E. T. NELSON, M. A., Ph. D., M. D., Delaware.....................

C. O. PROBST, M. D., Secretary, Columbus.

*Reappointed, term expires December, 1902.

General Report.

This is the tenth annual report of the State Board of Health, and is for the year ended October 31, 1895.

PERSONNEL OF THE BOARD.

There has been no change in the membership of the Board since the last report, which remains as follows:

Delaware.

Cincinnati.

E. T. Nelson, M. A., Ph. D., M. D...

B. Stanton, M. D.............

John K. Richards, Attorney-General, ex-officio.

Four meetings of the Board were held during the year; two in Columbus, one in Cleveland and one in Toledo. An abstract of the proceedings of these meetings is given in following pages.

The January meeting, held in Columbus, was a joint meeting of the State and local boards of health, the fifth of its kind. The proceedings of that meeting, although properly belonging to this report, were published in the ninth annual report, which was then going through press. Some very valuable papers, interestingly discussed, were presented at this meeting.

HEALTH OF THE STATE.

So far as reports enable us to speak, the year seems to have been one of general good health, except at its close, when typhoid fever was more than usually prevalent.

We must again deplore the fact that Ohio is without a proper system for the collection of vital statistics, which would enable us to present accurate data showing its healthfulness as compared with that of other states, and the healthfulness of its cities and towns as compared with. one another. No one knows the number of deaths or the number of births that occurred in Ohio during the past, or any other year. Thousands die and thousands are born of whom no official record is made or can be obtained. Crime is made easy, the settlement of estates

and legacies difficult, and a study of the causes of death and meansfor their removal impossible, from the lack of such records. With but little inconvenience to the people, and without a greater expenditure than is now made for the purpose, it would be possible to provide for a comparatively complete and accurate system for the collection of vital statistics through the medium of the State and local boards of health. It is sincerely hoped that the next General Assembly will give its attention to this matter and make such changes in the laws as will insure thecollection of information of such vital importance to all the people.

SMALL-POX.

Small-pox appeared in a number of places during the year, and in Cincinnati, Bridgeport and Martin's Ferry threatened to assume epidemic proportions. The places infected and number of cases were as follows:

At the close of the year, October 31, 1895, the disease was only present in Bridgeport, Pease township, near Bridgeport, and Martin's Ferry.

Small-pox is the most expensive disease, except possibly cholera and yellow fever, with which any community has to deal. Looked at from a purely financial standpoint, no effort should be spared to prevent its introduction, or to limit its spread when it is once introduced. A single case of small-pox in a small village has been known to cost many hundreds of dollars in actual outlay and loss of business, while an epidemic of the disease may bring a community to the verge of bankruptcy. Panic follows in neighboring communities, and the most irksome restrictions are placed on traffic and travel. Railroad trains are stopped and searched for persons from the infected place; merchandise of the most harmless character, hardware, glassware, even coal and railroad ties, are refused as freight or express, and quarantine becomes almost as hard to bear as the

epidemic. Thirty or forty cases of small-pox in a town of small size have more than once produced such a pandemic in our own State. It behooves business men and transportation companies to use every possible means to prevent small-pox, and fortunately this may be easily done.

cases.

The city of Denver prohibits the erection of wooden buildings anywhere within her borders, and most cities establish limits from which frame structures are excluded. This is a wise precaution against conflagrations, and is fully justified, though it may work hardships in individual So a community may protect itself against small-pox by requiring all of its inhabitants to be vaccinated. No fact in medicine is better established than that vaccination and revaccination will give almost absolute immunity against small-pox, and a city with all its inhabitants protected by vaccination has little to fear from small-pox. This is cheap insurance against not only great financial loss, but against sickness and death from the most loathsome of all diseases.

It is doubtless impossible in this country to enforce general vaccination except in the face of an epidemic; but the courts have sustained health authorities in requiring school children to be vaccinated, and employers could require this of all their employes. The great benefit from doing so was strikingly shown during the recent epidemic of small-pox in Wheeling, W. Va. A case of small-pox, which was concealed for fear of quarantine, occurred in the family of a man who worked at Bloch Brothers' large tobacco works in that city. The man was in constant attendance on his child at night, and other children in the family regularly attended school. No cases resulted from this exposure, and it was doubtless due to the fact that all the employes of the tobacco works. and all the school children had been recently vaccinated.

No necessary expense should be spared when small-pox first makes its appearance to check its spread. A few hundred dollars judiciously spent in the beginning may save thousands. Such was the experience of one of our cities, whose actual outlay finally ran up to $3,000 per week, while the business loss was several times this amount. Business men should bear this in mind, and when small-pox appears in a community they should heartily support the Board of Health in every effort to stamp out the disease.

WATER SUPPLIES AND SEWERAGE.

To supply our cities with pure water is becoming each year more difficult and more costly. While our lake cities are, perhaps, most favored by natural advantages, the universal custom of turning crude sewage into the lake at points not far distant from where water supplies are taken has rendered these, in many instances, a source of danger.

Few if any of our rivers escape sewage pollution, and none of them affords a perfectly satisfactory supply in an unpurified state. Increasing population will soon make it absolutely necessary for the protection of the public health to prevent the pollution of sources of public water supplies, or to require such supplies to be purified by artificial means. The experience of thickly settled Europe teaches that both of these measures will eventually be necessary. For even if all crude sewage and manufacturing wastes are kept out of our streams, they still, in populated districts, receive so much surface filth as to render them unfit for domestic purposes in a raw state.

A very considerable part of the Board's work during the year has related to public water supplies and sewerage systems. It is remarkable the number of small villages that are making improvements of this kind; which speaks well for the diffusion of sanitary knowledge throughout the State.

The Board has acted upon applications from the following places for approval of public water supplies:

Ashland, Cadiz, Canal Dover, Celina, Columbus, Columbiana, Dalton, Fostoria, Lebanon, Logan, Lorain, Montpelier, Osborn, Painesville, Port Clinton, Salem, St. Bernard, Wapakoneta.

These were all approved excepting Columbus, Lorain, Painesville, Port Clinton and Salem. Approval for supplies for Lorain and Port Clinton was withheld pending further investigation.

The city of Columbus proposed to obtain an additional supply of water by placing a low dam across the Scioto river within corporate limits. The Board refused to approve this supply without purification by sand filtration, performed in a manner to satisfy the Board. Great local opposition also developed against the proposed supply, and the project was finally abandoned.

Columbus was on the verge of a water famine during the dry season of the year, and water was taken to make up the deficiency that was totally unfit for domestic use.

The typhoid fever death rate in Columbus for the past eight years shows conclusively that a contaminated water supply is being used. During that period 415 deaths have occurred in the city from this disease, which is equal to 3.86 per cent. of the deaths from all causes. This is a higher rate, on that basis, than that of any other large city in the State. It has been claimed that this high death rate from typhoid fever is due to the use of polluted well water, and no doubt many of the deaths from this disease are chargeable to that cause; but the public water supply is also polluted, and yearly distributes typhoid fever throughout the city. Columbus cannot hope to escape being scourged with this disease until a