chief health officer is a physician in good standing. Such a health 

 officer is next best to a trained sanitary engineer of whom there 

 are but few in the country. It is not unusual in the cities of the 

 size of San Diego to pay for only part of the time of the health 

 officer. However, this is a serious handicap for an efficient de- 

 partment. The city has already grown to a size where this can- 

 not be continued. It should be wilHng to pay a salary large 

 enough to obtain the full time of a scientifically trained man, who 

 is familiar with the best methods of controlling public health. 

 Such a man cannot be considered for a salary of less than $5,000, 

 because an executive big enough for the position can secure a 

 larger income in private practice. With such a man at the head 

 of the health department, all subjects relating to the prevention 

 and control of disease could be studied and a far-reaching and 

 constructive program laid out. 



Cost 



The Health Department employs a health officer at $125.00 a 

 month, who spends one hour of the day in the Health Depart- 

 ment office and such other time as is necessary for the care of 

 contagious diseases. It is not possible for a man in one hour or 

 even in several hours a day to more than meet the urgent de- 

 mands on his time as an executive. No time is allow^ed for the 

 study of preventive measures in any local health situation. The 

 city administration is said to have provided liberally for necessi- 

 ties, but to have never gone beyond actual necessities. When 

 one considers the heavy death rates from such a communicable 

 disease as tuberculosis or the spread of the horrors of venereal 

 diseases, one wonders what is meant by necessities in such a state- 

 ment; especially, since eastern cities, where an active campaign 

 against tuberculosis has been waged, have reduced their death 

 rates from this scourge. In San Diego, tuberculosis has in- 

 creased surprisingly. Furthermore, when eighty-five babies 

 under a year old died last year in San Diego — a natural children's 

 paradise — and when a majority of these deaths could have been 

 prevented by a pure milk supply, and by giving mothers instruc- 

 tions for the care of their children through public health nurses, 

 one again wonders what is meant by necessities. The Health De- 

 partment in 1912 expended $26,398. (See chart for per cent, 

 spent for health as compared with other city departments.) The 

 estimated cost for the last fiscal year is $31,739. The receipts 

 are $10,725, making the actual cost to the city only $21,014. The 

 pest houses will be maintained and enlarged at a cost of $6,375. 

 At the present time there is no hosp'tal in the city where chil- 

 dren with diptheria, scarlet fever, measles, etc., can be taken. 

 They must be quarantined in their homes. Among the poor, 

 either in the congested parts or in the scattered homes on the 

 city's edge, there is little chance for proper protection of the rest 

 of the family, or outsiders. 



Care of Communicable Diseases 



Under the state law, contagious and infectious diseases must 



