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making this test upon groups of children. Many towns have taken advantage of this offer. As diphtheria preys largely upon children it seems strange that parents do not realize more fully their responsibility in this matter and are not willing to let their children have the protection against diphtheria. A study of the mortality statistics issued by the Department of Vital Statistics shows conclusively that deaths from this disease are constantly decreasing through use of antitoxin, toxin-antitoxin and the Schick test. An interesting table is printed below showing the constant decrease in cases and deaths of diphtheria during a five year period:

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The Supreme Court has handed down decision printed. below regarding vaccination and we trust this matter is settled for all time and that the repeal of this most important law will never again be brought before the legislature.

Extracts from opinion of Barber v. School Board handed down Nov. 3, 1926, by the Supreme Court of New Hampshire.

In this case the court held that "The constitutionality of vaccination statutes has been passed upon in many cases, and the uniform conclusion has been that they constitute a valid exercise of the police power of the state."

Also that "A proper certificate was furnished in 1924. The demand for a new certificate in 1925 precipitated the present controversy. The statute is silent as to how often a certificate may be required. It was the legislative intent

to provide efficient protection, and the statute is to be construed accordingly. Conditions making it improper to vaccinate the child at one time might not exist at a later date. Jacobson v. Massachusetts, 197 U. S. 11 assuming that the physical conditions might be such as to show that and also assuming that in such a case no more than one certificate could be required, the point of the present controversy is not reached.

There is nothing to show the existence of such conditions here. The plaintiff rests his case upon the proposition that in all cases one certificate is sufficient for all time. This construction cannot be adopted. The meaning of the statute is that a new certificate may be required whenever there is reasonable ground to believe that there may have been such a change of conditions that the child is no longer "an unfit subject for vaccination."

In some cases the matter of adequate salary has been adjusted in a fair way. Other cases have not been so fortunate. The board would call attention to this matter and would respectfully advocate salaries commensurate with work required. Many workers leave this department for positions in other states where much larger salaries are paid for similar work. This is a decided loss to the department, which must bear the responsibility of training the worker to its specific needs.

The Department of Vital Statistics needs more space for cases in which to file records. This department is housed in a fire proof vault. Plans have been submitted that would double the capacity of the vault and take care of the needs of this department for many years to come. We trust the legislature will see the great need of this department and take steps to meet same.

The splendid results accomplished by the Division of Maternity, Infancy and Child Hygiene will be published elsewhere in this report as well as work accomplished by the Division of Venereal Disease Control.

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The proportion of births, marriages, divorces and deaths to each 1,000 of the population* for the two years men

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Division of Chemistry and Sanitation

CHARLES D. HOWARD, S. B., Chief

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