INTRODUCTORY. We have the honor to present to the people of the State the Fifth Annual Report of the State Board of Health, for the year of grace 1889. No great emergency has arisen during the year, demanding unwonted activity and expenditures for the control of some extensive and fatal epidemic; no new measures have been inaugurated to attract attention by their novelty or by other meretricious circumstances; but we have gone on in the even tenor of our way, carrying out the methods already in use for educating the people in the gospel of hygiene, and for aiding them in the control of those familiar but destructive pestilences that are always with us. We do not undertake, in this report, to give a detailed account of all the work undertaken and accomplished by the Board. Such a report would contain a great amount of correspondence with local boards and individuals, consisting largely of repetitions of matter already published; it would make this a large volume, which would have little practical value except for those directly concerned, to whom the information that it would contain has been already communicated. Such parts of this correspondence as are of general value and interest can be better utilized in articles intended for general instruction and information, such as that presented by the Secretary under the title of Various Sanitary Topics. Sanitary Progress. This is a time of rapid progress in sanitary matters, and we believe that the State of Maine is, in most respects, keeping well up in the procession. When we consider that only five years ago this Board was organized, and that then, as a rule, the knowledge of our people in regard to hygienic principles and practice was of the most primitive character, the present condition of things is gratifying in the extreme. A fuller knowledge of the epidemic infectious diseases, the conditions under which they may be imported and spread, and the means by which, and extent to which, they can be controlled, have taken away much of that terror born of ignorance with which they were formerly regarded. On the other hand, a fuller knowledge of the nature of our domestic pestilences, the conditions under which they are liable to be communicated, the necessity for their control by public sanitary authorities and the measures necessary for its accomplishment, have awakened the people from the supineness with which their progress was wont to be looked upon, and have made them generally ready to coöperate in those measures necessary for protection. During the past year we have seen evidences that this work has gone on; that the people have become more enlightened in regard to the nature and dangers of infectious and contagious diseases and the practicability of securing immunity from them, and more ready to cooperate with the local health authorities in the means necessary for their restriction. But not to take too rose-colored a view of things, this is by no means yet the case universally, and the necessity for continued work by precept and example, is still sufficiently obvious. Contagious and Infectious Diseases. Physicians are required to report promptly, to the local boards, their cases of contagious and infectious diseases, especially small-pox, diphtheria, scarlet fever and typhoid fever; and local boards are requested to make weekly reports to the State Board during the prevalence of such diseases. Such reports have been received quite promptly from a majority of the towns; but from 159 out of 434 no reports of contagious diseases have been received, either in weekly or annual reports. As there are among these several of our largest towns and one city, it is not presumable that none of them have had cases of these diseases. In some instances, probably, the fault is primarily with physicians who neglect to report their cases. Local boards should insist that such reports be promply rendered-adopting legal measures of compulsion when necessary-and they should in turn report promptly to the State Board. The Secretary has continued to furnish weekly reports of these diseases to the newspapers of the State. The dissemination of such information has been objected to by some persons, probably on the ground that "where ignorance is bliss, 'tis folly to be wise." Not having adopted this sentiment as the motto of our Board, and not believing that it is in consonance with the spirit of this age, we have, while carefully considering such objections, unanimously decided to continue the publication of these reports. |