 
 gan School for the Deaf, Detroit House of Correction, Michigan State Public 
 School, State Industrial Home for Girls, Michigan State Reform School, and 
 the Eastern Asylum for the Usane. These replies were read at the meeting 
 of the Board, and were referred to Dr. Hazlewood for further careful study 
 and report. 
 
 POISONING BY TYROTOXICON. 
 
 A communication was read from Dr. Wm. C. West, of Monroe, Michigan, 
 concerning about twenty cases of cheese poisoning in that city. Those poisoned 
 “were taken at first with great prostration — a sensation as though they would 
 die. This was followed by vomiting, which would relieve them somewhat. 
 The vomiting was very severe in most of the cases. The vomiting was followed 
 by diarrhea. There was pain in the stomach and bowels.” AH who ate of the 
 cheese were affected. 
 
 A sample of the cheese was sent to Professor R. C. Kedzie for analysis, and 
 the following reply was received: — 
 
PROCEEDINGS, JULY 10, 1888. 
 
 3 
 
 MICHIGAN AGRICULTURAL COLLEGE. 
 
 Department of Chemistry. ) 
 Ingham Co., Mich., June 20, 1888. $ 
 
 Dr. H. B. Baker, Sec . , State Board of Health : 
 
 Dear Doctor: The specimen of cheese you sent me for examination of the 16th inst. 
 has been carefully tested for tyrotoxicon. I find the poison present in very distinct 
 quantity. I have separated the poison in needle-shaped crystals, usually associated in 
 stellar form. The reactions with ferrocyanide of potassium and ferric chloride, also with 
 iodic acid and starch are very distinctly given. 
 
 I did not try the poison on the animal system, but have no question that the cheese 
 contains tyrotoxicon, and that its poisonous effect is to be ascribed to that substance. 
 
 Very truly yours, 
 
 R. C. KEDZIE. 
 
 HEALTH OFFICERS SHOULD ACT ON DIAGNOSIS OF RELIABLE PHYSICIAN. 
 
 Complaints reach the State Board that some health officers use their offi- 
 cial position to injure brother practitioners who report dangerous communi- 
 cable diseases, by going to a case after the prominent symptoms have disap- 
 peared, deciding that it is not the disease reported, and thus bringing upon 
 the physician who reported it the contempt of the family. After considera- 
 ble discussion, the following resolution was adopted : 
 
 Resolved, That it is the opinion of this State Board that when a case of a 
 dangerous communicable disease is reported by a reliable physician, the health 
 officer should act upon the diagnosis of such physician without question. 
 
 COMPENSATION OF HEALTH OFFICERS. 
 
 A postal card with printed questions was sent to each of 1,055 health 
 officers of townships, 213 health officers of villages, 48 health officers of cit- 
 ies (in all, 1,316 localities) asking for information concerning the compensa- 
 tion of health officers, work performed by them, etc. Beplies have been 
 received from 551 townships, 104 villages and 20 cities, — in all 675 localities. 
 
 According to the reports, provision is made for an annual salary in 111 
 townships, 54 villages and 18 cities. The annual salaries provided for aver- 
 age $16.93 for each township, $128.33 for each city, and $26.21 for each 
 village. 
 
 In 13 townships compensation was allowed by the day: in nine of them, 
 $2.00; in three, $1.00; in one, $1.50. (A general law, Act 137 Laws 
 of 1883, provides for not less than two dollars per day.) In one town- 
 ship it is reported that the health officer is paid 75 cents per visit. 
 
 Charges for services rendered, including salaries, were made in 467 locali- 
 ties: an average of $11.60 for each of 389 townships; in 17 cities, an average 
 of $137.00 for each city ; and in 61 villages, an average of $22.00 for each 
 village. In 196 localities, no charges were made for services ; and in 12 
 localities, where charges were made, the amount was either not allowed, or 
 is in process of settlement. 
 
 Compensation for health officers was allowed and paid in 455 localities as 
 follows: In 376 townships an average for each township of $11.17; in 18 
 cities an average of $132.33 ; in 61 villages an average of $19.19. 
 
 In response to the question “How much, in your judgment, should the 
 health officer in your jurisdiction receive for the full and thorough discharge 
 of his duties under the law?” replies were received from 344 townships, stat- 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 ing an average of $37 29 for each township; from 19 cities, estimated 
 amounts, averaging $331.58 for each city; from 76 villages, an average of 
 $81.12 for each village. 
 
 From the foregoing statements it will be seen that the amount of compen- 
 sation allowed to health officers for their services during the year 1887, was for 
 health officers of townships, less than one-third, for health officers of cities, a 
 little more than one-third, and for health officers of villages not quite one- 
 fourth, the amount they consider a proper compensation. 
 
 In reply to the same question, relative to mode of compensation, 72 health 
 officers stated that proper compensation should be a certain sum per day for 
 actual service, — the amounts stated averaging $2.19 per day. One said $3.00 
 per visit, and one, fifty cents per hour. Forty-six health officers made replies 
 like the following: “According to work performed,” “according to circum- 
 stances, ” “ all he earns,” “regular fees,” “ same rate as physician,” etc. 
 
 HOW WELL DOES PUBLIC OPINION SUSTAIN PUBLIC-HEALTH WORK P 
 
 A large majority — 444 of the 593 health officers — stated that they were well 
 sustained ; 151 said that they were poorly sustained, and 36 stated that public 
 opinion did not sustain them at all. 
 
 SERVICES RENDERED BY THE HEALTH OFFICERS. 
 
 Replies to the question as to services rendered by the health officer were 
 received from 593 localities. The number of nuisances inspected in all the 
 localities reported was 5,075; the number abated was 3,679. The number of 
 reports made to the State Board of Health was 4,029, and the number of 
 communicable diseases looked after was 5,389. The above numbers do not 
 fully show the amount of service performed, because many health officers 
 stated that they had inspected and abated nuisances, sent reports to the State 
 Board of Health, and looked after cases of communicable diseases, but had 
 kept no record in either case ; therefore the foregoing numerical statements 
 of work performed are too small; and they represent only 593 out of the 
 1,494 localities in the State. It is possible that the most active and reliable 
 health officers made reports on this subject, and if so it would not be safe to 
 assume that those not heard from performed services in the same proportion 
 as did those who reported. However, the health officers of some cities, who 
 make regular reports to the State Board, failed to respond to this circular. 
 The health officers of the two largest cities in the State — Detroit and Grand 
 Rapids — did not respond ; neither did the health officers of the following 
 cities: Alpena, Battle Creek, Charlotte, Dowagiac, Eaton Rapids, East Sagi- 
 naw, Escanaba, Grand Haven, Greenville, Ionia, Manistee, Marquette, Mason, 
 Marshall, Menominee, Monroe, Mt. Clemens, Muskegon, Niles, Owosso, 
 Port Huron, Saginaw City, St. Clair, Stanton, West Bay City, Wyandotte, 
 Ypsilanti. 
 
 If all the 1,494 health officers in Michigan performed services in the same 
 proportion as did the 593 who reported, then there were over nine thousand 
 (9,263) nuisances abated, and over thirteen thousand (13,595) cases of dan- 
 gerous communicable diseases looked after with the view of restricting their 
 spread in Michigan during the year 1887. 
 
PROCEEDINGS, JULY 10, 1888. 
 
 5 
 
 EXAMINATION OF PLANS FOR A PROPOSED STATE BUILDING. 
 
 The plans for a proposed cottage for convalescent insane near the asylum 
 at Kalamazoo were examined at considerable length, but not very satisfactory 
 results could be reached because of lack of statement of details. Letters 
 explanatory by the Medical Superintendent, Dr. Palmer, were read by the 
 Secretary, andi these letters gave more information than did the plans them- 
 selves. 
 
 The proposed cottage is to accommodate fifty inmates. The plans and let- 
 ters show that considerable attention has been given to some of the sanitary 
 requirements. However there were no plans or specifications indicating the 
 nature of the plumbing or house-drainage ; there was no explanation of the 
 construction or intended uses of the basement. The plans show no ventilation 
 of the water-closets; but a letter refers to a ventilating pipe from each. 
 The details of the plans were not shown with such definiteness as would enable 
 the Board to express an opinion on many of the points of proposed construc- 
 tion. This was regretted, especially as faulty construction and management 
 of ventilation and house-drainage has recently been alleged to have caused 
 serious outbreaks of preventable disease, and deaths, in two State institutions 
 in Michigan. The sizes of fresh-air inlets are stated in a letter to be four by 
 twelve inches, and the foul-air outlets, four by six inches. The Board sug- 
 gested that they be larger, and specified the area of such inlets and outlets 
 recommended for some of the rooms. 
 
 QUARTERLY REPORT OE WORK IN THE OFFICE OF THE BOARD 
 DURING THE SECOND QUARTER OF 1888. 
 
 The office during the quarter has received information of and taken action 
 concerning 2? outbreaks of typhoid fever, 59 outbreaks of diphtheria and 84 
 outbreaks of scarlet fever. To the localities where these outbreaks have oc- 
 curred, the usual number of documents on the restriction and prevention of 
 these diseases have been sent for distribution to those most interested. The 
 office ha3 also received information concerning 9L outbreaks of measles. 
 
 Since the last meeting of the Board the printing on the Proceedings of the 
 Sanitary Convention at Traverse City has been finished, the Proceedings of 
 the Convention at Owosso have been printed, and the Proceedings of the Con- 
 vention at Albion have been edited and are in the hands of the printer. June 
 5 and 6, a sanitary convention was held under the auspices of the Board at 
 Manistee. Members of the Board were in attendance at this Convention. 
 
 The printed proceedings of the last regular meeting of this Board, have 
 been sent to Sanitary Journals, Secretaries of State Boards of Health, and 
 other sanitarians. Extracts therefrom have appeared in numerous periodi- 
 cals. 
 
 The Annual Report of the Board for 1886 has been received from the 
 printer, and about 400 copies have been sent out, one copy in a place, by 
 mail. Copies of the supplements (Sanitary Conventions at Traverse City, 
 and at Owosso) have also been sent to sanitarians, and to persons in the places 
 where the conventions were held. 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 A second demand has been made on clerks of delinquent cities, villages and 
 townships, for a return of the name and address of the health officer. There 
 have been received, filed and entered in the books, the names of health offi- 
 cers of 40 cities, 178 villages, and 1,025 townships. Documents explanatory 
 of the proper work of health officers and of local boards of health have been i 
 sent to each health officer whose name has been returned, also to the clerk or 
 supervisor making the return. 
 
 A demand has been made on new health officers of cities and villages for 
 weekly card-reports of sickness under observation. 
 
 The article on meteorology for the Report of 1887 is in the hands of the 
 printer, and the article based on weekly reports of diseases is ready to send 
 down as soon as the article on meteorology is printed. The facts concerning 
 scarlet fever and typhoid fever in 1887 have been compiled for the article 
 on communicable diseases. 
 
 The summary of meteorological observations for each month at this sta- 
 tion has been regularly sent to the chief signal officer at Washington and to 
 Sergt. Conger, of the State service ; and the weekly and monthly summary 
 has been compiled and used in comparison with weekly and monthly reports 
 of diseases in Michigan. Fifteen meteorological tables, and their accom- 
 panying diagrams for the year 1887 have been completed, and the work of 
 compilation of tables for 1888 has been begun. 
 
 The compilation of the annual reports of health officers and clerks of 
 cities, villages, and townships for the year 1887 has been completed so far as 
 relates to the communicable diseases. 
 
 Cards for reply and copies of a circular letter asking information concerning 
 the compensation of health officers were sent to all the health officers of 
 townships, cities and villages in Michigan, the cards to be returned to Dr. 
 Hazlewood of this Board. The cards received by Dr. Hazlewood have been 
 forwarded to this office. Only 675 localities were heard from. These cards 
 have been compiled and the compilation is ready to be returned to Dr. Hazle- 
 wood for editing, and then to be printed if the Board deems it advisable to 
 do so. The facts brought out by the compilation are ready to be presented at 
 this meeting. 
 
 During the quarter, 124 books and pamphlets have been received and placed 
 in the library of the Board — fifty of them being periodicals which had been 
 previously received and recently bound by the state binders. 
 
 During the quarter, 637 pages of hektograph work have been executed, 
 among which was a circular informing a large number of health officers of 
 the entrance into their jurisdiction of a person or persons who had been 
 exposed to scarlet fever, a circular to' superintendents of State institutions 
 asking for bills of diet at those institutions, and several proposed bills for 
 the prevention and spread of dangerous communicable diseases, the adultera- 
 tion of milk and milk products, and the sale of certain explosives without 
 proper labels, — copies of these billsTeing thus submitted for criticism and 
 amendment to members of this Board and other persons. 
 
 The reports from the different State institutions relating to diet lists, when 
 received, were sent to Prof. Vaughan, the committee of this Board on foods. 
 They have been returned in order to be presented to this Board at this meeting. 
 
PROCEEDINGS, JULY 10, 1888. 
 
 7 
 
 HEALTH IN MICHIGAN IN THE SCCOND QUARTER OF 1888. 
 
 Contagious Diseases. 
 
 Compared with the preceding quarter (January, February and March), 
 reports received from all sources show the number of places at which 
 diphtheria was reported, to have decreased by an average of nineteen places 
 per month, scarlet fever to have decreased by an average of two places per 
 month, typhoid fever to have decreased by an average of ten places per month, 
 and measles to have decreased by an average of fourteen places per month. 
 Small-pox was reported at one place in each quarter. 
 
 Meteorology, and Sickness from all Causes, Compared with the Preceding 
 
 Quarter. 
 
 A comparison of the meteorological conditions of the second quarter of 
 1888, with the meteorological conditions of the preceding quarter, shows the 
 temperature to have been much higher, the absolute humidity to have been 
 much more, the relative humidity to have been about the same, the day ozone 
 slightly less and the night ozone slightly more in the second quarter. 
 
 Compared with the preceding quarter (January, February, March), the re- 
 ports from regular observers show a marked increase of measles, and a marked 
 decrease of influenza, pneumonia, bronchitis and neuralgia, in the second 
 quarter of 1888. 
 
 Compared with Nine Years, 187 9-1887. 
 
 A comparison of the meteorological conditions of the second quarter of 
 1888, with the average of the corresponding quarters in the nine years, 1879- 
 1887, shows that in 1888 the temperature was slightly lower, the absolute 
 humidity was slightly less, the relative humidity was the same, and the day 
 and night ozone considerably less in the second quarter of 1888. 
 
 Compared with the corresponding quarter in the nine years, 1879-1887, the 
 reports received from regular observers indicate that measles was more than 
 usually prevalent, and that intermittent fever, remittent fever, consumption 
 of the lungs, diphtheria, diarrhea, and whooping-cough were less than usually 
 prevalent in the second quarter of 1888. 
 
 These statements are for the State of Michigan as a whole ; in certain local- 
 ities there has been more, in other localities less sickness than usual. 
 
 Henry B. Baker, 
 
 Secretary. 
 
1 
 
 Ofn. Ub. 
 
 THE LIBRARY OF THE 
 
 JUN 25 1951 
 
 UNIVERSITY OF ILLINOIS 
 
 ABSTRACT OF PROCEEDINGS 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 
 MEETING, FEB. 7, 1889. 
 
 1144] 
 
 A meeting of the Michigan State Board of Health was held in the State 
 Capitol in Lansing, Feb. 7, 1889. The members present were as follows: 
 Hon. John Avery, M. D., President; Prof. Henry F. Lyster, M. D. ; J. H. 
 Kellogg, M. I).; Arthur Hazlewood, M. D. ; Prof. Delos Fall, and Henry B. 
 Baker, M. D., Secretary. 
 
 At the morning session, besides a large amount of routine business, such as 
 the examination and auditing of bills and accounts, some proposed health 
 legislation was discussed. 
 
 COLD WEATHER DISEASES IN CHILI. 
 
 In several papers Dr. Baker has pointed out the fact that most of the dis- 
 eases of the lungs and air-passages, and communicable diseases which enter 
 by way of the air-passages, increase after the cold weather, and decrease after 
 warm weather. In an article on pneumonia it has been suggested that 
 one of the most important diseases would be lessened by securing the proper 
 warming and moistening of the air breathed indoors. At this session of the 
 Board the secretary reported having requested and received a communication 
 from Hon. Clement Carpenter, of Toledo, Ohio, ex- Secretary of Legation to 
 Chili, relative to his observations in Chili on this subject. Mr. Carpenter’s 
 communication was read, and was found to contain evidence which it would 
 be difficult, and perhaps impossible, to obtain in this country. It shows 
 apparently great prevalence of all the above-mentioned diseases under con- 
 ditions the reverse of those recommended by Dr. Baker for their prevention. 
 The letter states that “ The winters in the central and southern portion of 
 the country being as severe as with us, yet no amount of argument could 
 persuade its people into heating their houses after our methods, or in fact 
 heating them at all. They will bundle and wrap themselves up in heavy 
 
2 
 
 MICHIGAN STATE BO^RD OF HEALTH. 
 
 clothing in all manner of ways, Ifet will avoid a fire as they would a pesti- 
 lence.” In Chili they have a specific disease which they call Irae, brought 
 about, as is claimed, entirely by cold draughts of air. It is a kind of paralysis, 
 affecting chiefly the nose and the muscles of the face, and you meet many 
 people disfigured by it.” “ There are a great many deaths in Santiago [capital 
 of the country] every year from consumption, and from the beginning to the 
 end of the winter season diphtheria and small-pox rage there with a violence 
 and intensity, and to an extent that we know nothing about, and have never 
 experienced in this country in cities of like population.” 
 
 The entire communication, together with other facts bearing on the sub- 
 ject, was ordered printed in the annual report. 
 
 PRECAUTIONS SHOULD BE TAKEN IN CASES OF MEMBRANOUS OR INFLAMMA- 
 TORY CROUP. 
 
 At the afternoon session, after a good deal of discussion, the following 
 resolution was unanimously adopted : 
 
 Whereas, It is often impossible to discriminate between cases of diphtheria 
 and membranous or inflammatory croup ; and 
 
 Whereas, Modern researches point to a probable common origin of these 
 diseases, 
 
 Resolved , That in the opinion of this Board, membranous or inflammatory 
 croup should be classed with diseases communicable and dangerous to the 
 public health, and should be reported as such, and the same precautions 
 should be taken in cases of this disease, as regards isolation and disinfection, 
 as in cases recognized as diphtheria. 
 
 THE SMEAD DRY-CLOSET SYSTEM OF DISPOSAL OF EXCRETA. 
 
 The Secretary presented the following communication from G. R. Brandt, 
 Principal of the Public Schools of Bancroft, concerning the working of the 
 Smead system for disposing of excreta. The communication is as follows: 
 
 Bancroft, Mich., January 26 , 1889. 
 
 H. B. Baker , M. D., Laming , Mich.: 
 
 Dear Sir,— Yours of the 25th inst., in connection with reports, at hand. In compliance with your 
 request, I would report as follows : During cold weather, when the air outside is much colder than 
 that inside, the ventilation by means of the Smead system is very good, and no foul odors exist in 
 any part of the buildiog during school hours, but as soon as fires are not kept burning in the 
 furnaces, ventilation ceases in part, and the disagreeable odors are very noticeable even in the 
 school rooms. The tendency in this direction is very much augmented when rainy weather exists, 
 and it is then utterly impossible to keep the rooms in fit condition even when the greatest cire is 
 exercised by keeping a fire in the ventilating shaft heater and opening basement windows. I find 
 also that matters are becoming worse as the amount of excreta increases, and that the foul air does 
 not dry or remove the moisture from excreta to any considerable extent in passing over the same. 
 
 Very respectfully, 
 
 G. R. BRANDT. 
 
 The Secretary presented a report by Prof. Vaughan of the examination and 
 analysis of water, sent by Dr. Clapp of Mendon, Michigan, by way of the 
 office of the State Board of Health, the water having been suspected of caus- 
 ing typhoid fever : 
 
ABSTRACT OF PROCEEDINGS, Feb. 7, 1889. 
 
 CHEMICAL ANALYSIS. 
 
 Free Ammonia 
 
 Albuminoid Ammonia 
 
 Chlorine - 
 
 Parts per Million. 
 
 0.02 
 
 0.21 
 
 34.0 
 
 None. 
 
 Grains 
 per Gal. 
 
 0.0012 
 
 0.012 + 
 
 1.9828 
 
 -- 
 
 Nit' rJ, -t ftS -- 
 
 None. 
 
 
 Hardness 
 
 ll. on Clark’s scale. 
 
 
 No absolute standard for the chemical ; 
 
 ourity of drinking water can be given, but good authorities 
 
 agree on the following : 
 
 
 
 1. — The chlorine ought not to exceed 10 parts per million. 
 
 According to this rule the above water is very bad. 
 
 2. — The Free Ammonia ought not to be more that 0.05 of a part. 
 
 There is no excess of Free Ammonia in the Mendon water. 
 
 3. — If 0.10 part of Albuminoid Ammonia be present the water should be regarded as suspicious, and 
 the presence of 0.15 of a part or more of this substance should certainly condemn the water. 
 
 As will be seen, the Mendon water contains too much Albuminoid Ammonia. 
 
 BACTERIOLOGICAL EXAMINATION. 
 
 The water contains 120 Bacteria in each drop. 
 
 No pathogenic germs were found, but the putrefactive micro-organisms were identified : 
 
 A liquefying bacillus; a short, thick rod with rounded edges. 
 
 2. — Micrococcus candicans; this does not liquefy gelatine. 
 
 3. — A fluorescing bacillus : a short rod with rounded ends, and which does not liquefy gelatine. 
 Notwithstanding the fact that the typhoid germ was not found, the bad condition of the water, as 
 
 shown by the chemical analysis and the large number of germs in it, should condemn its use for 
 drinking purposes. 
 
 V. C. VAUGHAN, M. D., 
 
 » Director of the Michigan State Laboratory of Hygiene. 
 
 Ann Arbor, February 1 , 1889. 
 
 REGISTRATION OF PLUMBERS. 
 
 The following resolution presented by Dr. Henry F. Lyster, was, after 
 discussion, unanimously adopted: 
 
 Resolved , That it is the opinion of this Board that it is desirable that all 
 persons engaged in the mechanical trade of plumbing or acting as plumbers 
 should be licensed and registered, and that their work should be supervised 
 by inspectors appointed by authority, — this to apply to all cities and villages 
 in the State. 
 
 Resolved , That it is advised that, when revisions of charters are being 
 made by authorities of cities and villages, the incorporation of these provis- 
 ions in their respective charters be asked from the State legislature. 
 
 SANITARY CONVENTIONS. 
 
 Invitations to hold sanitary conventions at Otsego and at Tecumseh were 
 accepted, and the secretary was authorized to meet with committees of citi- 
 zens, and to perfect arrangements for the same. 
 
 ARSENICAL PAPER, CARD-BOARD, TOYS AND FABRICS. 
 
 The secretary exhibited before the Board a toy (called a ‘ ‘Kazoo’’ and 
 designed to be put in the mouth) which had caused sickness in Lansing. The 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 part which came in contact with the mouth was found to be covered with 
 green arsenical paper. The secretary stated that frequently boxes made of 
 arsenical card -board were received at the office. Poisonous card-board is not 
 infrequently used for tickets. On motion of Dr. Kellogg, the secretary was 
 authorized to draft a bill to be presented to the next legislature proposing 
 the prohibition, under penalty, of the manufacture and sale of arsenical 
 paper, card-board, fabrics, toys and other articles. 
 
 TYROTOXICON IN 
 
 CASTERS. 
 
 Dr. Kellogg called attention to a recent case of tyrotoxicon in oysters. A 
 boy in a printing office in Battle Creek took an oyster stew at a restaurant at 
 11 o’clock at night. The stew was very slightly warmed. In a few hours 
 he was taken very sick with vomiting and purging and was sick all the next 
 day. Dr. Kellogg sent for some of the oysters and obtained a good test for 
 tyrotoxicon. A few days afterwards he sent for some more oysters from the 
 same restaurant from which also he obtained tyrotoxicon. He thought the 
 probable reason why there were not more frequent cases of poisoning by eat- 
 ing oysters was that the tyrotoxicon was destroyed by heat in cooking. The 
 oysters had been received in kegs and kept open, thus giving a good oppor- 
 tunity for the tyrotoxicon to develop. 
 
 SECRETARY’S QUARTERLY REPORT OF WORK IN THE 
 OFFICE OF THE BOARD DURING THE QUARTER ENDING 
 JANUARY 8, 1889. 
 
 During the quarter the office has received information of and taken action 
 concerning 85 outbreaks of diphtheria, 77 outbreaks of scarlet fever, 48 out- 
 breaks of typhoid fever and one of typhus fever. There have also been 
 reported to the office outbreaks of small-pox in Port Huron, East 
 Saginaw, Howell village, Howell township, New Haven township, Lansing, 
 Cheboygan and Detroit. The office has been in constant communication with 
 most of these localities, and neighboring localities, urging the vaccination of 
 all susceptible persons and the thorough isolation of all those who could pos- 
 sibly convey the disease. 
 
 In response to a letter asking the opinion of the members of the Board, a 
 majority of the members expressed the opinion that a letter should be sent to 
 the Governor stating the facts concerning the existence of small-pox in other 
 States and the probability of its reaching this State. In accordance with this 
 expressed opinion, November 27, 1888, a letter was sent to the Governor refer- 
 ring to the law passed in 1885 providing for an inspection service to prevent 
 the introduction and spread of dangerous communicable diseases. The 1 tter 
 stated that the State Board of Health was prepared to maintain such inspec- 
 tion “whenever, in the opinion of the Governor, it may be deemed necessary.” 
 The letter indicated that the present year was a year when small-pox might 
 be expected, gave the names of States where small-pox at that time prevailed. 
 
ABSTRACT OF PROCEEDINGS, Feb. 7, 1889. 
 
 5 
 
 called special attention to the outbreak in Sarnia and the cases which had 
 occurred in East Saginaw and Port Huron. 
 
 A copy of the letter to the Governor was sent to each member of this Board. 
 
 November 14, a copy of the proceedings of the Board at its October meet- 
 ing was sent to the health officer of every city and village in Michigan, with a 
 marked paragraph giving the resolution of this Board urging local boards to 
 recommend general vaccination, and giving the law authorizing local boards 
 to furnish free vaccination. 
 
 December 7, a circular which had received the approval of the members of 
 the board was sent to the healtn officer of every city, village and township in 
 the State urging local boards to recommend the vaccination and re-vaccina- 
 tion of all unprotected persons in their jurisdiction. Several letters were re- 
 ceived in response to this circular, stating that the local Board of Health had 
 issued a notice urging general vaccination, or that free vaccination was being 
 offered to all, or to those unable to pay for it. 
 
 No response was received from Grand Rapids until there was received a 
 marked copy of the Grand Rapids Democrat of December 21, in which the 
 health officer of Grand Rapids was reported as saying in an interview that 
 there was not any probability of the Board of Health of that city urging a 
 general vaccination, because the emergency had not arisen. In reply, the 
 Secretary of this Board sent a communication to the Grand Rapids Democrat 
 urging the importance of the vaccination and re-vaccination of all unpro- 
 tected persons. Some correspondence followed these communications. The 
 difference between the Grand Rapids Board of Health and the State Board 
 of Health seems to be that this board has recommended they ? revention of 
 small-pox by the only known means, vaccination and re -vaccination, the 
 Grand Rapids Board did not propose to recommend this, but to rely upon 
 the restriction of the disease after it -reaches them. 
 
 December 24, on receipt of notice from Dr. J. A. Wessinger that two 
 children of Oliver Anderson (who was sick with small-pox) in Howell, 
 Mich., had been sent to Chatham, Ontario, a letter and telegram were at 
 once sent to the health officer of Chatham, giving the information. In 
 reply a letter was received from the town clerk, and also a copy of the 
 Banner , published at Chatham, from which the following quotation is 
 taken : 
 
 “The telegram was a most kind and neighborly warning, and was promptly acted upon. 
 Dr. Hall, Medical Health Officer, at once had the family isolated at the residence of their grand- 
 mother, King street, east, and Chief Young has arranged for a continuous guard of the house 
 day and night. The clothes of the family, bedding and indeed the whole premises have been 
 fumigated and disinfected, and the wearing apparel of the children cremated. 
 
 “ There are no indications of small-pox in the family, nor of any disease ; but the authorities 
 being aware that the children were exposed to the contagion, act on the principle of making 
 sure ; and an ounce of prevention is worth a pound of cure in such cases. A few days’ careful 
 quarantine will well repay the work if there is any risk to be avoided. The Michigan Board of 
 Health deserves the thanks of the people of Chatham for their prompt warning.” 
 
 About one thousand more pamphlets than are usually sent out during a 
 quarter have been sent to those localities where diphtheria, scarlet fever and 
 typhoid fever prevailed, bearing on the restriction and prevention of these 
 diseases. A large number of pamphlets on the prevention of small-pox have 
 also been sent to those localities where this disease has prevailed. 
 
 The numerous outbreaks of small-pox in Michigan have occasioned con- 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 siderable correspondence with localities adjoining or near to infected locali- 
 ties. As an illustration of such correspondence, reference may be made to a 
 letter received from the president of the village council of Brighton, stating 
 that proper restrictive measures were not taken in the village of Howell. A 
 copy of this letter was sent to the members of the board and to the health 
 officer of Howell. In response, the health officer of Howell visited the 
 office of this board for conference, and the Board of Health of Howell held 
 a meeting and on motion took possession of a large square house in the out- 
 skirts of the village for a hospital. 
 
 In response, I was able f o say to the President of the Board of Health of 
 Brighton, that I had taken the liberty to present the questions he had asked 
 to the health officer of Howell, who says that there are four cases of small- 
 pox at Howell — including two cases of varioloid — and one suspected case ; 
 that all persons suspected of being liable to communicate the disease are 
 isolated, and that efforts are being made to find such persons. Ho one liable 
 to spread the disease is allowed on the streets. 
 
 During the quarter 94 volumes and pamphlets have been received and 
 entered in the library of the Board, of which 27 were by purchase, and 67 
 were by gift or exchange. 
 
 Since the last meeting of the Board there have been 1,007 pages of hekto- 
 graph work executed. Of these 233 were notifications of and other corre- 
 spondence relative to outbreaks of small*pox in Port Huron, Lansing, New 
 Haven, Howell and Cheboygan; 77 were circulars urging local boards to 
 encourage vaccination, and the rest pertain to the general work of the Board. 
 A hektograph letter was sent to some health officers in Michigan recom- 
 mending that they attend the meeting of the American Public Health Asso- 
 ciation in Milwaukee. 
 
 The printed proceedings of the last meeting of this Board have been sent 
 to health officers of cities and villages, sanitary journals, prominent sanita- 
 rians, etc. 
 
 During the quarter about twenty-five hundred copies of the Report for 
 1887 have been distributed. This includes those sent to the health officers 
 of cities, villages and townships, and to lists of names supplied by members 
 of the Board. With some of these reports there was sent a supplement giv- 
 ing the proceedings of the Manistee Sanitary convention, and other publica- 
 tions. 
 
 December 3 and 4 a profitable sanitary convention was held in Hastings 
 under the auspices of the Board. Most of the papers read at this convention 
 are now in the office of the Board. 
 
 Blanks and circular letters asking for an an annual report have been sent 
 to every health officer in the State, also to the clerk of every local board of 
 health ; 242 reports have been received at this date (Jan. 7). 
 
 Proof has been read on the Annual Report of the Board for 1888, all of 
 which has now been printed except the article on the communicable diseases, 
 which is ready to print. The Report has been indexed as fast as it has been 
 printed. 
 
 Three diagrams illustrating an article in the Annual Report for 1888 have 
 been made and sent to the engraver. The plates have been received. 
 
 A monthly summary of meteorological conditions at this station has been 
 regularly sent to the chief signal officer at Washington, a briefer one supplied 
 to the director of the Michigan Weather Service, and a summary for each 
 
ABSTRACT OF PROCEEDINGS, Feb. 7, 1889. 
 
 7 
 
 Treek has been used in connection with the weekly reports of diseases in 
 Michigan. 
 
 Blank meteorological registers, stamped envelopes, etc., have been sent to 
 meteorological observers for their use during the year 1889. 
 
 Since the last meeting of the Board compilations of meteorological condi- 
 tions for each month in 1888, except December, on registers from nineteen 
 stations, have been carried on and are nearly completed. 
 
 PRETENTION OF SMALL-POX UNDER DIFFICULTIES. 
 
 About election time a man came from Fargo, Dakota, to Howell, Mich., 
 sick with varioloid. The* disease was not recognized at first in Howell ; but was 
 called chicken-pox, therefore it spread somewhat. The disease was carried 
 from Howell to Azalia, where again it was not recognized. While it was 
 being mistaken for another disease the president of the local board of health 
 was exposed to it and was then isolated. The other members of the board 
 endeavored to cope with the disease, and a committee of citizens was appointed 
 to cooperate with them as a health committee. They were unable to take 
 proper precautions because of lack of funds and lack of confidence of the 
 people that the bills would be allowed by the Board of Supervisors; and they 
 came to Lansing to consult with the Secretary of this Bjard as to what action 
 should be taken. The Secretary referred them to decisions of the Supreme Court, 
 which seemed to indicate that the Board of Supervisors must audit all claims 
 allowed by the local board. Members of the committee stated that members 
 of the Board of Supervisors of their county had expressed themselves as not 
 favorable to allowing such bills, and that the committee knew of no way of 
 obtaining money to cope with the disease, that a number were sick and many 
 more had fyeen exposed and should be isolated. These facts were laid before 
 the Governor, also the fact that if the disease was not stamped out in Azalia, 
 it was likely to spread to other parts of the State, and on this presentation 
 the Governor authorized the use of a small amount of the appropriation 
 under Act No. 230, laws of 1885, to provide for the prevention of the intro- 
 duction and spread of cholera and other dangerous diseases. 
 
 A mistaken idea has been expressed that the Governor has ordered that 
 bills be sent to the State Board of Health for payment by the State of all 
 expenses incurred in restricting small-pox. There is no such general order, 
 and probaoly will not be. In this one specified instance in which the circum- 
 stances were exceptional, and there seemed to be danger of the spread of the 
 disease about the State, provision was promptly made by the Governor to 
 prevent the spread of small-pox. But those peculiar circumstances are not 
 likely to occur in other localities. 
 
 HEALTH IN MICHIGAN IN THE FOURTH QUARTER OF 1888. 
 
 Contagious Diseases. 
 
 Compared with the preceding quarter (July, August and September), 
 reports received from all sources show diphtheria to have increased by an 
 average of fifteen places per month, scarlet fever to have increased by an 
 average of twenty-one places per month, typhoid fever to have increased by 
 an average of six places per month, small-pox to have increased by an average 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 of four places per month and measles to have decreased by an average or four 
 places per month. 
 
 Meteorology , and Sickness from all Causes , Compared with the Preceding 
 
 Quarter. 
 
 A comparison of the meteorological conditions of the fourth quarter of 
 1888, with the meteorological conditions of the preceding quarter shows the 
 temperature to have been much lower, the absolute humidity to have been 
 much less, the relative humidity and the night ozone to have been more, and 
 the day ozone to have been less in the fourth quarter of 1888. 
 
 Compared with the preceding quarter (July, August and September), the 
 reports from regular observers show a marked increase of tonsilitis, influenza, 
 bronchitis, rheumatism, pneumonia and typho-malarial fever, and a marked 
 decrease of diarrhoea, cholera morbus, dysentery, cholera infantum and con- 
 sumption of the lungs in the fourth quarter of 1888. 
 
 This Quarter compared with the Average for Nine Years , 1879-87. 
 
 A comparison of the meteorological conditions of the fourth quarter of 
 1888, with the average of corresponding quarters in the nine years, 1879-1887, 
 shows that in 1888, the temperature was slightly higher, the absolute humid- 
 ity was slightly less, the relative humidity was less, the day ozone* was slightly 
 more and the night ozone* was about the same in the fourth quarter of 1888. 
 
 Compared with the average for the corresponding quarters of the nine 
 years, 1879-1887, the reports received from regular observers indicate that 
 intermittent fever, consumption of the lungs, diphtheria, remittent fever and 
 pneumonia were less prevalent, and that there was no disease more than 
 usually prevalent in the fourth quarter of 1888. 
 
 This Quarter Compared with the Average for Two Years, 1886-7. 
 
 A comparison of the meteorological conditions of the fourth quarter of 
 1888 with the average of corresponding quarters in the two years, 1886-87, 
 shows that in 1888 the temperature was slightly higher, the absolute humid- 
 ity was slightly more, the relative humidity and the day and the night 
 ozone * were less in the fourth quarter of 1888. 
 
 Compared with the average for the corresponding quarters of the two 
 years, 1886-87, the reports received from regular observers indicate that con- 
 sumption, diphtheria and pneumonia were less prevalent, and that there was 
 no disease much more than usually prevalent in the fourth quarter of 1888. 
 
 (* Allowance is made for less sensitive test paper used in 1888 than in the preceding year (.51 for the 
 day ozone and . 4 2 for the night ozone). 
 
0*n. Ub» 
 
 JHE LI3RASY OF THE 
 
 ^ ttb * JUN 25 1951 
 
 UN1VERS1IY Of 11UWOIS 
 
 ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 & 
 
 REGULAR MEETING, APRIL 9, 1889. 
 
 [ 148 ] 
 
 The annual meeting of the Michigan State Board of Health was held in 
 the State Capitol in Lansing, April 9, 1889. The members present were as 
 follows: Hon. John Avery, M. D., President; Arthur Hazlewood, M. D., 
 Prof. V. C. Vaughan, M. D., Prof. Delos Fall, and Henry B. Baker, M. D., 
 Secretary. 
 
 At the morning session, besides routine business such as the examination 
 and auditing of bills and accounts, Dr. John Avery, President of the Board, 
 instead of a formal annual address, made a few remarks concerning the 
 increasing value of the work of the Board in collecting and spreading among 
 the people information useful for the saving of life, and concerning the 
 necessity of continuing the work of investigation and of impressing upon the 
 people the facts already demonstrated concerning the prevention and restric- 
 tion of the dangerous communicable diseases. 
 
 RELATION OF FILTH TO DISEASE. 
 
 Considerable attention was given to a discussion of the influence of unsani- 
 tary surroundings in affecting the virulence of disease. After the subject 
 had been very thoroughly discussed, a motion prevailed that Dr. V. C. 
 Vaughan be requested to prepare a paper presenting what evidence he could 
 procure on the influence of filth on disease. 
 
 ELECTION OF PRESIDENT. 
 
 This being the regular annual meeting and the time for the election of 
 President, Hon. John Avery, M. D., of Greenville, was re-elected for the term 
 of two years. 
 
 A FATAL DISEASE IN CONCORD TOWNSHIP. 
 
 A report by Prof. Delos Fall, of a fatal outbreak in Concord township was 
 presented, discussed and ordered published in the Annual Keport. 
 
MICHIGAN STATE BOARD OF HEALTH. 
 
 PROPOSED HEALTH LEGISLATION. 
 
 The Secretary presented copies of the following bills, which, by direction 
 of the Board at its last meeting, he had transmitted to the health committee 
 of the House of Representatives: 
 
 A bill, to require the labeling of all gasoline, benzine and naphtha sold at 
 retail. 
 
 A bill, to prevent the introduction of dangerous communicable diseases into 
 any township, city or village in Michigan, except under specified regulations. 
 
 A bill, to prevent the sale and use of infected milk and milk products, by 
 prohibiting the sale and providing for the punishment of offenders. 
 
 A bill, to prevent the spread of dangerous communicable diseases by provid- 
 ing for the punishment of offenders. 
 
 A bill, to declare the least proportion of milk solids and of fat in unadul- 
 terated milk. 
 
 The Secretary also presented House bill No. 671 (File No. 201), introduced 
 by Representative Hanscom, entitled, — 
 
 A BILL to Regulate the Practice of Medicine, requiring certain Qualifi- 
 cations of persons beginning the Practice of Medicine in Michigan, and the 
 Registration of all Practitioners; repealing sections 1, 2, 4, 5, 6, and 7 of 
 act No. 167, Laws of 1883, and section 2 of Act No. 268, Laws of 1887, and 
 all other acts or parts of acts inconsistent with this act. 
 
 If this bill should become a law, those legally authorized to practice medi- 
 cine at the time it shall take effect would be permitted to continue ; but it 
 would require that all who subsequently enter the medical profession in 
 Michigan shall have certain minimum qualifications, as evidenced on exami- 
 nation in the fundamental medical sciences of anatomy, physiology, and 
 pathology, the causation of disease, the chemistry of poisons, sanitary science 
 including disinfection and ventilation, and the English language. The 
 examining board is to be appointed by the Governor and Senate, and the 
 State’s appointments are left untrammeled by any requirement that any 
 medical sect or pathy shall be represented ; it is, therefore, in the power of 
 the appointing power to fairly represent the people of the State of Michigan, 
 not only so far as relates to the majority, or any exclusive system which now 
 exists, but also any “new school” which may hereafter arise. This could 
 not be if only existing Medical Societies were allowed to control. There is, 
 however, provision for securing a certain proportion of expert examiners, — 
 each medical college in Michigan authorized by law to confer the degree of 
 Doctor of Medicine, or to examine candidates for such degree to be conferred 
 by the regents of the University, being authorized to nominate one member 
 of the board of examiners, as is also the State Superintendent of Public 
 Instruction, and the State Board of Health. On the part of the State, no 
 examination is permitted in subjects concerning which only opinions can be 
 expressed. This proposed Jaw does not attack any present or future medical 
 sect or pathy ; it simply requires a little positive knowledge. The examina- 
 tion by the State is confined to questions of fact. “In the English lan- 
 guage the questions shall be restricted to established usage, and in the 
 sciences they shall be restricted to established and demonstrable knowledge, 
 accepted as such by those who teach those sciences.” The examining board 
 is required to publish an annual report which shall include “copies of 
 questions asked — which shall not all be the same in any two years,” so that 
 
ABSTRACT OF PROCEEDINGS, April 9, 1889. 
 
 3 
 
 although the details shall not be known in advance, the nature of the exami- 
 nation shall be open to public criticism. 
 
 While, under the provisions of this bill, no very high standard of require- 
 ments would be set up, yet it must be apparent that if its requirements were 
 enforced the tendency would be to very greatly elevate the standard of 
 knowledge among those in whose care the life of any citizen may at any time 
 be placed, and in whose care the life of each and every person in the Scate is 
 likely to be more than once entrusted. The movement, then, is in the inter- 
 ests of public health, and safety to life. 
 
 SANITARY CONVENTION. 
 
 The Board accepted an invitation from citizens of Lapeer to hold a 
 sanitary convention in that place, and early in September was suggested as 
 the time for such convention. 
 
 CULTURES OF DISEASE GERMS. 
 
 Dr. V. C. Vaughan, having with him thirty or forty pure cultures of disease 
 germs, was asked by the Board to exhibit them. Among these cultures were 
 the following: — the germ of white pus ; the lactic acid ferment ; Friedlander’s 
 butyric acid ferment (the possible cause of tyrotoxicon) ; Dencke’s bacillus 
 (found in cheese and resembling Koch’s comma bacillus) ; the Wurzel bacillus 
 (so called because the cultures branch out like roots) ; the blue milk bacillus ; 
 Emerich’s cholera germ (sometimes called the Naples germ, which has since 
 been found in the normal faeces, — Emerich has given up the idea of its being 
 the cause of cholera ; it resembles somewhat the typhoid germ); Salmon’s 
 germ of hog cholera; micrococcus prodigiosus (the cause of red bread) * 
 Loeffler’s diphtheria germ ; and the bacillus tuberculosis , this culture being 
 of especial interest because it is the 115th generation of Koch’s original cul- 
 ture. 
 
 At the request of the Board, Dr. Vaughan then gave a short account of his 
 work in Prof. Koch’s laboratory of hygiene at Berlin, of Koch’s lectures on 
 hygiene, and Prof. Frankel’s lectures on bacteriology; also of inoculations 
 against hydrophobia witnessed in Pasteur’s laboratory at Paris. 
 
 SECRETARY’S QUARTERLY REPORT OF WORK IN THE OFFICE 
 OF THE BOARD DURING THE QUARTER ENDING 
 APRIL 9, 1889. 
 
 During the quarter the office has received information of and taken action 
 relative to 87 outbreaks of diphtheria, 131 outbreaks of scarlet fever, 38 out- 
 breaks of typhoid fever, and 13 outbreaks of small-pox. The usual number 
 of documents on the restriction of these diseases have been sent to the local- 
 ities where these diseases prevailed. 
 
 A printed abstract of the proceedings of the Board at its last meeting has 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 been sent to health officers of cities and villages, sanitary journals, promi- 
 nent sanitarians, etc. 
 
 A circular letter and blank for the annual return of the name and address 
 of health officer have been sent during the quarter to the supervisors of town- 
 ships, the clerks of villages and cities and to the presidents of villages and 
 the mayors of cities, and replies are being rapidly received. 
 
 During the quarter there have been sent out about 500 copies of a circular, 
 “Now is a Good Time to be Vaccinated;” also about 1,200 copies of a pam- 
 phlet on the restriction and prevention of small-pox. 
 
 During the quarter, the Secretary visited Otsego and Tecumseh to make 
 arrangements for sanitary conventions in those places. The printed announce- 
 ments for these conventions have been sent out. 
 
 During the quarter 120 books and pamphlets have been received and entered 
 in the library of this Board, mostly in exchange for the publications of this 
 Board. 
 
 Annual reports have been received from 587 health officers and 620 clerks 
 of townships, cities and villages. All the cases and deaths from diphtheria, 
 scarlet fever, typhoid fever and measles mentioned in these reports have been 
 compiled. All the letters and reports received concerning the dangerous 
 communicable diseases in Michigan in 1888 have been assorted, and the com- 
 pilation of the same has been begun. 
 
 Three hundred and eighty-seven blanks giving names of medical prac- 
 titioners have been received, arranged and filed. 
 
 Proof has been read on the last part of the Annual Report for 1888; it has 
 been indexed, and copies should now be ready for distribution ; but are not 
 yet received from the State printer. 
 
 The proceedings of the sanitary convention at Hastings have been edited, 
 with the exception of a few papers which have not as yet been received. The 
 copy has been sent to the State printer. 
 
 Accounts for expenses for nurse hire, etc., in restricting the epidemic of 
 small-pox at Azalia to the extent of four hundred dollars have been audited 
 and paid. The small pox was stamped out. 
 
 During the quarter, 374 pages of hektograph work have been executed, 
 among which may be mentioned various bills in the interest of public 
 health sent to members of this Board and others, and finally presented to the 
 Legislature. 
 
 A monthly summary of meteorological conditions at this station has been 
 regularly sent to the chief signal officer at Washington, a briefer one supplied 
 to the director of the Michigan Weather Service, and a summary for each 
 week has been used in connection with the weekly reports of diseases in 
 Michigan. 
 
 Compilations of meteorological conditions for the year 1888 at 21 different 
 stations have been made and are ready to be tabulated. 
 
 Since January 1, 1889, a 7 P. M. observation of average temperature, 
 absolute and relative humidity, per cent of clouds, direction of wind, barom- 
 eter and ozone, has been made daily at the State Board of Health office, and 
 by the observers at Thornville, Ann Arbor and Kalamazoo. Since February 1, 
 such observation has been taken at three other stations in the State. 
 
 During the quarter, 21 diagrams have been made, illustrating the Annual 
 Report for 1889, the proceedings of the Sanitary Convention at Hastings, and 
 
ABSTRACT OF PROCEEDINGS, April 9, 1889. 
 
 5 
 
 some statistics collected and compiled for Prof. Vaughan, relating to diseases 
 of infancy. 
 
 The compilation of the weekly reports of diseases for 1888, to be printed in 
 the Annual Report for 1889, is well under way. 
 
 HEALTH IN MICHIGAN IN THE FIRST QUARTER OF 1889. 
 
 Contagious Diseases. 
 
 Compared with the preceding quarter (October, November and December, 
 1888), reports received from ali sources show diphtheria to have increased by 
 an average of two places per month, scarlet fever to have increased by an 
 average of sixteen places per month, typhoid fever to have decreased by an 
 average of thirteen places per month, measles to have increased by an average 
 of two places per month, and small-pox to have increased by an average of five 
 places per month. 
 
 Meteorology , and Sickness from all Causes , Compared with the Preceding 
 
 Quarter . 
 
 A comparison of meteorological conditions of the first quarter of 1889 
 with the meteorological conditions of the preceding quarter shows the tem- 
 perature to have been considerably lower, the absolute humidity to have been 
 less, the relative humidity to have been more, and the day and the night 
 ozone to have been slightly more in the first quarter of 1889. 
 
 Compared with the preceding quarter (October, November and December, 
 1888), the reports from regular observers show a marked increase of pneu- 
 monia, influenza, tonsilitis and bronchitis, and a marked decrease of typho- 
 malarial, remittent, and intermittent fevers, diarrhoea, dysentery and cholera 
 morbus in the first quarter of 1889. 
 
 This Quarter compared with the Average for Three Years , 1886 - 1888 . 
 
 A comparison of the meteorological conditions of the first quarter of 1889 
 with the average of corresponding quarters in the three years, 1886-1888, 
 shows that in 1889 the temperature was higher, the absolute humidity slightly 
 more, the relative humidity less, and the day and the night ozone * were 
 slightly more in the first quarter of 1889. 
 
 Compared with the average for the corresponding quarters in the three 
 years, 1886-1888, the reports received from regular observers indicate that 
 intermittent fever, measles, consumption of lungs and neuralgia were less 
 prevalent, and that there was no disease much more than usually prevalent 
 in the first quarter of 1889. 
 
 * Allowance is made for less sensitive test paper used in the first quarter of 1889 than the average 
 of that used in the corresponding quarters of the preceding three years. 
 
THE LIBRARY OF THE 
 
 C«n. Ub. JUN 25 1951 
 
 ABSTRACT OF PROCEEDIN®^— “ 
 
 OF THE 
 
 ♦ . - -- t 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 MEETING APRIL 15, 1890. 
 
 [ 158 .] 
 
 The annual meeting of the Michigan State Board of Health was held in 
 the State Capitol in Lansing, April 15, 1890. The members present were 
 as follows: Hon. John Avery, M. D., President; Arthur Hazlewood, M. 
 D., Prof. Delos Pall, and Henry B. Baker, M. D., Secretary. 
 
 . At the morning session, besides routine business, such as the examina- 
 tion and auditing of bills and accounts, Dr. Avery reported that the com- 
 mittee had made progress on the plans for model school-houses, and stated 
 that the system of ventilation would be such as the Board had before 
 recommended, with a separate foul-air shaft for each room. 
 
 VENTILATION OF SCHOOL-HOUSES. 
 
 . The Secretary presented a communication from Albert McCaleb, build- 
 ing contractor, Chicago, concerning the heating and ventilation of school- 
 houses in accordance with the recommendations in the first Annual Report 
 of the Michigan State Board of Health. Selections from this letter are as 
 follows: 
 
 _ 7 “ Chicago, III., March 15., 1890. 
 
 Dr. Baker , Lansing, Michigan: 
 
 “Dear Sir:— It may be of interest to you to know that a system for 
 ventilating which embodies the construction proposed by Dr. Kedzie in 
 his first report on school hygiene to your board, in 1873, has been in suc- 
 cessful operation as a part of the heating system in a number of schools in 
 this vicinity. 
 
 The defects noticed have been just what Dr. Kedzie mentioned in his 
 first reports, and those mentioned at various times by your board mem- 
 bers, such as unequal ventilation of rooms, especially those farthest from 
 ^ the flues, or reversal of currents through the building caused by adverse 
 winds, foul weather, etc., thereby causing ‘back drafts,’ and, when closets 
 were used, perceptible odors in school rooms. Much complaint was caused, 
 but no remedy has as yet been applied. 
 
 When new school buildings were erected the boards investigated many 
 devices, but adopted a method directly in line with Dr. Kedzie’s recom- 
 mendations, combined with a system of furnace-heating. Briefly described, 
 the system is as follows: 
 
 Powerful furnaces, filled with vertical air tubes, are placed in a ‘ bat- 
 f? ^ v 11 a * cen ^ ra ^ location. These are inclosed in brick in such manner 
 that the air from all mingles in a common head. This head, or warm air 
 chamber, is as high as circumstances will permit. Every room requiring 
 heat is provided with a brick heat flue, and each flue is connected by metal 
 pipes to the warm air chamber. 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 “The advantages of the ‘battery’ arrangement are obvious. One fire 
 warms the w’hole house in mild weather, and no fuel is wasted. Much 
 labor and fuel is saved. 
 
 “Fresh air is supplied to the battery by the following arrangement: A 
 large fresh air receiving-room is placed directly behind and connected to 
 the ‘battery.’ Ducts of large size supply this room from all sides of the 
 house. Each duct is fitted with automatic valves in such manner that 
 those on the windward side are always open, receiving a full supply of 
 fresh air, crowded in by whatever force the wind may give, while those 
 valves on the opposite side are closed by the same force. A sudden change 
 of wind changes instantly the position of the valves and no diminution of 
 supply is noticed. The tendency of the wind to come through the warm 
 air pipes in gusts is overcome by the elasticity of the air in the cold air 
 receiving room. Thus it will be seen that a steady supply of fresh air is 
 assured. 
 
 “Dr. Kedzie’s plan of ventilating is carried out, though in a slightly 
 modified manner. The large flue recommended by him, divided by parti- 
 tions into a number of smaller flues, is expensive and not always practica- 
 ble. It has been found much cheaper, and the results have been better, 
 to build in the partition walls a ventilating flue for each room. These 
 flues are placed side by side with heat and smoke flues, in such manner 
 that some heat is imparted to assist the ventilation. 
 
 “As a matter of economy and to save space, it is customary to stop off 
 the heat-flues for first floor rooms, then continuing on and using the same 
 flues to ventilate the second story rooms. 
 
 “The floors of each room are furred up from the joists by two strips, 
 making the air space continuous. The spaces around the circumference of 
 each room are stopped off with mortar .and boards, with the result that the 
 space under the floor of each room is an air-tight box. Air can enter it 
 from no source whatever, except from the room to be ventilated. The air 
 from the room is permitted to enter this space through grated openings 
 placed at intervals in the room, and thence passes into the flue through a 
 large opening provided below the floor. 
 
 “If summer ventilation is desired by means of the flue, a small gas 01 
 oil heater is placed in each flue to accelerate the current. 
 
 “The result in every case has been that the ventilation is equal and 
 reliable and not affected by outside influences. 
 
 “ Reverse currents or regurgitation of air from one room to another is 
 impossible. As the air is carried through the shortest possible path, nc 
 motive power is wasted in overcoming friction, as in the Smead system. 
 By isolating each room, a ‘slow-burning’ construction is obtained.. 
 
 * * * “The heating and ventilating system without closets is in use 
 
 in Marshall, Minn., Madison, Wis., Racine and Beloit, Wis. 
 
 * * * “I inclose plan of Duncan avenue school, Hyde Park, to illus- 
 
 trate the foregoing description. 
 
 “ I have erected school buildings in which the Ruttan system is used 
 and am now erecting two buildings with the above system of independen 
 ventilation embodied. One of the boards fo^ whom I am now buildim 
 had intended to use the Ruttan, and drew their plans accordingly, bu 
 upon investigation quickly changed and adopted the system abov( 
 described. 
 
 “Respectfully, 
 
 “Albert McCaleb, 
 
 “ Building Contractor 
 
ABSTRACT OF PROCEEDINGS APRIL 15, 1890. 
 
 3 
 
 THE RESTRICTION OF MEASLES. 
 
 The question is frequently asked the office of the State Board of Health : 
 Should measles be restricted in the same manner as other dangerous com- 
 municable diseases? 
 
 At this meeting of the board the Secretary presented facts, opinions and 
 statistics in Michigan and elsewhere bearing on the questions: At what 
 age is measles most severe? and At what period of the disease is measles 
 most communicable? Some of this evidence is as follows: 
 
 TABLE 1. — Exhibiting the number of Deaths from Measles in persons under five years of age and in each 
 year under five , together with the total number of Deaths from Measles in persons of all ages in the 
 United States for the three , and for each of the three census years. ( Compiled from the Eighth , Ninth 
 and Tenth Censuses of the United States.) 
 
 Years. 
 
 All Ages. 
 
 Under 1. 
 
 1 to 2. 
 
 2 to 3. 
 
 3 to 4. 
 
 4 to 5. 
 
 Under 5. 
 
 1860 
 
 3,899 
 
 760 
 
 884 
 
 646 
 
 332 
 
 188 
 
 2,810 
 
 1870 
 
 9,237 
 
 1,871 
 
 2 222 
 
 1,257 
 
 728 
 
 387 
 
 6,465 
 
 1880+ 
 
 8,072 
 
 2,008 
 
 * 1,621 
 
 982 
 
 534 
 
 338 
 
 5,483 
 
 Sum 
 
 21,208 
 
 4,639 
 
 4,727 
 
 2,885 
 
 1,594 
 
 913 
 
 14,758 
 
 Average . _ _ . . 
 
 7,069 
 
 1,546 
 
 1,576 
 
 962 
 
 531 
 
 304 
 
 4,919 
 
 
 
 3,122* 
 
 
 
 
 
 *Over half of all deaths occur in children under two years of age, and the numbers average greatest in 
 the second year. 
 
 fThe numbers in this line except under “All Ages,” are computed from the “Deaths in Each One 
 Thousand Deaths At Known Ages, Classified by Age, Sex and Cause.” Tenth U. S- Census (1880) Vol. XII, 
 Mortality and Vital Statistics, Part II, Table XVI, p. 366. 
 
 TABLE 2— Exhibiting, relative to 96 outbreaks, 927 cases of Measles, in Michigan, in 1887 , the number of 
 Cases and Deaths, and the Per Cent of Deaths to Cases in each ten-year Period of Age. 
 
 Of All (Nine-six) Outbreaks. 
 
 Of All 
 Out- 
 breaks. 
 Total. 
 
 Reported Cases and Deaths— by Periods of Age. 
 
 Under 10. 
 
 10 to 20. 
 
 20 to 30. 
 
 30 to 40. 
 
 40 to 50. 
 
 50 and over. 
 
 GO 
 
 I 
 
 o 
 
 Deaths. 
 
 Cases. 
 
 Deaths. 
 
 go" 
 
 CD 
 
 £ 
 
 o 
 
 Deaths. 
 
 Cases. 
 
 Deaths. 
 
 Cases. 
 
 Deaths. 
 
 CD 
 
 CO 
 
 a 
 
 O 
 
 Deaths. 
 
 Cases. 
 
 Deaths. 
 
 Total cases and deaths at each period- 
 
 927 
 
 23 
 
 545 
 
 18 
 
 268 
 
 0 
 
 90 
 
 1 
 
 15 
 
 2 
 
 5 
 
 1 
 
 4 
 
 1 
 
 Per cent of deaths to cases 
 
 2.5* 
 
 3.3 
 
 0 
 
 1.1 
 
 13.3 
 
 20 
 
 25 
 
 TABLE 3.— Exhibiting, relative to 2,484 ( all in which the ages were reported) cases of Measles in Michigan 
 in 1888 , the number of Cases , and Deaths, and the Per Cent which the Deaths were of the Cases in several 
 periods of ages. 
 
 
 Reported Cases and Deaths within Certain Ages. 
 
 AH 
 
 Ages. 
 
 Under 
 10 yrs. 
 
 10 
 
 to 
 
 20. 
 
 20 
 
 to 
 
 30. 
 
 30 
 
 to 
 
 40. 
 
 40 
 
 to 
 
 50. 
 
 50 
 
 and 
 
 over. 
 
 Number of Cases. 
 
 Number of Deaths.. 
 
 • 2.484 
 48 
 
 1,303 
 
 34 
 
 842 
 
 7 
 
 216 
 
 3 
 
 86 
 
 2 
 
 28 
 
 2 
 
 9 
 
 0 
 
 Per Cent the Deaths were of the Cases 
 
 *1.9 
 
 2.6 
 
 0.8 
 
 1.4 
 
 2.3 
 
 7.1 
 
 0 
 
 *The per cent which the deaths are of the cases, as here given, relates only to those cases for which the 
 age of the patient was stated in the report. 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 From tables 1, 2 and 3 it appears that between the ages of ten and twenty 
 years the deaths from measles are but a very slight per cent of the cases, 
 being, in fact, in the year 1887, zero, and in the year 1888 . only eight- 
 tenths of one per cent. Possibly, if the statistics were compiled for five- 
 year periods instead of ten-year periods, the result might be different. 
 The question arises whether, if children were carefully protected from this 
 disease until this favorable age were reached, and were then permitted to 
 have the disease in isolation hospitals (or otherwise subjected to proper 
 isolation), the deaths from this disease would not be reduced to a minimum, 
 and the sickness as mild or milder than that produced by vaccination. 
 
 This experience in Michigan is similar to the expressed opinion of med- 
 ical writers. William Squire in Quain’s Medical Dictionary, states: “With 
 us more than half of the whole number of deaths from measles are of 
 children under two years of age.” 
 
 To quote from Thomas: “The age of the patients is, under all condi- 
 tions, of the greatest influence upon the mortality of measles. Disregard- 
 ing the fact that healthy and very young children (up to about the age of 
 six months) probably from their feebler predisposition, are attacked very 
 mildly if at all, the rule may be laid down that measles is essentially 
 dangerous only for young or very young children; that its danger decreases 
 rapidly with the accession of years, and in the late years of childhood is 
 already at a minimum; in old people who have, however, but little predis- 
 position and are rarely attacked, the disease is again dangerous. Excep- 
 tions to this are not often reported.” 
 
 The Time When Measles is Most Contagious. 
 
 William Squire (Quain’s Medical Dictionary): “The catarrhal stage, 
 infectious throughout, is often mistaken for a common cold, and no timely 
 separation is attempted. The cough is an important means of conveying 
 the infection at this time. * * * Infection begins before the rash 
 
 appears, and the contagium may be given off by the third day, most proba- 
 bly during the greater part of the incubation period. The contagious prin- 
 ciple, developed only in the bodies of the sick, is found during the height 
 of the disease in the tissues, the secretions, the blood and the breath.” 
 “ After an attack of measles personal infection is probably over by the end 
 of a month; it may persist longer, or be conveyed somehow by convales- 
 cents for another month. How long infection may cling to articles of 
 clothing, or linger in closed rooms, is uncertain.” On the fourth day of the 
 initial fever the eruption appears and continues four days. 
 
 Wood’s Reference Hand book states: “Although the nature of the 
 disease may be conjectured during the prodromal stage, it is only during 
 the eruptive stage that the diagnosis of measles can be definitely deter- 
 mined.” “ The danger of contagion is proportionate to the propinquity of 
 the contaminating influence, being greatest in the sick room. It can not 
 be denied that measles may be spread by mediate contagion. In such 
 cases the clothing probably becomes the disseminating agent. * * * 
 
 Except small-pox measles is probably the most contagious of the exan- 
 themata and is communicable from the early prodromal stage until 
 desquamation is completed. The infectious properties are probably most 
 active during the prodromal stage. The great difficulty of identifying 
 measles during this stage in great measure explains the rapid dissemination 
 of the disease in schools, asylums, etc. The contagious properties continue 
 
ABSTRACT OF PROCEEDINGS APRIL 15, 1890. 5 
 
 throughout the stage of eruption, but speedily diminish with it and proba- 
 bly become extinct during desquamation.” 
 
 I. N. Brainerd, M. D., of Alma, Michigan, in a letter to this office bear- 
 ing on this subject, dated March 8, 1890, states: 
 
 “Dr. Hardaway, Professor of diseases of the skin in the St. Louis Post- 
 graduate School of Medicine and in the Missouri Medical College, St. 
 Louis, and President of the American Dermatological Association, says: 
 ‘Various circumstances render it probable that measles is most readily 
 propagated during the stage of efflorescence.’ — Pepper's System of Medi- 
 cine , Vol. I ., page 560. This being the case, the most infectious stage of 
 the disease is not passed before the disease can be recognized and notice 
 of its presence be given. It is true that measles is communicable during 
 the four days of prodromal fever, during the five days of efflorescence and 
 during the five days ( about ) of exfoliation. Conceding that we can offer 
 no protection during the first four days, shall we therefore offer no protec- 
 tion during the remaining ten days? * * * * Hardaway says : ‘ Leav- 
 
 ing out of account sucklings under six months of age, in whom measles is 
 rare and said to be slight, most deaths from the disease [measles] occur 
 among very young children, from the greater liability to complications. 
 According to Beddoes, the mortality from measles is, beyond all compari- 
 son, greatest in the second year of life.’ — Pepper, Vol. I., p. 578. Vital 
 Statistics of Michigan, 1885, says, p. 221, that 84.22 per cent of the deaths 
 from measles in that year occurred in children under five years of age, and 
 that only 2.63 were above twenty years of age.” 
 
 Importance of Restricting Measles. 
 
 Quain’s Dictionary states: “The annual mortality from measles in Lon- 
 don is nearly five per ten thousand.” In Michigan, the reported deaths 
 from measles for the twelve years, 1876-1887, average 146 per year. If we 
 assume that only three-fourths of the deaths were reported, the deaths in 
 Michigan from measles have been about two hundred per year. 
 
 In Measles , premises should be placarded and finally disinfected. 
 
 After considerable discussion, the members of the Board expressed the 
 opinion that health officers should placard premises where measles exists, 
 and, after death or recovery, should disinfect premises, as in outbreaks of 
 other diseases “dangerous to the public health,” measles being such a dis- 
 ease, and as such coming under the law requiring the health officer to take 
 such action. The law also requires that measles shall be reported by 
 householders, physicians, and health officers. 
 
 SANITARY CONVENTIONS. 
 
 Sanitary Conventions will be held under the auspices of the Board at 
 Battle Creek, June 25 and 26; Alpena, July 10 and 11, and at Charlevoix, 
 August 14 and 15. 
 
 EXAMINATION OF PLANS FOR PROPOSED NEW BUILDING AT THE MICHIGAN 
 
 STATE REFORM SCHOOL. 
 
 The law requires that before the final adoption of plans for proposed 
 new buildings at the State Institutions they shall be submitted to the 
 State Board of Health for its opinion relative to the provisions for the 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 heating, ventilation, sewerage and other sanitary appliances and arrange- 
 ments. Boards of control of the several State Institutions are not required 
 to adopt plans approved by the State Board of Health or to reject plans 
 disapproved by this Board; but this method supplies State boards of con- 
 trol with reports of the opinions of the State Board of Health of plans 
 submitted to them by architects and others, and with such suggestions for 
 improvement as the State Board of Health may offer. 
 
 At this meeting of the State Board of Health, plans for a proposed new 
 main building at the State Reform School were submitted, and were care- 
 fully examined. (A committee of this Board, consisting of D/s. J. H. 
 Kellogg and Henry B. Baker, had previously examined them. ) The Sec- 
 retary was directed to transmit the report to the Board of Control of the 
 State Reform School; and a copy will be published in the Annual Report 
 of the State Board of Health. 
 
 SECRETARY’S QUARTERLY REPORT OF WORK IN THE 
 OFFICE OF THE BOARD DURING THE QUARTER 
 ENDING APRIL 8, 1890. 
 
 During the quarter the office has received information of and taken 
 action relative to 145 outbreaks of diphtheria, 166 outbreaks of scarlet 
 fever, 78 outbreaks of typhoid fever, and 114 outbreaks of measles.* The 
 usual number of documents on the restriction of these diseases (except 
 measles) have been sent to the localities where these diseases prevailed. 
 No case of small-pox has been reported during the quarter. 
 
 A circular letter and blank for the annual return of the name and address 
 of health officer have been sent during the quarter to the supervisors of 
 townships, the clerks of villages and cities and to the presidents of villages 
 and the mayors of cities. 
 
 During the quarter 103 books and pamphlets have been received and 
 entered in the library of this Board, mostly in exchange for the publica- 
 tions of this Board. 
 
 During the quarter ending April 10, 1890, there have been received 
 annual reports from 717 health officers and 688 clerks of townships, cities 
 and villages, making a total of 1,405 annual reports received, as against a 
 total of 1,207 received during the corresponding quarter of 1889, and 864 
 for the corresponding quarter of 1888. 
 
 All the cases and deaths from diphtheria, scarlet fever, typhoid fever and 
 measles mentioned in these reports have been compiled. All the letters 
 and reports received concerning the dangerous communicable diseases in 
 Michigan in 1889 have been assorted, and the compilation of the same has 
 been begun. 
 
 Three hundred and twenty-two blanks giving names of medical practi- 
 tioners have been received, arranged and filed. 
 
 During the quarter a successful sanitary convention was held at Lapeer, 
 and an invitation has been received for a convention at Charlevoix during 
 the coming summer. Steps have also been taken at Battle Creek for a 
 sanitary convention in that city. 
 
 * Record of measles was not begun until the middle of the quarter. 
 
ABSTRACT OP PROCEEDINGS APRIL 15, 1890. 
 
 7 
 
 During the quarter, 1,800 pages of hektograph work have been executed. 
 
 The proceedings of the sanitary conventions at Pontiac and Vicksburg 
 have been edited, printed, and sent to those who took part in the conven- 
 tions, to libraries (80 in all), to the secretaries of State medical societies, 
 to secretaries of State boards of health, to sanitary journals and exchanges, 
 health officers of cities and villages in Michigan, the health officers of other 
 States, and to the correspondents of this Board. A list of the publications 
 of the Board which may be had, on payment of postage, was sent to the 
 health officers of townships, cities and villages. In response to requests 
 (in answer to this list) a large number of reports, supplements and reprints 
 have been sent out. 
 
 A monthly summary of meteorological conditions at this station has been 
 regularly sent to the chief signal officer at Washington, a briefer one sup- 
 plied to the Director of the Michigan Weather Service. 
 
 The computations of meteorological registers for 23 stations in Michigan 
 during the year 1889 have been made. 
 
 The regular weekly and monthly bulletins of health in Michigan have 
 been issued, and work has been begun on the compilation of the weekly 
 reports of diseases for 1889. 
 
 Twenty diagrams have been made during the quarter in hektograph ink, 
 for facilitating studies of the relations of certain meteorological conditions 
 to diseases, and two of these diagrams have been photo-engraved. 
 
 Seventeen hundred and sixty-two newspapers have been looked over 
 since Feb. 14 for reports of communicable diseases. This has resulted in 
 giving this office information of the occurrence of 22 outbreaks of diph- 
 theria, 24 outbreaks of scarlet fever, 15 outbreaks of typhoid fever, and 61 
 outbreaks of measles, during the time between Feb. 14- Mar. 31, 1890. 
 
 TABLE 4. — Showing the number of outbreaks of Diphtheria, Scarlet fever, Typhoid fever and Measles from 
 February 14, to March 31, 1800, of which notice was received at the office of the Michigan State Board of 
 Health ; the per cent of reports, information concerning which was received through the newspapers ; the 
 per cent of newspaper reports which were confirmed by the health officer ; the per cent of newspaper reports 
 which were denied by the health officer, and the per cent from which no reply was received from the health 
 officer. 
 
 Diseases. 
 
 Reports 
 from all 
 sources. Feb. 
 14— March 81, 
 1890. 
 
 Per cent of 
 all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent of 
 n e w s p a per 
 reports 
 which were 
 confirmed by 
 the health 
 officer. 
 
 Per cent of 
 newspaper 
 reports 
 which were 
 denied by 
 the health 
 officer. 
 
 Per cent of 
 newspaper 
 reports to 
 which the 
 health officer 
 made no re- 
 ply to notice 
 sent from 
 this office. 
 
 Diphtheria . 
 
 69 
 
 32 
 
 36 
 
 27 
 
 36 
 
 Scarlet fever... 
 
 92 
 
 26 
 
 21 
 
 29 
 
 50 
 
 Typhoid fever ... . . 
 
 27 
 
 56 
 
 27 
 
 33 
 
 40 
 
 Measles 
 
 114 
 
 54 
 
 64 
 
 5 
 
 30 
 
 Averages for the four Diseases 
 
 
 42 
 
 37 
 
 24 
 
 39 
 
8 
 
 ABSTRACT OP PROCEEDINGS, STATE BOARD OP HEALTH. 
 
 HEALTH IN MICHIGAN IN THE FIRST QUARTER OF 1890. 
 
 Communicable Diseases. 
 
 Compared with the preceding quarter (October, November and Decem- 
 ber, 1889), reports received from all sources show diphtheria to have 
 decreased by an average of three places per month, scarlet fever to have 
 increased by an average of three places per month, typhoid fever to have 
 decreased by an average of forty -eight places per month, measles to have 
 increased by an average of fifty-one places per month, and smcdl-pox to 
 have increased by an average of one place per month. 
 
 Meteorology , and Sickness from cdl Causes , Compared with the Pre- 
 ceding Quarter. 
 
 A comparison of meteorological conditions of the first quarter of 1890, 
 with the meteorological conditions of the preceding quarter, shows the 
 temperature to have been lower, the absolute humidity to have been less, 
 the relative humidity to have been slightly more, and the day and the 
 night ozone to have been considerably more in the first quarter of 1890. 
 
 Compared with the preceding quarter (October, November and Decem- 
 ber, 1889), the reports from regular observers show a marked increase of 
 influenza, pneumonia, cerebro-spinal meningitis, measles, pleuritis and 
 membranous croup, and a marked decrease of typho-malarial fever, typhoid 
 fever (enteric), cholera infantum, small-pox, cholera morbus, dysentery, 
 inflammation of brain, puerperal fever, intermittent fever, remittent fever, 
 diphtheria, diarrhea and scarlet fever in the first quarter of 1890. 
 
 This Quarter Compared icith the Average for Four Years, 1886-1889. 
 
 A comparison of the meteorological conditions of the first quarter of 
 1890, with the average of corresponding quarters in the three years, 1886- 
 1889, shows that in 1890 the temperature was slightly higher, the absolute 
 humidity was more, the relative humidity was slightly less, and the day 
 and the night ozone were more in the first quarter of 1890. 
 
 Compared with the average for the corresponding quarters in the four 
 years, 1886-1889, the reports received from regular observers indicate 
 that influenza and measles were more than usually prevalent, and that 
 typho-malarial fever, typhoid fever (enteric), small-pox, scarlet fever, 
 cholera morbus, puerperal fever, dysentery and diphtheria were less prev- 
 alent in the first quarter of 1890. 
 
 Henry B. Baker, 
 
 Secretary. 
 
f 
 
 ABSTRACT OF PROCEEDI 
 
 THE L13RARY OF THE 
 
 JUN 2 5 1951 
 
 ittSUY OF iLUNOiS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH 
 
 MEETING OCTOBER 14, 1890. 
 
 [ 188 .] 
 
 REPORTED BY THE SECRETARY OF THE BOARD. 
 
 The regular meeting of the Michigan State Board of Health was held in 
 the State Capitol in Lansing, October 14, 1890. The members present 
 were as follows: Arthur Hazlewood, M. D., Prof. V. C. Vaughan, M. D., 
 Prof. Delos Fall, M. S., and Henry B. Baker, M. D., Secretary. 
 
 The regular routine business, such as the examination and auditing of 
 bills and accounts was first transacted. 
 
 PROTECTION OF THE SCHOOL POPULATION FROM CONSUMPTION. 
 
 At previous meetings, the State Board of Health has had before it the 
 subject of the best methods for the restriction and prevention of consump- 
 tion; and, a few years ago, published its opinion that all sputa from 
 consumptive persons should be disinfected. The subject has also been 
 publicly discussed, by the Secretary of the Board and others, at several 
 Sanitary Conventions held under the auspices of the State Board of Health, 
 including the one at Pontiac, referred to below. 
 
 Just previous to this meeting of the Board, a letter from a valued corres- 
 pondent of the Board was presented to members of the Board, as follows: — 
 
 Milford, Mich., Sept. 29, 1890. 
 
 Dr. H. B. Baker , Secy. State Board of Health : 
 
 Dear Sir — There have been several deaths from pulmonary consumption among the pupils who have 
 attended our school during the past two years, and as I feared our building might be infected or unsafe— 
 I had it thoroughly disinfected with bichloride of mercury. There is now in attendance a pupil from a 
 family where there have been several fatal cases of phthisis. 1 circulated the Reports of the Pontiac 
 Sanitary Convention sent me, and several of the pupils are afraid to attend in the room along with the 
 pupil who is coughing and is suspected to have consumption. Can our sohool boai’d exclude cases of 
 consumption from school as we do cases of scarlet fever, diphtheria, etc.? I am quite sure there are other 
 school-houses in our county that are unsafe, also churches and other public halls. Would it not be well 
 for the State Board of Health to issue a circular to school boards and others having charge of churches 
 and public buildings, showing the necessity for thorough disinfection and giving a formula, and method 
 for thorough (annual or semi-annual) disinfection? 
 
 Is phthisis officially considered to be communicable? 
 
 Respectfully, 
 
 Robt. Johnston. 
 
 Although, by leading medical and sanitary authorities, consumption is 
 now quite generally believed to be a “communicable” disease, and it is 
 known to be one of the most dangerous, yet the State Board of Health has 
 not officially declared the opinion that it is a “ disease dangerous to the 
 public health,” as the term is in the Michigan laws, perhaps for the reason 
 that under existing laws the health officers throughout the State are 
 generally required, under penalties, to “give public notice of infected 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 places, by placard on the premises,” to order the “ prompt and thorough 
 isolation of those sick” with snch a disease, and to do other acts which are 
 important relative to certain other diseases which endanger the public 
 health, but which are not yet believed by sanitarians to be judicious to 
 attempt relative to consumption. A pamphlet is in preparation, designed 
 to state precisely what this Board deems to be the best methods for the 
 restriction of consumption. However, the subject of the protection of the 
 school population from consumption is so important that the Board 
 considered it at this meeting, in advance of the more complete document, 
 and adopted the preambles, resolution, and statement relative to disinfec- 
 tion and destruction of sputa of consumptives, as follows: — 
 
 COUGHING CONSUMPTIVES SHOULD BE EXCLUDED FROM SCHOOLS. 
 
 Whereas, The indoor confinement and the severe competitive work of the schpol- 
 room tend to render recovery of health by consumptive pupils impossible; and, 
 
 Whereas, Except consumptives exercise great care with their sputa, and except the 
 ventilation is such as to cause all dust to pass out of the room near the floor level, the 
 presence of consumptives in the school room may endanger the health and lives of then- 
 fellow pupils, 
 
 Resolved , That, in the opinion of this Board, any pupil or person known to be affected 
 with pulmonary consumption should be excluded from all public schools, colleges, and 
 other institutions of learning until such pupil or person is so far recovered from con- 
 sumption that no cough or expectoration occurs. * 
 
 ALL SPUTA OF CONSUMPTIVES SHOULD BE DESTROYED OR DISINFECTED. 
 
 As a measure for the restriction of the spread of consumption, this Board recommends 
 the destruction or disinfection of all sputa of consumptives. 
 
 This can be done if each consumptive provides himself with pieces of soft, tough 
 paper that has been paraffined or otherwise made waterproof, each piece to be used but 
 once, its ends immediately so twisted as to allow no escape of the sputa, and then 
 enveloped in another similar paper, similarly twisted, and all burned at the first 
 opportunity. 
 
 The importance of protecting young people from consumption seems 
 not to be generally sufficiently understood. Consumption causes more 
 deaths in Michigan than does any other disease. A considerable portion 
 of the deaths are of young persons. Thus, in 1884, no less than 20 per 
 cent of all the deaths reported from consumption in Michigan were of per- 
 sons under twenty years of age, ( as many as thirty-five per cent were under 
 twenty-five years of age). Including teachers (some of whom, however, 
 are over twenty years of age), the population in colleges and other insti- 
 tutions of learning, a large portion of the inhabitants of Michigan, under 
 the age of twenty years are in school. According to the census of 1884, 
 about 87 per cent of the inhabitants attended school during the year. 
 According to the Report of the Superintendent of Public Instruction, for 
 the year 1889, the number of pupils and teachers, in that year, was over 
 480,000, about 17,000 being teachers. 
 
 Consumption may come to the school population in other ways than by 
 school attendance, yet, with no effort at restriction, other things being 
 equal, the greater the number of persons in an assembly the greater 
 the chance of there being a person present infected with, and capa- 
 ble of spreading, the disease. Consumption is now believed to be most 
 generally spread by the inhalation of dust from the dried sputa of con- 
 sumptive persons. And, wdiile it may not yet be considered judicious to 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 14, 1890. 
 
 3 
 
 completely isolate all consumptives, it does seem judicious to protect all 
 large assemblies of persons susceptible to consumption. Unless local 
 boards of health make extraordinary provision therefor,* there are, as yet, 
 no special guardians of assemblies in churches, opera houses, theatres, 
 etc. ; but it seems to be practicable for school officers, on the ground of 
 public policy, to regulate the attendance in schools, and to exclude there- 
 from persons suffering from dangerous communicable diseases. If a school 
 board cannot legally do this on its own responsibility, it would seem that 
 the law might well be so amended that it can; but under present laws, it 
 should be able to enforce the orders of the local board of health, respect- 
 ing persons whom the board of health shall decide to be suffering from a 
 dangerous communicable disease. It therefore seems to be practicable to 
 take such action as shall probabty result in a very considerable saving of 
 human life, and among a class of inhabitants especially worth saving. 
 
 The attention of school officers throughout the State is especially called 
 to this subject. 
 
 The public-health interests of the State will also gain greatly if the 
 modes of spread of the most dangerous communicable diseases shall come 
 to be well known to the school population of the State. The office of the 
 Secretary of the State Board of Health holds itself in readiness, at all 
 times, to do what it can to aid school officers and teachers toward the 
 accomplishment of that very desirable object. 
 
 TYPHOID FEVER SUPPOSED TO HAVE BEEN CAUSED BY WATER OR MILK. 
 
 Preliminary Report. 
 
 A valued correspondent of this Board w T rote, Sept. 28, that typhoid fever 
 had been unusually prevalent in his vicinity this Autumn; cases had 
 occurred among persons using the water from wells, and among those using 
 water from the river, and such a number had occurred among users of milk 
 from one particular cow that the question had arisen whether the disease 
 was all spread by the milk, or whether one or both sources of water were 
 to be charged with its causation. 
 
 Samples of the milk, of the river water, and of the well water were sent 
 to Prof. Vaughan, Director of the Laboratory of Hygiene, Ann Arbor, and 
 at this meeting he made a verbal preliminary report that bacteriological 
 examination revealed the fact that both of the samples of water and the 
 milk contained micro-organisms wffiich, by their life processes, in nutritive 
 solutions, form poisons. 
 
 THE PRESENT COMPARATIVE IMMUNITY OF ADULTS FROM DIPHTHERIA. 
 
 {The Beginning of a Statistical Study.) 
 
 Dr. Baker presented a table and an illustrative diagram exhibiting the 
 epidemic-waves of diphtheria in England during the period 1855-1888, 
 inclusive. The part representing the period, 1855-1881, was published in 
 the Proceedings of the Sanitary Convention held at Beed City in April, 
 1883; but Dr. Baker has now extended the statistics and the diagram to 
 1888, and has associated with it evidence as to the change which has taken 
 place in the age of decedents from diphtheria in England. 
 
 * Under §1647 or §1673 Howell’s Statutes. 
 
TABLE 1. Epidemic Waves.— Deaths from Diphtheria in England and in Michigan for Years Stated. 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 1888 
 
 4815 
 
 168 
 
 717 
 
 1887 
 
 4443 
 
 157 
 
 935 
 
 1886 
 
 4098 
 
 147 
 
 1117 
 
 1885 
 
 4471 
 
 163 
 
 1054 
 
 1 1 
 
 ra rs 1 1 
 IS s r 
 
 So I 
 qo 
 
 4218 
 
 158 
 
 1007 
 
 I 
 
 00 
 
 00 
 
 3992 
 
 151 
 
 1416 
 
 ( 
 
 1881 
 
 3153 
 
 121 
 
 2063 
 
 1880 
 
 2810 
 
 109 
 
 1542 
 
 1879 
 
 3053 
 
 120 
 
 1473 
 
 1878 
 
 3498 
 
 140 
 
 887 
 
 1877 
 
 2731 
 
 111 
 
 593 
 
 1876 
 
 
 
 3151 
 
 129 
 
 311 
 
 1875 
 
 3415 
 
 142 
 
 207 
 
 1874 
 
 3560 
 
 150 
 
 213 
 
 1873 
 
 2531 
 
 108 
 
 217 
 
 ^ 1 
 
 g ! 
 
 2152 
 
 93 
 
 192 
 
 1871 
 
 2525 
 
 111 
 
 121 
 
 1870 
 
 2699 
 
 120 
 
 121 
 
 1869 
 
 2606 
 
 117 
 
 89 
 
 1868 ; 
 
 3013 
 
 137 
 
 1867 
 
 
 
 2600 
 
 120 
 
 110 
 
 9981 
 
 3000 
 
 140 
 
 
 1 
 
 4145 
 
 196 
 
 
 1864 
 
 5464 
 
 261 
 
 
 § 1 rs rs 
 a I Lc§ L* 
 
 
 1862 
 
 4903 
 
 241 
 
 
 1861 
 
 4517 
 
 225 
 
 
 1 
 
 5212 
 
 261 
 
 
 05 
 
 urs 
 
 00 
 
 fft f l P 
 
 [g c® 
 
 
 1858 
 
 8 8 
 
 to 00 
 
 
 1857 
 
 1583 
 
 82 
 
 
 ?o 
 
 00 
 
 00 <03 
 
 s - 
 
 
 1855 
 
 1 S 
 
 
 PLACES. 
 
 ' ! England: 
 
 No.of deaths 
 
 Deaths per 
 Million In- 
 habitants*. . 
 
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 theria is usually not fatal to adults, to be explained (altogether or in part) by their having had the disease once in 
 early life? If this hypothesis is the true explanation, then when diphtheria first reaches a country there should be 
 a much larger proportion of adults among the decedents than there is afterwards; because at first the adults would 
 not be protected through having had the disease, while afterwards, if the disease becomes general and permanent, 
 many of the adults would be thus protected, in case immunity is thus obtained. 
 
EPIDEMIC WAVES — DEATHS FROM DIPHTHERIA IN ENGLAND, YEARS 1853-SS-* 
 
 ABSTRACT OP PROCEEDINGS, OCTOBER 14, 1890. 
 
MICHIGAN STATE BOARD OP HEALTH. 
 
 6 
 
 Notwithstanding the belief among statisticians that in the mortality 
 statistics in England, diphtheria was first separated from scarlet fever in 
 1855, Dr. Baker expressed the view, based upon his examination of the 
 evidence, that it seemed to him probable that diphtheria first reached, and 
 commenced to spread through, England in 1855, — that previous to 1855 
 there was very little if any real diphtheria which could have been separated 
 from scarlet fever. Dr. Hazlewood, president pro tern, of the State Board 
 of Health at this meeting, and who in early life was a medical student in 
 England, expressed a similar view’. 
 
 TABLE 2 . — Deaths from Diphtheria in England. 
 
 t 
 
 Years. 
 
 Diphtheria Decedents. 
 
 Deaths from Diph- 
 theria per Million 
 Inhabitants.* 
 
 Per Cent' Under 
 10 Years of Age. 
 
 Per Cent Over 10 
 Years of Age. 
 
 1857 
 
 f 85.48 
 
 t 14.52 
 
 82 
 
 1859 
 
 79.22 
 
 20.78 
 
 517 | 
 
 1860 
 
 79.82 
 
 20.18 
 
 261 
 
 1861 
 
 79.37 
 
 20.63 
 
 225 
 
 1868 
 
 82.60 
 
 17.40 
 
 137 
 
 1869 
 
 81.77 
 
 18.23 
 
 117 
 
 1870 
 
 80.77 
 
 19.23 
 
 120 
 
 1871 __ __ 
 
 81.59 
 
 18.41 
 
 111 
 
 1872 
 
 81.18 
 
 18.82 
 
 93 
 
 1873 
 
 83.21 
 
 16.79 
 
 108 
 
 1 1874 
 
 80.67 
 
 19.33 
 
 150 
 
 1 1875 
 
 80.81 
 
 19.19 
 
 142 
 
 I 1876 
 
 82.70 
 
 17.30 
 
 129 
 
 1877 
 
 82.52 
 
 17.48 
 
 111 
 
 1878 
 
 83.28 
 
 16.72 
 
 140 
 
 1879 
 
 82.44 
 
 17.56 
 
 120 
 
 1880 
 
 83.47 
 
 16.53 
 
 109 
 
 1882 
 
 84.97 
 
 15.03 
 
 151 
 
 1883 
 
 84.57 
 
 15.43 
 
 158 
 
 1884 
 
 84.06 
 
 J5.94 
 
 185 
 
 1885 
 
 83.74 
 
 16.26 
 
 163 
 
 1886 
 
 84.82 
 
 15.18 
 
 147 
 
 1887 
 
 86.41 
 
 13.59 
 
 157 
 
 1888 
 
 87.16 
 
 12.84 
 
 168 
 
 * Fiftieth Animal Report, Registrar-General of England, 1887, page lviii. 
 
 t For the year 1857 only 310 deaths of persons at all ages were included in the table, therefore these 
 figures may not supply very reliable evidence on this point, for that year; but if the evidence is good, 
 there is a possible explanation further on. 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 14, 1890. 
 
 7 
 
 Diphtheria reached its maximum prevalence in England in 1859, in which 
 year over 10,000 deaths from it were reported. Among the decedents 
 from diphtheria in England in 1859 was there a larger proportion of adult 
 persons than there has been since that time? Examination of the statis- 
 tics seems to prove that there was: The proportion of decedents over ten 
 years of age has been gradually decreasing since 1859, in England, and, 
 conversely, the proportion of the decedents that are under ten years of age 
 has been correspondingly increasing. The proportions in decedents in each 
 of specified years (taken somewhat at random) are shown in Table 2, 
 above. 
 
 If it is true that diphtheria first gained a permanent existence in England 
 in 1855 ; and if once having diphtheria confers comparative immunity from 
 the disease, then diphtheria should have caused a greater mortality when 
 it first spread through England than it ever did afterwards. Table 1, and 
 especially the diagram shows that this is the fact, — that there were more 
 deaths from diphtheria in England in 1859 than there has been in any year 
 since, notwithstanding a considerable increase in the population.* 
 
 That there shall be gained a knowledge of the reason why adults now 
 have comparative immunity from diphtheria is important, for several rea- 
 sons: If the immunity is gained only or chiefly through having the dis- 
 ease, then, if through isolation of cases, and thorough disinfection, the dis- 
 ease shall be generally greatly lessened, j there will gradually be a lessening 
 of the proportion of adults who are comparatively immune, that is to say 
 there will be a correspondingly large proportion of adults who may have 
 fatal diphtheria whenever the disease does come to them; and instead of 
 the disease being, as it now is, a disease fatal chiefly to children it would 
 become fatal also to adults. 
 
 On the other hand, if the comparative immunity of adults is due to their 
 power for resisting the disease being greater than it is among children, 
 through influences incident to age alone ( such, for instance, as tougher skin 
 and mucous membrane of throat), then the practical sanitarians have a 
 more simple task before them. 
 
 Some of the facts developed by this study of the statistics of England 
 and of Michigan-are more in accord with the last-mentioned hypothesis 
 than with the idea that the immunity is due chiefly to having had the dis- 
 ease. Eor instance, it seems that in the very first year (1857) for which 
 the computation could be made in England, the per cent of decedents aged 
 under ten years was 85.48, which is about the average of late years. This 
 is shown in the first line in Table 2. 
 
 Then in the table ( No. 3 ) for Michigan, it is seen that there was not 
 from the first a gradual decrease of proportion of adults among the dece- 
 dents from diphtheria, but the table shows that generally in those years 
 when the deaths were most numerous there was the greatest proportion of 
 adult decedents. J This might be the case if we suppose that the increase 
 in the mortality from diphtheria in those years was due not altogether to 
 an increased number of susceptible persons among the inhabitants, but 
 also to greater intensity of the diphtheritic virus in those years, or to a 
 greater intensity of meteorological conditions favoring the disease. 
 
 *It is proper to state that, although this is true for England as a whole, in the city of London, by itself, 
 there was a slightly greater reported death-rate from diphtheria in 1888 than in 1859. 
 
 t There is good evidence that this is now being done in Michigan. 
 
 X As may be seen by the last three lines in Table 3, relative to diphtheria in Michigan, when the 
 reported deaths from diphtheria are over five-tenths of one death per thousand inhabitants, the average 
 per cent of diphtheria decedents over ten years of age is 22.55, and when the reported deaths from diph- 
 theria are less than five-tenths of one death per thousaud inhabitants, the average per cent of diphtheria 
 decedents over ten years of age is 19.27. (The average per cent of diphtheria decedeuts aged over ten 
 ears is 20.68.) 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 TABLE 3 . — Deaths from Diphtheria in Michigan , for each of the twenty-one Years 
 1868-1888 ; Per Cent of Decedents Under Ten Years of Age ; Per Cent of Decedents 
 Over Ten Years of Age ; Number of Deaths at all Ages ; Estimated Population ; and 
 Reported Deaths per one thousand Inhabitants. Average for the years 1868- 77, 
 1887-88, when the death-rate was more than five-tenths of one death per thousand 
 inhabitants ; average for the years 1878-86, when the death-rate was less than five - 
 tenths of one death ; and, average for the whole series of years 1868-88. 
 
 
 Diphtheria Decedents. 
 
 Total Deaths 
 from 
 
 Diphtheria 
 at all Ages. 
 
 Estimated 
 Population, in 
 June of each 
 Year. * 
 
 y .-_. ' . ; i 
 
 Reported 
 Deaths from 
 Diphtheria 
 per 1,000 
 Inhabitants. 
 
 Year. 
 
 Per cent 
 Under 10 
 years of Age. 
 
 Per cent 
 Over 10 
 years of Age. 
 
 1868 
 
 f75.00 
 
 25.00 
 
 72 
 
 1,080,906 
 
 -1 
 
 1869 
 
 79.78 
 
 20.22 
 
 89 
 
 1,131,600 
 
 .08 
 
 1870 
 
 83.47 
 
 16.53 
 
 121 
 
 Jl, 184.282 
 
 .10 
 
 1871 
 
 82.64 
 
 17.36 
 
 121 
 
 1,223,176 
 
 .10 
 
 1872 
 
 80.21 
 
 19.79 
 
 192 
 
 1,263,352 
 
 .15 i 
 
 1873 
 
 84.79 
 
 15.21 
 
 217 
 
 1,304,842 
 
 .17 
 
 1874 
 
 85.45 
 
 14.55 
 
 213 
 
 1,347,678 
 
 .16 j 
 
 1875 1 — 
 
 81.64 
 
 18.86 
 
 207 
 
 1,391,927 
 
 .15 1 
 
 1876 
 
 78.14 
 
 21.86 
 
 311 
 
 1,437,621 
 
 .22 
 
 1877 
 
 77.91 
 
 22.09 
 
 593 
 
 1.484,824 
 
 .40 
 
 1878 
 
 1 
 
 76.10 
 
 f 23.90 
 
 1 
 
 887 
 
 1,533,573 
 
 1 
 
 r .58 
 
 1879 
 
 
 77.12 
 
 22.88 
 
 i 
 
 1,473 
 
 1,583,932 
 
 1 
 
 .93 | 
 
 1880 
 
 
 78.15 
 
 | 21.85 
 
 1,542 
 
 Jl, 636, 937 
 
 1 
 
 .94 
 
 1881 
 
 
 74.80 
 
 ! 25.20 
 
 2,063 
 
 1,677,346 
 
 
 1.23 
 
 i 
 
 1882 
 
 
 76.55 
 
 -{ 23.45 
 
 1,416 
 
 1,718,761 
 
 * 
 
 .82 
 
 1883 
 
 
 80.24 
 
 | 19.76 
 
 1.007 
 
 1,761,202 
 
 
 .57 
 
 1884 
 
 
 80.47 
 
 ! 19.53 
 
 1,065 
 
 §1,804,699 
 
 
 I .59 
 
 1885 
 
 
 77.99 
 
 | 22.01 
 
 1,054 
 
 1,849,258 
 
 
 .52 
 
 1886 
 
 
 75.65 
 
 124.35 
 
 1,117 
 
 1,894,928 
 
 
 .59 
 
 1887 
 
 78.82 
 
 21.18 
 
 935 
 
 1,941,710 
 
 .48 
 
 1888 
 
 80.89 
 
 19.11 
 
 717 
 
 1,989,653 
 
 .36 
 
 1889 .... 
 
 
 
 
 ! 2,038,784 
 
 
 1890 
 
 
 
 
 ! 
 
 12,089,792 
 
 
 1868-77. 1887-88 
 
 80.73 
 
 19.27 
 
 
 .20 
 
 1878-86 .. 
 
 77.45 
 
 22.55 
 
 
 
 .75 1 
 
 1868-88 (Av. for whole series) 
 
 79.32 
 
 20.68 
 
 
 
 .44 
 
 *The statememts of the estimated population for the years 1868 and 1869 werp taken from the “Intro- 
 duction” to the “Statistics of Michigan 1870,” page lxxx; those for the years 1870, 1880, and 1890 were of 
 the exact numbers of inhabitants as enumerated for the U. S. census; for the remaining years, they were 
 estimated by taking the figures of the U. S. census of 1870, 1880, and 1890 and computing for each decen- 
 nial period, the annual increase per 1,000 inhabitants. From 1870 to 1880 this was, approximately, 82.85; 
 and from 1880 to 1890 it was about 24.7. The figures in Michigan censuses in 1864, 1874, and 1884 were not 
 used for the purpose of this estimation, nor in this table for the census years, because the State censuses for 
 1864 and 1874 were taken at a different time of the year from that of the U. S. censuses, and, although the 
 State census for 1884 showed a greater population than the estimate based on the preceding and succeed- 
 ing U. S. censuses, the State census figures could not be used because not comparable with those for the 
 other years estimated from the annual increase per 1,000 inhabitants according to the U. S. census, 
 t For the last nine (9) months of the year 1868. 
 i According to the U. S. census. 
 
 §The population of Michigan in June, 1884, according to the State census, was 1,858,658. 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 14, 1890. 
 
 9 
 
 The meteorological conditions favoring the disease in any given year are 
 well shown in tables and diagrams in various articles prepared by myself, 
 and published by this State Board of Health; speaking generally, the evi- 
 dence is conclusive that diphtheria rises after the cold months, and falls 
 after the warm months; but this study has not yet been extended so as to 
 show whether the same general law holds true by years as it does by 
 months. 
 
 NONE BUT WELL-QUALIFIED PHYSICIANS. 
 
 PROPOSED LEGAL ORGANIZATION OF THE ENTIRE MEDICAL PROFESSION OF 
 
 THE STATE. 
 
 At this meeting of the Board, the subject of an attempt to stop the con- 
 tinued influx of unqualified practitioners was brought up, through a com- 
 munication to the Secretary of the Board, from George Duffield, M. D., Sec. 
 of a committee of the State Medical Society, whereupon the following pre- 
 amble and resolutions were adopted: 
 
 Whereas, It is agreed by all classes of people that the public health would be much 
 better protected if none but properly-qualified persons were permitted to practice med 
 icine, and thus to have in their keeping measures relative to life and death. 
 
 Resolved , That it is believed to be practicable, through judicious legislation, to so 
 organize the present legal medical practitioners in Michigan, as that through represent- 
 atives, elected by themselves, they shall guard the entrance to the profession, by a pre- 
 liminary examination of students, and a final examination of graduates of colleges and 
 of proposed practitioners who come from other States, so that the entire medical pro- 
 fession of this State shall be united in the effort to improve the qualifications of its 
 new members. 
 
 Resolved , That the Secretary of this Board be directed to transmit a copy of the fore- 
 going preamble and resolution to the chairmen of the committees on public health in 
 the Senate and House of Representatives in the State Legislature, as soon as it is in 
 
 session. 
 
 SECRETARY’S REPORT OF WORK IN THE OFFICE OF THE STATE BOARD OF HEALTH 
 DURING THE SIX MONTHS ENDING OCTORER 13, 1890. 
 
 During the last two quarters the office has received information of, and 
 taken action relative to 221 outbreaks of diphtheria, 202 outbreaks of scar- 
 let fever, 179 outbreaks of typhoid fever, and 243 outbreaks of measles. 
 The usual numbers of pamphlets on the restriction of these diseases have 
 been sent to the localities where these diseases prevailed. No case of small- 
 pox has been reported during the second and third quarters of 1890. 
 
 A little over 1,700 pages of letter-copy book have been used since the 
 April meeting. 
 
 The Public-health Laws of Michigan, compiled last year, have been care- 
 fully examined, the proof on the compilation has been read, table of contents 
 and index prepared, and the book is nearly ready for distribution. 
 
 The copy for that part of the Annual Beport for the year 1889 which 
 follows the articles on meteorology and the weekly reports of diseases has 
 been carefully edited and the articles up to the one relative to typhoid fever 
 have been printed. The last part of the article relative to typhoid fever, 
 was somewhat delayed by the preparation of further evidence on the 
 relation of low water in wells, and the height of ground above the ground 
 water, to the prevalence of typhoid fever in Michigan. 
 
 ANNUAL REPORTS OF HEALTH OFFICERS AND CLERKS, AND THEIR COMPILATION. 
 
 Since the last regular meeting of this Board a compilation has been 
 made from the annual reports of health officers and clerks of local boards, 
 the compilation including all the deaths and cases reported as having 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 occurred during the year 1889, from the following-named dangerous com- 
 municable diseases: — diphtheria, scarlet fever, typhoid fever, measles, and 
 whooping-cough. The information from this source is to be united with 
 that from the special reports relative to those diseases, and with that 
 derived from the weekly postal-reports. The whole number of annual 
 reports from which the compilations were made, are as follows: — 
 
 From health officers 732 
 
 From clerks t _ _ 700 
 
 Total . 1,432 
 
 REPORTS OF NAMES AND ADDRESSES OF PRACTICING PHYSICIANS. 
 
 Under the law, Act No. 268, Laws of 1887, it is the duty of the supervisor 
 at the time of making the annual assessment in each year, to make a list of 
 all physicians within his township, village, ward, or city as the case may be, 
 and to return such list to the village or city clerk, “and annually on or 
 before the first day of January, such clerks shall furnish certified lists of 
 the same to the Secretary of the State Board of Health.” This law is not 
 being generally obeyed. During the year 1890 only 429 out of a possible 
 1,517 reports have been received, and most of these reports have come from 
 townships and small villages, in which the population was not great, in 
 many cases there being no physician in the township. The result is, that 
 the intention of the law to supply to the office of the State Board of Health 
 information relative to the medical practitioners throughout the State, is 
 not fulfilled and the information has to be obtained from other sources. 
 The best available source is the “Medical and Surgical Directory” compiled 
 by R. L. Polk & Co., of Detroit, but the latest edition seems to be not 
 later than that of 1886. 
 
 METEOROLOGICAL REPORTS AND WORK IN THE OFFICE. 
 
 Since the last report (April, 1890), the weekly and monthly summary of 
 meteorological conditions at this station have been made, and a copy of 
 the monthly summary sent, each month, to the Chief Signal Officer at 
 Washington, D. C., and also a copy to Sergt. N. B. Conger, Director of the 
 Michigan State Weather Service, at Lansing, Mich. 
 
 Compilations of the meteorological conditions for the year 1889, at 24 
 stations in different parts of the State, are nearly completed, and 26 dia- 
 grams made in the photo-engraver’s ink, ready for the photo-engraver. 
 
 Meteorological registers have been received and examined from 22 sta- 
 tions in Michigan — for each of the months, April to August, and from 
 nearly all of those stations for September, 1890. The computation of all 
 the meteorological conditions on these registers from J anuary to August, 
 1890, has been made (but not proved) except for the absolute and relative 
 humidity, observations of the barometer, and of fog. 
 
 SANITARY CONVENTIONS HELD. 
 
 Two successful sanitary conventions w T ere held, one at Alpena, J uly 10 
 and 11, and one at Charlevoix, August 14 and 15. These were attended by 
 the secretary, as well as by other members of this board. 
 
 A PUBLIC MEETING AT HOLLAND, OTTAWA COUNTY. 
 
 On account of difficulty in restricting diphtheria, the health officer and 
 other prominent citizens of Holland asked that a sanitary convention, 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 14, 1890. 
 
 11 
 
 under the auspices of the State Board of Health, be held in Holland; and 
 arrangements were made for one; but the time set for it was so distant 
 that it seemed desirable to hold at once a public meeting for the special 
 purpose of placing before the citizens generally the best means for the 
 restriction of diphtheria. July 17, such a public meeting was held, at 
 . which the mayor of the city presided; and, on invitation received from 
 the board of health of Holland, Doctors Avery, Hazlewood, and Baker, of 
 the State Board of Health, attended and spoke at the meeting. The 
 secretary of this board also distributed to the audience, which was a large 
 one, copies of the documents, issued by the State Board of Health, on the 
 best measures for the restriction of diphtheria. 
 
 NOTICES, PAMPHLETS, BLANKS, ETC., ISSUED. 
 
 Announcements for Sanitary Conventions to be held at Holland, Niles, 
 and Centerville, have been printed and liberally distributed. Programs 
 for the Sanitary Conventions held at Alpena and Charlevoix were printed 
 and distributed. Announcements for the postponement of the Convention 
 at Holland have been distributed in order that those previously invited, 
 might not be misled into going at the wrong time. 
 
 At the Alpena Convention about 250 copies of pamphlet Supplements 
 to the Annual Reports of this Board and 103 sets of pamphlets and dia- 
 grams were distributed. At the Charlevoix Convention about 50 sets of 
 pamphlets and diagrams, and about 120 copies of pamphlet proceedings of 
 sanitary conventions were distributed. The usual number of pamphlets 
 have been sent where communicable diseases prevailed, supplying instruc- 
 tions how to restrict such diseases. The list of health officers for town- 
 ships, villages, and cities has been compiled, printed, and sent to all the 
 health officers, and to the supervisors or presidents of villages and mayors 
 of cities where no health officer was returned. The number of copies sent 
 out was about 1,519; this being the number of local boards of health in 
 Michigan. 
 
 The usual documents, pamphlets, blanks, etc., have been sent to each 
 health officer of a township, village, and city as soon as his name was 
 returned; also to the clerk of each township, village, and city who made 
 report of the name of a health officer for his township, village, or city. 
 
 The usual work of keeping a record of the documents sent out from, and 
 received in the office has been kept up. 
 
 JOURNALS, BOOKS, AND PAMPHLETS RECEIVED. 
 
 During the last two quarters, the numbers of journals received at the 
 office of the State Board of Health, mainly in exchange for the publications 
 of this Board, were as follows : 
 
 Journals. 
 
 First 
 
 Quarter. 
 
 Second 
 
 Quarter. 
 
 Quarterly ... 
 
 _ | 
 
 4 
 
 1 
 
 Monthly . 
 
 134 
 
 111 
 
 Semi-Monthly 
 
 37 
 
 37 
 
 Weekly _ 
 
 284 
 
 266 
 
 During the quarter ending June 30, 1890, there were 120 books and 
 pamphlets added to the library of the Board. 
 
12 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Among the hecktograph work clone during this second quarter, were 
 copies of report, and supplementary report, of examination by this Board 
 of plans for the new buildings at the State Reform School. 
 
 During the quarter ending Sept. 30, 1890, there were 98 books and 
 pamphlets 'added to the library of the Board. 
 
 Hecktograph and mimeograph work was made, during the third quarter 
 to the number of 3,057 pages, among which were letters on “ Sulphurous 
 Disinfection” and “How Diphtheria is Spread by Corpses;” said articles 
 were distributed to members of the Board, sanitary exchanges, secretaries 
 of other State Boards of Health, and others where it was thought they would 
 do good. 
 
 COMMUNICABLE DISEASES. 
 
 Quarter Ending June 30, 1890. 
 
 The number of outbreaks of communicable diseases of which information 
 was received, from all sources, and filed, and the corresponding numbers of 
 special letters sent during the quarter, were as follows: — for diphtheria, 
 118; scarlet fever, 94; typhoid and typho-malarial fever, 52; measles, 189. 
 Total for the five diseases, 453. (No small-pox was reported.) 
 
 The “Final” reports received and filed during the quarter, were: for 
 diphtheria, 65; scarlet fever, 76; typhoid and typho-malarial fever, 18; 
 measles, 8. 
 
 Written cards and demands for weekly or final reports, on cards, or in 
 the form of the circular letter, were sent during the quarter, to the number 
 of 792. Besides this, card receipts for communications from health officers 
 and others were sent of which no record is kept. 
 
 Newspapers have been looked over during the quarter for reports of 
 communicable diseases to the number of 2,348. This has resulted in giving 
 this office information of the occurrence of 24 outbreaks of diphtheria, 8 
 outbreaks of scarlet fever, 15 outbreaks of typhoid and typho-malarial fever, 
 and 64 outbreaks of measles, during the quarter. 
 
 TABLE 4.- Showing the number of outbreaks of Diphtheria, Scarlet fever, Typhoid fever 
 and Measles, from April 1, to June 30, 1890, of which notice was received at the office 
 of the Michigan State Board of Health ; the per cent of reports, information concern- 
 ing which was received through the newspapers ; the per cent of newspaper reports 
 which were confirmed by the health officer : the per cent of newspaper reports which 
 were denied by the health officer, and the per cent from which no reply was received 
 from the health officer. 
 
 DISEASES. 
 
 Reports from 
 all sources. 
 April 1— June 
 30, 1890. 
 
 ! 
 
 Per cent of 
 all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent of 
 newspaper 
 reports 
 which were 
 confirmed by 
 the health 
 officer. 
 
 Per cent of 
 ne w s p a p er 
 reports 
 which were 
 denied by 
 the health 
 officer. 
 
 • 
 
 Per cent of 
 newspaper 
 reports to 
 which the 
 health officer 
 made no re- 
 ply to notice 
 sent from 
 this office. 
 
 Diphtheria.. . ... __ 
 
 118 
 
 20 
 
 29 
 
 29 
 
 42 
 
 Scarlet fever .. .. 
 
 94 
 
 9 
 
 38 
 
 25 
 
 38 
 
 1 Typhoid fever.. 
 
 52 
 
 29 
 
 13 
 
 20 
 
 67 
 
 Measles. .. 
 
 189 
 
 34 
 
 38 
 
 20 
 
 42 
 
 Averages for the four Diseases . . . 
 
 
 23 
 
 29 
 
 24 
 
 47 
 
ABSTRACT OP PROCEEDINGS, OCTOBER 14, 1890. 
 
 13 
 
 COMMUNICABLE DISEASES. 
 
 Quarter Ending Sept. 30, 1890. 
 
 The number of reports of outbreaks of dangerous communicable diseases 
 received from all sources and filed, and the corresponding number of cir- 
 cular letters sent during the quarter, are as follows: for diphtheria, 103; 
 for scarlet fever, 108 ; for typhoid and typho-malarial fever, 127 ; for meas- 
 les, 54. Total for the five diseases, 392. (No small-pox was reported.) 
 
 The “Final” reports received and filed during the quarter, were: for 
 diphtheria, 76; scarlet fever, 73; typhoid and typho-malarial fever, 33; 
 measles, 19. Total for the five diseases, 201. 
 
 Written cards, and demands for weekly or final reports, on cards, or in the 
 form of the circular letter, were sent out during the quarter, to the number 
 of 539, 
 
 Newspapers (local columns) have been looked over during the quarter 
 for reports of communicable diseases, to the number of 1,844. This has 
 resulted in giving this office information of the occurrence of 12 outbreaks of 
 diphtheria, 11 outbreaks of scarlet fever, 16 outbreaks of typhoid and typho- 
 malarial fever, and 3 outbreaks of measles. 
 
 The number of communications relative to dangerous communicable dis- 
 eases received and placed on file during the quarter was 977. 
 
 TABLE 5. — Showing the number of outbreaks of Diphtheria , Scarlet fever , Typhoid 
 fever and Measles from July 1 to September 30, 1890, of which notice was received 
 at the office of the Michigan State Board of Health ; the per cent of reports , infor- 
 mation concerning which was received through the newspapers ; the per cent of 
 newspaper repoi'ts which were confirmed by the health officer ; the per cent of news- 
 paper reports which were denied by the health officer, and the per cent from which 
 no reply was received from the health officer. 
 
 Diseases. 
 
 K e p o r t s 
 from all 
 sources. July 
 1, Sept. 30, 
 1890. 
 
 Per cent of 
 all reports 
 whichwere 
 obtain e d 
 from the 
 newspapers. 
 
 Per cent of 
 news paper 
 reports 
 
 which were 
 confirmed by 
 the health 
 officer. 
 
 Per cent of 
 newspa per 
 reports 
 
 wh i c h were 
 denied by 
 the health 
 officer. 
 
 Per cent of 
 new spaper 
 reports to 
 which the 
 health officer 
 made no reply 
 to notice sent 
 from this office. 
 
 Diphtheria 
 
 103 
 
 12 
 
 58 
 
 0 
 
 42 
 
 Scarlet fever _ 
 
 108 
 
 10 
 
 27 
 
 18 
 
 55 
 
 Typhoid fever ... . 
 
 127 
 
 13 
 
 38 
 
 31 
 
 31 
 
 Measles 
 
 54 
 
 6 
 
 33 
 
 33 
 
 33 
 
 Averages for the four Diseases 
 
 i 
 
 1 
 
 10 j 39 j 21 
 
 40 
 
 During the second quarter of 1890, 3,675 postal cards, and 245 record 
 books were sent to 245 health officers and regular correspondents; the 
 weekly card-reports received were entered and compiled; 42 copies of the 
 hektographed weekly bulletin, “Health in Michigan,” were mailed each 
 week; 79 copies of the monthly bulletin, “Health in Michigan,” and 121 
 copies of the diagram of “Comparative Sickness, ’’^have been hektographed 
 and mailed each month. 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 These bulletins have also been consolidated for the quarterly report 
 made today. Work has been done on the compilation of the weekly card 
 reports of sickness for the Annual Report. 
 
 During the third quarter of 1890, 2,340 postal cards and 156 record books 
 were sent to 156 health officers and regular correspondents ; tKe weekly card 
 reports received were entered and compiled; 42 copies of the weekly bulletin, 
 “Health in Michigan,” were hektographed and mailed each week; 80 copies 
 of the monthly bulletin, “Health in Michigan,” and of the diagram of 
 “Comparative Sickness,” have been hektographed and mailed each month. 
 
 These bulletins have also been consolidated for the quarterly report 
 made today. Work has been done on the compilation of the weekly card 
 reports of sickness for the Annual Report. 
 
 HEALTH IN MICHIGAN IN THE SECOND QUARTER OF 1890. 
 
 Communicable Diseases. 
 
 Compared with the preceding quarter (January, February and March, 
 1890), reports from all sources show diphtheria to have decreased by an 
 average of two places per month, scarlet fever to have decreased by an 
 average of fourteen places per month, typhoid fever to have decreased by 
 an average of thirteen places per month, measles to have increased by an 
 average of thirty-seven places per month and small-pox to have decreased 
 by an average of one place per month, disappeared before this quarter 
 began. 
 
 Meteorology , and Sickness from all Causes, Compared with the Preceding Quarter. 
 
 A comparison of meteorological conditions of the second quarter of 1890, 
 with the meteorological conditions of the preceding quarter, shows the 
 temperature to have been much higher, the absolute humidity to have been 
 considerably more, the relative humidity to have been slightly less, the day 
 and the night ozone to have been more, the rainfall at Lansing to have 
 been 2.53 inches more and the depth of ground above the water in the well 
 at Lansing to have been ten inches less in the second quarter of 1890. 
 
 Compared with the preceding quarter (January, February and March, 
 1890), the reports from regular observers show a marked increase of cholera 
 morbus, typho-malarial fever, inflammation of brain, measles, dysentery, 
 cholera infantum and puerperal fever, and a marked decrease of small-pox, 
 pneumonia, influenza, pleuritis and typhoid fever (enteric) in the second 
 quarter of 1890. 
 
 This Quarter Compared with the Average for four Years , 1886-1889. (As regidar 
 rainfall and ground water, the periods are different.) 
 
 A comparison of the meteorological conditions of the second quarter of 
 1890, with the average of corresponding quarters in the four years, 1886- 
 1889, shows that in 1890, the temperature- was the same, the absolute 
 humidity was slightly more, the relative humidity was the same, the day 
 ozone and the night ozone were more. 
 
 In the second quarter of 1890, the rainfall at Lansing was 1.13 inches 
 more than for the corresponding quarters in the eleven years 1879-1889, 
 and the depth of ground above the water in the well at Lansing, was ten 
 inches more than in the corresponding quarters in the five years 1885-1889. 
 
 Compared with the average for the corresponding quarters in the four 
 years, 1886-1889, the reports received from regular observers indicate that 
 membranous croup, measles and cholera infantum were more prevalent, 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 14, 1890. 
 
 15 
 
 and that typho-malarial fever, cholera morbus, typhoid fever (enteric) and 
 intermittent fever were less than usually prevalent in the second quarter of 
 
 1890. 
 
 HEALTH IN MICHIGAN IN THE THIRD QUARTER OF 1890. 
 
 Communicable Diseases. 
 
 Compared with the preceding quarter ( April, May and June, 1890), 
 reports from all sources showed diphtheria to have decreased by an average 
 of six places per month, scarlet fever to have been the same, typhoid fever 
 to have increased by an average of thirty -one places per month, and 
 measles to have decreased by an average of sixty -eight places per month. 
 
 Meteorology , and Siekness from all Causes, Compared with the Preceding Quarter. 
 
 A comparison of meteorological conditions of the third quarter of 1890, 
 with the meteorological conditions of the preceding quarter, shows the 
 temperature to have been higher, the absolute humidity to have been more, 
 the relative humidity to have been slightly more, the day ozone and the 
 night ozone to have been less, the rainfall at Lansing to have been 2.5 
 inches less, and the depth of ground above the water in the well at Lansing 
 to have been one inch less, in the third quarter of 1890. 
 
 Compared with the preceding quarter (April, May and June, 1890), the 
 reports from regular observers show a marked increase of cholera infantum, 
 cholera morbus, dysentery, typhoid fever (enteric), diarrhea, typho-mala- 
 rial fever and inflammation of bowels, and a marked decrease of membran- 
 ous croup, measles, puerperal fever, pneumonia, inflammation of brain, 
 influenza, remittent fever and cerebro-spinal meningitis, in the third quar- 
 ter of 1890. 
 
 This Quarter Compared with the Average for the Four Years , 1886-1889. (As regards 
 rainfall and ground water the periods are different.) 
 
 A comparison of the meteorological conditions of the third quarter of 
 1890, with the average of corresponding quarters in the four years, 1886- 
 1889, shows that in 1890, the temperature was slightly lower, the absolute 
 humidity was slightly less, the relative humidity was the same, the day 
 ozone and the night ozone were slightly more in the third quarter of 1890. 
 j In the third quarter of 1890, the rainfall at, Lansing was 1.06 inches 
 ess than for the corresponding quarters in the eleven years, 1879-1889, 
 and the depth of ground above the water in the well at Lansing was five 
 inches more than in the corresponding quarters in the five years, 1885-1889. 
 
 Compared with the average for the corresponding quarters in the four 
 years, 1886-1889, the reports received from regular observers indicate that 
 neuralgia, measles, influenza, cerebro-spinal meningitis and scarlet fever 
 were more prevalent, and that puerperal fever, typho-malarial fever, inflam- 
 mation of brain, whooping-cough and typhoid fever ( enteric ) Avere less 
 than usually prevalent in the third quarter of 1890. 
 
 Respectfully submitted, 
 
 Henry B. Baker, 
 
 Secretary . 
 

 
 :vT! > filin’; 
 
 
0*1 
 
 
 C®n. Lib. 
 
 Trit LI3RARY OF illE 
 
 JUN 25 1951 
 
 ABSTRACT OF PROCEEDI^twStwwi i ur illihuIS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 *« 
 
 REGULAR MEETING, JULY 12, 1892. 
 
 [185.] 
 
 The regular quarterly meeting of the Michigan State Board of Health 
 was held in the State Capitol in Lansing, July 12, 1892. The members 
 present were as follows: Arthur Hazle wood, M. D., Mason W. Gray, M. 
 D., Hon. Frank Wells, and Henry B. Baker, M. D., Secretary. 
 
 The usual routine work was performed. There was also the usual 
 auditing of bills and accounts. 
 
 SYNOPSIS OF THE SECRETARY’S REPORT OF WORK IN THE OFFICE OF THE BOARD, 
 AND OF THE CONDITION OF HEALTH IN MICHIGAN DURING 
 THE QUARTER ENDING JUNE 30, 1892. 
 
 Dangerous Communicable Diseases. 
 
 The number of reports of outbreaks of dangerous communicable dis- 
 eases in Michigan, received from all sources and filed, and the corre- 
 sponding number concerning which action was taken by this office, 
 during the quarter, are as follows: for diphtheria, 140; for scarlet fever, 
 194; for typhoid and typho-malarial fever, 54; for measles, 63. Total for 
 the five diseases, 451. 
 
 Small-pox was reported in two localities during the quarter; one case in 
 the city of Detroit, reported April 25, recovered, no spread of the disease; 
 one case in Green Oak township, Livingston county, reported May 30, 
 died; no spread of the disease. The patient was an immigrant, who landed 
 at Quebec, from a ship which was supposed to be infected with measles. 
 
 The number of communications relative to dangerous communicable 
 diseases, received and placed on file during the quarter, was 1,534. 
 
 Relative to dangerous communicable diseases, letters, written cards, and 
 demands for weekly or final reports, on cards, or in the form of the cir- 
 cular letter, were sent out during the quarter, to the number of 1,489. 
 
 The ‘‘Final ” reports of outbreaks received and filed during the quarter, 
 were: for diphtheria, 98; scarlet fever, 133; typhoid and typho-malarial 
 fever, 28; measles, 15. Total for the five diseases, 274. 
 
 During the quarter, the local columns of newspapers to the number or 
 3,124, have been looked over for reports of occurrence of communicable 
 diseases. This has resulted in giving this office information of the alleged 
 occurrence of 12 outbreaks of diphtheria, 16 outbreaks of scarlet fever, 11 
 outbreaks of typhoid and typho-malarial fever, and 7 outbreaks of measles. 
 To what extent the reports of these alleged outbreaks were verified, is 
 shown in the accompanying table. 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 TABLE 1 . — Showing the number of Outbreaks of Diphtheria , Scarlet fever , Typhoid 
 fever and Measles, from April 30 to June 30, 1892, of which notice was received at 
 the office of the Michigan State Board of Health ; the per cent of reports, informa- 
 tion concerning ichich was received through the Newspapers ; the per cent of news- 
 paper reports which were confirmed by the health officer ; the per cent of newspaper 
 reports which were denied by the health officer, and the per cent from which no reply 
 teas received from the health officer. 
 
 Diseases. 
 
 Reports from 
 all sources, 
 April 30— June 
 30, 1892. 
 
 Per cent of all 
 reports which 
 were obtained 
 from the news- 
 papers. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were confirmed 
 by the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were denied 
 by the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports to which 
 the health offi- 
 cer made no 
 reply to notice 
 sent from this 
 office. 
 
 Diphtheria . 
 
 140 
 
 9 
 
 58 
 
 8 
 
 33 
 
 Scarlet fever 
 
 194 
 
 8 
 
 38 
 
 13 
 
 50 
 
 Typhoid fever 
 
 54 
 
 20 
 
 0 
 
 45 
 
 55 
 
 Measles 
 
 63 
 
 11 
 
 43 
 
 0 
 
 57 
 
 Averages for the four diseases 
 
 
 12 
 
 35 
 
 17 
 
 49 
 
 Annual Reports of Clerks and Health Officers. 
 
 Animal reports were received during the second quarter of 1892 from 
 347 health officers and 414 clerks. 
 
 On May 20, 1892, a ‘‘Third Request for Annual Report” for the year 1891 
 was sent, in a sealed envelope, to 942 health officers and clerks from 
 whom no report had been received; from about 700 no response whatever 
 has been received, possibly, in some cases, owing to changes made at the 
 elections held in March and April. 
 
 Of the 1,550 localities in the State including cities, and villages, the 
 whole number of annual reports for the year 1891 received up to June 30, 
 1892, is: from health officers 1,148, and clerks 1,152. 
 
 Of annual reports of health officers and clerks combined, 800 have not 
 yet been received. A large number of the localities from which no report 
 has been received are in the newer counties and recently incorporated 
 villages. 
 
 The annual reports received for the year 1891, have been arranged 
 alphabetically by counties and townships ready for compilation. 
 
 Reports of Medical Practitioners in their localities, were received dur- 
 ing the second quarter, from 93 clerks. The total number of such reports 
 received since Jan. 1, 1892, is 490. 
 
 The list of supervisors and clerks for the year 1892, supplied by the 
 Secretary of State, and giving nearly complete returns for 85 counties, has 
 been copied for use in this office. 
 
 Return of Health Officers. 
 
 Blanks and printed envelopes for the return of the name and address of 
 health officers were sent to 2,493 supervisors of townships, presidents of 
 villages, mayors of cities, and clerks of cities, villages and townships. 
 The returns have been received from 1,028 townships, 229 villages, and 51 
 cities, and have been placed on file in this office. 
 
 Distribution of Publications. 
 
 The following pamphlets were sent to the 1,308 health officers of cities, 
 villages and townships whose names were reported to this office, and to the 
 1,177 clerks, supervisors, or other persons who made a return of the name 
 and address of a health officer: “Work of Health Officers and of Local 
 
ABSTRACT OP PROCEEDINGS, JULY 12, 1892. 
 
 3 
 
 Boards of Health”; pamphlets on the restriction and prevention of 
 diphtheria, scarlet fever, typhoid fever, typhoid and typho-malarial fever, 
 measles; the leaflet on the restriction of “Dangerous Contagious Diseases”; 
 a blank for recording diseases dangerous to the public health, blanks for 
 final reports, diagrams, and a mimeograph letter relative to a proposed 
 change in the law so that only health officers, instead of health officers and 
 clerks, shall be required to make annual reports to this office. 
 
 A copy of the Public Health Laws was sent to each of the 521 new 
 health officers, and to 1,177 clerks, supervisors, or other persons who made 
 a return of the health officer. 
 
 The reprint from the Annual Report on the Time of the Greatest Pre- 
 valence of each disease in Michigan during 1889 was sent to the 134 
 physicians who made sickness reports to the office. 
 
 The reprint from the Annual Report on the Meteorological Conditions 
 in Michigan during the year 1889 was sent to meteorological observers, 
 meteorological exchanges, and to the members of this board. 
 
 About 900 copies of the proceedings of the Iron Mountain sanitary con- 
 vention were sent to members and ex-members of this Board, secretaries of 
 State Boards of Health, secretaries of State Medical Societies, sanitary 
 journals and other exchanges, meteorological observers and exchanges, 
 members of the State Board of Corrections and Charities, correspondents 
 of this Board, health officers of cities and villages in Michigan, presidents 
 and secretaries of previous sanitary conventions, and health officers, etc., 
 in other states. 
 
 Compiling , Editing, etc., for Publication. 
 
 During the quarter the reports from health officers and clerks have been 
 compiled, and the articles have been written on the following subjects, for 
 the Annual Report: Glanders, tyrotoxicon, hydrophobia, whooping-cough, 
 epidemic pneumonia, casualties from gasoline, and injuries caused by 
 illuminating oils; work on the article on typhoid fever has been continued; 
 considerable work has been done on the first part of the report, and the 
 indexing has been commenced. 
 
 Library Accessions, etc. 
 
 During the second quarter of 1892 three hundred and eighty-seven 
 (387) journals (weeklies, monthlies, and semi-monthlies) were received at 
 this office; and sixty-eight (68) books and pamphlets were received and 
 entered on the library accession book, making the total number of books 
 and pamphlets (not including volumes of journals not yet bound) con- 
 tained in the library 8,229. 
 
 Work on Meteorology. 
 
 The regular tri-daily meteorological observations have been continued 
 at this station, and a summary for each week and month during the quar- 
 ter has been made, and copies sent to the director of the Michigan State 
 Weather Service and local forecast official at Detroit for his use; he then 
 sends them to the chief of the Weather Bureau, at Washington, D. C. 
 
 Meteorological conditions at from 8 to 22 stations in Michigan for 1891 
 have been tabulated as follows: Average temperature, average daily range 
 of temperature, average absolute humidity, average relative humidity, 
 average per cent of cloudiness, rainfall, average velocity of the wind, aver- 
 age day ozone, average night ozone, average atmospheric pressure, and 
 average daily range of atmospheric pressure. Computations of average 
 temperature, average per cent cloudiness, direction of wind, average day 
 and night ozone, average daily range of temperature, and rainfall have 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 been made from meteorological registers at from 15 to 21 stations for the 
 first five months of 1892. 
 
 Graphic Illustrations , for Study , Publication, or Distribution. 
 
 Eight diagrams have been made with photo-engraving ink for purposes 
 of study or for publication by the Board, as follows: — 
 
 “Relations of Privies and Wells, Block 36, Holland, Mich.” 
 
 “ Scarlet Fever in Michigan in 1889.” 
 
 “Low Water in Wells and Sickness from Typhoid Fever in Michigan 
 (11 years, 1878 and 1880-89).” 
 
 “ Fog and Sickness from Typhoid Fever in Michigan, in 1889.” 
 
 “ Low Water at Lansing and Typhoid Fever in Michigan, in 1889.” 
 
 “ Diseases Restricted by Public-Health Work.” 
 
 “Map, Distribution of Scarlet Fever in Michigan in 1889.” 
 
 Diagram, 51x33 inches, on cloth, — “Isolation and Disinfection Res- 
 tricted Scarlet Fever and Diphtheria in Michigan during the 4 years 
 1886-89.” 
 
 Five diagrams have been made with hektograph ink, and copies printed 
 for distribution. 
 
 Meteorological instruments have been entrusted to observers during the 
 quarter, — to J. W. Ash, Ashton, Osceola Co., to Lieut A. H. Boies, Hud- 
 son, Michigan, and to W. C. Gates, M. D., Rockland, Michigan. 
 
 Work in Connection with Sickness Statistics. 
 
 During the second quarter of 1892, 3,612 blank postal cards, 241 record 
 books and 251 copies of printed circulars have been mailed in packages to 
 241 health officers and regular correspondents; 1,158 weekly report cards 
 have been received and entered; 43 copies of the hektographed weekly 
 bulletin “Health in Michigan,” were mailed each week; 100 copies of 
 the monthly bulletin “ Health in Michigan,” have been hektographed and 
 mailed each month. These bulletins have also been consolidated for the 
 quarterly report. Work has also been done on the compilation of the 
 weekly card reports of sickness during the year 1890 for the annual report. 
 
 The Weather and the Health in Michigan in the second quarter of 1892, compared 
 with the average for the six years 1886-1891. 
 
 A comparison of the meteorological conditions of the second quarter of 
 1892, with the average for the second quarters in the six years, 1886-1891, 
 shows that in 1892, the prevailing direction of the wind was the same 
 (south-west), the average velocity was greater, the temperature was slightly 
 lower, the rain-fall at Lansing was 1.87 inches more, the absolute, and the 
 relative humidity were slightly more, the day, and the night ozone were 
 considerably less and the depth of ground above the water in the well at 
 Lansing was nine inches more than in the corresponding quarters in the 
 six years 1886-1891. Compared with the average in the corresponding 
 quarters in the six years 1886-1891, the reports received from regular 
 observers indicate that small-pox, diphtheria and scarlet fever were more 
 prevalent, and that measles, typho-malarial fever, intermittent fever, 
 cerebro-spinal meningitis, whooping-cough, remittent fever, consumption 
 of lungs and typhoid fever were less than usually prevalent in the second 
 quarter of 1892. 
 
 Cholera. 
 
 Relative to the reported presence of cholera in foreign countries, and 
 the possibility of its being brought to this country, Secretary Baker 
 remarked that it would be a particularly unfortunate time if cholera 
 should soon reach Chicago or Detroit, because it tends to spread in much 
 
ABSTRACT OF PROCEEDINGS, JULY 12, 1892. 
 
 5 
 
 the same ways as typhoid fever, only with much greater rapidity, and 
 typhoid fever is unusually prevalent in Chicago, and appears to have been 
 increasing lately in Detroit. If cholera should gain entrance to either 
 city, so many of our people visit those cities that we might soon find chol- 
 era spread in many places throughout Michigan. This office is prepared 
 to issue circulars, already printed, advising local health officers just how 
 to restrict cholera. 
 
 Contagious Diseases Brought in by Immigrants. 
 
 The Secretary presented the subject of infected immigrants, and, to 
 illustrate a point, read a letter from a township health officer, stating that 
 he had found, isolated and vaccinated the person of whom he was notified 
 as possibly infected with small-pox, also reporting his action concerning 
 one of the immigrants, of whom he had received notice, who had come 
 down with measles. The expense incident to these cases was about $17. 
 He thought the national government might go a step further and detain 
 at the seaboard those immigrants likely to be infected. 
 
 Sanitary Subjects at the meeting of the American Medical Association in Detroit , 
 June 7-11 , 1892. Report of Attendance by Delegates. 
 
 Dr. Hazlewood reported verbally that “The notable features of the 
 meeting of the American Medical Association in Detroit, were the large 
 attendance, the good accomodations for the meetings of sections as well as 
 for the general meetings; the meetings for work of the sections morning 
 and afternoon, and the prominence given to subjects having a bearing upon 
 preventive medicine, not confined to the section on State Medicine. The 
 section on Diseases of Children virtually gave up two morning sessions to 
 a discussion of the prevention of diphtheria and scarlet fever. Dr. Duf- 
 field there explained the difficulties incident to carrying out any plan of 
 isolation in the homes of the poor, when the family had no spare room, and 
 the mother was unaided in any of her domestic duties, and often tenants 
 only of premises occupied in part by other families equally restricted in 
 space or assistants. Dr. Duffield outlined a scheme for Cottage Hospitals 
 which he had presented to the Common Council in which provision would 
 be made for the removal of all cases of contagious disease, together with 
 the mother of the child, where all precaution could be taken and the 
 patient would be better placed than in any ordinary home. 
 
 “With so many sections holding sessions at the same time it was impos- 
 sible to get in to all that was of interest to the sanitarian. ,At the after- 
 noon session on Wednesday of the State Medical section, Dr. Bell of 
 Brooklyn read an interesting article advocating a National Bureau of Health 
 in which he cited some of his own experiences and the good results from 
 steaming the holds of vessels that have been infected with yellow fever. 
 Dr. Harvey Reed advocated more inspection of the slaughter houses, and 
 meat there prepared for food, and asked for a committee. Dr. Gihon pro- 
 tested that the U. S. government inspection was complete and asked how 
 the committee were to be compensated. Dr. Reed answered that the 
 expense was not to be considered; that a committee could be formed of 
 members, residents near the large slaughter houses, and he thought good 
 would come of it. On his representation the committee was authorized by 
 a vote of 13 to 5. The number in attendance was an evidence also of the 
 interest in this section. 
 
 “Thursday afternoon the section on State Medicine was not quite so 
 well attended. The sanitary side of the drinking question was presented, 
 and the view that the habit should be considered as a disease was empha- 
 sized. Dr. Bell cited a case of his own experience on board ship,* where a 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 youthful sailor was whipped for drunkenness with good effect. The general 
 opinion as expressed however was, that the confirmed drinker should be 
 treated as an insane person and protected in a hospital. 
 
 “The river excursion cut short the arguments, and the section adjourned 
 after electing Dr. Charles A. Lindsley, of Conn., chairman, and Dr. S. P. 
 Duffield, of Detroit, secretary. 
 
 “Friday morning several of the sections either failed to meet or had 
 already adjourned so that I found nothing of special importance in a sani- 
 tary point of view, until the hour for the general session which closed 
 with the masterly address on State Medicine by Dr. J. Berrien Lindsley, 
 of Tenn., and finished the work of the Association, and of which I can only 
 refer you to the published copy in the Journal of the Association. 
 
 Dr. Mason W. Gray reported verbally as a delegate to the meeting of the 
 American Medical Association: The section on preventive medicine was 
 largely attended; and public-health work was given a prominent part in 
 the meeting of the association. Dr. Hazlewood neglected to state that, 
 in the section on State Medicine, he and Dr. Vaughan took prominent part 
 in the discussion of the contagiousness of scarlet fever. An interesting 
 fact was mentioned by Dr. Brush, from Mt. Pleasant, N. Y., that the 
 source of contagion in a case of scarlet fever had been traced to 
 clothing infected with scarlet fever which had been opened after being 
 packed away for thirty-five years. Dr. J. Berrien Lindsley of Tennessee, 
 gave a very fine address on State Medicine, and Dr. Gihon, in his address 
 on the Practice of Medicine, gave much of interest to the sanitarian. I 
 was agreeably surprised to see that preventive medicine took such a prom- 
 inent part in the association, and in the discussions in the several sections, 
 and that the subject is being given more and more prominence in the 
 affairs of medical men. 
 
 A Sanitary Day. 
 
 Dr. Hazlewood brought up the subject of a “ Sanitary Day,” concern- 
 ing which, since the last meeting, there has been correspondence with 
 members of this Board by the Secretary. Dr. Hazlewood thought that 
 the subject was worthy of action, and that it should be brought into pub- 
 lic notice as soon as practicable. The subject was discussed by the mem- 
 bers present. The health interests suffer because they are not supported 
 by the people; it is believed that they would be properly supported if 
 facts were carefully put before the people every year at a sanitary meet- 
 ing similar to the school meeting in September. 
 
 The origin and nature of the movement may be learned from what here 
 follows : — 
 
 Dr. Joseph F. Edwards, chairman of a special committee of the Penn- 
 sylvania State Board of Health on this subject, wrote to the Secretary of 
 the Michigan Board, stating that “ It has been suggested to our board by 
 the mayor of one of our cities, that we should recommend to our legisla- 
 ture the setting apart of two days annually, one in the Spring, the other 
 in the Fall, to be known as ‘Sanitary Days;’ these days to be devoted, 
 in an especial manner, to domestic and municipal ‘ cleaning up.’ ” * * * 
 “As we have Labor, Arbor and Independence days, with their appropriate 
 celebrations, so might we also have Sanitary Days, on which, in each 
 town and village special instruction in hygiene might be given to the 
 people.” 
 
 The Secretary of the Michigan Board replied: 
 
 “ Dear Doctor— Replying to your letter of June 18, 1 think the suggestion for a ‘ Sanitary Day’ to be- 
 devoted to public health subjects a very important suggestion. * * * * 
 
ABSTRACT OF PROCEEDINGS, JULY 12, 1892. 
 
 7 
 
 “ However, cleanliness and ‘ cleaning up ’ are of minor importance, compared with the restriction and 
 pievention of the dangerous communicable dieseases ; these are the diseases which cause most deaths in 
 Pennsylvania, as in Michigan. I enclose a diagram showing the five diseases which cause most deaths in 
 Michigan. You will see that only one of the five (typhoid fever) is due to filth, and can be very much 
 restricted by ordinary cleanliness. 
 
 “ Four of the five diseases which cause most deaths in Michigan are increased during or following the 
 cold weather; and the remaining one, typhoid fever, reaches its highest point in October. I think the 
 Sanitary day should be in the autumn. 
 
 “ In reply to your request for suggestion for the proper observance of the day, I send you, by this mail 
 a copy of the Journal of the American Medical Association, of May 21, 1892, on the first two pages of 
 which is an article by myself on this subject, proposing the setting apart by law of a day in each year on 
 which to present locally to the people of every township, city and village, the facts and reasons why 
 expenditures for public-health work are in the public interests; the purpose being the appropriation of 
 money for public-health work. But there would be very much besides the appropriation of money, to be 
 gained through such a systematic presentation of sanitary affairs throughout the country on such a day 
 set apart in each year. 
 
 “ I agree with you that spasmodic action on one or two days in a year is not enough; but, if proper 
 work is done on this one day proposed, I think it would be one of the most important measures for the 
 advancement of public health that has ever been proposed in this country. I wish the movement great 
 success. Very respectfully, 
 
 HENRY B. BAKER, Secretary." 
 
 The article referred to in the forgoing letter was the annual oration on 
 i general medicine before the Michigan State Medical Society, in May, 1892. 
 It is as follows: 
 
 THE WORK AND PAY OP HEALTH OFFICERS. 
 
 (Published by permission of the Michigan State Medical Society.) 
 
 BY HENRY B. BAKER, M. D., OF LANSING, MICH. 
 
 Mr. President and Members of the State Medical Society : — I wish, first 
 of all, to thank the section of Practice of Medicine for this opportunity to 
 place before you what I have to offer. I have assumed that I would be 
 expected to deal with some subject likely to be of interest to the general 
 practitioners, and which my own occupation might enable me to have more 
 than ordinary opportunities for studying. Inasmuch as the State law 
 now requires that, wherever it is practicable, every health officer shall be 
 a physician, and there are now fifteen hundred health officers chosen in 
 Michigan every year, there is a posibility of my subject being of interest 
 to a considerable proportion of the general practitioners in the State, be- 
 cause many of them may, at some time, be health officers, and because, if 
 my views were to be carried out, nearly fifteen hundred practitioners would 
 devote the greater part of their energies to official duties, and not to the 
 practice of medicine. 
 
 Although the title of this address is “The Work and Pay of Health 
 Officers,” I desire, at this time, to deal especially with the subject of pay. 
 My belief is that the compensation of the health officers, generally 
 throughout the State, with only a few exceptions, is ridiculously small 
 and inadequate; and that the best interests of all concerned are injured 
 thereby, and will be best conserved by such a general change as shall 
 recognize the fact, as old as the scriptures, that “the laborer is worthy of 
 his hire” or reward. 1 I suppose it is not necessary for me to laboriously 
 prove that this proposed change would be a good thing for the medical 
 profession in this State; if it is ever questioned I will try to prove it, on 
 some other occasion; but it may not, at first glance, be so apparent that 
 it would be a good thing for the sanitary interests of the whole people of 
 the State. Therefore the reasons for a belief that such is the fact may 
 well be stated. 
 
 1 1 Timothy, v. 18, and Luke x. 7. 
 
s 
 
 MICHIGAN STATE BOARD OP HEALTH. 
 
 At first thought, it might seem that gratuitous services by physicians 
 acting as health officers would always be for the best interests of the 
 people generally; and, in the beginning of any movement for sanitary re- 
 form, it undoubtedly is for the best interests of the people. The people 
 of Michigan owe a great debt of gratitude to the philanthropic physicians 
 throughout this State who have generously performed services for the 
 public which the people generally were not sufficiently informed to ask for, 
 to pay for, or to appreciate, but which have tended to place Michigan in 
 the front rank of progress in sanitary reform. The officers and members 
 of this State Medical Society, especially, have contributed very greatly to 
 place Michigan in the lead in sanitary progress. 
 
 But, in the evolution of organized society, there come times when 
 methods, which have served exceedingly useful purposes, need to undergo 
 slight modification in order better to fit them for the changed conditions. 
 In my opinion, the time has arrived when it will best serve the people of 
 Michigan to gradually educate them into a knowledge of the real value of 
 public-health work, and into an appreciation of the fact that it is best for 
 corporations and governments, townships, cities and villages, as it has long 
 been known to be best for individuals, not to try to get something for 
 nothing. In the long run, an effort to get something for nothing is un- 
 successful. Such efforts generally lead the individual to the penitentiary, 
 and the government to a penitential mood. 
 
 The people have gradually so increased in appreciation of the impor- 
 tance of public-health work that their representatives, the law-makers, 
 have provided so much work to be done by health officers, and have affixed 
 to the non-performance of the duties such penalties that no ordinary 
 practitioner can without adequate compensation afford to take the chances 
 of being held accountable under the law for the neglect of official duty. 
 But the main reason why it does not now seem to be best that the duties 
 of the health officer should generally be performed gratuitously, is that 
 no ordinary practitioner can afford to, and it is getting so that generally no 
 competent physician will, for any small sum, neglect his practice and do 
 all that the law and public sentiment now expect to be done by the health 
 officer. 
 
 The amount of service that is now required of the health officer is 
 frequently not appreciated by the physician until he has accepted the 
 office, when he finds that, owing to comparatively recent laws, more is re- 
 quired of him than he anticipated. 
 
 What is needed is some method whereby not only physicians, but the 
 people generally, who have to pay the health officer, shall become informed 
 of the nature, extent, and importance of the work of the health officer. 
 It seems to me that, as might have been expected from the occupation, 
 those who have managed the school interests in Michigan have shown 
 most wisdom in their methods of impressing the people with the impor- 
 tance of their work, and also in obtaining from the people the necessary 
 money to carry on the school work. We need to adopt their methods. 
 Whoever will examine his receipt for taxes will find that the main items are 
 for school purposes. Yet the people vote to assess themselves for those 
 purposes, after the subject has been carefully put before them. And those 
 who have the interests of the schools in charge have opportunity, and they 
 carefully prepare and put before the people every year, at the school 
 meeting in September, the amounts of money which is estimated should 
 be used for school purposes, and facts and reasons why those amounts are 
 needed. There should be a law similar to the school law, relative to 
 
ABSTRACT OF PROCEEDINGS, JULY 12, 1892. 
 
 9 
 
 public-health affairs. Surely the interests of the health and life of the 
 whole people, including the children, are of more consequence than the 
 ischool education of the children alone! 
 
 All that is required to make this apparent, is such an opportunity as the 
 school laws provide for placing the facts before the people at the time the 
 vote is taken to adopt the estimates of those who have this branch of the 
 public service in charge. 
 
 How to get Money for Public Health Work . — Have a public meeting of 
 citizens of the city, village or township, at which meeting the amount of 
 money to be assessed and collected for public-health purposes shall be 
 voted upon. Have the local board of health present to that meeting esti- 
 mates of the amounts proper to be collected. The health officer should 
 be prepared, and should present to this public meeting the facts, and rea- 
 sons why expenditures for public-health work are in the public interests. It 
 ought not to be difficult to convince the people generally that the lives 
 and health of the people themselves are of more consequence than any 
 other subject for which they collect taxes. 
 
 Let us suppose that opportunity is given the health officer to put before 
 •the people of a township, village or city the facts and reasons for public- 
 health work; what can be presented? This can be presented: — 
 
 1. The health officer can assure the people that, if they are situated in 
 the average locality in Michigan, the death-rate will average about 17 per 
 thousand inhabitants per year; that, of those deaths, about 11.8 per cent, 
 will be from consumption, 6.5 from diphtheria, 2.7 from scarlet fever, and 
 3.2 from typhoid fever. He can assure the people that these are all com- 
 municable diseases, that they are all preventable through measures which 
 are now well known to sanitarians; and, what is more to the point, he can 
 assure them that reliable statistics, collected by the Michigan State Board 
 of Health, from the experience of local officers in Michigan, have proved 
 that (even after the disease has been introduced) about 75 or 80 per cent 
 of the cases and deaths from diphtheria and from scarlet fever are pre- 
 vented by measures which a good health officer, acting in accordance 
 with our present laws, and supported by the people of his locality, can 
 inaugurate and maintain. Knowing approximately the population of the 
 township, village or city, the health officer can readily compute the 
 saving of life which such a saving, as has been proved to occur under 
 such measures, would be for that number of inhabitants. Let us suppose 
 a small city, of four thousand inhabitants — then the deaths from all 
 causes, at the rate of 17 per thousand per year, would be 68; the deaths 
 from consumption (11.8 per cent.) would be 8; the deaths from diph- 
 theria (6.5 per cent.) would be about 4-| (4.4); the deaths from scarlet 
 fever (2.7 per cent.) would be nearly two (1.8); the deaths from typhoid 
 fever (3.2 per cent.) would be a little over two. If 75 per cent, of these 
 deaths were to be prevented, there w r ould be a saving of the lives of about 
 three persons from death by diphtheria, about one from scarlet fever, and 
 one from typhoid fever. These five persons constitute a part of the pro- 
 ductive energy of the city upon which its prosperity depends. They are 
 worth to the city, for what has been expended to raise them, and for what 
 they will earn in excess of costs of maintenance, at least as much each 
 as a good slave would sell for before the war, which was about the same as 
 the statisticians compute as the value of an ordinary laborer — say for the 
 •adult person one thousand dollars, and for each of the children one- half 
 of that .amount. The four who are saved from diphtheria and scarlet 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 fever would be likely to be children, while the one saved from typhoid 
 fever would be likely to be in the prime of life. The actual money value 
 of the five persons, therefore, would be three thousand dollars. If a city 
 of four thousand inhabitants should vote to use three thousand dollars 
 per year in public-health work, I have no doubt whatever but the five lives, 
 above mentioned, could be saved, from those three diseases alone; and 
 probably lives could be saved from other diseases. Then how much 
 better to save those lives, and avoid the grief and sorrow which would 
 result from their loss. Again, the money used would be only the amount 
 which, without effort for restriction, would be lost to the city — the actual 
 outlay would not be at all increased. It seems to me that any meeting of 
 citizens, of ordinary intelligence, could be made to see that the lack of 
 public health work is a wasteful extravagance, and that it is better to use 
 a certain sum of money to pay a health officer than to permit the death of 
 loved ones that have actually cost as much as that sum, and who, if they 
 die, are a dead loss, in more than one sense. 
 
 These facts are applicable to every locality in Michigan, making allow- 
 ance for a greater or less number of Inhabitants. ***** 
 
 I have given you some of the reasons why I favor legal provision for the 
 presentation locally, to all voters throughout the State, of the benefits to 
 be expected from sanitary work, after the manner of the meetings to de- 
 termine the amounts of money to be raised for school purposes. 
 
 Abstract of the Proceedings of the Special Committee Meeting , at the Russell House r 
 
 Detroit , Mich.. April 28, 1892. 
 
 The committee of the State Board of Health met in Detroit in accordance with the following resolution t 
 
 Resolved , That a committee, consisting of the president and four other members of this Board, be 
 appointed to visit Detroit, and confer with the health officer and with the board of health of Detroit and 
 with other city officers if found desirable, with the view of learning and of reporting to this Board, so much 
 as is possible concerning the difficulties under which the Detroit officers are laboring for the restriction 
 and prevention of the dangerous diseases. 
 
 The meeting was called to order at 2:00 P. M. by chairman John Avery, M. D., of Greenville. The 
 members present were: Hon. John Avery, M. D., Victor C. Vaughan, M. D., and Arthur Hazlewood, M. D.. 
 Mason W. Gray, M. D., was delayed in coming and arrived about 3:00 P. M., and Henry B. Baker, M. D.,. 
 was sick and could not attend. 
 
 The following named persons attended the meeting: Hon. Hazen S. Pingree, mayor of the city, John 
 McVicar, president of the Board of Public Works, Samuel P. Duffield, M. D., health officer of the city, 
 Drs. J. E. Clark, C. J. Lundy, J. H. Carstens, C. W. Hitchcock, H. O. Walker, H. F. Lyster, C. G. Jen- 
 nings, W. C. Stevens, L. J. Lenox, G. E. Roehrig, and Mrs. Lemkie of 546 Fifteenth Street. 
 
 Dr. Vaughan said that the Board called this meeting because they believed that scarlet fever and diph- 
 theria were uncommonly prevalent in Detroit, and they would like to find out, if possible, the difficulties 
 under which the Detroit officers were laboring in the restriction and prevention of the dangerous diseases;, 
 and they came with the idea of aiding, if they could, in the restriction of these diseases, and were not 
 there for the purpose of criticising the Detroit Board. 
 
 Dr. Vaughan read a comparison of the cases and deaths from diphtheria and scarlet fever in Detroit 
 with the State of Michigan for 1888, and in Detroit compared with New York, Chicago, and some other 
 cities of the United States for the month of March, 1892. A hektographed copy of these comparisons was 
 given to each person present. 
 
 Dr. Duffield said— We have many men in Detroit, who are dependent upon their daily work for the 
 support of their families. When a child of one of these families is taken with scarlet fever, we cannot 
 lock up the whole family including the father, in an attempt at isolation ; yet Secretary Baker seems to 
 insist that we should isolate the whole family by just that sort of method.* The Detroit Board of Health 
 has, hitherto, had very little cooperation with, and support from, the city authorities. If we were to 
 attempt the perfect isolation of these cases, just see how impossible it would be. There were last year 
 1,359 cases, an average of 136 per month. Each case would require three police, each standing guard eight 
 hours, or 408 policemen to isolate these cases, which is more than the whole number of policemen, which 
 now cost $500,000. 
 
 * TNo. Dr. Baker wants the State law complied with, and in that there is no authority for locking up 
 anybody, except after conviction by a court. It requires the health office? to order isolation. H. B. B.} 
 
ABSTRACT OF PROCEEDINGS, JULY 12, 1892. 
 
 11 
 
 Suppose you isolated the first cases, said Dr. Vaughan, you would not have had so many; and you are 
 going to have more next year, as they will all the time increase. 
 
 Dr. Duffield said that there is no doubt that would lessen the number of cases, but that it was just 
 impossible for them to have perfect isolation, for reasons he had just stated. If we were to lock these 
 families up, there would immediately be a habeas corpus taken out. We asked for $10,000 for contagious- 
 disease-isolation-hospitals, and could not get it. The poor fund is exhausted, and the commission is now 
 running on credit. It is not a lack of knowledge on the part of medical men of Detroit that prevents us 
 handling this matter, but a lack of money. I have no power to lock a man in his house; t and, until we 
 can get isolation hospitals, we can do no better than we are doing at present. A system of police quarantine 
 is impossible.^ If the State Board of Health can put $500,000 in our hands we might follow their instruc- 
 tions.:}: The law provides for isolation, but I have no power to lock a person up. It is impossible to 
 quarantine a tenement house ; and, if I should, the inmates would all come down with the disease. We 
 take certain precautions in issuing permits to go to work. I cannot lock a man up unless I can provide 
 him food.§ I shall continue to issue permits, no matter if contrary to law. 
 
 Dr. Hazlewood asked what they did in cases of varioloid. 
 
 Dr. Duffield— We take them to the hospital for such cases, provided for by the city; and, upon recovery 
 or death, we burn all infected clothing, and the city pays the expense. 
 
 Dr. Hazlewood— Do you regard small-pox as more dangerous than scarlet fever or diphtheria? 
 
 Dr. Duffield— No. Small-pox is an adult disease. 
 
 Dr. Vaughan— Many times more people die every year of diphtheria than of small-pox, in Michigan. 
 
 Dr. Lundy — Vaccination and other measures can be resorted to, to suppress small-pox. 
 
 That is so, said Dr. Vaughan, and, because there is no vaccination for diphtheria, is a good reason why 
 diphtheria should be quarantined. 
 
 Dr. Lundy said that sometimes four or five Polish families resided in the same house, and to talk about 
 isolating a case in such a house, without its removal, was simply futile. It would cost a great deal of 
 money to isolate these cases, but we cannot get this money. I am in sympathy with all of the work of 
 the State Board of Health, as they are doing a great and good work; but, while in sympathy with the 
 State Board, I wish to help our efficient health officer to explain the difficulties under which the Detroit 
 Board is laboring. 
 
 Dr. Vaughan said, to lock five or six well children in a house with a child who has diphtheria or small- 
 pox is not isolation, that is murder, that is what that is. Dr. Vaughan then read the law, where it pro- 
 vides that the board of health shall provide a hospital for small-pox or other contagious disease patients. 
 Dr. Vaughan said that there were more people to the acre in the city of New York than in any other part 
 of this continent; yet their death-rate would not compare with that of Detroit. 
 
 Dr. Lundy — The city of Detroit has poor sewers in some localities, and cesspools are allowed to stand. 
 
 Yes, said Dr. Duffield, and these cesspools are established by ordinance. 
 
 Dr. Carstens asked Dr. Vaughan if he knew why the death-rate was so much lower in New York than in 
 Detroit, and Dr. Vaughan replied that it was because they had a more perfect system of isolation of dan- 
 gerous diseases. 
 
 Exactly, said Dr. Carstens, they have the laws, and have the money to enforce them. Give us the 
 same, and we will take care of the diphtheria and scarlet fever in Detroit. New York does not boast of 
 how little its health department costs them, as does the city of Detroit. They know what the spread of 
 these diseases means in their dense population, and they act like sensible people, and are not afraid to 
 spend a few dollars in the restriction of disease. All we need in Detroit is the money, and we wish that 
 the State Board of Health would help us to get it. 
 
 Drs. Lundy, Carstens, Duffield and Clark all said that money was what they wanted, and hoped that the 
 State Board of Health would help them get it. 
 
 In reply to Dr. Vaughan’s question of “ What does the Detroit Board consider the dangerous commu- 
 nicable diseases?” Dr. Duffield said that scarlet fever, diphtheria, typhus, small-pox and glanders were 
 placarded, and placed under rules arranged by the Detroit Board. 
 
 Dr. Vaughan asked Health Officer Duffield what was done when a case of dangerous disease was 
 reported, for instance diphtheria. 
 
 Dr. Duffield.— The patient and inmates of the infected house are given instructions, and a pamphlet of 
 instructions is sent to the infected house. 
 
 Dr. Vaughan asked how he knew that his instructions were carried out. Do you send around a police- 
 man to see that the instructions are carried out? 
 
 Dr. Duffield said that they depended upon the attending physician to see that the instructions were car- 
 ried out ; he is the custodian of the life of the patient, and we rely upon the honor of the physician to see 
 that this is done. Dr. Carstens said he would like to catch Dr. Duffield sneaking around his patients ; if 
 he caught him at it, he thought he would give Dr. Duffield a good talking to. 
 
 Dr. Vaughan said that the State law provides a penalty to whoever disobeys the orders of the health 
 officer, and this implies that some officer should see that his instructions are carried out. 
 
 Dr. Duffield said that he sent a policeman, with a placard to be put up, but relied upon the physician 
 to see that the instructions of the board are carried out. 
 
 t [The State Board of Health’s instructions are not what Dr. Duffield appears to think. H. B. B.] 
 
 § [This is required by law. Act 137, laws of 18S3. H. B. B., Sec. State Board . J 
 
12 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Dr. Vaughan asked who disinfected, after a person dies or recovers, in a case of scarlet fever or diph- 
 theria, to which Dr. Driffield said “ Our Disinfector.” 
 
 Dr. Vaughan asked what disinfectants were used. Dr. Duffield replied— Those recommended by the 
 State Board of Health,— sulphur and corrosive sublimate. 
 
 Dr. Vaughan asked who was the one to give the convalescing patient permission to go out. Dr. Duf- 
 field replied that the attending physician gave that permission, and that he had no right to doubt the 
 physician ; and, so long as the law of Michigan allows quacks to practice, the public must take the 
 consequences. 
 
 Dr. Jennings said that he did not agree with Drs. Carstens and Duffield, and that he would have no 
 ■objections to the health officer coming around and looking after the sanitary affairs, as they were not 
 expected to look after the treatment, and that he always referred any question of sanitation to the Board 
 of Health. It is almost impossible for the profession in attending a case of contagious disease, to look 
 after all the sanitary conditions, and do it perfectly. 
 
 Dr. Carstens said that when he was president of the Board of Health, some years ago, the law was that 
 attending physicians could report the patient well, and that many, suffering from scarlet fever, were 
 ■reported well within a week. We worked until we got the law changed so that no case of scarlet fever 
 or diphtheria could be reported well under four weeks; but so long as druggists are allowed to prescribe 
 for sore throats, we will have exposures to diphtheria. You cannot separate children, and the only way 
 is to have a hospital where a child suffering from a sore throat can be isolated. 
 
 Dr. Avery said that he thought that the health officer and physicians misunderstood the object of the 
 visit of the committee to Detroit; that they did not come there to criticise, but to see if they could be of 
 any help in the restriction and prevention of disease. We are not law makers, cannot make the quacks 
 get out of the State; what we wish is to get the necessary information 60 that we can aid you. The 
 State Board of Health has found that public sentiment is the greatest help in their work. In 
 “the case of an outbreak of small-pox there is plenty of public sentiment, and if the health officer did 
 not attend to his duties, the locality would force him to do so. But what we want is the proper 
 public sentiment in the case of diphtheria and scarlet fever, and we wish to have this in Detroit. 
 We have no trouble in the country in restricting and preventing the spread of the different diseases. 
 (He cited instances in his resident city, Greenville, and showed how complete isolation and disinfec- 
 tion restricted dangerous diseases.) We can restrict dangerous diseases in the country, and I see no rea- 
 son why you cannot do it in Detroit. The State Board of Health wishes to aid you in getting what 
 you wish and need, and we care to have no friction between the boards. 
 
 Dr. Lundy said that he thought that the citizens of Michigan knew that the State Board of Health 
 was doing a good work, and appreciated the great work they were doing. “ I know that they have saved 
 human lives, and have saved millions of dollars to the commonwealth of this State.” 
 
 Dr. Hitchcock spoke of the law and rules relative to the removal of the placard from an infected 
 house, and said that he had the greatest respect for the work of the State Board of Health. He also 
 spoke of a case of diphtheria which he attended, and how he gave full instructions and orders that the 
 extra bed in the room on which the father slept should be moved out, and when he came again he found 
 nothing had been done ; he was then very emphatic and they obeyed. He thought that an intelligent 
 sanitary police officer would do a great deal of good, if he could happen around at the right time. Peo- 
 ple generally are afraid of a man with brass buttons, and would do for him what they would not do for a 
 physician 
 
 Dr. Lundy asked if it would not be productive of great good to have three or four of the sanitary offi- 
 cers to happen around at the right time. Just a few ought to be obtained in some way. 
 
 Dr. Duffield thought that the contagious disease hospitals would be the easiest way to get over the 
 difficulty, and that it would be the cheapest way in the end. 
 
 Dr. Avery said he knew that the State Board of Health would be pleased to assist the Detroit board of 
 health to get anything they needed. 
 
 Mayor Pingree said that he wished to thank the State Board for coming; and that he knew if this 
 meeting had happened before the meeting of the board of estimates that the appropriation would have 
 been forthcoming. He spoke of a man coming into the Detroit club rooms who had just lost a child 
 from diphtheria, and said that this man’s friends were crowding around him and condoling with him, 
 but he was very careful to keep as far away from him as possible, as he knew that there was danger of 
 carrying the contagion. 
 
 Dr. Vaughan again read the law relative to when the small-pox or other disease dangerous to the pub- 
 lic health shall break out the “ board of health shall immediately provide a hospital ” and asked Dr. 
 Duffield if he did not think the law ample. Dr. Duffield replied that he did. Dr. Vaughan asked what 
 steps would have to be taken to get these hospitals. 
 
 Dr. Duffield replied that the poor fund was only $6,000, and the poor commissioner thought that a 
 plea for hospitals to the board of estimates would get them, but we made the plea and you can see the 
 outcome. We are expecting to have to remove our present hospital for small-pox out further, as they 
 keep extending the city limits, and I have a proposition before the board for a series of cottage hospitals 
 when this old hospital is abandoned, and that they be called isolation hospitals instead of pest-houses or 
 contagious disease hospitals. 
 
 Dr. Hazlewood said that he could sympathize with a health officer in a large city, where everyone is so 
 crowded, and that the only way was to have an isolation hospital, and that he would be in favor of a 
 series of hospitals instead of one large building. 
 
ABSTRACT OF PROCEEDINGS, JULY 12, 1892. 
 
 13 
 
 Dr. Vaughan asked if a few sanitary police, if they were men above the average brightness, would not 
 do a great deal of good in restricting the liberty of the patients and in the education of the people in 
 sanitary matters. 
 
 Dr. Vaughan recommended that a committee consisting of Mayor Pingree, Dr. Henry B. Baker, and 
 Health Officer Duffield, be appointed by this meeting to draw up a statement, to the common council, of 
 the necessity of cantagious-disease hospitals. 
 
 Dr. Clark thought it would be well to have included in that recommendation the largest medical 
 society in the city so as to have as many physicians as possible interested in the matter. 
 
 Dr. Vaughan thought that it would be better to have the sanction of this meeting and bring in the 
 medical societies later. 
 
 Dr. Jennings suggested that the recommendation be for a larger appropriation to the Board’s present 
 appropriation so that it could get its own police. 
 
 Dr. Avery asked Dr. Duffield if he thought there would be more than 100 placards out in one day, today 
 for instance. * 
 
 Dr. Duffield said that he thought there might be from 150 to 190 out that day, and that they were very 
 much scattered. 
 
 Dr. Lundy asked Dr. Duffield if he thought that ten police would be sufficient if they were mounted. 
 
 Dr. Duffield replied that he did, and that most of the cases were outside of a radius of two and one-half 
 miles from the City Hall. He asked what they were going to do with people they found violating the 
 health laws, and arrested when they were sick, some of the judges do not wish to have contagious diseases 
 brought into their presence. 
 
 Dr. Lundy asked Mayor Pingree if he did not think that they could get the money. 
 
 Mayor Pingree said he did not know that things were so bad in Detroit, and he was sure that most 
 people in Detroit were as ignorant as himself; but if the people were educated on this subject, there would 
 be no trouble in getting the necessary amount. 
 
 Dr. Lundy asked if there was not some way to get it before the next meeting of the Board of Estimates, 
 and Dr. Duffield replied that an appeal to the common council might do it. 
 
 Dr. Lundy thought by a combined action of the two boards, and with the cooperation of the physicians 
 in Detroit there would be little doubt but that they would get the money. 
 
 Dr. Lyster thought that this combined action would be a good step to take, and that the chances were 
 good for getting the money. He also spoke of the scarlet fever which had occurred on Jefferson avenue, 
 as occurring on the bright side of the avenue, and thought that it might be caused by the patients recover- 
 ing from the disease walking on that side of the street more than on the other side. 
 
 Dr. Jennings said that he had noticed the same thing, but upon investigation found that the children 
 having the disease were mostly attending one school, and thought that was the explanation. 
 
 The following resolutions were presented by Dr. Vaughan: 
 
 Resolved , That the Health Department should send officials frequently to infected houses to see that 
 patients are isolated, and that other rules of the board of health are complied with. 
 
 Resolved , That we recommend a committee consisting of Mayor Pingree, Secretary Baker of the State 
 Board of Health, and Health Officer Duffield to draw up a statement of the great need of contagious dis- 
 ease hospitals. 
 
 Dr. Clark objected to the last clause of the first resolution, where it reads “ that other rules of the board 
 of health be complied with.” He said that the resolution looked very simple and harmless, but if it 
 passed it would antagonize most of the physicians in Detroit. I should not like to have a policeman 
 come in and tell me that the patient should be moved on account of poor ventilation or recommend some 
 other kind of treatment. 
 
 Dr. Lundy said it was a mistaken idea that the sanitary precautions should interfere with the treatment. 
 
 Dr. Clark thought that there would be a clashing between the physician and the board of health when 
 the board of health dictated as to what should be done in the case of disinfection, etc., but Dr. Lundy 
 thought there would be no such clashing. 
 
 Relative to the spreading of dangerous diseases in the schools, Dr. Vaughan asked Health Officer Duf- 
 field what was done to let the teacher know that such a child was infected with a dangerous disease. Dr. 
 Duffield replied that the superintendent was notified every morning of new cases, and he had postals 6ent 
 to the principals of the several schools. 
 
 In connection with this subject, Mrs. Lemkie of 546 Fifteenth Street, said she had reason to believe that 
 the principals of the schools were not always notified from the superintendent’s office. She cited a case 
 where a card was put up on a house near her residence and she immediately went to the principal of the 
 Bagley school to see if the children of that infected house were in attendance at school and found that 
 they were, and that the principal had heard nothing of the existence of this diphtheria; she also found her 
 own little boy had been looking down the throats of the children complaining of sore throat who were 
 from the infected house. 
 
 Dr. Duffield said the fault was with the superintendent then, for his office is notified every morning 
 between nine and ten o’clock. 
 
 Mrs. Lemkie said the difficulty was, they had a politician instead of a superintendent of schools. 
 
 Dr. Lenox corroborated what Mrs. Lemkie had stated, and in his own practice he could cite several 
 instances where the board of education had been notified but no notice had been sent to the teacher. He' 
 also stated that he knew that convalescing children were too frequently permitted to go to school, andi 
 were the means of spreading the dangerous diseases in many instances. 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Dr. Duffield said that there ought to be but little danger from spreading the diseases in that way, for 
 the patient is held in quarantine twenty-eight days, and there is a time for disinfection, and the school 
 authorities generally require that the child be kept isolated for ten days more. 
 
 Dr. Gray (member State Board of Health) , said that the lack of restriction of a child’s liberty upon 
 apparent recovery, was too frequently the source of spreading a disease, and it was at that time that a 
 sanitary inspector would do the greatest good, to see that convalescents were isolated from the public. 
 Several sanitary inspectors to drop down on an infected locality at the right time, would aid Health Offi- 
 cer Duffield very much in his public-health work. 
 
 Dr. Duffield said that there were no sanitary policemen on his pay-roll, but that he had the privilege to 
 use some of the police from the city department for the purpose of placing placards, etc., but would be 
 very glad indeed, to have a number for his special use. 
 
 Dr. Lenox thought that sanitary police would be the means of making many physicians angry, for he 
 had already complaints that the police were often impertinent and insolent in the discharge of their 
 duties. He thought that the attending physician was the best detective to see that the rules and instruc- 
 tions of the Board of Health were complied with. 
 
 Dr. Clark made a motion to strike out that part of the first resolution where it read “ that other rules 
 of the Board of Health be complied with.” The motion was lost. 
 
 A vote was taken on the adoption of the resolutions as read, but the chairman was unable to decide, 
 and called for a rising vote which adopted the resolutions. 
 
 On motion the committee adjourned at 5:00 P. M. 
 
 D. W. H. Moreland sent a communication of which the following is an 
 abstract: — 
 
 “ As you will see by my card, enclosed, I live in Detroit, and in soliciting freight and passenger business 
 there I get around the city considerably, and am forced to notice the extremely filthy condition of the 
 alleys and back yards, where there are accumulated hundreds of tons of garbage, in a putrefying condition, 
 which have accumulated since the shutting down of the garbage works nearly a year ago. The proper 
 authorities of the city of Detroit, with shame to themselves, should be forced to do something for the 
 proper collection and disposal of the city’s garbage. * * * * There is such an immense volume of 
 travel constantly in and out of Detroit from the State at large, that you certainly do right to insist on an 
 explanation from the city authorities, and a prompt and effective remedy. The Board of Health in 
 Detroit are practically powerless in the matter, but the mayor, aldermen and Board of Public Works are 
 to blame, particularly the mayor and aldermen. The amount of infectious diseases, particularly diph- 
 theria and scarlet fever, which the city has been inflicted with the last few months, is a disgrace to the 
 city and the State at large, and to any civilized country on God’s green earth.” 
 
 Replies to questions in the schedules, used by the committee, have been 
 received by mail from a number of physicians and other citizens of Detroit. 
 
 Dr. David Inglis says, relative to work to obtain cooperation of citizens, 
 U I think the sanitary conventions [under the auspices of the State Board 
 of Health] have been of incalculable benefit, and I do not see why a series 
 of local or ward sanitary meetings in Detroit could not be carried out.” 
 * * * * “In the supervision of plumbing and drainage in new buildings we 
 are far behind New York, Washington, or Buffalo; every plumber does as 
 he sees fit; drainage is done in a reckless way. We will never get rid of 
 diphtheria by placards, disinfectants, quarantine or any expedients as long 
 as our clay soil is saturated from loosely-jointed crock drains running 
 under cellar floors.” 
 
 Dr. W. B. Sprague replied to many of the questions in the schedules, 
 and from his replies one would infer that everything possible to be done 
 was being done in Detroit to restrict dangerous diseases. There being 
 doubt as to whether Dr. Sprague understood the questions to apply to the 
 city as a whole, he was asked to explain, and he says his replies related to 
 his own practice only. 
 
 Dr. Charles W. Hitchcock replied to a number of the questions. He, 
 also, seems to have replied mainly concerning his own practice. 
 
 There is no question that, in the practice of the most intelligent and 
 philanthropic physicians, the proper measures for the restriction of the 
 dangerous diseases are ordered, and, so far as the physician alone can do 
 so, they are enforced; but not all families, in time of great trial, will 
 conform to restrictive measures, not for their own good but for the benefit 
 of the public; and the physician’s duty is primarily to the family that 
 
ABSTRACT OF PROCEEDINGS, JULY 12, 1892. 
 
 15 
 
 employs him ; the public interests are to be watched and guarded by the 
 physicians (health officer, and board of health ) and other officials employed 
 and paid by the public, for that especial service. 
 
 The set of schedules which the committee left with the health officer, to 
 be filled out by him, have not been received from him. No response has 
 been received from any medical member of the Detroit board of health. 
 
 James E. Pittman, Superintendent of Police, replied to two questions, 
 relative to what is done with reference to dangerous communicable dis- 
 eases, that “The members of the Detroit police force have acted under 
 instructions from the health officer.” Replying to what is done — “What- 
 ever is directed by the health officer.” 
 
 The only response by any member of the Detroit board of health to the 
 requests for replies to the schedules, stating the specific facts as to just 
 what are the methods generally employed in Detroit, is as follows: — 
 
 Hon. Frank J. Hecker, President Metropolitan Police, and member of 
 the Detroit Board of Health, referring to the schedules and requests for 
 facts, replied “I beg to advise you that I have referred the same to Dr. 
 Samuel P. Duffield, health officer of this city, as I have no personal know- 
 ledge of the subject matter thereof.” 
 
 In the absence, from this meeting of the State Board, of the chairman 
 of the committee, this subject was not finally disposed of, but the 
 following is a — 
 
 Summary of the Most Important Fficts Learned Concerning the Difficulties in 
 Bestriding Dangerous Diseases in Detroit. What is done in Detroit, Com- 
 pared with what the State Board of Health has Generally Recommended. 
 
 According to the evidence collected, Dr. Duffield does not appear to 
 understand the views of the Secretary of the State Board of Health, nor 
 the system of work recommended by the State Board. The Secretary of the 
 Board does not advise that the local health officer, as Dr. Duffield expresses 
 it, “lock up the whole family,” in any case. There is no State law directly 
 authorizing that. The Secretary recommends that the health officer com- 
 ply with the State laws, especially with Act 137, laws of 1883, which (unless 
 he is directed by his local board to do otherwise), requires the health officer — 
 
 "To order the prompt and thorough isolation of those sick or infected with such disease, so long as 
 there is danger of their communicating the disease to other persons ; to order the prompt vaccination or 
 isolation of persons who have been exposed to small-pox; to see that no person suffers for lack of 
 nurses or other necessaries because of isolation for the public good; to give public notice of infected 
 places by placard on the premises, and otherwise if necessary; to promptly notify teachers or superin- 
 tendents of schools concerning families in which are contagious diseases; to supervise funerals of 
 persons dead from scarlet fever, diphtheria, small-pox, or other communicable disease which endangers 
 the public health; to disinfect rooms, clothing, and premises, and all articles likely to be infected, before 
 allowing their use by persons other than those in isolation; to keep the president of his own board of 
 health, and the Secretary of the State Board of Health constantly informed respecting every outbreak 
 of a disease dangerous to the public health, and of the facts so far as the same shall come to his know- 
 ledge, respecting sources of danger of any such diseased person or infected article being brought into or 
 taken out of the township, city, or village of which he is the health officer.” 
 
 If the health officer gives these orders, as the law requires, then any 
 person who disobeys one of these orders is liable to a fine, and to imprison- 
 ment if the fine is not paid. If each case is, as it should be, kept under 
 surveillance by the health officer, through his agents, who may be sanitary 
 policemen or sanitary inspectors, any violation of the orders may be 
 learned and the legal penalties inflicted. If, in Detroit, this were generally 
 done, it would soon be generally known, and the laws and orders would 
 generally be obeyed. It seems that in Detroit this law is not fully complied 
 with by the health officer, that the isolation of infected households is not 
 ordered, but only advised, that no sanitary inspector finds out whether or 
 
16 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 not the order or advice is complied with, and, therefore, that no thorough, 
 systematic attempt is made to isolate inmates of houses infected with diph- 
 theria and scarlet fever; permits are given for adults to go out from infected 
 premises to work. So long as the most important law for the restriction of 
 disease is disregarded by the chief officer of health in the city, or negatived 
 by the action of the local board of health, there is little hope for progress 
 in the restriction of the dangerous communicable diseases. It is not to be 
 wondered at, it follows as a matter of course, that diphtheria and scarlet 
 fever are very prevalent in Detroit. 
 
 The committee seem to have found that perhaps the most important “ dif- 
 ficulty under which the Detroit officers are laboring for the restriction of the 
 dangerous diseases” is the lack of cooperation with the health officials by the- i 
 other city officers, and by the people generally. This was testified to by his 
 honor the Mayor, by Dr. Duffield, and by others ; it was spoken of by president 
 Avery of the State Board of Health; Mayor Pingree expressed the view that 
 if the citizens of Detroit and their official representatives knew the facts they 
 would readily respond to the proper requests of the health department. This 
 is in accordance with the experience of the State Board of Health, and with 
 the theory of its system of work, which is not accepted and acted upon by 
 the Detroit health department. The theory of the State Board is that an 
 “ educational campaign ” should be continually carried on for the purpose 
 of building up a correct public opinion on the restriction of the most 
 dangerous diseases. The State Board issues pamphlets on the best meas- 
 ures for the restriction of each of the most dangerous diseases, and it 
 wants these pamphlets distributed, by the local health department, to the 
 neighbors of every house in which there is a dangerous communicable 
 disease. In time, if this is done, all the people are thus reached, at a time 
 of special danger from disease, when the pamphlet is read, because of 
 unusual interest, and heeded because issued by State authority, and the 
 result is a public sentiment that will sustain and support proper health 
 measures, carried on by the local health department. 
 
 In Detroit, a pamphlet, issued by the local board, is left with the inmates 
 of the infected premises; but there the “ educational campaign ” stops, the 
 people are left uninstructed, and the health officials continue to be power- 
 less, for lack of cooperation, not only of the people generally, but also of 
 those other city officials who control the appropriation and expenditure 
 of money; isolation hospitals are not provided for, because few of the 
 people have been instructed concerning the necessity or importance of 
 isolation for the restriction of the most common diseases; disinfecting 
 stations are not provided, because few of the people know how important 
 disinfection is, for the restriction of diphtheria and scarlet fever. 
 
 The State Board of Health issues a diagram which shows at a glance, 
 and conclusively, because representing indisputable statistics, the two 
 important facts — that isolation and disinfection do restrict diphtheria. It 
 issues a diagram that shows these same two important facts concerning scar- 
 let fever. One of these diagrams, with a copy of the State Board’s pamphlet 
 on the restriction of the disease then threatening, should be placed before 
 every neighbor of a house in which there occurs a case of one of these dis- 
 eases. If this were done in Detroit, it would not be long before there would 
 be an enlightened public opinion which would tend to support the local 
 health officials in proper efforts for the restriction of those two dangerous 
 communicable diseases which are now so prevalent in Detroit. 
 
 Henry B. Baker, 
 
 Secretary. 
 
(s» I L ~l " C ’T 
 
 '(Yl S U 
 
 t wy 
 
 ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 SPECIAL MEETING, SEPT. 29 AND 30, 1893. 
 
 [ 199 .] 
 
 A special meeting of the Michigan State Board of Health was held at 
 Lansing, Sept. 29 and 30, 1893. The members present were: Hon. Frank 
 Wells, President, Lansing; Prof. Delos Fall, M. S., Albion; George H. 
 Granger, M. D., Bay City; Samuel G. Milner, M. D., Grand Bapids; and 
 Henry B. Baker, Secretary, Lansing. 
 
 The regular business of auditing of bills and accounts was transacted. 
 
 TUBERCULAR DISEASES DECLARED “ DISEASES DANGEROUS TO THE PUBLIC 
 
 HEALTH.” 
 
 A resolution offered by Dr. Henry B. Baker was unanimously adopted, 
 placing consumption (and other diseases due to the tubercle bacillus) on 
 the list of diseases dangerous to the public health, which are required by 
 law to be reported by physicians and householders. This means that 
 henceforth still greater effort than in the past is to be put forth to restrict 
 the ravages of this “ great white plague,” which causes more deaths in 
 Michigan than any other disease. This important move by the Board 
 calls for the most earnest cooperation of health officers, physicians, and 
 the people generally. The resolution is as follows: 
 
 “ Resolved , That hereafter, consumption (and other diseases due to the 
 Bacillus tuberculosis) shall be included in the official list of ‘Diseases 
 dangerous to the public health’ referred to in sections 1675 and 1676, 
 Howell’s statutes, requiring notice by householders and physicians to the 
 local health officer, as soon as such a disease is recognized.” 
 
 [In this resolution the question of isolation of the patient is not mentioned. Its purpose is to secure 
 to the local health authorities and to the State Board of Health information of the location of each case 
 of this most dangerous disease, with the view of placing in the hands of the patient reliable information 
 how to avoid giving the disease to others, and in the hands of those most endangered, information how to 
 avoid contracting this disease.] 
 
 - ft , \ 0 -4A 
 
 "ft 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 HOW OTHER DANGEROUS DISEASES ARE RESTRICTED. 
 
 The reporting of other dangerous diseases to the State Board has 
 enabled it to place pamphlets and leaflets of instructions just where they 
 would do' most good, and at a time when most likely to be read, namely 
 when the disease is actually present and threatening. Many years of 
 experience show that restrictive measures recommended by the State 
 Board of Health, relative to dangerous diseases, have been the direct 
 means of great reductions in the death-rates of dangerous diseases; from 
 scarlet fever, for instance, the death-rate is only about half what it was 
 before the State Board of Health undertook restrictive measures. When 
 consumption is reported it can be dealt with in a similar manner, 
 so far as relates to the teaching of the people how to restrict it, and many 
 cases of consumption can be avoided every year. It is a disease easily 
 restricted, and the State Board of Health distributes a pamphlet telling 
 just how to do it. If the physicians and citizens of Michigan will report 
 consumption as they have in the past reported other dangerous diseases, 
 and cooperate with the local health officials and with the State Board of 
 Health in its efforts to instruct the people, much suffering and loss of life ' 
 can be prevented. 
 
 PRINTING AND DISTRIBUTION OF PAMPHLETS OF INSTRUCTION. 
 
 In connection with the subject of reprinting the leaflet on the restriction 
 of dangerous contagious diseases, in several different languages for dis- 
 tribution to the neighbors of the persons sick with a dangerous disease, 
 Drs. Granger and Milner, the recently appointed members of the Board, 
 said they had for years watched with interest the good work that these 
 instructive pamphlets had been doing in the restriction and prevention of 
 the several diseases. 
 
 The Board directed the Secretary to reprint this leaflet in several dif- 
 ferent languages. Dr. Granger said that many of our recently-arrived for- 
 eigners did not believe that some of these diseases were dangerous, and 
 that this leaflet was just what was wanted to educate this class of people, 
 because diphtheria and other diseases were spread among them and by 
 them to other classes of people. 
 
 In foreign countries from which immigrants are coming to Michigan, the 
 dangerous communicable diseases generally are more prevalent than in 
 Michigan, where restrictive measures have been in force for many years. 
 Thus the death-rate from measles is much greater in England than in 
 Michigan. In many of the foreign countries small-pox is common, while 
 there is none now in Michigan. 
 
 AMENDMENT OF RULES FOR IMMIGRANT INSPECTION. 
 
 The Board amended its rules for the inspection of immigrants at the 
 Michigan border by adding to Rule 1 “and no immigrant shall come into 
 this State, or travel within the State, until inspected under these rules, and 
 until authorized to do so by an inspector appointed or accredited by the 
 Michigan State Board of Health.” 
 
 Rule 5 was so amended as to hold immigrants until their baggage has 
 been disinfected. 
 
 An additional rule was adopted as follows: 
 
ABSTRACT OF PROCEEDINGS, SEPTEMBER 29-30, 1893. 
 
 3 
 
 Rule 7. Dangerous communicable diseases being now present in every 
 country from which immigrants are coming into Michigan, no immigrant, 
 and no traveler or other person believed by the State Board of Health or 
 by its authorized inspector to have .been exposed to and liable •to convey 
 cholera, diphtheria, or other dangerous communicable disease, shall pass 
 through Michigan, or from one township, city or village to another within 
 the State, without permission from the State Board of Health or its author- 
 ized inspector. 
 
 The following resolution, offered by Dr. G ranger, was unanimously 
 adopted: 
 
 Resolved , That it is the will of this Board that the President and Secre- 
 tary continue to take such action as may be necessary to enforce the rules 
 of this Board and to enforce quarantine at the Michigan border and 
 within the State against diseases dangerous to the public health, and to 
 compel any railroad company operating within the State to obey the State 
 laws and the rules and regulations of the State Board of Health made 
 under the law. 
 
 MINNEAPOLIS, ST. PAUL AND SOO R. R. VS. STATE BOARD OF HEALTH. 
 
 About July 6 an order was served on each member of this State Board 
 of Health to appear at Marquette, July 15, to show cause why a prelimi- 
 nary injunction should not issue to stop the inspection of immigrants and 
 travelers under the rules of the Michigan State Board of Health. Accord- 
 ingly the Attorney General of Michigan, and the President and Secretary 
 of the State Board of Health, went to Marquette, to appear before Judge 
 H. F. Severens, United States Circuit Judge of the Northern Division of 
 the Western District of Michigan. On account of the importance of the 
 case Judge Severens had asked U. S. Circuit Judge George R. Sage, of 
 Cincinnati, to sit with him. 
 
 In a few days the finding of the U. S. Judges was handed down, and a 
 copy was sent to the office of the Secretary of the State Board of Health, 
 and is as follows: 
 
 CIRCUIT COURT OF THE UNITED STATES, WESTERN DISTRICT OF 
 MICHIGAN— NORTHERN DIVISION. 
 
 Minneapolis, St. Paul & S. Ste. Marie Railway Company, 
 
 vs. 
 
 Samuel G. Milner, et al., Members of and constituting the State Board of 
 
 Health of Michigan. 
 
 On motion for a preliminary injunction. Before Judges Severens and 
 
 Sage. 
 
 The bill sets forth that the complainant, a corporation of the State of Michigan, is 
 and has been for several years past, engaged, under a traffic arrangement with the 
 Canadian Pacific Railway Company, in the transportation of passengers, on through 
 tickets from Quebec westward through Canada and over the line of the complainant’s 
 railway to and through the State of Michigan, Wisconsin, Minnesota and North Dakota, 
 also eastward, from those States, through Canada to Quebec, a large portion of the 
 passengers westward being persons traveling from Norway and Sweden to points in said 
 States. 
 
 The defendants, it is averred, constitute the State Board of Health of Michigan, act- 
 ing under an act passed by the legislature of Said State and approved June 20th, 1885, 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 entitled “An act to provide for the prevention of the introduction and spread of cholera \ 
 and other ‘dangerous communicable diseases’” as amended by an Act approved April 
 25th, 1893. The bill has attached to it as exhibits a copy of such of said acts, and of certain 
 rules adopted by said Board, purported to be issued under and by virtue of the author- 
 ity conferred by said amendatory Act. It is further averred that said Board acting 
 through its Secretary and one of its inspectors and in pursuance of said rules, is daily 
 detaining and attempting to detain passengers on said Canadian Pacific Railway at the 
 point opposite Sault Ste. Marie, Michigan, and prohibiting their entering the State of 
 Michigan until they have undergone the quarantine detention and until the disinfec- 
 tion of their baggage as prescribed in said rules. It is averred that this detention, 
 examination and process of disinfection of baggage is applied to all emigrants irrespec- 
 tive of whether they came from an infected or healthy locality abroad and without 
 regard to their point of destination. It is further averred that all said emigrants and 
 travelers have been, before said detention, inspected by United States officials detailed 
 for said purpose and that complainant has not received nor permitted to be conveyed 
 within the State of Michigan any passenger, traveler or emigrant coming from any 
 European port through the Dominion of Canada, excepting such as have presented a 
 certificate of inspection of the United States inspector. It is also averred that said 
 Board is threatening to arrest officials and employes of complainant unless complainant 
 shall submit to and comply with said requirements of said Board 
 
 The claim is that the rules and action of said Board of Health are in direct violation 
 of Section 8, Article 1, of the Constitution of the United States, in that they attempt to 
 regulate and prohibit commerce with foreign Nations; and that they are also in viola- 
 tion of the treaty made by and between the United States and Norway and Sweden and 
 now existing; also that they are over, above and beyond the powers conferred upon 
 said Board by said Act and Amendatory act of the Legislature of Michigan. The bill 
 then sets forth averments of irreparable damages and prays for an injunction. 
 
 The motion for a preliminary injunction will be over-ruled for the following reasons: 
 
 1. In Brown vs. Maryland, 12 Wheaton 419-433, Chief Justice Marshall recognized 
 that the removal or destruction of infectious or unsound articles was undoubtedly an 
 exercise of the police power of the State, and an exception to the prohibition resulting 
 from the exclusive power of Congress to regulate the operations of foreign and inter- 
 state commerce, and he says that “Laws of the United States expressly sanction the 
 Health laws of the State.” In the license cases 5 Howard, 504, 576, Chief Justice Taney 
 declares that “It must be remembered that disease pestilence and pauperism are not 
 subjects of commerce, although sometimes among the attendant evils. They are not 
 things to be regulated and trafficked in, but to be prevented as far as human foresight ! 
 or human means can guard against them.” In Ceatcher vs. Kentucky, 141 U. S. 47; 
 Justice Bradley refers to these cases with approval, and states with great clearness and 
 force the distinction between the exercise of its police power by a State and an attempt 
 to legislate upon matters of interstate Or foreign commerce, which are exclusively 
 within the power of the Federal Government. These authorities render it unnecessary 
 to refer particularly to the cases cited for the complainant. It is sufficient to say that 
 they all relate to State enactments concerning articles of commerce and thence are not 
 applicable here. Moreover the Quarantine Act of Congress, approved February 15, 
 1893. expressly recognizes the validity of State laws, and in Section 3 requires the 
 Supervising Surgeon General of the Marine Hospital Service to cooperate with and aid 
 State and Municipal Boards of Health in the execution and enforcement of their rules 
 and regulations. 
 
 2. We find nothing in any existing treaty with Norway and Sweden which conflicts 
 with the institution or enforcement by any one or more of the States of this Union of 
 quarantine regulations. 
 
 3. We do not deem it necessary to express an opinion whether the provision of the 
 Michigan Statute making it a misdemeanor to violate the rules of the State Board of 
 Health adopted in pursuance of the Act, is constitutional or valid, for we should not, 
 even if we were of opinion that it is unconstitutional undertake to issue an injunction 
 against Criminal Prosecution by the State. That the Legislature might authorize the 
 Board to adopt rules is, we think, beyond question. Such rules are essential to the 
 proper enforcement of the law. 
 
 4. To the objection that passengers from non-infected countries and localities are 
 detained, the answer is that such detentions are in the nature of the case, to a certain 
 extent unavoidable; and passengers from such countries and localities may have become 
 properly subject to detention by reason of having mingled with others who could com- 
 municate pestilence or disease to which they themselves had been exposed or subjected. 
 An opportunity for separation is indispensible also. 
 
 5. The objection that passengers who had certificates from United States inspectors, 
 
ABSTRACT OF PROCEEDINGS, SEPTEMBER 29-30, 1893. 
 
 5 
 
 were detained, is not tenable. The States may exercise their police power according to 
 their own discretion and by means of their own officials and methods. The inconven- 
 ience resulting to emigrants and travelers from being halted and subjected to exam 
 ination and detention at State lines is of trifling importance, at a time when every 
 effort is required and is being put forth to prevent the introduction and spread of 
 pestilential and communicable diseases. 
 
 The costs and charges which are incurred in such quarantine inspection may lawfully 
 be imposed on the Railway Co. as being incident to the business in which they are 
 engaged. The costs of the motion will be taxed to the complainant. 
 
 July 29th, 1893. H. F. Severens. 
 
 Geo. R Sage. 
 
 CONGRATULATORY LETTERS RELATIVE TO THE U. S. COURT DECISION. 
 
 Copies of the foregoing decision were sent to Secretaries of State Boards 
 of Health, railroad authorities, and others interested in public health sub- 
 jects, and especially in this case. Letters of congratulation have been 
 received by the Secretary of the Board, and extracts from a few of them 
 are as follows : 
 
 Dr. J. H. Hamilton, Secretary of the Vermont State Board of Health, 
 writes: “ Will you allow me to congratulate you on the important decision 
 you obtained, not only for your Board and that of other States, but for 
 the people at large. I shall make use of this decision in my report soon 
 to be published.’ ’ 
 
 E. B. Frazer, M. D., Secretary of the Delaware State Board of Health, 
 says: “Your Board won of course . Railroad companies want dollars — 
 care nothing about the spread of diseases and the loss of life. I will be 
 pleased to hear from you further on the subject. As a rule our State 
 courts uphold State Boards of Health, and this is as it should be.” 
 
 N. D. Baker, M. D., Secretary of the West Virginia State Board of 
 Health, says: “You have conferred a public benefit of far-reaching con- 
 sequences in thus securing so unequivocal a statement of the rights and 
 powers of the health authorities of the States.” 
 
 It is undoubtedly understood that all that was done by the State Board 
 of Health was to prepare a statement of facts bearing upon the subject. 
 Some of these facts are very interesting, and not generally known. They 
 may be published later. 
 
 OUTBREAKS OF DIPHTHERIA IN ALCONA, HURON, IOSCO AND SANILAC COUNTIES, 
 THE CONTAGIUM OF WHICH IS ALLEGED TO HAVE BEEN FROM 
 “CAMP NO. 8” IN MILLEN TOWNSHIP, ALCONA COUNTY. 
 
 In the latter part of May, 1893, it was reported to the Secretary of the 
 State Board of Health that a man named “ Corboski,” who had been work- 
 ing at a lumber camp in Millen towuship, Alcona county, known as Loud 
 & Sons’ “Camp No. 8,” was taken ill, went to Oscoda, and died within 
 three days after his arrival in that village. The cause of his death was 
 given as “Ulcerative Tonsilitis.” Corboski’s body was shipped, immedi- 
 ately after his death, to Paris township, Huron county, for burial, where a 
 “wake” and a public funeral were held. Several families of persons who 
 had attended the “wake” and funeral, were stricken with diphtheria. 
 Outbreaks of the disease occurred in several localities in Huron and Sani- 
 lac counties the contagium of which was alleged to have been traced 
 directly or indirectly to the “ wake ” and funeral over the body of Corboski. 
 
 In Alcona county, which lies north of Saginaw Bay, outbreaks of diph- 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 theria occurred in several townships, the contagium of which was alleged 
 to have been traced to “Camp No. 8.” 
 
 The Secretary of the State Board of Health was in constant correspond- 
 ence with the local boards of health of the several infected localities, and 
 urged emphatically, that they put forth every effort possible to stamp out 
 the disease. 
 
 The health officer and president of the board of health of Millen town- 
 ship, in which “Camp No. 8” is situated, reported that no cases of diph- 
 theria had occurred in their jurisdiction. 
 
 Bequests were received from local boards of health and individuals of 
 seven different localities, who ascribed the cause of the outbreaks to infec- 
 tion from the camp referred to, that the State Board investigate the sub- 
 ject. In compliance with such request, the State Board employed Dr. J. W. 
 Hauxhurst, of West Bay City, to proceed to the infected localities in 
 Alcona county, and endeavor to ascertain the cause of the different out- 
 breaks of the disease. After his investigation he reported that “Reliable 
 and undisputed evidence could not be found to substantiate the statement 
 that diphtheria originated at 4 Camp No. 8,’ nor that it has been the source 
 whence all the cases in ” the several townships came. “That the Corboski 
 case went from ‘ Camp No. 8’ to Oscoda, died there, his body being sent to 
 Huron county, has not been denied.” * * * “That he died of diph- 
 
 theria is not at all doubtful.” He reported that three other men who- 
 worked at the camp referred to, went to their homes, had diphtheria, and 
 died, and that other cases occurred in their families. He reports that he 
 inspected the sanitary conditions of “Camp No. 8” and found everything 
 in good condition, except the well from which water was drawn for culi- 
 nary and laundry purposes. The well had been banked up with manure 
 to prevent the pump and pipes from freezing, and that water percolated 
 through the manure into the water in the well. It does not appear from 
 the doctor’s report that water from the well was used for drinking, but it 
 was used for culinary purposes. There is no evidence that it contained the 
 germs of diphtheria, or that if diphtheria was there it was spread by any 
 other than the common mode — namely, from person to person. He also 
 found foulness at the point where a drain from the cook-room, etc., dis- 
 charged into an adjacent swamp. 
 
 The following table shows the jurisdictions into which diphtheria was 
 alleged to have spread from “Camp No. 8” located in Millen township, 
 Alcona county; also the number of cases and deaths which have been 
 reported from each jurisdiction, up to Sept. 23, 1893. In the majority of 
 instances, the outbreaks have been reported as over and final reports sent 
 in, and last reports from the other localities indicate that the disease has 
 been practically eradicated. 
 
ABSTRACT OF PROCEEDINGS, SEPTEMBER 29-30, 1893. 
 
 T 
 
 Counties and townships. 
 
 Cases. 
 
 00 
 
 3 
 
 c« 
 
 a 
 
 
 f [ *Harrisville Tp 
 
 19 
 
 10 
 
 
 j *Haynes Tp. 
 
 9 
 
 3 
 
 
 Alcona Co. ... ■{ *Mikado Tp 
 
 1 
 
 0 
 
 
 j f Millen Tp — 
 
 0 
 
 0 
 
 
 L *Gustin Tp._ 
 
 9 
 
 2 
 
 “ Camp No. 8,” Alcona 
 
 
 
 
 On., Millen Tp. -< 
 
 f * Paris Tp 
 
 38 
 
 16 
 
 
 Huron Co. ^Bingham Tp 
 
 5 
 
 2 
 
 
 1 
 
 L *Dwight Tp 
 
 7 
 
 2 
 
 
 ( IGreenleaf Tp. 
 
 1 
 
 0 
 
 
 Sanilac Co < 
 
 
 
 
 ( JMinden Tp 
 
 5 
 
 2 
 
 
 I Torch Co. *OfiCoda Vil. 
 
 m 
 
 IT 1 
 
 
 
 Total CaHfiR and Daathfi 
 
 95 
 
 38 
 
 
 
 
 
 * Infection alleged to be direct from “ Camp No. 8.” 
 
 t Health officer and supervisor of Millen township will not admit that diphtheria is or has been present 
 in “ Camp No. 8.” 
 
 ± Secondary infection from Paris township. 
 
 “ Corboski,” whose body was shipped to Paris township, and conveyed the infection to the counties- 
 south of Saginaw bay. 
 
 SECRETARY’S REPORT OF WORK DONE IN THE OFFICE OF THE STATE BOARD OF' 
 HEALTH, DURING THE QUARTER ENDING WITH SEPTEMBER, 1893. 
 
 Communicable Diseases. 
 
 The number of reports of outbreaks of dangerous communicable dis- 
 eases in Michigan, received from all sources and filed, and the corre- 
 sponding number concerning which action was taken by this office during 
 the quarter, are as follows: for diphtheria, 142; for scarlet fever, 134; for 
 typhoid and typho-malarial fever, 135; for measles, 37. Total for the 
 five diseases, 448. 
 
 The number of communications relative to dangerous communicable 
 diseases, received and placed on file during the quarter, was 1,768. 
 
 Relative to dangerous communicable diseases, letters, written cards, and 
 demands for weekly and final reports, on cards, or in the form of the cir- 
 cular letter, were sent out during the quarter to the number of 1,643. 
 
 The “ final ” reports of outbreaks received and filed during the quarter, 
 were: for diphtheria, 99; scarlet fever, 109; typhoid and typho-malarial 
 fever, 37 ; measles, 50. Total for the five diseases, 295. 
 
 During the quarter, the local columns of newspapers to the number of' 
 774, have been looked over for reports of occurrence of communicable 
 diseases. This has resulted in giving this office information of the alleged 
 occurrence of 16 outbreaks of diphtheria, 8 outbreaks of scarlet fever, 15 
 outbreaks of typhoid and typho-malarial fever, and 1 outbreak of 
 measles. To what extent the reports of these alleged outbreaks were 
 verified, is shown in the accompanying table: 
 
s 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 TABLE 1. -Showing the number of Outbreaks of Diphtheria , Scarlet fever , Typhoid fevr and Measles , 
 from July 1 to Sept. 30, 1893, of which notice was received at the office of the Michigan State Board of 
 Health; the per cent of reports, information concerning which was received through the Newspapers; 
 the per cent of newspaper reports which were confirmed by the health officer; the per cent of newspaper 
 reports which were denied by the health officer ; and the per cent from which no reply was received 
 from the health officer. 
 
 Diseases. 
 
 Reports 
 from all 
 sources, 
 July 1-Sept. 
 30, 1893. 
 
 Per cent of 
 all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent of 
 newspaper 
 reports 
 which were 
 confirmed 
 by the health 
 officer. 
 
 Per cent of 
 newspaper 
 reports 
 which were 
 denied by 
 the health 
 officer. 
 
 Per cent of 
 newspaper 
 reports to 
 which the 
 health officer 
 made no re- 
 ply to notice 
 sent from 
 this office. 
 
 Diphtheria 
 
 142 
 
 11 
 
 31 
 
 H7 
 
 31 
 
 Scarlet fever 
 
 134 
 
 6 
 
 50 
 
 25 
 
 25 
 
 Typhoid fever 
 
 135 
 
 11 
 
 20 
 
 60 
 
 20 
 
 Measles 
 
 37 
 
 3 
 
 100 
 
 0 
 
 0 
 
 Averages for the four diseases. .. 
 
 
 9 
 
 33 
 
 43 
 
 25 
 
 Compiling, Editing, Printing , etc., for Publication. 
 
 A compilation of reports from health officers and clerks has been made, 
 and the article relative to small-pox in Michigan in 1890 has been written 
 for the Annual Report for 1891 ; work on the compilation of the reports, 
 etc., for the articles on Diphtheria and Scarlet Fever in Michigan in 1891, 
 have been commenced. The article on Scarlet Fever in Michigan in 1890 
 has been written and proved. The articles on Typhoid Fever and on 
 Nuisances in Michigan in 1890 have been completed for the printer. The 
 article on Small-pox in Michigan in 1890 has been proved, and work on 
 the proving of the article on Measles in Michigan in 1890 has been 
 commenced. 
 
 Work in connection with the printing of the Annual Report for 1891 
 has been continued. Copy has been prepared for the printer, and the 
 Proceedings of the Stanton Sanitary Convention has been printed in 
 pamphlet form. 
 
 The article “ Health in Michigan ” for the new edition of “ Michigan 
 -and Its Resources,” which has been published by the Secretary of State, 
 has been revised, and additions were made. 
 
 A pamphlet “Names and Addresses of Health Officers in Michigan for 
 the year 1893-4,” has been prepared from the official returns, printed, 
 and distributed. 
 
 Distribution of Publications, etc. 
 
 A copy of the pamphlet “ Names and Addresses of Health Officers in 
 Michigan for the year 1893-4,” has been sent to each of 1,260 health officers 
 whose name and address has been returned to this office. A copy of the 
 pamphlet has been marked and sent to each delinquent locality. 
 
 Copies of the Eighteenth Annual Report of this Board, to the number 
 of 1,800, have been sent to presidents and clerks of villages, and sanitarians 
 in this and other States. 
 
ABSTRACT OF PROCEEDINGS, SEPTEMBER 29-30, 1893. 
 
 9 
 
 About the usual number of pamphlets, on the Restriction and Preven- 
 tion of each of the Dangerous Communicable Diseases, has been 
 distributed to localities where dangerous diseases exist. 
 
 Work on Meteorology . 
 
 The regular tri-daily meteorological observations have been continued 
 at this Station, and a summary for each week and month, during the 
 quarter, has been sent to the Director of the Michigan Weather Service 
 and Local Forecast Official at Detroit for his use, and it is then sent by 
 this Official at Detroit to the Chief of the U. S. Weather Bureau at 
 Washington. 
 
 A supply of ozone test-paper for the months of Oct., Nov. and Dec. was 
 sent, on Sept. 15, to each of fifteen meteorological observers. 
 
 Diagrams for the Annual Report were made as follows: Nos. ii., iii., iv., 
 vi., vii., viii., ix., and xi., illustrating some of the principal meteorological 
 conditions in Michigan for the year 1891. A diagram of “ Impure source 
 of water used by a person who contracted typhoid fever in Hartford, 
 Michigan,” and a diagram “ Deaths from Cholera in London per 100,000 
 persons living ” were made. This last is to illustrate a paper read by 
 Mr. Willitts at the Hillsdale Sanitary Convention. 
 
 The meteorological tables for the year 1892 have been made, and 
 meteorological registers for Stations in Michigan from June to August, 
 1893, inclusive, have been examined, and compilations on these registers 
 have been made, with the exception of columns relating to humidity and 
 atmospheric pressure. 
 
 Accessions to the Library , etc. 
 
 During the quarter 132 books and pamphlets, and 256 numbers of 
 journals (weeklies, monthlies and semi-monthlies) have been received and 
 entered in the library of this Board. The work on the card catalog has 
 been continued. 
 
 Correspondence , Hektograph Work, etc. 
 
 During the quarter 1,676 pages of letter-book have been used in copying 
 the correspondence of the Office, not including the many postal cards and 
 circulars which have been sent out but not copied. 
 
 More than the usual amount of hektograph work has been done, due to 
 the great number of lists of immigrants destined to settle in Michigan 
 which have been received from the ports of debarkation, and from the 
 immigrant inspectors on the Michigan border, and sent from this office to 
 the health officers of the localities to which these immigrants were going. 
 About 1,747 pages of hektograph work have been made, of which some 
 190 pages were relative to the opinion of the U. S. Judges in the case of 
 Minn. St. Paul and Sault Ste. Marie R. R. vs. State Board of Health. 
 Copies of the opinion were sent to the press and to persons interested in 
 the subject. 
 
 Work in Connection with Sickness Statistics. 
 
 During the third quarter of 1893, 1,755 blank postal report cards, 125 
 record books, 35 printed circulars and 72 hektographed circular letters 
 2 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 regarding weekly card reports, have been mailed, in packages, to 122 
 health officers and regular correspondents; 1,434 weekly card-reports have 
 been received and entered on the register; 52 copies of the hektographed 
 weekly bulletin “ Health in Michigan ” were mailed each week, and 101 
 copies of the monthly bulletin “ Health in Michigan ” have been hekto- 
 graphed and mailed each month. These bulletins have been consolidated 
 for this quarterly report. Work has also been done on the compilation of 
 the weekly card reports of sickness during the year 1891, for the annual 
 report for 1892. 
 
 Health in Michigan in the third quarter of 1893. Communicable 
 
 Diseases. 
 
 Compared with the preceding quarter, (April, May and June), reports 
 from all sources show diphtheria to have decreased by an average of one 
 place, scarlet fever to have decreased by an average of eighteen places, 
 typhoid fever to have increased by an average of thirty-five places and 
 measles to have decreased by an average of thirty -five places. 
 
 Meteorology, and Sickness from all Causes , third quarter of 1893, Com- 
 pared with the preceding quarter. 
 
 A comparison of meteorological conditions of the third quarter of 1893, 
 with the meteorological conditions of the preceding quarter, shows the 
 prevailing direction of the wind to have been the same (southwest), the 
 average velocity 26 per cent less, the temperature 10.83 degrees higher, 
 the rainfall at Lansing 4.17 inches less, the absolute humidity considerably 
 more, the relative humidity slightly less, the day, and the night ozone 
 much less, and the hight of ground above the water in the well at Lansing 
 to have been 2 inches less. 
 
 Compared with the preceding quarter, (April, May and June,) the 
 reports from regular observers show a marked increase of diarrhea and 
 inflammation of bowels, and a marked decrease of influenza, bronchitis 
 and inflammation of kidney in the third quarter of 1893. 
 
 The Weather , and the Health in Michigan in the third quarter of 1893 9 
 compared with the average for the seven years , 1886-1892. 
 
 A comparison of the meteorological conditions of the third quarter of 
 1893, with the average for the third quarters in the seven years, 1886-1892, 
 show r s that in 1893, the prevailing direction of the wind was the same, 
 (southwest), the velocity was slightly greater, the temperature was nearly 
 the same, the rainfall at Lansing was 1.25 inches less, the absolute and the 
 relative humidity were slightly less, the day, and the night ozone were 
 considerably less, and the hight of ground above the water in the well at 
 Lansing was five inches less. 
 
 Compared with the average in the corresponding quarters in the seven 
 years, 1886-1892, the reports received from regular observers indicate that 
 erysipelas, intermittent fever, remittent fever and consumption were less 
 than usually prevalent, and that no disease was more than usually preva- 
 lent in the third quarter of 1893. 
 
ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 REGULAR MEETING JANUARY 12, 1894. 
 
 [ 202 .] 
 
 A regular meeting of the Michigan State Board of Health was held at 
 Lansing, Jan. 12, 1894. The members present were: Hon. Frank Wells, 
 President, Lansing; Prof. Delos Fall, M. S., Albion; Mason W. Gray, M. 
 D., Pontiac; and Henry B. Baker, Secretary. The absent members had 
 notified the Secretary that they would be unable to attend this regular 
 meeting. 
 
 The regular business of auditing of bills and accounts was transacted. 
 
 ANALYSIS OF UNCONTAMINATED SPRING WATERS IN MICHIGAN. 
 
 Prof. Delos Fall, M. S., of Albion, Committee of this Board on Water 
 Supply and Purification of Sewage-contaminated Water, made a prelimin- 
 ary report. Prof. Fall has undertaken an analysis of the uncontaminated 
 spring waters throughout Michigan in order to ascertain the normal 
 amount of chlorine. Ten parts per million has been considered the max- 
 imum amount of chlorine which should be found in good water, but he 
 thinks that the standard will have to be raised somewhat for Michigan as 
 most of the samples that he has examined contain over ten parts of chlor- 
 ine per million parts of water. Prof. Fall proposes to continue these 
 analyses of spring waters not contaminated by leachings from barns, 
 stables, residences, etc. He wants a half pint of such water in a perfectly 
 clean bottle, the bottle having a new cork, and the sample accompanied 
 with a reliable statement of the source and surrounding conditions. Prof. 
 Fall would be glad to receive samples of such spring water, and would 
 consider it a favor if any person interested would send him a sample, the 
 express charges to be paid by Prof. Fall. The report, which Prof. Fall 
 will make to this Board, will be looked for with interest, as it will supply 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 one standard by which to judge of the extent of sewage contamination of 
 waters hereafter examined chemically. . 
 
 The Board voted to aid Prof. Fall in his valuable work by appropriating 
 a small sum of money to be used in paying expressage on samples of 
 water sent to him. 
 
 SANITARY CONVENTION AT MENOMINEE, MICHIGAN. 
 
 The Secretary presented an invitation from the leading citizens of the 
 city of Menominee, requesting the State Board of Health to hold one of 
 its Sanitary Conventions in that city. 
 
 Thirty-nine successful Sanitary Conventions have been held in different 
 parts of the State under the auspices of the State Board, and the proposed 
 convention at Menominee will be the fortieth. These conventions have 
 been productive of much good, and have been the means of teaching laige 
 audiences important facts in every-day sanitation and the best measures 
 for the restriction of the dangerous communicable diseases. The first 
 Sanitary Convention was held in Detroit in January, 1880. 
 
 The Board appointed Prof. Fall a committee to make arrangements for 
 a Sanitary Convention at Menominee. 
 
 MICHIGAN INSPECTION OF IMMIGRANTS AND TRAVELERS DISCONTINUED. 
 
 The subject of the further continuance of the Michigan Inspection of 
 immigrants was discussed. Secretary Baker thought that the Michigan 
 inspection of immigrants, which has been in progress for some time, has 
 done much to prevent the introduction aud spread of dangerous communi- 
 cable diseases. He thought also that the stand the Michigan State Board 
 had taken has been the means of raising the standard of quarantine in 
 this country, tending as it has toward the disinfection of the baggage at 
 all immigrants coming into this country. It is not improbable, that the 
 inspection at the border has been the means of keeping Michigan tree 
 from small-pox, and it is probable that it has lessened the introduc- 
 tion of other diseases. The Michigan rules for disinfection were earned 
 out during the past summer at Levis, near Quebec, and are now being 
 carried out at Halifax, under the direction of Dr. Wickwire, Port Health 
 Officer at Halifax. Small-pox is now quite prevalent in several States, but 
 it is hoped that Michigan will not be visited by this disease. Owing to 
 the depression in mining, lumbering, and in other business, immigration 
 will probably be much lessened. 
 
 The recent judicial decision was discussed, and a resolution was 
 adopted, as follows: 
 
 Resolved , That in view of the adverse decision of the Hon. Joseph H. Steere, of the eleventh Judicial 
 Circuit, declaring the penalty portion of the Michigan quarantine law unconstitutional, the immigrant 
 inspection at the Michigan border is hereby suspended from and after January 13, 1894. 
 
 It is understood that legal measures have been taken to obtain a decis- 
 ion on this subject by the Supreme Court. 
 
 Brief History of Action Taken. 
 
 Robert Finch, a railroad agent at Sault Ste. Marie, violated and contin- 
 ued to violate the Rules of the State Board of Health, relative to the 
 
ABSTRACT OF PROCEEDINGS, JANUARY 12, 1894. 
 
 3 
 
 detention and disinfection of immigrant baggage, the Rules having been 
 made under Act 47, Laws of 1893. Inspector Rogers made complaint to 
 the Justice of the Peace, and asked that a warrant for the arrest of Agent 
 Finch be issued. Justice Frank R. Warner refused to issue the warrant, 
 holding that Act 47, Laws of 1893, is unconstitutional. John Hurst, the 
 Prosecuting Attorney, then made application to the Circuit Judge to see 
 why a peremptory mandamus should not issue compelling the Justice to 
 issue the warrant for the arrest of the offender. The hearing was held 
 before Judge Joseph H. Steere; of the eleventh judicial circuit, December 
 8, 1893, and the following is a copy of the finding: 
 
 Decision by Judge Joseph H. Steere. 
 
 State of Michigan.— In the Cibcuit Court fob the County of Chippewa. 
 
 n 
 
 John Hubst, Relator, 
 
 YS. 
 
 Mandamus. 
 
 Frank R. Wabneb, Respondent. | 
 
 J 
 
 Application for writ of mandamus to compel Frank R. Warner, a Justice of the Peace, to entertain 
 criminal complaint and to proceed with the trial of a case sought to be brought for violation of rules pro- 
 mulgated by the State Board of Health under the provisions of Act No. 47 of the Session Laws of 1893. 
 
 Statement of Issue. 
 
 In his application for a mandamus the petitioner sets forth that on November 28th, 1893, he, being the 
 Prosecuting Attorney of Chippewa county, formerly presented a criminal complaint, made under oath 
 and in writing, to the Respondent, who was a duly qualified Justice of the Peace of said county, and then 
 and there asked from him a warrant for the arrest of one Robert B. Finch, who was charged in said com- 
 plaint with violating certain rules and orders of the Michigan State Board of Health; 
 
 That the complaint was accompanied by an order from the Prosecuting Attorney for a warrant, and 
 that he then offered to produce other and further testimony to substantiate the complaint, having 
 witnesses in attendance for that purpose. 
 
 The petitioner further alleges that said justice thereupon refused to issue a warrant upon said complaint 
 for the arrest of said Robert B. Finch and persisted in so doing, and gave the following reasons for said 
 refusal. 
 
 1. “ Because Act No. 230 of the Session Laws of 1885, as amended by Act No. 47 of the Laws of 1893, of 
 the Legislature of this State, was unconstitutional and void.” 
 
 2. “ Because that even if said Act was not void, Rule No. 2 of the Board of Health of said State of Mich- 
 igan, under which this complaint was drawn, was not authorized by said Act and because the Board of 
 Health exceeded their authority in passing said rule No. 2, and that he did not wish to make this county 
 any unnecessary expense and cost.” 
 
 A copy of the complaint and order for a warrant are attached to and made a part of the petition. 
 
 The complaint is carefully drawn and properly states an offense under the Statute and rules, if they are 
 valid. 
 
 His return is, in substance, a demurrer. 
 
 In his answer filed in response to the order to show cause, he admits the facts stated in the petition, but 
 alleges, as the reasons why a mandamus should not issue, as follows: 
 
 “ That the Statute, Act No. 230 of the Laws of 1885, as amended by Act No. 47 of the Laws of 1893 of the 
 State of Michigan, under which the rules of the Board of Health of the State of Michigan are adopted, is 
 unconstitutional and void in that it delegates legislative authority to an appointive board and assumes to 
 give said board the power to enact rules, a violation of which, when framed and published (though the 
 manner of publication is not prescribed) is made an offense punishable by a fine and imprisonment, and 
 to give to said Board the further power to change, suspend, revoke and re-enact said rules whenever cer- 
 tain conditions are shown to the satisfaction of said Board to exist, though the manner in which the 
 existence of such conditions is to be shown is not pointed out.” 
 
 The respondent further alleges that, “ even if said Statute is constitutional and valid, Rule No. 2 of the 
 said Board of Health, a copy of which is made a part of this answer, for a violation of which said com- 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 plaint was made and respondent is asked to issue a warrant, is void, for the reason that said rule is not 
 authorized by said Act No. 230 of the Laws of 1885 as amended by Act No. 47 of the Laws of 1893, nor by 
 any other statute of the State of Michigan, and that for these reasons this respondent should not be com- 
 pelled to issue a warrant for the arrest of the said Robert B. Finch upon said complaint.” 
 
 Upon this issue argument was had. 
 
 Opinion- 
 
 The Mandamus will be denied for the reason that the Statute under which these criminal proceedings 
 are sought to be brought is invalid in the particular that it seeks to delegate to a non-elective subordi- 
 nate board legislative powers to create a misdemeanor, and is in violation of Sections 1 and 38 of Article 
 4 of the Constitution of the State of Michigan. 
 
 Section 1 of said Article provides: “The legislative power is vested in a Senate and House of 
 Repre sen tat i ves . ” 
 
 Section 38 of said Article is as follows: “The Legislature may confer upon organized townships, 
 incorporated townships and villages and upon the Board of Supervisors of the several counties such 
 powers of a local, legislative, and administrative character as they may deem proper.” 
 
 The latter article is clearly a constitutional limitation defining the scope within which the Legis- 
 islature may delegate its legislative powers to subordinate bodies. The State Board of Health is not 
 enumerated among those bodies to which this power can be delegated, and, by implication of law, is 
 consequently excluded from those upon whom such power can be conferred. / 
 
 It seems clear that the Legislature cannot confer upon the State Board of Health any legislative 
 functions. The statute, to the extent that it assumes to do so, is certainly unconstitutional and void. 
 
 3 Mich., 343. 
 
 29 Mich., 460. 
 
 24 Mich., 108. 
 
 Cooley on Constitutional Limitations, p. 139, and cases cited. 
 
 On behalf of the petitioner, in support of the application for a mandamus, it is contended that the law 
 does not delegate, and cannot be construed as attempting to delegate any legislative power; that it only 
 authorizes the Board to make rules within certain well defined limits, giving it no discretion to declare 
 penalties, the penalty being fixed by the law itself. 
 
 Counsel cites to statutes clearly constitutional in which it is provided that an officer shall give notice 
 to do or not to do a certain thing, on failure to observe which notice a person shall be deemed guilty of 
 the misdemeanor, etc. Authority is also cited to the effect that it is not delegated power to be author- 
 ized to determine some fact or condition of things upon which the law makes its own operations depend. 
 
 Locke’s appeal, 72 Pa. St., 491. 
 
 It is also well reasoned that there are many things upon which wise legislation depends which cannot 
 be known to the law making power and must therefore be suggested afterward and determined subse- 
 quent to the enactment of the law. 
 
 This argument would be conclusive if the scheme of the statute in controversy went no further than to 
 authorize the Board to give notice to do or not to do certain things therein stated, or to determine cer- 
 tain facts or a certain state of facts set forth in the law, and upon which the law would become operative, 
 but it seems to us that the Legislature, in the statute in question, attempted to go much further. The 
 Board is first authorized to determine certain facts in their discretion relative to passengers and baggage 
 coming from infected districts. Then, having determined those facts, it is further authorized, as a dis- 
 cretionary matter, to formulate rules upon the subject, a violation of which rules, when formulated and 
 published, constitute a misdemeanor and put in operation the criminal laws of the State of Michigan. 
 
 Those rules may involve, and as formulated do involve, certain acts and conditions of things which are 
 not recited in the statute, a violation of which constitute a misdemeanor, but without which no offense 
 would exist. 
 
 We have no doubt of the authority of the legislature to authorize the Board to adopt rules essential to 
 the proper administration of the law, involving 6uch measures as may be necessary to enfore those rules, 
 such as the detention of a person or baggage, preventing their entry into the country, and perhaps seiz- 
 ure and forfeiture of property. But we don’t think that misdemeanors can be created and criminal pro- 
 secutions authorized by such indirect and delegated proceedings as those contemplated by the statute in 
 question. Such seems to be the view taken by the Supreme Court of California in the ex parte case of 
 John Cox on Habeas Corpus, 63 Cal., p. 21, and the case of the Board of Harbor Commissioners of the 
 Port of Eureka, Appellant, vs. The Excelsior Redwood Company, Respondent, 88 Cal., p. 491. 
 
 Our attention has been called to the matters discussed in the case of the Minneapolis, St. Paul and 
 Sault Ste. Marie Ry. Co. against the State Board of Health of Michigan, decided in the Circuit Court of 
 
ABSTRACT OP PROCEEDINGS, JANUARY 12, 1894. 
 
 5 
 
 the United States for the Western District of Michigan, northern division, decided by Judges Severens 
 and Sage. In that case the motion for a preliminary injunction was overruled, the question involved 
 being, mainly, the authority of the States to enact laws and provide rules relative to quarantine matters, 
 under Section 8 of Article 1 of the Constitution of the United States and certain treaties existing between 
 the United States and foreign countries. The issues decided are not raised in the case at bar, and the 
 question which we have before us, though referred to, was not decided in that opinion, the Court saying: 
 “ We do not deem it necessary to express an opinion whether the provision of the Michigan Statute 
 making it a misdemeanor to violate the rules of the State Board of Health adopted in pursuance of the 
 Act, is constitutional or valid, for we should not, even if we were of the opinion that it is unconstitutional, 
 undertake to issue an injunction against criminal prosecution by the State,” leaving the question before 
 us undetermined. 
 
 Our attention is called to the fact that the Federal quarantine laws contain provisions for the promul- 
 gation and enforcement of rules by proper officers, and that those rules have been long in existence and 
 enforced without question. 
 
 We recognize that these laws and rules, with the usage in their administration, are entitled to respect- 
 ful consideration, and might, in a doubtful case, in the absence of other authority, though not binding 
 in the interpretation of our State laws, practically control a decision. But, after a careful examination 
 of the laws to which our attention is called, being a pamphlet issued April 4, 1893, by the Treasury depart- 
 ment, entitled “ Laws and regulations for the Maritime Quarantines of the United States,” we fail to 
 there find any authority to resort to criminal procedure to enforce the quarantine rules , or anything in 
 the statutes making the violation of those rules a criminal offense. Violations of quarantine laws and 
 misconduct of its officers are made criminal offenses punishable by heavy penalties, but the rules are to 
 be enforced by other methods such as the exclusion of the parties who fail to observe them from entering 
 the country or importing property, or by the seizure and detention of a person or property for a limited 
 period, or the seizure and forfeiture of property, as for a violation of the revenue laws. 
 
 We fully recognize, with Counsel for petitioner, all that has been urged relative to the valuable services 
 which the Michigan State Board of Health has rendered the State, and the difficulties which beset it in 
 the performance of its duties. We cheerfully endorse all which has been 6aid as to the importance of 
 rigid quarantine laws to protect the health and lives of our citizens from the importation of infectious 
 diseases. But we know that the Courts universally recognize that the State, through its proper legisla- 
 tive body, has ample power to go to extremes in the enactment of rigid laws upon the subject, and to 
 provide heavy pennlties for their violation. This case simply involves a constitutional question as to 
 the method of getting the proper provisions upon that subject in legal shape for their enforcement. It 
 is our opinion that where it is sought to make a violation of any quarantine regulation a crime, the legis- 
 lature must, by its own enactment, clearly set forth the facts and conditions creating the offense in the 
 statute itself, and that it cannot leave the question open for subsequent action by another body, and del- 
 egate the authority to create a misdemeanor, as has been attempted in the statute in question. 
 
 For these reasons the mandamus is denied but, inasmuch as this is a friendly litigation, carried on by 
 all parties in interest in good faith for the purpose of obtaining a decision upon an important and 
 doubtful question, the decision is without costs. 
 
 Dated December 18, 1893. J. H. Steebe, 
 
 Circuit Judge. 
 
 SCARLET FEVER AT THE SCHOOL FOR THE DEAF, AT FLINT. 
 
 Secretary Baker presented and read a letter dated J anuary 11 which he 
 had received from Mr. F. D. Clarke the Superintendent of the Michigan 
 School for the Deaf, at Flint. Mr. Clarke said that although he had the 
 greatest confidence in the School’s physician and the city board of health 
 he would very much like to have the State Board of Health send an expert 
 to the institution to aid in prevendng the spread of this dangerous disease. 
 In accordance with Mr. Clarke’s request, the Board voted to send Doctor 
 John W. Hauxhurst of West Bay City, who had several times acted as 
 expert and had aided localities in Michigan in preventing the spread of 
 dangerous diseases. 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 PROPOSED ESTABLISHMENT OF A CHAIR OF SANITARY SCIENCE AT THE 
 STATE AGRICULTURAL COLLEGE. 
 
 In a circular letter December 2, the Secretary wrote to each member of 
 the State Board of Health that “ An opportunity has arisen on a subject 
 which I have long held in mind, — the establishment of a chair of hygiene at 
 the State Agricultural College, and I have acted promptly for myself, but 
 not having opportunity to consult members of this Board I am not certain 
 that they fully concur in both the recommendations in my memorial to the 
 State Board of Agriculture (for the creation of a chair, and for the appoint- 
 ment of Prof. Brewer) so I send a copy herewith, and ask you to inform 
 me as soon as practicable, so that the full influence of this Board can be 
 exerted so far as members of the Board direct, and no further.” As said 
 in the foregoing letter, there was an “ opportunity” in the fact that the 
 the services of a good man could be secured at that time; an opportunity 
 which had not presented itself before; and it was because of this oppor- 
 tunity that the Secretary took immediate action, thinking that if the right 
 man could be had, the probabilities of the establishment of a chair were 
 greater than they would be if the State Board of Health urged the estab- 
 lishment of the chair, but could not provide for a man to fill the same. Of 
 course the State Board was not urging that any individual be appointed, 
 but only that some good reliable Professor able to teach modern sanitary 
 science, be called to fill the chair. There were perhaps others who would 
 acceptably fill the chair, but the Secretary had not before had the oppor- 
 tunity to recommend the establishment of a professorship and at the same 
 time suggest one who could fill it. 
 
 The following is a copy of the memorial which had been prepared by the 
 Secretary, and sent to the members of this State Board. So far as it 
 related to the establishment of a chair of sanitary science, it received the 
 approval of a majority of the Board, before it was formally placed before 
 the State Board of Agriculture at their meeting, at Lansing, December 4, 
 1893. Following the memorial are letters which the Secretary received 
 from the members of the State Board of Health, and placed before the 
 Board of Agriculture. The memorial and letters are as follows: 
 
 MEMORIAL FOB THE ESTABLISHMENT OF A OHAIB OF HYGIENE AT THE MICHIGAN STATK AGRICULTURAL 
 
 COLLEGE. 
 
 STATE BOARD OF HEALTH, MICHIGAN, 'i 
 Office of the Secretary, > 
 
 Lansing , December 1 , 1893. ) 
 
 To the Honorable , the Michigan State Board of Agriculture : 
 
 Gentlemen— Permit me to memorialize your Honorable Board for the appointment of a Professor of 
 Hygiene at the State Agricultural College, and to suggest a few of the many reasons why at this one of 
 the most important colleges in Michigan, the teaching of Sanitary science should be prominent. 
 
 A large proportion of the graduates and students at the Agricultural College will occupy prominent 
 positions among the people of the State, being leading agriculturists, horticulturists, dairymen, lawyers, 
 teachers, physicians, and business men. As has been the fact in the past, many of them will be found in 
 the State Legislature, framing laws for the government of the whole people. It is for the general good 
 of the people of Michigan that these leaders of thought and action throughout the State shall be well 
 grounded in that sort of knowledge which is of most worth. I presume that all of you are familiar with 
 the result of that inquiry into the question— “ What knowledge is of most worth?” which was so ably 
 worked out by that great philosopher Herbert Spencer, in his book on “ Education.” He seems to have 
 demonstrated that that knowledge is of “ most worth ” “ which tends directly to preserve life;'” and that 
 next, in the scale of value, is that knowledge which tends indirectly to preserve life, leaving, as not even 
 of secondary importance, many of the branches of knowledge so frequently taught in our schools and 
 
ABSTRACT OF PROCEEDINGS, JANUARY 12, 1894. 
 
 7 
 
 colleges. Sanitary science includes both of these two classes of knowledge which have thus been dem- 
 onstrated to be of “ most worth ” and as of next most worth,— that class of knowledge which tends 
 directly to preserve life, and that class of knowledge which tends indirectly to preserve life. 
 
 It is understood that in order to preserve life one must have a means of earning a livelihood; but means 
 of subsistance have advanced so rapidly that for the immediate future all sorts of food products are 
 cheap and plentiful. 
 
 Sanitary science has made wonderful progress in recent years, so there is much more now than formerly 
 that is positively known, and which can be taught to students. There are now many well-developed 
 branches of sanitary science. We have, therefore, an abundant store of that “ knowledge which is of 
 most worth ” which is now available to the teacher of hygiene. That knowledge is gradually being dis- 
 seminated through the action of State Boards of Health. But it is not for the public interests that 
 the graduates and students of the State Agricultural College, who are to be among the leaders of 
 thought and action throughout the State, shall be merely on a level with the common, educated peo- 
 ple concerning these most important of all public questions— relative to the high interests of human health 
 and life. Fortunately, the Michigan State Agricultural College has among its professors one who has- 
 been a leader in sanitary progress— Prof. R. C. Kedzie has been president of the State Board of Health, 
 and president of the American Public Health Association, and much of value in a sanitary way is taught 
 by Professor Kedzie; but his work in this direction is necessarily narrowed by the requirements of his 
 duties as Professor of Chemistry. A similar remark applies to the work of Prof. F. S. Kedzie, who also 
 has given much attention to sanitary subjects. Prof. Grange has given attention to at least one branch 
 of sanitary science— bacteriology; but his duties as Professor of Veterinary science and practice necessa- 
 rily engross his attention. 
 
 Permit me to commend to you, as a Professor of Hygiene— Prof . F. W. Brewer, who for the past year 
 and a half has been Superintendent of the Bureau of Hygiene in the Department of Liberal Arts, at the 
 World’s Columbian Exposition, who previous to that time was for about a year employed at the experi- 
 ment station of the State University of Nebraska, and previous to that was an Assistant to Prof. Vaughan 
 at the Michigan University, he being a graduate of the Medical Department of the Michigan University. 
 A year or more ago, Prof. Brewer was an applicant for the position of bacteriologist at the Michigan Agri- 
 cultural College, and sent testimonials of his fitness for the position. I cannot claim personal knowledge 
 of his acquirements in bacteriology or in other branches of sanitary science, or of his qualities as a 
 teacher; but I can claim to know that he has been an earnest student with Prof. Vaughan at our Univer- 
 sity, that he has studied the Vital Statistics of Michigan, that he has been recommended by those with 
 whom he has been associated, and that his work in connection with the World’s Fair has brought him in 
 contact with the best lines of sanitary work being done throughout this country, and some of that being 
 done in other countries. If you employ him as a Professor of Hygiene and bacteriology, you will have 
 one who will, I believe, teach bacteriology not only with reference to the many important bearings upon 
 agriculture, but who will teach it also with reference to its numerous exceedingly important bearings 
 upon the life and health of humanity; one who will, I believe, teach hygiene not as it was before the 
 recent great progress, but as it has been enriched by the wonderful discoveries of Pasteur, Koch, Kitisato 
 and others. 
 
 I hand you herewith a letter which I have received from Professor Brewer, and a copy of a number of 
 commendatory letters relating to him. 
 
 Hoping that your Honorable Board will appoint some person to the important position of Professor of 
 Hygiene, and commending to you for that position Professor Brewer, I am, 
 
 Very respectfully, 
 
 Henry B. Baker. 
 
 MICHIGAN UNIVERSITY, 
 
 Office of Dean of the Medical Department, 
 
 Ann Arbor, Mich., December 2 , 1893. 
 
 Dr. Henry B. Baker, Lansing, Michigan : 
 
 Dear Doctor:— It will be impossible for me to come to Lansing next Monday. I should be glad to 
 to do so, and should also be glad to do anything in my power to aid in the establishment of a chair of 
 Hygiene at the Agricultural College, and I gladly join you in the recommendation of my old friend and 
 former student, Doctor Brewer, for a professorship in that college. Dr. Brewer was my assistant for 
 some three years, and I can say that he is conscientious and skillful in his work. The Agricultural Col- 
 lege can make no mistake in establishing a chair of Hygiene and in calling Dr. Brewer to occupy the 
 same. Yours truly, 
 
 Victor C. Vaughan. 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 STATE BOARD OF HEALTH, 
 Michigan, 
 
 Grand Rapids , Mich., Dec. 3, 1893. 
 
 Dear Doctor Baker:— I most heartily commend and second all you say regarding the importance of 
 the establishment of a chair of Sanitary Science in our Agricultural College. Indeed, I was surprised to 
 learn that heretofore there has been no special attention given to that subject there. In such an institu- 
 tion I think it would be much more important to have a chair in Sanitary or Hygienic Science than to 
 have a chair of Modern Languages. 
 
 As to the recommendation of a particular person to fill such chair, it may be deemed inadvisable for 
 our board to take any action, although personally I would be willing to sanction the choice of yourself, 
 or Dr. Vaughan. Very respectfully, 
 
 S. G. Milner. 
 
 STATE BOARD OF HEALTH, \ 
 Michigan, > 
 
 Lansing , December 4, 1893. ) 
 
 Dr. H. B. Baker, Sec'y State Board of Health: 
 
 Dear Sir:— I am in hearty sympathy with the views expressed by you, relative to the importance of 
 establishing a chair of Hygiene at the State Agricultural College as embodied in your communication to 
 the State Board of Agriculture under date of Dec. 1. The knowledge gained during the last twenty years 
 concerning the causes of all communicable diseases and the means for their prevention is second to no 
 other knowledge of this marvelous age, in its influence upon human life, human health and human happi- 
 ness. Such being the case it would seem that little argument should be necessary to convince any 
 thinking person that this knowledge should be given the greatest possible publicity. The most practical 
 means to this end would certainly seem to be the employment of teachers thoroughly equipped for the 
 work in all our institutions of learning. While its rudiments should be and I doubt not soon will be 
 taught in the lower grades of these institutions, our common schools, yet it is in the higher, which have to 
 do with youth who are about to take up the duties of citizenship where it must prove of the greatest value. 
 The Michigan Agricultural College is second to none in this country for keeping abreast of the scientific 
 investigations of our day and of impressing them upon the minds of its graduates. It is greatly to be 
 hoped that the new and valuable facts concerning human life and health which form so important a sec- 
 tion of these investigations may be incorporated into its curriculum. I cannot doubt but that such a step 
 will greatly increase its efficiency and add to its already noble reputation. 
 
 Very truly yours, 
 
 Frank Wells, 
 
 President Mich. State Board of Health. 
 
 STATE BOARD OF HEALTH, 
 Michigan, 
 
 Pontiac, December 5, 1893. 
 
 Dr. Henry B. Baker, Secretary of the State Board of Health : 
 
 My Dear Doctor: - Your letter of the 2nd inst. relative to the establishment of a chair of hygiene at the 
 Agricultural College and the appointment of Prof. Brewer to the chair, was received yesterday, but, 
 owing to an unusual amount of work, was not read until this evening. Of course this reply will probably 
 not reach you as soon as you hoped it would, but I wish to say that I heartily concur in everything you 
 say in your memorial to the Board of Agriculture. Though I know Prof. Brewer only by reputation, I 
 believe him fully qualified for the important place. Very truly yours, 
 
 Mason W. Gray. 
 
 STATE BOARD OF HEALTH, 
 Michigan, 
 
 Albion, December 4, 1893. 
 
 Dear Dr. Baker:— Your letter of yesterday, concerning the establishment of a chair of sanitary science 
 at the Agricultural College, is at hand. It seems to me that the influence of the Board should be used to 
 the fullest extent whenever it could bring about such a result, not alone in this case but in all others. 
 The time should come when there should be no institution of any grade that did not give particular atten- 
 tion to this most important subject. 
 
 As to the Board’s recommending a special candidate, I am not so clear ; you can do it personally, and I 
 
ABSTRACT OF PROCEEDINGS, JANUARY 12, 1894. 
 
 9 
 
 could do the same, but we should, I fear, bring criticism on us if we combine in any particular person’s 
 interest. I do not know Prof. Brewer, but you do, and you could consistently work for his appointment. 
 
 Yours very respectfully, 
 
 Delos Fall. 
 
 SANITARY SCIENCE SHOULD BE TAUGHT IN MICHIGAN LITERARY COLLEGES. 
 
 The subject of a Chair of Sanitary Science at the State Normal School, 
 and at the State Agricultural College, was presented by Doctor Baker. He 
 mentioned that the State Board of Agriculture had already been memo- 
 rialized by the president and other members of this Board and himself, to 
 establish a chair of hygiene; but he thought the Board as a whole should 
 continue to exert its influence. He argued that the State law compelled 
 the common schools of Michigan to devote time to the teaching of hygiene, 
 but that there was not much provision for the proper education of those 
 teachers who are compelled to teach hygiene. The State Normal School 
 is devoted to the training and education of teachers, and the State Agri- 
 cultural College has its vacation in the winter, in order that its students 
 may teach, yet neither of these institutions has a chair of Sanitary 
 Science. The State Board of Health had already put forth its efforts for 
 such a chair at the Michigan University, and a Laboratory of Hygiene had 
 been established and is now doing great good. Dr. Baker thought that 
 the youngest pupil in our schools should have an idea of how the most 
 dangerous communicable diseases are spread, and that it would be just as 
 practicable to teach them the restrictive measures, as it is to teach them 
 all about the bones, muscles, and nerves, as is now attempted. Each pupil 
 should know also just what disease causes most deaths in Michigan, and 
 just how it may be prevented or avoided. But how are these pupils to be 
 taught such subjects, when there is practically no adequate provision for 
 the education of the teachers? 
 
 Dr. Baker said: The work of the State Board of Health is, to a great 
 extent, educational; and it is effective when brought to bear upon the 
 neighbors of a residence placarded for a dangerous disease. Eventually 
 every part of the State is thus reached by its instructions, at such times of 
 especial danger. But this is a slow process; and, although in the twenty 
 years of the work of the State Board of Health the death-rate from scarlet 
 fever has been reduced at least one-half, yet the statistics prove that in 
 those localities in which the teachings of the State Board have been wholly 
 complied with by the people, the death-rate has been not more than one- 
 sixth what it was where this has not been done. This implies that if this 
 teaching could, in some way, be made to reach every locality in the State, 
 the death-rate should be reduced by five-sixths instead of by one-half. 
 What is needed for the greater saving of life from scarlet fever, and from the 
 other dangerous diseases, — because the same principle applies to them, is 
 the proper education of all the young people of the State. The State laws 
 require that Hygiene shall be taught in all the schools. But how is it 
 taught? How can it be properly taught so long as there are no text-books 
 which teach sanitary science as it is taught by the State Board of Health, 
 and so long as the teachers themselves are not properly prepared? How 
 can the teacher be properly prepared? 
 
 It seems plain that in order that the teachers shall be properly prepared, 
 their places of preparation must be such as will make this possible. Many 
 of the teachers are trained for their work at the State Normal School. J. E. 
 
 2 
 
10 
 
 MICHIGAN STATE BOARD OP HEALTH. 
 
 Hammond, Deputy Supt. of Public Instruction, says: “ In all two thou- 
 sand two hundrend students have graduated from the school, besides many 
 others who, not having completed the course, are numbered among the 
 progressive teachers of the State. Michigan is justly proud of the work 
 of this great institution, and its influence is felt in almost every village 
 and city through the entire State.’ 5 * 
 
 The State Agricultural College also is a school which supplies quite a 
 number of teachers, the college vacation being in the winter for the espec- 
 ial purpose of permitting the students to teach. 
 
 Prof. Fall said he was very glad to say that Albion College was teaching 
 Sanitary Science. A large class of the best students in the college have 
 this course of training. 
 
 On motion of Prof. Fall, the Board voted that a committee of three be 
 appointed by the President to memorialize the State Board of Education 
 to establish a Chair of Sanitary Science at the State Normal School. Prof. 
 Fall, of Albion, Dr. Baker, and Dr. Milner, of Grand Rapids were appointed 
 to act as this committee. 
 
 On motion of Dr. Baker, it was voted that Dr. Gray of Pontiac act as 
 chairman of a committee to memorialize the State Board of Agriculture to 
 establish a Chair of Sanitary Science at the State Agricultural College. It 
 was also voted that President Wells and Prof. Vaughan of the University 
 be the other members of this committee. 
 
 BURNING OF PEOPLE IN RAILWAY WRECKS MIGHT BE PREVENTED. 
 
 During this quarter, (Nov. 15, 1893), the State Commissioner of Rail- 
 roads referred to the Secretary of the State Board of Health a letter which 
 he had received from John S. Lorimer, General Storekeeper of the Chi- 
 cago and Grand Trunk Railway, relative to the subject of hand fire extin- 
 guishers on railroad coaches, to be used in case of wrecks, to prevent the 
 burning of railway coaches loaded with human beings, as occurred recently 
 in the fearful accidents at Jackson and Battle Creek where many lives 
 were lost, and others received injuries that would last them through their 
 lives. 
 
 With the letter of Mr. Lorimer, the Commissioner of Railroads gave to 
 the Secretary of the State Board of Health, a circular which had been 
 sent out from the Commissioner’s Office in which was urged upon General 
 Managers and Superintendents of Railroads the importance of taking 
 every precaution in preventing the further occurrence of accidents on 
 railroads and the burning alive of the human beings intrusted to the 
 railroads for safe transportation. The Commissioner urgently recom- 
 mended the placing of hand fire extinguishers in all railroad coaches 
 within easy reach and most convenient for use, the use of oil which would 
 stand the burning test of 300 degrees or more, as provided by the statutes 
 of Michigan, and the use of the safest known pattern of car heaters. 
 
 After carefully reviewing the subject, the Secretary of the State Board 
 of Health made a report to the Hon. S. R. Billings, State Commissioner 
 of Railroads, of which the following is a copy: 
 
 “Relative to the question asked of you by John S. Lorimer, General 
 Storekeeper of the Chicago and Grand Trunk Railway, in his letter of 
 Nov. 14, referred to me yesterday, I can report that the State Board of 
 
 “ Michigan and Its Resources,” “ 1893,” page 137. 
 
ABSTRACT OF PROCEEDINGS, JANUARY 12, 1»94. 
 
 11 
 
 Health has not recently considered the exact subject of hand fire extin- 
 guishers for use on passenger trains; but some years ago the general 
 subject of ‘The Conditions of Inflammability’ was very thoroughly 
 investigated and reported upon by Prof. E. C. Kedzie, then a member of 
 this Board, and I take pleasure in placing that report before you, because 
 it will, I think, be found valuable for its suggestiveness in relation to the 
 subject of the prevention of fires on wrecked passenger trains; because it 
 is probable that if the cars, interior fittings and contents, could be made 
 incombustible, or even incapable of burning with a flame, a great part of 
 the danger from fire, would be done away with. That this can be done so 
 far as relates to the cars and fittings, at an expense which would be justi- 
 fiable, I have no doubt. The report to which I refer is published in the 
 Annual Eeport of this Board for the year 1880. I refer especially to 
 pages 180-183. 
 
 “ The substances which can be applied to wood, cloth, paper, etc., and 
 thus render such substances incapable of burning with a flame, are com- 
 mon, not expensive, and are numerous, so that no difficulty should be 
 found in selecting those which will not interfere with the ornamentation 
 of the car or its fittings. 
 
 “ In complying with your important suggestion that ‘All railroad com- 
 panies doing passenger business in this State, — provide all eoaches, baggage, 
 express, and mail cars with the best known appliances adapted for hand 
 use, to extinguish fire; such fire extinguishers to be placed within easy 
 reach, and most convenient for use,’ some of the principles set forth in 
 Prof. Kedzie’s report should be useful to the storekeepers for the several 
 railroads. In that report a number of solutions are mentioned which 
 when applied to wood- work, cloth, paper, etc., render such articles not 
 easily inflammable. Solutions to be kept in the so-called ‘ hand grenades,’ 
 for extinguishing fire, must, I suppose, be of such strength that they will 
 not freeze and thus break the glass or other container; but I think this 
 is easily accomplished. A saturated solution of common salt would not 
 freeze, and would be a useful article in such ‘hand grenades.’ But it is 
 possible that there are substances much more useful than that. (Many a 
 soot fire in a chimney has been extinguished with a few handfulls of com- 
 mon salt.) By having two kinds of grenades kept for use together, each 
 to break into the other, one containing a solution of a bicarbonate, and 
 the other a solution of an acid sulphate, carbonic acid gas could be liber- 
 ated as is done in the chemical fire engines, on a principle similar to that 
 of the ‘ Babcock Fire Extinguisher.’ 
 
 “ If desired, I have no doubt this Board would have a special investi- 
 gation made to ascertain what methods would be most feasible, or at least 
 what scientific principles are available. If you wish, I will submit the 
 subject to the Board at its next meeting. 
 
 “ Herewith I send you a copy of the Eeport of this Board for 1880, 
 containing the article by Prof. Kedzie, which I have mentioned. 
 
 “ Very respectfully, 
 
 “ Henry B. Baker, 
 
 “ Secretary .” 
 
MICHIGAN STATE BOARD OF HEALTH. 
 
 12 
 
 The Secretary reported that he had mailed to each member of the Board 
 a copy of the revised list of committees, which is as follows : 
 
 STANDING COMMITTEES OF MICHIGAN STATE BOARD OF HEALTH. 
 
 Committees as re-arranged and adopted by the Board, Sept. 30, 1893. Members appointed by President- 
 Frank Wells, October, 1893. 
 
 1. Epidemic, endemic and communicable diseases.— Victor C. Vaughan, M. D. 
 
 2. Sewerage, and the disposal of excreta.— Mason W. Gray, M. D. 
 
 3. Water supply, including purification of sewage— contaminated water.— Prof. Delos Fall, M. S. 
 
 4. Buildings, including house drainage, ventilation, heating, etc.— Samuel G. Milner, M. D. 
 
 5. Climate, geology, topography, and drainage.— Henry B. Baker, M. D. 
 
 6. Food, drinks and their adulterations.— Victor C. Vaughan, M. D. 
 
 7. Poisons, explosives, etc. — Prof. Delos Fall, M. S. 
 
 8. School hygiene and sanitation.— Samuel G. Milner, M. D. 
 
 9. Sanitary inspections in cities and villages.— Prof. Delos Fall, M. S. 
 
 10. Statistics of mortality and sickness.— Henry B. Baker, M. D. 
 
 11. Public-health legislation.— George H. Granger, M. D. 
 
 12. Finances of the Board.— Hon. Frank Wells. 
 
 13. Animals’ diseases dangerous to man.— Mason W. Gray, M. D. 
 
 14. Relations of preventable sickness to taxation.— George H. Granger, M. D. 
 
 15. Quarantine at the Michigan border and within the State.— Hon. Frank Wells. 
 
 SECRETARY’S REPORT OF WORK DONE IN THE OFFICE OF THE STATE BOARD OF 
 HEALTH, DURING THE QUARTER ENDING WITH DECEMBER, 1893. 
 
 Communicable Diseases. 
 
 * 
 
 The number of reports of outbreaks of dangerous communicable dis- 
 eases in Michigan, received from all sources and filed, and the corre- 
 sponding number concerning which action was taken by this office during 
 the quarter, are as follows: for diphtheria, 115; for scarlet fever, 147; for 
 typhoid and typho-malarial fever, 139; for measles, 18. Total for the four 
 (or five?) diseases, 419. 
 
 The number of communications relative to dangerous communicable 
 diseases, received and placed on file during the quarter, was 1,913. 
 
 Relative to dangerous communicable diseases, letters, written cards, and 
 demands for weekly and final reports, on cards, or in the form of the cir- 
 cular letter, were sent out during the quarter to the number of 1,583. 
 
 The “final” reports of outbreaks received and filed during the quarter, 
 were: for diphtheria, 84; scarlet fever, 106; typhoid and typho-malarial 
 fever, 120; measles, 11. Total for the five diseases, 321. 
 
 During the quarter, the local columns of newspapers to the number of 
 927, have been looked over for reports of occurrence of communicable 
 diseases. This has resulted in giving this office information of the alleged 
 occurrence of 10 outbreaks of diphtheria, 11 outbreaks of scarlet fever, 31 
 outbreaks of typhoid and typho-malarial fever, and no outbreak of measles. 
 To what extent the reports of these alleged outbreaks were verified, is- 
 shown in the accompanying table: 
 
ABSTRACT OF PROCEEDINGS, JANUARY 12, 1894. 
 
 13 
 
 TABLE 1 .— Showing the number of Outbreaks of Diphtheria, Scarlet fever, Typhoid 
 fever and Measles, from Oct. 1 to Dec. 31, 1893, of which notice was received at the 
 office of the Michigan State Board of Health; the per cent of reports, information 
 concerning which was received through the Newspapers ; the per cent of newspaper 
 reports which were confirmed bt/ the health officer: the per cent of newspaper reports 
 which were denied by the health officer; and the per cent relative to which no 
 reply was received from the health officer. 
 
 Diseases. 
 
 Reports from 
 nil sources, 
 Oct. 1 to Dec. 
 31, 1893. 
 
 Per cent of 
 all reports 
 which were 
 obtained from 
 the 
 
 newspapers. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were confirmed 
 by the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were denied by 
 the health 
 officer. 
 
 Per cent of 
 newst aper re- 
 ports to which 
 the health 
 officer made 
 no reply 
 to notice sent 
 from this 
 office. 
 
 Diphtheria 
 
 115 
 
 9 
 
 30 
 
 50 
 
 20 
 
 Scarlet fever 
 
 147 
 
 7 
 
 45 
 
 18 
 
 36 
 
 Typhoid fever 
 
 139 
 
 22 
 
 29 
 
 42 
 
 29 
 
 Measles 
 
 18 
 
 0 
 
 1 
 
 0 
 
 0 
 
 0 
 
 Averages for the four diseases . . 
 
 
 12 
 
 38 
 
 38 
 
 29 
 
 No small-pox has occurred in Michigan during the quarter. 
 
 Small-pox now or recently in other States and Provinces. 
 
 In accordance with action of the National Conference of State and 
 Provincial Boards of Health at Toronto, 1886, and Washington, 1887, 
 “Inter-State Notifications of Dangerous Communicable Diseases” have 
 been received, and the following facts learned relative to small-pox in 
 other States and Provinces:— 
 
 State. 
 
 Date of last notice 
 
 Cases. 
 
 Deaths. 
 
 Ohio _ 
 
 October 24, 1893 
 
 5 
 
 
 Minnesota 
 
 November 6, “ . 
 
 1 
 
 
 Tennessee 
 
 “ 9, “ ... 
 
 1 
 
 
 West Virginia 
 
 “ 15, “ 
 
 1 
 
 
 Illinois.. 
 
 Indiana .. 
 
 “ 25, “ 
 
 December 12, “ 
 
 158 
 
 21 
 
 Maine 
 
 “ 13, “ 
 
 1 
 
 Louisiana 
 
 “ 30, “ 
 
 1 
 
 
 Connecticut 
 
 January 4, 1894 
 
 6 
 
 
 Massachusetts .. 
 
 “ 9, “ 
 
 47 
 
 4 
 
 Pennsylvania 
 
 “ 11, “ 
 
 *710 
 
 *18 
 
 Prov. Ontario 
 
 “ 11, “ 
 
 5 
 
 
 
 
 * These cases and deaths are in the city of Beading, Berks Co. Cases are also reported in Berks Co. at 
 Fnztown, West Leesport and Gibraltar, and at Friedensburg, Schuylkill Co. At Mechanicsburg, Cum- 
 berland Co., ten cases and one death. One case at Carlisle, Cumberland Co., and two at Willow Grove, 
 Allegheny Co. 
 
 3 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Summary Relative to the Year , 1893 . 
 
 Duriug the year 1893, this office took action upon 1,881 outbreaks of 
 dangerous communicable diseases, which number includes 540 outbreaks 
 of diphtheria, 674 outbreaks of scarlet fever, 394 outbreaks of typhoid 
 and typo-malarial fever, 271 outbreaks of measles, and 2 outbreaks of 
 small-pox. 
 
 Relative to dangerous communicable diseases, letters, written cards, etc., 
 were sent out during the year to the number of 6,705. The number of 
 communications relative to such diseases, which were received and placed 
 on file during the year was 7,365. 
 
 A record is kept of facts concerning every outbreak of a “ disease dan- 
 gerous to the public health,” upon which action is taken by this office, 
 and also of every communication relating thereto received or sent out. 
 This required over 14,000 entries to be made in the “ Record Books,” one 
 of which books is kept for each dangerous communicable disease. 
 
 During the year 1893 compared with the year 1892, action was taken on 
 outbreaks of dangerous commuicable diseases as follows: On diphtheria, 
 44 outbreaks more; scarlet fever, 18 outbreaks more; on typhoid and typho- 
 malarial fever, 10 outbreaks more; measles, 136 outbreaks more; and small- 
 pox, the same number as in 1892. In all 208 outbreaks more were acted 
 upon in 1893 than in 1892. 
 
 (The number of outbreaks acted upon in 1893 was almost the same as 
 in 1891. The number in 1891 was 1,879, in 1893 it was 1,881. )' 
 
 TABLE 2 . — Showing the number of Outbreaks of Diphtheria, Scarlet Fever, Typhoid 
 fever and Measles, from January 1 to December 31 , 1893, of which notice was 
 received at the office of the Michigan State Board of Health ; the per cent of 
 reports , information concerning which was received through the Newspapers; the 
 per cent of newspaper reports which were confirmed by the health officer; the per 
 cent of newspaper reports which were denied by the health officer, and the per cent 
 relative to which no reply was received from the health officer. 
 
 DISEASES. 
 
 Reports from 
 all sources. 
 Jan 1-Dec. 
 31, 1893. 
 
 Per cent of all 
 reports which 
 were obtained 
 from the news- 
 papers. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were confirmed 
 by the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were denied 
 by the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports to which 
 the health offi- 
 cer made no 
 reply to notice 
 sent from this 
 office. 
 
 Diphtheria 
 
 *540 
 
 11 
 
 28 
 
 38 
 
 39 
 
 Scarlet fever 
 
 *674 
 
 9 
 
 45 
 
 19 
 
 35 
 
 Typhoid fever 
 
 *394 
 
 18 
 
 80 
 
 41 
 
 30 
 
 Measles 
 
 *271 
 
 10 
 
 22 
 
 8 
 
 70 
 
 Averages for the four Diseases 
 
 
 12 
 
 33 
 
 30 
 
 38 
 
 * The numbers of outbreaks given in this table do not necessarily agree with the numbers given in tables 
 in another part of the volume inclnding the Annual Report, for the reason that all alleged outbreaks, of 
 which information was obtained from the newspapers and other sources are included in this table. If 
 the health officers denied that such outbreaks occurred, or if they make no response to the letters 
 sent from this office, relative to newspaper reports, such alleged outbreaks are not included in the com- 
 pilation of that disease. 
 
ABSTRACT OP PROCEEDINGS, JANUARY 12, 1894. 
 
 15 
 
 During the year, the local columns of newspapers to the number of 
 3,441 have been looked over for' reports of the occurrence of dangerous 
 communicable diseases. This has resulted in giving this office informa- 
 tion of the alleged occurrence of 61 outbreaks of diphtheria, 62 outbreaks 
 of scarlet fever, 71 outbreaks of typhoid and typho-malarial fever, and 
 27 outbreaks of measles. To what extent the reports of these alleged 
 outbreaks of the five diseases were verified during the year, is shown in 
 the accompanying table. 
 
 Small-pox in Michigan in 1893. 
 
 Ten cases of, and three deaths from small-pox, were reported to this 
 office during the year 1893. There were two outbreaks of the disease, both 
 during the month of January; one occurred in the township of Springport, 
 Jackson county, which was confined to the first case; the patient was 
 exposed to the disease at Akron, Ohio, where the disease prevailed to a 
 considerable extent during December, 1892, and January, 1893. The 
 second outbreak occurred in Pittsfield township, Washtenaw county, dur- 
 ing which 9 cases and 3 deaths occurred. The contagium of the disease 
 was brought into that locality by a family of German immigrants, named 
 “ Jagar,” which “ came to this country on the steamer ‘ Saale,’ about Dec. 
 1, 1892.” It is alleged that small-pox “ broke out on the vessel and the 
 infected passengers were allowed to scatter all over the country.” (Quota- 
 tions from a letter, dated March 4, 1893, to Gov. Rich, from the health 
 officer of Pittsfield township.) 
 
 There is good reason to believe that infected persons from the same 
 vessel were responsible for the outbreak of small-pox at Akron, Ohio, in 
 which 41 cases and 9 deaths had already occurred Jan. 31, 1893, and 
 from which place the infection was carried to Springport township, Jackson 
 county, Mich., and caused the outbreak referred to above. 
 
 Two cases in and near to Cincinnati, Ohio, occurred in January, 1893. 
 Relative to these cases, Dr. Probst, the Secretary of the Ohio State Board 
 of Health, says: “ Cincinnati and Norwood cases are German immigrants, 
 arrived on ship ‘ Saale,’ via New York.” 
 
 Alleged Hydrophobia in Michigan in 1893. 
 
 Two deaths from alleged hydrophobia occurred during the year, 1893. 
 One, a young lady residing in the village of Deerfield, Lenawee county, 
 was taken ill June 24, and died June 26, 1893. Dr. Bliss, the village 
 health officer, wrote that the lady “ was bitten by a rabid dog, about the 
 middle of April.” In reply to an inquiry from this office relative to what 
 disposition was made of the dog, the health officer says: “ So far as regards 
 the dog that bit Miss Burnham, nothing is known. He has not been seen 
 or heard from since the day that he bit her.” 
 
 The second death from alleged hydrophobia occurred in Olive township, 
 Clinton county, on the 16th day of Aug. 1893. Dr. Wiggins of St. Johns, 
 who was the attending physician, says: “ I treated Mr. H. about two weeks 
 just before and up to his death. Up to the second week I was unable to 
 make a diagnosis satisfactory to myself. I was then told that in March 
 last he was bitten on his right hand (index finger) by a young hog, while 
 trying to give it medicine. The animal died soon after, of what was 
 thought to be hog cholera. There was no suspicion of rabies attached to 
 
16 
 
 MICHIGAN STATE BOARD OP HEALTH. 
 
 the hog, nor was it known that it had ever been bitten by any other 
 animal. Before this case, I had treated three other cases of hydrophobia. 
 One person was bitten by a skunk, another by a dog while trying to part 
 two dogs in a fight, and the third, a child, bitten by a kitten. The 
 first patient made the peculiar squall of a skunk; the second barked, and 
 the child would mew like a kitten, and Mr. Huntoon grunted and snorted 
 like a hog. His was a pronounced and well marked case of violent hydro- 
 phobia. Another proof of this fact was his great aversion to the use of 
 water, or the presence of it, and further, he at no time lost the control of 
 his mental faculties. When he felt his paroxysms approaching, he would 
 request that he be tied or confined, saying, he feared he might hurt those 
 around him. 
 
 “Mr. Huntoon was about 56 years of age, of good constitution and health, 
 up to about three weeks before his death.” 
 
 Alleged Cholera in Michigan in 1893. 
 
 Aug. 3, 1893, an “outbreak report” relative to “a case of supposed 
 cholera” was received from the clerk of Calvin township, Cass county. A 
 letter was sent at once to the health officer, requesting that precautionary 
 measures be taken to restrict the spread of the disease, and asking that, if 
 the disease was really Asiatic cholera, the facts be telegraphed to this 
 office without delay. 
 
 A letter of similar import was sent to the clerk of the township, asking 
 whether the patient was an immigrant, and if so, where he came from 
 and by what ship, and when he arrived in this country. Also asking for 
 the name and address of the attending physician. A prompt reply was 
 asked for. 
 
 Pamphlets on the restriction and prevention of cholera were sent to the 
 health officer and clerk, for their own instruction and for distribution. 
 
 After some delay on the part of the health officer and clerk, it was 
 learned that the name of the attending physician was John A. Harris, 
 postoffice, Day, Mich. A letter was at once sent to the physician request- 
 ing a description of the symptoms of the disease, and asking if any exam- 
 ination had been made after death, to learn the true nature of the disease. 
 No response was received to that request. 
 
 The patient was reported to have died within twenty-four hours after 
 first attack. He came from South Bend, Indiana, two days before being 
 taken sick. He was not an immigrant, and it could not be learned that he 
 had been exposed to cholera. 
 
 Relative to precautions taken to prevent the spread of the disease, the 
 health officer reported that the burial was “private,” that “those that 
 were at the house, were kept there, those that had gone home, were quaran- 
 tined at their homes.” That all of the rooms in the house and the privy 
 were disinfected with the fumes of burning sulphur, five pounds having 
 been used for the purpose. He reported that the discharges of the patient 
 were disinfected with chloride of lime and then buried. 
 
 Compiling , Editing , Proof-reading , Printing , etc. 
 
 A compilation of the reports from health officers and clerks has been 
 made, the compilation proved, and the article relative to Scarlet Fever in 
 Michigan in 1891 has been commenced; the compilation of reports from 
 
ABSTRACT OF PROCEEDINGS, JANUARY 12, 1894. 
 
 17 
 
 health officers and clerks relating to Typhoid Fever in Michigan in 1891, 
 has been commenced; the work in connection with proving and writing the 
 article relative to Measles in Michigan in 1890 has been completed; the 
 compilation relative to Diphtheria in Michigan in 1891 has been made and 
 about half proved. 
 
 Articles relative to Typhoid Fever, Whooping-cough, Consumption, Glan- 
 ders, Hydrophobia, Anthrax, Lump-jaw, Tyrotoxicon, Injuries, and Loss 
 of Life and Property in Michigan from the use of Kerosene, Gasoline and 
 Naphtha, and Alleged Nuisances in Michigan, for the Annual Report of the 
 State Board of Health for the year 1891, have b°en written, proof has been 
 read in this Office, and the articles have been printed. 
 
 Proof has been read on the Proceedings of the Sanitary Conventions 
 held under the auspices of this Board at Stanton and at Hillsdale. 
 
 The printing of the Annual Report of the Secretary of the State Board 
 of Health for the fiscal year ending June 30, 1891, has been nearly com- 
 pleted. The indexing of this Report is nearly completed. 
 
 A statement of the Cases and Deaths from Diphtheria, Scarlet Fever, 
 Typhoid Fever, Measles, and Whooping-cough in Michigan in 1892, has 
 been made from the annual report blanks from health officers and clerks 
 of townships, cities and villages in Michigan. 
 
 Distribution of Publications , etc. 
 
 The Proceedings of the Sanitary Convention held at Stanton has been 
 sent to the Officers and participants of the Convention, Members and Ex- 
 Members of this Board, Secretaries of State Boards of Health and of State 
 Medical Societies of other States, Sanitarians of this and other States, and 
 other persons interested in Sanitary work, to the number of about 1,100 
 copies. At the same time the Resolution of this Board relative to Con- 
 sumption being a “ Disease dangerous to the Public Health,” was also 
 sent to the foregoing-named persons, and has been widely distributed else- 
 where to the number of about three thousand copies. 
 
 During the quarter 1,571 envelopes were directed to health officers of 
 townships, cities and villages, and about the same number (1,570) of 
 envelopes were directed to clerks of townships, cities and villages. These 
 envelopes are to be used in sending to each clerk and health officer in 
 Michigan blank forms for making annual reports of “ Diseases dangerous 
 to the Public Health” during the year 1893. Each health officer and each 
 clerk also receives, with each set of blanks, a circular letter giving instruc- 
 tions for making out the annual reports, etc. Although the blanks were 
 printed, the envelopes addressed and filled with the annual report blanks 
 and letter of instruction, there was time only to send the supplies to 363 
 health officers and 362 clerks of cities and villages. The supplies to health 
 officers and clerks of townships will be sent immediately after Jan. 1, 1894. 
 
 About the usual number of pamphlets relating to the restriction and 
 prevention of the different dangerous communicable diseases, were dis- 
 tributed to health officers of localities where dangerous diseases were 
 reported. It was requested at the same- time that these pamphlets be dis- 
 tributed to the neighbors of the persons sick with such dangerous disease. 
 
 Correspondence , Hektograph work , etc. 
 
 During the quarter, 1,061 pages of letter-book have been used in copy- 
 ing the correspondence of the Office, not including many postal cards and 
 circulars which were sent out but not copied in the letter-book. 
 
18 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 About 1,728 pages of hektograph work have been made, of which 150 
 pages were relative to the special meeting of the Board October 27 and 28, 
 1893; 270 pages were relative to the Dangerous Location of Consumptives, 
 as reported to this office by Dr. Myron Briggs, health officer of Speaker 
 Township, Sanilac county, and 200 pages were relative to the opinion of 
 Judge Steere, in the case of Hurst vs. Warner. The hecktograph work is 
 slightly less than the preceding quarter, owing to the change in the man- 
 ner of sending out immigrant notices, which are now mostly sent on blank 
 forms for that purpose. 
 
 Work on Meteorology . 
 
 The regular tri-daily meteorological observations have been continued 
 at this Station, and a summary for each week and month during the 
 quarter has been made for use in this office, in connection with sickness 
 reports. The monthly summary has been sent, at the end of each month, 
 to the Director of the Michigan Weather Service and Local Forecast 
 Official at Detroit, for his use, and is then sent by him to the Chief of 
 the U. S. Weather Bureau, at Washington, D. C. 
 
 On December 16, 1893, meteoroligical blank registers, envelopes, postal 
 cards, ozone-test paper, etc., were sent to meteorological observers for the 
 State Board of Health, for their use during the year 1894. 
 
 Diagrams for the Annual Report for the year 1892, were made as fol- 
 lows: Nos. xvi., x., v., xii., xiv., xv., illustrating some of the principal 
 meteorological conditions in Michigan for the year 1891; Nos. 1, 2, 3, 4 
 and 5 to be used in the article “Time of Greatest Prevalence of Each 
 Disease in Michigan, in 189 1 ;” and a Diagrammatic “ Map showing location 
 and order of occurrence of Sanitary Conventions held in Michigan.” This 
 last-named diagram or map accompanies Prof. Fall’s paper on “ Sanitary 
 Conventions in Michigan,” which was read before the National Conference 
 of State and Provincial Boards of Health, at Lansing, June 6, 1892. A 
 diagram showing the “ Reported Deaths from Measles in Michigan during 
 each year 1868-91 ” was also made and has been printed in connection 
 with the article relative to measles in the Annual Report for 1891. 
 
 Accessions to the Library , etc. 
 
 During the quarter, 84 books and pamphlets and 309 numbers of journ- 
 als (weeklies, monthlies and quarterlies), have been received and entered 
 in the library of this Board. The work on the card-catalogue of the 
 books and pamphlets has been continued. 
 
 Work in connection with Sickness Statistics. 
 
 During the fourth quarter of 1893, 1,725 blank postal report cards, 126 
 record books and 34 hektographed circular letters regarding weekly card- 
 reports, have been mailed, in packages, to 119 health officers and regular 
 correspondents; 1,474 weekly card-reports have been received and entered 
 on the register; 53 copies of the hektographed weekly bulletin “Health 
 in Michigan” were mailed each week, and 110 copies of the monthly 
 bulletin “ Health in Michigan” have been hektographed and mailed each 
 month. These bulletins have been consolidated for this quarterly report. 
 
ABSTRACT OF PROCEEDINGS, JANUARY 12, 1894. 
 
 19 
 
 Work has also been done on the compilation of the weekly card reports of 
 sickness during the year 1892, for the annual report for 1893. 
 
 Health in Michigan in the fourth quarter of 1893. Communicable 
 
 Diseases. 
 
 Compared with the preceding quarter, (July, August and September), 
 reports from all sources show diphtheria to have decreased by an average 
 of six places, scarlet fever to have increased by an average of fourteen 
 places, typhoid fever to have increased by an average of nineteen places 
 and measles to have decreased by an average of fifteen places. 
 
 Meteorology and Sickness from all Causes , fourth quarter of 1893 , 
 Compared with the preceding quarter. 
 
 A comparison of meteorological conditions of the fourth quarter of 
 1893, with the meteorological conditions of the preceding quarter, shows 
 the prevailing direction of the wind to have been the same (southwest), 
 the average velocity 42 per cent greater, the temperature 28.92 degrees 
 lower, the rain-fall at Lansing 2.47 inches more, the absolute humidity 
 much less, the relative humidity much more, the day ozone slightly more, 
 the night ozone considerably more and the depth of water in the well at 
 Lansing to have been seven inches less. 
 
 Compared with the preceding quarter, (July, August and September), 
 the reports from regular observers show a marked increase of influenza, 
 bronchitis and tonsillitis, and a marked decrease of dysentery, diarrhea and 
 inflammation of the bowels in the fourth quarter of 1893. 
 
 % 
 
 The Weather and the Health in Michigan , in the fourth quarter of 1893, 
 Compared with the average for the seven years 1886-1892. 
 
 A comparison of the meteorological conditions of the fourth quarter of 
 1893, with the average for the fourth quarters in the seven years, 
 1886-1892, shows that in 1893, the prevailing direction of the wind was 
 the same (southwest), the velocity was slightly greater, the temperature 
 was nearly the same, the rain-fall at Lansing was 1.67 inches more, the 
 absolute, and the relative humidity were more, the day ozone was less, the 
 night ozone was more and the depth of water in the well at Lansing was 4 
 inches more. 
 
 Compared with the average in the corresponding quarters in the seven 
 years, 1886-1892, the reports from regular observers indicate that influenza 
 was more than usually prevalent, and that intermittent fever, remittent 
 fever, erysipelas and inflammation of kidney were less than usually prev- 
 alent in the fourth quarter of 1893. 
 
 Respectfully submitted, 
 
 Henry B. Baker, 
 
 Secretary. 
 
ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 [ICHIGAN STATE BOARD OF HEALTH. 
 
 [ 208 .] 
 
 ANNUAL MEETING APRIL 13, 1894. 
 
 REPORTED BY THE SECRETARY OF THE BOARD. 
 
 This was the annual meeting. A brief address was made by the Pres- 
 lent of the Board, who congratulated the members of the Board on the 
 ict that, “ During the last year the State Board of Health has done much 
 Dod work, including that in connection with quarantine and the preven- 
 on of the introduction into Michigan of dangerous communicable dis- 
 hes. The Board has entered upon a most important work— for the 
 retention and restriction of tuberculosis in man, and I believe that the 
 ?S ults will be great. This Board has taken the lead of other State 
 hards of Health in declaring consumption to be ‘ dangerous to the pub- 
 c health,’ and has recommended advanced measures for its restriction, 
 .t this meeting committees are to report upon two other measures of 
 Bstriction which it is believed will prove to be exceedingly important. 
 There were present at this meeting: Hon. Frank Wells, president, 
 jansing; Prof. Victor C. Vaughan, M. D., Ann Arbor; Prof. Delos Fall, 
 I. S., Albion; Mason W. Gray, M. D., Pontiac; Samuel G. Milner, M. D., 
 hand Bapids, and Henry B. Baker, M. D., Secretary. 
 
 The minutes of the last quarterly and two special meetings were read, 
 tie auditing of bills and accounts, and other regular business was 
 ransacted 
 
 The Secretary presented and read portions of his report of work done 
 a the office during the quarter just ended, which included the action 
 aken for the restriction of 412 outbreaks of dangerous communicable dis- 
 ases, 6 outbreaks being of small-pox. The 412 outbreaks do not include 
 ne hundred and eightv-five localities which reported consumption, and 
 
 ^ \T« 5 3 
 
MICHIGAN STATE BOARD OP HEALTH. 
 
 o^Health^ w h lc h action was taken, in each instance, by the State Boai 
 AprilVand S 6 UC ° eSsful Sanitar y Convention has been held, at Menomine! 
 
 The Secretary said that, “ Compared with the average in the correspond 
 ing quarters in the eight years 1886-1893, the reports from regula 
 observers indicate that intermittent fever, remittent fever, erysipelas 
 diarrhea, consumption, pneumonia and pleuritis were less than" usuall 
 prevalent, and that no disease was more than usually prevalent in tii 
 first quarter of 1894,” 
 
 CONFERENCE OF MICHIGAN HEALTH OFFICERS. 
 
 It was voted that the State Board of Health hold this year anothe 
 Conference of Michigan Hea th Officers, at Ann Arbor, some time in Jurn 
 A committee of three, of which Doctor Vaughan is chairman, was appoints 
 to make arrangements for that Conference. Last year a useful Conferenc 
 was held with special reference to cholera. That subject is still of inter 
 est, and dangerous immigrants are still coming into Michigan. But it i 
 proposed this year to give special attention to that disease which is alread' 
 here and causes most deaths — consumption; and to give the health officer 
 opportunity to study the subject at the State Laboratory of Hygiene 
 where the bacteriological and other facts relative to the causation of thi; 
 disease can be so well demonstrated. 
 
 It is believed that every local board of health in Michigan may well pav! 
 the expenses of its health officer as a delegate to this meeting, because of! 
 the useful information which he may there gain, for the benefit of thel 
 people of his jurisdiction. 
 
 TUBERCULOSIS IN ANIMALS AND IN MAN. 
 
 The subject of tuberculosis in animals as a cause of tubercular diseases in 1 
 man, was presented by Dr. Milner by a resolution at the special meeting at 
 Menominee, April 6, directing the Secretary of this Board to institute au 
 investigation of the cattle and milk in different parts of this State, and report 
 in what way and to what extent the health and lives of the people are endan- 
 rf re 5r by tuberculous meat and milk. The resolution was then referred to 
 Dr. Mason W. Gray, the committee on “ Animals’ Diseases dangerous to 
 man, with request to report at this meeting. Dr. Gray reported that he 
 had conferred with veterinary surgeons in Pontiac and Detroit, had visited 
 the health department in Detroit for conference, that a few months ago he. 
 had corresponded on this subject with members of the State Live Stock 
 Commission, and he read extracts from the letters: Hon. J. J. Woodman 
 had said, that the presence of tuberculosis in animals is not being reported 
 to the State Live Stock Commission. Dr. Barringer had expressed the 
 hope that this Board would investigate the subject thoroughly. Dr. Gray 
 believed that the State Live Stock Board would cooperate freely with this 
 Board in an investigation of tuberculosis in animals. 
 
 Dr. Baker said he had conferred with the State Veterinarian, who 
 advised further and personal conference by this Board with the State Live 
 Stock Commission. . Dr. Baker read from the last report of the commis- 
 sion, relative to tuberculosis “ It is beyond question both infectious and 
 contagious, particularly in the pulmonary development or consumption of 
 
ABSTRACT OF PROCEEDINGS, APRIL 13, 1894 
 
 3 
 
 . ie lungs.” “Years of added experience and careful observation lead us 
 » the conclusion that the annual losses among Michigan cattle from 
 | iberculosis are much greater than from all the other contagious diseases 
 fecting our domestic animals, and that the disease is steadily increasing. 
 T’e have given the subject very careful thought and consideration, and 
 | ive as yet failed to find a satisfactory plan for its treatment or extermina- 
 I on. It, as yet, is one of the unsolved problems, lying all in front and 
 I ke some bridges, in our pathway, the day is not far distant when an 
 ! tempt must be jnade to cross.” 
 
 1 Secretary Baker thought that now, since . the vigorous action by this 
 oard for the restriction of tuberculosis in man, is the favorable time for 
 Lie commission to make the attempt to “cross the bridge,” and he earnestly 
 ; ;>ped that the State Live Stock Commission would cooperate with this 
 i oard in the effort for the restriction and prevention of tuberculosis in 
 liinals and in man. 
 
 It was voted that the President be requested to call a special meeting of 
 i iis State Board of Health at such time as arrangements can be made, for 
 joint meeting with the State Live Stock Commission, to consider the sub- 
 ct of the restriction of tuberculosis in animals and in man. 
 
 L 
 
 A proposed State Hospital for Consumptives. 
 
 [At the special meeting of this Board at Menominee, April 6, 1894, the 
 ! Beretary presented the subject of a proposed State Hospital for Con- 
 imptives. He stated that since the publication of the two hektographed 
 iges which he had sent to each member of this Board, and to newspapers 
 id journals, the proposition had been favorably received, the President 
 ! this Board and Prof. Yaughan had both expressed themselves as favor- 
 i g the proposition. But the Secretary wished for such formal expression 
 : would make it the Board’s proposition. He moved the adoption of a 
 solution, — “That the proposition for the establishment of a State Hospi- 
 1 for Consumptives is very cordially approved by the State Board of 
 , ealth.” The subject was then discussed. On motion the resolution was 
 ferred to the standing committee on “Epidemic, Endemic and Communi- 
 
 I ble Diseases” — Prof. Victor C. Vaughan, with request for a report on it 
 the next meeting of this Board. ] 
 
 As chairman of the Standing Committee on “Epidemic, Endemic and 
 Dmmunicable Diseases,” Prof. Vaughan made a report on the subject of 
 e restriction of tuberculosis in man by means of a proposed State Hos- 
 tal for Consumptives, this subject having been referred to him at the 
 st special meeting. The subject was discussed at great length and reso- 
 tions were adopted as follows: 
 
 Resolved , That we recognize the following facts: 
 
 1. That tuberculosis is the most grave and fatal disease now affecting the 
 ^alth and lives of the people of this State, destroying about three thou- 
 nd lives per year; 
 
 i 2. That this disease originates principally by transmission from man to 
 an or from man to animals and again to man; 
 
 , 3. That the spread of this disease can be best arrested by the disin- 
 ! ction of the sputa and other discharges, by special supervision of those 
 fected, and by the care of such persons under conditions which will 
 event the transmission of the disease to others; 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 4. That such disinfection and supervision can not be carried out in 
 the crowded houses of the poorer classes; and 
 
 5. That, under conditions which will prevent reinfection, many con- 
 sumptives may be permanently cured, and returned to their homes and 
 work, educated in the methods of restricting the disease. In view of these 
 facts * 
 
 Resolved , That this Board request of the next Legislature an appropri- 
 ation of $ , for the purpose of building, equipping and maintain- 
 
 ing a State Hospital for Consumptives. 
 
 Prof. Delos Fall presented a preamble and resolution, which were 
 
 adopted as follows : . 
 
 Whereas, It is desirable that every step taken shall tend toward giving 
 the largest amount of sanitary education to the teachers and to the peo- 
 ple of the State, therefore, 
 
 Resolved, That it is the judgment of this Board that the proposed State 
 Hospital for Consumptives should be located at the seat of the State 
 University at Ann Arbor, in order that it may afford the best opportuni- 
 ties for the observation and study of this most important disease, in con- 
 junction with the investigations now being so satisfactorily pursued, in 
 bacteriology and other departments of sanitary science, at the State Lab- 
 oratory of Hygiene. ' 
 
 Sputa may be Examined at the State Laboratory of Hygiene . 
 
 For the convenience of physicians in the diagnosis of a case of tuber- 
 culosis, it was suggested that there should be some central place where the 
 sputa of persons suspected to be suffering with tuberculosis could be bac- 
 teriologically examined, at a slight cost to the physician or patient. Reply- 
 ing to an inquiry whether the State Laboratory of Hygiene would make 
 these examinations, Dr. Vaughan said that he would have such examinations 
 made there at a small cost to the physician or patient. Any physician 
 wishing such examination made at the State Laboratory of Hygiene 
 should correspond with Prof. Victor C. Vaughan, M. D., Director of the 
 State Laboratory of Hygiene, .Ann Arbor, Michigan. 
 
 IS THE USE OF ATROPINE IN FITTING GLASSES A BRANCH OF THE PRACTICEj 
 
 OF MEDICINE. 
 
 The Secretary mentioned that he had received letters, asking whether oi 
 not atropine could legally be used in fitting glasses in cases where the 
 optician was not a Doctor of Medicine, and whether or not such an 
 optician would be required to comply with the State law relative to the 
 practice of medicine. Recently the Secretary had received an interesting 
 letter on this subject from a prominent physician in Michigan, which he 
 read to the members of the Board. The letter is as follows: 
 
 Grand Rapids , Michigan , February 21, 1894. 
 
 H. B. Baker , M. D., Secretary State Board of Health, Lansing, Michigan. 
 
 My dear Doctor There is a law in the State of Michigan to regulate the practice of medicine (“ Tc 
 promote the public health”). Under said law, a man is required to register, etc., before practicing med- 
 icine in any branch, or prescribing, etc. In these days the practice of medicine includes all specialties 
 and any specialty or part thereof is the practice of medicine, in the meaning of the law. Now, is nol 
 the use of atropine in the eyes in fitting glasses a prescription or prescribing for a patient in the same 
 sense that making a plate and extracting the teeth preparatory thereto, is practicing dentistry? If per 
 
ABSTRACT OP PROCEEDINGS, APRIL 13, 1894. 
 
 5 
 
 sons should have trouble with their eyes, and think they needed glasses and go to an advertising optician 
 {spectacle vender) and he was in the habit of using atropine in eyes, now suppose this said patient had 
 acute or chronic glaucoma, the optician would not know it, having no knowledge of opthalmology, and 
 he would put atropine into the patient’s eyes, it might be the cause of the patient losing the sight of both 
 eyes. You see the point. The use of atropine or any midriatic in glaucoma does harm, and frequently 
 causes blindness, therefore the necessity of great care in selecting cases in which there are eye symptoms 
 in which atropine is a safe remedy. The case in point is a spectacle vender here who fits glasses, and 
 uses atropine in eyes for fitting. Is this not practicing medicine, and should men uneducated (in med- 
 icine) be allowed to tinker with eyes, when they are the most delicate organs of the body, and in the face 
 of the fact that so many people lose their eyesight by neglect and improper treatment? I have a patient 
 whose eyes were undoubtedly affected with glaucoma; they pained her and she wanted to have glasses 
 fitted by an optician; he used atropine in her eyes which increased her pain and she finally left him and 
 went to another optician who completed the test, but she had pain and symptoms of glaucoma for a long 
 time, and her sight is very much impaired, so glasses will not help her; had she gone to an oculist he 
 would have detected the glaucoma and given her proper treatment and saved her eyes. This is a matter 
 of great importance, and. I should like your opinion. I believe opticians have no right to fit glasses 
 inasmuch as the majority of the young people who need glasses should have them fitted by a competent 
 oculist. If people want to call for glasses all right, but opticians have no right to advertise to fit them 
 any more than a druggist has to advertise to prescribe for all the ills of man (free of charge) to get cus- 
 ; tomers when he is not a Doctor. Please let me hear from you. 
 
 Very truly yours, 
 
 D. M. Greene. 
 
 The members of the State Board of Health thought that a person using 
 atropine in the eyes for the purpose of fitting glasses was practicing med- 
 icine, and should comply with the State law relative to the practice of 
 medicine. 
 
 CONSUMPTION A DISEASE DANGEROUS TO THE PUBLIC HEALTH. 
 
 A special report by the Secretary. 
 
 So far as known at this office, the Michigan State Board of Health was 
 the first State Board to take action for the notification of this most import- 
 1 ant cause of deaths. Sept. 30, 1893, this Board officially declared consump- 
 tion and other diseases due to the Bacillus tuberculosis to be “ diseases 
 dangerous to the public health” and, in accordance with Sections 1675 and 
 1676 Howell’s Statutes, to be reported by householders and physicians to 
 the local health officer, as soon as such a disease is recognized. This 
 recent action was for the legal control. This Board has carried on an 
 educational campaign since the year 1881, w T hen it first published and 
 distributed information relative to the contagious character and prevention 
 of consumption. Since that time much has been written, published and 
 distributed on this subject by this Beard. In Sept., 1891, the Board pub- 
 lished a four-page leaflet on “ The Restriction and Prevention of Con- 
 i sumption,” to the number of 5,000 copies. One other edition of five 
 thousand copies of the pamphlet has been printed. It is believed that the 
 pamphlet has been instrumental in the education of the people for the 
 restriction of tubercular diseases. 
 
 Action by the New York City Board of Health. 
 
 According to the Sanitarian of March, 1894, the New York City Board 
 of Health, on July 13, 1893, took action for the restriction and prevention 
 of tuberculosis. The Report of JDr. Cyrus Edson, Chairman of the 
 Sanitary Committee of the City Board of Health, was adopted. It 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 summarized a report which Dr. Herman M. Biggs, the bacteriologist of 
 the Department, had made, and which was, in the opinion of Dr. Edson, 
 timely and well advised. Dr. Biggs’ report is summed up in the following 
 three statements: First , tuberculosis is a contagious disease, and is dis- 
 tinctly preventable; Second , it is acquired by direct transmission of the 
 tubercle bacilli from the sick to the well, usually by the means of the dried 
 and pulverized sputum floating in the dust of the air; and Third , it can 
 be largely prevented by simple and easily applied measures of cleanliness 
 and disinfection. 
 
 Dr. Edson’s report, which was adopted, included recommendations: 1, 
 that an instructive circular be prepared and distributed; 2, that physicians 
 and other persons having knowledge of the existence of a case, report it 
 to the Health Department within seven days; 3, that the medical sanitary 
 inspectors should investigate the cases and get samples of the sputa for 
 diagnostic purposes, as is done in diphtheria, and if tubercle bacilli are 
 found the inspector is to inform the physician and request him to instruct 
 the patient and persons liable to be endangered, or if the physician pre- 
 fers the inspector gives these notices; 4, that the Board urge upon hos- 
 pital authorities of the city of New York the importance of separation so 
 far as possible in the hospitals in this city of persons suffering from pul- 
 monary tuberculosis from those affected with other diseases, and urge 
 that proper wards be set apart for the exclusive treatment of this disease, 
 and that the commissioners of Charities and Corrections be recommended 
 to take such steps as will enable them to have and control a hospital to be 
 known as the “Consumptive Hospital” to be used for the exclusive treat- 
 ment of this disease, and that as far as practicable, all inmates of tho 
 institutions under their care suffering from tuberculosis be transferred to 
 this hospital; 5, that it be recommended that the disinfecting corps disinfect 
 places where evidence of infection from tuberculosis exists whenever, in 
 the opinion of the chief inspector of contagious diseases, it shall be 
 necessary; and 6, that suitable receptacles (cuspidors) be provided and 
 properly cared for in all places where persons are brought or caused to 
 congregate for any purpose, especially in factories. 
 
 According to “ The Doctor of Hygiene ” for Dec. 20, 1893, the New 
 York City Board of Health has adopted the following resolutions: 
 
 “ Resolved, That this Board urge upon hospital authorities of the City of New York the importance of 
 separation, so far as possible, in the hospitals of this City, of persons suffering from pulmonary tuber- 
 culosis from those affected with other diseases, and urge that proper wards be set apart for the exclusive 
 treatment of this disease ; and, be it further 
 
 “ Resolved , That the Commissioners of Charities and Corrections be recommended to take such steps 
 as will enable them to have and control a hospital to be known as “The Consumptive Hospital,” to be 
 used for the exclusive use of this disease, and that, as far as practicable, all inmates of the institution 
 under their care suffering from tuberculosis be transferred to this hospital.” 
 
 Action by the New York State Board of Health. 
 
 At a meeting of the New York State Board of Health, February, 1894,. 
 Doctor Edson, to whom the subject had been referred, made a report stating 
 that “ Tuberculosis is a contagious disease, and is distinctly preventable;” 
 that it is acquired by direct transmission, usually by the dried and pulver- 
 ized sputum floating as dust in the air; and that it can, to a great extent, be 
 prevented by cleanliness and disinfection. Dr. Edson recommended that 
 instructive circulars be distributed; that cases be reported to the local 
 
ABSTRACT OF PROCEEDINGS, APRIL 13, 1894. 
 
 7 
 
 health officers within seven days of the time when the sick persons come 
 under observation, and the health officers should then take the necessary 
 action, visiting the premises, leaving printed instructions. After the death 
 of the patient the room occupied and the premises should be disinfected; 
 and that cuspidors be put in all public places, such as railroad cars, factories, 
 stations, etc. Dr. Edson also recommended that a circular to health 
 officers be sent out stating that local health officers will register the name, 
 address, sex, age of each person suffering from tuberculosis ; upon notice of 
 a case, inspectors will visit the premises and family and leave instructive 
 circulars relative to the precautions to be taken; the thorough disinfection 
 of all infected articles; and that the authorities of all public institutions 
 that are under the jurisdiction of the State Board of Health, such as hos- 
 pitals, asylums, prisons, etc., shall be required to furnish the State Board 
 of Health the name and last address of every consumptive coming under 
 observation within seven days. 
 
 The recommendations of Dr. Edson were embodied in a circular which 
 has been issued and distributed by the Board. The disease was recognized 
 as a dangerous communicable disease, and measures were recommended 
 for its prevention and restriction. The circular requests that physicians 
 report each case to the health official of the jurisdiction in which a case 
 occurs. 
 
 The New York State Board of Health has also investigated the preva- 
 lence of tuberculosis in cattle, and has issued a circular of rules and regu- 
 lations for inspectors, owners or keepers, and all other persons having 
 charge of cattle suffering from tuberculosis. Dr. Balch, the secretary of 
 the board, writes “ I have to inform you that this department has had in 
 its employ two or more competent veterinarians to examine cattle supposed 
 to be tuberculous, and have examined some 20,000 head either by physical 
 or tuberculin test. Of the number examined some 3 per cent were found 
 to be tuberculous, and were ordered killed. The work, however, had been 
 summarily stopped by order of the board.” 
 
 Action by the Philadelphia Board of Health. 
 
 The Sanitary Committee of the Philadelphia Board of Health, to whom 
 was referred the subject of the restriction of tuberculosis, made an elabor- ' 
 ate report, and recommended a series of resolutions, which were adopted 
 by the board. The resolutions embrace recommendations that registration 
 be postponed for the present; that circulars containing rules for the pre- 
 vention of the disease be distributed; that physicians be requested to 
 cooperate with the board in the distribution of these circulars, and to 
 notify the board of cases in which disinfection is required; that a medical 
 inspector visit each house in which a death from tuberculosis has occurred, 
 and satisfy himself that the premises have been disinfected; and that all 
 cases of tuberculosis reported to the Health Bureau be recorded as are 
 cases of other contagious diseases. 
 
 The action of the Philadelphia Board is in accordance with the recom- 
 mendations of the County Medical Society, and in part with the recom- 
 mendations of the College of Physicians and Surgeons. 
 
 Action by the Wayne County Medical Society. 
 
 On invitation of the Wayne County Medical Society, the Secretary of 
 this Board read a paper before the meeting of that society in Detroit, Feb. 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 15, on the subject of “ Consumption as a Disease Dangerous to the Public 
 Health.” The following resolution was adopted by the society: 
 
 “ Resolved , That hereafter, consumption (and other diseases due to the Bacillus tuberculosis) shall be 
 included in the list of diseases of which notice should be given by householders and physicians to the 
 local health boards, as soon as such a disease is recognized.” 
 
 Proposed Action by the Detroit Board of Health. 
 
 The Health Commissioner and one member of the Detroit Board of 
 Health were in attendance at this meeting of the Wayne County Medical 
 Society, and thought that consumption should be reported to the local 
 board, the subject of unsanitary surroundings, damp basements, etc., could 
 then be investigated, as well as such action as is practicable for the restrict- 
 ion of the disease. The Health Commissioner thought it would be practi- 
 cable for the local board to make bacteriological examinations of sputa of 
 suspected cases, as soon as the new health department building is ready 
 for occupancy. 
 
 Addresses , Discussions, etc., in Michigan. 
 
 On invitation from the President of the Michigan Agricultural College, 
 your Secretary read a paper in the College Chapel, Friday evening, March 
 23, before the faculty and students, on the subject: “ Our Greatest Danger, 
 and How it may be Avoided ” — “ The Bacillus tuberculosis .” The Secre- 
 tary has also read a similar paper before the U. and I. Literary Club of 
 Lansing. As is well known to the members of this Board the subject of 
 the restriction and prevention of consumption was discussed at length, and 
 several papers were read at the recent Sanitary Convention under the 
 auspices of this Board at Menominee. 
 
 Action by the Board of Health of Asbury Park, N. J. 
 
 The Board of Health of Asbury Park, N. J., has declared consumption 
 a communicable disease dangerous to the public health, and requires cases 
 to be reported to the board of Health, where a record will be made, circu- 
 lars of information will be issued, and measures will be taken for the 
 restriction of the disease. 
 
 Action by the Ohio State Board of Health. 
 
 The Secretary of the Ohio State Board of Health has sent out a circular 
 letter, with schedule of seven questions, asking the physicians in Ohio to 
 give their views of the practicability of the State Board o’f Health taking 
 action for the prevention and restriction of consumption. 
 
 The Subject Discussed in Florida. 
 
 In a letter dated March 24, Dr. J. L. Horsey, Assistant State Health 
 Officer of Florida, informs the Secretary of the Michigan Board that he 
 had used extracts from Dr. Baker’s paper read February 15, before the 
 Wayne County Medical Society, and read a paper on the subject of the 
 Restriction of Consumption before the Florida State Medical Society, at 
 
ABSTRACT OF PROCEEDINGS, APRIL 13, 1894. 
 
 9 
 
 Tampa, March 20 and 21, 1894, and by so doing brought out considerable 
 discussion, which showed the views of the medical profession of Florida 
 on this subject. 
 
 Proposed Action in California. 
 
 The Scientific American, of March 24, contains an article, quoted from 
 the Southern California Practitioner, in which it is recommended that 
 California follow the example of Michigan, and officially declare Con- 
 sumption a Contagious disease, and go one step further and deny con- 
 sumptives the privilege of engaging in occupations whereby they may 
 endanger the life or health of others. 
 
 The Subject Discussed in Minnesota. 
 
 The Secretary has recently received from H. Longstreet Taylor, A. M., 
 M. D., of St. Paul, Minn., a copy of his paper on “The Necessity of 
 Special Institutions for the Consumptive Poor. The first step toward a 
 complete eradication of Tuberculosis,” in which Doctor Taylor in a note 
 at the end of his paper says, “ Since writing the above the State of Mich- 
 igan has, through its efficient Board of Health, put tuberculosis upon the 
 list of contagious diseases that must be reported by the Physician to the 
 health board. This will soon collect a mass of data of the greatest value 
 to the student of the disease in that State, and will, by the limitation of 
 the ravages of the disease in, Michigan, soon force the matter to the atten- 
 tion of the other States, and eventually the National Government must 
 take it up.” 
 
 The movement for the restriction of consumption seems to be a general 
 one, and other boards of health will probably soon take action. The fore- 
 going brief statement has been prepared to show, as far as the Secretary 
 is officially informed, what has recently been done for the restriction of 
 the most important disease — Consumption. 
 
 SECRETARY’S REPORT OF WORK DONE IN THE OFFICE OF THE STATE BOARD OF 
 HEALTH, DURING THE QUARTER ENDING MARCH 31, 1894. 
 
 Communicable Diseases. 
 
 The number of reports of outbreaks of dangerous communicable dis- 
 eases in Michigan, received from all sources and filed, Rnd the corre- 
 sponding number concerning which action was taken by this office, during 
 the quarter, are as follows: for diphtheria, 110; for scarlet fever, 184; for 
 typhoid and typho malarial fever, 55; for measles, 57; for small-pox, 6. 
 Total for the five diseases, 412. Consumption is mentioned further on. 
 
 The number of communications relative to dangerous communicable 
 diseases, received and placed on file during the quarter, was 1,820. 
 
 Relative to dangerous communicable diseases, letters, written cards, and 
 demands for weekly and final reports, on cards, or in the form of the cir- 
 cular letter, were sent out during the quarter to the number of 1,662. 
 
 The “final” reports of outbreaks received and filed during the quarter, 
 were: for diphtheria, 81; scarlet fever, 134; typhoid and typho-malarial 
 fever, 52; measles, 18; small-pox, 3. Total for the six diseases, 288. 
 
 During the quarter, the local columns of newspapers to the number of 
 
^ MICHIGAN STATE BOARD OF HEALTH. 
 
 1,018, have been looked over for reports of occurrence of communicab] 
 diseases. I his has resulted in giving this office information of the allege 
 occurrence of 4 outbreaks of diphtheria, 11 outbreaks of scarlet fever, 
 outbreaks of typhoid and typho-malarial fever, and 2 outbreaks of measles 
 lo what extent the reports of these alleged outbreaks were verified i 
 shown in the accompanying table: 
 
 TABLE 1 --Showing the number of Outbreaks of Diphtheria, Scarlet fever, Typhoi 
 fever and Measles, from Jan. 1 to March 31, 1894, of which notice was received at tl 
 office of the Michigan State Board of Health; the per cent of reports, informativ 
 concerning which was received through the Newspapers ; the per cent of newspape 
 reports which were confirmed by the health officer ; the per cent of newspaper report 
 which were denied by the health officer; and the per cent relative to which n 
 reply was received from the health officer. 
 
 Diseases. 
 
 Reports from 
 all sources, 
 Jan. 1 to 
 March 31, 1894. 
 
 Per cent of 
 all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were con- 
 firmed by the 
 health officer. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were denied by 
 the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports to whici 
 the health 
 officer made 
 no reply 
 to notice sent 
 from this 
 office. 
 
 Diphtheria.... 
 
 110 
 
 4 
 
 25 
 
 25 
 
 50 
 
 Scarlet fever 
 
 184 
 
 6 
 
 55 
 
 0 
 
 45 ! 
 
 Typhoid fever ... 
 
 55 
 
 5 
 
 33 
 
 33 
 
 33 
 
 Measles 
 
 43 
 
 4 
 
 0 
 
 0 
 
 100 
 
 Averages for the four diseases 
 
 
 5 
 
 40 
 
 10 
 
 50 
 
 Consumption in Michigan During First Quarter of 1894 . 
 
 Daring the quarter Consumption was reported present in 185 localities 
 in the State. A record is kept of the names of the localities, the date of 
 the receipt of the information that the disease was present in the locality, 
 and when correspondence was opened with the health officers of the juris- 
 dictions in which the cases are. Over eighteen hundred copies of the 
 four-page leaflet on the restriction and prevention of consumption were 
 sent to the different localities for distribution where they would be most 
 likely to do good. 
 
 Small-pox in Michigan. 
 
 There had been no small-pox m Michigan since January, 1893 (when 
 there was an outbreak at Springport, Jackson Co., and Pittsfield Tp., 
 Washtenaw), until the disease appeared during the first part of this quar- 
 ter. Small-pox has been reported: At Otsego township and Otsego vil- 
 
 of Crystal Palls, Iron Co.; and in the cities 
 of Menominee, Ishpeming and Kalamazoo. The total number of cases 
 reported from the six localities was 16; the number of deaths was 4. A 
 statement of the outbreaks is as follows: 
 
ABSTRACT OF PROCEEDINGS, APRIL 13, 1894. 
 Small-pox in Allegan County. 
 
 11 
 
 ( 
 
 I In compiling, the outbreak of small-pox in Otsego township would be 
 i eated as one outbreak, and the cases in Otsego village would be treated 
 j) a separate outbreak; but on account of the intimate relation between 
 I ie cases, the fact that the cases all originated directly or indirectly from 
 l 6 first case, and for convenience in this quarterly report, I will here 
 eat these cases as belonging to one outbreak. Although diligent efforts 
 ive been made, the source of the outbreak is in doubt. 
 
 Theirs/ person taken sick who is known to have had small-pox was 
 'r. Burnside, who resided just outside the village in the township of 
 tsego, and was taken sick Jan. 16. He was employed in the Bardeen 
 aper Company’s mill, where his work necessitated his handling baled 
 igs. No evidence could be obtained that he handled infected rags, unless 
 s sickness from small-pox be considered such evidence. His wife, who 
 as employed in the rag room in the paper mill, was slightly indisposed a 
 w days prior to Mr. Burnside’s illness, but it cannot be ascertained with 
 ‘rtainty that she had varioloid. Mr. Burnside’s illness, when he was first 
 .ken sick, was diagnosed as scarlet fever. Burnside was taken ill with 
 ipposed scarlet fever January 9, and died on the morning of January 16. 
 The second case (varioloid) in this outbreak was Dr. Milton Chase, the 
 llage health officer, who was called to treat Mr. Burnside. Doctor Chase 
 is recovered. The third case was a Mr. Bopp who resided in the village 
 id had been nursing the first case. Th q fourth and fifth cases were two 
 derly people, Mr. and Mrs. Sherwood, residing in the village of Otsego, 
 id at whose house Mr. Ropp boarded. Mr. Sherwood died. The sixth 
 as a Mrs. Herrington, who kept a boarding house just outside the village 
 mits. The source of contagium in this case was supposed to be the 
 btending physician who had attended the other patients, and had been 
 eating Mrs. Herrington for some other ailment. Mrs. Herrington 
 ^covered. March 13, a final report was received from the township, and 
 ie from the village. No other cases are expected to occur. 
 
 January 30, the Secretary of this Board received a telegram from E. J. 
 ose, Clerk of the Otsego Board of Health saying “ Disagreement as to 
 hether we have small-pox in Otsego or not. Come at once. Answer.” 
 a accordance to the foregoing request for an expert, Dr. J. J. Mulheron, *• 
 it Detroit, was requested to go to Otsego, which he did, and the following 
 his report: 
 
 Small-Pox in Otsego , Allegan County , Michigan. 
 
 “ Detroit , February 2 , 1894. 
 
 Henry B. Baker, M. D., Secretary State Board of Health, Lansing, Michigan: 
 
 1 Dear Doctor:— Pursuant to instructions received from you to proceed to Otsego, Allegan County, 
 investigate the alleged outbreak of small-pox at that place, I left Detroit by M. C. E. R. on the after- 
 >on of January 31. An accident to the engine of the train at Parma caused a delay which necessitated 
 ,7 remaining at Kalamazoo over night. I reached Otsego at 7:30 A. M. of the 1st inst, and reported at 
 ce to Dr. F. W. French, the local health officer. After receiving his statement as to the status of affairs 
 vas driven to the bouse of D. A. Ropp, which I found placarded for small-pox. After removing my 
 ercoat and donning an oil cloth ulster I proceeded to make an examination of Mr. Ropp, who was con- 
 led to his bed. This examination revealed a case of varioloid, the eruption being in the pustular stage. 
 ■*ound the house and its inmates carefully quarantined as per the regulations prescribed by the Michigan 
 ate Board of Health. 
 
 ’* I next visited the residence of Dr. Milton Chase,- on the porch of which I noticed two placards and a 
 I flag. One of these placards bore the word “ small-pox,” and the other, over which floated the red 
 2 
 
12 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 flag, indicated “ chicken-pox.” I learned that the small-pox placard had been put in place by the 1 
 health authorities, and that the chicken-pox sign and the red flag were posted at the instance of 
 Chase, the occupant of the house. I entered unaccompanied and was cordially met by Dr. Chas< 
 whom I explained the object of my visit. I found that the doctor himself was the patient in regar. 
 whose ailment there existed the difference of opinion indicated by the two placards on the hones 
 submit herewith the doctor’s own typewritten statement regarding his case. 
 
 ‘“On Tuesday, January 23, 1894, 1 got out of bed after having had several light chills, and si 
 general .pains, during the night. Through the day I had several light chills, slight fever, and a g 
 deal of mental depression. 
 
 “ ‘ On the 24th, symptoms about the same, but a little increased sense of prostration. 
 
 “ 4 On the 25th, about the same, except that I could not sleep during the night, was much depressed, 
 thought best to keep my bed. 
 
 “ 4 Had a restless night on the 26th, but no chills, although a slight fever, and much sense of prostral 
 
 44 4 On the 27th had a slight chill, and a little fever during the night, slept a little and felt much bet 
 Was about the house during the day. Had two or three small points of some eruption on my fore! 
 appear during the day. 
 
 44 4 On Sunday 28, feel better than yesterday, slept better during the night, no chills or fever, 
 irruptive points on my forhead are one celled vessicles. 
 
 44 4 29. Had a better day than 'yesterday. Vessicles fully developed, and new ones appearing on b 
 breast and arms. 
 
 44 4 80. First vessicles dried down, some of the newer ones disappearing, and some new ones appeal 
 on left arm and on head.’ 
 
 “The doctor believed himself to be suffering from varicella. In this diagnosis I did not concur 
 gave it as my opinion, based on the appearance of the eruption and the age of the patient (about 60 ye 
 that the disease was varioloid. The doctor readily acquiesced and forthwith ordered the chicken-pox c 
 removed. 
 
 '‘'‘History. During the late Christmas holidays Mr. Abram Burnside, aged 42, and his wife, b 
 employes of the Bardeen Paper Mills of Otsego, made a trip to Allegan in the same county where t 
 spent one day. The exact date of the visit I could not ascertain. Soon after their return (how soc 
 could not ascertain) Mrs. Burnside was indisposed for a few days during which a slight eruptioi 
 4 pimples ’ appeared on her body. The nature of the eruption could not be ascertained as the indisp 
 tion was not sufficient to cause her to call in medical aid. Shortly after Mr. Burnside sickened, ar 
 submit herewith, the history of the case which was kindly furnished me by Dr. Milton Chase, his med 
 attendant: 
 
 “ 4 History of the irregular case of Scarlet Fever , that occurred in the village of Otsego , Mich ., during 
 month of J an., 1894. 
 
 44 ‘On the 9th day of Jan., 1894, Dr. M. Chase was called to see one Abram Burnside, who lives in 
 northwest part of said village, having no other resident member of his household, save his wife. 
 
 44 4 He was an American born, Caucasian, aged about 42 years, an employee in the Paper Mill at Ots 
 village. His business was that of a foreman in the rag-room and his duties consisted mainly in gett 
 up bales of rags, from the store-room, and opening them up, ready for the assorter’s use, and remov 
 them after they had been assorted. He had been in this employment for more than three years, last p< 
 
 44 4 By history he was found to be a man of temperate habits and good hygienic and social habits, 
 wife was also an employee in the same mill with hjm, in the rag department. He had had very lil 
 sickness during his life, was about 5 ft. 7 in. high, and weighed about 175 pounds. He was of rathe 
 muscular and sanguine temperament. 
 
 “ 4 He had not been away from home, save a trip, one day, to Allegan, during the holidays last past, 
 could not recall that he had seen any one sick with any irruptive skin disease. So much for a prelin 
 ary statement. 
 
 “ 4 1 found him suffering from fever of a moderate degree, and a good deal of general muscular ps 
 He complained most of pain in his back and head. Tongue, not badly coated, moderate nausea, and 
 vomiting. 
 
 “ 4 On the 11th, I was called to see him again, and I visited him one or more times, each succeeding c 
 until the 16th, on which day he died. 
 
 “‘On the 11th, he had very much the same symptoms as at my first visit, to which was added 
 appearance of a rash upon his face, neck, and chest, that presented itself in thickly set spots, about > 
 an inch in diameter, that did not feel rough or hard. He had a fine, evenly diffused redness of the ton 
 and fauces. He had acute inflammation of the tonsils and the papillae of the tongue were enlarged ; 
 
ABSTRACT OF PROCEEDINGS, APRIL 13, 1894. 
 
 13 
 
 ided through its coating. He complained of a difficulty in swallowing and had very little thirst, or 
 ) for food. 
 
 )n the 12th he was much the same in general conditions as on the 11th, but the rash had extended 
 is arms and trunk, and down onto his thighs, and on his face and neck it was blended into an even 
 t-colored rash. The rash did not have the feel of papulae or any sharply defined areas. He had con- 
 ble delirium, but could be controlled by the persuasions and advice of his wife. There was also 
 tsed difficulty in swallowing. He complained quite a good deal of general itching, 
 in the 13th this rash discolored the entire surface of his body, and looked too dusky to be called red 
 mid not be called black. 
 
 >n the 14th, about the same general conditions, only in higher grade, extreme restlessness, and the 
 ilty in swollowing so great that he could not, or would not swallow anything save a little water. 
 
 Jp to this time, his wife had had no assistance in caring for him, but said she could care for him one 
 night. 
 
 t no time up to this date had the thermometer registered more than 102°. His pulse was quite soft 
 ad a frequency of 110. He breathed as if he had some bronchial difficulty, respirations 24 a minute, 
 d slept some during the night and day in short naps, was still delirious but could be controlled by 
 age. 
 
 luring the day sometime, while his wife was temporarily absent at an out house, she found him, 
 
 her return, standing at the pump, clad only in his shirt, pumping water on his feet. 
 
 )n the fifteenth there was a general appearance of great exhaustion. He had not been able to take 
 
 f his medicine, and an extremely email amount of water. The color of his face was black, shading 
 
 " to a dark red on his chest and scarlet on his legs. There was a little tendency to flakey desquama- 
 
 )n his forehead. His respiration was more hurried, pulse softer and about 110. He could answer all 
 
 ions put to him intelligently, but was still delirious, when left to himself, having short spells of 
 
 ness of from 5 to 10 minutes long. There were quite large and flakey scales over his face, ears and 
 
 This was at morning call. In the evening the conditions were about the same as in the morning, 
 
 increased restlessness and less obedience to commands. He had been able to swallow practically 
 
 ng during the day, and for the first time during his sickness, assistance was called in (a nurse 
 
 ' ired). [This was D. A. Eopp, the man to which I have referred as suffering from varioloid — J. J. 
 
 ) . 
 eron.J 
 
 •jn the 16th, at morning visit, about 8 A. M., the patient was found in collapse, and soon after died. 
 
 [ story of the case, through the night, I learned that the patient was found able to swallow, along 
 1 11 or 12 o’clock at night. He was extremely restless and irritable during the night. I was at the 
 de at the time of his death. 
 
 I There was at no time during the patient’s sickness a vesicle or a pustule on his body. I think that 
 ig the last night of his sickness, from the history given by the attendant, and the condition pre- 
 id in the morning, that he had had a tonsillar abscess break during the night. 
 
 [ advised the widow that there should be a speedy burial of the corpse, that it should be wrapped in 
 infected sheet, placed in the coffin, and that the coffin should not be afterwards opened, and that 
 r, should be no funeral services at the house, and that only a few of the intimate friends should be 
 Led to follow it to the grave. That at the grave there should be only a short ceremony. To all this 
 ■ widow agreed, and it was so done. By her request, I went to the undertaker and told him how 
 rad agreed to dispose of the corpse, and requested that he use all the antiseptic precaution necessary 
 revent the contagion going out of the coffin, during the process of burial. This he told me he 
 d do, and afterwards told me, he did do.’ 
 
 \ am clearly of the opinion that Abram Burnside suffered and died of small-pox, of the hemorrhagic 
 sty, that D. A. Ropp, his nurse, contracted a severe attack of varioloid from his exposure to the case, 
 that Dr. Milton Chase, his attending physician, escaped with a very mild attack of varioloid, 
 j cannot close this report of my investigation without expressing my admiration of the intelligent 
 ! energetic action of the local Board of Health in the serious danger which threatened the residents of 
 1 go and the adjacent country * In the absence of an efficient board of health during the emergency the 
 ralence of small-pox would unquestionably have been very general. As it is there is good reason to 
 | ive that the trouble was stamped out in its very incipiency. 
 
 “ Very respectfully yours, 
 
 J. J. MUIiHERON, M. D.” 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Small-pox in Crystal Falls, Iron county. 
 
 The second outbreak of small-pox occurred in Crystal Falls villas 
 Iron county. The first and only case reported was taken ill Monday. 
 19, 1894. The patient was a male school teacher, aged 35 years. Eh 
 been indisposed the previous Friday, but taught school that day an 
 following Monday until noon. Monday afternoon he called upon a 
 sician, and at a conference of the health officer and the attending phys 
 on the following morning it was decided that the patient was sufi. 
 from small-pox. Relative to the source of contagium of this outbreal 
 health officer, Dr. Darling, writes March 10, as follows: 
 
 “ Regarding the case of small-pox in our village, would state that Mr. Williams, who is the victi 
 a teacher in our public schools, and was obtained through the S. R. Winchell Teachers’ Agen 
 Wabash ave., Chicago. He had been here about a week when taken sick, and said he did not knov 
 had been exposed. As soon as I found he had small-pox, I quarantined the house and all the in 
 It has now been 21 days since he ‘ broke out ’ and the school board desires to commence school 
 row. (There were no new cases and the man is getting well.) But I thought better to wait anothe 
 as I think the most dangerous time is as desquamation is taking place. I told them I would wr 
 and get your opinion. Please answer by return mail and oblige. 
 
 “Yours respectfully, 
 
 “A. M. Dabli 
 
 The following reply was sent to Dr. Darling: 
 
 “ Deab Sir:— Accept thanks for your letter of March 10, relative to small-pox, in your village 
 average duration of the infectiousness of small-pox after apparent complete recovery, and with el 
 disinfection, is probably six weeks. So long as a patient, who is recovering from the disease, sho 
 process of desquamation, he should be kept in isolation, and the health officer should be very su: 
 desquamation has ceased before releasing him, and that should not be done until after thorough dii 
 tion of his clothing. Particular attention should be paid to the disinfection of the patient’s ha 
 beard. He should also take a bath. 
 
 As a rule, this Board does not advise the closing of schools where dangerous communicable d: 
 are present, but does advise the complete isolation of any person sick or infected with such a d 
 Also the disinfection of any infected thing or room.” 
 
 The final report of this outbreak at Crystal Falls has not yet 
 received, but it is inferred that no new cases have occurred, that 
 patient has recovered and that the outbreak is over. 
 
 Small-pox in Menominee, Menominee county. 
 
 The third outbreak was reported by telegraph from Menominee, 
 26. The source of contagium was given as “ brought from Fort Hov 
 Wisconsin.. In this outbreak, to the close of the quarter, there has I 
 reported six cases and two deaths. No new cases or deaths have 1 
 reported since the week ending March 17. A notice from the Secretar 
 the Wisconsin State Board of Health, dated Feb. 14, informed this c 
 that four cases and one death had occurred up to that date, at Fort E 
 ard, Wis. The date of that notice (Feb. 14) antedates the date of the 
 covery of the first case at Menominee just 12 days. No final report 
 yet been received relative to this outbreak at Menominee. 
 
 Small-pox in Marquette County. 
 
 The fourth outbreak of small-pox occurred at Ishpeming, March 13, 1 
 Relative to the source of contagium in this outbreak, Dr. Geo. G. Bari 
 
ABSTRACT OF PROCEEDINGS, APRIL 13, 1894. 
 
 15 
 
 tv health officer, writes March 18. “ Patient, with a partner, have 
 
 on a tramp from Spring Yalley, 111. They reached here last Tuesday, 
 ne of them, a Mr. Martin Lucas, was taken sick the same night, but 
 cted to call a physician until last evening. I immediately quaran- 
 ; the whole family, and this morning vaccinated them all. It is not a 
 b case, and I trust we may be able to keep it confined to one house, 
 eel like congratulating ourselves on the fact that we have vaccinated 
 people, mostly children, within the past three weeks, and with most 
 lent success. It is quite probable that he ^ contracted the disease m 
 igo, but of course we cannot say positively.” 
 
 his weekly report for the week ending March 24, the health omcer 
 ts one other case, and says, “ Small-pox from same source as the first 
 nt, or from first patient.” From that it may be inferred that the 
 id case is the “ partner” spoken of. From other sources it is learned 
 che two men had left Ishpeming some weeks previous, in search of 
 
 i, and had gone to Spring Valley, 111., and not being successful there, 
 
 rone to the “ drainage canal” near or in Chicago, and from there had 
 ned. home to Ishpeming. , . 
 
 om Jan. 1, 1894, to Feb. 14, 1894, there had occurred m Chicago 259 
 of small-pox, and it is very probable that the disease in this fourth 
 teak was contracted in Chicago or its suburbs. 
 
 Small-pox in Kalamazoo County. 
 
 ie fifth and last outbreak was reported at Kalamazoo city, March 28. 
 live to this outbreak Doctor Adolph Hochstein, the city health officer, 
 e March 27, as follows: 
 
 liter Jackson, aged 15, colored, returned from Chicago two weeks ago today, after staying there one 
 , Last Saturday morning he took sick, but a physician was not called in until yesterday noon. This 
 oon I was requested by the attending physician, who regarded the case as suspicious, to see the 
 t with him, and I found a case of confluent small-pox in the papular stage, some vesicles had put 
 ir appearance. 
 
 e patient is under, strict quarantine with two nurses. Five other individuals, who have been 
 ; ?d, are also under quarantine in another house. Necessary vaccination is being done, 
 little 13 year old boy, who has been exposed, left yesterday morning for Grand Rapids. I will 
 iiately communicate the facts to the health officer of that city. 
 
 >u will oblige us here by withholding the matter from the press.”* 
 
 amediately upon the receipt of Dr. Hochstein’s letter at this office, a 
 t was sent to the health officer of the city of Grand Rapids, informing 
 that an infected person had gone to his city from Kalamazoo. Pam- 
 ts on the restriction and prevention of small-pox were also sent, 
 rom the foregoing it may be seen that small-pox was present at the 
 3 of the quarter in three different localities in the State, and probably 
 
 j , but it is fair to assume that the outbreak at Crystal Falls is over. 
 
 Compiling , Editing , Proof-reading, Printing, etc. 
 
 I compilation of reports from health officers and clerks has been made, 
 i compilation proved, and the article relative to Measles in Michigan in 
 I L has been commenced; the compilation of the reports relating to 
 
 ' iia request was not complied with, because it is contrary to the settled policy of giving the public 
 [ [formation, to enable all to cooperate for the general safety. 
 
16 MICHIGAN STATE BOARD OP HEALTH. 
 
 Typhoid Fever in Michigan in 1891 has been completed: the compilatii 
 relating to Diphtheria in Michigan in 1891 has been completed, and b 
 work of writing the article has been commenced; and the compilatii 
 relating to Scarlet Fever in Michigan in 1891 has been made, and t. 
 article is practically ready for the printer. Some new and useful tabl 
 have been incorporated in the articles relative to Scarlet Fever and Dip 
 theria, especially those showing the death-rates per 10,000 inhabitants 
 each county, and in each tier of counties in Michigan. 
 
 The index for the Annual Report for 1891 has been completed, and tl 
 Report is now being bound, and it is hoped to have copies for distribute 
 soon. 
 
 Proof on the “ first part ” of the Annual Report of the Secretary f, 
 the fiscal year ending June 30, 1891, and on the index for the 1891 Repoi 
 has been read, and the “ first part ” of the Report for 1892 is ready f< 
 the printer. The printing on the last part of the Annual Report of tl 
 Secretary for 1892 has been commenced, and proof has been read on tl 
 articles “Meteorological Conditions in Michigan in 1891” and “Tl 
 Time of Greatest Prevalence of Each Disease in Michigan in 1891.” 
 
 Work has been begun on the articles relative to Meteorology and Sic] 
 ness Statistics, and on the “first part” of the Annual Report for 1893. 
 
 Hektograph Work, Correspondence, etc. 
 
 During the quarter 2,400 pages of hektograph work have been made, < 
 which 600 pages were relative to a paragraph quoted from the title page ( 
 the annual report of the Australian Health Society for 1892-93, wkic 
 paragraph had been quoted from a paper by the Secretary, and related t 
 the Michigan plan of the education of the people for the restrictio 
 of dangerous communicable diseases. There was considerable work i 
 connection with the brief abstract of the January meeting, and on otkt 
 subjects. 
 
 There were 1,106 pages of letter-book used in copying the corresponc 
 ence of the office, not including many postal cards which have been ser 
 out but not copied in the letter-book. 
 
 Distribution of Publications , etc. 
 
 About 1,100 copies of the Abstract of the Sept. 29 and 30, 1893, meet 
 ing, and about 1,200 copies of the Abstract of Proceedings of the Jan. IS 
 1894, meeting of this Board, have been sent to members and ex- member 
 of this Board, sanitary journal exchanges, meteorological observers an 1 
 meteorological exchanges, members of State Boards of Corrections an* 
 Chanties, secretaries of State Boards of Health, secretaries of State Med 
 ical Societies, libraries, newspapers, and health officers in other States. 
 
 About 1,500 copies of the printed proceedings of the Hillsdale Sanitar 
 Convention were distributed to: Officers and participants of the Conven 
 tion, members and ex-members of this Board, secretaries of State Board 
 of Health and of State Medical Societies, sanitary journal exchanges 
 members of State Boards of Corrections and Charities, secretaries of pre 
 vious sanitary conventions, libraries, newspapers, and health officers ii 
 other States. 
 
 That portion of the printed abstract of the Jan., 1894, meeting of .thii 
 Board, which referred to the establishment of chairs of sanitarv science 
 
ABSTRACT OP PROCEEDINGS, APRIL 13, 1894. 
 
 17 
 
 s marked, and, together with the Hillsdale Sanitary Convention pro- 
 dings and the paragraph quoted from the title page of the annual 
 )ort of the Australian Health Society, was sent to members ol faculties 
 all colleges in Michigan, members of the State Board of Agriculture, 
 incipals of high schools and superintendents of graded schools in 
 
 Aboutthe usual numbers of pamphlets on the restriction and prevention 
 the different dangerous communicable diseases were sent to the health 
 leers of localities from which dangerous diseases had been reported, it 
 ,s at the same time requested of these health officers that the pamphlets 
 distributed to the neighbors of the persons sick with such diseases, and 
 such other places as they would be likely to do good. 
 
 By special request of sanitarians in this and other otates, copies o 
 mual Beports, proceedings of meetings and sanitary conventions, and 
 mphlets on the restriction and prevention of the dangerous diseases, 
 ve been sent where it was thought practicable and likely to benefit pub- 
 , health interests. 
 
 teturn of the Name and Postoffice Addresses of Health Officers, 
 
 for the year 1894-95. 
 
 Envelopes to the number of 1,930 have been addressed to supervisors of 
 wnships, presidents and clerks of villages, and mayors and clerks o 
 ties in Michigan. These envelopes were used for sending to these 
 ficials a circular letter of instructions, together with a form and addressed 
 ivelope for the return to the Secretary of the State Board of Health, of 
 »e name and postoffice address of the newly appointed health officer m 
 ■cordance with the State law. 
 
 Annual Beports from Health Officers and Clerks, for 1893. 
 
 | Annual reports for the year 1893 have been received from 1,123 health 
 | ficers and from 1,053 clerks of townships, cities and villages m Michigan, 
 hese reports convey to this office information relative to the prevalence 
 • each dangerous communicable disease, and the condition of health, and 
 ! health work in each jurisdiction. Also, the name, postoffice, address, 
 
 1 3 ar of graduation, and the school of medicine to which each medical prac- 
 ! tioner in the township, city or village belongs. ,. 7 
 
 On February 21, a “ Second request for annual report was sent to 44 1 
 i sal th officers and clerks from whom no report had yet been received; and 
 :-i March 24, a “ Third request ” was sent to 284 health officers and clerks 
 \l cities and villages, who were still delinquent. 
 
 ! On March 14, a “ Second request for annual report was sent to l,Ui« 
 j ealth officers and clerks of townships from whom no report had been 
 hceived. Many of the reports from townships have been received, but a 
 Third request” will soon be sent out to those still delinquent, 
 j Of the 1,578 localities in Michigan, including townships, cities and vil- 
 i iges, annual reports have been received from 1,397, leaving at the end ot 
 ■ lis quarter 181 localities delinquent. More reports are expected; and, 
 j ompared with preceding years, there is a smaller number of delinquent 
 } icalities 
 
 } Beports of medical practitioners in their jurisdictions have been received 
 j com 501 clerks of townships, cities and villages. 
 
18 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Work on Meteorology. 
 
 The regular tri-daily meteorological observations have been continued a 
 this station, and a summary for each week and month during the quarte: 
 has been made for the use of this office in connection with sickness statis 
 t J cs - . The monthl y summary has been sent at the end of each month t< 
 the Director of the Michigan Weather Service and Local Forecast Officia 
 at Detroit for his use; it is sent by him to the Chief of the U. S. Weathei 
 Bureau at Washington, D. C. 
 
 Ozone test paper (supply for three months) was sent to each of sixteei 
 meteorological observers in Michigan. 
 
 Diagrams “ Cases and Deaths from Scarlet Fever in Michigan in 1891 ' 
 and “ Reported Deaths from Scarlet Fever in Michigan, 24 years 1868-91” 
 have been prepared, and photo- engraved plates made to be used in the 
 annual report of this Board for 1892. 
 
 Accessions to the Library , Card-Cataloguing , etc. 
 
 During the quarter 119 books and pamphlets and 351 numbers of 
 journals (weeklies, monthlies, and quarterlies), have been received and 
 entered in the library-accession book of this office. The work on the 
 card-catalogue of the library has been continued. 
 
 Work in Connection with Sickness Statistics. 
 
 During the first quarter of 1894, 2,352 blank postal report-cards, 159 record 
 books, 27 hektographed circular letters and 18 printed circulars regard- 
 ing weekly card-reports, have been mailed to 152 health officers and reg- 
 ular correspondents; 1,287 weekly card-reports have been received and 
 entered on the register; 53 copies of the hektographed weekly bulletin 
 Health m Michigan” were mailed each week, and 106 copies of the 
 monthly bulletin “Health in Michigan” have been hektographed and 
 mailed each month. These bulletins have been consolidated for this 
 quarterly report. W^ork has also been done on the compilation of the 
 f 766 ! «QQ CarC ^' re ^ >0r ^ S s ^ c ^- ness during the year 1892, for the annual report 
 
 Health in Michigan in the First Quarter of 1894. Communicable 
 
 Diseases. 
 
 Compared with the preceding quarter, (October, November and Decem- 
 ber), reports from all sources show scarlet fever to have increased by an 
 average of nineteen places, diphtheria to have decreased by an average of 
 three places, typhoid fever to have decreased by an average of forty-four 
 places, measles to have increased by an average of seventeen places and 
 small-pox to have increased by an average of three places. 
 
 Meteorology and Sickness from all Causes , First Quarter of 1894, com- 
 pared with the Preceding Quarter. 
 
 A comparison of meteorological conditions of the first quarter of 1894, 
 with the meteorological conditions of the preceding quarter, shows the pre- 
 vailing direction of the wind to have been the same (southwest), the aver- 
 
ABSTRACT OF PROCEEDINGS, APRIL 13, 1891. 
 
 19 
 
 ge velocity 1.6 miles per hour greater, the temperature 7.44 degrees 
 □wer, the rainfall at Lansing 2.26 inches less, the absolute and the relative 
 tumidity considerably less, the day ozone slightly more, the night ozone 
 auch less and the depth of water in the well at Lansing two inches more 
 a the first quarter of 1894. 
 
 Compared with the preceding quarter (October, November and Decem- 
 •er), the reports from regular observers show a marked increase of pleuritis, 
 aflammation of kidney, pneumonia and influenza, and a marked decrease 
 f diarrhea, remittent fever and intermittent fever in the first quarter of 
 894. 
 
 fhe Weather, and the Health in Michigan in the First Quarter of 1894 , 
 compared with the Average for the eight years, 1886 - 1893 . 
 
 A comparison of the meteorological conditions of the first quarter of 
 894, with the average for the first quarters in the eight years, 1886-1893, 
 hows that in 1894, the prevailing direction of the wind was southwest 
 instead of northwest), the velocity was 1.6 miles per hour greater, the 
 emperature was 4.82 degrees higher, the rainfall at Lansing was .54 of an 
 ich less, the absolute humidity was more, the relative humidity was less, 
 re day ozone, and the night ozone were much less, and the depth of water 
 l the well at Lansing was four inches more. 
 
 Compared with the average in thp corresponding quarters in the eight 
 ears 1886-1893, the reports from regular observers indicate that intermit- 
 .at fever, remittent fever, erysipelas, diarrhea, consumption, pneumonia 
 nd pleuritis were less than usually prevalent, and that no disease was 
 lore than usually prevalent in the first quarter of 1894. 
 
ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 REGULAR MEETING OCTOBER 12, 1894. 
 
 [216J [Reported by the Secretary of the Board.] 
 
 The Michigan State Board of Health held its quarterly meeting, at the 
 office of the Secretary, in the Capitol, at Lansing, Oct. 12, 1894. The 
 meeting was called to order by President Frank Wells of Lansing; Prof. 
 Fall of Albion, Doctor Vaughan of Ann Arbor, Doctor Gray of Pontiac, 
 Doctor Milner of Grand Bapids, and Secretary Baker of Lansing, were 
 present. Dr. Henry Sewall, Secretary of the Colorado State Board of 
 Health, was present and made a few appropriate remarks regarding the 
 organization and work of the Colorado Board, the law for which was 
 modeled after the Michigan law. The regular business including the 
 auditing of bills and accounts was transacted. 
 
 Condition of Health in Michigan during the third quarter of 1894. 
 
 Secretary Baker reported that during the third quarter of 1894, there 
 has been an unusual prevalence of typhoid fever, which has not been con- 
 fined to Michigan ;!probably connected with the drouth and unusually low 
 water in wells. Except as regards typhoid fever, the public health in 
 Michigan has been remarkably good. [His quarterly report of ^details of 
 dangerous communicable 1 ! .diseases dealt with, and of sickness from all 
 causes is printed at the close of these “ Proceedings.”] 
 
MICHIGAN STATE BOARD OF HEALTH. 
 
 2 
 
 The Board adopted resolutions drafted by Prof. Fall, as follows: — 
 
 Whereas, The members of the State Board of Health have heard with deep regret, that ‘‘The silent 
 reaper whom men call Death” has removed from the scene of his life’s activities one who was for many 
 years a highly esteemed and useful member of this Board, therefore, 
 
 Resolved , That in the death of 
 
 HENRY F. LYSTER, M. D., 
 
 the more immediate and intimate circle in which he moved, the City of his residence, and the State have 
 suffered a loss which is severe indeed. His influence was far reaching and powerful and always for the 
 good of those on whom that influence rested. 
 
 Resolved , That the members of this Board, his associates for so many years desire to place on record 
 their high appreciation of his great work to the cause of sanitary reform. To this cause he gave freely of 
 his wealth of time and talents. He was peculiarly fitted to further the work of education of the people 
 on the lines of sanitary science. He was cultured and versatile an entertaining lecturer, an extensive 
 traveler and wide observer of men and affairs, and all these he contribute to his work for the good of 
 others. , 
 
 Resolved , That we tender the bereaved family our most heartfelt sympathy. 
 
 Resolved , That these resolutions be spread on the minutes of the Board, and that a copy be sent to the 
 friends of the deceased. 
 
 Report of Delegate to International Congress of Hygiene. 
 
 Prof. Victor C. Vaughan, M. D., Ph. D., Director of the Michigan State 
 Laboratory of Hygiene, made a verbal report of his attendance at the 
 International Congress of Hygiene, at Budapest, Hungary, Sept. 1-9. A 
 brief synopsis is as follows: 
 
 The Congress met Sept. 1 for registration, and was officially opened 
 Sept. 2, in the great Hall of the Municipal Building, by Archduke Charles 
 Louis, acting for his brother, the Emperor. There were short addresses 
 from representatives of different Nations, and a memorial address, Sept. 2 
 being the anniversary of the death of the Hungarian physician who first 
 inaugurated the use of antiseptic surgery, in obstetrical cases. The Con- 
 gress was divided into some twenty-five sections, and, of course, it was 
 impossible for one man to attend sections other than those on the subjects 
 of most interest to him. There were delegates to the Congress from nearly 
 every civilized and semi-civilized country in the world, being about 2,000 
 delegates in all, of whom eight were from the United States of America. 
 
 In the section on Bacteriology, Prof. Buchner of Munich, opened the 
 discussion of the subject of the germ theory of disease, and was followed 
 by Metschnikoff, the father of the theory of Phagocytosis. Both these 
 great men gave their views on immunity and it was plainly seen that their 
 views were getting closer together. Prof. Fodor, of Budapest, read a paper 
 on the alkalinity of the blood, and I read a paper on Nucleins. It is 
 gratifying to say that the work for the production of immunity by the use 
 of nucleins is shaping itself into a tangible form. The Section on Bacteri- 
 ology was largely attended by the prominent bacteriologists in the world. 
 
 Prof. Gruber of Budapest said that the Comma bacillus is a cause of 
 cholera, but there is something else that plays an important part in the 
 causation of cholera. Prof. Metschnikoff detailed his experiments with 
 the cholera germ, the results of which go to prove that cholera is due to a 
 mixed infection, the Comma bacillus being the principal factor, and yet 
 that the cholera germ may be present without cholera. Dr. Vaughan 
 explained by saying that if X equals the cholera germ, Z the personal 
 peculiarity of susceptibility, Y is what has been the missing link, which 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 12, 1894. 
 
 3 
 
 has just been discovered by Metschnikoff to be the mixed infection, the 
 Comma bacillus with the Sarcince, or with the putrefactive germs. 
 Metschnikoff said that two years ago the cholera bacillus was present in 
 the river Seine without the presence of cholera among those who drank its 
 waters, showing that the necessary mixed infection was not present. Koch’s 
 school has advocated or implied that filth has nothing to do with the 
 causation of cholera and typhoid fever, but the section on bacteriology 
 seemed to favor the idea that too little attention has been given to filth as 
 a factor in the causation of these diseases. I never saw such enthusiasm 
 over a paper as there was over the one read by Metschnikoff. There were 
 only a few reprints of his paper, and, notwithstanding the paper would 
 be printed in a few days, the leading bacteriologists scrambled over the 
 tops of the seats to get a copy of the reprint. 
 
 A paper prepared by Dr. Behring on his experiments in connection 
 with his work on immunity from diphtheria was presented, and read to the 
 Congress by Dr. Heubner of the University of Berlin. The paper detailed 
 his experiments in rendering goats immune against diphtheria, and then 
 taking the immunizing blood-serum of the goat for the treatment of diph- 
 theria in the human being. Dr. Roux, of the Paris Pasteur Institute, read 
 a paper on nearly the same subject, except that he had used horses in his 
 experiments, and had taken the immunizing blood-serum of the horse for 
 the treatment of diphtheria. While Dr. Behring left his method prac- 
 tically a secret, Dr. Roux revealed every detail of his work, and offered to 
 supply the serum, and made known his intentions to give his time to the 
 Prevention of Diphtheria. Under Dr. Roux’s direction, in Paris, some 400 
 diphtheria cases had been treated, with a mortality of only 15 per cent, 
 which was a reduction from a mortality of 55 or 60 per cent prior to the 
 great discovery. Although Dr. Roux has not had time to fully prove his 
 method, he will make many hundreds of tests of his treatment before stat- 
 ing absolutely as regards its efficacy. 
 
 In the discussion of the subject of the restriction and prevention of 
 diphtheria, Dr. Billings, Deputy Surgeon-General of the United States 
 Army, presented a paper which had been written by Dr. Welch, Bacter- 
 iologist at Johns Hopkins University, Baltimore, giving not only his own 
 researches, but the work of others in the Eastern States of this Union. It 
 was apparent that all the best work in connection with the pre- 
 vention of diphtheria has been done in the United States, and that no 
 city or country has done so much as has been done in the city of New 
 York in connection with the bacteriological diagnosis of diphtheria. His 
 paper showed that out of 6,000 cases in which the bacteriolgical examina- 
 tion had been made, 60 per cent were found to be diphtheria and were so 
 treated by the Health Department, and the rest were discharged as not 
 being diphtheria. 
 
 Dr. Leyden read a paper on the “ Prevention of Tuberculosis,” which 
 was one of the most important papers of the Congress. Dr. Leyden said 
 that tuberculosis was a communicable disease, and in the homes of the 
 poor co v uld be restricted only by the withdrawal of the sick from the family, 
 and isolation in consumptive hospitals. He advocated two classes of 
 hospitals, one for the incurable, and one for the curable cases. He showed 
 that the expense of caring for a consumptive in a hospital was about 62^ 
 cents per day. Dr. Vaughan said that he was surprised to hear that there 
 were several free government hospitals for consumptives already in 
 operation in Germany. 
 
 2 
 
MICHIGAN STATE BOARD OP HEALTH. 
 
 Telegraphic reports announced that Kitasato, of Japan, had discovered 
 the germ of Asiatic Plague; but Yersin, of France, had already sent word 
 of his discovery to the Congress, together with plates and cultures of the 
 germs. The four rules of Koch have been fully complied with, so there is 
 probably no doubt but that the germ has been discovered by Yersin, and 
 that Kitasato has verified the discovery.” 
 
 It was voted by the Board to thank Dr. Vaughan for his verbal report, 
 and to request that he make his written report as soon as practicable. 
 
 The Production of Immunity against Diphtheria. 
 
 Dr. Vaughan asked the Board what it wished to do in connection with 
 the Prevention or Restriction of Diphtheria, by the use of immunizing 
 blood-serum. He believed that great progress in our knowledge of this 
 subject, could be made in Michigan by being able to supply health officers 
 and physicians with the immunizing blood-serum. 
 
 On motion of Dr. Baker, it was voted that Dr. Vaughan — the Director 
 of the Michigan, State Laboratory of Hygiene — be requested, if practicable, 
 to enter upon the production of immunizing blood-serum for use in the 
 production of immunity from diphtheria, with a view of still further 
 testing, in this country, the efficacy of the method. 
 
 The Disinfection of Solid Masses of Dried Tuberculous and Diphtheritic Sputa. 
 
 The question of a disinfectant which shall destroy the germs in a solid 
 dried mass of tuberculous or diphtheritic sputum was presented, from a 
 prominent health officer in Michigan, Dr. Johnston, of Milford. On 
 motion, the Board voted to request Dr. Vaughan to make such investiga- 
 tions as will settle the point whether sulphur fumes will penetrate a dried, 
 solid tuberculous or diphtheritic sputum, as it is generally found when 
 deposited on a trunk of an immigrant or on the floor. If sulphur fumes 
 are not adequate for such disinfection, to test so as to learn just what 
 mode of disinfection is adequate. 
 
 A N on-Infectious Public Drinking Cup for Schools. 
 
 The subject of the contraction of diphtheria and other diseases by means 
 of public drinking cups was presented and discussed, by reason of a commu- 
 nication to the Secretary from Dr. G. W. Goler, medical inspector, board 
 of health, Rochester, N. Y. Dr. Baker read an account of the actual 
 demonstration of diphtheria bacilli on two cups in actual use in a school. 
 The value of public drinking fountains, such as have been in use in New 
 York City, and similar to one in Romeo, Michigan, was considered. The cups 
 are stationary on the top of the open end of the water pipe, the water 
 rising in the center and flowing over the edges. When in use 
 running water continually overflows the sides of the public cup and tends 
 to wash away any infectious material that otherwise collects upon the 
 edges and sides of the cup. Whenever there is a general water supply 
 with pressure a similar fountain cup might easily be attached to the pub- 
 lic drinking place for school children, and it would tend to prevent the 
 spread of diphtheria, and other diseases of specific origin. 
 
ABSTRACT OP PROCEEDINGS, OCTOBER 12, 1894. 
 
 5 
 
 Consumptives Should not he School Teachers. 
 
 Dr. Milner, of Grand Rapids, said that he had noted several instances 
 where school children had probably contracted consumption from their 
 teacher. Dr. Milner moved that the Board request the committee on 
 public health legislation to frame a bill for the next legislature, which 
 shall prohibit any person from teaching school or acting as a professional 
 nurse without having the certificate from a reputable physician stating 
 that the proposed teacher or nurse is free from any communicable form of 
 tuberculosis. 
 
 Milk of Tuberculous Animals Should not he Sold. 
 
 Dr. Vaughan suggested that the committee on legislation be requested 
 to frame a law which should prohibit a milkman from selling milk in a 
 city unless he has a license from the State Live Stock Commission show- 
 ing that his cows have been examined by the State Veterinarian, or a com- 
 petent veterinarian, and found to be free from tuberculosis, the tuberculin 
 test being applied in case of any doubt. 
 
 Proposed Systematic Observations of Carbonic Acid in the Atmosphere. 
 
 Prof. Fall, of Albion, committee to whom was referred the subject of 
 fluctuations in the amount of carbonic acid gas in the atmosphere, made a 
 preliminary report on the instruments and apparatus needed to make reg- 
 ular and accurate examinations to determine the amount. 
 
 The written portion of Prof. Fall’s report is as follows: 
 
 Carbon di oxide in the atmosphere. 
 
 At the quarterly meeting of this Board held July 13, 1894, Secretary Baker, as Com- 
 mittee on Climate, etc., presented the subject of the “Decrease of the amount of Car- 
 bon Di-oxide in the atmosphere,” and remarked that some twenty years ago he had 
 asked the Board to authorize a series of regular and accurate chemical analyses of the 
 atmosphere with a view of determining whether there was any change in the amount 
 of the carbonic acid gas in the atmosphere by seasons of the year and by long periods 
 of years. Dr. Baker said that the subject is important now and may become more so, 
 in relation to the public health. He quoted from the Chemical News , London, August, 
 1893, as follows: As evidence that the composition of the atmosphere is still slowly 
 changing, it is stated that “ the latest and most careful determinations of carbonic 
 acid in the air have shown a decided decrease (0.05 to 0.03) in the past fifty years.” 
 
 On the other hand, Dr. Paul C. Freer, Professor of Chemistry in Michigan Univer- 
 sity, says, in his General Chemistry, just published, that “so far as we know, the 
 amount of carbon di-oxide in the atmosphere is not diminishing; if it is growing 
 less the rate of decrease is so very slow that in the short time that chemists have been 
 able to make accurate observations, no change could be noted.” He further says: “ The 
 amount of carbon dioxide in the air varies slightly, but normally it is about four parts 
 in ten thousand, and it seems that the amount is greater at night than in the daytime, 
 and in summer than in winter. In the higher regions of the atmosphere, where vege- 
 tation is impossible, the amount of the gas may increase to eleven parts in ten thousand, 
 while a continued rain may diminish it to two and a quarter.” 
 
 The report was accepted with thanks, and the committee continued. 
 Dr. Baker was very enthusiastic in his plea that the observations be com- 
 menced and continuously made, so that the facts be known and recorded 
 for future use in connection with studies on the causation of diseases, with 
 a view to their prevention. 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 THE STATE QUARANTINE LAW. 
 
 The law is constitutional. 
 
 The Secretary reported as follows: — 
 
 “ During the quarter, the State Supreme Court has decided the question 
 of the constitutionality of the law which authorizes the State Board of 
 Health, under certain circumstances 4 to establish a system of quarantine 
 for the State of Michigan or for any portion thereof.’ 
 
 “ The court decides that the law is constitutional. 
 
 Rule 2 of this Board , under the State Quarantine Law , is not valid. 
 
 “The ‘circumstances’ specified in the law, as warranting the State 
 Board of Health in establishing a system of quarantine, are such as gen- 
 erally prevail in every country, it being within the knowledge of this 
 Board through its system of exchanges of weekly, monthly and other 
 reports, etc., throughout the world, that such ‘ dangerous communicable 
 diseases’ specified in the law, are now and are generally present in every 
 country. This was true at the time this Board made and published the 
 ‘Buies’ under this State quarantine law. It was also true relative to 
 cholera, which, although not the most dangerous disease to citizens of Mich- 
 igan, is yet one of such “dangerous communicable diseases” contemplated 
 by the law; cholera was then liable to be brought to this country by any 
 immigrant from any country, because of the diffusion of cholera inso many 
 centers of distribution of immigrants. But in this declaration of the ‘cir- 
 cumstances’ upon which this Board based its ‘Buies’ made under the law, 
 these facts were not advertised. Without making plain the fact that there 
 was then danger of the introduction of a ‘dangerous communicable dis- 
 ease’ from every country, the ‘Buie 2’ required the disinfection of all 
 baggage of all immigrants. The Supreme Court has decided that ‘ Buie 
 2’ as made and published, was not authorized by the law. 
 
 “ I hope it will be possible to frame a rule which shall be authorized by 
 law, and which shall fill the requirements for protection of the people of 
 Michigan from the introduction of dangerous disease. 
 
 “Perhaps it may be sufficient to declare that such diseases are present 
 in every known country. But this may not be sufficient; and the framing 
 of a rule may not be as easy as at first sight it appears. 
 
 Is the State Quarantine Law Sufficients 
 
 “ When immigration increases again, danger of the introduction of dis- 
 ease may and probably will attend all baggage of all immigrants. Unless 
 the law is amended, it may be necessary to specify, by name, every known 
 country, and not only that but the names of the particular dangerous dis- 
 eases present in each such country. Probably this may be done; but in 
 an emergency it might delay proper action by this Board. 
 
 “The theory of the law seems to me to be wrong. It seems to assume 
 that if there is no dangerous communicable disease in a given country it 
 is entirely safe to permit immigrants from that country to enter Michigan 
 without any precaution whatever. This theory is probably held to be true 
 by most people, including courts and juries, but it entirely disregards 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 12, 1894. 
 
 < 
 
 important facts relative to the modes of spreading dangerous communica- 
 ble diseases: — 
 
 “1. An immigrant may come from a place free from infection of any 
 dangerous disease, and his baggage may become infected on shipboard or 
 at some center of embarkation or debarkation where immigrants from 
 many countries congregate. He may himself be immune against a given 
 disease, and thus himself be free from any evidence of infection; yet his 
 baggage when opened in the home of some inhabitant of Michigan may 
 spread a dangerous disease. 
 
 “2. An immigrant may really come from a place which is infected with 
 a dangerous disease, yet his place of embarkation may be in a country, or 
 at least in a city in which the particular disease with which his baggage 
 is infected may not be present. If he is considered as from the country 
 in which he embarked, he will be considered as free from the infection 
 which in reality his baggage contains. 
 
 “ There are other facts bearing upon the subject, which are well known 
 to members of this Board, but those I have mentioned seem to be suffi- 
 cient to indicate the imperfection in the theory of the State Quarantine 
 Law.” 
 
 “The decision of the Supreme Court is as follows: — 
 
 DECISION OF THE SUPREME COURT. 
 
 SUPREME COURT. 
 
 John Hurst, 
 vs. 
 
 Frank R. Warner. 
 
 Montgomery, J. 
 
 The plaintiff, who is prosecuting attorney for the county of Chippewa, on the twenty-fourth of Novem- 
 ber, 1893, presented to the respondent, who is a justice of the peace of said county, a complaint alleging 
 that one Robert B, Finch was a station agent of the Minneapolis, St. Paul & Sault Ste. Marie R. R. Co. at 
 Sault Ste. Marie, and on the twenty-third of November, 1893, in charge of a train belonging to said rail- 
 way company; that on said train there was baggage consisting of clothing, wearing apparel, etc., belong- 
 ing to one Edmund Watelet, an immigrant, late of Havre, France, who was traveling through Michigan 
 to Minneapolis and whose baggage was liable to be disinfected by one Thomas N. Rogers, an inspector, 
 authorized by the Michigan State Board of Health, of all immigrants destined to pass into or through the 
 State of Michigan; that said Finch was requested by said Rogers to detain said baggage for disinfection 
 and inspection and wilfully refused so to do and proceeded with said train and said baggage in and 
 through Michigan, in violation of rule number two, framed and published by the Michigan State Board 
 of Health, under act number 230 of the laws of 1885, as amended by act number 47 of the laws of 1893 of 
 this State. Upon the presentation of this complaint the respondent was requested by the relator to cause 
 a warrant to be issued, based upon said complaint, but declined to do so for the reason that act number 
 47 of the laws of 1893 was unconstitutional and void, and for the further reason that if said act was not 
 void, rule number two, upon which the prosecution was based, was not authorized by said act, and that 
 the Board of Health exceeded its authority in passing said rule. The relator then applied to the circuit 
 judge for a mandamus, which was refused, and certiorari has been issued to review his decision. The two 
 questions presented here are those which determined the action of the justice. 
 
 I. It is contended, and the circuit judge held, that the statute in question is unconstitutional for the 
 reason that it delegates to the Board of Health legislative power in contravention of section one of 
 article four of the Constitution, which provides that “ legislative power is vested in a senate and a house 
 of representatives.” To determine the question involved it is necessary to refer at some length to the 
 provisions of the statute. 
 
 Section one provides that “ whenever it shall be shown to the satisfaction of the State Board of Health 
 that cholera, diphtheria, or other dangerous, communicable disease exists in any foreign country, neigh- 
 boring state, or locality within this State whereby the public health is imperiled, and it shall be 
 
 | Filed Sept. 27, 1894. 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 farther shown that immigrants, passengers, or other persons seeking to enter this State, or to travel from 
 place to place within this State, are coming from any locality where such dangerous, communicable dis- 
 ease exists, and are likely to carry infection of such dangerous, communicable disease, the State Board of 
 Health shall be authorized to establish a system of quarantine for the State of Michigan or for any portion 
 thereof.” 
 
 Section two provides that “ 6uch quarantine shall be for the purpose of preventing all immigrants, pas_ 
 sengers or other persons, under the circumstances mentioned in section one of this act, from entering the 
 State or from going from place to place within the State, who in the opinion of the State Board of Health, 
 or in the opinion of an inspector duly appointed by said Board, are likely to carry infection of cholera, 
 small-pox, diphtheria, or other dangerous, communicable disease; and for the detention of all such per- 
 sons outside the borders of the State, or if already within the State, at the places where they may be or at 
 the place they have been exposed to or have contracted such dangerous, communicable disease or at such 
 suitable place as such board may provide, during the period of the incubation of such disease, or of its 
 existence if already developed, and until in the opinion of the State Board of Health such persons are free 
 from all danger of infection.” 
 
 Section three provides that “ the State Board of Health is authorized to establish general rules, and, by 
 an inspector acting by virtue thereof, to detain railroad cars or other public or private conveyances 
 whenever it shall be shown to the satisfaction of such Board, or to the inspector as provided in such 
 rules, that such cars or other conveyances contain any passenger, person or property which has been 
 exposed to cholera, diphtheria, or other dangerous, communicable disease, or when it shall be shown to 
 the satisfaction of such board or inspector as aforesaid, any [passenger, person or property are being 
 transported on such railroad cars or other public or private conveyance from any locality within or with- 
 out this State where any such dangerous, communicable disease exists and where under the circumstances 
 shown to such board, such persons or property are likely to carry infection of such dangerous, com- 
 municable disease. In such case said board may, by its duly constituted inspectors, remove, isolate, 
 place under the care of local boards of health, order to be returned to the places whence they came, or 
 dispose of in any other manner it may consider proper, all railroad cars or other conveyances, all pas- 
 sengers in such railroad cars or other conveyances, where there is reason, as aforesaid, to believe such 
 may have contracted or become infected with any dangerous, communicable disease, or have been exposed 
 or infected by any such disease in a manner likely to render them bearers of infection. * * * * * .” 
 
 Section four provides, “All such persons, their baggage and other personal effects, and all such con- 
 veyances shall be disinfected under such rules and regulations as the State Board of Health may 
 establish for the purpose of carrying into effect the provisions of this act, before such persons or baggage 
 or conveyances shall be permitted to enter the State, or to proceed to their or its destination if already 
 in the State.” 
 
 Section five provides for the disinfection of goods, merchandise, conveyance or other property which 
 the State Board have reason to believe may carry the germs of cholera or other dangerous communicable 
 diseaee, and under the circumstances mentioned in sections two and three of the act, to prohibit the 
 entry of such goods, merchandise or other property into the State, or their being moved if within the 
 State, until such disinfection shall be accomplished. 
 
 Section six provides, “ It shall be the duty of the State Board of Health to frame and publish rules for 
 the inspection, isolation, detention and disinfection contemplated in this act;” and further provides as 
 follows: “ Whoever shall wilfully violate the rules of the State Board of Health made in pursuance of 
 this act, or the order, by its duly appointed inspector, made in obedience to such rules, shall be deemed 
 guilty of a misdemeanor, and cn conviction thereof shall be liable to payment of a fine of one hundred 
 dollars and costs of prosecution, or imprisonment in the county jail for a period not to exceed ninety 
 days,” etc. 
 
 As was said by Chief Justice Marshal in Wayman v. Soythard, 10 Wheaton, 1. “ It will not be contended 
 that Congress can delegate to the courts or to any other tribunals, powers which are strictly and exclu- 
 sively legislative. But Congress may certainly delegate to others powers which the legislature may right- 
 fully exercise itself. * * * The difference between the departments undoubtedly is that the 
 
 legislature makes the executive executes and the judiciary construes the law. But the maker of the law 
 may commit something to the discretion of the other departments, and the precise boundary of this power 
 is a subject of delicate and difficult inquiry.” 
 
 In In Re Griner, 16 Wis., 457, Justice Cole, speaking for the court and referring to the rule that the powers 
 of the different departments are not to be confounded or delegated by the one department to the other, said, 
 “ Most of the propositions stated are recognized political maxims under our form of government. It is 
 only the conclusion or deduction from those propositions about which any doubt can exist. No one will 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 12, 1894. 
 
 9 
 
 seriously contend that congress can delegate legislative power to the president. Bnt a distinction must 
 be made of ‘ those important subjects which must be entirely regulated by the legislature itself from those 
 of less interest in which a general provision may be made and power given to those who are to act under 
 such general provisions to fill up the detail.’ It would seem that the power given to the president to 
 make all rules and regulations to carry into effect the law for calling out the militia, is of the latter 
 character. Congress might have regulated by legislstion the whole details of the draft, if it had thought 
 proper to do so. But having in the most ample manner clothed the president with power to call forth 
 the militia, it further provided that he should make all proper rules ond regulations for the enforce- 
 ment of the draft where State laws upon the subject were defective. ******* This 
 no more partakes of legislative power than that discretionary authority entrusted to every department 
 of the government in a variety of cases. The practice of giving discretionary power to other departments 
 or agencies who were intrusted with the duty of carrying into effect some general provisions of the law, 
 had its origin at the adoption of the Constitution and in the action of the first congress under it, as the 
 federal legislation abundantly shows.” 
 
 See also as bearing upon this question, Field v. Clark, 12 S. C. R., 495; Locke’s Case, 12 Pa. St., 491; 
 Georgia R. R. v. Smith, 9 A. R. R. Cases, 385. 
 
 In the present case we think it can hardly be doubted under the authorities cited that the legislature 
 might have provided for the disinfection of the baggage and personal effects of travelers coming from 
 infected ports, under the direction of an inspector of the board. To have made such a law effective it 
 would have been essential that the inspector should have been given authority to act and to have made it 
 a misdemeanor to refuse to recognize his authority. The present act does nothing more except that it 
 provides that such disinfection shall take place under general rules to be adopted by the State Board of 
 Health. The rules relate to matter of detail. It is well known that there are different methods of disin- 
 fection. It was properly left to the board by the legislature to determine as to these methods, and instead 
 of intrusting it to the discretion of the individual inspector it was prescribed that general rules should 
 be adopted. We are referred to the case of the Senate of the Happy Home Club v. The Board of Super- 
 visors, 57 N. W, R., 1101, recently decided by this court, as authority for respondent’s contention. The 
 statute considered in that case bears no analogy to the statute under consideration. The power was there 
 delegated to a private corporation to make rules governing the conduct of the accused, the observance of 
 which rule should operate to acquit and discharge the accused. This did not leave a discretion in public 
 officials as to the mere details of the operation of the law, but was an attempt to delegate power to a 
 private corporation, which it was clearly beyond the authority of the legislature to do. Reliance seems 
 to have been placed by the circuit judge upon two cases of Ex Parte Cox, 33 Cal., 21, and Harbor Commis- 
 sioners v. Redwood Co., 88 Cal., 491. In the latter case an attempt was made to confer upon the board of 
 harbor commissioners the power to prescribe rules and fix the penalty for their violation, which clearly 
 distinguishes it from the present. In the case of Ex Parte Cox, the petitioner was convicted of a misde- 
 meanor consisting of a violation of a rule and regulation of the board of State Yiticultural Commis- 
 sioners. The act of the legislature in question declared that the board should have power to declare and 
 enforce rules and regulations in the nature of quarantine to govern the manner of and restrict and pro- 
 hibit the importation into the State of infected articles and empty fruit boxes, and declared that a wilful 
 violation of the quarantine regulations of the board should be a misdemeanor. The court say, “ The act 
 before us does not say it shall be unlawful to import, distribute or dispose of infected articles, but it 
 purports to confer upon the board the power to so declare.” We think our statute is distinguishable in 
 principle from the one here dealt with. The effect of the provisions of our statute is to declare it unlaw- 
 ful for any person to refuse to permit his baggage and personal effects to be disinfected in accordance 
 with the rules and regulations of the Board of Health. The rules and regulations are limited to the pur- 
 poses which are specifically described by the act. We think the statute is constitutional. 
 
 II. As above stated, by the above act of 1893 it was not intended to confer upon the Board any power 
 beyond that of fixing the method to be adopted in carrying into effect the details of the isolation, 
 inspection, disinfection, etc., provided for by the law itself. By the first section the Board was author- 
 ized to establish a quarantine when it is shown to the satisfaction of the Board that dangerous, com- 
 municable disease exists in any foreign country, neighboring state or locality within this State and when 
 it shall be further shown that immigrants, passengers, or other persons seeking to enter this State or to 
 travel from place to place within this State are coming from any locality where such dangerous, com- 
 municable disease exists. By section three it is provided that “ the State Board of Health is authorized 
 to establish general rules, and, by an inspector acting by virtue thereof, to detain railroad cars or other 
 public or private conveyances whenever it shall be shown to the satisfaction of such board or to the 
 inspector as provided in such rules, that such cars or other conveyances contain any passenger, person 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 or property which has been exposed to cholera, diphtheria, or other dangerous, communicable disease, or 
 when it shall be shown to the satisfaction of such board or inspector as aferesaid, that any passeDger, 
 person or property are being transported on such railroad cars or other public or private conveyance 
 from any locality within or without this State where any such dangerous, communicable disease exists 
 and where under the circumstances shown to such board, such persons or property are likely to carry 
 infection of such dangerous, communicable disease.” A careful examination of the rules declared by the 
 board, and particularly of the one alleged to have been violated, leads us the conclusion that the board 
 exceeds the authority conferred by the statute by the promulgation of the rule in question. The rules 
 recite the existence of communicable diseases in various foreign countries from which immigrants are 
 coming to the United States in large numbers, and then proceeds by rule two, “ Except as hereinafter 
 specifically excepted, all baggage of all immigrants and all containers of all such baggage destined to pass 
 into or through Michigan must be detained until disinfected.” The exceptions mentioned are, first, 
 “ baggage bearing a certificate issued by an inspector authorized or accredited by the Michigan State 
 Board of Health;” second, baggage contained in sealed cars, such seals not to be broken or the cars 
 opened in the State of Michigan; third, “ hand baggage of immigrants used en route, and known to have- 
 crossed the ocean in ships uninfected with any dangerous, communicable disease, or bearing a certificate 
 of disinfection, issued by an inspector authorized or accredited by the Michigan State Board of Health.” 
 Under these rules the baggage of all immigrants was subject to disinfection whether such immigrant 
 came from a port or locality where any dangerous, communicable disease existed or not. Indeed, there 
 was no allegation in the complaint that the baggage in question came from such locality. This is 
 beyond the power of the board. We do not intimate that it would not be competent for the legislature 
 to provide for the disinfection of all baggage, where, in the opinion of the Board of Health, from the 
 prevalence of a contagious disease, such precaution is necessary. But, instead of doing so, it is provided 
 by section three that the board is authorized to establish general rules and by an inspector acting by 
 virtue thereof to detain railroad cars or other public or private conveyances, etc., whenever it shall be 
 shown to the satisfaction of such board or to the inspector as provided in such rules, that such cars or 
 other conveyances contain any passenger, person or property which has been exposed, etc., or when it is 
 shown to the satisfaction of such board or inspector as aforesaid that such passenger, person or pro- 
 perty are being transported from any locality where any such dangerous, communicable disease exists 
 and where such persons or property are likely to carry infection of such dangerous, communicable dis- 
 ease. The rule in question did not make it a pre-requisite to the inspection that the baggage being trans- 
 ported come from a locality where such disease existed, as ascertained either by the board or inspector, 
 and in this respect was broader than the statute and cannot be sustained. 
 
 It follows that the justice was right in refusing to issue the warrant. We have, however, gone at 
 length into the consideration of the provisions of the statute to show to what extent authority is con- 
 ferred upon the board, as the question involved is one of great public importance. 
 
 The judgment will be affirmed. 
 
 The other Justices concurred. 
 
 IN THE SUPREME COURT. 
 
 STATE OF MICHIGAN, -ss. 
 
 Glebe’s Office. 
 
 I, Charles C. Hopkins, Clerk of the Supreme Court of the State of Michigan, do hereby certify that the 
 annexed and foregoing is a true and correct copy of the opinion of the Court now on file in said Court in 
 said cause; that I have compared the same with the original, and that it is a true transcript therefrom, 
 and the whole of said original. 
 
 In Testimony Whebeof, I have hereunto set my hand and affixed the seal of said Supreme 
 1 _l. s. | Court, at Lansing, this first day of October A. D. 1894. 
 
 CHAS. C. HOPKINS, Clerk . 
 
 By Jos. H. Dunnebacke, Deputy Clerk. 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 12, 1894. 
 
 11 
 
 SECRETARY’S REPORT OF DANGEROUS COMMUNICABLE DISEASES. 
 
 OF WORK DONE IN THE OFFICE OF THE STATE BOARD 
 OF HEALTH, AND OF THE CONDITION OF HEALTH GEN 
 ERALLY IN MICHIGAN DURING THE QUARTER 
 ENDING SEPTEMBER 30, 1894. 
 
 Dangerous Communicable Diseases. 
 
 Tlie number of reports of outbreaks of dangerous communicable diseases 
 in Michigan, received from all sources and filed, and the corresponding 
 number concerning which action was taken by this office, during the 
 quarter, are as follows: for diphtheria, 93; for scarlet fever, 107; for 
 typhoid and typho-malarial fever, 155; for measles, 21; for small-pox, 2; 
 and for consumption, 42. Total for the six diseases, 420. 
 
 The number of communications relative to dangerous communicable 
 diseases, received and placed on file during the quarter, was 1,972. 
 
 Relative to dangerous communicable diseases, letters, written cards, and 
 demands for weekly and final reports on cards, or in the form of the cir- 
 cular letter, were sent out during the quarter to the number of 1,692. 
 
 The “final” reports of outbreaks received and filed during the quarter, 
 were: for diphtheria, 61; scarlet fever, 91; typhoid and typho-malarial 
 fever, 59; measles, 104; small-pox, 13; consumption, 1. Total for the six 
 diseases, 329. 
 
 During the quarter, the local columns of 696 newspapers, have been 
 looked over for reports of occurrence of communicable diseases. This has 
 resulted in giving this office information of the alleged" occurrence of 5 
 outbreaks of diphtheria, 4 outbreaks of scarlet fever, 7 outbreaks of typhoid 
 and typho-malarial fever, 2 outbreaks of measles, and 1 outbreak of small- 
 pox. To what extent the reports of these alleged outbreaks were verified, 
 is shown in the accompanying table. 
 
 TABLE I. — Showing the number of Outbreaks of Diphtheria , Scarlet fever , Typhoid 
 fever, Measles, Small-pox and Consumption, from July 1 to September 30, 1894, of 
 which notice was received at the office of the Michigan State Board of Health ; the 
 per cent of reports, information concerning which was received through the News- 
 papers; the per cent of newspaper reports which were confirmed by the health officer ; 
 the per cent of newspaper reports which were denied by the health officer ; and the 
 per cent relative to which no reply was received from the health officer. 
 
 Diseases. 
 
 Reports from 
 all sources, 
 July 1 to 
 Sept. 30, 1894. 
 
 Per cent of 
 all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were con- 
 firmed by the 
 health officer. 
 
 Per cent of 
 newspaper re- 
 ports which 
 were denied by 
 the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports to which 
 the health 
 officer made 
 no reply 
 to notice sent 
 from this 
 office. 
 
 Diphtheria __ 
 
 93 
 
 5 
 
 80 
 
 20 
 
 0 
 
 Scarlet fever . _ . _ _ 
 
 107 
 
 4 
 
 25 
 
 50 
 
 25 
 
 Typhoid fever 
 
 155 
 
 5 
 
 71 
 
 29 
 
 0 
 
 Measles __ 
 
 21 
 
 9 
 
 50 
 
 0 
 
 50 
 
 Small-pox 
 
 2 
 
 50 
 
 100 
 
 0 
 
 0 
 
 Consumption 
 
 42 
 
 0 
 
 0 
 
 0 
 
 0 
 
 Averages for the six diseases 
 
 
 5 
 
 63 
 
 26 
 
 11 
 
12 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Small-pox in Michigan in Third Quarter of 1894. 
 
 Two new outbreaks of small-pox were reported during the quarter. One 
 in Clayton township, Genesee county, and one in Rives township, Jackson 
 county. 
 
 The outbreak in Clayton township was reported to this office July 2. 
 Two cases occurred, both of which recovered. The source of the infection 
 of that outbreak was not learned. The health officer says: — “Possibly 
 from a tramp at Lennon.” No other case was reported at Lennon or in 
 that locality. 
 
 The second outbreak was reported from Rives township , Jackson county, 
 September 22. The patient is a child aged ten years, whose mother is 
 alleged to have died of small-pox at Marion, Indiana, on September 4, 
 1894. After the release of the child from isolation, it came with its father 
 to Rives township, and is said to have been taken sick with the disease on 
 the way. The case is reported as recovering, and it is believed that no 
 new cases will occur in that locality. 
 
 The outbreak of small-pox which began in Detroit during the quarter 
 ending June 30, 1894, still continues. During the quarter for which this 
 report is made, thirty-nine new cases and eight deaths from the disease 
 have been reported from that city, of which eight new cases and one death 
 are reported to have occurred during the week ending September 29. 
 
 Compiling, Editing, Proof-reading, Printing , Etc. 
 
 A compilation of reports from health officers and clerks, relative to 
 Scarlet Fever in Michigan in 1892, and the tables for the article, have been 
 made. The Compilation of the reports relative to “Typhoid Fever in 
 Michigan in 1892” has been commenced. The compilation of the “ Diph- 
 theria in Michigan in 1892” has been proved, and the proving of “ Scarlet 
 Fever in Michigan in 1892 ” is well under way. 
 
 Articles for the Report for 1892, have been prepared on the following 
 subjects: Typhoid Fever in 1891; Typhus Fever; Consumption; Dysen- 
 tery; Membraneous Croup; Mumps; Chicken-Pox; Erysipelas; Poisoning 
 from Canned Fruit; Poisoning from Lead Pipe; Poisoning from Tyrotox- 
 icon; Nuisances in Michigan in 1891; and the article relative to injuries 
 and loss of life and property from the use of kerosene in Michigan in 1891 
 is nearly ready for the printer. 
 
 The articles mentioned in the preceding paragraph, with the exception 
 of the one relating to kerosene, have been edited and sent to the State 
 Printer for publication in the Annual Report of the Board for 1892. 
 
 Proof has been read on the larger portion of the “ First Part ” of the 
 Report for 1892, and on that portion of the “ Second Part ” following the 
 article on Measles. Proof has also been read on the Proceedings of the 
 July meeting. 
 
 The printing on the Report for 1892 has been well advanced and it is 
 expected that the printing will be completed by the first of November. 
 It is hoped that the Report will be ready for distribution some time during 
 the fourth quarter of 1894. 
 
 Work on Meteorology. 
 
 The regular tri-daily meteorological observations have been continued at 
 this station, and a summary for each week and month during the quarter 
 
ABSTRACT OP PROCEEDINGS, OCTOBER 12, 1894. 
 
 13 
 
 has been made for use in this office in connection with sickness statistics. 
 The monthly summary has been sent at the end of each month to the 
 director of the Michigan Weather Service and local forecast official for his 
 use; it is sent by him to the chief of the United States Weather Bureau 
 at Washington, I). C. 
 
 Ozone test paper (supply for three months) was sent to each of seven- 
 teen meteorological observers in Michigan. 
 
 Diagrams Nos. V., XIV., and XV., to illustrate the article relating to 
 meteorology in Michigan in 1892, were made, the photo-engraved plates 
 therefrom procured, and the article for the annual report for 1893 com- 
 pleted and sent to the printer. 
 
 Nine additional diagrams have been made and photo-engraved, for use 
 in the annual report of this Board for 1893. 
 
 Compilations on meteorological registers for 1893, except barometer, 
 are nearly completed. 
 
 Meteorological registers for April to July, 1894, inclusive, have been 
 received, examined, and computations made (barometer and humidity 
 excepted) for each of eleven stations. 
 
 Distribution of Publications, etc. 
 
 Copies of the annual report for the year 1891, to the number of 2,700, 
 were sent to: Sanitary journal exchanges, secretaries of other state boards 
 of health and state medical societies, correspondents, meteorological 
 observers, meteorological exchanges, members of state boards of correc- 
 tions and charities, superintendents of State institutions, health officers in 
 other states, libraries, health officers and clerks of townships, cities, and 
 villages, and presidents of villages, and mayors of cities in Michigan, and 
 sanitarians in this and other states. 
 
 The proceedings of the Holland Sanitary Convention has been sent to 
 presidents of villages, the proceedings of the Charlevoix Convention has 
 been sent to clerks of villages, and the proceedings of the Sanitary Con- 
 ventions at Traverse City, Owosso, Otsego, a paper by Dr. Baker on the 
 “ Restriction and Prevention of Dangerous Communicable Diseases,” a 
 discussion on “The Prevention of Consumption” by Dr. Baker, have been 
 sent to each of 970 health officers of townships in Michigan. 
 
 About 400 copies of the proceedings of the Menominee Convention have 
 been sent to citizens, officers of the convention, and to those who took part 
 in the convention. 
 
 The proceedings of the Menominee Convention, the consumption slip, 
 and the abstract of proceedings of the July 13, 1894, meeting were sent to: 
 Members and ex-members of this Board, sanitary journal exchanges, secre- 
 taries of State boards of health, and of State medical societies, meteorolog- 
 ical observers and exchanges, superintendents of State institutions, 
 libraries, correspondents, health officers in other States, health officers of 
 cities and villages in Michigan, presidents and secretaries of preceding- 
 sanitary conventions. The pamphlet proceedings of the Menominee 
 Convention has also been sent to clerks and mayors of cities in Michigan. 
 
 The announcement of the Union City Convention has been distributed 
 to the number of about 1,250 copies. The announcement for the Charlotte 
 Convention has been distributed to the number of 1,350 copies. 
 
 About the usual number of pamphlets on the restriction and prevention 
 of the different dangerous diseases were sent to the health officers of 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 localities in which dangerous diseases had been reported. It was at the 
 same time requested of these health officers that the pamphlets be dis- 
 tributed to the neighbors of the persons sick with such diseases, and to 
 such other persons as they would be likely to benefit. 
 
 In response to special requests of sanitarians in this and other States, 
 copies of Annual Reports, proceedings of meetings and sanitary conven- 
 tions, and pamphlets on the restriction and prevention of the dangerous 
 communicable diseases, have been sent where it was thought likely to 
 benefit public-health interests. 
 
 The usual record of the distribution of publications has been kept. 
 
 A list of the “Names and Addresses of Health Officers in Michigan for 
 the year 1894-95” has been made and printed to the number of 1,700 
 copies, and distributed to each health officer of a township, city or village, 
 whose name had been returned to this office. In any locality where the 
 list showed that the name and address of the health officer had not been 
 returned, the space was marked and sent to the President of the Village, 
 Mayor of the City, or Supervisor of the Township, as the case may have 
 been. This has resulted in our receiving the names of a few health offi- 
 cers in addition to those printed in the list. 
 
 Accessions to the Library, Card-Cataloguing , etc. 
 
 During the quarter 98 books and pamphlets and 820 numbers of jour- 
 nals (weeklies, monthlies, and quarterlies), have been received and entered 
 in the library-accession book of this Office. 
 
 The work on the card-catalogue of the library has been continued. 
 
 The work in connection with the financial accounts of the Office has 
 been continued. 
 
 Publication of Circular Letter Relative to Consumption. 
 
 In August, a circular letter [No. 218.] “Official demand for special 
 reports relative to consumption, under Section 8, Act 81, laws of 1873,” 
 was planned and printed to the number of 500 copies. The circular 
 requests that the health officer make weekly reports on blank “ M,” and 
 give any information he may possess on the subject, which will enable the 
 State Board to have a “ general supervision of the interests of the health 
 and life of the citizens of this State.” The circular reads as follows: — 
 
 [Official demand for special reports relative to consumption, under Section 8, Act 81, Laws 
 
 of 1873.] 
 
 OFFICE OF THE SECRETARY OF THE MICHIGAN STATE BOARD OF HEALTH, 
 
 [213] Lansing , Mich., 189 
 
 To 
 
 Health Officer of 
 
 Mich. 
 
 Dear Sir: — On 189. _ I wrote to you relative to consumption in your 
 
 jurisdiction, sending you blanks for reports to this office, and leaflets on the restriction 
 
ABSTRACT OF PROCEEDINGS, OCTOBER 12, 1894. 
 
 15 
 
 and prevention of that disease, for distribution among those likely to be endangered. 
 No report or other information has been received from you since 
 
 Consumption is the most destructive disease in Michigan at this time; it is 
 now known to be a communicable disease, and it has been decided by this State Board 
 that it be included in the official list of diseases “ Dangerous to the public health,” and 
 as such, it is the health officer’s duty, under the law , to take such action as will tend to 
 restrict the spread of the disease. Such action will be largely educational, reporting 
 to and cooperating with the State Board of Health, in its “ campaign of education ” of 
 consumptives and their friends and associates. I trust that you will also comply with 
 that part of the law (Section 1, of Act 137, Laws of 1883,) which requires you to keep the 
 “Secretary of the State Board of Health constantly informed” respecting cases of 
 consumption in your jurisdiction. 
 
 I earnestly request that you comply with the law and make, each week, a report to 
 this office (on blank “ M,” copies of which have been sent to you), and that you give 
 any information which you may possess relative to the subject, which will assist this- 
 Board to perform the duties enjoined upon it by law, which are in part “ The general 
 supervision of the interests of the health and life of the citizens of this State.” 
 
 Very respectfully, 
 
 HENRY B. BAKER, 
 
 Secretary . 
 
 Pamphlet on the Restriction and Prevention of Typhoid Fever. 
 
 At the July meeting of this Board the pamphlet on “ The Prevention of 
 Typhoid Fever ” was ordered reprinted, and the new edition was to contain 
 the most important points in the leaflet on “ Typhoid and Typho-Malarial 
 Fever ” the publication of which was discontinued. 
 
 Accordingly the pamphlet on “ The Prevention of Typhoid Fever” was 
 revised, and the “ Eighth amended edition ” has been printed to the 
 number of ten thousand copies. 
 
 Publication of the Slip Relative to the Prevention of Consumption. 
 
 The slip containing, on one side the resolution of the Board relative to 
 reporting cases of tuberculosis, and on the other side a short statement of 
 methods for the prevention of consumption, has been reprinted to the 
 number of five thousand copies. This was the second edition of the two- 
 page slip. [A copy of the edition in June, 1894, is printed on pages 17-18 
 of the “ Abstract of Proceedings” “ July 13, 1894.”] 
 
 Proceedings of Second Annual Conference of Michigan Health Officers. 
 
 The “copy ” for the pamphlet proceedings of the Second Annual Con- 
 ference of Michigan Health Officers, held at Ann Arbor, has been 
 prepared, edited and the copy sent to the State Printer. It is hoped to 
 soon have the pamphlet ready for distribution. 
 
 Extra Work During This Quarter. 
 
 Owing to the fact that the State Board of Agriculture required the room 
 which had been used by three clerks of this Office, it became necessary, in 
 order to have room for the clerks, to remove the contents of our store-room 
 
16 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 to the old State-Office building. Owing to the crowded condition of the 
 Office, many things had been carried to the store-room which could not 
 without sorting be destroyed, or go into the waste paper. This sorting has 
 involved the use of considerable time, most of which had to be taken from 
 regular office work. 
 
 The summer quarter is the time when the clerks generally want to take 
 their annual vacation. This has made the work of the Secretary consider- 
 ably greater than it would otherwise have been. 
 
 Sanitary Inspections of Localities, and Advice to Officers and Citizens. 
 
 During the quarter, your Secretary has been called upon for advice 
 involving the visiting of a number of localities. The association having 
 control of Harbor Point, desiring to make that beautiful summer resort a 
 model of sanitary excellence, invited me to visit and examine it, and advise 
 with its Board of Trustees with reference to the best plan for the disposal 
 of excreta and waste water. Inasmuch as the welfare of a considerable 
 number of people is involved, I did so, and will present herewith a copy of 
 my written report made to the Board of Trustees. 
 
 Diphtheria at Laingsburg. 
 
 An outbreak of Diphtheria at Laingsburg, Shiawassee county, did not 
 seem to be under the control of the local health authorities, and by request 
 of citizens, I visited Laingsburg, met the health officer and local board of 
 health in the council chamber, and conferred with and advised them con- 
 cerning the best measures for stamping out the disease. In that little 
 village of less than one thousand inhabitants, there was then said to have 
 occurred about forty cases of diphtheria. Since then the health officer has 
 reported that since the first case in February there have been 72 cases, 
 including seven deaths. It has invaded 34 families. Oct. 11, the health 
 officer reports only once case remaining. 
 
 Diphtheria at Portland. 
 
 An outbreak of diphtheria in the village of Portland, Ionia county, in 
 which four deaths occurred in one week, startled the health officer and 
 others. The health officer requested me to visit the locality, and the 
 president of the village came to this office to ask for aid from the State 
 Board of Health. Accordingly I went to Portland, met the health officer, 
 local physicians, local board of health and others, and advised a course of 
 action by the householders, physicians, health officer, local board of health, 
 and prosecuting attorney if necessary, which if strictly followed will, in 
 my judgment, stamp out the disease. The president of the village assured 
 me that vigorous action would be taken in the directions which I had 
 indicated. 
 
 Typhoid Fever in Marine City. Analyses of Water-Supply. 
 
 Dr. Shaver, the city health officer, has reported since June 9, ten cases 
 of typhoid fever in Marine City. No deaths. He intimates in his corre- 
 spondence that there are other cases of which he has not been notified. 
 In answer to the question as to the supposed cause of the fever, he states, 
 in his correspondence, that “I have found in the water taken from the 
 
ABSTRACT OP PROCEEDINGS, OCTOBER 12, 1894. 
 
 17 
 
 various hydrants in that vicinity” (where the disease was) “large num- 
 bers of worms resembling earth-worms, from one-lialf to two inches in 
 length. There is certainly something wrong with our water.” In another 
 communication he says: “During the last two or three years there has 
 been a great number of cases of typhoid fever and diphtheria in our city, 
 the cause of which has not been determined; I have recommended to the 
 board of health that there be made an analysis of the drinking-water pro- 
 vided by our system of water works; also of the water of Belle river, a 
 stream with scarcely any current, running through the city and emptying 
 into St. Clair river within the city limits, and into which many sewers 
 empty above the surface of the water. Our water-supply is obtained from 
 St. Clair river only twenty-five feet from shore, and above this point there 
 are two private sewers emptying into this water, one of which is within 300 
 yards of the water- works.” 
 
 The general water-supply of the city being suspected as the cause of the 
 typhoid 4 fever, and therefore many lives being, possibly, jeopardized, the 
 secretary thought best to have the water examined, and accordingly caused 
 a sample taken from the same source as that drank by the person having 
 the fever to be collected and a chemical and bacteriological examination to 
 be made at the Michigan State Laboratory of Hygiene, at Ann Arbor. 
 Dr. McClintock, assistant in charge of the laboratory in the absence of Dr. 
 Vaughan, made the examinations and reported in detail to this office. 
 Two samples of the water were found to be chemically bad. “ The worms 
 found are of the genus Gordia, in one stage, a parasite or water beetle, etc.” 
 The microscopical examination showed nematoid worms and ova, large 
 vegetable debris, desmids, diatoms, infusoria, and bacteria. Germs were 
 found in the water, which, when inoculated in white rats promptly killed 
 them. Dr. McClintock gave hi s conclusions and recommendations as 
 follows: — 
 
 “This water is bad chemically and bacteriologically. Still I cannot say 
 positively that it will produce disease, as the first ’ sample was so long 
 delayed that the bacteriological analysis was not reliable. The water 
 should not be used for drinking purposes without being boiled.” 
 
 The result of this examination was promptly communicated to Dr. 
 Shaver, health officer of Marine City. 
 
 The practical test of the water by its daily use seems to teach us that a 
 small proportion of those who use it contract typhoid fever. But no per- 
 son desires to have the fever, it being considered a preventable filth dis- 
 ease, so the water should be boiled before it is used, and as soon as 
 practicable either the sewers which empty into it should be removed, or 
 the in-take pipe put further up the stream and in a better place. 
 
 Work in Connection with Sickness Statistics. 
 
 During the third quarter of 1894, 2,090 blank postal report cards, 153 
 record-books and 67 hektographed circular letters regarding weekly card 
 reports, have been mailed to 141 health officers and regular correspondents; 
 1,495 weekly card-reports have been received and entered on the register; 
 50 copies of the hektographed weekly bulletin “Health in Michigan,” 
 were mailed each week, and 108 copies of the monthly bulletin “ Health in 
 Michigan” have been hektographed and mailed each month. These 
 bulletins have been consolidated for this quarterly report. The compila- 
 
18 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 tion of the weekly card-reports of sickness during the year 1892, for the 
 annual report for 1893 has been completed, and work has also been done on 
 the compilation for the annual report for 1894. 
 
 Health in Michigan in the Third Quarter of 1894. Communicable Diseases. 
 
 Compared with the preceding quarter (April, May and June), reports 
 from all sources show typhoid fever to have increased by an average of 
 forty-nine places, consumption to have increased by an average of thirteen 
 places, measles to have decreased by an average of seventy -three places, 
 scarlet fever to have decreased by an average of twenty-eight places, diph- 
 theria to have decreased by an average of twelve places and ‘small-pox to 
 have decreased by an average of three places. 
 
 Meteorology at one Central Station, and Sickness throughout Michigan from all 
 causes, Third Quarter of 1894, compared with the Preceding Quartet. 
 
 A comparison of meteorological conditions of the third quarter of 1894, 
 with the meteorological conditions of the preceding quarter, shows the 
 prevailing direction of the wind to have been south-west (instead of north- 
 west), the average velocity 1.2 miles per hour less, the temperature 10.21 
 degress higher, the rainfall 2.48 inches less, the absolute humidity con- 
 siderably more, the relative humidity less, the day ozone slightly less, the 
 night ozone much less and the depth of water in the well at Lansing 
 4 inches less in the third quarter of 1894. 
 
 Compared with the preceding quarter (April, May and June), the 
 reports from regular observers show a marked increase of dysentery, 
 typhoid fever, diarrhea and remittent fever, and a marked decrease of 
 measles, pneumonia, influenza, pleuritis, erysipelas, inflammation of 
 kidney, tonsillitis, scarlet fever and bronchitis in the third quarter of 
 1894. 
 
 The Weather and the Health in Michigan in the Third Quarter of 1894, Compared 
 with the Average for the Eight Years , 1886-1893. 
 
 A comparison of the meteorological conditions of the third quarter of 
 1894, with the average for the third quarters in the eight years, 1886-1893, 
 shows that in 1894, the prevailing direction of the wind was the same 
 (south-west), the velocity was 0.7 of a mile per hour greater, the tempera- 
 ture was 1.97 degrees higher, the rainfall was 1.04 inches less, the absolute 
 humidity was slightly less, the relative humidity was much less, the day 
 and night ozone were slightly more and the depth of water in the well at 
 Lansing was 2 inches less. 
 
 Compared with the average in the corresponding quarters in the eight 
 years 1886-1893, the reports from regular observers indicate that typhoid 
 fever was more than usually prevalent, and that erysipelas, intermittent 
 fever and remittent fever were less than usually prevalent in the third 
 quarter of 1894. 
 
ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 REGULAR MEETING, JANUARY 11, 1895. 
 
 219.] 
 
 The Michigan State Board of Health held its regular quarterly meeting, 
 it the office of the Secretary, in the Capitol at Lansing, January 
 LI, 1895. The meeting was called to order by the President. Hon. Frank 
 Veils, President, of Lansing; Prof. Delos Fall, of Albion; Prof. V. C. 
 Vaughan, of Ann Arbor; Mason W. Gray, M. D., of Pontiac; Samuel G. 
 Milner, M. D., of Grand Rapids; George H. Granger, M. D., of Bay City; 
 md Henry B. Baker, M. D., Secretary, were present. The regular busi- 
 less, including the auditing of bills and accounts, was transacted. 
 
 Should the State Board of Health undertake to supply Antitoxine? 
 
 ' As special committee to report to the board the advisability of entering 
 lpon the production of immunizing-blood-serum (antitoxine) for use in 
 ;he production of immunity from diphtheria, with a view of still further 
 lesting, in this country, the efficacy of the method, Doctor Vaughan, 
 Director of the Michigan State Laboratory of Hygiene, reported that he 
 lad thoroughly considered the subject, and had concluded that at the pres- 
 ent time, the expense would be too great for the State Board of Health to 
 mdertake. 
 
 Doctor Baker also, suggested that such action by this Board would not 
 le in accord with its former action. It would be in the line of treatment, 
 vhich this Board has heretofore been very careful to avoid. He said that 
 f any line of treatment were to be commended by the State Board of 
 Sealth, he would suggest that devised by Dr. Loeffler, the German physi- 
 cian who discovered the bacillus now recognized as the specific cause . of 
 liphtheria. He read a letter which he had received from Erwin F. Smith, 
 )f Washington, D. C., a former employe of this office, relative to the new 
 ;reatment of diphtheria recommended by Dr. Loeffler. In artificial cultures, 
 Dr. Loeffier’s solution kills the bacillus of diphtheria in five seconds.* 
 Dr. Baker suggested that if the local treatment which Doctor Loeffler 
 
 ♦Since the meeting, it has been learned that “ Loeffler’s Solution ” is prepared and sold by manufactur- 
 ng chemists of Detroit. 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 recommends, kills the germ before it has had opportunity to produce it 
 toxine, there would be less use for the antitoxine. But it would be mon 
 appropriate for this Board to continue along the line in which it has beei 
 working, for the restriction of diphtheria, through isolation and disinfec 
 tion. He pointed out the fact that in all localities in Michigan in whicl 
 the measures recommended by the State Board of Health are full’ 
 accepted and enforced, in each outbreak, an average of only .48 of on 
 death occurs from diphtheria. (This is shown by the right-hand columi 
 in the diagram printed herewith, page 8.) This is in localities into whic. 
 the disease has been introduced. This being an established fact, it seem 
 a little like “refining pure gold” for the Board to go back to any metho< 
 of treatment. If, however, it is claimed that even this small residue of .4 
 of one death per outbreak should be reduced, he would claim that i 
 should be done by a continuance of the principle of prevention. H 
 thought it more important than any mode of treatment of diphtheria tha 
 there should be a State law which would prevent the introduction of 
 dangerous disease into a locality. There is no general law in Michigai 
 under which punishment can be inflicted for conveying diphtheria or an; 
 dangerous disease from place to place; and every year our reports sho\ 
 that this is done, in numerous instances. The present law is not operat 
 ive until after the local board of health has made and published regulations 
 He had several times drawn a bill to remedy this defect, but the legislatur 
 has never yet passed one. 
 
 Examination of Samples of Antitoxine offered for sale in Michigan 
 
 It was suggested that the Board take action to protect the people agains 
 spurious antitoxines. On motion of Dr. Granger, the Board voted t 
 appoint Prof. Victor C. Vaughan, M. D., Director of the Michigan Stat 
 Laboratory of Hygiene, a special committee to test the immunizing proper 
 ties of samples of antitoxine offered for sale in Michigan. 
 
 An Improved Law for Registration of Births and Deaths. 
 
 Dr. Baker offered the following preambles and resolutions, which wer 
 unanimously adopted: 
 
 Whereas, An accurate and prompt registration of the deaths and th 
 causes of deaths in each locality of this State would be of very great prac 
 tical usefulness to the work of this Board, and consequently of great vain 
 to the people of Michigan, and . 
 
 Whereas, Under the present law, which has not been amended sine 
 1869, the registration of vital statistics has failed to give accurate results 
 and to present them sufficiently early to be of the greatest practical sani 
 tary use and public interest; therefore 
 
 Resolved , That the Michigan State Board of Health earnestly recom 
 mends the enactment of an improved law for the registration and retur: 
 of deaths (and also of births), which law shall provide for their immediat 
 record, and prompt report to the State Department. 
 
 Resolved, That a committee be appointed by this Board to present th 
 subject to the Legislature, and to urge such action; said committee to ac 
 independently or in conjunction with similar committees of the Michiga. 
 State Medical Society, Michigan Academy of Science, or other organiza 
 tions, as may be deemed advisable. 
 
, memGkU STATE BOARD OF HEALTjK EXHIBIT./ 
 
 OLATION AND DISINFECTION RESTRICTED 
 ARLET FEVER AND DIPHTHERIA IN MICHI- 
 N DURING THE 5 YEARS 1886-90. 
 
 SCARLET FEVER. 
 
 SOLATION AND 
 
 1EG LECTED .IN 
 !66 OUTBREAKS, 
 
 DISINFECTION 
 
 ENFORCED. IN 
 
 361 OUTBREAKS, 
 
 DIPHTHERIA. 
 
 ISOLATION AND DISINFECTION 
 NECLECTER ^ ENFORCED , IN 
 
 317 OUTBREAKS 
 
 252 OUTBREAKS, 
 
 2.04 
 
 v AVERAGE 
 
 JASES DEATHS. 
 
 CASES, 
 
 AVERAGE*- 
 
 DEATHS 
 
 AVERAGE 
 
 CASES. DEATHS 
 
 AVERAGE 
 
 'OTALS i OUTBREAK S,I,857*;CA$ES,II,3I2;DEATHS,$9I 
 
 V • 
 
 IIC ATE D SAVINC OF CASES 13.29 X 1,857 • I r.3 1 2 = I3,3b*8 
 
 T0TALS>0UTBREAKS.I.9 8S ! CASES.II,6 31 ) DEATHS,2,S7e 
 INDICATED SAVINC OF CASES 13.57 X 1.9 85 • 1 1,6 3 4: 15,3 02 
 
 IDICATED SAVINC OF LIVES .69 X 1.857 • 591 = 690 
 
 UU* (trinru*, net flrrriy V/ym ltd' tf 'Lnjeretd 
 
 INDICATED SAVINC OF LIVES 2.67 X 1.9 85-2,5 7 0 = 2.7 22 
 
 •: --v J 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 The subject was referred to the Committee on “Statistics of Mortalitj 
 and Sickness,” with request to act in accordance with the resolutions. 
 
 Poisoning by Dried Beef at Somerset Center , Hillsdale Co. 
 
 Doctor Vaughan, the committee to whom was referred the subject o 
 suspected poisoning by dried beef, at Somerset Center, Hillsdale county 
 reported: “We find that the meat contains a short bacillus whieh, whei 
 injected under the skin of rats, guinea pigs and rabbits, causes deatl 
 within from 24 to 48 hours. The bacillus causes marked local irritation 
 and there can be no doubt that it was the active agent in causing the dis 
 tress in the persons who ate of the meat. A careful biological study o 
 this germ will be made, and a further report will be sent you at a late 
 date.” 
 
 Suspected Poisoning by Pressed Chicken at Sturgis. 
 
 Doctor Vaughan also reported relative to suspected poisoning by presses 
 chicken at Sturgis. During a banquet some 200 persons were poisonec 
 A sample of the chicken was examined at the State Laboratory of Hygiene 
 and found to contain a short capsulated bacillus which was poisonous, bu 
 not of such a virulent character as the one found in the dried beef. It wa 
 found, by inoculation, that the germ would kill guinea pigs, but did no 
 kill rats. 
 
 A Bill to Regulate Employment of Consumptive Nurses and Teachers 
 
 Doctor Milner of Grand Rapids, Committee on Schools, was directed t 
 prepare a bill, for introduction in the Legislature, which shall regulate th 
 employment of teachers in our public schools, and professional nurse* 
 who are affected with any communicable form of tuberculosis. Instance 
 have been noted and referred to by Dr. Milner at a previous meeting 
 where it is probable that tuberculosis (consumption) has been contracte 
 from a teacher. 
 
 Proposed Improvement of Sanitary Lazos relative to Live Stock. 
 
 On motion, the Board voted to direct the Committee on Legislator 
 Doctor Granger of Bay City, to confer with members of the State Liv 
 Stock Commission and the State Veterinarian, to prepare bills for th 
 improvement of the sanitary laws of the State relative to live stock, rek 
 tive to diseases communicable to man, and to look to the introduction an 
 passage of such bills. 
 
 A proposed State Hospital for Consumptives. 
 
 The proposed bill for a “ State Hospital for Consumptives,” in Conner 
 tion with the State Laboratory of Hygiene at the University, was rea 
 section by section, amended and approved by the Board. The objects c 
 the hospital are: (1) the proper care and treatment of persons havin 
 the disease known as consumption, phthisis or tuberculosis, in order th? 
 the spread of this disease may be lessened; (2) the training and educatio 
 of persons who shall go out from that hospital, in the best methods fc 
 
ABSTRACT OF PROCEEDINGS, JANUARY 11, 1895. 
 
 5 
 
 •estricting the spread of this dangerous disease; (3) the training in such 
 nethods, of medical students who are to practice medicine in Michigan, so 
 hat they may know how to restrict tuberculous diseases; and (4) that 
 ffiysicians and others may be enabled to study this disease under favorable 
 conditions, thereby obtaining knowledge useful for the prevention of the 
 ipread of this disease, and for its ultimate restriction or extinction in 
 Michigan. 
 
 Proposed Enforcement of Public TLealth Laws in localities ichere 
 
 Local Officers fail to act. 
 
 By invitation of the Governor, the Board met the Governor in his room 
 or conference relative to the work of the Board, and a proposed increase 
 n its scope, one question being whether the public interests might be bet- 
 er subserved if the Board were given power to stamp out dangerous dis- 
 eases in localities where for any reason the local officers were unable or 
 mwilling to take proper measures. 
 
 ;ECRETARY’S report of dangerous communicable diseases, 
 
 ' OF WORK DONE IN THE OFFICE OF THE STATE BOARD 
 OF HEALTH, AND OF THE CONDITION OF HEALTH GEN- 
 ERALLY IN MICHIGAN DURING THE QUARTER 
 ENDING DECEMBER 31, 1891. 
 
 Dangerous Communicable Diseases. 
 
 The number of reports of outbreaks of dangerous communicable diseases 
 n Michigan, received from all sources and filed, and the corresponding 
 lumber concerning which action was taken by this office, during the 
 [uarter, are as follows: for diphtheria, 155; for scarlet fever, 189; for 
 yphoid and typho-malarial fever, 176; for measles, 16; for small-pox, 21; 
 nd for consumption, 8. Total for the six diseases, 565. 
 
 The number of communications relative to dangerous communicable 
 liseases, received and placed on file during the quarter, was 2,482. 
 
 Relative to dangerous communicable diseases, letters, written cards, and 
 lemands for weekly and final reports on cards, or in the form of the cir- 
 ular letter, were sent out during the quarter to the number of 2,012. 
 
 The “final” reports of outbreaks received and filed during the quarter, 
 tere: for diphtheria, 96; scarlet fever, 100; typhoid and typho-malarial 
 ever, 143; measles, 2; small-pox, 13; consumption, 0. Total for the six 
 iseases, 347. 
 
 During the quarter, the local columns of 800 newspapers, have been 
 Doked over for reports of occurrence of communicable diseases. ( This work 
 3 done by the clerk who acts as messenger and janitor, in the intervals of 
 is performance of other duties.) This has resulted in giving this office 
 uformation of the alleged occurrence of 6 outbreaks of diphtheria, 3 out- 
 breaks of scarlet fever, 17 outbreaks of typhoid and typho-malarial fever, 
 outbreak of measles, and 3 outbreaks of small-pox. To what extent the 
 eports of these alleged outbreaks were verified, is shown in the accom- 
 •anying table. 
 
6 MICHIGAN STATE BOARD OP HEALTH. 
 
 TABLE I . — Showing the number of Outbreaks of Diphtheria , Scarlet fever, Typhoid 
 fever, Measles, Small-pox and Consumption, from October 1 to December 31, 1894, of 
 which notice was received at the office of the Michigan State Board of Health; the 
 per cent of reports, information concerning which was received through the News- 
 papers ; the per cent of newspaper reports which were confirmed by the health officer ; 
 the per cent of newspaper reports which were denied by the health officer; and the 
 per cent relative to which no reply was received from the health officer. 
 
 Diseases. 
 
 Reports from 
 all sources, 
 Oct. 1 to 
 Dec. 31, 1894. 
 
 Per cent 
 of all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent 
 of newspaper 
 reports which 
 were con- 
 firmed by the 
 health officer. 
 
 Per cent 
 of newspaper 
 reports which 
 were denied 
 by the 
 
 health officer. 
 
 Per cent of 
 newspaper re- 
 ports to which 
 the health 
 officer made 
 no reply 
 to notice sent 
 from this 
 office. 
 
 Diphtheria 
 
 155 
 
 4 
 
 67 
 
 0 
 
 33 
 
 Scarlet fever. 
 
 189 
 
 2 
 
 100 
 
 0 
 
 0 
 
 Typhoid fever 
 
 176 
 
 10 
 
 47 
 
 12 
 
 41 
 
 Measles 
 
 16 
 
 6 
 
 0 
 
 0 
 
 0 
 
 Small-pox 
 
 21 
 
 14 
 
 100 
 
 0 
 
 0 
 
 Consumption 
 
 8 
 
 0 
 
 0 
 
 0 
 
 0 
 
 Averages for the six diseases 
 
 
 
 5 
 
 60 
 
 6 
 
 33 
 
 Small-pox in Michigan in the fourth quarter of 1894. 
 
 Eleven new outbreaks were reported during the quarter. These occur- 
 red in Manchester township, Washtenaw Co.; Norvell township, Jacksor 
 Co.; Cheboygan city; St. Johns village, Clinton Co. ; Royal Oak township, 
 Oakland Co.; Sebewa township, Ionia Co.; Danby township, Ionia Co.; 
 Adrian city; Watersmeet township, Gogebic Co.; Chester township, Eator 
 Co.; and Marquette city. Of these outbreaks, final reports of those at Nor- 
 vell township, Cheboygan and Adrian, have been received. It is inferred 
 that those at Manchester township, Chester township and Danby township 
 are over, but no final reports of these three outbreaks have yet reached 
 this office at this date — Jan. 1, 1895. 
 
 Small-pox is still present at Marquette, Detroit, St. Johns, Sebewa town- 
 ship, Royal Oak township, Watersmeet township. 
 
 The outbreak which began in Detroit during the second quarter of 1894 
 still continues. During the quarter just closed, there have occurred ir 
 that city, 72 cases and 21 deaths, which make a total of 142 ca^es and 34 
 deaths since the outbreak began. From the beginning of the outbreak ir 
 Detroit, (about May 25, 1894,) up to the first week of October, there 
 occurred 70 cases and 13 deaths, which is a death rate of 19 per cent 
 During the quarter ending Dec. 31, 1894, there have occurred 72 cases anc 
 21 deaths, a death rate of 29 per cent during the last half and coolei 
 months during which the outbreak has existed. 
 
ABSTRACT OF PROCEEDINGS, JANUARY 11, 1895. 7 
 
 | 1 ' 
 
 In the thirty-eight outbreaks of small-pox reported during the year 1894, 
 Deluding Detroit, there have occurred 262 cases and 60 deaths, a death 
 •ate of 23 per cent. The death rate for the city of Detroit and for locali- 
 ties outside of that city, have been nearly the same, — Detroit a little less 
 :han 24 per cent, and outside localities, a fraction less than 22 per cent. 
 
 In twenty-one of the twenty-nine outbreaks now over, the infection was 
 restricted to the one house in which it first occurred. 
 
 Summary Relative to the Year , 1894. 
 
 During the year 1894, this office took action upon 2,036 outbreaks of 
 dangerous communicable diseases, which number includes 469 outbreaks 
 i)f diphtheria, 656 outbreaks of scarlet fever, 447 outbreaks of typhoid 
 ind typho-malarial fever, 275 outbreaks of measles, 16 outbreaks of small- 
 pox, and 128 outbreaks of consumption.f 
 
 TABLE II , — Showing the number of Outbreaks of Diphtheria , Scarlet Fever , Typhoid 
 Fever and Measles, from January 1 to December 31, 1894, of which notice was 
 received at the office of the Michigan State Board of Health ; the per cent of reports, 
 information concerning which was received through the Newspapers ; the per cent 
 of newspaper reports which were confirmed by the health officer; the per cent of 
 newspaper reports which were denied by the health officer, and the per cent relative 
 to which no reply was received from the health officer. 
 
 Diseases. 
 
 Reports from 
 all sources. 
 Jan. 1-Dec. 
 31, 1894. 
 
 Per cent 
 of all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent 
 of newspaper 
 reports which 
 were con- 
 firmed by the 
 health officer. 
 
 Per cent 
 of newspaper 
 reports which 
 were denied 
 by the 
 
 health officer. 
 
 Per cent of 
 newspaper re- 
 ports to which 
 the health 
 officer made 
 no reply 
 to notice sent 
 from this 
 office. 
 
 Diphtheria 
 
 *469 
 
 4 
 
 50 
 
 22 
 
 28 
 
 Scarlet fever 
 
 *656 
 
 4 
 
 57 
 
 9 
 
 35 
 
 Typhoid fever 
 
 *447 
 
 7 
 
 48 
 
 23 
 
 29 
 
 Measles 
 
 *275 
 
 6 
 
 33 
 
 13 
 
 53 
 
 Small-pox 
 
 *61 
 
 20 
 
 50 
 
 50 
 
 0 
 
 Consumpticfnt 
 
 *128 
 
 0 
 
 0 
 
 0 
 
 0 
 
 Averages for the six diseases 
 
 
 5 
 
 48 
 
 21 
 
 80 
 
 * The numbers of outbreaks given in this table do not necessarily agree with the numbers given in tables 
 in another part of the Annual Report, for the reason that all alleged outbreaks, of which information 
 was obtained from the newspapers and other sources are included in this table. If the health officers 
 denied that such outbreaks occurred, or if they make no response to the letters sent from this office, 
 relative to newspaper reports, such alleged outbreaks are not included in the compilation of that disease, 
 t Consumption for the last nine months of the year only. 
 
 Relative to dangerous communicable diseases, letters, written cards, etc., 
 were sent out during the year to the number of 7,135. The number of 
 communications relative to such diseases, which were received and placed 
 on file during the year was 8,418. 
 
8 
 
 MICHIGAN STATE BOARD OP HEALTH. 
 
 A record is kept of facts concerning every outbreak of a “disease dan- 
 gerous to the public health,” upon which, action is taken by this office, 
 and also of every communication relating thereto received or sent out 
 This required oyer 15,500 entries to be made in the “ Record Books,” one 
 of which books is kept for each dangerous communicable disease. 
 
 During the year 1894 compared with the year 1893, action was taken on 
 outbreaks of dangerous communicable diseases as follows: On diphtheria, 
 71 outbreaks less, scarlet fever, 18 outbreaks less; on typhoid and typho- 
 malarial fever, 53 outbreaks more; measles, 4 outbreaks more; and small- 
 pox, 59 outbreaks more than in 1893. In all 155 outbreaks more were 
 acted upon in 1894 than in 1893, and 363 outbreaks more in 1894 than in 
 1 892 , 
 
 Compiling , Editing , Proof-Reading , Printing , etc. 
 
 The articles relating to injuries and loss of life and property in Michi- 
 gan in 1891, from the use of kerosene, gasoline, naphtha, etc., have been 
 completed. 
 
 The article relative to nuisances in Michigan in 1892, has been nearly 
 completed. 
 
 The article relating to diphtheria in Michigan in 1892 has been com- 
 pleted ready for the printer. 
 
 A compilation of reports from all sources relative to typhoid fever in 
 Michigan in 1892, has been made, and a similar compilation relative to 
 measles in Michigan, for the same year, has been about half completed. 
 
 The compilation of reports from all sources, relative to scarlet fever in 
 Michigan during the year 1892, has been proved and some of the tables 
 based thereon have been made. 
 
 Those portions of the annual reports from health officers and clerks of 
 townships, cities and villages for the year 1893, which relate to diphtheria 
 have been compiled, and a compilation of such parts of those reports as 
 relate to scarlet fever is well advanced. 
 
 Copy has been prepared for the pamphlet proceedings of the Sanitary 
 Convention held under the auspices of the State Board of Health at Union 
 City, Oct. 25 and 26, 1894, and a portion of the copy has been sent to the 
 printer. 
 
 The copy for the proceedings of the Charlotte Sanitary Convention is 
 now nearly ready for the printer. 
 
 Copy on the proceedings of the Second Annual Conference of Health 
 Officers, at Ann Arbor, J une, 1894, has been prepared and the proceedings 
 printed in pamphlet form. 
 
 The index for the Annual Report of this Board for the fiscal year end- 
 ing J une 30, 1892, has been made and printed. 
 
 Proof has been read on the following: Proceedings of the Second 
 Annual Conference of Health Officers; Proceedings of the Meeting, Oct. 
 12; and articles for the Annual Report for 1892 relating to the following 
 subjects: Membraneous Croup, Chicken-pox, Erysipelas, Leprosy, Hydro- 
 phobia. Glanders, Tyrotoxicon Poisoning, Poisoning from Canned Cur- 
 rants, Poisoning by Lead Pipe, Suspected Coffee Poisoning, Alleged 
 Nuisances, Injuries and Loss of Life and Property from Kerosene, Gaso- 
 line and Naphtha; and also on the index for the Annual Report for the 
 year 1892. 
 
 That portion of the Report for the Fiscal year ending June 30, 1892, 
 relative to the above-mentioned articles (including the Index) has been 
 
ABSTRACT OF PROCEEDINGS, JANUARY 11, 1895. 
 
 9 
 
 printed, and the Eeport is now being bound by the State Printer. Copies 
 will be ready for distribution by the middle of January. 
 
 Hektograph work to the number of 1,650 pages has been made, of which 
 about 350 pages were relative to the Small-pox situation in Michigan since 
 January 1, 1894, being in the form of tabular statements. Only 35 pages 
 have been notifications relative to possibly infected immigrants. 
 
 A diagram “Ages of persons, 5 to 80 years, who died from diphtheria in 
 Massachusetts during the period 22 years, 1863-84” was hektographed to 
 the number of 41 copies. A diagram similar to the foregoing, but for 
 Michigan for 21 years, 1872-92, was hektographed to the number of 37 
 copies. 
 
 Work on Meteorology. 
 
 The regular tri-daily meteorological observations have been continued at. 
 this station, and a summary for each week and month during the quarter 
 has been made, for immediate use in this office in the weekly and monthly 
 bulletins relating to sickness statistics. The monthly summary has been 
 sent, at the end of each month, to the Director of the Michigan Weather 
 Service and Local Forecast Official at Detroit for his use, and it is sent by 
 him to the Chief of the U. S. Weather Bureau at Washington, D. C. 
 
 Meterological blank registers, envelopes, postal cards, ozone test-paper, 
 etc., were sent to observers for the State Board of Health on Dec. 15, for 
 their use in 1895. 
 
 The article relating to Meteorology in Michigan in 1892 has been sent 
 to the State Printer, and two forms have been printed, for the Annual 
 Eeport for 1893. 
 
 Distribution of Publications , etc. 
 
 About 600 copies of the Proceedings of the last regular meeting, (Oct. 
 12, 1894) have been distributed to: Members and Ex-members of this 
 Board, Sanitary Journal Exchanges, Meteorological Observers, members 
 of the State Board of Corrections and Charities, Secretaries of State Boards 
 of Health, Health Officers of cities and villages in Michigan, Judges of 
 The Supreme Court, and Sanitarians. 
 
 About 1,300 copies of the Programs of the Union City Sanitary Con- 
 vention, and about 1,300 copies of the Program for the Charlotte Sanitary 
 Convention have been distributed, from this Office. 
 
 During the quarter 1,573 envelopes were directed to health officers of 
 townships, cities and villages, and about the same number (1,572) of 
 envelopes were directed to clerks of townships, cities and villages. These 
 envelopes were used in sending to each clerk and health officer in Mich- 
 igan blank forms for making annual reports of “Diseases dangerous to the 
 public health” during the year 1894, a circular letter giving instructions 
 for making out the annual reports, and an envelope for the return of the 
 report to this office. This material was mailed from this Office Dec. 29 
 and 31, 1894. 
 
 About the usual numbers of pamphlets on the restriction and prevention 
 of the different dangerous diseases were sent to the health officers of local- 
 ities in which dangerous diseases have been reported. It was at the same 
 „time requested of these health officers that the pamphlets be distributed 
 to the neighbors of the persons sick with such diseases , and to such other 
 persons as they would be likely to benefit. In response to special requests 
 of sanitarians in this and other States, copies of annnal reports, proceed- 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 mgs of Sanitary Conventions, proceedings of meetings, and pamphlets or 
 the restriction and prevention of the dangerous communicable diseases 
 have been sent where it was thought likely to benefit public-health 
 interests. 
 
 The usual record of distribution of publications has been kept. 
 
 Accessions to the Library , Card- Cataloguing, etc. 
 
 One hundred and eighteen books and pamphlets, and some 325 numbers 
 of journals (weeklies, monthlies, quarterlies) have been received and 
 entered in the library-accession book of this Office. 
 
 Work on the card- catalogue of the library has been continued. 
 
 The work in connection with the financial accounts of the Office hat 
 been continued. 
 
 The Michigan Plan for the Restriction of Consumption. 
 
 Your Secretary has recently received a letter from Dr. H. B. Horlbeck, 
 who for many years has been the efficient Health Officer of Charleston. 
 S. C., a prominent member of the American Public Health Association, 
 and a prominent sanitarian in this country, in which the hope is expressed 
 that Charleston may follow the “ good example set by the State of Michi- 
 gan in attacking consumption or tuberculosis.” In accordance with Dr. 
 Horlbeck’s request, Secretary Baker sent him such pamphlets, leaflets, 
 copies of laws under which the work is being done in Michigan, and dia- 
 grams showing the result of a similar work which has been so successful 
 in Michigan in lessening the number of deaths from scarlet fever. The 
 information given Dr. Horlbeck related to Michigan’s plan for the legal 
 control of tuberculosis, and more especially for the restriction of the dis- 
 ease through the systematic and continuous education of the people most 
 endangered — the relatives, friends and associates of consumptives. 
 
 Medical Attendance on an Indigent Person is a Charge upon the County. 
 
 About December 14 the Secretary received a letter from a health officer 
 of a township, who had been called as a physician to treat a case of typhoid 
 fever in a township of another county. He had presented his bill to the 
 health officer of that township, the health officer had certified to its cor- 
 rectness; and the bill was presented to the board of supervisors. The orig- 
 inal amount of the bill was $33.00, and the board of supervisors cut the 
 bill to $19.00. The attending physician had been obliged to go a long dis- 
 tance, and had not at any time charged to exceed $2.00 per visit. The 
 reduction in the bill therefore seemed to be unreasonable. The Secretary’s 
 reply was substantially as follows: 
 
 STATE BOARD OF HEALTH, ) 
 Office of the Secretary, y 
 Lansing, Michigan, Dec. 14, 1894. ) 
 
 Dear Doctor — Replying to your letter of Dec. 12, it would seem from the facts 
 
 before me that your bill was extremely reasonable, in the case of , Michigan, 
 
 and should have been allowed by the Board of Supervisors. 
 
 Section 1647 Howell’s statutes provides that where a person is sick or infected with 
 a dangerous communicable disease, the local board of health of the township shall 
 make such provisions as they deem necessary by providing nurses and other assistance 
 and necessaries, which shall be at the charge of the person himself, his parents or 
 other persons, who may be liable for his support, if able; otherwise at the charge of 
 the county to which he belongs. Medical attendance is certainly one of the “ neces- 
 saries” mentioned in this section. 
 
ABSTRACT OF PROCEEDINGS, JANUARY 11, 1895. 
 
 11 
 
 The Supreme Court, of Michigau, has decided (3rd Mich. Report, p. 475) that when 
 any expenses incurred under this section are chargeable to the county, and the amount 
 due has been ascertained, and fixed by the local board of health, it is the duty of the 
 Board of Supervisors to allow at once that amount, and to provide for its payment. 
 The Board of Supervisors have no discretion in the matter further than to ascertain 
 whether the patient or those who may be liable for his support, are able to pay, the 
 expenses incurred under this section. 
 
 The only criticism that I might make is that your bill should have been allowed by 
 the local board of health, then the Board of Supervisors should allow “ that amount” 1 
 and provide for its payment. I advise you to present the bill to the local board of 
 health, and then again to the Board of Supervisors, with a reference to 3rd Michigan 
 Report, 475. 
 
 I know of no higher law, in this State, than the decision of the State Supreme 
 Court, and that decision is very clear, as is shown in the footnote on page 3 of the 
 pamphlet [120] which I send you herewith. In another envelope I send you another 
 
 marked copy, which you may want to use, to show to Mr. that the “ law” is very 
 
 plain, and not as his letter says. (1) The health officer and the local board are 
 required to “contract such bills;” (2) the law, section 1647 Howell’s statutes, provides 
 pay by the county; and (3) there has been appeal from the Board of Supervisors to the 
 Supreme Court, and this subject has been decided by that court of last resort — 3rd 
 Michigan Report, 475. Very respectfully, 
 
 Henry B. Baker, 
 
 Secretary. 
 
 Special Investigations by the Secretary. 
 
 During this quarter many urgent requests have been made of this 
 office for an expert diagnostician, and for aid in restricting communi- 
 cable diseases. Upon an urgent request, your secretary visited Man- 
 chester to advise relative to the best methods to adopt for the restric- 
 tion of small-pox at that place. 
 
 Your secretary has visited the townships of .Portland, Sunfield, 
 Bebewa and Danby, Ionia county, to see whether it was necessary to 
 (establish a quarantine under the State law against Sebewa and Danby 
 in which townships small-pox had broken out. I advised with the health 
 officials of the townships and villages surrounding Sebewa and Danby, 
 concerning how quarantine could be practically established by the local 
 boards of health, under the law which authorizes the local board to- 
 make and enforce regulations. I also visited Sebewa and Danby, and 
 advised with the acting health officials of those townships. 
 
 Sanitary Conventions at Union City and at Charlotte. 
 
 An interesting and successful Sanitary Convention was held under 
 the auspices of this Board at Union City, Oct. 25 and 26. Another 
 Sanitary Convention was held at Charlotte, Nov. 22 and 23, 1894. This 
 Sanitary Convention also was a very successful one. 
 
 Re-arranging the Secretary's Room. 
 
 The secretary’s room has been thoroughly cleaned, and a large file 
 case placed on the east side of the room. Linoleum has been placed 
 on the floor, instead of the old carpet which has been there since the 
 Capitol was completed. The re-arranging of this room has occasioned 
 considerable work in addition to the regular work of the office. 
 
 Work in Connection with Sickness Statistics. 
 
 During the fourth quarter of 1894, 1,875 blank postal report cards, 125 
 record books and 11 hektograph circular letters regarding weekly card 
 reports, have been mailed to 117 health officers and regular correspondents; 
 
 3 
 
- 
 
 12 MICHIGAN STATE BOARD OF HEALTH. 
 
 1,306 weekly card reports have been received and entered on the register; 5 1 
 copies of the hektographed weekly bulletin “ Health in Michigan,” wer( 
 mailed each week, and 110 copies of the monthly bulletin “ Health ir 
 Michigan,” have been hektographed and mailed each month. These bul 
 letins have been consolidated for this quarterly report. Work has alsc 
 been done on the compilation of the weekly card reports of sickness 
 during the year 1893, for the annual report for 1894. 
 
 Health in Michigan in the Fourth Quarter of 1894. Communicable Dis 
 
 eases. 
 
 Compared with the preceding quarter (July, August and September) 
 reports from all sources show scarlet fever to have increased by an aver 
 age of forty -three places, diphtheria to have increased by an average ol 
 thirty-six places, typhoid fever to have increased by an average of thirty 
 seven places, small-pox to have increased by an average of three places 
 consumption to have increased by an average of two places and measles 
 to have decreased by an average of eleven places. 
 
 Meteorology at one Centred Station , and Sickness throughout Michigan 
 from all Causes , Fourth Quarter of 1894, Compared 
 with the Preceding Quarter. 
 
 A comparison of meteorological conditions of the fourth quarter oi 
 1894, with the meteorological conditions of the preceding quarter, shows 
 the prevailing direction of the wind to have been west (instead of south 
 west), the average velocity 3 miles per hour greater, the temperature 
 30.02 degrees lower, the rainfall .01 of an inch less, the absolute humid- 
 ity much less, the relative humidity much'T&ore, the day and night ozone 
 much less and the depth of water in the*- wejl $t Lansing 14 inches less 
 in the fourth quarter of 1894. 
 
 Compared with the preceding quarter (July, August and September) 
 the reports from regular observers show a marked increase of diphtheria 
 influenza, pneumonia, pleuritis, bronchitis, tonsillitis and scarlet fever 
 and a marked decrease of cholera infantum, cholera morbus, dysentery 
 diarrhea, intermittent fever and inflammation of bowels in the fourth 
 quarter of 1894. 
 
 The Weather and the Health in Michigan in the Fourth Quarter oj 
 1894 , Compared with the Average for the Fourth 
 Quarters in the Eight Years 1886-1893. 
 
 A comparison of the meteorological conditions of the fourth quartei 
 of 1894, with the average for the fourth quarters in the eight years, 1886- 
 1893, shows that in 1894, the prevailing direction of the wind was tht 
 same (west), the velocity .8 of a mile per hour greater, the temperature 
 was .65 of a degree higher, the rainfall was .97 of an inch less, the 
 absolute and relative humidity were nearly the same, the day and nighi 
 ozone were less and the depth of water in the well at Lansing was II 
 inches less. 
 
 Compared with the average in the corresponding quarters in the eight 
 years 1886-1893, the reports from regular observers indicate that typhoic 
 fever was more than usually prevalent, and that intermittent fever, typho- 
 malarial fever, erysipelas, consumption, dysentery, pneumonia and remit- 
 tent fever were less than usually prevalent in the fourth quarter of 1894. 
 
\ 5 % 
 
 r 
 
 ABSTRACT OF PROCEEDINGS. 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 ANNUAL MEETING, APRIL 12, 1895. 
 
 [ 225 ] 
 
 . [Reported by the Secretary.] 
 
 The m ee ting was called to order by the President. There were present: 
 Hon. Frank Wells, President, Lansing; Prof. Delos Fall, M. S., Albion; 
 George H. Granger, M. D., Bay City; and Henry B. Baker, M. D., Secre- 
 tary, Lansing. 
 
 President Wells read the following recommendations: 
 
 “ P seem „ s proper that I should call your attention to charges made by 
 members of the present legislature concerning the members of this board 
 during the recent discussion of the bill now before the legislature known 
 as the Miller bill. (House bill 693, File No. 121.) 
 
 These charges affect not only the business and professional character 
 ot the members of this Board but also their integrity. In my opinion 
 self-respect demands that we request of the House of Representatives that 
 it appoint a committee for the purpose of thoroughly investigating these 
 charges, to the end that proper remedies may be apolied should all or 
 any ot them be sustained.” 
 
 a P ft k er the following preamble and resolution, 
 
 dratted by Prof. Fall, were unanimously adopted: 
 
 Whereas, Serious charges have been make on the floor of the House of 
 Representatives, reflecting on the business and professional character, as 
 wed as the integrity of the members of this Board, therefore. 
 
 Besolved, That this board respectfully and earnestly request the Hon- 
 orable, the House of Representatives, to appoint a committee to investigate 
 the above-mentioned charges, and that the committee be authorized and 
 ducted to make a thorough investigation of all the acts of this Board. 
 
 * It L?° Ve PIf amble and resolution were placed in the form of a letter 
 to the Honorable, the Speaker and House of Representatives, signed by 
 the President and Secretary, and immediately sent to the Speaker* 
 
 almost immediate attention. 
 
 ttesolvea , That a committee of three be annointart Vw tLiq tj — . _ „ 
 
 Hon. J. 
 
 j mu . suam ’ onerea me ronowing resolution: 
 
 invSdSon of n °j threeb e appointed by the Speaker of this House to make a thorough 
 
 LTBo£d. ° th ‘ S H ° U8e againSt the St8te Board ot Health ' in 
 
 wite to^efav^fdewlft.fn w ed ^^flons, endeavored to lay the resolution on the table, and other- 
 ItepresIntatWei Cook 8CU881 ° n ^ at aft , ernoon session, the resolution was adopted. 
 
 T M A book ’ Amidon and Holden were appointed to serve on the above mentioned committee 
 Later, Mr. Amidon requested to be excused from serving, and Mr. Edgar was appoinS iS his p W 
 
 * ^ \<L 50 = 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 O 
 
 
 The members then informally discussed the action which had thus far 
 been taken on the Miller bill (House bill No. 693) and also informally 
 considered the Bialy bill (Senate bill No. 329, File 247), which was pending 
 in the Senate. No formal action was taken. 
 
 The regular business, including the auditing of bills and accounts was 
 transacted. 
 
 The secretary mentioned that he had received a letter from the secre- 
 tary of the Ohio State State Board of Health and a copy of a letter from 
 the Meat and Food Inspector of Toledo. A copy of each letter was 
 handed to each member of the board, but no formal action was taken by 
 the board.* 
 
 The letters are as follows: 
 
 “OHIO STATE BOARD OF HEALTH, \ 
 Office of the Secretary, > 
 Columbus , Ohio , April 9, 1895. ) 
 
 Dr. Henry B. Baker, Secretary , State Board of Health , Lansing , Michigan : 
 
 Dear Doctor:— I enclose herewith a copy of a letter received from the meat and food inspector of 
 Toledo, Ohio. Oar Attorney General advises that this constitutes an offense against the State of Michigan 
 on the part of Mills & Miller, and that they should be dealt with by the authorities of your State. I have 
 so informed Mr. Sacks. 
 
 If any action is taken by your Board in this matter I should be pleased to know of it. 
 
 Yours truly, 
 
 C. O. Probst, 
 
 Secretary. 
 
 Toledo , Ohio, April 6, 1895. 
 
 Dr. Probst, State Health Department, Columbus, Ohio: 
 
 Dear Sir: — I have a case here which the school board of the Homeless Children and Orphans School 
 of Coldwater, Michigan, are the complainers. They had a fat cow which they had slaughtered (for their 
 own use) by Mills & Miller of Coldwater, Michigan. Mills & Miller informed the board that the cow was 
 diseased. At once the board secured two veterinary surgeons to inspect the meat and they found the 
 lungs badly diseased and filled with pus, also found several tumors on the meat between the ribs also 
 filled with pus, and they pronounced the meat unwholesome, and the board asked Mills & Miller whether 
 they could not dispose of the meat by feeding it to Mills & Miller’s hogs that were about the slaughter 
 house, and they said they would do so. 
 
 A few days later Mills & Miller cut the tumors neatly from the beef and shipped the beef to Toledo, 
 Ohio, consigned to Armour & Co., and the school board was notified to that effect, and at once sent their 
 superintendent to Toledo, and informed me of the facts, I at once looked after the case and found the 
 meat at the Lake Shore freight depot in the car. At once I obtained an order from Armour & Co., and 
 paid the freight and took the meat in my charge, and I also have it in my possession now. It is a very 
 fine looking piece of meat, weighing between 700 and 800 pounds. The superintendent identified the meat 
 as soon as he saw it. The places where Mills & Miller cut out the tumors can plainly be seen. This is a 
 very peculiar case and I would like your advice at once. 
 
 Yours respectfully, 
 
 Caspar Sacks, 
 
 Meat and Food Inspector." 
 
 1610 22d Street, Toledo, Ohio. 
 
 This being the Annual meeting, an address by the President was in 
 
 order. . . . , , . 
 
 President Wells said that together with his personal business, and his 
 efforts with the Legislature, and the fact that he had been suffering with 
 la grippe, he had not had time to prepare the address that he had intended 
 to make. However, he had put a few remarks on paper, and would read 
 them. His address was as follows: — 
 
 *The secretary sent a copy to the Prosecuting Attorney of Branch county, also to the Attorney General. 
 
ABSTRACT OF PROCEEDINGS APRIL 12, 1895. 
 
 3 
 
 THE ADDRESS OF THE PRESIDENT OF THE MICHIGAN STATE BOARD 
 OF HEALTH, AT ITS ANNUAL MEETING IN THE CAPITOL, 
 
 ' LANSING, APRIL 12, 1895. 
 
 BY HON. FRANK WELLS, PRESIDENT. 
 
 To the Members of the State Board of Health : 
 
 Gentlemen — On the 12th day of April, 1873, just twenty-two years 
 ago to-day, the bill organizing the Michigan State Board of Health was 
 approved. The provisions of this bill which became a law of the State on 
 that day have never been changed. The law is liberal and comprehensive 
 and fairly states the objects sought to be secured by the creation of a State 
 Board of Health, so far as sanitary knowledge and experience had, at the 
 time of its enactment made these objects manifest. The newly created 
 board was given general supervision of the interests of the health and life 
 of the citizens of this State. It was required especially to study the vital 
 statistics of the State and endeavor to make intelligent and profitable use 
 of these records. It was made its duty to make sanitary investigations and 
 inquiries respecting the causes of disease and especially of epidemics; also 
 the causes of mortality and the effects of localities, employments, condi- 
 tions, ingesta, habits and circumstances on the habits of the people. It 
 was authorized when required or when it might deem it best to advise offi- 
 cers of the Government or other State Boards in regard to the location, 
 drainage, water supply, disposal of excreta, heating and ventilation of any 
 public institution or building. Finally, it was required to recommend from 
 lime to time standard works on the subject of hygiene for the use of the 
 .schools of the State. 
 
 The reputation of Michigan for healthfulness, since its earliest settle- 
 ment had not been an enviable one. The class of diseases known as mala- 
 rial had been of universal prevalence. They spared neither age, sex nor 
 condition, and during all the early years of the history of our State, its 
 founders, the pioneers and their children, suffered from these diseases far 
 beyond anything the present generation can imagine. During many 
 months of the year over large areas, harvests could be but partially gath- 
 ered, village work shops and stores were deserted and closed, schools were 
 sparsely attended, and nearly all the activities of life were suspended. 
 Pinched and sallow faces met the gaze everywhere and existence seemed a 
 burden. 
 
 There were many years of disease and misery before drainage and sun- 
 light gradually banished these enemies of human health and happiness, 
 until they have finally become nearly extinct in our borders. Scarcely a 
 hint of the character of these enemies entered the minds of the physicians 
 or sanitarians of those days. It is well to remember the foes that have 
 been vanquished, to record the history of the conflicts had with them, and 
 fhe weapons used to achieve success, for the campaign is to consist of many 
 conflicts, and in no warfare is experience and knowledge of more value 
 than in the one waged by sanitarians against the enemies of health and 
 life. Our own history shows this to be true, for as the hostile hordes of 
 malaria disappeared, others more malignant appeared in our midst. These 
 assumed new methods of attack. They concentrated their forces and 
 seemed to descend upon communities in battalions. Typhoid fever, cerebro- 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 spinal meningitis, diphtheria and other adversaries of life became epidemic 
 in the cities and villages of Michigan. 
 
 Man was powerless to resist them for he knew little concerning these 
 unseen but powerful destroyers, or of any methods whereby their constant 
 and savage inroads could be checked. The friends of the law creating the 
 State Board of Health were probably inspired by hope rather than belief 
 in making investigations concerning the causes of epidemics one of the 
 chief duties of its members. What these causes were, or how they could 
 be sought out and their baleful influences counteracted was an enigma not 
 yet solved, and but little considered. 
 
 It was known that measles, scarlet fever, small-pox and several other 
 diseases could, in some way, be communicated by contact, and that one 
 attack usually secured immunity from subsequent attacks. 
 
 Vaccination for small-pox had been proved to be efficacious, and that 
 cUsease had largely ceased to menace the world with its horrors. Beyond 
 this, science had scarcely taken a step in the direction of preventing or 
 stamping out outbreaks of any of the communicable diseases, discovering 
 their causes, or learning which of the diseases that afflict humanity,, 
 properly belonged to this class. 
 
 Scarcely a glimmer of the light that was soon to illumine these problems 
 and create the twin sciences, sanitation and biology, was then visible. 
 Revelations of the microscope concerning low forms of life were still 
 regarded even by scientific men, as curiosities of nature only. 
 
 The relation of some of these forms of life to disease, was suspected by 
 some, but believed in by only a few original investigators, in Europe, 
 whose names are now familiar to the world as the greatest benefactors of 
 their race that any age can show. The story of the labors of Schwann, of 
 Davaine, of Tyndall, of Pasteur, Koch, and a host of later laborers in the 
 fields of enquiry which have rendered them famous, is familiar to you all* 
 and in the light of the knowledge those labors have revealed, the path 
 which leads to success and victory is no longer the one of obscurity and 
 doubt which, twenty-two years ago your predecessors were expected to 
 explore. Sanitation had but one dogma then. It was a very old dogma 
 and can never be superseded. It may be expressed in the single word 
 cleanliness. The opposite of cleanliness was the cause of disease. How 
 filth caused disease, or why amid filthy surroundings people were often 
 healthy, were mysteries. With this lack of the knowledge now so common,, 
 the accomplishments of the State Board of Health during the early years 
 of its existence must have been of comparatively little practical value. 
 
 It was five years after its formation before Pasteur announced to the 
 world his discoveries concerning anthrax, and it is from this date only,. 
 1877, that what is called the Germ Theory of Disease, may be said to have 
 had an existence. From then until now, what an expanse of knowledge 
 concerning the cause and prevention of a large proportion of the diseases 
 which affect humanity, has been opened to our view. 
 
 This knowledge which is daily widening is as continually increasing the 
 complexity of the problems it presents. From a single dogma, sanitary 
 knowledge has evolved almost at a bound a science of its own, correlated to 
 many of the other sciences, and second to none of them in importance. 
 
 Its advance today is more rapid than any of its sisters, and he who keeps 
 step with its speedy progress must be familiar with its history, and have 
 the time and the ability to properly digest and assimilate the facts which 
 original workers, all over the world, are daily adding to its records. The 
 
ABSTRACT OF PROCEEDINGS, APRIL 12, 1895. 
 
 practical work which all this knowledge makes valuable should never be 
 entrusted to feeble or incompetent hands. I believe the history of the 
 Michigan State Board of Health shows in this respect a list of names, of 
 which any State might feel proud, many of them being known beyond the 
 ■confines even of our own nation. 
 
 I should like to dwell on the results of the labors of these men, but you, 
 equally with myself, are familiar with these results, showing as they do 
 the saving of thousands of valuable human lives to their families and to 
 the State. The Michigan State Board of Health has been a pioneer in 
 many of its lines of life-saving work. It has nearly always had among its 
 membership men engaged in original investigations. It has at its service, 
 probably the best equipped laboratory of hygiene on the continent, having 
 for its director one of its own members, Prof. Vaughan, whose well earned 
 reputation cannot be added to by any words of mine. 
 
 This laboratory aids greatly the work of the State Board of Health, and 
 is of much value to physicians and to the people. It furnishes facilities 
 for promptly determining suspected cases of typhoid fever, diphtheria, and 
 tuberculosis. During the last two years meetings of local health officers 
 have been held at this laboratory, for conference and for witnessing 
 methods for the detection of disease organisms. These meetings are 
 believed to be of the greatest value, and should certainly be continued. 
 
 I have endeavored to sketch briefly, and it seems to me very imperfectly, 
 on this anniversary occasion, some of the reasons why the people of Michi- 
 gan should feel thankful for the law creating the State Board of Health, and 
 for the absence of the epidemics, whose inroads before its enactment, filled 
 with mourning thousands of homes. That this feeling does exist among 
 the people has been often manifested at the popular sanitary conventions 
 held in two or three of the cities of the State every year, where expressions 
 of gratitude for the work of the Board are very common. While it is true 
 that members of the Legislature, now in session, have made and are making 
 serious efforts to abolish the present Board, alleging as one of the reasons 
 for such action, the large expense of carrying forward the lines of work 
 upon which this Board is engaged, yet it is gratifying to know that no 
 popular demand is at the foundation of this attempt. On the contrary, 
 there comes to us from all over the State, not only from the medical fra- 
 ternity, but from citizens generally, expressions of the deepest concern and 
 indignation at such action. These expressions show that the Michigan 
 State Board of Health is firmly entrenched in the esteem and appre- 
 ciation of the intelligent element of our people. This is not the first 
 time in its history that this Board has been the target of ignorance and 
 malice from legislators and others in authority. It is not likely to be the 
 last. 
 
 Many of the acts of the Board are necessarily invasive of private rights, 
 and result in making enemies of those who suffer from such acts. The 
 quarantine established by this Board for the inspection of immigrants 
 coming into this State, and the disinfection of their baggage during the 
 prevalence of cholera in Europe was a case of this class. This action, taken 
 amid frantic appeals made by the people to this Board for protection, 
 caused railroads some inconvenience, and was resented by a few of 
 them. It was even defied by one, and led to litigation that resulted in 
 the law being sustained by the courts, though the rules made by the Board 
 were regarded as exceeding the authority expressed in the law. But igno- 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 ranee is equally prolific in provoking opposition. Sanitary science is yet 
 young, and comparatively few have obtained much insight into its mys- 
 teries. To such the present expenditure of one cent per capita per annum 
 for the purposes for which the Michigan State Board of Health was created 
 seems large, and not only is any additional sum asked for to protect the 
 people from those diseases known to be preventable regarded as unneces- 
 sary, but the small sum now used is considered extravagant. 
 
 Until ignorance gives place to knowledge, this will continue. It is one 
 of the duties of this board to hasten the coming of that time. While we 
 are doing much to overcome ignorance by means of the distribution of the 
 Board’s literature, and the holding of sanitary conventions, are there not 
 other methods which can be adopted to secure this end? The public 
 school is an avenue through which we seek, by legislation, to enter. I 
 earnestly hope we may be enabled to do so, and thus begin sanitary 
 instruction where other instruction properly begins in the minds of our 
 youth. But the main channel by which information reaches the people 
 is the public press. It is to this that a large majority turn for knowledge 
 concerning current events. The use made of this instrument by the 
 Michigan State Board of Health is extremely limited. It consists of 
 little more than a condensation of the weekly reports of sickness statistics 
 sent to members and others from the office of the secretary. With bound- 
 less information of interest and value at hand, with daily papers willing 
 to publish short and interesting articles, and with a community willing 
 and anxious to absorb knowledge in this manner, it seems proper and right 
 that this information, which is of greater value than any other, be pre- 
 sented to the people in the form in which they are disposed to receive it. 
 
 Education being the chief instrument upon which we must rely to 
 accomplish the work we are set to do, should we not use this instrument 
 in every promising field? 
 
 To do so may require of us more of time, more of energy and more of 
 sacrifice in other ways, but these should not be wanting. We have 
 accepted a trust second to no other in importance. The labors and respon- 
 sibilities involved in this acceptance I believe no member of this board 
 desires to evade. If more of the talents given to each one of you are 
 needed, I believe they will be forthcoming. The spirit and purpose 
 which have inspired you in the past will, even if unappreciated by those 
 to whom such spirit and purpose cannot appeal, continue to animate and 
 stimulate you in the future. 
 
 Humanity needs your efforts, and no higher reward can crown achieve- 
 ment, in any department of human endeavor, than a consciousness of 
 having been instrumental in the saving of human life and the relieving of 
 human woe. 
 
 The relations which have existed between the members of this board, 
 during the time I have through your partiality presided over your deliber- 
 ations, have been most friendly, and I desire in closing to thank you all 
 for the courtesy and indulgence I have during that period uniformly 
 received at your hands. 
 
ABSTRACT OF PROCEEDINGS, APRIL 12, 1895. 
 
 7 
 
 Following the President’s address, the election of a President of the 
 Board for the ensuing two years was in order. There being no other 
 nominations, on motion of Dr. Granger, Hon. Frank Wells, was unani- 
 mously elected president of the State Board of Health for the ensuing 
 two years. 
 
 The newly-elected president made a few brief remarks, in which he 
 reviewed some of the past work of the Board, and made a few suggestions 
 regarding his views of some of the future plans of the Board. 
 
 The Secretary presented his quarterly report of work done in the office. 
 The report is as follows : 
 
 SECRETARY’S REPORT OF DANGEROUS COMMUNICABLE DISEASES, 
 OF WORK DONE IN THE OFFICE OF THE STATE BOARD 
 OF HEALTH, AND OF THE CONDITION OF HEALTH GEN- 
 ERALLY IN MICHIGAN DURING THE QUAR- 
 TER ENDING MARCH 31, 1895. 
 
 Dangerous Communicable Diseases. 
 
 The number of reports of outbreaks of dangerous communicable dis- 
 eases in Michigan, received from all sources and filed, and the corres- 
 ponding number concerning which action was taken by this office, during 
 the quarter, areas follows: for diphtheria, 117; for scarlet fever, 195; 
 for typhoid and typho-malarial fever, 76; for measles, 53; for small- 
 pox, 12; and for consumption, 154. Total for the six diseases, 601. 
 
 The number of communications relative to dangerous communicable 
 diseases, received and placed on file during the quarter, was 2,482. 
 
 Relative to dangerous communicable diseases, letters, written cards, 
 and demands for weekly and final reports on cards, or in the form of the 
 circular letter, were sent out during the quarter to the number of 2,084. 
 
 The “final” reports of outbreaks received and filed during the quarter 
 were: for diphtheria, 109; scarlet fever, 191; typhoid and typho-malarial 
 fever, 91; measles, 21; small-pox, 12; consumption, 2. Total for the six 
 diseases, 426. 
 
 During the quarter, the local columns of 942 newspapers, have been 
 looked over for reports of occurrence of communicable diseases. (This 
 work is done by the clerk who acts as messenger and janitor, in the inter- 
 vals of his performance of other duties.) This has resulted in giving this 
 office information of the alleged occurrence of 3 outbreaks of diphtheria, 
 6 outbreaks of scarlet fever, 2 outbreaks of typhoid and typho-malarial 
 fever, 2 outbreaks of measles. To what extent the reports of these alleged 
 outbreaks were verified, is shown in the accompanying table : 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 TABLE I . — Showing the number of outbreaks of diphtheria, Scarlet fever , Typhoid 
 fever , Measles, Small-pox, and Consumption, from January 1, to March 31, 1895, of 
 which notice was received at the office of the Michigan State Board of Health ; the 
 per cent of reports, information concerning which was received through the News- 
 papers ; the per cent of newspaper reports which were confirmed by the health offi- 
 cer; the per cent of newspaper reports which were denied by the health officer; and 
 the per cent relative to which no reply was received from the health officer. 
 
 Diseases. 
 
 Reports from 
 all sources, 
 Jan. 1 to 
 Mar. 31, 1895. 
 
 Per cent 
 of all reports 
 which were 
 obtained 
 from the 
 newspapers. 
 
 Per cent 
 of newspaper 
 reports which 
 were con- 
 firmed by the 
 health officer. 
 
 Per cent 
 of newspaper 
 reports which 
 were denied 
 by the 
 
 health officer. 
 
 Per cent of 
 newspaper re- 
 ports to which 
 the health 
 officer made 
 no reply 
 to notice sent 
 from this 
 office. 
 
 Diphtheria 
 
 Ill 
 
 3 
 
 33 
 
 33 
 
 33 
 
 Scarlet fever 
 
 195 
 
 3 
 
 33 
 
 33 
 
 33 
 
 Typhoid fever 
 
 76 
 
 3 
 
 0 
 
 50 
 
 50 
 
 Measles 
 
 53 
 
 4 
 
 0 
 
 100 
 
 0 
 
 Small-pox 
 
 12 
 
 0 
 
 0 
 
 0 
 
 0 
 
 Consumption 
 
 154 
 
 0 
 
 0 
 
 0 
 
 0 
 
 Averages for the six diseases 
 
 
 2 
 
 23 
 
 46 
 
 31 
 
 Small-pox in Michigan in the first quarter of 1895. 
 
 Twelve new outbreaks of small-pox were reported during the quarter. 
 These occurred in Bengal township, Clinton Co. ; Southfield township, Oak- 
 land Co. ; Plymouth village, Wayne Co. ; Highland Park village, Wayne 
 Co. ; Mayville village, Tuscola Co. ; Pontiac city ; Royal Oak township, Oak- 
 land Co. ; Hamtramck township, Wayne Co. ; Grand Rapids city ; Three 
 Rivers village, St. Joseph Co. ; Ypsilanti city and Watson township, 
 Allegan Co. Of these outbreaks, final reports of those at Bengal, South- 
 field, Plymouth, Pontiac, and Royal Oak, have been received. In the 
 outbreaks at Highland Park, Ypsilanti and Hamtramck the cases have all 
 recovered, but no final reports of these three outbreaks have yet reached 
 this office at this date (April 1, 1895). Relative to the alleged outbreaks 
 at Mayville and Three Rivers, no reports have been received at this office, 
 at this date (April 1, 1895), from either of these localities, since the “blue 
 letter” was sent from this office, and it is inferred that there may have 
 been no small-pox at either of these localities. (This has since been 
 found to be true.) 
 
 April 1, small-pox is still present at Detroit, Grand Rapids, and Watson 
 township. 
 
 The outbreak which began in Detroit in May, 1894, still continues. 
 During the quarter ending March 31, 1895, there have occurred in that 
 city, 77 new cases, and 26 deaths, which, with the 17 cases that were still 
 sick at the close of the quarter ending December 31, 1894, make a total of 
 94 cases and 26 deaths, during the first quarter of 1895. 
 
ABSTRACT OF PROCEEDINGS, APRIL 12, 1895. 
 
 9 
 
 (From the beginning of the outbreak in May, 1894, up to April 1, 1895, 
 there have occurred in the city of Detroit 217 cases and 60 deaths.) 
 
 In the ten outbreaks of small-pox, not including Detroit, and from 
 which reports have been received during the quarter ending March 31, 
 1895, there have occurred 21 cases and only 1 death. 
 
 In the five outbreaks, relative to which final reports have been received, 
 the infection was in every instance restricted to the one house in which it 
 first occurred. 
 
 Compiling , Editing , Proof-Reading , Printing , etc . 
 
 The compilation of reports from all sources, relative to Measles in Mich- 
 igan in 1892, has been completed, and the work on proving the compila- 
 tion for the article for the Annual Report has been commenced. 
 
 The compilation of reports from all sources relative to Diphtheria in 
 Michigan in 1893, is practically completed, and the material for the tables 
 for the article for the Report for 1894, has been collected. 
 
 The article “ Scarlet Fever in Michigan in 1892 ” has been written, based 
 upon the compilation, and will be ready for the printer as soon as proved. 
 
 The article “ Diphtheria in Michigan in 1892 ” has been proved. 
 
 The article “ Nuisances in Michigan in 1892 ” has been completed. 
 
 About one-half of the compilation of “ Typhoid Fever in Michigan in 
 1892 ” has been proved. 
 
 Short articles on various subjects, have been written, based upon the 
 compilations, as follows: Typhus Fever, Membraneous Croup, Erysipelas, 
 Mumps, Alleged Anthrax. Puerperal Fever, Chicken-pox, Cholera (spor- 
 adic), Whooping-cough, Rotheln, Typho-pneumonia, and Small-pox. 
 
 Proof has been read on the Proceedings of the Union City Sanitary 
 Convention, on the latter part of the article on “ Meteorology in Michigan 
 in 1892,” and on the first portion of the article relative to “ Sickness 
 Statistics in Michigan in 1892.” 
 
 The work on printing the Annual Report for 1893 has been commenced 
 and about ninety pages of the report have already been printed. 
 
 Making Diagrams , Tables , etc. 
 
 A table has been made, showing the numbers of cases of Sickness and 
 Deaths from Diphtheria, Scarlet Fever and Small-pox, reported to have 
 occurred in Detroit during each week of the years 1890-95 as reported to 
 this office by the Health Officer of Detroit. 
 
 A Map — Distribution of Scarlet Fever in Michigan in 1892 — has been 
 made. 
 
 A large diagram (32 by 45 inches) has been made in India ink to illus- 
 trate the relative importance, in Michigan, of the principal communicable 
 diseases — Consumption, Pneumonia, Diphtheria, Typhoid Fever, Scarlet 
 Fever, Whooping-Cough, Measles, and Small-pox. 
 
 Hektograph Work. 
 
 Hektograph work to the number of 4,246 pages has been made, of which 
 about 355 pages were relative to the small-pox situation in Michigap since 
 January 1, 1895, being in the form of tabular statements. A large 
 proportion of the remaining pages relates to public-health legislation in 
 Michigan in 1895. 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Accessions to the Library, Card- Cataloguing, etc. 
 
 About 60 books and pamphlets, and some 300 numbers of journals 
 (weeklies, monthlies, quarterlies) have been received and entered in the 
 library accession book of the office. 
 
 Work on the card-catalog of the library has been continued. 
 
 Work in connection with the financial accounts of the office has been 
 continued. 
 
 Annual Reports from Health Officers and Clerks for 1894. 
 
 Annual reports for the year 1891 have been received from 1170 health 
 officers and from 1145 clerks of townships, cities and villages in Michigan. 
 These reports convey to this office information relative to the prevalence 
 of each dangerous communicable disease, and the .condition of health, and 
 health work in each jurisdiction. 
 
 On February 28, a ‘‘Second request for annual report,” was sent to 1,392 
 health officers and clerks from whom no report had yet been received; and 
 on March 31, a “Third request” was sent to the health officers of 215 
 localities from which no report from either health officer or clerk had been 
 received. 
 
 Of the 1,578 localities in Michigan, including townships, cities and villa- 
 ges, annual reports have been received from 1,419, leaving at the end of 
 this quarter 159 localities delinquent. Of these delinquent localities, 9 are 
 townships which are either in a disorganized condition, or from which 
 neither the name of a supervisor or clerk has been returned for several 
 years. 
 
 Reports of Medical Practitioners in their jurisdictions have been received 
 from 531 clerks of townships, cities and villages. 
 
 Work on Meteorology. 
 
 The regular tri-daily meteorological observations have been continued 
 at this station, and a summary for each week and month during the quarter 
 has been made for use in this office in connection with sickness statistics. 
 The monthly summary has been sent at the end of each month to the 
 Director of the Michigan Weather Service, formerly at Detroit, now at 
 Lansing, for his use; it is sent by him to the Chief of the U. S. Weather 
 Bureau at Washington, D. C. 
 
 . Nearly all the exhibits for the Annual Report for 1894, have been 
 computed. 
 
 Ozone test-paper (supply for three months) was sent to each of 17 
 meteorological observers in Michigan. 
 
 Meteorological registers for the last 9 months of 1894 have been received 
 for each of 11 stations, examined and computed, barometer, relative and 
 absolute humidity excepted. 
 
 Diagrams have been made relating to: Average Temperature, Av. 
 Daily Range of Temperature, Absolute and Relative Humidity, Per Cent 
 of Cloudiness, Rainfall, Day and Night Ozone, Velocity of the Wind, 
 Barometric Pressure at Stations in Michigan, and Velocity of the Wind at 
 Lansing, all for year 1893; also diagrams — Relation of sickness from 
 Pneumonia to the Av. Atmospheric Temp, for four months, Sept, to Dec., 
 1894, at Calumet, Mich., and Death-Rates in Michigan during each of 25 
 
ABSTRACT OF PROCEEDINGS, APRIL 12, 1895. 
 
 11 
 
 years, 1869-93, per 100,000 population from following diseases, — Consump- 
 tion, Diphtheria and Croup, Scarlet Fever, Typhoid Fever, Measles, Small- 
 pox, Whooping-Cough, Cancer and Pneumonia. 
 
 Hektograph copies of a form for “ Measurements of Ground- Water ” 
 have been made for use of Meteorological Observers for the Michigan 
 State Board of Health. 
 
 A map was made, in photo-engraving ink, showing Spencer and Oak- 
 field townships, Kent Co , and lakes No. 3 and 4 with dam at outlet of one 
 of the lakes, whereby a nuisance was caused by over-flow in consequence 
 of said dam; also a map of the township of Jefferson, Hillsdale Co., show- 
 ing lakes and rivers, drains and marshes, where an alleged nusiance was 
 caused by the overflowing of low lands, by a dam in the city of Hillsdale. 
 
 Distribution of Publications , etc. 
 
 About 800 copies of the Proceedings of the last regular meeting (Jan. 
 11, 1895), have been distributed to: Members and ex-members of this 
 Board, Sanitary Journal Exchanges, Meteorological Observers and 
 exchanges, members of Board of Correction and Charities, health officers 
 of cities and villages, presidents and secretaries of previous sanitary con- 
 ventions, members of the Legislature, and to Sanitarians. 
 
 About 200 copies of the Proceedings of the regular meeting, held at 
 Lansing, Oct. 12, 1894, have been distributed to sanitarians. 
 
 About 1,200 copies of the Proceedings of the Second Annual Conference 
 of Michigan Health Officers, at Ann Arbor, and about 1,200 copies of the 
 Proceedings of the Sanitary Convention held at Union City, have been 
 distributed to: Members and ex-members of this Board, sanitary journal 
 exchanges, meteorological observers and exchanges, members of the Board 
 of Correction and Charities, secretaries of other State Boards of Health, 
 health officers of cities and villages, presidents and secretaries of previous 
 sanitary conventions, and to Sanitarians. About 150 copies of the 
 Proceedings of the Ann Arbor Conference were sent to members of the 
 Legislature. 
 
 About 200 copies of the Annual Report of the Board for 1892 have been 
 distributed to sanitarians in this and other States and Countries. 
 
 During the quarter 1,939 envelopes were addressed to 1,211 supervisors 
 of townships, 294 presidents of villages, 294 clerks of villages, 70 mayors 
 of cities and 70 clerks of cities. In each envelope was sent a circular 
 letter of instruction and a blank form for the return of the name and post- 
 office address of the health officer for the ensuing year, and a return 
 envelope. At the same time and in the same envelope there was sent to 
 each clerk of a city and to each supervisor of a township a blank to be 
 handed to the clerk of the city or to the clerk of the township for his pur- 
 pose in keeping a record of each physician and each under graduate prac- 
 ticing medicine in the township or city as the case may be; at the same 
 time, in case there is an incorporated village within the township, the 
 supervisor of the township is sent an extra blank for keeping a record of 
 physicians and under-graduates to be handed to the clerk of the village. 
 
 About the usual numbers of pamphlets on the restriction and prevention 
 of the different dangerous diseases were sent to the health officers of local- 
 ities in which dangerous diseases have been reported. It was at the same 
 time requested of these health officers that the pamphlets be distributed 
 
12 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 to the neighbors of the persons sick icith such diseases and to such other 
 persons as they would be likely to benefit. In response to special requests 
 of sanitarians in this and other States, copies of annual reports, proceed- 
 ings of sanitary conventions, proceedings of meetings of the board, and 
 pamphlets on the restriction and prevention of the dangerous communi- 
 cable diseases, have been sent where it was thought likely to benefit pub- 
 lic health interests. 
 
 The usual record of distribution of publications has been kept. 
 
 Transportation of Corpses Dead of Tuberculosis. 
 
 In a letter dated April 11, 1895, John L. Freeman, General Baggage 
 Agent of the Lake Shore and Michigan Southern Railway Co., wrote to 
 know how bodies dead of Consumption were to be treated by the railroad 
 authorities, the agent at Grand Rapids, Michigan, having received a 
 corpse dead of Consumption the transit permit reading “ Contagious 
 Disease.” 
 
 The following is the Secretary’s reply: 
 
 STATE BOARD OF HEALTH, MICHIGAN, ) 
 Office of the Seobetaby, > 
 Lansing , April 13, 1395. ) 
 
 John L. Freeman , General Baggage Agent , Lake Shore and Mich. Southern Ry. Co., Cleveland , Ohio: 
 
 Deab Sib— Your letter of April 11, transmitting letter of March 29 from J. W. Lawton, Grand Rapids, 
 relative to corpse dead of consumption, is before me. 
 
 The State Board of Health of Michigan, Sept. 30, 1893, adopted a resolution “ That hereafter, consump- 
 tion (and other diseases due to the Bacillus tuberculosis ) shall be included in the official list of ‘ diseases 
 dangerous to the public health.’ ” In this resolution the question of isolation of the patient is not 
 mentioned, and the question of the spread of the disease from a corpse has never been acted upon by this 
 Board. 
 
 The subject has not reached such a definite stage that I can give you definite advice. I think most 
 sanitarians still hold to the belief that there is not much danger of consumption being spread by a corpse, 
 yet, inasmuch as consumption is the most dangerous disease, I incline to the view that it would be safest 
 for ,the public and also for your company to include bodies of those dead from consumption under 
 sections 2 and 3, Rule 52, adopted by the American Association of General Baggage Agents, at Mackinaw, 
 July, 1892.* Very respectfully, 
 
 Henby B. Bakeb, 
 
 Secretary. 
 
 Is Testing Eyes and Fitting Glasses Practicing a “ Branch of Medicine?” 
 
 During the quarter the Secretary has received letters asking whether or 
 not testing eyes and fitting glasses is a branch of medicine, and whether 
 persons doing such work should not be required to comply with the State 
 law regulating the practice of medicine. It is claimed by oculists, that a 
 lens is a surgical appliance for overcoming an optical defect, and that he 
 who tests eyes and adjusts glasses is practicing a branch of medicine, and 
 should register in the office of the county clerk in accordance with the 
 State law regulating the practice of medicine, before he or she is legally 
 authorized to practice this branch of medicine. The opinion of the State 
 Board of Health has been asked, and the subject should have been placed 
 
 * Section two of Rule 52, designates how bodies dead from contagious, infectious, or communicable 
 diseases, must be prepared before the railroads will accept them for transportation. 
 
 Section 3 provides that no infected clothing shall accompany the body except that which is in the 
 coffin or box, and also requires affidavits stating how the body has been prepared and kind of coffin or 
 casket used. 
 
ABSTRACT OF PROCEEDINGS, APRIL 12, 1895. 
 
 13 
 
 before the Board had there been opportunity. During the interval of a 
 meeting the Secretary made the following reply to a letter on this subject: 
 
 STATE BOARD OF HEALTH, MICHIGAN, ) 
 Office of the Secretary, > 
 
 Lansing , Feb. 21, 1895. ) 
 
 A. Overfield , M. D., Houghton , Michigan: 
 
 Dear Doctor I send you by this mail a copy of the pamphlet proceedings of this Board at its meeting 
 in April, 1894, in which you will find marked paragraphs relative to the subject of your letter tome 
 Feb. 19. 
 
 Replying to your letter of Feb. 19, 1 send you herewith a copy of the law regulating the practice of 
 medicine in Michigan. It provides that every person practicing medicine and surgery “ in all [any of ?] 
 its departments ” shall be a graduate of a legally-authorized medical college in this or any other country, 
 and shall file with the county clerk a statement relative to his medical education and graduation. 
 The question would be whether testing and fitting the eyes with glasses, is one of the “branches” or 
 “ departments ” of medicine. If so, the individual could, perhaps, be punished under the State law. I 
 presume it would rest with the court, or the jury in case a jury trial was had, to decide that point. There 
 is no telling how they might decide it. For myself I am inclined to believe such practice is a branch of 
 medical practice, and should be regulated by the law relative to the practice of medicine. 
 
 Very respectfully, 
 
 Henry B. Baker, 
 
 Secretary . 
 
 INVESTIGATION OF OUTBREAKS OF COMMUNICABLE DISEASES. 
 
 March 21, 1895, the Secretary of the State Board of Health received a 
 telegram from Allegan, Michigan, as follows: 
 
 “Small-pox reported here, disputed, can you send expert immediately? 
 — John Germain , health officer of Watson .” 
 
 This was received very late at night. The Secretary telegraphed as 
 follows: “Isolate patient, vaccinate all exposed. Will try to send expert 
 tomorrow.” 
 
 March 22, the Secretary telegraphed Doctor George H. Granger, member 
 of State Board of Health, as follows: “Small-pox reported at Watson, 
 Allegan County, diagnosis disputed, want expert immediately, will you go 
 and “Investigate ?” The following reply was received: “Cannot leave my 
 business. Have several very sick patients. — Geo. H. Granger .” 
 
 The same telegram sent to Doctor Granger was then sent to Doctor 
 Victor C. Vaughan, member of State Board of Health, and reply was 
 received as follows: “Caunot go. Ask Mulheron. — V. C. Vaughan ” 
 
 The same telegram was then sent to Doctor Samuel G. Milner, member 
 of State Board of Health, and a reply was received as follows: “I cannot 
 go, but Hazlewood will. — Milner .” 
 
 A similar telegram was sent to Mason W. Gray, M. D., member of State 
 Board of Health, and the following reply was received: “Cannot go, try 
 some one else. — Mason W. Gray.” 
 
 March 22, the following telegram was sent to John Germain, health 
 officer of Watson, Allegan County, Michigan: “ No member of Board could 
 go. Doctor Cattermole of this office will reach Allegan 8:16 tomorrow 
 morning. — Baker , Secretary.” 
 
 March 23, Doctor Cattermole telegraphed the Secretary of the State 
 Board of Health, as follows: “One case diagnosed Varioloid. Sick ten 
 days. Many persons exposed, but active measures are being taken in vac- 
 cination and isolation. Will start home tonight.” 
 
 This experience teaches the difficulty of relying upon members of the 
 State Board of Health, who are engaged in active practice as physicians, 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 for service as Contagious-Disease Inspectors. In this instance every medi- 
 cal member of the Board was asked to go, and every one found it imprac- 
 ticable to do so. (It was impracticable for the Secretary to go, because of 
 pressing official duties in the office of the Board, aud especially as the 
 Correspondence Clerk chanced to be absent. ) This is only one of many 
 instances, which are being constantly repeated, in which the need of a 
 State Communicable-Disease Inspector is rendered imperative. 
 
 Small-pox in Watson, Allegan County. 
 
 Report of an investigation by Dr. Cattermole, of the Office of the State 
 Board of Health: 
 
 Lansing, Michigan, ) 
 March 26, 1895. ) 
 
 Henry B. Baker, M. D., Secretary of State Board of Health, Lansing, Michigan: 
 
 Dear Doctor— The following is my report of the special investigation of a suspected case of small- 
 pox, located in Watson township, Allegan Co., Michigan, in which investigation I was engaged on the 23d 
 and 24th days of March, 1895. The facts of interest in the case are as follows:— 
 
 I arrived in Allegan Saturday morning, March 23, and went first to see E. D. Osmon, M. D., health officer 
 of the village and also of the township of Allegan, who told me that the suspected case of small-pox was 
 in the adjoining township of Watson, and that Dr. Charles Russell of Allegan, who was attending the case, 
 would take me out to see it. 
 
 1 was taken to the office of Dr. Russell and there met John Germain, the father of the sick boy, who 
 said that he was not the health officer of Watson township, but had signed himself, when telegraphing to 
 Secretary Baker, to avoid delay, as the health officer lived on the opposite side of the township. 
 
 The reason given for telegraphing to the Secretary of the State Board of Health to send an expert there 
 was not from any doubt in the minds of the physicians as to the nature of the disease, but Germain would 
 not accept their diagnosis, he maintained that it was a case of “German Measles,” and telegraphed the 
 Secretary of State Board of Health signing himself health officer. 
 
 Mr. Germain is Drain Commissioner of Allegan County, and gets home only once or twice a week. He 
 had not been home then since Sunday, March 17. His duties keep him traveling about the county ; he had 
 also been in Grand Rapids, about three weeks before I saw him. 
 
 After talking with Germain, I went, in company with Dr. Russell, to see the case. 
 
 The farm house where the case is quarantined is about four miles east of the village of Allegan, and only 
 a short distance over the line separating the township of Allegan from the township of Watson. The 
 house is of fair size and in good sanitary condition. It stands back from the public highway about five 
 rods, and near the road was a signboard bearing the words “ Small-pox here.” 
 
 The case, Eddie Germain, 12 years old, attended the district school on Wednesday, March 13, but was 
 not feeling well that day. He remained at home on Thursday, suffering from severe pains in his back and 
 legs: he was vomiting and having epigastric pains for several days. Had fever, his mother says, and that 
 his feet began to swell at this time ; they were still swollen when I saw him, March 23, which was ten days 
 after he first complained of feeling sick. 
 
 His mother says, the rash appeared first Saturday evening, March 16, as red spots on the face. Sunday, 
 March 17, Dr. W. E. Albright of Allegan was passing the house and they called him in to see the boy. He 
 called it a case of the “grippe.” 
 
 On this same Sunday there were a number of the neighbors in the house, and the neighbors visited the 
 house as late as Tuesday, March 19, when an old lady said it was a case of “ Dutch measles this alarmed 
 the mother, and on Wednesday, March 20, they sent to Allegan for Dr. Russell to come out and see the 
 case. He saw the boy Wednesday evening, and says the case then presented the vesicular stage of 
 varioloid. 
 
 Dr. Russell telephoned to Grand Rapids that evening for vaccine points and the next morning went to 
 the Germain home accompanied by Dr. Edward Amsden, who had had considerable experience with 
 small-pox during the war. Dr. Amsden concurred in the diagnosis of varioloid, and the Doctors at once 
 vaccinated such members of the family as were then at home. 
 
 The family consists of the father, who was then in Allegan (he was vaccinated that same day), the 
 mother and five boys (including the sick child).— ages of boys from five to twenty-one,— were all vaccina- 
 
ABSTRACT OP PROCEEDINGS, APRIL 12, 1805. 
 
 15 
 
 ted on Thursday morning; a daughter, who works in Allegan was at home on Sunday and then returned 
 to her place in town, but was sent home Saturday evening, March 28. The father went home at the same 
 time, as the people of Allegan objected to his remaining in that village. 
 
 When I saw the case on Saturday morning, March 23 (the tenth day of the disease), the boy had a 
 temperature of 101-1-2 F. Tongue coated, pain in the epigastrium. Over the face, ears, hands, and 
 especially about the elbow and knee joints, there were numbers of dark red scabs from the size of a grain 
 of wheat to that of a pea (1 to 3 tenths of an inch) . The scabs were raised above the surface of the skin, 
 dry and hard to the touch and having an indurated base. Those crusts which had not been disturbed by 
 scratching, presented slight umbilication. Only one spot had the appearance of a pustule, the others 
 being uniformly dark red in color. The only symptom which seemed to be lacking to make it a well 
 defined case of small-pox was the abortion of the case before reaching the stage of pustulation. The boy 
 has a large scar on the left arm, the result of vaccination less than two years ago. 
 
 We returned to Allegan, and met some neighbors of S. P. Albertson, health officer of Watson township, 
 conversed with them relative to what the State Board of Health would recommend them to do in this 
 case. I sent my credentials and a marked copy of the pamphlet. “ The Work of Health Officers and of 
 Local Boards of Health in Michigan ” to Mr. Alberton, saying, that if the local health officials were still 
 dissatisfied with the diagnosis of the case, that the Secretary of the State Board would recommend them 
 to employ Dr. John Mulheron of Detroit, or Dr. Arthur Hazelwood of Grand Rapids, as expert, but that 
 under the circumstances, the fees and expenses of these gentlemen could not be defrayed by the State 
 Board of Health. 
 
 Dr. Russell offered to vaccinate all persons who had been exposed, if Mr. Albertson would have them 
 meet at the district school house next day (Sunday), and notify him when to meet them there. Dr. 
 Russell telephoned to Grand Rapids for vaccine points, which were received Saturday evening. 
 
 I expected to meet Mr. Albertson on Saturday afternoon, but he did not come into town. On Sunday 
 morning, I am told, he called at Dr. Russell’s house to say that the children of school district No. 10, would 
 meet the Doctor at the school building that afternoon. I did not see him, and he was not at the 
 school house that afternoon. I accompanied Dr. Russell that day, and we vaccinated 68 persons, mostly 
 children in attendance at that school. Many of them received primary vaccination. 
 
 The children had been there to school the Friday before, but the parents who were present promised to 
 close the school for at least two weeks, and then if no new cases occurred, to use it only after thorough 
 fumigation with sulphur. 
 
 As to the probable source of contagium in the case of Eddie Germain, all that we could learn was, that 
 his father traveled about the country most of the time, coming in contact with ail classes of people ; he 
 had also visited Grand Rapids since the outbreak of small-pox in that city. 
 
 The teacher in the district school spends his Saturdays and Sundays in Otsego, where there are some 
 paper mills (these paper mills are thought to have been the source of an outbreak ef small-pox which 
 occurred in Otsego about two years ago, in which there were several cases and one death). 
 
 John Shay, who lives on the adjoining farm to that occupied by John Germain, has a son who works in 
 the Otsego paper mills; he usually spends Sunday at his father’s home. One of Shay’s daughters, a girl 
 about fifteen years old, attends the village school at Otsego; she spends her Saturdays and Sundays at 
 home. About three weeks ago this girl had what they say was German measles, and her two younger 
 sisters had the rash a few days later; the two younger girls attend the district school (No. 10). Their 
 mother says, the rash lasted about two days; the girls were not very sick. They said, the “ German 
 measles,” had prevailed in the Otsego schools for some time. 
 
 After vaccinating as stated above, and explaining such methods of restriction— vaccination, isolation 
 and disinfection— as are recommended by the State Board of Health, I left the neighborhood Sunday 
 evening. The case of Eddie Germain was doing well and in good way for a speedy recovery ; there were 
 no new cases reported. 
 
 I left Allegan on Monday morning, without gaining any more information. 
 
 I am, yours very respectfully, 
 
 Geo. H. Cattermole. 
 
 WORK IN CONNECTION WITH SICKNESS STATISTICS. 
 
 During the first quarter of 1895, 2,205 blank postal report cards, 147 
 record- books and 27 hektographed circular letters regarding weekly card- 
 reports, have been mailed to 139 health officers and regular correspondents; 
 1,202 weekly card- reports have been received and entered on the register; 
 
16 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 53 copies of the hektographed weekly bulletin, “ Health in Michigan,” 
 were mailed each week, and 107 copies of the monthly bulletin, “ Health 
 in Michigan” have been hektographed and mailed each month. These 
 bulletins have been consolidated for this quarterly report. The com- 
 pilation of the weekly card-reports of sickness during the year 1893, for 
 the annual report for 1894, have been completed during this quarter. 
 
 Health in Michigan in the First Quarter of 1895. Communicable Diseases . 
 
 Compared with the preceding quarter (October, November and Decem- 
 ber, 1894), reports from all sources show typhoid fever to have decreased 
 by an average of seventy-two places, diphtheria to have decreased by an 
 average of twenty-four places, measles to have increased by an average of 
 thirteen places and scarlet fever to have increased by an average of one 
 place. There were the same number of cases of small-pox as in the pre- 
 ceding quarter. 
 
 Meteorology at one Central Station , and Sickness throughout Michigan 
 from all Causes, First Quarter of 1895 , Compared with the 
 Preceding Quarter. 
 
 A comparison of meteorological conditions of the first quarter of 1895, 
 with the meteorological conditions of the preceding quarter, shows the 
 prevailing direction of the wind to have been the same (south-west), the 
 average velocity 4.1 miles per hour greater, the temperature 47.28 degrees 
 lower, the rainfall .11 of an inch more, the absolute humidity much less, 
 the relative humidity slightly less, the day and night ozone less, and the 
 depth of water in the well at Lansing 22 inches less in the first quarter of 
 1895. 
 
 Compared with the preceding quarter (October, November and Decem- 
 ber), the reports from regular observers show a marked increase of 
 influenza, pleuritis and pneumonia, and a marked decrease of remittent 
 fever, diarrhea and intermittent fever in the first quarter of 1895. 
 
 The Weather and the Health in Michigan in the First Quarter of 1895 y 
 Compared with the Average for the Nine Years, 1886-1894. 
 
 A comparison of the meteorological conditions of the first quarter of 
 1895, with the average for the first quarters in the nine years, 1886-1894, 
 shows that in 1895, the prevailing direction of the wind was the same, 
 (south-west), the velocity was 1.2 miles per hour greater, the temperature 
 was 5.03 degrees lower, the rainfall was .52 of an inch less, the absolute 
 and relative humidity and the day and night ozone were all less, and the 
 depth of water in the well at Lansing was 21 inches less. 
 
 Compared with the average in the corresponding quarters in the nine 
 years 1886-1894, the reports from regular observers indicate that erysipelas, 
 remittent fever and intermittent fever were more than usually prevalent, 
 and that consumption and inflammation of bowels were less than usually 
 prevalent in the first quarter of 1895. 
 
ABSTRACT OF PROCEEDINGS 
 
 OF THE 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 QUARTERLY MEETING, JAN. 8, 1897. 
 
 [235] [Reported by the Secretary. J 
 
 The Michigan State Board of Health met in regular quarterly meeting 
 at the State Capitol, January 8. The meeting was called to order by the 
 president, Hon. Frank Wells, of Lansing. The other members present 
 were: Prof. Delos Fall, of Albion, Judge A. V. McAlvay, of Manistee, 
 and Secretary Henry B. Baker, of Lansing. 
 
 The regular business of auditing bills and accounts was transacted. 
 
 Pneumonia a Communicable Disease. 
 
 Prof. Fall mentioned that there had recently been brought to his atten- 
 tion an outbreak of pneumonia which tended to show the communicabil- 
 ity of the disease. There were five # cases with two deaths, which all 
 seemed to have been spread directly, one after another, from preceding 
 cases. 
 
 That pneumonia is a germ disease has been demonstrated; that it is a 
 dangerous communicable disease there is no question. It is now 
 known that exposure to cold and to the germs causes pneumonia. There 
 are at least two species of germs, either one of which causes pneumonia. 
 Just which one was present in this instance was not ascertained. Prob- 
 ably, after a time, we shall be able to distinguish the different forms of 
 the disease due to the different germs. But, before this can be done, 
 ' physicians who have such outbreaks in charge must see that, from the 
 germs present, cultures are made by some competent bacteriologist, and 
 records must be made of the signs and symptoms, so that these may be 
 compared with those in outbreaks due to the different germs. 
 
 Pneumonia is a disease which causes many deaths in Michigan in 
 every year; and while the State Board of Health has done much for the 
 education of the people preparatory to its restriction, the Board has not 
 yet recommended isolation of patients as in diphtheria, scarlet fever, and 
 small-pox. It is anxious to collect all the information it can bearing 
 upon the modes by which pneumonia is spread, in order that, as soon as 
 practicable, the best measures may be recommended for its restriction. 
 
2 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 For the Restriction of Typhoid Fever. 
 
 The Board directed the secretary to reprint 10,000 copies of the leaflet 
 relative to the prevention of typhoid fever, for distribution to school 
 teachers, and to the neighbors of premises placarded for that disease. 
 
 Scarlet fever has been greatly lessened by the people acting on the advice 
 of the State Board of Health. Should not that advice be more generally 
 accepted and acted upon? 
 
 Dr. Baker read a paper with the above title. The paper was illus- 
 trated by tables and a diagram exhibiting death-rates from scarlet fever 
 in Chicago, before and since the Illinois State Board of Health began to 
 labor for its restriction; also in Michigan before and since such efforts 
 have been in operation; also in one portion of the State compared with 
 other portions and with the State as a whole. 
 
 The paper was ordered to be published in t'he Annual Report of the 
 Board for 1897. 
 
 A Quarter Century of Public-health Work. 
 
 Dr. Baker made a brief preliminary report relative to utilizing the 
 coming occasion of the completion of a quarter century of public-health 
 work in Michigan for the especial advancement of the purposes which 
 the legislature had in view in establishing the State Board of Health, — 
 the lessening of sickness and the prevention of deaths. 
 
 A communication from Theodore R. MacClure, on an allied subject, 
 was presented and acted upon. 
 
 Formalin “ Formic Aldehyde” as a Disinfectant. 
 
 Dr. Baker asked the attention of the Board to the claims being made 
 for the efficiency, economy, and general usefulness of Formic Aldehyde 
 as a disinfectant. It is obtained by partially burning methyl alcohol, 
 commonly called wood alcohol, in s.uch manner as to remove from it two 
 atoms of its hydrogen. Formic Aldehyde is said to be a volatile, rapidly 
 diffusing gas, having nearly the same specific gravity as air; it is exceed- 
 ingly penetrating and, it is claimed, will destroy cultures of typhoid fever 
 and of diphtheria germs even when they are folded in mattresses and bed- 
 ding. It is claimed that it is as easily managed as the fumes of burning 
 sulphur, and that it has the very great merit of disinfecting without the 
 destruction, discoloration or decoloration of even the finest fabrics. Dr. 
 Baker thought it desirable that the State Board of Health -take measures 
 to ascertain whether or not Formic Aldehyde has advantages as a 
 disinfectant. 
 
 The subject was referred to Prof. Fall for investigation and report to 
 the Board at a future meeting. 
 
 Memorial to Michigan members of Congress , relative to Senate Bill 1552 u for 
 
 the further prevention of cruelty to animals in the District of Columbia.” 
 
 The following memorial was unanimously adopted by the Board: — 
 
 Whereas, Senate Bill 1552, “For the further prevention of cruelty to animals in 
 the District of Columbia” is now pending in the United States Senate, and it is 
 believed by this Board that such a law would cause great and lasting damage and 
 obstruction to further scientific work in this country; 
 
ABSTRACT OF PROCEEDINGS JANUARY 8, 1897. 
 
 3 
 
 
 
 
 4-h 
 T' o 
 
 
 <2*C\ n \ 
 O J ! 
 
 Resolved, That we, the members of the Michigan State Board of Health, make 
 urgent appeal to our Senators and Representatives in Congress, and respectfully 
 memorialize them to use vigorous effort to prevent the passage of Senate Bill 1552. 
 
 Resolved, That the Secretary of this Board is directed to transmit a copy of the 
 foregoing preamble and resolution to each Michigan Senator and Representative 
 in Congress. 
 
 Memorial to Michigan Members of Congress, Relative to a Permanent Census 
 Service of the United States. 
 
 The following memorial was unanimously adopted : — 
 
 Whereas, “The bill to provide for a permanent census service” reported to Con- 
 gress by Hon. Carroll D. Wright, will be of great usefulness to the sanitary service 
 of this State, as follows:— (1) By providing a more frequent statement of population, 
 thereby affording a basis for reliable vital rates and a more accurate calculation of 
 intercensal population, upon which such rates depend; (2) By providing means for 
 ascertaining, for the first time in the history of the census, a reliable representative 
 death-rate for the State which will be comparable with those of other States and 
 countries — Michigan being now a so-called non-registration State; (3) If Michigan 
 shall become a registration State by act of the present Legislature for the imme- 
 diate registration of deaths, by providing an annual comparative compilation of its 
 data in connection with those of other registration States, thereby greatly increas- 
 ing the usefulness of the Michigan statistics; therefore be it 
 
 Resolved, That the Michigan State Board of Health, at its quarterly meeting held 
 at Lansing, January 8, 1897, urgently recommends the passage of the bill for a per- 
 manent census service, on the ground of the improvement that will result therefrom 
 to the sanitary interests of the country; and therefore, 
 
 Resolved, That a copy of this resolution be sent to each Senator and Representa- 
 tive from Michigan in Congress, with the request that they labor for the passage of 
 the measure. 
 
 Memorial to the Michigan Legislature Asking for Improvement in Existing 
 Laws Relative to Registration of Vital Statistics. 
 
 The following memorial was unanimously adopted: — 
 
 Whereas, Under the present system of registration of vital statistics, which has 
 remained without alteration or improvement since 1869, there is failure to obtain a 
 large proportion of the births and deaths that actually occur in the State, and to 
 obtain such data as are collected in time to be of the greatest practical use to the 
 work of this Board; therefore be it 
 
 Resolved, That the Michigan State Board of Health respectfully petitions the 
 Michigan Legislature to pass a law that shall provide for the early registration of 
 all deaths that occur in the State, requiring certificates of deaths, and making pro- 
 vision for an early publication of results so that they shall be available for the use 
 of this Board and of local health officers in their every-day work of restricting dis- 
 eases in this State. 
 
 SPECIAL BIENNIAL REPORT OF THE STATE BOARD OF HEALTH. 
 
 Relative to Public-health Laws and Proposed Legislation in the Interests of 
 
 Public Health. 
 
 To the Present Governor and to the Incoming Governor of Michigan : — 
 
 Although not required by the letter of the law, public policy dictates 
 that the results of the observations and studies of the State Board of 
 Health, so far as they relate to imperfections in existing laws relating to 
 the public health, or to proposed amendments of those laws, be placed 
 before the retiring Grover nor and incoming Governor, to the end that 
 in case either of those officials deems it best, convenient opportunity may 
 
4 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 thus be afforded to bring to the notice of the legislature any such 
 propositions which seem to be for the public good. Accordingly, this 
 special report by the State Board of Health is respectfully submitted. 
 
 The State Quarantine Law , — Act 1893 . 
 
 At the present time, no unusual sickness or mortality is being experi- 
 enced in Michigan. None is seriously threatened. The State Quaran- 
 tine Law (Act 47, Laws of 1893), to enable the Governor and the State 
 Board of Health to do certain acts in an emergency, has been acted under 
 a few times during the past two years, with results which have been very 
 satisfactory to this Board and to the people of threatened localities. 
 
 Because of the lessened immigration, and because of other conditions, 
 no occasion has seemed to call for such action, under that law, as the 
 inspection of immigrants or travelers at the State line, to keep out dan- 
 gerous infection. If occasion had demanded such action, it is not prob- 
 able that it could properly have been taken successfully, for the reason 
 that the law is not so framed as to be useful for that purpose, the State 
 Supreme Court having decided (102 Mich., page 248) that such rules as, 
 in the opinion of the State Board of Health, are required to make the law 
 of use for the purpose of excluding infection from entry into the State, 
 cannot be made and enforced by the State Board of Health. If the people 
 of Michigan wish to provide for an emergency when they are to rely upon 
 the State quarantine law to protect from the danger of cholera, small-pox, 
 or any other dangerous disease being brought into the State by immi- 
 grants or travelers, further legislation is necessary. 
 
 As before suggested, that law is very useful, from time to time, for the 
 investigation of outbreaks within the State of dangerous diseases which 
 may threaten to spread. 
 
 Some of the reasons why the present law (Act 47 of 1893) is not useful, 
 for one of the main purposes for which it was enacted, are stated on 
 pages xcvii-xcviii of the Annual Report of the State Board of Health for 
 the year 1894, and on pages lxxxvi-lxxxvii of the Annual Report for the 
 year 1895. 
 
 Proposed Amendment of Law Relative to Vital Statistics. 
 
 The law establishing the State Board of Health says: “They shall 
 especially study the vital statistics of this State, and endeavor to make 
 intelligent and profitable use of the collected records of deaths.” This has 
 been done, and the statistics have been found valuable; but their value 
 and usefulness would be very much greater if the law were so amended 
 that the records were made immediately after the occurrence of the 
 deaths, instead of postponing the making of the first record, as is now 
 done, until a year or more has elapsed. In his Annual Report on this 
 subject, the Secretary of State, under whose direction the mortality 
 statistics are collected and published, has recommended the amendment 
 of the law; the chief of the division of vital statistics has drawn a bill 
 which has been considered by a committee of the State Medical Society, 
 by a committee of the State Conference of local health officers, and by 
 a committee of the State Board of Health, all of which organizations 
 have recommended the amendment of the law, and it is hoped that the law 
 may be amended at this coming session of the legislature. 
 
ABSTRACT OF PROCEEDINGS JANUARY 8, 1897. 
 
 5 
 
 State Hospital for Consumptives. 
 
 Although consumption is now well known to be a dangerous communi- 
 cable disease, and one which among intelligent and well-to-do people is 
 one of the easiest diseases to restrict — by the careful destruction of the 
 infectious sputa — yet that disease still continues to destroy more people 
 in Michigan than does any other disease. The State Board of Health has 
 long recognized the fact that it can never be avoided by the most intelli 
 gent and most conscientious classes of our people so long as the ignorant 
 and poor people afflicted with that disease are permitted and by circum 
 stances are forced to continue to infect crowded work shops, factories, 
 schools and public places. The law requires cases of dangerous com- 
 municable diseases to be reported to the local health officer. An impor- 
 tant question is what shall be done relative to those consumptives, of both 
 sexes, who, when reported, are found at that stage of most danger of 
 spreading the disease, whom circumstances require to continue to labor, 
 and who have not been taught and who cannot easily be taught how to 
 avoid spreading this most fatal disease to others? 
 
 Previous to the last session of the legislature, the State Board of Health 
 had given this subject much consideration. It was considered by the 
 State Conference of local and State health officials, at Ann Arbor in 
 181)1, and resolutions unanimously adopted as follows : — 
 
 “Resolved, That it is the judgment of this Conference of Health Officers and other 
 delegates of Michigan Boards of Health, that consumption (and other diseases due 
 to the Bacillus tuberculosis) should be included in the list of ‘Diseases dangerous to 
 the public health,’ referred to in Secs. 1675 and 1676 Howell's Statutes, requiring 
 notice by householders and physicians to the local health officer,. as soon as such a 
 disease is recognized. 
 
 “ Resolved , That we recognize the following facts: 
 
 “1. That tuberculosis is the most grave and fatal disease now affecting the health 
 and lives of the people of this State, destroying about three thousand lives per year; 
 
 “2. That this disease originates principally by transmission from man to man or 
 from man to animals and again to man; 
 
 “3. That the spread of this disease can be best arrested by the disinfection of the 
 sputa and other discharges, by special supervision of those infected, and by the care 
 of such persons under conditions which will prevent the transmission of the disease 
 to others; 
 
 “4. That such disinfection and supervision cannot be carried out in the crowded 
 houses of the poorer classes; and 
 
 “5. That, under conditions which will prevent reinfection, many consumptives 
 may be permanently cured, and return to their homes and work, educated in the 
 methods of restricting The disease. In view of these facts; 
 
 “ Resolved , That this Conference, by its officers, respectfully memorialize the next 
 Legislature for an appropriation sufficient for the purpose of building, equipping 
 and maintaining a State Hospital for Consumptives. 
 
 “Resolved, That the planning, construction and equipping of the State Hospital 
 for Consumptives may well be entrusted to the State Board of Health. 
 
 “ Resolved , That the location of the Hospital should be such that it may be accessi- 
 ble by railroad to the thickly-settled parts of the State, and such as to permit of out- 
 door exercise and light out-door labor whenever the weather will permit. 
 
 “Resolved, That although consumption is the most dangerous communicable dis- 
 ease, a hospital can be so planned, equipped and managed as that it shall not 
 seriously endanger the neighboring inhabitants; and as it is desirable that it shall 
 contribute the largest amount of sanitary education to the teachers and to the peo- 
 ple of the State, therefore, 
 
 “Resolved, That it is the judgment of this Conference that the proposed State Hos- 
 pital for Consumptives should be located at the seat of the State University at Ann 
 Arbor, in order that it may afford the best opportunities for the observation and 
 study of this most important disease, in conjunction with the investigations now 
 
6 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 being so satisfactorily pursued in bacteriology and other departments of sanitary 
 science, at the State Laboratory of Hygiene. 
 
 “ Resolved , That this Conference hereby respectfully memorializes the Legislature 
 of Michigan at its next session to take such action as will result in a knowledge of 
 the extent to which the dairy cattle and other animals supplying milk, meat or other 
 food products to the people of Michigan are infected with tuberculosis. Also that it 
 take such action as will tend to stop the spreading of tuberculosis among animals, 
 and from animals to man.” 
 
 Pursuant to this action, the State Board of Health carefully prepared 
 a bill to establish a State Hospital for Consumptives, and the bill was 
 introduced into both houses of the legislature, it being “Senate bill 433” 
 and “House bill 828.” Neither of these bills was given any consideration 
 whatever by the legislature. A copy of the bill is printed on pages 
 xxviii-xxx of the Annual Report of the State Board of Health for 1895. 
 
 The question which the State Board of Health wishes to have placed 
 before the present legislature is: Is general poverty and “hard times” 
 a valid reason for not considering a plan designed to lessen, among the 
 people generally, one of the most common causes of poverty and “hard 
 times,” namely that most general disease which causes most deaths and 
 most prolonged and expensive sickness and disability for productive 
 labor? 
 
 The Regulation of the Practice of Medicine. 
 
 At the present time, any person taken suddenly too ill to dictate what 
 physic ian shall be employed, is liable to be placed in the care of some pre- 
 tender who holds himself out as a physician. When able to select a 
 physician, people generally have no way whereby they can well judge 
 of the extent of the education and skill of those who appear to be 
 physicians. Lawyers are not permitted to take charge of the legal inter- 
 ests of the people, which, usually, relate only to pecuniary affairs, 
 except that they shall first pass an examination tending to show them to 
 be qualified for such duties. Physicians deal always with the interests of 
 life and health; yet in Michigan the legislature has mot provided for 
 guarding those great interests as well as it has those interests connected 
 with legal controversies. 
 
 Recently systematic effort has been made by so-called medical colleges 
 in adjoining States to induce persons in Michigan to purchase diplomas, 
 so that they may register as physicians under the present very imperfect 
 law. Numbers of persons who were not qualified to practice medicine 
 have applied to the county clerks, and in some instances have been per- 
 mitted to register and enter upon practice as physicians, upon the claim 
 that they were entitled to do so because of such diplomas purchased 
 without their having attended any medical college. 
 
 The public health suffers, in many ways, through the ignorance of those 
 who assume to. practice medicine: (1) The health and life of persons who 
 come under the care of unqualified physicians are endangered by their 
 ignorance. (2) Dangerous communicable diseases occur in their practice, 
 and such doctors fail to recognize and report them to the local health 
 officer, the disease is not restricted, and unnecessary sickness and loss of 
 life results. (3) Such medical practitioners do not realize the impor- 
 tance of many of the subjects on which the State Board of Health advises 
 the people, consequently they fail to cooperate for the restriction and 
 
ABSTRACT OF PROCEEDINGS JANUARY 8, 1897. 
 
 7 
 
 prevention of diseases. (4) Some of these unqualified persons are chosen 
 as health officers, and thus the health interests of whole communities 
 are jeopardized. 
 
 The present law — Act 167 of 1883, as amended by Act 268 of 1887 — 
 permits any person to practice medicine in Michigan who is a “graduate 
 of any legally authorized medical college in this State or any (one) of 
 the United States, or in any other country.” As medical colleges located 
 in adjoining States and claiming to be “legally authorized” advertise 
 extensively in Michigan, and thus induce many unqualified persons to 
 purchase diplomas without attendance at such “colleges,” the law is not 
 a sufficient protection. Another serious defect in the law is that it leaves 
 with the several county clerks the decision of who are graduates of 
 legally-authorized medical colleges, and these officers are unable to obtain 
 the necessary information. 
 
 The law should be amended so as to require one State commission or 
 . board with a central office at the State Capitol to collect the facts which 
 will make it possible to decide not only who are graduates of legally 
 authorized medical colleges, but also who are properly qualified to be 
 entrusted with the health and lives of citizens of Michigan. The law 
 should not permit the registration of any physician except after examina- 
 tion of the physician, or of his diploma and positive knowledge of the 
 standing of the medical college which granted his diploma. 
 
 It is probable that the philanthropic medical profession of the State 
 would willingly contribute, as re-registration fees, sufficient money to 
 carry out the provisions of a good law on this subject. Or those hereafter 
 admitted to practice may be made to meet the expenses. But in the 
 opinion of this Board this subject is of sufficient importance to the people 
 of the State to warrant the expenditure of the public money necessary to 
 secure protection from the present evils. 
 
 It is the belief of the State Board of Health that the supervision of the 
 registration of physicians should not be required of the State Board of 
 Health, whose members are and should be selected for important duties 
 requiring knowledge, experience and studies in sanitary science, public- 
 health administration, and the prevention of sickness and deaths, quali- 
 fications very different from those required in judging of the qualifications 
 of physicians for the cure of disease, or for the surgical treatment of 
 maladies and injuries. 
 
 There should be a State Medical and Surgical Board, appointed by the 
 Oovemor and Senate, having its office at the Capitol, and having at least 
 one paid official constantly on duty. Money losses will thus be prevented 
 more than sufficient to meet the expense; and life and health in Michigan 
 will be more secure. 
 
 For the Restriction and Prevention of Disease , Educational Work , to Secure 
 the Co-operation of the People , is Necessary. 
 
 Experience has proved that for the successful restriction or prevention 
 of the dangerous diseases, the cooperation of the people themselves is 
 requisite, and the people themselves must know what diseases are com- 
 municable, how they are spread, and the best measures for their restric- 
 tion. For many years, the State Board of Health has systematically aided 
 
8 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 local health officials to restrict dangerous diseases, by supplying to the 
 neighbors of the infected premises information necessary to enable them 
 to cooperate with the local health officers. The official reports to the State 
 Board of Health, and the mortality statistics collected and published by 
 the Secretary of State agree in proving that there has been a very great 
 saving of human life in Michigan while this work has been done, compared 
 with the death-rates when it was not being done. The evidence is that 
 more than a thousand lives per year have been saved, and thousands of 
 cases of sickness avoided, involving a saving to the people of this State of 
 money values exceeding a million dollars per year. This work by the 
 State Board of Health has grown, more diseases are dealt with than, 
 formerly, and the appropriations for the use of the Board are now inade- 
 quate to do the work. 
 
 Another method of education of the people for their cooperation in 
 public-health work has been by means of the Sanitary Conventions for 
 which, together with several other purposes, a small annual appropriation 
 ($2,000 per year) has been made. The other purposes specified in the law 
 have so encroached on the fund as to leave very little for the Sanitary 
 Conventions, and this Board deems it for the public good that more such 
 conventions be held than it has been found possible to hold heretofore. 
 
 The legislature in 1895, by Act 146, required the State Board of Health 
 to send to all school teachers in the State data and statements to enable 
 them to teach the modes of spreading and the best means of restricting 
 the dangerous communicable diseases. No appropriation has been made 
 for this additional work. This Board considers this law to be of the 
 utmost importance, and for the first year complied with it as fully as pos- 
 sible, In doing so, however, no money was left with which to meet the 
 expenses oif the Sanitary Conventions, and of other lines of work required 
 of the Board. 
 
 The State Board of Health believes that the best interests of the people 
 will be subserved by the making of a small appropriation, not exceeding 
 ten thousand dollars per annum, for the general purposes for which the 
 board exists, including the fulfillment of Act 146 of 1895, and other laws. 
 
 It seems certain that the appropriations already made for and used by 
 the Board have been returned to the people many fold, in money values 
 saved. It is believed that the additional appropriation here asked for will* 
 yield equally valuable returns. 
 
ABSTRACT 0F‘ PROCEEDINGS JANUARY 8, 1897. 
 
 9 
 
 SECRETARY’S REPORT OF DANGEROUS COMMUNICABLE DISEASES, OF WORK 
 DONE IN THE OFFICE OF THE STATE BOARD OF HEALTH, AND OF 
 THE CONDITION OF HEALTH GENERALLY IN MICHIGAN 
 DURING THE QUARTER ENDING 
 DECEMBER 81, 1898. 
 
 Dangerous Communicable Diseases. 
 
 The number of reports of outbreaks of dangerous communicable diseases in Michi 
 gan, received from all sources and filed, and the corresponding number concerning 
 which action was taken by this office, during the quarter, are as follows: For diph- 
 theria, 144; for scarlet fever, 102; for typhoid and typho-malarial fever, 156; for 
 measles, 62; for whooping-cough, 45; and for consumption, 41. Total for the six 
 diseases, 550. 
 
 The number of communications relative to dangerous communicable diseases, 
 received and placed on file during the quarter, was 2,966. 
 
 Relative to dangerous communicable diseases, letters, written cards, and demands 
 for weekly and final reports on cards, or in the form of the circular letter, were 
 sent out during the quarter to the number of 2,188. 
 
 The “final” reports of outbreaks received and filed during the quarter were: For 
 diphtheria, 91; scarlet fever, 73; typhoid and typho-malarial fever, 188; measles, 41; 
 whooping-cough, 39; consumption, 35. Total for the six diseases, 467. 
 
 During the quarter, the local columns of 1,929 newspapers, have been looked over 
 for reports of occurrence of communicable diseases. (This work is done by the 
 clerk who acts as messenger and janitor, in the intervals of his performance of 
 other duties.) This has resulted in giving this office first information of the alleged 
 occurrence of 5 outbreaks of diphtheria, 4 outbreaks of scarlet fever, 26 outbreaks 
 of typhoid and typho-malarial fever, 7 outbreaks of measles, 5 outbreaks of whoop- 
 ing-cough, and 7 cases of consumption. To what extent the reports of these alleged 
 outbreaks were verified, is shown in the accompanying table: 
 
 TABLE I. — Fourth Quarter of 1896 . — Exhibiting the number of outbreaks of Diph 
 theria , Scarlet Fever , Typhoid Fever , Measles, Whooping-cough, and Consumption 
 from October 1 , to December 31, 1896, of which notice was received at the office of 
 the Michigan State Board of Health ; the per cent of reports, first information con- 
 cerning which was received through the newspapers ; the per cent of newspaper 
 reports which were confirmed by the health officer; the per cent of reports which 
 were denied by the health officer; and the per cent relative to which no reply was 
 received from the health officer. 
 
 Diseases. 
 
 Reports from 
 all sources, 
 Oct. 1, to Dec. 
 31, 1896. 
 
 Per cent of 
 all reports which 
 were obtained 
 from the news- 
 papers. 
 
 Per cent 
 of newspaper 
 report^ which 
 were confirmed 
 by the health 
 officer. 
 
 Per cent 
 of newspaper 
 reports which 
 were denied by 
 the health 
 officer. 
 
 Per cent 
 of newspaper 
 reports to which 
 the health offi- 
 cer made no 
 reply to no- 
 tice sent 
 from this 
 office. 
 
 Diphtheria 
 
 144 
 
 3 
 
 40 
 
 40 
 
 20 
 
 Scarlet fever 
 
 102 
 
 4 
 
 75 
 
 0 
 
 25 
 
 Typhoid fever . . . 
 
 156 
 
 17 
 
 58 
 
 42 
 
 0 
 
 Measles 
 
 62 
 
 11 
 
 43 
 
 29 
 
 28 
 
 Whooping-cough 
 
 45 
 
 11 
 
 40 
 
 40 
 
 20 
 
 Consumption 
 
 41 
 
 17 
 
 43 
 
 14 
 
 43 
 
 Average for the 
 six diseases ... 
 
 
 10 
 
 52 
 
 33 
 
 15 
 
 i 
 
 2 
 
10 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Summary Relative to the Year , 1896. 
 
 The number of reports of outbreaks of dangerous communicable diseases in 
 Michigan, received from all sources and filed, and the corresponding number con- 
 cerning which action was taken by this office, during the year 1896, are as follows: 
 For diphtheria, 419; for scarlet fever, 385; for typhoid and typho-malarial fever, 563; 
 for measles, 310; for whooping-cough, 218; for consumption, 316; and for small-pox, 
 8. Total for the seven diseases, 2,219. 
 
 Not including telephone and verbal messages, the number of communications rela- 
 tive to dangerous communicable diseases, received and placed on file during the 
 year, was 10,012. 
 
 Relative to dangerous communicable diseases, letters, written cards, and demands 
 for weekly and final reports on cards, or in the form of the circular letter, were 
 sent out during the year to the number of 7,619. 
 
 The “final” reports of outbreaks received and filed during the year 1896, were: 
 For diphtheria, 328; scarlet fever, 321; typhoid and typho-malarial fever, 491; 
 measles, 224; whooping-cough, 119; consumption, 128; small-pox, 8. Total for fee 
 seven diseases, 1,619. 
 
 During the year 1896, the local columns of 6,571 newspapers have been looked 
 over for reports of occurrences of communicable diseases. (This work is done by 
 the clerk who acts as messenger and janitor, in the intervals of his performance of 
 other duties.) This has resulted in giving this office first information of the alleged 
 occurrence of 27 outbreaks of diphtheria, 14 outbreaks of scarlet fever, 86 outbreaks 
 of typhoid and typho-malarial fever, 32 outbreaks of measles, 36 outbreaks of 
 whooping-cough, 1 outbreak of small-pox, and 70 cases of consumption. To what 
 extent the reports of these alleged outbreaks were verified, is shown in the accom- 
 panying table: 
 
 Table II. — Year 1896. — Exhibiting the number of outbreaks of Diphtheria , Scarlet 
 F ver, Typhoid Fever, Measles, Whooping-cough, Small-pox and Consumption , from 
 January 1 to December 31, 1896, of which notice was received at the office of the 
 Michigan State Board of Health ; the per cent of reports, first information concern- 
 ing which was received through the newspapers ; the per cent of newspaper reports 
 which were confirmed by the health officer; the per cent of reports which were 
 denied by the health officer; and the percent relative to which no reply was received 
 from the health officer. 
 
 Diseases 
 
 Reports from 
 all sources, 
 Jan. 1 t Dec. 
 31, 1896. 
 
 Per cent of 
 all reports which 
 were obtained 
 from the news- 
 papers. 
 
 Per cent 
 of newspaper 
 reports which 
 were confirmed 
 by the health 
 officer. 
 
 Per cent 
 of newspaper 
 reports which 
 were denied by 
 the health 
 officer. 
 
 Per cent of 
 newspaper re- 
 ports to which 
 the hea th 
 officer made 
 no reply 
 to notice sent 
 from this 
 office. 
 
 Diphtheria 
 
 *419 
 
 6 
 
 48 
 
 37 
 
 15 
 
 Scarlet fever 
 
 *385 
 
 4 
 
 50 
 
 29 
 
 21 
 
 Typhoid fever... 
 
 *563 
 
 15 
 
 48 
 
 47 
 
 5 
 
 Measles 
 
 *310 
 
 10 
 
 53 
 
 38 
 
 9 
 
 W hooping-cough 
 
 *218 
 
 17 
 
 50 
 
 42 
 
 8 
 
 Consumption 
 
 *316 
 
 22 
 
 56 
 
 23 
 
 21 
 
 Small-pox 
 
 *8 
 
 13 
 
 100 
 
 0 
 
 0 
 
 Average for the 
 seven diseases 
 
 
 12 
 
 51 
 
 37 
 
 12 
 
 * The numbers of outbreaks given in this table do not necessarily agree with the numbers given in 
 tables in another part of the Annual Report, for the reason that all alleged outbreaks, of which infor- 
 mation was obtained from the newspapers and other sources are included in this table. If the health 
 officers denied that such outbreaks occurred, or if they make no response to the letters sent from this 
 office, relative to newspaper reports, such alleged outbreaks are not included in the compilation of that 
 disease. 
 
ABSTRACT OF PROCEEDINGS JANUARY 8, 1897. 
 
 II 
 
 For the purpose of facilitating the proper action for the restriction of every “dis- 
 ease dangerous to the public health,” and to make it possible to compile the impor- 
 tant “contagious-disease statistics,” a record is kept of facts concerning every out- 
 break of a “disease dangerous to tile public health” upon which action is taken by 
 this office, and also of every important communication relating thereto received or 
 sent out. This required over 17,631 entries to be made in the “Record Books,” one 
 of which books is kept for each dangerous communicable disease. 
 
 During the year 1896, compared with the year 1895, action was taken on out- 
 breaks of dangerous communicable diseases as follows: On diphtheria, 8 outbreaks 
 more; scarlet fever, 144 outbreaks less; typhoid and typho-malarial fever, 70 out- 
 breaks less; measles, 134 outbreaks more; whooping-cough, 141 outbreaks more; 
 small-pox, 17 outbreaks less; and consumption, 7 outbreaks more than in 1895. In 
 all, 56 outbreaks more were acted upon in 1896 than in 1895, and 124 outbreaks more 
 in 1895 than in 1894; but an accurate comparison cannot easily be made, for the 
 reason that no action was taken relative to whooping-cough, until July 1, 1895. 
 
 Small pox in Michigan During the Year 1896. 
 
 At the beginning of the year small-pox was still present in Detroit. Eight new 
 outbreaks of small-pox were reported during the year. These were in Riga town- 
 ship, Lenawee Co.; Imlay township, Lapeer Co.; Saginaw city; Ionia city; Green- 
 bush township, Clinton Co.; Burlington township, Lapeer Co.; Marine City and 
 Bay City. The outbreak reported at Greenbush township was afterwards reported 
 as measles. Final reports have been received from each of the remaining seven 
 outbreaks. These final reports show that outside of Detroit, there have occurred in 
 the State, during the year 1896, 16 cases and 2 deaths, and that in every one of the 
 seven outbreaks the infection was restricted to the one house in which it first 
 occurred. 
 
 Every one of those outbreaks was due directly or indirectly to infection spread 
 from Detroit. The outbreak which began in Detroit in May, 1894, was reported 
 closed during the week ending March 28, 1896, but for the week ending April 18, 
 1 new case was reported which died. During the year 1896 there have occurred in 
 the city of Detroit 21 new cases and 14 deaths; this, with the 2 cases which were 
 still sick at the close of the year 1895, make a total of 23 cases and 14 deaths in the 
 city of Detroit during the year 1896. (From the beginning of the outbreak in May, 
 1894, until its ending in April, 1896, there occurred in the city of Detroit 298 cases 
 and 85 deaths.] 
 
 Since April 18, 1896, up to the close of the year 1896, the State is believed to have 
 been entirely free from small-pox. 
 
 Compiling, Editing, Proof-reading , Printing, Etc., Fourth Quarter of 1896. 
 
 The compilation of “Diphtheria in Michigan in 1895” has been finished and proved. 
 The compilation of reports, letters, etc., from all sources relative to “Scarlet Fever 
 in Michigan in 1895” has been made and proved. The compilation relative to 
 “Typhoid Fever in Michigan in 1895” is nearly finished and proved as far as 
 completed. Compilations of material relative to “Nuisances in Michigan in 1895” 
 and relative to “Injuries and Loss of Life and Property from Kerosene and 
 Gasoline in Michigan in 1895” have been made. 
 
 The article on “Typhoid Fever in Michigan in 1894” has been completed. Short 
 articles relative to Measles, Consumption, and Small-pox in Michigan in 1894 have 
 been made ready for the printer. 
 
 Considerable work lias been done in connection with the introduction or sum- 
 mary of the Communicable-Diseases articles for the Annual Report for 1895. The 
 statement is a summary relative to some of the pecuniary results of the Board’s 
 efforts in the saving of life and the prevention of sickness. This summary has been 
 reprinted in pamphlet form for distribution. It is reprint No. 472. It was sent to 
 members of the Legislature and to editors of newspapers; many newspapers pub- 
 lished a notice of it; one such notice, in the State Republican, November 25, 1896, 
 is reproduced further on in this report. 
 
 The index for the Report for 1895 has been completed, and the printing of it will 
 immediately commence. 
 
12 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 For the Report for 1896, but relating to the year 1895, articles have been prepared 
 on subjects as follows: Rabies, chicken-pox, puerperal fever, lump-jaw, tetanus, 
 cholera infantum, danger from careless dog poisoning, diseased meat and milk, 
 tuberculosis in cattle, glanders, disease in hogs, syphilitic ozena. 
 
 The preparation of copy for the Annual Report for 1896 is well under way to 
 completion. It is hoped that during the next quarter the Report will be printed. 
 More than half of the copy is now practically ready for the printer. 
 
 The article “Time of Greatest Prevalence of Each Disease in Michigan in 1895“ 
 has been well commenced. 
 
 The article relative to “Meteorology in Michigan in 1895“ is nearly completed and 
 ready for the printer. 
 
 The copy for the “First Part” of the annual report of the Secretary for the fiscal 
 year ending June 30, 1S96, has been completed and a portion of it has been sent to 
 the printer. 
 
 Proof has been read and an immense amount of printing has been done during 
 this quarter. Over 450 pages of the Annual Report for 1895 have been printed. The 
 Report is all completed with the exception of printing the index and binding the 
 volume. 
 
 Work on Meteorology. 
 
 The regular tri-daily meteorological observations have been continued at this 
 station, and a summary for each week and month during the quarter has been 
 made for use in this office in connection with sickness statistics. The monthly sum- 
 mary has been sent, at the end of each month, to the director of the Michigan State 
 Weather Service, at Lansing, for his use; it is then sent by him to the chief of the 
 U. S. Weather Bureau, at Washington, D. C. 
 
 The regular yearly supply of meteorological material, consisting of blank regis- 
 ters, blanks for measurements of ground-water, stamped envelopes, blank postal 
 cards, was sent to each of 18 meteorological observers; there was also sent to 13 
 observers a supply of ozone test-paper sufficient to last three months. 
 
 The following maps and diagrams have been made to illustrate the Annual Report 
 of this Board: 
 
 Map — Movements of Contagion of Typhoid Fever in Michigan in 1894. 
 
 Map — Distribution of Typhoid Fever in Michigan in 1894. 
 
 Map— Movements of Contagium of Small-pox in Michigan in 1894. 
 
 Map — Movements of Contagium of Measles in Michigan in 1894. 
 
 Map — Distribution of Measles in Michigan in 1894. 
 
 Diagram — Decreasing Death-rate in Michigan from Scarlet Fever per 10,000 inhab- 
 itants. 
 
 Diagram — Increasing Life Saving in Michigan, from Scarlet Fever, per 10,000 
 inhabitants. 
 
 Diagram— Reported Deaths from Small-pox in Michigan, during eacb of the 26 
 years, 1869-94. 
 
 Diagram — Decreasing Death-rate in Michigan, from Small-pox, per 10,000 inhab- 
 itants. 
 
 Diagram — Increasing Life Saving in Michigan, from Small-pox, per 10,000 inhab- 
 itants. 
 
 Diagram — Typhoid Fever in Duncan Township, Michigan. 
 
 Diagram — Isolation and Disinfection Restricted Typhoid Fever in Michigan in 
 1894. 
 
 Diagram — Decreasing Death-rate in Michigan, from Typhoid Fever, per 10,000 
 inhabitants. 
 
 Diagram— Reported Deaths in Michigan from Typhoid Fever for each of the 27 
 years, 1868-94. 
 
 Diagram— Isolation and Disinfection Restricted Measles in 1894. 
 
 Diagram — Alleged Nuisance in Colon Township, St. Joseph Co., Michigan. 
 
 Diagrams 1, 2, 3, 4, 5, 6— Average Temperature, Average Daily Range of Tempera- 
 ture, Absolute and Relative Humidity, Fogs and Rainfall, relating to conditions in 
 Michigan during the year 1895. 
 
 Meteorological registers from 11 stations have been received and examined for 
 errors, and computations of the registers from these stations for the months of 
 September, October, and November, 1896, have been made. 
 
ABSTRACT OF PROCEEDINGS JANUARY 8, 1897. 
 
 13 
 
 Accessions to the Library , Card-Cataloguing, Etc. 
 
 About 75 books and pamphlets, and some 300 numbers of journals (weeklies, 
 monthlies and quarterlies) have been received, mostly in exchange for our publica- 
 tions, and entered in the library accession book. 
 
 Considerable work has been done in card-cataloguing the library: 
 
 Work in keeping the financial accounts of the office has been continued. 
 
 Hektograph Work. 
 
 Hektograph work to the amount of about 2,930 pages has been prepared, includ- 
 ing 1,140 pages of weekly and monthly bulletin “Health in Michigan;” 408 pages of 
 proceedings of regular and special meetings; pages of a “Special Biennial Report 
 of the State Board of Health to the present and incoming Governors;” 100 pages 
 relative to examination of plans and specifications for proposed public buildings; 
 277 pages relative to delinquent card reports, etc. 
 
 Educational Leaflets to School Teachers, etc. 
 
 To teachers and others, there have been sent some 2,166 copies of the four-page 
 leaflet No. 226; 900 copies of the leaflet No. 227; and about 742 sets of the several 
 different leaflet publications of this office bearing upon the subject of teaching in 
 the schools the modes of spreading and the best methods for the restriction and 
 prevention of the dangerous communicable diseases. 
 
 Of the above-mentioned 2,166 copies of the leaflet No. 226, about 900 copies were 
 distributed to teachers and others during the meeting of the State Teacher’s Asso- 
 ciation, at Lansing, December 28-30, 1896. 
 
 For the lack of available appropriation, the distribution of the Board’s publica- 
 tions to this class of public-health workers has been necessarily small; mainly to 
 teachers and others who applied for them. 
 
 State Teachers’ Association, Lansing, Dec. 28-30, 1896. 
 
 At the meeting of this association a paper on “School Hygiene” was read by Prof. 
 W. E. Conkling, of Dowagiac, and discussed by Prof. J. L. Wagner, of Charlotte. 
 Before the College section of the association, a paper was read by Prof. Delos Fall, 
 Albion College, member of the State Board of Health, on “A College Course in Sani- 
 tary Science.” This paper was followed by an address by Prof. Victor C. Vaughan. 
 M. D., of the University of Michigan, and the subject was discussed by others. 
 
 To facilitate the teaching of sanitary science in colleges and high schools, Prof. 
 Fail has made a list of publications of the Michigan State Board of Health, arranged 
 in order to serve as data for a college or high-school course in sanitary science. This 
 list and the publications mentioned therein have been sent to Prof. Montgomery, at 
 Olivet College, and Prof. Sloan, at Hillsdale College, since the meeting of the State 
 Teachers’ Association. It is understood that the subject will be taught at both of 
 these colleges. Other colleges and high schools might receive the publications, but 
 probably not all such schools could be supplied with all of the publications. 
 
 Annual Reports from Health Officers for the Year 1896. 
 
 Work has been done to prepare for securing the annual reports from health offi- 
 cers. Two blanks and a circular letter have been made ready, and envelopes to the 
 number of 1,584 have been addressed to health officers of townships, cities and vil- 
 lages. Each envelope contains one circular letter No. 218, one copy of blank “I,” 
 and one blank form “Copy of Record” of diseases dangerous to the public health in 
 1896. These supplies will be sent out during the first week in January, 1897. 
 
 General Distribution of Leaflets, Diagrams, Etc. 
 
 About the usual numbers of pamphlets on the restriction and prevention of the 
 dangerous communicable diseases were sent to health officers of localities in which 
 dangerous diseases have been reported. It was at the same time requested of those 
 
14 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 health officers that the pamphlets be distributed to the neighbors of the persons sick 
 with such diseases and to other persons likely to be benefited by the information 
 therein contained. 
 
 In response to special requests of sanitarians in this and other States and coun- 
 tries, copies of the Annual Report, proceedings of sanitary conventions held in 
 Michigan under the auspices of the State Board of Health, and pamphlets on the 
 restriction and prevention of the dangerous diseases, have been sent where it was 
 thought likely to benefit public-health interests. However, the distribution of the 
 Board’s publications has been much less than usual, because of the lack of suffi- 
 cient appropriation. The Annual Report for 1894 has for many months been ready 
 for distribution, but no funds have been available for this purpose. The appropria- 
 tion for 1897 will become available January 1, 1897, and it is hoped that the 1894 
 Report can then be distributed. The Report for 1895 is nearly ready for distribution. 
 About 1,390 wrappers have been addressed for use in sending out the Report of this 
 Board for 1894. 
 
 The usual record of the distribution of publications has been kept. 
 
 Printing and Reprinting Pamphlets, Circulars, Etc. 
 
 During this quarter no pamphlet, leaflet, circular, etc., has been reprinted which 
 would necessitate mention here. 
 
 In December the new slip [234] relative to life saving has been printed to the 
 number of 10,000 copies and already widely distributed, in letters and other com- 
 munications being sent out. 
 
 This new slip is here reproduced as follows: 
 
 [234.] 
 
 RECENT SAVING OF SICKNESS AND LIFE IN MICHIGAN. 
 
 EQUAL TO OVER FIVE MILLION DOLLARS SAVED TO THE TAX PAYERS. 
 
 “The Secretary of the State Board of Health has just published (in Reprint No. 
 472) official statistics on the results of the life-saving work of that Board, which 
 show that through compliance with the recommendations of that Board during the 
 five years, 1890-94, there were probably saved to the people of Michigan 112,843 
 cases of sickness and about 5,261 deaths, from the four diseases— diphtheria, scarlet 
 fever, typhoid fever and measles. At a very low estimate* the money value 
 thereby saved the State during these five years is $5,097,800, or over one million dol- 
 lars per year, from these four diseases. If all the dangerous diseases were consid- 
 ered, the saving would undoubtedly be much more. 
 
 “The State Board of Health exists for the purpose of guarding the highest inter- 
 ests of every man, woman and child in Michigan; and, if it had the cooperation of 
 all, and its advice was fully complied with, the results of the work would be still 
 more effective. As it is, the money values saved to the people of the State greatly 
 exceed the cost of the public-health work, being, in fact, nearly half as much as the 
 entire amounts required to sustain the State government and all the State institu- 
 tions. From an unhealthful State, Michigan is fast becoming one of the most health- 
 ful.”— State Republican, November 25, 1896. 
 
 Special Investigation of Sanitary Conditions at Delray, Mich. 
 
 During this quarter the Secretary had received letters, petition, etc., fom Delay, 
 Michigan, relative to the alleged unsanitary conditions and the prevalence of dis- 
 ease. After conference with the President of this Board, and after correspondence 
 with the Health Officer and others at Delray, the Secretary investigated the com- 
 plaints. The Secretary’s report (hektograph 1741) will be found herewith. [Not 
 printed.] 
 
 * “ The basis on which this estimate is made is as follows For medical attendance and other neces- 
 sary expenses in each case of sickness, $20 ; for each Mineral preven’ed, $40; value of each life saved, 
 $500. (B fore the late war a slave was worth about *800, for what it would earn over and above its cost 
 of main’ enance, and now the courts count an average person’s life worth about $5,000— ten times the 
 amount used in this e timate.)” 
 
ABSTRACT OF PROCEEDINGS JANUARY 8, 1897. 
 
 15 
 
 Special Biennial Report to the Present and to the Incoming Governor of 
 
 Michigan. 
 
 Since the last meeting, the Secretary has transmitted to the Hon. John T. Rich, 
 the present Governor, and lion. Hazen S. Pingree, the incoming Governor of Michi- 
 gan, the “Special Biennial Report of the State Board of Health, relative to public- 
 health laws, and proposed legislation in the interests of public health.” The report 
 is submitted herewith. (Hektograph No. 1728.) [Printed on preceding pages.] 
 
 Immigrants Exposed to Contagious Diseases and Destined to Settle in 
 
 Michigan. 
 
 During the fourth quarter of 189(5, notices were received at this office from Dr. J. 
 H. Senner, U. S. Commissioner of Immigrants at New York City, that measles had 
 occurred on board five steamships, and scarlet fever on board one steamship, arriv- 
 ing at that port, and having on board passengers destined for points in Michigan. 
 Copies of these notices wore mailed to the health officers of the several places of 
 destination, as under: — 
 
 Steamship. 
 
 Date of 
 arrival. 
 
 Disease on board. 
 
 Notices sent to the health 
 officers of : 
 
 Friesland __ 
 
 Oct. 
 
 6 
 
 Measles 
 
 Detroit, Kalamazoo. 
 
 Phdnicia 
 
 Nov. 
 
 8 
 
 
 Greenville. 
 
 Lucania 
 
 14 
 
 U 
 
 Iron Mountan, Lansing. 
 
 Lake Linden, Ishpeming. 
 
 Iron Mountain. 
 
 St. Louis 
 
 
 22 
 
 Scarlet fever 
 
 Campania 
 
 u 
 
 28 
 
 Measles 
 
 Karle ruhe 
 
 Dec. 
 
 13 
 
 (( 
 
 Detroit. 
 
 
 
 A notice was also received November 10, from the Surgeon of the SS. Canada, 
 which arrived at Quebec, November 5, stating that measles had occurred on board. 
 A copy of this notice was sent to the Health Officer at Sault Ste. Marie, one of the 
 passengers being destined for that city. 
 
 Work in Connection With Sickness Statistics. 
 
 During the fourth quarter of 1896, 1,869 blank report, receipt and return postal 
 cards, 130 record books, 64 printed and 261 hektographed circular letters regarding 
 weekly card-reports, have been mailed to 318 health officers and regular corres- 
 pondents; 1,156 weekly card-reports have been received and entered on the register; 
 49 copies of the hektographed weekly bulletin, “Health in Michigan,” were mailed 
 each week, and 110 copies of the hektographed monthly bulletin, “Health in Michi- 
 gan” were mailed each month. These bulletins have been consolidated for this 
 quarterly report. Considerable work has been done on the compilation of the 
 weekly card-reports of sickness during the year 1895, for the Annual Report for 
 1896. 
 
 Health in Michigan in the Fourth Quarter of 1896. Communicable Diseases. 
 
 Compared with the preceding quarter, (July, August and September), reports 
 from all sources show typhoid fever to have decreased by an average of twenty-seven 
 places per month, measles to have decreased by an average of three places per 
 month, scarlet fever to have increased by an average of sixteen places per month, 
 whooping-cough to have decreased by an average of seven places per month, diphtheria 
 to have increased by an average of forty-three places per month, and consumption 
 to have increased by an average of two places per month, in the fourth quarter of 
 1806. 
 
16 
 
 MICHIGAN STATE BOARD OF HEALTH. 
 
 Meteorology at one Central Station , and Sickness Throughout Michigan 
 from all Causes , Fourth Quarter of 1896 , Compared with 
 the Preceding Quarter. 
 
 A comparison of meteorological conditions of the fourth quarter of 1896, with 
 the meteorological conditions of the preceding quarter, shows the prevailing dir- 
 ection of the wind to have been southwest, (instead of south-southwest), the velocity 
 2.8 miles per hour greater, the temperature 28.24 degrees lower, the absolute humid- 
 ity much less, the relative humidity more, the day and night ozone less, the rainfall 
 4.07 inches less and the depth of water in the observation well at Lansing 5 inches 
 more in the fourth quarter of 1896. 
 
 Compared with the preceding quarter (July, August and September), the reports 
 from regular observers show a marked increase of diphtheria, pneumonia, influenza, 
 tonsilitis, bronchitis and pleuritis and a marked decrease of diarrhea, typhoid fever, 
 intermittent fever, and remittent fever in the fourth quarter of 1896. 
 
 The Weather and the Health in Michigan in the Fourth Quarter of 1896, 
 Compared with the Average for the Corresponding Quarters 
 in the Ten Years, 1886-1895. 
 
 A comparison of the meteorological conditions of the fourth quarter of 1896, with 
 the average for the fourth quarters in ten years, 1886-1895, shows that in 1896 the 
 prevailing direction of the wind was the same (southwest), the velocity was .1 
 of a mile per hour greater, the temperature was .44 of a degree higher, the rain- 
 fall was .86 of an inch less, the absolute humidity was less, the relative humidity 
 was the same, the day and night ozone were less and the depth of water in the 
 observation well at Lansing was 11 inches less. 
 
 Compared with the average in the corresponding quarters in the ten years, 1886- 
 
 1895, the reports from regular observers indicate that intermittent fever, remittent 
 fever, consumption, inflammation of bowels, scarlet fever, erysipelas, diarrhea and 
 inflammation of kidney were less than usuallv prevalent in the fourth quarter of 
 
 1896. 
 
UNIVERSITY OF ILLINOIS-URBAN A 
 614.09 M58A C001 1887-97 
 Abstract of proceedings. 1886-1897. 
 
 3 0112 088526360