218 ANNUAL REPORT OF THE Off. Doc. 



ture of large amounts of money and are, therefore, not so readily 

 prosecuted by local boards, but the furnishing of opportunities 

 for the prompt diagnosis of such of the communicable diseases as 

 can be thus distinguished is now recognized as the duty of the 

 boards of health of all cities. 



Wherever in this summary of the duties of boards of health I' 

 have made use of the w^ords municipalities or municipal authorities, 

 1 desire to be understood as including those quasi-municipalities 

 known as townships, the importance of Avhich the State Legislature 

 is just beginning to recogni/.e as essential factors in State adminis- 

 tration by conferring upon them for the first time in the history 

 of the State, powers of self-government. Tw^o comparatively recent 

 acts make them self-governing as regards the enforcement of sani 

 tary laws and regulations. TIk se enactments have come none too 

 soon. The country districts are sadly in need of sanitary super- 

 vision. In the words of another, a practising physician living in 

 the country, "the experience of every countr}^ physician will bear 

 us out when we say that such diseases as typhoid fever, diphtheria, 

 scarlet fever and measles have quite as many victims in the country 

 as in the city. There is many a household with a vacant chair 

 by the hearth in every neighborhood in our broad land, which can 

 also testify to this terrible truth." Today he might have added 

 to his list, small-pox, which is going up and down through our rural 

 districts, not like a roaring lion, but rather like a sneaking wild 

 cat, seeking whom it may devour, maim or disfigure. Some years 

 since, I requested a distinguished physician to read a paper before 

 a sanitar}^ convention on "Typhoid Fever and its Prevention.'' 

 When he came to the platform, he announced that he had taken 

 the liberty of changing the title to "Ty])hoid Fever, a Disease of 

 the Village and Farm." His essay amply justified the title. "Sub- 

 urban and rural districts," he maintained, "possess a special lia- 

 bility to this disease, which lies chiefly in the contamination of 

 their w^ater supply. > These conditions iwv (^asily understood and 

 are usually due to direct communication hrtween cesspools and 

 wells. The fluids percolating the soil fi-om a cesspool near a well, 

 or overflowing in time of rains carry the disease with tenfold more 

 certainty than the much dreaded sewers of the city. Ju«t so long 

 as townshi])s are without regularly constituted, eflicient and intelli- 

 gent health authorities, just so long will the farmers of our State 

 sow abundant cro])s of little white headstones in th(Mr God's acres 

 as well as of wheat and corn in their broad fields. 



In conclusion, it may be asked whether State medicine has 

 achieved results which justify its existence? The answer is not 

 far to seek and is most gratifying and conclusive. In the Cen- 

 sus Bulletin of the Twelfth Census of tlie United States, published 



