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ANNUAL REPORT
OF THE
SURGEON GENERAL of the
PUBLIC HEALTH SERVICE
of the ~NITED STATES.Pu.bl·.:
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FOR THE FISCAL YEAR
1933
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UNITED SfATF.S
GOVERNMENT PRINTING OFFICE
WASHINGTON: 1933
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TREASURY DEPARTMENT
Document No. 3059
Public Health Service
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LETTER OF TRANSMITTAL
TREASURY DEPARTMENT,
OFFICE OF THE SECRETARY,
Washington, December 20, 1933.
Srn: In accordance with section 9 of the act of Congress approved
July 1, 1902, I have the honor to transmit herewith the report of
the Surgeon General of the Public Health Service for the fiscal year
1933.
Respectfully,
Jr.
Acting Secretary.
H. MoRGENTHAu,
The SPEAKER OF THE HousE OF REPRE~ENTATIVES.
Ill
418532
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CONTENTS
Pap
Foreword________________________________________________________
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Division of Scientific Research______________________________________
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Cancer_______________________________________________________
17
Heart disease__ ____ ___________________________________________
19
Leprosy __________________________________________ · ___________ · 20
Malaria______________________________________________________
21
Nutritional diseases___________________________________________
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Plague_______________________________________________________
Psittacosis___________________________________________________
24
Rocky Mountain spotted fever__________________________________
24
Tularaemia___________________________________________________
26
Child hygiene investigations __________________________ ·__________
27
Milk investigations____________________________________________
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Studies of public health methods________________________________
29
Statistical investigations_______________________________________
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Stream pollution investigations_________________________________
31
National Institute of Health____________________________________
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Miscellaneous_________________________________________________
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Division of Domestic (Interstate) Quarantine_________________________
Plague suppressive measures in California________________________
40
Trachoma prevention work_____________________________________
41
Psittacosis___________________________________________________
42
43
Supervision of water supplies used by common carriers_____________
Railway sanitation____________________________________________
45
Shellfish sanitation____________________________________________
46
Cooperative work with States relative to stream sanitation_________
46
46
Cooperative public health engineering work______________________
47
Mosquito control, District of Columbia _______________________.___
Summary of work carried on by the various districts______________
48
Rural health work_____________________________________________
49
Division of Foreign and Insular Quarantine and Immigration___________
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Transactions at maritime quarantine stations __________________ c _ _
55
•Mexican border stations_______________________________________
57
Transactions at United States air ports of entry for airplanes from
foreign ports________________________________________________
58
Transactions at foreign ports_ _ _ ________________________ ___ __ ___
60
Medical inspection of aliens____________________________________
61
Division of Sanitary Reports and Statistics___________________________
75
Morbidity and mortality reports________________________________
75
International exchange of sanitary information ________ ~----------76
Prevalence of communicable diseases during the calendar year 1932_ _
77
Sanitary legislation and court decisions__________________________
78
Publications issued by the division______________________________
78
Negro health work __________________________ - ~________________
78
Publications distributed and exhibits prepared____________________
79
Division of Marine Hospitals and Relief_____________________________
83
Classes of beneficiaries and amount and character of services rendered_
84
Dental treatment_ __________________________________________ "_
85
Coast Guard_________________________________________________
85
Operating costs_______________________________________________
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Consolidated and detailed reports_______________________________
Di vision of Venereal Diseases___ _________________________________ ___
96
Research_____________________________________________________
96
Studies of prevalence of venereal diseases__ _ _ ___ _________________
97
The venereal disease clinic, Hot Springs, Ark _________ - ____ _______
97
Cooperative activities __________________________________ - __ __ ___
98
Venereal disease information____________________________________
99
Tabular summaries ____________________ - _- _____ - _- __ - - - - - - _- ___ 100
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CONTENTS
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Division of Mental Hygiene________________________________________
N!l-ture_and_ treat1!1ent of ~rug addiction ___________________ -,-____
D1ssemmat1on of information___________________________________
Studies of abusive uses and the medicinal and scientific needs_______
Administration of narcotic farms________________________________
Medical and psychiatric services in Federal penal and correctional
institutions_________________________________________________
Other investigations___________________________________________
Division of Personnel and Accounts_________________________________
Personnel____________________________________________________
Property records______________________________________________
Accounts section______________________________________________
Personnel statement___________________________________________
Chief Clerk's Office________________________________________________
Appendix________________________________________________________
Financial statement___________________________________________
Quarantine service________________________________________
Savings__________________________________________________
Funds transferred from other departments___ ________________
Miscellaneous receipts_____________________________________
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ANNUAL REPORT OF THE SURGEON GENERAL OF THE
PUBLIC HEALTH SERVICE
TREASURY DEPARTMENT,
BUREAU OF THE PUBLIC HEALTH SERVICE,
Washington, D.O., October 15, 1933.
Sm: In accordance with the act ap_proved July 1, 1902, I have the
honor to submit for transmission to Congress the following report of
the transactions of the Public Health Service of the United States for
the fiscal year ended June 30, 1933. This is the sixty-second annual
report of this service, covering the one hundred and thirty-fifth year
of its existence.
The several duties imposed upon the Public Health Service by law
include the prevention of the introduction and spread of infectious
diseases from foreign, countries into the United States. This is one of
the important public-health functions of the Federal Government.
The relation between the spread of epidemic diseases and commercial
intercourse has long been recognized. In protecting our territory
from invasion by diseases from foreign countries in accordance with
the requirements of law, it has been necessary to keep currently informed as to the prevalence of disease throughout the world insofar as
practicable. The increasing use of international aerial transportation
makes it especially necessary that current information relating to the
prevalence of disease in all countries be available.
WORLD HEALTH CONDITIONS
The available re:ports indicate generally good health conditions in
most of the countnes of the world during the calendar year 1932 as
compared with preceding years.
Influenza _appeared in England and Scotland in epidemic form in
December 1932, appearing later in Ireland. It was reported in most
of the European countries, but was most severe in the British Isles,
Germany, France, Switzerland, and Spain. The disease was generally
mild, and the death rates were not seriously affected except in a few
countries and for short periods. In Germany data collected by the
sickness funds indicated that the characteristics of the disease did
not differ among the workers and the unemployed.
In 1932, about 75,000 cases of cholera were reported throughout the
world, with 39,000 deaths. In 1931, 260,000 cases and 141,000
deaths were reported. Most of the recorded cases occurred in India.
It is probable that many cases in portions of Asia, where vital statistics.
cannot be secured, were not recorded.
In the Philippine Islands 420 cases of cholera were reported during
the calendar year 1932, as compared with 936 cases in 1931.
In the United States and in England smallpox was less prevalent
in 1932 than it was in 1931, but in British India this disease caused
26,900 deaths in 1932 and 19,000 deaths in 1931. During the first
6 months of 1933 there was a marked increase in the prevalence of
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PUBLIC HEALTH SERVICE
smallpox in India. In Mexico smallpox caused about 10,000 deaths
in 1931 and somewhat less than 7,000 deaths in 1932.
Plague was widespread throughout the world in 1932. Wherever
commerce goes rats are carried, and some of these rats carry plagueinfected fleas. Plague did not appear in the Philippines dunng the
year, but there were 6 cases of plague with 5 deaths m the Territory of
Hawaii, and plague-infected rodents were found in Hawaii and in .
California. In India plague caused more than 38,000 deaths in
1932-about 10,000 more than occurred in that country in 1931.
Typhus fever, another disease of widespread occurrence, is reported
from all of the great divisions of the world. In Mexico typhus fever
caused more than 1,000 deaths in 1932 and nearly 1,500 deaths in
1931. In the United States most of the cases of typhus fever are
of the mild form, but in many countries where the disease is spread
by body lice it is comparatively severe. In eastern Europe and
western Asia typhus fever is endemic, but the numbers of cases and
deaths have been decreasing since the World War.
Yellow fever was reported in several provinces of Brazil during the
calendar year 1932 and in several countries in Africa, including
French West Africa, Portuguese Guinea, the Gold Coast, and Nigeria.
The numbers of cases reported were not large, but the infection exists
in large areas.
HEALTH CONDITIONS IN THE UNITED STATES
During the calendar year 1932 and the first half of the year 1933
health conditions were good in the United States as compared with
those of preceding years. The general death rate for the year 1932
was the lowest ever recorded. Infant mortality and the death rates
for tuberculosis, diphtheria, and typhoid fever also reached new low
records. There were no unusual widespread epidemics, and the
principal increases in the death rates over rates for/receding years
were for cancer, heart disease, and other so-calle "degenerative
diseases," the death rates of which have been increasing for years.
Whatever influence distressing economic conditions may have had on
the health of the people of the United States generally, ·unfavorable
results are not yet apparent from an examination of crude death
rates, the reports of cases of communicable diseases, or deaths of
infants.
The general death rates in 27 States (having an aggregate population of more than 92 million) for the last 5 years are as follows:
Dtat/11
JHT 1,000
populalion
Ytar
1928 _______ ___________ ________ ___ ________ _________ ____ __ ____ _____
1929 ___ ______ _______ _________ ___ ________ _________ _____ ___ ___ ___ __
1930 ___ ___ ____ ________ ____ ____ ____ _____ ___________ _____ _______ __ _
1931 _____ ___ ________ ____ ___ __ _____ _____ ____ _______ ____ _______ ___ _
1932 __ ___ ___ ___ ________ ____ ________ _____ ______ ________ ___ ___ _____
12. 0
11. 8
11. 2
11. 0
10. 8
These rates are about one tenth of 1 per 1,000 population lower than
the rates for the death registration area.
The decrease in the numbers of deaths from several of the communicable diseases since the beginning of the present century is shown
by the following comparison of death rates in the registration area in
1900 with death rates computed from reports to the Public Health
Service for 1932: Tuberculosis death rates, 1900, 201.9 per 100,000
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PUBLIC HEALTH SERVICE
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population; 1932, 61.3 per 100,000. Diphtheria, 1900, 43.3 per
100,000; 1932, 4.8. Typhoid fever, 1900, 35.9 per 100,000; 1932,
4.6. These figures indicate that if the death rates of 1900 had prevailed in 1932 there would have been 175,000 more deaths from tuberculosis in the United States in 1932 than actually occurred, 48,000
more deaths from diphtheria, and 40,000 more deaths from· typhoid
fever. The total saving of life in 1932 as compared with 1900 in
these three diseases alone amounted to 263,000 lives. The increases
in deaths from some diseases during the period covered are more than
balanced by these and other decreases. The general death rate in
1900 was 17.5 per 1,000. If this death rate had prevailed in the
United States in 1932, there would have been 800,000 more deaths in
1932 than actually occurred.
Infant mortality has been decreasin~ since comparable annual
statistics have been collected in the Umted States. As recently as
1915, 1 infant of every 10 born in the registration area died before
reaching its first birthday; in 1920, 1 out of each 12 died; in 1925,
1 out of 14; in 1930, 1 out of 15; in 1931, 1 out of each 16; while
in 1932 only 1 out of each 17 babies died before the expiration of its
first year.
The birth rate in the United States continues to decline. In 1915
there were 25.1 recorded births per 1,000 population; in 1920 the rate
was 23.7 per 1,000; in 1925, 21.5; in 1930, 18.9; in 1931, 17.8; and
in 1932 preliminary reports showed 17 .3 births per 1,000 population.
Reductions in birth rates are also being noted in many foreign countries.
In 1932, 46 States reported 10,887 cases of smallpox, as compared
with 28,755 cases in 1931 and 46,560 cases in 1930. The decrease
was 76.6 percent in 2 years. The reports indicate that the prevalence of smallpox in the United States was less in 1932 than it has
been at anf time since the Public Health Service began to collect
statistics o its prevalence. The smallpox death rate for 1932 was
the lowest ever recorded by the Public Health Service-4 smallpox
deaths in each 10,000,000 of the population. In Mexico the smallpox
death rate in 1932 was about 1,000 times the rate in the United
States-4 per 10,000 population. However, even the comparatively
small number of cases of smallpox in the United States caused a great
amount of suffering which could have been prevented.
Late in November 1932 an increase was noted in the prevalence
of influenza in some Southern and Western States. The numbers of
reported cases increased rapidly and the disease spread toward the
East and North, reaching a peak for the country as a whole the last
week in December. The decline in prevalence was continuous, and
the number of cases of influenza reported for February was below
the average of the preceding 3 years, which were not epidemic years.
The disease was unusually mild, and the general death rate in large
cities rose for only a short time and did not reach the high point of
1931. The highest weekly death rates in these cities for the last
five winters were: 1929, 20.5 per 1,000 population, in February; 1930,
14.1 per 1,000, in March; 1931, 15.1, in January; 1932, 14.7, the last
week in February; and 1933, 13.6, the first week in January.
During the calendar year 1932, no case of plague occurred in the
United States, but 2 plague-infected ground squirrels and 4 plagueinfected rats were reported in California. In the Territory of Hawaii,
6 cases of plague with 5 deaths were reported, and plague-infected
rats were found on the islands of Hawaii and Maui.
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PUBLIC HEALTH SERVICE
Cholera and yellow fever did not appear in the United States during
1932, but more than 400 cases of cholera were reported in the Philippine Islands, and yellow fever was present in South America..
During 1932, 421 cases of Rocky Mountain spotted fever with 76
deaths were reported. Of this number, 304 cases with 66 deaths occurred in the Rocky Mountain and Pacific States, while 103 cases
and 10 deaths were reported in the Atlantic Seaboard States. Between these groups, South Dakota reported 13 cases and Tennessee
1 case. Montana reported the greatest number-100 cases and 17
deaths.
Forty-four States reported 7,074 deaths from pellagra in 1930,
5,773 deaths in 1931, and 4,091 deaths in 1932. Many health officers anticipated an increase in the prevalence of :pellagra as a result
of economic conditions, but there is yet no evidence that it has
occurred. It is likely that health education and preventive measures
have been instrumental in produQing the reduction in the pellagra
death rate.
For the year 1932, 955 cases of typhus fever with 53 deaths were
reported in the United States. Of the total number of cases, three
States, Alabama, Georgia, and Texas, reported more than 80 percent.
The disease is most prevalent in the Southern States. There were
almost three times as many cases reported in 1932 as in 1931, but
some of this increase may be due to better reporting of cases.
·
One thousand five hundred and two cases of undulant fever, with
71 deaths, were reported in the United States during 1932. This
disease was prevalent over the entire United States, with New York,
Missouri, and CaJifornia reporting about one third of the total number of cases.
Nine hundred and forty-five cases of tularaemia, with 31 deaths,
were reported during the year 1932. More than half the cases were
in six States, Illinois, Kentucky, Minnesota., Missouri, Ohio, and
Virginia.
PREVENTION OF THE INTRODUCTION OF DISEASES FROM ABROAD
During the fiscal year no instance occurred of the importation into
the United States or its dependencies of any quarantinable disease.
One vessel arrived at the New Orleans quarantine station infected
with typhus fever; 1 case of smallpox developed among passengers
undergoing quarantine detention at the San Francisco quarantine
station; 1 vessel arrived at Honolulu after having had 1 death from
cholera on board; and 1 vessel with 2 cases of cholera arrived at the
port of Manila. In each instance effective measures were taken at
the respective stations to prevent the introduction of these diseases
into United States territory.
Epidemic cholera in China required special precautionary measures
at the ports of Amoy and Hong Kong. Quarantine against both ports
was declared by the Quarantine Service in the Philippine Islands on
July 7, 1932, and remained in effect until the epidemic had subsided
in the late summer.
The prevalence of smallpox in Hong Kong, Canton, and Shanghai
also made it necessary to enforce appropriate quarantine restrictions
against those ports. The proximity of the Philippines to many infected centers-in some instances within 36 hours' sailing, less than
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PUBLIC HEALTH SERVICE
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the incubation period of the quarantinable diseases-imposes a heavy
quarantine responsibility on Service officers in the Orient.
During the year 10,935 vessels, 555,726 passengers, and 852,536
seamen were inspected by quarantine officers on arrival at domestic
ports; at insular ports 2,982 vessels, 133,446 passengers, and 222,218
seamen were inspected, and at foreign ports 179 vessels, 69,301 passengers, and 4,570 seamen· were inspected prior to departure for the
United States. In addition, 4,186 airplanes arrived at airports of
entry in the United States from foreign ports, requiring quarantine
inspection. These planes carried 25,767 persons. Of this number,
only 2,209 airplanes, carrying 20,396 persons, of whom 2,327 were
aliens, were subjected to medical examination by medical officers of
the Public Health Service prior to entry. The remainder, comprising
1,977 airplanes, carrying 5,371 persons, entered without the medical
examination required by law, owing to permission of arrival at airports at which medical officers are not available.
Of the passengers who embarked at European ports for United
States ports, 13,515 were vaccinated and 5,887 were deloused under
the surveillance of medical officers of the Public Health Service at
ports of embarkation, and 12,928 pieces of baggage were disinfected
to safeguard against the introduction of smallpox and typhus fever.
At United States ports, 1,567 vessels were fumigated, either because
of the occurrence of disease on board or for the destruction of rats to
prevent the possible introduction of plague. Of the 6,088 dead rats
recovered following fumigation, 3,589 were examined for plague
infection.
On October 6, 1932, the regulations governing the importation of
parrots into ports of the United States, prescribed in accordance with
the provisions of Executive Order No. 5264, approved January 24,
1930, were revised and extended to cover all birds of the parrot family.
On March 3, 1933, the President rescinded Executive Order
No. 5143, dated June 21, 1929, which restricted the transportation
to the United States of passengers from certain ports in the Orient in
the vicinity of which epidemics of cerebrospinal meningitis prevailed.
The special regulations prescribed by the Secretary of the Treasury
under the provisions of that Executive order thereupon ceased Lo be
in effect.
The draft of the International Sanitary Convention for Air N avigation which was adopted by the Permanent Committee of the
International Office of Public Hygiene in Paris at its April-May
(1932) session was formally submitted to the United States for ratification. The Government of the United States has signified its
willingness to sign the convention with certain reservations, similar
to those made in ratifyin~ the International Sanitary Convention of
Paris, 1926, and it is anticipated that the ratification of the convention
by this Government will soon be accomplished.
MEDICAL EXAMINATION OF ALIENS
At domestic ports, 398,574 alien passengers and 805,028 alien
seamen were examined by medical officers of the Public Health
Service under the immigration laws. Of this number 13,942 passengers and 991 seamen were certified for various diseases and disabilities. The most important causes of certification of alien passengers
were as follows: Trachoma, 252; tuberculosis, 139; feeble-mindedness,
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PUBLIC HEALTH SERVICE
91; insanity, 72; syphilis, 220; and gonorrhea, 345. Of the alien
seamen examined 4 were certified for trachoma; 13 for tuberculosis;
67 for syphilis; 83 for chancroid; and 162 for gonorrhea.
The procedures in the examination of aliens continued as in the
preceding year, with the exception of a change in the method of
examining third-class aliens at New York. This class of aliens had
formerly been brought to Ellis Island for medical examination, but
since August 19, 1932, in accordance with an order of that date issued
by the Commissioner of Immigration at Ellis Island, they have been
accorded the required Il_ledical inspection on board the vessels on
which they arrived. Conditions on shipboard do not permit as
thorough medical examinations and, accordingly, examination on
board results in the discovery and certification of a much reduced
number of defects and diseases.
During the fiscal year 26,543 applicants for immigration visas
were examined by medical officers of the Public Health Service
attached to American consulates in foreign countries. Of this
number 17,107 were examined in American consulates in Europe,
and 9,436 were examined in American consulates in the Western
Hemisphere. Mental or physical defects were found in 3,980 of the
applicants examined in Europe, and in 1,634 of those examined in the
Wes tern Hemis:phere. One thousand four hundred and ninety of
those examined m Europe and 878 of those examined in the Western
Hemisphere were refused visas for medical reasons. Of 24,175
aliens who had been given a preliminary medical examination
in American consulates in foreign countries and to whom visas had
been issued, only 4 were certified upon arrival at a United States
port as being afflicted with a defect or disease requiring mandatory
deportation.
PREVENTION OF THE SPREAD OF CONTAGIOUS AND INFECTIOUS
DISEASES IN INTERSTATE COMMERCE
In cooperation with State health agencies, 95 percent of the 2,214
sources of drinking water used by railroads and bus lines, 97 percent
of the 253 sources used by vessels, and 97 percent of th'e 116 sources
used by airplane carriers were inspected and controlled b;v the Public
Health Service. Municipal health agencies cooperated m this work
by collecting and examinmg approximately 5,000 samples of drinking
water taken from common carriers.
Sixty-one percent of the vessels engaged in interstate commerce
were issued certificates showing that their drinking and culinary
water systems complied with the regulations, while 19 percent were
issued temporary certificates pending inspection.
Surveys of the efficiency of State control over the sanitation of the
shellfish industry continued, with such inspections in growing areas
and shellfish establishments as were necessary. Approval was given
to 1,301 State certificates issued during_.the year.
Request for assistance by States engaged in stream pollution
Eltudies and control made it advisable during the year to establish
the Office of Stream Sanitation, for the purpose of advising the
States as to methods of procedure where the problems are interstate
in character, and assisting in the correlation of data.
Public health engineering services rendered other branches of the
Government required 25.8 percent of the time of the engineering
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PUBLIC HEALTH SERVICE
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:field force. Approximately 24 percent of this time was devoted to
assistance to the Bureau of Indian Affairs, National Park Service,
Supervising Architect's Office, Bureau of Prisons, and the Forest
Service. Assistance was rendered the Lighthouse Service in developing effective water-treatment systems applicable for their tenders and
lightships on the Great Lakes.
Financial and technical assistance was given to 28 States for the
purpose of aiding them in demonstrating the value of properly
organized local health service. These demonstrations were conducted in 172 local areas. In addition, special assistance was rendered
to States by the detail of 4 regular officers and 4 technical employees,
who gave particular attention to the development of local rural health
units.
According to the information submitted by the States, 581 county
or district health departments were in operation on December 31,
1932, a decrease of 35 from the preceding year. While this decrease
is regretted, it is more apparent than real, since many of the discontinued health units were organized to meet the epecial health
problem in drought-stricken areas and were :financed very largely by
special grants from the Federal Government, which terminated on
June 30, 1932.
Trachoma eradication activities conducted in cooperation with the
State health authorities were continued in Georgia, Tennessee,
Kentucky, Missouri, and Texas. The disease is still a serious problem
in the mountain regions of the South Central States.
Following the discovery of psittacosis infection among parrakeets
grown in California aviaries and the occurrence of several outbreaks
of human cases •in other States in which the infection was traceable
to birds shipped in interstate commerce, it was considered advisable
to place some restriction on the interstate shipment of birds of the
parrot family. Accordingly, on September 28, 1932, the Acting
Secretary of the Treasury promul~ated an amendment to the interstate quarantine regulations reqmring that all interstate shipments
of psittacine birds be accompanied by a certificate from the State
health authority to the effect that such birds are, so far as can be
determined, from an establishment free from psittacosis infection.
Transportation companies and the State board of health of California
immediately gave their cooperation in the enforcement of this regulation, with the result that no case of human psittacosis was reported
outside of California during the remainder of the :fiscal year.
No case of human plague occurred in California. Rodent pla&'ue
was reported in San Benito County, however. Plague eradication
measures must be carried on continuously in the rural area about
San Francisco and Oakland to keep rodent infection under control.
INVESTIGATIONS OF PUBLIC HEALTH PROBLEMS
The program for the cancer investigations of the Public Health
Service has been a continuation of the work undertaken prior to the
present fiscal year. The following lines of research were pursued:
Studies of the biological effects of radiation; studies of resistance to
malignant growths; biochemical and cytological studies and studies
designed to secure further fundamental knowledge concerning the
chemical conditions which control the life, growth, and multiplication of normal and cancer cells. The studies are of a fundamental
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PUBLIC HEALTH SERVICE
nature and much time and effort are required to put them into effect.
Progress is being made, however, and it is believed that worth-while
information on the cause and treatment of cancer will be forthcoming
as a result of this work.
Studies of rheumatic heart disease, begun during the last fiscal vear,
have included the possible relationship of a nutritional deficiency to
rheumatic fever; the role played by stre.Ptococci in the etiolo~ of
this disease; and epidemiolo~cal observat10ns as to the relative infrequency of rheumatic fever m child-care institutions in Washington
as evidence of the powerful operation of some environmental factor
in the prevention of disease.
At the leprosy investigation station at Honolulu an effort was made
to learn the early manifestations of leprosy by an examination of
:approximately 100 children who are the sons and daughters of leprous
parents confined to institutions in Honolulu. The results of the
:atudy suggest that minor neurological manifestations may be detected
previous to the appearance of definite lesions of the skin, but will not
permit of deductions concerning the relation of the period of contact
of the child and leprous parent and a subsequent development of
leprosy in the child.
Experiments on the cultivation of the bacilli of human and rat
leprosy have been continued. Investigations of the effects of diet
on the course of rat leprosy, while producing striking results in some
instances, do not justify the conclusion that the development of rat
leprosy was affected by the dietary, under the circumstances which
surrounded these tests.
Inoculations of white mice with rat leprosy have been successfully
accomplished, and the disease has been reproduced by transfer from
mouse to mouse as far as the third transfer. The intranasal instillation into rats of material of rat leprosy has resulted, in some instances, in the production in the lymph nodes of lesions histologically
characteristic of those found in rat leprosy, a finding considered of
significance in the interpretation of a probable route of introduction
of rat leprosy into the animal under natural conditions.
In investigations of malaria-control measures, it has been demonstrated that dusting with paris green at 10-day intervals almost
completely controls the incidence of Anopheles quadrimactdat'U8 and
is within the economic ability of most southern counties, while the
21-dav interval was shown to be insufficient to control malaria in the
average climate of the Mississippi Valley.
.
The plasmochin studies begun last year have been brought to a
close. Results indicate that 2 centigrams of plasmochin administered weekly gave a negative result in the control or prophylaxis of
malaria. Studies indicate that atabrine controls the acute attack as
effectively as quinine and apparently does so a little more quickly
and without the usual quinine discomfort to the patient. This study
is being continued.
Tests of the pellagra-preventive value of various foodstuffs have
been continued; the studies in the human being are correlated with
those for black-tongue in the dog. Attempts to develop a satisfactory method of evaluating the potency of concentrates of the pellagrapreventive factor, using the albino rat, have been continued, and
.during the year several crude yeast fractions were given a preliminary
test.
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Studies of the epidemiology of plague and measures for its control
in the Hawaiian Islands have been continued. In the two regions
where plague now exists it is endemic among field.rats. The intensive
and constant distribution of poison appears to be the only method
which may eventually reduce the rodent population of the fields to a
point where plague may be adequately controlled. The identification of a new species of the Xenopsylla family which was noted last
year was identified and named Xeno1Jsylla hawaiiensis by Dr. Karl
Jordan. Xenopsylla hawaiiensis is evidently the plague-transmitting
agent responsible for the existence of the endemic type of rural
infection found in the Hawaiian Islands.
· In the investigation of the flea infestation of rats over 19,755 rats
were collected, 20 percent of which were Rattus hawa,iiensis, a species
formerly believed to be nearly extinct.
Stuclies of psittacosis were resumed during the year and a psittacosis laboratory was established at Pasadena, . Calif. Thirty-seven
cases of human psittacosis, with nine deaths, were reported jn the
United States during the year. To date there have been no laboratory
infections contracted by the personnel engaged in work with this
highly communicable disease, a fact attributed to the efficiency of
the technique developed by service personnel.
At the Rocky Mountain spotted fever laboratory 205,000 cc of the
Public Health Service vaccine for the prevention of this disease was
manufactured for the season of 1933. This is an increase of 3,600
percent since 1926, when this vaccine was first distributed. The
demand for the vaccine continues to increase and the entire output
has been distributed. The heaviest call has been from the Rocky
Mountain States, but approximately 10,500 cc were forwarded to the
National Institute of Health for distribution in the East.
Observations of the agglutination of protem X organisms by spotted
fever sera indicate that agglutinins are seldom present in sufficient
titer to be of diagnostic value before the tenth day of illness, and in a
considerable percentage of cases the highest agglutinin titer is present
in sera secured during early convalescence. In some cases agglutinins
for the several strains of protem X used as antigen are never present
in the blood in sufficient titer to be of diagnostic value.
The identity of the so-called "Sao Paulo typhus" of Brazil and
Rocky Mountain spotted fever has been established by workers
at both the Hamilton laboratory and ·at the National Institute of
Health, and it has also been demonstrated by workers at the National
Institute of Health that a close immunological relationship exists
between spotted fever and the fievre boutonneu-8e of the Mediten-a.nean
littoral.
There has been a marked increase in the prevalence of Rocky
Mountain spotted fever in Wyoming during the spring of 1933.
There has also been some increase in California, Nevada, Colorado,
and Washington. During the year the infection was reported from
Iowa for the first time.
Child hygiene investi~ations have included studies of the vision
and hearing of school children to determine the· progress of defective
vision or hearing over a period of years and to determine methods of
prevention; stuclies of the physical status, growth, and development
of school children; studies of the mental status of children having had
some type of abnormal birth; and studies of the relation of dental
caries to diet and climate among Indian school children.
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Dental studies with regard to the distribution of mottled enamel in
the United States indicate that there are probably close to 200 areas
where this condition is prevalent, divided among 22 States. Laboratory studies in relationship to the mottled-enamel investigations
have been directed towards the determination of the minimum
amount of fluorides in water which will cause the condition.
Industrial dermatitis occurring among the employees of certain
industries has been studied in an endeavor to determme the irritant
causing the outbreak and to recommend measures for its control.
During the year investigations were made in the rubber, C!lnning,
cigarmaking, cotton milling, sirup manufacturing, and rayon industries.
Studies of industrial dusts in relation to the health of workers in
dusty trades have included additional surveys in the marble-, talc-,
slate-, and granite-quarrying industries, air abrasive blasting, and the
size-frequency of industrial dusts. Industrial poisoning studies have
dealt with the lead hazard in a storage-battery flant, the health
hazard of radium dial painting, and the toxicity o osrmc tetroxide.
In connection with the study of the pollution of city. air, a further
study was made on the amount of lead dust and fumes normally
present in the air. Lead in amounts from 0.1 to 0.13 milligram per
10 cubic meters of air was found present in industrial establishments.
On congested street intersections the average amount found was 0.09
milligram. During the year a study was begun to determine the
effect of the dust of anthracite-coal mines on the health of workers.
This study is being made in the hard-coal fields of Pennsylvania and
was undertaken at the request of the Governor of that State and has
met with the hearty approval of the hard-coal operators and labor
unions. The study of the frequency of sickness among industrial
employees was continued for the twelfth consecutive year.
Milk sanitation investigations included studies to determine the
necessary specifications for pasteurization machinery to insure that
any given trme and temperature combination will be properly applied
in practice; the bactericidal treatment of milk con tamers and equipmtmt; and the proper treatment of udders prior to milking. In
addition, the personnel have rendered advisory assistance upon
request to State and city health departments in connection with the
enforcement of the Public Health Service milk ordinance.
In order to evaluate prevailing public health practices, it was deemed
necessary to study a group of individuals receiving one or more of
the various services supplied by local health departments. Such a
study was inaugurated in Brunswick and Greensville Counties, Va.,
and is being extended to other counties in order to observe the work
of small county health departments. The results of these investigations will be furnished to local health departments for their guidance.
In addition, general consultation service is being rendered to State
and local health departments upon request.
In an effort to determine the effect of the depression upon health,
information was collected on sickness and mortality in a group of
unemployed families. A 4-year family income history !l.Ild a 3-month
illness record were obtained by Cd.nvass· of about 1,000 families in
each of 10 communities located in 8 large cities and 2 more or less
rural places. Preliminary analysis indicates higher sickness rates
among the poor, particularly in the case of the more serious illnesses
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that caused inability to work or that confined the patient to bed.
It also appears that those families who were moderately comfortable
in 1929 but who had been in poor circumstances for 2 to 3 years had
more sickness than ·those who had only recently become unemployed
and poor.
The final papers in the series reporting the results of the respiratory
studies have been published. These studies have added to the knowledge of the epidemiology of these diseases, including such facts as
the extent of illness from this cause, the age and other groups most
susceptible to attack and to serious complications when attacked.
Certain stream-pollut\On studies undert!tken during recent years
were concluded. These include experimental studies of water purification, the field study of the pollution and natural purification of
the Ohio River, and the experimental studies of the natural purification of polluted waters. With the termination of these studies, two
principal lines of research have been undertaken: (1) The elucidation
of natural reactions occurring during the process of oxidation of
organic matter in polluted streams, and (2) factors that interfere
with the efficient functioning of biological oxidation processes of
sewage treatment.
In the investigations on the relationship of rats and fleas to tyfhus
fever, a survey of the rodent population and a collection o rat
parasites was undertaken at Savannah, Ga. Coincident with this, a
record was kept of the occurrence of typhus in the human population
of that city, and records of the location where rats were trapped were
checked •with the location of cases of typhus.
Granular conjunctivitis has been studied in two series of monkeys.
In the one series the condition was induced by direct transfer of
secretions from trachomatous eyes and in the other by inoculation
from cultures of Bacterium granulosis. A vaccine made from Bacterium granulosis failed to protect the animals against either condition.
Tularaemia was reported by health officers from 39 States and the
District of Columbia during 1932, a total of 933 cases being reported
as compared with 675 for 1931.
Studies upon bacterial variants, or mutants, have been continued
and, as has been the experience of previous investigators, changes
have been produced in bacterial morpholo~ and behavior which art:
believed due to genuine mutations. Smee bacteriologists have
rejected the claims to production of genuine mutants on the ground
that the experiments have never completely excluded the possibility
of contaminations, the chief effort during the year has been towarcl
the development of a technique which excludes contaminating
organisms and at the same time provides an opportunity for the
study of causes of variants and mutants among bacterial species.
The grouping of 240 hemolytic streptococci from a great varietyof disease sources from many parts of the world, according to sensitiveness to three races of bacteriophage, gives promise that relation- •
ships may be revealed which may be useful in tracing the source of
epidemics.
A provisional unit for determining the potency of Vibrion septiq_ue
• antitoxin was established which is somewhat larger than the umts
proposed by Great Britain, France, and the Argentine Republic, but
1t is hoped that agreement will be reached among the various countries
looking to the establishment of an international standard.
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PUBLIC HEALTH SERVICE
A practice.I method for the manufacture of e. scarlet-fever prophyb.ctic (streptococcus toxoid) has been completed. Sufficient toxo1d
may be given in 3 doses to induce immunity in over 80 percent
of those tested.
Studies with alum-precipitated diphtheria. toxoid he.ve shown that
1 dose of 1 cc is at least as effective as 2 doses of 1 cc each of
original unmodified toxoid.
In studies of meningococcic meningitis, emphasis he.s been placed
on the production of meningitis experimentally in animals, chiefly
with the object of finding e. method of testing therapeutic sere. better
than any method now available.
The rate of hydrolysis e.nd the disintegration products of the phosphoric e.nd phosphorous ester under certain conditions in vitro have
been studied in relation to their phe.rmacolo~c action. This investigation disclosed a funde.mente.l difference m the hydrolysis of the
esters in aqueous e.nd alcoholic systems. Besides suggesting a.
probable mechanism for the peculiar action of some of the esters in
the animal body, these observations e.lso indicate a. chemical method
for the quantitative estimation of certain of the phosphoric esters in
animal tissues.
Continued sugar researches he.ve yielded date. of value in the study
of the physiological chemistry of the sugars e.nd have led to the
discovery of new sugar derivatives and the development of methods
for their isolation in pure condition.
THE MARINE HOSPITALS AND OTHER RELIEF STATIONS
Hospital and out-patient co.re was furnished to American seamen
and other legal beneficiaries in 154 ports, 302,478 accredited persons
applying for treatment or other medical service. The Coast Gue.rd,
for whose personnel of 13,181 the Public Health Service has sole medico.I responsibility, was served at the regular relief stations and 102
other places; 23 medical and dental officers were also assigned to
Coe.st Guard ships and shore stations. The usual assistance was
~ven to the Employees' Compensation Commission in treating
mjured Federal employees, to the Civil Service Commission in
examining applicants and employees, and to the other Government
agencies that utilize Public Health Service facilities. The number of
patients at the National Leper Home increased to 370.
Treatment of ex-service men and women, a major function from
1919 to 1922 when the Public Health Service performed more than
80 percent of that work, has been continued wherever required by
the Administrator of Veterans' Affairs. From 1923 to 1933, mclusive,
66,551 veterans received an aggregate of nearly 2,000,000 days in
marine hospitals in addition to out-patient treatment and physical
examinations. Because of recent legislation and a change of policy,
the care of veterans has now become of minor importance; only 37
• such patients remained in the marine hospitals on June 30. ·
PREVENTION AND CONTROL OF VENEREAL DISEASES
During the fiscal year the work relating to the venereal diseases
has continued with satisfactory progress. In general, the activities
may be said to em.brace research, cooperative, informative, and
preventive work.
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PUBLIC HEALTH SERVICE
Research experiments in the laboratory have been carried on in the
field of personal prophylaxis, the study of the carrier problem in
syphilis has been furthered, and an endeavor has been made to explain
certain peculiar phenomena in experimental syphilis on the basis of a
life cycle of the Spirocheta pallida. Clinically, a study of the late
effects of untreated syphilis in the Negro was instituted during which
it was necessary, in order to uncover the cases desired for the study,
to make a serological survey of 4,025 Negroes of the far South. Of
the 4,025 Negroes, 907, or 22 percent, gave a definite positive test
for syphilis on 2 occasions. Four hundred Negro males past the
age of 25 were obtained in this group and subjected to a thorough
physical and roentgenological examination. A very cursory analysis
of the records indicates that involvement of the cardiovascular
system of the Negro in the syphilitic process offers a very serious
problem.
·
The 1-day census method of obtaining a report of all cases of
venereal diseases under treatment has also been continued and the
prevalence established in 1 county including a fairly large city.
The results of such surveys in two other localities have been published.
The trend of the venereal diseases as ascertained by resurveys made
in 16 communities last year was also the subject of a scientific paper.
Fort;y-seven States reported 386,597 cases of the venereal diseases
to the Public Health Service during the year. Continued assistance
was extended to several States in the development of State venereal
disease programs or in furthering this work within their boundaries.
The distribution of educational pamphlets to the public and of
informative reprints and other publications to physicans has been
curtailed to some extent owing to limited funds; but, in spite of this,
85,203 pamphlets were distributed to State boards and departments
of health and to private individuals. Publication of the monthly
abstract journal, "Venereal Disease Information", was also continued.
The work of the Public Health Service Clinic at Hot Springs, Ark.,
was conducted as in the past, and the limited personnel made a
remarkable showing in its capacity for efficiently handling a very
large group of patients. The educational work, both in connection
with the extending of post-graduate courses to J?hysicians, and the
preparation of scientific papers also constituted an unportant function.
NARCOTIC FARMS AND MEDICAL AND PSYCHIATRIC CARE OF
FEDERAL PRISONERS
The collection of data dealing with the medico-social aspects of
drua: addiction was continued during the fiscal rear. A further
analysis was made of the legal distribution of narcotic drugs throu~hout the United States in connection with the studies of the abusive
use of such drugs and of the quantities necessary for supplying the
medical and scientific needs of the country. Studies of the nature of
drug addiction and methods of treatment were also continued.
Construction of the superstructure on the first United States
Narcotic Farm, near Lexington, Ky., was begun on March 25, 1933.
On May 26, 1933, title was acquired to the property selected as the
site for the second United States Narcotic Farm at Fort Worth, Tex.
The Public Health Service continued to supervise and furnish the
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PUBLIC HEALTH SERVICE
tional institutions under the control of the Department of Justice.
Five new institutions were brought within the scope of these activities
during the past fiscal year, making a total of 15 medical units operated
by the Public Health Service at Federal penal and correctional
institutions at the closs of the fiscal year.
COOPERATION WITH OTHER AGENCIES
During the fiscal year the Public Health Service continued its
cooperative activities with official and unofficial organizations in
matters pertaining to the public health. A number of these cooperative activities are required by law and the remainder are deemed
essential in the interests of economical and efficient administration.
By means of this cooperation, similar or related activities a.re coordinated and duplication of effort is avoided. The cooperative
activities during the past fiscal year have been, in general, similar to
those of the preceding 5 or 6 years.
The Public Health Service desires to acknowledge assistance of the
following:
The Department of Health of Puerto Rico for the use of its laboratories; the New York State Institute for the Study of Malignant
Diseases, for the care and study of cases of suspected cancer; Harvard
University Medical School, for furnishing laboratory space for field
investigations of cancer; Roscoe B. Jackson Memorial Laboratory,
Bar Harbor, Maine, and Mount Desert Island Biological Laboratory,
Salisbury Cove, Mount Desert Island, Maine, in cancer research;
Milledgeville State Hospital, Milledgeville, Ga., in the conduct of
pellagra studies; University of Minnesota Medical School, in experimental studies of the occurrence of Rocky Mountain spotted fever in
nature; Johns Hopkins Hospital and the Baltimore Social Service
Exchange, in a study of the mental status of children of various types
of birth; Milbank Memorial Fund, in the collection and analysis of
statistical data with reference to specific health problems; State
Hospital, Columbia, S.C., by furnishing laboratory space for studies
of malarial inoculation in paresis therapy; the State Boards of Health
of Florida, Wisconsin, Michigan; the State laboratories of North
Carolina and Maryland and the University of Kentucky, for Wassermann tests; Health Department of Pasadena, Calif., in furnishing a
laboratory building for field investigations of psittacosis; District of
Columbia Departments of Health and Education, in the studies of
hearing and vision of school children and the District Health Department in connection with an epideiniological study of rheumatic heart
disease; hospitals, clinics, and other institutions in the District of
Columbia, in connection with the clinical investigations of rheumatic
heart disease; Tennessee Academy of Science, for furnishing quarters
for studies of mosquito control.
NEW ADMINISTRATION BUILDING
The new administration building of ·the Public Health Service at
Constitution Avenue and Nineteenth Street NW. was occupied
during the fiscal year. The actual moving into the new building
occurred during the period May 11 to May 16, 1933 .. From the
establishment of the Service (then called Marine Hospital Service)
'l July 16, 1798, to 1870 the affairs of the Public Health Service
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PUBLIC HEALTH SERVICE
were conducted by a clerk in the Treasury Department. Effective
August 1, 1870, the Service was organized in accordance with the
act approved June 29, 1870. It appears that it continued to be
located in the Treasury Department Building until 1876, when it
was moved to 1419-21 G Street NW. That location was occupied
until July 1888, when transfer was made to 1306-8 F Street NW.
This location was vacated and the Public Health Service was transferred to the Butler Building, 3 B Street SE., June 11, 1891. The
Butler Building was vacated on April 19, 1929. During the World
War and immediately following, when the burden of the medical
-care of ex-service men and women was placed upon the Public Health
Service, it became necessary to expand to meet this emergency.
Accordingly, the larger divisions were transferred to Temporary
Building C at 16 Seventh Street SW. For approximately 10 years
the Surgeon General spent half a day at the Butler Building and the
remainder at C Building. With the demolition of the Butler
Buildin~, to make way for the new House Office Building Annex,
all divis10ns of the Public Health Service were moved, in April 1929,
to Temporary Building C. The completion of the new administration building for the Public Health Service and its occupancy mark
another important milestone in housing the administrative headquarters of the Service.
RECOMMENDATIONS
The prevention of disease and the. promotion of public health are of
vital importance to the Nation. Recommendations as to methods of
improving the public health in the most economical and efficient
manner are necessary from time to time.
New problems in the field of public health are constantly arising.
As recent examples may be mentioned the outbreak of epidermc
-encephalitis in St. Louis, the identification of Rocky Mountain spotted
fever of the eastern type, along the Atlantic seaboard of the United
States, and the recognition of parrot fever, or psittacosis, as an endemic disease among birds of the parrot family in certain sections of
the Pacific coast. Constant efforts are required for the detection
and prevention of new dangers to the public health that arise from
time to time.
The recommendations submitted herewith constitute the most
important needs at the present time.
SCIENTIFIC RESEARCH
One of the most important functions of the Federal Government
in connection with public health is the conduct of scientific investigations for the purpose of devising new methods for preventing disease
and ascertaining the importance and extent of new problems as
they arise.
In connection with the present program of economy, it has been
necessary materially to curtail a number of studies that could be
profitably pursued and which are of great public-health importance.
No field of public-health research is without important problems, but
in some fields there is a more pressing need to extend the work now
under investigation. It is hoped that the research activities of the
Public Health Service may be restored to normal as rapidly as the
financial policy of the Federal Government will permit.
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PUBLIC HEALTH SERVICE
STATE AND LOCAL HEALTH WORK
The lack of effective local health organization in most rural areas
and in many of the smaller cities is a serious handicap to the application of public-health measures. This difficulty is encountered repeatedly when attempting to prevent the spread of epidemic diseases
between the States. For a number of years, therefore, the Public
Health Service has worked with the States in building up local health
organizations in the rural areas, particularly where the need is greatest.
Owing to limitation in funds and personnel, this work has been confined for the most part to local studies and demonstrations. The
time has arrived when the Public Health Service should enter into
cooperation with States for the support of local health organizations
on a more substantial basis than has obtained in the past as a part
of the national defense against disease.
MARITIME QUARANTINE
The ratification by the United States, as soon as practicable, of
the International Sanitary Convention for Air Navigation, with
certain minor reservations, is recommended. This convention will
not only facilitate the observation of measures for the protection of
the United States against the introduction of quarantinable diseases
through air commerce originating in infected foreign ports, but it
will also assist in the prevention of the international dissemination
of the infection of such diseases from infected areas throughout the
world, which ultimately serves to reduce the exposure of the United
States as well as other noninfected countries to possible infection.
In addition, the convention would permit the imposition of only
necessary coordinated and uniform restrictions in the various countries, and this would serve to promote international air commerce, in
the extension of which American companies are actively engaged.
MARINE HOSPITALS
Appropriations in normal amounts should be restored to enable
the marine hospitals and other relief stations to function without
degrading the standards of medical care or repudiating legal obligations. The building program should be completed.
PERSONNEL
The reduction of personnel because of the economy requirements
has produced an acute shortage of medical officers, particularly in the
commissioned corps. It has been difficult to meet emergencies such
as the outbreak of epidemic encephalitis in St. Louis and the mobilization of Coast Guard destroyers in and around Cuba. These two
emergencies, which occurred simultaneously, necessitated the withdrawal of more than 20 commissioned medical officers from other
important work. The opening of new units of Federal penal and
correctional institutions renders necessary the replacement of commissioned officers who have been placed upon the retired list. It is
essential to the proper maintenance and development of the commissioned corps that a certain number of officers be admitted in the
grade of assistant surgeon each year.
H. s. CUMMING,
Surgeon General.
Hon. WILLIAM H. Woonrn,
Secretary of the Treasury.
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DIVISION OF SCIENTIFIC RESEARCH
In charge of AS6t. Surg. Gen. L. R.
THOMPSON
CANCER
The work conducted under the direction of Med. Dir. J. W. Schereschewsky at the office of Field Investigations of Cancer, located at the
Harvard Medical School, Boston, Mass., during the past fiscal year
was _a con~uation of the. pro~ram of the p_!eceding y~ar. Tl3;ese
studies have mcluded the biological ·act10n of X-rays, studies of rmtogenetic radiation and the biological effects of electromagnetic radiation. Reports on the latter two subjects have been prepared and are
now in press.
STUDIES OF RESISTANCE TO MALIGNANT GROWTHS
The study of the general problem of immune reactions to malignant
growths was continued by Biologist H. B. Andervont.
Cross immunity studies.-The extent to which immunity against
one type of transplantable tumor might induce resistance agamst other
types was further studied in stock animals durin~ the year.
The results obtained in a large number of expenments may be summarized as follows: Immunity following tail moculation may be induced by carcinomas 206 and 11 and sarcomas 37 and 180, resl?ectively. Induced resistance to sarcoma 180 is likewise effective agamst
carcinomas 206, 11, and 63. However, immunity induced against
these three carcinomas is not effective against sarcoma 180. Neither
sarcoma 37 nor sarcoma 180 produce immunity against each other.
It was found that the duration of immunity against sarcoma 180 was
at least 10 months.
Ejfect of immunity against a transpl,antable tumor upon the subsequent development of spontaneous tumor.-Through the kind cooperation of Dr. C. C. Little, Director of the Roscoe B. Jackson Memorial
Laboratory, Bar Harbor, Maine, arrangements were made for
Biologist Andervont to test the various strains of mice at that institution known to have a high spontaneous tumor rate for their ability
to become immunized through the method of tail inoculations to
mouse sarcoma 180. An effort to immunize mice against transplants
of spontaneous tumors originating in a number of their particular
strain by means of induced resistance to sarcoma 180 failed because
resistance to sarcoma 180 could not be established in these high-tumor
strains.
Cooperative work at the Roscoe B. Jackson Memorial Laboratory.The results of preliminary work conducted at Bar Harbor by Biolo~ist
Andervont made it desirable to explore still further the relat10n
between the ability to acquire immunity to a transplantable tumor
and susceptibility to spontaneous tumors. Dr. John J. Bittner, of
the staff of the Laboratory, was appointed as special expert to carry
on this phase of the studies. Studies were simultaneously carried on
at Boston. This cooperative work is still in progress.
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PUBLIC HEALTH SERVICE
Effect of bacterial washings upon spontaneous tumors.-In the preceding annual report mention was made of the effects of the injection
of bacterial washings upon mouse sarcoma 180, as originally reported
upon the liposarcoma of guinea pigs by Gratia and Linz and upon
mouse sarcoma 180 by Shwartzman and Michallovsky. The injection of these washings produces hemorrhages in the tumor, and apparently in no other location. The intratumoral hemorrhages are
frequently followed by regression of the tumor. These results were
confirmed at this laboratory, so far as concerns sarcoma 180. The
injection of the bacterial washings was without effect upon the growth
of spontaneous tumors.
Effect of injections of trypan blue upon susceptibility to spontaneous
tumor transplants.-During the preceding year, it was noted that the
injection of trypan blue prevented mice from becoming resistant to
mouse sarcoma 180 and, further, that the injection of resistant mice
with this material "broke down" an established immunity so that
they became susceptible once more to inoculation with the sarcoma.
In pure strains of mice exhibiting a high spontaneous tumor rate,
transplants of a spontaneous tumor arisin~ in a member of the strain
will, when transplanted, "take" in pract1cally all other members of
the strain. Inoculations from the tumor, however, are negative when
attempted upon the members of another strain, provided the strain
be pure. This resistance to the transplantation of fragments of spontaneous tumor from an alien strain disappeared with the use of trypa.n
blue.
Studies with pure strain mice from the Roscoe B. Jackson Memorial,
Laboratory.-In investigations to determine whether other strains of
transplantable tumor propagated at this laboratory were capable o.f
inducing resistance in these mice, it was found that sarcoma 37 immunizes two strains of spontaneous tumor-bearing mice which cannot
be immunized to mouse sarcoma 180. It was also found that carcinoma 63 induces immunity in several strains of these mice. This
tumor, in the past, has been generally regarded as a nonimmunizing,
transplantable neoplasm. The fact that concomitant immunity can
be established in several pure strains of mice exhibiting a high spontaneous tumor rate emphasizes the importance of taking both the
strain and the tumor into consideration when experiments dealing
with immunity to transplantable growths are undertaken.
BIOCHEMICAL STUDIES
Effects of calcium salts on tumor growth.-More than 1,200 tumorbearing mice were employed in this study; a number of calcium salts,
including the lactate and gluconate, were administered in the diet
and drink. The results were essentially negative.
Determination of the calcium ion concentration of the blood.-In the
parallel investigation of the effects of calcium salts on tumor growth,
essentially negative results were obtained. Further study on the
determination of the calcium ion concentration of the blood, begun in
the previous fiscal year, was discontinued.
.
Studies of fluid exchange in malignant tissue.-In continuing studies
begun at the end of the preceding fiscal year, on the relation of tumor
growth to certain basic physicochemical processes of the cell, the
phenomena of cell permeability, inhibition, and reactions of the cellwall to surrounding media of various composition are being investi-
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PUBLIC HEALTH' SERVICE
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gated in vitro. One phase of these investigations, bearing upon the
swelling of tumor cells in vitro in various types of solutions, carried
on in collaboration with Cytologist L. C. Fogg, has been completed
and a report is being prepared for publication.
CYTOLOGICAL STUDIES
The first part of the fiscal year was spent by Cytologist L. C. Fogg
in the development and organization of a cytological laboratory which
could be adapted to two distinct lines of work, namely, to experimental
tissue culture, and to general cytology. This laboratory has now been
organized.
Tissue culture work.-Both normal and malignant cells have been
grown and observed under conditions that varied as to pH, modifications of the media, heterologous media, types of food, and other
changing conditions. The use of vital strains aided in these observations. Attention was given to comparative growth rates, changes in
cell volume, and to intracellular characteristics such as the chromosomes, the nucleoli, the central area (centrosphere), mito-chondria,
Golgi bodies, plastids, vacuoles, and cell membranes.
Studies of proteolysis.-The phenomenon of fibrolysis observed in
cell cultures has been studied during the year, especially with respect
to its variation according to the media, the type of tissue, and when
cells are associated in the culture with other tissue cells. The investigation of methods for inhibiting the lysis without changing the growth
rate is also being carried out.
In the course of these studies the observation was made that culture
medium, which had been liquefied by tumor cells, acts in manner similar
to the action of tumor extracts. As is well known, these act as accelerators to the growth of normal cells in tissue cultures in the same
manner as do the extracts of embryonic tissue which are used regularly for this purpose. Although tumor cells will not grow in it, lysed
plasma acts as an accelerator to the growth of normal cells when added
to the culture medium.
Water equuibria of cells.-In collaboration with Biochemist Shear,
and using the hanging drop technique, direct observations on the water
eqwlibria of various types of cell were made during the year. These
data have yielded a considerable body of interesting results which
are being prepared for publication.
HEART DISEASE
Investigations of heart disease have been continued under the
direction of Medical Director A. M. Stimson. Study has been confined almost exclusively to the subject of rheumatic heart disease.
On account of the strong probability suggested by epidemiological
studies that some particular environmental factor was responsible at
least for predisposition to rheumatic fever, and further, that some
nutritional deficiency would seem the most likely one, a series of dogs
was kept on a vitamin A deficient diet and then inoculated with
streptococci isolated from rheumatic fever cases. These organisms
were also inoculated into monkeys, rabbits, and mice.
Blood specimens for culture were secured from over a hundred
patients, includin~ those suffering from rheumatic· fever and active
rheumatic heart disease, and others taken for control purposes. From
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PUBLIC HEALTH SERVICE
some patients a number of specimens were taken at various times.
Certain of the organisms thus obtained were inoculated into some 50
dogs and 40 monkeys. A larger number of rabbits and mice were
employed.
As a result of these experiments it can be said only that, while the
organisms to which these animals were exposed showed a tendency to
produce lesions in the heart and joints, this tendency was by no
means uniform, and the lesions were not of a type corresponding to
those of rheumatic fever in human beings.
The epidemiological observations were made for the purpose of
estimating the prevalence and distribution of rheumatic heart disease
in Washington and endeavoring to detect any environmental or other
factors which might have a bearing on the etiology of the disease.
The evidence collected to date tends to confirm the observation of
others that rheumatic fever is predominatingly a disease of the lower
economic groups. On the other hand, the evidence secured from
institutions for children in Washington indicates that this disease
is very rarely observed among the inmates, who are nevertheless
recruited from amon~ the lower economic classes,
The following articles were prepared for publication during the
vear: Observations on Vitamin A Deficiency in Dogs (Pub. Health
Rept., Apr. 28, 1933); The Present Conception of the Etiology of
Rheumatic Fever (accepted for publication in the Annals of the
District of Columbia Medical Association); Heart Disease in Marine
Hospitals (Pub. Health Rept., May 26, 1933); A Form of Experimental Endocarditis Produced in Rabbits. (In press.)
,
LEPROSY
Studies at the Leprosy Investigation Station, Honolulu, Hawaii
and the providing of medical relief for patients of the adjoining Territorial Receiving Station and Hospital, have been under the direction
of Surg. N. E. W ayiilOn.
Clinical studies.-An effort has been made to learn the early manifestations of leprosy by an examination of approximately 100 children
who are the sons and daughters of leprous parents and who are confined to institutions in Honolulu. The results will not justify deductions concerning the relation of the period of contact of the child and
leprous parent and a subsequent development of leprosy in the child.
A comparison of the beneficial effects to be obtained by the destruction of individual lesions through the application of carbon-dioxide
snow or the intradermal injection of an irritant oil, such as that of
iodized chaulmoogra esters, has been carried on throughout the year.
There appears to be no material difference in the end results obtained
by these two methods.
During the latter part of the year observations were made, and are
being continued, of the effect of administering 3 to 5 grains of the
iodides daily to a selected group of J;>atients. It is hoped that a
method of therapy may be evolved which will be of value.
A test has been made of 50 patients with extracts and refined
proteids from tubercule bacilli ana other acid-fast bacteria, including
an extract of one grown from a leprous nodule. The reactions to the
intra.dermal injections in these patients of over 15 years of age seem
definitely more indicative of the presence of clinical tuberculosis than
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obtains among persons of similar ages in Honolulu and in continental
United States.
Experimental investigations.-Experiments were continued during
the first half of the year to cultivate the bacilli of human leprosy and
of rat leprosy. The methods used were confined largely to media
composed of chick embroyo, the embryonic juice of chicks, and
Tyrode solution. Numerous successive transfers were accomplished
by this method. However, the inoculation of rats with the acid-fast
bacteria grown in these cultures from rat leprosy did not result in
the production of the disease. The subcutaneous injection of rats
• with these organisms was followed in a few instances by the development of a small granuloma which subsequently healed.
Investigations of the effects of diet on the course of rat leprosy,
which were in process during the preceding year, were contmued.
While some of the results were striking, there did not seem to be a
consistency in the various experiments and in the different groups of
animals which wo11ld justify a final conclusion that the development
of rat leprosy was affected by the dietary under the circumstances of
these tests.
Inoculations of white mice with rat leprosy· have been successfully
accomplished, and the disease has been reproduced by transfer from
mouse to mouse as far as the third transfer. The disease in the mouse
resembles that" in the rat very closely. Some comparisons are being
made of infections of mice by inoculation with the bacteria of avian
tuberculosis and with material from lesions of rat leprosy.
The intranasal instillation into rats of material of rat leprosy has
resulted, in some instances, in the production in the lymph nodes of
lesions histologically characteristic of those found in rat leprosy.
This finding is considered of significance in the interpretation of a
probable route of introduction of rat leprosy into the animal under
natural conditions, though the development of cutaneous lesions,
successive to this manner of inoculation, has not yet been observed
in areas remote from these nodes.
MALARIA
Investigations of malaria continued under the direction of Surg.
L. L. Willia.ms, Jr.
Paris green studies.-The IO-day interval dusting study carried on
in Dougherty County, Ga., under the direction of Surg. T. H. D.
Griffitts has been completed. This 4-year study has demonstrated
that a 10-da:y interval of paris green dusting almost completely controls the incidence of Anopheles quadrimaculatus when applied on a
county-wide basis by a county organization and is within the economic ability of an average southern county. It is believed that the
21-day interval dusting study, which has been in progress for 4 years,
has definitely shown that this interval between applications of paris
green is insufficient to control malaria in the average climate of the
Mississippi Valley. Although the result insofar as regards malaria
control was negative, valuable information was gathered concerning
the effectiveness of various types and methods of paris green distribution and unit costs.
Plasmochin studies.-During the preceding year San. Eng. W. H. W.
Komp inaugurated in Panama, m cooperation with the Gorgas
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PUBLIC HEALTH SERVICE
Memorial Laboratory, studies on the effect of plasmochin as a drugmethod in the control of malaria. This study was completed during
the year. Although there was a reasonable reduction in the infective
rate among the mosquitoes, 12 months of observation, with a blood
index each month, showed practically the same fluctuation in the
malaria rate in the villages where plasmochin was administered as
occurred in the villages where quinine only was administered. The
report is being published in a Gorgas Memorial Laboratory bulletin.
Atabrine studies.-Preliminary studies with atabrine were commenced last year. Mr. Komp, at the Gorgas Memorial Laboratory
in Panama, and Dr. Bruce Mayne, at the State Hospital in Columbia, ·
S.C., have checked the effect of atabrine in doses of I½ grains three
times a day for 5 days on the clinical course of acute malaria of all
three types (P. malariae, vivax, and falciparum). Their experience
is that atabrine controls the acute attack as effectively as quinine,
and apparently _does so a little more quickly and without the usual
quinine discomfort to the patient. In addition, Mr. Komp commenced an extensive field experiment in five new villages on the
Chagres River in Panama, with a total population of approximately
500, to determine whether wholesale treatment with atabrine in an
infected population would control the rate of malarial infection.
This study will be continued.
Malarial inoculation in paresis therapy.-ln cooperation with the
State Hospital for the Insane at Columbia, S.C., Dr. Mayne has
established strains of benign tertian, of quartan, and a relatively
mild strain of estivo-autumnal malaria. He has experimented extensively with shipments of blood and live mos~mtoes and with
sporozoite material dissected from infected anophelines.
Florida study.-Surg. T. H. D. Griffitts has established headquarters at Jacksonville, Fla., to cooperate with the State health department for malaria control through county health departments. Malaria control will be inaugurated only at the most heavily infected
foci. The effect on the malaria rate of the county as a whole and
the effect on the rate at the lesser infected foci will be studied as the
heavy foci of infection are eliminated.
Tennessee study.-At Reelfoot Lake in west Tennessee, Senior San.
Eng. J. A. Le Prince and Passed Asst. San. Eng. H. A. Johnson
have set up equipment and traps to test various methods of attracting
Anopheles to their destruction. The effects of size, shape, and location of traps and of various smells, colors, and sound are under study.
Studies of salt-marsh mosquito control.--Surveys of breeding areas
of salt marsh mosquitoes and methods for control of production have
been made under technical assistant in sanitary engineering C. T.
Carnahan, in the areas about Norfolk, Va., in approximately half of
the coastal section of North Carolina, and on the Gulf Coast in the
regions around Galveston and Port Arthur, Tex. Through the
headquarters office, assistance was given to similar surveys made in
Maryland and Delaware.
Studies of airplane convection of mosquitoes.-Studies were continued, in cooperation with the Division of Foreign Quarantine, of the
convection of Aedes aegypti by means of airplanes from possibly infected territory to the southern part of this country and the possibility of the introduction of new species of mosquitoes. No mosquitoos arrived alive at any of our airports when a plane, including those
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PUBLIC HEALTH SERVICE
23
known to be loaded with live mosquitoes, had been sprayed during
the flight with an oil extract of pyrethrum flowers.
Microscopic examinations.--Of 18,000 thick-film slides examined
during the year from 13 counties in Florida, Georgia, and Tennessee,
6.68 percent were found positive.
NUTRITIONAL DISEASES
The nutrition studies under the direction of Surg. G. A. Wheeler,
as in the past, have been primarily concerned with the determination
of the pellagra-preventive value of various foodstuffs. The work at
the Milled~eville State Hospital, Milledgeville, Ga., has been under
the immediate supervision of Asst. Surg. D. J. Hunt.
The results of the study of the pellagra-preventive value of collards,
greens, cabbage, mustard greens, and kale were submitted for publication. All of these vegetables may be considered as very practicable
contributory sources of the pellagra-preventive factor. A special report was made of the tests of autoclaved yeast, haddock, and English
peas (Pub. Health Rept., Jan. 20, 1933). The autoclaved yeast and
English peas are satisfactory sources of the preventive factor, while
the haddock contains a relatively small amount. Tests of onions,
lettuce, lean smoked pork shoulder, and peanut meal are now in
pr<>gress.
The studies at the National Institute of Health were continued
under the immediate supervision of Surgeon Wheeler, with the
assistance of Passed Asst. Surg. W. H. Sebrell.
The laboratory studies have been for the most part concerned with
the determination of the probable pellagra-preventive value of various
foods by tests in the dog correlated with the human tests.
The results of tests in the dog of a number of foods have been
submitted for publication. Canned corned beef, canned evaporated
milk, canned turnip greens, and peanut meal showed satisfactory
preventive value. Canned spinach, canned mustard greens, red
kidney beans, and collards showed some degree of protection, but
were less satisfactory. The Irish potatoes and sweetpotatoes, rolled
oats, rye meal, onions, evaporated apples, and navy beans showed
no appreciable preventive value.
The tests in the dog of canned chicken and prunes were completed,
with the indication that chicken contains a sufficient amount of the
blacktongue-preventive factor fully to protect against the disease,
while prunes have little or no preventive value.
Tests in the dog of the following foods are still in progress at the
end of the fiscal year: Cottonseed meal, evaporated peaches, meat
of the domestic rabbit, and lean smoked pork.
The study of the effects of a deficiency of chlorides on the red
blood cells and hemoglobin of dogs is in progress at the close of the
year.
Attempts to develop a satisfactory method of evaluating the
potency of concentrates of the pellagra-preventive factor, using the
albino rat, were continued, and several crude yeast fractions were
given a preliminary test.
The manuscript of the study of y-ellow liver (fatty infiltration) in
dogs was submitted for publicat10n. The results of this study
indicated that the condition is due either to a deficiency of vitamin G
or some closely related food factor.
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PUBLIC HEALTH SERVICE
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PLAGUE
The study of the epidemiology of plague and measures for its control
in the Hawaiian Islands, begun last year in cooperation with the
Territorial health authorities, has been continued under the direction
_
of Surg. C.R. Eskey.
In the two rural districts of Hamakua, Hawaii, and Makwao, Maui,
the infection has shown considerable activity. During the interval
from November 14, 1932, to February 3, 1933, 21 plague-infected
rats were found on a lar~e plantation in Hamakua. There were only
two human cases associated with the rat epizootic, the last being
reported February 6, 1933. There were three human cases on
Maui; the latest occurred September 18, 1932. Eight plague-infected
rats were discovered in the Makawao district, the latest on January 25,
1932.
In the two regions where plague now exists in the Hawaiian Islands.
it is endemic among field rats. Therefore, the intensive and constant
distribution of poison appears to be the only measure which may
eventually reduce the rat population of the fields to a point where
plague may be adequately controlled.
The investigation of the flea infestation of rats in and near communities where plague has occurred or is now present in the Hawaiian
Islands ended the latter part of March 1933. Nearly 60,000 fleas,
collected from 19,755 rats, were classified. Twenty percent of the
rats were Rattus hawaiiensis, which was formerly believed to be nearly
extinct.
The unknown member of the Xenopsylla family, whose presence
was noted last year, was identified as a new species by Dr. Karl
Jordan and named Xenopsylla hawaiiensis. This is evidently the
plague-transmitting agent responsible for the existence of the endemic
type of rural infection found in the Hawaiian Islands.
Xenopsylla cheopis were encountered in all regions where plague has
existed, but they were found in large numbers only on rats caught
inside or near buildings. They were as rare on field rats as X.
hawaiiensis were on building rats. In the vicinities of Honolulu and
Hilo, where plague formerly existed but disappeared in a few years
without endemic foci being established, X. cheopis were very prevalent,
while X. hawaiiensis were rarely found.
PSITTACOSIS
In October 1932, research activities on psittacosis were resumed by
the United States Public Health Service under the direction of Senior
Surg. H. E. Hasseltine. A well-equipped laboratory building was
made available for this purpose by the Pasadena (Calif.) Department
of Health, which also cooperated in every way to further the work.
Actual operations were started on December 20, 1932. During the
remainder of the fiscal year, 464 psittacine birds were autopsied for
psittacosis. There were 37 cases of human psittacosis, with 9 deaths,
reported in the United States during the fiscal year.
RocKY MouNTAIN SPOTTED FEVER
The study of Rocky Mountain spotted fever and other tick-borne
diseases of the western United States being conducted at the Hamilton
(Mont.) field station is under the direction of Special Expert R. R.
Parker.
·
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PUBLIC HEALTH SERVICE
The construction of the addition to this laboratory, authorized by
the Seventy-first Congress, was begun in April. The additional
space thus to be provided is badly needed to accommodate in part
the rapidly expanding activities of the station.
Vaccine.-A total of 205 liters of the Public Health Service vaccine
for the prevention of Rocky Mountain spotted fever was manufactured
for the season of 1933. Of this supply, 125 liters were suitable for use,
an increase of 52 liters, or approximately 75 percent, over the net
supply for 1932. The net amount produced has been increased 3,600
percent since 1926, the first year in which distribution was attempted.
The demand for this vaccme continues to increase. The entire net
output of about 125 liters for 1933 had been distributed before the
end of the fiscal year. As usual, the heaviest call has been from the
Rocky Mountain States where, for epidemiological reasons, it can be
used to the greatest advantage. · The two local areas of greatest
demand are the Bitterroot Valley section of western Montana and
Harney County, Oreg. This is the first year that there has been any
considerable demand from the areas in the eastern States in which
the disease is endemic.
Experimental studies.--Studies of the occurrence of spotted fever
virus in the rabbit tick (Haemaphysalis leporis-palustris) in Minnesota, in conjunction with Dr. R. G. Green of the University of Minne.sota Medical School, were continued during the summer of 1932.
Added evidence was secured of the wide-spread occurrence of a very
mild type of apparent spotted fever virus in the species of tick
concerned.
Further observations of the agglutination of proteus X organisms by
spotted fever sera have been made by Bacteriologist Gordon E. Davis.
The resulting data indicate that agglutinins are seldom present in
sufficient titer to be of diagnostic value before the tenth day of illness,
and in a considerable percentage the highest agglutinin titer is present
in sera secured during early convalescence. In some cases agglutinins
for the several strains of proteus X used as antigen are never present
in the blood in sufficient titer to be of diagnostic value. In many
such cases, however, blood samples taken late in the acute course or
during early convalescence show a broadened affinity for proteus X
strains. It is possible that this phenomenon is of diagnostic
significance.
Studies are being made for the purpose of determining the immunological relationships between Rocky Mountain spotted fever and
typhus-like diseases. Evidence that there is an actual identity
between the exanthematic typhus of Sao Paulo, Brazil, and spotted
fever has been secured.
Organisms of undetermined pathogenic relationships have been
isolated from Dermacentor albipictus from diseased game animals in
Minnesota and from D. andersoni collected in sections in which heavy
losses of cattle have been attributed to this tick.
During the spring of 1932, a domestic goat was hyperimmunized
against Rocky Mountain spotted fever by means of successively
increasing injections of highly potent tick virus. The antiserum of
this goat was found to have marked therapeutic value for laboratory
animals.
Mice have been believed to be nonsusceptible to Rocky Mountain
spotted fever. Experiments by Assistant Bacteriologist William L.
Jellison have proved the contrary in the case of mice belonging to the
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PUBLIC HEALTH SERVICE
genera Microtus and Peromyscus. Species of Microtus particularly
are highly susceptible. This observation is of importance inrelation
to the transmission of spotted fever by D. variabilis in sections east
of the Rocky Mountains.
Tick parasite studies.-The research studies relating to the possible
control of the Rocky Mountain s:potted fever tick D. andersoni by
means of parasites have been contmued under the immediate supervision of Entomologist R. A. Cooley. For several years millions of
parasites have been released during the late spring and early summer
on the assumption that it was necessary that they be liberated during
the period that the nymphal ticks were present in greatest abundance.
It has been ascertained, however, that under Rocky Mountain conditions it is doubtful that the developing parasite can successfully
pass the winter in engorged nymphal ticks, but that, on the other
hand, the parasites also attack "the engorging larvae and that the
eggs deposited within the latter remain latent in the resulting hibernating unfed nymph and do not develop until the nymphs ingest
blood the following spring. It appears likely that this phenomenon
of latency affords a natural means for carrying the parasite over the
winter. During the summer of 1932, therefore, parasites were released in various localities in western Montana; near Boise, Idaho; near
Burns, Oreg.; and in Conejos Canyon, Colo. Unfortunately, curtailment of funds during 1933 has made it impossible to check the results
of these releases except in western Montana. In this area, however,
very satisfactory findings have been made. The real test, however,
will be whether parasites can be recovered in 1934.
Epidemiology.-There has been a marked increase in the prevalence
of Rocky Mountain spotted fever in Wyoming during the spring of
1933. A less marked increase has occurred in California, Nevada,
Colorado, and Washington. Incidence has decreased in Montana,
Oregon, Idaho, Utah, and South Dakota. In all States except Colorado the case fatality rate has been slightly lower.
The 1933 cltse reports and late 1932 reports indicate new areas of
infection in the States of Montana, Colorado, Oregon, Washington,
Arizona, and New Mexico, and infection has been reported from
Iowa for the first time.
Additional evidence has been secured of the occurrence of second
infections.
TULARAEMIA
In connection with studies carried on by Bacteriologist Gordon E.
Davis, domestic rabbits have been found a useful adjunct to guinea
pigs for comparing the virulence of different strains of Bacterium
tularense.
..
The occurrence of very mild strains of Bact, tularense in nature has
been demonstrated.
The following experimental results in tularaemia transmission by
ticks and insects have been secured by Associate Entomologist C. B.
Philip:
The excreta of tularae.mia-infected ticks have been shown to retain
infectiousness for a period of 20. days.
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PUBLIC HEALTH SERVICE
CHILD HYGIENE INVESTIGATIONS
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The activities of the Office of Child Hygiene Investigations continued during the year under the direction· of Acting Asst. Surg. E.
Blanche Sterling.
STUDIES IN VISION, HEARING, PHYSICAL STATUS, GROWTH, AND DEVELOPMENT IN .
SCHOOL CHILDREN
Vision.-During the year tabulations of the data on the vision of
school children were completed. The purpose of this study is to
determine the changes, if any, in the eyes of rapidly ~rowing children
who are constantly subjectmg their eyes to more mtensive use as
school life progresses. The degree of change, its direction, and the
length of time apparently necessary to bring about a definite degree
of change have all been especially studied.
Hearing.-Steady progress during the fiscal year was made on
the intensive study of the hearing of school children. This investigation considers not only incidence and degree of hearing defects,
but possible causative factors which might furnish a basis for
determining preventive measures in relation to loss of hearing.
The physical status, growth, and development of school children.A study of the "Seasonal variation of average growth in weight of
elementary school children" (Pub. Health Rept., Mar. 3, 1933) was
completed and published.
Statistical analysis of weights of about 3,000 school children obtained
in May 1933, compared with the average weights for age and sex
obtained during the years 1923-28, is being made in an attempt to
determine the effect of the economic crisis upon the growth in weight
of school children.
THE MENTAL STATUS OF CHILDREN OF VARIOUS TYPES OF BIRTH
conl
This study involves for each child an investigation of the family
history, significant experiences, home environment, developmental
history, medical history, personality traits, behavior record, school
life experiences, and the obstetrical history of the mother. When
these factors are correlated with the type of birth, some light may be
shed on the effect of obstetrical procedures upon the mental status of
the child.
STUDIES IN DENTAL CARIES
Two studies relating to dental caries are now in progress. One
concerns the relationship, if any, of dental caries to diet and climate.
The data used in this study were obtained from oral examinations of
over 8,000 Indian school children living under varying climatic
conditions and Indian tribal habits. The second study relates to the
prevalence of dental decay among Negro and white children of the
same locality .
.MATERNAL, FETAL, AND NEONATAL MORTALITY AMONG INDIANS
In cooperation with the medical division of the Office of Indian
Affairs a study was made of 1,815 American Indian women receiving
obstetrical care in hospitals. (Pub. Health Rept., May 19, 1933.)
1M63-33--3
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MILK INVESTIGATIONS
The activities of this office were carried on under the direction of
Sanitary Engineer Leslie C. Frank.
The bactericidal treatment of milk containers and equipment.-The
thermal- and chlorine-resistance characteristics of the criterion
organism selected last year have been intensively studied in the
laboratory.
Thermal resistance of criterion orqanism.-The resistance of strain
11-B to heat has been detennined m two ways: In the first method
it was necessary to find the thermal death points (i.e., the minimum
time required to kill the most resistant individual at different temperatures) of approximately 200 to 500 organisms per cc in milk and
m water.
The thermal death points of strain 11-B in Inilk were found to
range from 50 minutes at 140° F. to 1.5 minutes at 160° F., and in
water from 15 minutes at 140° F. to 0.8 minute at 160° F. These figures
for strain 11-B compare with the following reported by Park for
B. tuberculosis in Inilk; 15 minutes at 140° F., and 0.4 minute at 160° F.
Strain 11-B in water is, therefore, a suitable criterion of heat sterilization of B. tuberculosis and all less resistant pathogens in Inilk.
In the second method the thermal percentage survival of different
concentrations of test organisms was determined after different
periods of exposure to different temperatures in water and in milk.
This method is superior for routine bactericidal efficiency tests,
because it is less subject to the judgment of the investigator and to the
"skip" results inherent in the method of determining the last survivor.
The thermal percentage survival tests indicate that a 99.99 percent
reduction of approximately 1,000,000 criterion organisms per cc in
water is obtained in 24 Ininutes at 140° F. and 0.6 minute at 160° F.
Chlorine resistance of criterion organism.-Resistance of strain H-B
to chlorine has also been deterinined in two ways. In the first
method it was necessary to find the Ininimum residual concentration
of chlorine gas in distilled water which is lethal in 30 seconds to strain
11-B in concentrations of approximately 300 per cc, in order to
compare its chlorine death point with the death points of several
hundred other strains, including Inilk pathogens, tested by Tonney.
The criterion organism usually survives 0.19 p.p.m., sometimes as
high as 0.27 p.p.m., and is therefore more chlorine resistant than most
of the pathogens tested by Tonney.
Since this method produces the objectionable "skip" results
inherent in determining the last survivor, the percentage survival of
approximately 1,000,000 organisms per cc has been determined after
different periods of exposure for 6 hypochlorites and 4 chloramine-T's.
Tremendous differences in bactericidal efficiency were found. In
the absence of organic matter all hypochlorites produce a 99.99
percent reduction of 1,000,000 test organisms in 2 minutes in initial
concentrations of 1 to 8 p.p.m., while chloramine-T's require from
25 to 800 p.p.m.
Proposed new field test for chlorine.-Attempts were made to adapt
the starch-iodide test to field use by combining all the reagents in a
single solution. A test solution was developed which produced a
sharp-end point, gave accurate results for chlorine concentrations
ranging from 10 p.p.m. to 100 p.p.m., and which can be kept in the
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PUBLIC HEALTH SERVICE
refrigerator for 3 months without losing more than 2 percent of its
chlorine demand.
Tests to determine chlorine concentrations required in the germicidal
treatment of milk coolers.-Tests were made to determine the number
of p.p.m. of chlorine for different commercial chlorine preparations
which are required to produce a 99.99 percent reduction of the criterion
culture of B. coli communior upon a commercial milk cooler by means
of a 2-minute rinse with the chlorine solution.
The work has not yet been completed, but it has been rou~hly
determined that the number of p.p.m. of available chlorine reqmred
varies greatly with the presence or absence of detergent substances,
with the source of chlorine, and possibly with the hardness and hydrogen-ion concentration of the rinse water.
Studies of pasteurization and pasteurization eguipment.-Studies
were begun to determine the time and temperature combinations
required to produce a 99.99 percent reduction of the test organism
11-B when treated in full scale pasteurization equipment. This work
has not proceeded sufficiently far as yet to justify a statement of
results.
Studies to determine the proper treatment of udders prior to milking.Experiments were conducted to determine the relative effectiveness
of washing udders with plain water, with soap and water, and with a
chlorine solution. It was concluded that wiping contaminated
udders with a 100 p.p.m. chlorine solution for 20 to 30 seconds will
remove over 95 percent of a heavy contamination of a test culture oI
B coli communior organisms, whereas simply washing with plain water
or with soap and water will remove less than 30 percent of the test
organisms in the same time. It requires a prohibitive washing period
per udder in order to produce with plain-water washing a. result
approximately the equivalent of a chlonne wipe.
A survey of milk-borne disease outbreaks for the year 1932.-During
the year 1932 the following outbreaks of milk-borne disease were
reported to the Office of Milk Investigations by the State and city
health authorities: Typhoid fever, 23; septic sore throat 3; scarlet
fever, 6; miscellaneous, 1; total, 33.
STUDIES OF PUBLIC. HEALTH METHODS
The Office of Studies of Public Health Methods has continued under
the direction of Surg. Joseph W. Mountin. The dual purpose has
been pursued, as heretofore; 01) to determine the effectiveness and
economy of public health procedures in relation to the needs of the
people; and (2) by means of a consultation service to transmit the
results of investigations and observations to local health departments.
In order to determine the effectiveness and economy of prevailing
public health practices it was deemed necessary to study a group of
individuals receiving one or more of the various services supplied by
local health departments.
Brunswick and Greensville Counties, Va., were selected because
the health organization and public health problems there were
thought to be typical of a large section of the United States. The
study is being done in cooperation with the Office of Rural Sanitation
of the Division of Domestic Quarantine and with the State and local
health authorities.
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PUBLIC HEALTH SERVICE
The successive steps in the study were: (1) General social and health
survey of the county; (2) study of health problems in a random
sample of families selected from the population; (3) case study of the
persons served by individual workers of the county health department.
This general plan of study is being extended to other counties in
order to observe the work of small county health departments operating under different plans of administration. Detailed records are
being kept on a large series of individual cases and family groups to
determine the effect of different services performed by the health
department.
An appraisal of public health service in Tennessee was made in
collaboration with Dr. Allen Freeman and Dr. H. S. Mustard, of the
department of public health administration of the Johns Hopkins
School of Hygiene. The public health administration in the State
of New Hampshire was studied for the Brookings Institution as a
part of their general survey- of the State government. A special
survey of public health adnunistration in Delaware County, Pa., was
made at the request of the various agencies operating in the county.
STATISTICAL lNVESTIGA TIO NS
The office of statistical investigations continued under the direction
of Senior Statistician Selwyn D. Collins, with Edgar Sydenstricker,
W. H. Frost, and Lowell J. Reed, acting as consultants in various
phases of the work.
THE DEPRESSION AND HEALTH
For several years this office has obtained provisional mortality
data from State health departments as a current index of the Nation's
health. Mortality has been decreasing in almost every State.
However, mortality in the general population does not truly reflect
all the unfavorable factors in the people's health. No change in
mortality would be expected in that part of the population that was
still employed; the health of the unemployed is the real matter to be
considered and sickness is a better index of health than mortality.
Information on sickness and mortality in a group of families was
collected by house-to-house canvas~. Reasonably accurate income
and unemployment estimates were obtained for a 4-year period.
The sickness record was limited to the 3 months prior to the ca:Q.vass.
The causes of all illness were recorded, together with the duration,
calls to a physician, days of bedside nursing, nurses' visits, and days
in a hospital. The 4-year employment history and the 3-month
illness record permits the comparison of families whose heads have
been unemployed for 1, 2, 3, and 4 years with those not affected by
unemployment.
About 1,000 families were canvassed in each of 10 localities, including 8 large cities and 2 ~roups of villages. Communities were selected
that had been hard hit by the depression, and within the city the
districts with the most unemployment and relief work were surveyed,
except that slum areas where the "chronically poor" would be found in
large numbers, were omitted. Within the selected sections every
family was included, both employed and unemployed, and welfare and
nonwelf are.
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Preliminary results indicate higher sickness rates among the poor,
particularly in the case of the more serious illnesses that caused inability to work or that confined the patient to bed. It also appears
that those families moderately comfortable in 1929 but who had been
poor for 2 to 3 years had more sickness than those who had only
recently become unemployed and poor, and those now poor who were
formerly moderately comfortable reported more sickness than those
who had been poor the whole 4-year period.
The study of the effect of the depression on health is being made in
cooperation with the Milbank Memorial Fund. Consultant G. St.
J. Perrott, of the Milbank Fund, is in charge of the work.
RESPIRATORY STUDIES
Two papers on this subject were published (Pub. Health Rept.,
Sept. 2 and Nov. 11, 1932), and two other reports are in proof. These
studies complete the analysis of the extensive data collected after
the influenza epidemic of 1928-29.
MORBIDITY STUDIES
A paper (Pub. Health Rept., Mar. 24, 1933) on the causes of illness
in 9,000 families in 18 States was published. This is the first of a
series giving the results of the morbidity study made in cooperation
with the committee on the costs of medical care.
The field work of a morbidity study in New York State has been
completed and part of the tabulating has been done. Data from
Cattarau~us County include a 3-year record of both acute and chronic
illnesses rn a rural group of about 5,000 persons. Tabulations in
progress will show not only the prevalence of chronic conditions, such
as rheumatism and heart and kidney diseases, but will indicate the
amount of disability and the extent to which doctors were consulted
for these conditions during the 3-year period.
Papers were published on an epidemic of dysentery-like disease in
the surveyed part of Cattaraugus County (Pub. Health Rept., July 1,
1933) and on whooping cough in Hagerstown, Md. (Quarterly Bulletin,
Milbank Memorial Fund, Oct. 1932).
CURRENT PREVALENCE OF DISEASE
The 4-week reviews of the prevalence of diseases have been continued throughout the year. These summaries point out significant
changes in the case reports received weekly by telegraph from the
States as compared with preceding periods and previous years.
STREAM POLLUTION INVESTIGATIONS
Research studies in stream pollution and water purification have
been continued at the headquarters station at Cincinnati, Ohio, under
the direction of Sanitary Eng. J. K. Hoskins. To avoid, so far as
practicable, diverting attention of the scientific personnel from intensive research study, an administrative change was instituted at the
beginning of the fiscal year whereby cooperative activities with the
States and other governmental agencies in matters pertaining to stream
sanitation were transferred to the division of domestic quarantine.
During the year publications recording the conclusions derived from
field and laboratory studies undertaken during recent years were com-
•
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PUBLIC HEALTH SERVICE
pleted (Pub. Health Rept., Apr. 14, 1933) and studies of other problems of practical concern to the progress of stream improvement were
inaugurated. Also the field study of the pollution and natural purification of the Ohio River has reached a stopping place for the time
being with the publication of the results of a resurvey of a section of
the river between Cincinnati and Louisville (Pub. Health Bull. No.
204), undertaken to indicate the nature and extent of changes in the
sanitary condition of these waters since the original survey in 1914.
Likewise the experimental studies of natural purification of polluted
waters are being rounded out by- articles in the series of papers on
this subject discussing the selection of bacteriolo~cal dilution waters
(Pub. Health Rept., June 16, 1933), the detenmnation of dissolved
oxygen in the presence of organic matter, hypochlorites, and sulphite
wastes (Ind. and Eng. Chem., Anal. Ed., 4.59-64, 1932), and the socalled "catalytic" effect of iron and other salts on the rate of oxidation
(Jour. Am. Chem. Soc., 55:2012-2024, 1933). With the termination of
these phases of stream study, work has been undertaken on two principal lines of research in connection with: (1) The elucidation of natural
reactions occurring during the process of oxidation of ·organic matter
in polluted streams; and (2) factors that interfere with the efficient
functioning of biological oxidation processes of sewage treatment.
STUDY OF STREAM OXIDATION
A statistical and experimental study of stream oxidation phenomena
has the following immediate objectives: (1) An analysis of extensive
data bearing on oxidation in the Illinois River, and (2) an experimental
determination of the rates of atmospheric reaeration of streams of
deaerated water flowing through an artificial channel under various
conditions of depth, velocity, and temperature.
Increasing numbers of our larger municipalities are finding it
necessary to treat their sewage and industrial wastes in order to
alleviate excessive stream pollution. Certain lapses occur in the
efficiency of the activated sludge method of sewage treatment, which
is in wide use both in this country and abroad, caused by poor settlementor bulking of the sludge in the aerated sewage-sludge mixture.
Because of its widespread occurrence and difficulty of control', bulking affects detrimentally the efficiency of purification and cost of
operation of many large plants.
The factors responsible for sludge bulking; whether biological, chemical, or physical, are little understood. The studies of sewage treatment being undertaken, therefore, have as their objective some contribution to the knowledge of the causes of this unfavorable condition
and possible suggestions for its alleviation or control.
During the progress of these studies it has been found necessary
to devise new analytical procedures for the evaluation of changes in
the sewage brought about as it proceeds through the various stages
of treatment.
Ooeur d'Alene River and Lake lead-pollution study.-A study of the
extent of lead contributed by mining wastes to the waters of Coeur
d'Alene Lake through the Coeur d'Alene River in Idaho has been
completed in cooperation with the Idaho State Department of Public
Welfare. A comprehensive report was submitted to the State Legislative commission, presenting the results of analyses of over 150
samples of lake and river waters.
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NATIONAL INSTITUTE OF HEALTH
GENERAL
The administration of the National Institute of Health continued
under the supervision of Dir. George W. McCoy and Asst. Dir.
R. E. Dyer.
Publications.-Three bulletins and a number of scientific papers
were published during the year.
Library.-This unit of the Institute has continued under the immediate supervision of Miss Carrie Myers. During the fiscal year the
library acquired 501 volumes, making a total of 16,071 now on the
shelves.
DIVISION OF PATHOLOGY AND BACTERIOLOGY
Typhus-Rocky Mountain spottedjever.-The investigations of typhus
and Rocky Mountain spotted fever were continued by Surg. R. E.
Dyer and Passed Asst. Surgs. A. Rumreich and L. F. Badger, and
Asst. Surg. W. G. Workman. In the autumn of 1932 Surgeon Dyer
and Assistant Surgeon Workman contracted typhus in the course of
the investigations.
In continuation of investigations on the relationship of rats and
fleas to typhus fever a survey of the rodent population and a collection
of rat parasites was undertaken at Savannah, Ga., and coincidentally
a r.ecord was kept of the occurrence of typhus in the human population
of that city. Rats were systematically trapped in Savannah throughout the fiscal year, combed for parasites, and identification of the
parasites made. Records of the location where rats were trapped
were checked with the location of cases of typhus occurring in the
human population. During the year 5,639 rats were trapped and
112,444 parasites collected. Ninety-six cases of typhus were reported
in the city.
The virus of endemic typhus was recovered from the brain of a
wild rat trapped in Savannah at a location where human cases of
endemic typhus had occurred. It was found. that, in addition to
Xenopsylla cheopis and OeratophyUusjasciatus, XenopsyUa astia was an
efficient vector of endemic typhus under experimental conditions.
A study of typhus-control measures was begun at Dothan and
Enterprise, Ala. Measures of rodent control are being practiced with
a view to determining whether the procedures employed are effective
in reducing typhus incidence among the population.
Vaccines against typhus have been prepared from typhus-infected
fleas, and so far it has been found possible to protect about 50 percent
of the experimental animals.
Rocky Mountain spotted fever infection in ticks in nature was
demonstrated by finding the virus in ticks secured in northern Virginia.
It was found possible to infect young dogs and lambs with spottedfever virus; whether the:y serve as distributors of the infection under
natural conditions remains to be determined. It was shown that
spotted fever is not limited to the United States. A close immunological relationship was demonstrated to exist between spotted fever and
the fievre boutonneuse of the Mediterranean littoral. A disease
described in Brazil in 1929 under the name of "exanthematic typhus
of Sao Paulo" was found to be identical with S;J?Otted fever and of a
virulence comparable with that seen in the Bitter Root Valley of
Montana.
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PUBLIC HEALTH SERVICE
Trachoma.-Studies on the etiology of trachoma were continued by
Senior Bacteriologist Ida A. Bengtson. Granular conjunctivitis was
studied in 2 series of Macacus rhesus monkeys, in the one series the
condition having been induced by direct transfer of secretions from
trachomatous eyes of patients in Rolla, Mo., and in the other by
inoculation with cultures of Bacterium granulosis. A vaccine made
from Bacterium granulosis failed to protect the animals against either
condition.
Seasonal acute conjunctivitis occurring in the Southern States.-A
study was made by Senior Bacteriologist Bengtson of an acute conjunctivitis, popularly known as"gnat sore eyes", occurring during
the summer months in Georgia and other States in the South. The
condition, sometimes in virulent form, attacks young children in
particular, though adults also are affected. The disease is of importance, because in some sections it occasions more absence from school
than any other cause. A study was made of 50 cases at Bainbridge,
Ga. In this group the Koch-Weeks bacillus was isolated in 60 percent
of cases, the Morax-Axenfeld bacillus in 18 percent, and a pleomorphic
streptococcus in 24 percent.
Tularaemia.-lnvestigations under Medical Dir. Edward Francis
demonstrated marked resistance of cultures of Bacterium tularense to
alternate freezing and thawing. However, continuous freezing of
tularaemia rabbits at -15° C. resulted in the survival of virulent
infection in the brain and spinal cord for 1%years, in the spleen _and
muscle 1 year, in the liver 11 months, and in bone marrow 8 months,
thus demonstrating the danger to man of handling infected rabbits
kept continuously frozen for long periods.
Studies of bacterial variants or mutants.-Studies upon bacterial
variants or mutants have been continued by Surg. R. R. Spencer.
As has been the experience of previous investigators, changes have
been produced in bacterial morphology and behavior which are
believed due to genuine mutations.
The chief effort during the year has been toward the development
of a technique which excludes contaminating organisms and at the
same time provides an opportunity for the study of the causes of
variants and mutants among bacterial species.
Bacteriophage.-Two lines of study by Senior Bacteriologist Alice C ..
Evans on antistreptococcus bacteriophage are in progress. Immunization experiments have shown that rabbits may be protected against
lethal doses of streptococci by repeated injections with lysed cultures.
The grouping of 240 hemolytic streptococci from a great variety of
disease sources, from many parts of the world, according to sensitiveness to 3 races of bacteriophage gives promise that relationships may
be revealed which may be useful in tracing the source of epidemics.
Immunity.-Surg. W. T. Harrison, in collaboration with Surg.
Charles Armstrong, has made laboratory observations which show
that animals previously immunized to one disease were more resistant
to later infection with entirely unrelated diseases than were animals
not so previously immunized.
Studies of nutritional diseases.-Studies on nutritional diseases continued to be related primarily to the problems presented by pellagra.
They were carried on under the direction of Surg. G. A. Wheeler
assisted by Passed Asst. Surg. W. H. Sebrell.
Vitamin studies.-A study of the adsorption products between the
vitamin B complex and fuller's earth was begun by Associate BioDigitized by
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PUBLIC HEALTH SERVICE
chemist Victor Birckner. Adsorbates of this type varying in chemical
composition and physiological activity have long played a part as
important intermediates in procedures for the isolation of vitamin B
fractions.
Pathology.-Work in the section of pathology has been conducted
by Surg. R. D. Lillie, Asst. Surg. J. G. Pasternack, and Asst. Surg.
V. A. Gotcher. The histologic diagnostic service to marine hospitals
and other agencies has been continued, over 2,000 specimens being
examined and reports submitted thereon. In addition to this diagnostic work, specimens from over 1,200 experimental animals were
examined histologically and reports submitted.
Reports have been prepared and published or are ready for publication on the pathologic histology of psittacosis (N.I.H. Bull. 161), the
histopathology of some neurotoxic phenol esters (N .I.H. Bull. 160),
Romanowsky staining with buffered solutions, experimental meningitis in rabbits, a metastasizing chondrosarcoma of the mandible,
paraffin imbedding in vacuo, multiple branchiogenic acanthoma,
fibroma of the falx cerebri in the guinea pig, and the pathology of
experimental blacktongue and "yellow liver" in dogs.
There follows a tabulation of specimens examined during the fiscal
year:
A. Tissue specimens of human origin ______________________________ _ 2,078
B. Pathology of experimental diseases _____________________________ _ 1,232
C. Miscellaneous preparations ____________________________________ _
66
Total histopathology ______________________________________ _ 3,376
Blood and spinal fluid for Wassermann and Kahn test _______________ _ 17,218
Blood _________________________________________________________ _
Cultures _______________________________________________________ _ 2,931
146
Water _________________________________________________________ _
53
Other specimens ________________________________________________ _
130
Total miscellaneous ________________________________________ 20,478
SPECIAL STUDIES ON PROPHYLACTIC AND THERAPEUTIC AGENTS
Standardization of gas gangrene antitoxins.-A provisional unit for
determining the potency of Vibrion septique antitoxin was established
by Senior Bacteriologist Ida A. Bengtson, and has been made use of
in testing the serums received from various biological firms.
Hemolytic streptococcus studies.-Studies having to do with the
toxicogenic and antigenic properties of hemolytic streptococci from
various diseases have been continued by Surg. M. V. Veldee, with the
assistance of Passed Asst. Surg. G. L. Dunnahoo.
A practical method for the manufacture of a scarlet-fever prophylactic (streptococcus toxoid) has been completed and the resulting
material employed for the immunization of over 1,700 susceptible
persons. Sufficient toxoid may be given in 3 doses to induce
immunity in over 80 percent of those tested.
The toxicogenic properties of a considerable number of strains from
erysipelas sources have been studied, as well as the antitoxic properties of various commercial erysipelas antitoxins.
Staphylococcus studies.-Surg. Floyd C. Turner has undertaken
studies looking toward the development of standards by which to
gage the safety and efficacy of preparations falling in the group of
biologic products and intended for use in the prevention and treatment
of conditions due to staphylococci.
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PUBLIC HEALTH SERVICE
Diphtheria/rophylactics.-Studies on alum precipitated diphtheria
toxoid carrie on by Surg. W. T. Harrison have shown that 1 dose of
1.0 cc is at least as effective as 2 doses of 1.0 cc each of original
unmodified toxoid. Diphtheria toxoid is rapidly replacing other
prophylactics.
Meningococcus meningitis.-It has been shown by Senior Bacteriologist Sara E. Branham that a fatal meningitis can be produced in
rabbits by intracisternal injection of sufficiently virulent strains of
meningococci. Guinea :pigs have proved to be more susceptible to
meningococci than rabbits. Clinical and histopathological pictures
essentially identical with those produced by intracisternal injections
of living virulent cultures were produced in guinea pigs by similar
injections of filtered suspensions, by heat-killed suspensions as well,
and by Berkefeld filtrates of broth cultures of some strains. In both
guinea pigs and rabbits intoxication seemed to play an important
role.
Post vaccination complications.-Studies by Surg. Charles Armstrong
have resulted in the collection of 92 cases of post-vaccination encephalitis in the United States during the past 11 years, 13 of which occurred
in 1929, 26 in 1930, 15 in 1931, and 6 in 1932. Laboratory studies
confirmed evidence previously reported indicatin~ that experience
with various infections and antigens may render ammals increasingly
resistant to different diseases and toxins subsequently encountered.
Tetanus as a complication of vaccination has continued to decline,
but one case having been reported for the year.
Arsenicals.-Studies by Asst. Pharmacologist T. F. Probey on the
therapeutic activity of neoarsphenamine in experimental syphilis
in rabbits have been continued. The studies indicate that the trypa'nocidal activity test for the control of the commercial neoarsphenamines is not a safe guide as to therapeutic activity.
DIVISION OF PHARMACOLOGY
The following work was pursued by the division of pharmacology
of the National Institute of Health under the direction of Pharmacologist Director Carl Voegtlin:
(a) The hydrogen ion concentration oj normol, and malignant tissues
in the living animal.-The hydrogen 10n concentration (acidity) of
all living organisms is an important factor which controls many
important biochemical reactions, such as the action of proteolytic,
glycolytic, and other enzymes; oxidation-reduction; and the state of
tissue colloids. The work of Warburg and others has shown that
cancerous tissue removed from the animal body has an unusual ability
for converting glucose into lactic acid. Experiments were therefore
carried out to determine whether it is possible to increase the acidity
of malignant tumors in the living ammal by the administration of
glucose and other sugars. The results obtained clearly prove that the
administration of certain natural sugarsi more particularly glucose,
fructose and mannose, causes a gradua increase in acidity of the
malignant tissue 500 to 800 percent. The acidity of such normal
tissues as the skeletal muscle is but little affected. These findings
suggest that the biochemical reaction involved may have a relation
to the death of cancer cells and the death of adjoining normal tissue
cells. Work along this line is under way.
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PUBLIC HEALTH SERVICE
(b) Influence of the orygen tension on protein synthesis in tumors and
normal tissues.-It was demonstrated that under increased oxygen
tension protein is built up from normal and malignant tissue cleavage
products. Some of the results indicate that different tissues may
have different optima of oxygen tension and acidity for protein
synthesis.
(c) Tissue cultures.-The new method for simultaneous control of
the oxygen and carbon dioxide tensions and the hydrogen ion concentration of tissue cultures has been applied to the cultivation of the
Walker 256 mammary carcinoma. The results indicate that the
oxygen tension of the culture exerts a pronounced influence on the
growth of these malignant cells in vitro. A comparison of rat and
horse serum .in the culture medium indicates that the former favors
digestion of the medium, and apparently also the growth of malignant
cells.
(d) Chemistry of cell division.-Studies were made to discover the
optimum range of temperature for the various phases of the cell division
process in Amoeba proteus. In view of the apparent importance of
lactic acid production in cancerous tissue, an investigation was
conducted on the effect of this substance on cell division of Amoeba
proteus. Inhibition of cytoplasmic division has been observed.
This effect appears to be rather specific, and not merely a function
of hydrogen 10n ·concentration.
• (e) Ghemotherapy.-Several attempts have been made to influence
the growth rate of malignant tumors in animals by treatment with
certain chemicals. The results have mostly been negative, though
some chemicals seem to retard tumor growth appreciably.
The pharmacology of phenol esters.-Continumg the work of the
preceding year on the relation of chemical constitution to physiologic
action as exemplified by certain phenol esters, the action of the phosphorous acid esters of the phenols has been studied. Unlike the specificity of the phosphoric triester of orthocresol, as distinguished from
the related isomers, all the phosphorous acid esters of the phenols
were found to produce the same type of extensor rigidity with combined
degeneration of certain tracts in the spinal cord.
Vitamin studies.-A method was developed for the physiologic
assay of the thermostable growth-promoting vitamin B 2 • The application of this, together with the method previously described for the
assay of the antineuritic vitamin B 1 has made it possible to effect a
separation of the two vitamins by means of differential solvents.
A crystalline substance has been obtained in small amount with the
aid of picrolonic acid, which is highly potent in antineuritic activity.
On the basis of physiologic tests it appears to be the picrolonate of
the antineuritic vitamin. Further work is being done toward
increasing the yield of this substance sufficiently for chemical identification.
Refution between arsenoxide content and toxicity of commercial
arsphenamine.-Thirty-6.ve commercial samples of arsphenamine of
recent manufacture, when tested for arsenoxide content and toxicity,
showed that the high toxicity of certain products is chiefly due to their
arsenoxide content.
A simple chemical test was elaborated to distinguish between
arsphenamine, neoarsphenamine, and sulpharsphenamine.
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PUBLIC HEALTH SERVICE
Urinary antiseptics.-Work was initiated for the purpose of discovering efficient urinary antiseptics. The relation between minimum
fatal dose and antiseptic dose has been established for some drugs in
clinical use (hexamine) and some chemicals which have not been used
heretofore.
DIVISION OF CHEMISTRY
The work of the Division of Chemistry was continued under the
direction of Prof. Claude S. Hudson.
Sugar researches.-In order to throw further light on the naturally
occurring and biologically important uronic acids and their derivatives, studies were made of the oxidation of sucrose, a:-methyl-dxyloside, and a:-methyl-d-mannoside. These and related researches,
besides yielding data of value in the study of the physiological chemistry of the sugars, have also led to the discovery of new sugar derivatives and the development of methods for their isolation in pure
condition.
In connection with a study of the oxidation of xylose, the 4carbon sugar, threose, was isolated as a crystalline triacetate. This
sugar has been sought by chemists and ,?hysiologists for many years
in quantities sufficient for scientific studies. Studies have also been
made of the sulphur compounds of certain sugars and of their oxidation
compounds. The 'Y type of sugar structure is considered the precursor
of the ordinary type of sugar in the animal body and studies of interest
along this line were carried out.
Improved methods were developed for the preparation of mannose,
arabinose, fucose, the methyl glucosides, and -y-methyl mannoside,
which make these carbohydrates more readily available in pure condition for use by bacteriologists.
Enzyme researches.-As the difficulty of isolating toxins and antitoxins, vitamins, hormones, and enzymes frequently limits their use
in physiological research and in the prevention and treatment of
disease, one typical active agent has been purified by processes
restricted to those in which these active principles are in general
stable. The objective of the work was to develop experimental
technique of a type generally permissible in similar purifications.
Invertase, an enzyme present m the digestive tract and m yeast, was
chosen for investigation because it was readily available and because
it liberated glucose and fructose from sucrose, one of the few important
foodstuffs with a relatively simple chemical constitution.
After adsorbing the invertase from the highly impure yeast liquor
upon the surface of colloidal lead sulphide, the solid lead sulphide-invertase complex was decomposed by a smaller volume of the untreated
solution to give a filtrate of much higher potency than the original.
The observation was developed into a relatively convenient method by
which invertase, and perhaps eventually other shnilar active agents,
may be greatly purified. In another research invertase was found
to invert sucrose and to hydrolyze one constituent of a complex
mixture of fructose derivatives in a strictly similar manner. These
results are of value in enabling us to interpret the mechanism of the
inversion of sucrose by the enzyme. This work also led to the discovery of a crystalline, very reactive fructose derivative-a -y-methyl
fructoside-whose existence rendered uncertain the current chemical
views of the structure of sucrose.
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PUBLIC HEALTH SERVICE
Mosquito larvicides.-Studies were made in cooperation with Surg.
L. L. Williams, Jr., of larvicides which could be used for destroying
mosquito eggs deposited upon grass or shrubs growing in depressions.
Industrial hygiene.-Chemical work required in connection with a
study of air pollution in the larger cities of the United States was
carried out. The studies necessitated the analysis of 315 samples of
atmospheric dust from 14 different cities in the United States and 35
samples of settled dust collected in Washington, D.C.
Analytical work,_:.__ About 123 various analyses of miscellaneous
material, 34 determinations of carbon and hydrogen, 48 methoxyl
and ethoxyl determinations and 24 1nineral analyses of waters were
carried out; there were examined 11 arsenicals; and several toxicological examinations were made on body fluids and miscellaneous material.
There was a continuation of the analytical work required in the studies ,
of the relation of diet to pellagra.
DIVISION OF ZOOLOGY
Junior Nematologist M. 0. Nolan remained in supervisory charge
of the work of this division. The following work has been pursued:
Bulletins.-A bulletin was prepared for publication on the parasitic
diseases of pinnipedia. The manuscript of another bulletin on the
parasitic diseases of the lagomorpha (hares and rabbits) in relation to
the diseases of man, is nearly completed.
Examination of parasites for diagnosis.-This part of the routine
work of the division was continued throughout the year, and 169
specimens have been examined for various Government hospitals,
State health departments, universities, and practicing physicians.
In connection with the work on typhus fever, over 100,000 ectoparasites from Savannah rats have been determined. ·
MISCELLANEOUS
During the fiscal year 7 public-health bulletins and 2 National
Institute of Health bulletins were issued, and 157 scientific articles
for the Public-Health Reports orfor outside publication were subinitted
to this division for review and recommendation as to publication.
The annual meeting of the National Advisory Health Council was
held on May 9, 1933, for the purpose of reviewing the work of the
Public Health Service and securing the recommendations of the
council regarding future activities.
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DIVISION OF DOMESTIC (INTERSTATE)
QUARANTINE
In charge of Asst. Surg. Gen. C. E.
WALLER
PLAGUE-SUPPRESSIVE MEASURES IN CALIFORNIA.
Plague-suppressive measures conducted in cooperation with the
State authorities of California were continued in Alameda, Contra
Costa, San Francisco, and San Mateo Counties.
No human case of plague was reported during the year, but rodent
plague was reported in ground sqmrrels in San Benito County.
Plague in ground squirrels.-The work has been concentrated in the
area around centers of population and in adjacent territory in order
to maintain squirrel-free zones to prevent contact between ground
squirrels and rats, thereby preventing the introduction of plague into
urban centers.
The work in Alameda and Contra Costa Counties has been coordinated with that of the county authorities while in San Francisco and
San Mateo Counties all sqmrrel-control measures have been placed
in the hands of Public Health Service employees.
The field operations conducted by the Public Health Service are
shown in the following tabulated statement:
Number ofInspections____________________________________________ __
1,331
Reinspections____ _______ ____ __ ____ ____ __________________ __
4, 415
Acres inspected___________________________________________
263, 896
Acres reinspected_________________________________________ 1, 073, 422
Acres treated ___ ·_________________________________________
227, 789
Measures taken against rats.-This work in San Francisco consists
of: (a) Trapping and examination of rats; and (b) the investigation
of complaints of rat infestation of premises. The former activity is a
survey to determine whether any infection exists in these rodents
that would be dangerous to the public health. The latter consists of
visits to and examination of premises reported rat infested, for the
purpose of advising owners in regard to corrective measures. This
work is conducted in cooperation with the San Francisco Department
of Health under the direction of this office., No evidences of plague
infection have been found in any of the rats examined. A total of
1,145 rat complaints were investigated in San Francisco.
Rodent-control work has been continued through the year by the
Los Angeles Health Department. No plague infected rat has been
found since June 1932.
Public Health Service laboratory.-The laboratory was moved on
June 15, 1933, into a new building on the Marine Hospital reservation.
· The activities of the laboratory have been enlarged to embrace the
following: Serological and bacteriological work for other public health
service stations in this district; examination of water used on interstate carriers, in national l?arks, and on Indian reservations; and
serological work and animal moculations for other departments of the
Government.
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PUBLIC HEALTH SERVICE
The operations of the laboratory are shown by the following
tabulations:
Summary of laboratory operations
Received
Enmlnatlon of rodents for plague:
·
Rats from San Franclsoo •••••••••••••••••••••••••••••••••••• :...............
Rats from Oakland..........................................................
1
34,718
1, 286
r~~e~~~ H:!8i::~~oo::::::::::::::::::::::::::::-::::::::::::::::::::
·~
Serological examinations: Wassermann reactions ••••.•.•..••••••••.•••••••••••••••••••••••••
Bacteriological examinations {culture and mlcrosooplc):
Water•••••••••••••••••••••••••••••••••• •·•·•·•······························ ·• •• • • •• •• • •
Other •••••••••••••••••••••••••••••••••••••••••.•.•••••••••••••••••••••••••••••••••••••••
Miscellaneous••••••••••••••••••••••••••••••••••••••..••.•••••••.••••••••••••••••••••••••••••
TRACHOMA-PREVENTION
Examined
26,321
1,206
409
1
6,673
612
1117
71
w ORK
The United States Public Health Service started a cooperative campaign against trachoma in this country in 1913. The work has continued through this period of 20 years in Kentucky, with one short
interruption, for 17 years in Tennessee, and for the past 10 years in
Missouri. The disease is still a serious problem among white people
in certain sections of the coun ti:y.
The main points in the trachoma eradication program are: (1)
Case finding; (2) education in proper personal hygiene; and (3) treatment of the more severe individual cases. Of these, the most important is probably that dealing with the hygienic education of the
mdividual patient and his family.
Missouri.-Field and hospital work were continued throughout the
year, during which period 711 new cases of trachoma were contacted
by physicians from the hospital at Rolla, of which number, 38 percent
were cases already arrested, most of whom had had little or no treatment .
.An experiment conducted over a period of 20 months showed no
effect of a balanced diet reinforced with certain vitamins on the course
of untreated trachoma. The value of copper thiosulphate intravenously is being tried, and 12 patients have finished a course of 10
intravenous injections of this chemical.
· Kentucky.-With as large a personnel as the trachoma unit at
Rolla, the number of new trachoma cases contacted in Kentucky was
only 45 percent of the number seen in Missouri1 owing partly to the
fact that the trachoma hospital in Kentucky 1s removed from the
main trachoma area in that State. Of 306 new cases of trachoma
seen in Kentucky patients during the year 50 percent were under 29
years of age. The percentage of early cases must become less before
trachoma work can slow up. Kentucky still has a trachoma problem,
but a much less serious one than it had even 20 years ago. It is
interesting to note that out of 4,136 pupils examined in schools,.
largely country schools, only 27 were seen with a condition suspicious
of trachoma. The same nurse examined 4,708 peo:ple in homes that
she had never been in before and found 352 suspicious of trachoma.
Tennessee.-The trachoma unit in this State attempts to bring
special care and special training to the front door of the mountaineer
suffering from trachoma. Of 312 new cases of trachoma contacted
during the year, 19 percent were already arrested when first seen.
The percentage of early cases, those under 29 years of age, was only
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PUBLIC HEALTH SERVICE
42 percent of all the new cases seen. During the year there were six
field-treatment clinics held each week in the territory surrounding
Gainesboro.
Georgia.-The cooperative work in this State ceased June 15, 1933.
It is believed that the trachoma problem in Georgia will not become
serious if the boards of education and the county health officers will
encourage the use of astringent eye drops in the schools, as has been
done during the past 2 yea.rs.
Texas.-A trachoma survey was finished in central east Texas, including in it the only tribe of Indians living in Texas. Only one case
of trachoma was seen.
Field work
Field clinics:
Number of clinics held _______________________________________ _
Number of persons examined _________________________________ _
Trachoma cases seen (old trachoma) ___________________________ _
New trachoma cases seen ____________________________________ _
Suspicious cases seen ________________________________________ _
Treatments given at clinics ___________________________________ _
Field nurse activities:
Public talks given ___________________________________________ _
People (estimated) in audiences _______________________________ _
Homes visited ______________________________________________ _
PeopJe. examined _in homes ____________________________________ _
Susp1c10us cases m homes ____________________________________ _
Number pupils examined in schools ____________________________ _
Suspicious cases in schools ____________________________________ _
Number treatment clinics, nurse only __________________________ _
Number treatments by nurse _________________________________ _
559
18,646
5,633
1,280
2,559
7,932
139
10, 182
3,969
7,902
940
15,706
569
121
4,427
DiBpensary and hospital relief, operations, etc.
Dispensary relief:
Number examined ___________________________________________ _
Old cases, trachoma _________________________________________ _
New cases, trachoma ________________________________________ _
Total attendance ____ ~- ______________________________________ _
Average daily attendance of all stations ________________________ _
Combined dispensary and field-clinic data: Total number of new individual trachoma cases discovered __________________________________ _
Hospital relief:
Hospital capacity ___________________________________________ _
Cases admitted during the year (total) _________________________ _
Number cases first admission _________________________________ _
Days relief furnished ________________________________________ _
Operations: Total number of operations ___________________________ _
5,671
2,586
661
5,671
5. 04
1,941
77
777
513
25,867
671
PSITTACOSIS
The increasing fre9uency with which outbreaks of human psittacosis
were occurring in different sections of the country demanded that
steps be taken to curb the interstate spread of the disease.
Since it had been determined that psittacosis had become endemic
in certain domestic aviaries, the Public Health Service sought further
· to limit the spread of the disease, and on September 28, 1932, the
Acting Secretary of the Treasury promulgated an amendment to the
interstate quarantine regulations prohibiting the interstate transportation of psittacine birds by common carrier, except when accompanied by a certificate of health issued by the health authority of the
State of origin that to the best of his knowledge and belief the birds
so certified were free from psittacosis. As most health officers were
unwilling to assume such responsibility, very few certificates were
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PUBLIC HEALTH SERVICE
issued, and for a time interstate shipment of psittacine birds practically ceased.
The center of the parrakeet industry in the United States is located
in California. Immediately following the promulgation of the interstate quarantine regulations, the California State Board of Public
Health issued an order isolating all psittacine birds in the State and
quarantining those aviaries known to be infected. No birds could
be moved within the State without written permission of the local
health officer. Rules and regulations governing the breeding and
commerce in shell parrakeets were promulgated by the California
State Board of Public Health, on January 28, 1933. These combined
control measures of State and Federal Government apparently curbed
the spread of psittacosis in the United States. More than 50,000
parrakeets have been released from California aviaries for out-of-state
shipment in the past 3 months. Two cases of human psittacosis,
one as yet unconfirmed, have occurred in other States, but in both
instances it appeared that the birds involved had not been released by
the State health authority.
SUPERVISION OF
w ATER
SUPPLIES
u SED
BY COMMON CARRIERS
The inspection and certification of water supplies used for drinking
and culinary purposes on interstate carriers, under the cooperative
plan between the State health departments and the Public Health
Service, was continued with increasing efficiency. During 1932 only
1.6 percent of the total supplies were certified as unsuitable for use.
Assistance rendered the States in making actual inspections of
water supplies was considerably reduced, only 93 supplies being inspected. A total of 3,693 certificates of inspection were prepared in
the district offices and forwarded to the States for signatures of the
State health officers.
The increasing completeness of the certification work is shown in
the following table of percent for completed certifications.
Percent of completed certifications
Supply
1928
1929
1930
Railroad supplies....................................
82
81
87. 5
Vessel supplles......................................
78
78
88. O
Airplane supplies................................................................. .
1931
92.8
95.9
85.8
1932
95.1
97.2
97.4
Status of work by States.-The accompanying table covering the
calendar year 1932 shows the status of the work by States.
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PUBLIC HEALTH SERVICE
Interstate carrier supplies for calendar year 19SS
CertUlcatlon status
Source classlftcatlon
State
.Alabama ••••••••••.••••.••••
Arizona ••.••••••••••••••.•.•.
Arkansas •.••••••••••••••••.•
California •••••••••••••••••••
Colorado ••••••••••••••••••••
Connecticut •••••••••••••••••
Delaware •.••..••.•••••••••••
District of Columbia ••••••••
Florida •••••••••••••••••••.•.
Georgia••••••••••••••••••••..
Hawe.IL •••••.•••••••••••.•..
Idaho .•.•••.•.•••••••••••.••.
Illinois'·····················
Indiana•••••••••••••.•••••...
Iowa •••••••••••••••.••.•.•..
Kansas .•••••••••••.•••.•••••
Kentucky ••.••••••••••••••.•
Louisiana••••••••••.•••••.••.
Maine ...••••••••••••.•••••..
Maryland •••••••••••••••••• _
M8S88Chusetta••••.•••••••••.
Michigan•••••••••.•••••••.. _
Minnesota•••.•••••••••••••..
~=fpl ••••••••••••••••••
Montana ••••••••••••••••••••
Nebraska••••••••••••••••••••
Nevada••••••••••.•••••••••••
New Hampshire•••••••••••••
New Jersey ••••••••••••••••••
New Mexico•••••••••••••.•••
New York•••••••••••••••••••
North Carolina. •••••••••••••
N ortb Dakota•••••••••••••••
Ohio••••••••••••••••.••••••••
Oklahoma. ••••••••••••••••••
Oregon ••••••••••••••••••••••
PeDDBylvanla. ••.••••••••••••
Puerto Rico •••••••••••••••••
Rhode Island ••••••••••••••••
South Carolina ••••••••••••••
South Dakota •••••••••••••••
Tennessee •••••••••••••••••••
Texas• ••••••••••••.•••••••••
Utah ••••••••••••••••••••••••
Vermont ••••••••••••••••••••
Virginia •••••••••••••••••••••
W ashlngton ••.••••.•••••••••
West Virginia •••••••••.•••••
Wisconsin •••••••••••••••••••
Wyoming •••••••..••••••••••
Canal Zone •••••••....•..•.••
Total •.••.••••.••••••..
Per-
--#
Pub·
lie I
Com•
pany
38
13
44
67
27
23
9
2
49
61
3
17
82
49
61
0
64
32
3li
42
17
8
4
19
11
5
0
0
0
1
14
1
0
6
15
2
11
8
13
11
3
2
0
72
49
3li
67
11
22
4
6
9
17
12
1
6
10
13
3
19
10
24
68
41
34
137
1
7
33
21
30
130
12
11
63
41
38
52
14
2
2,043
1
7
0
5
50
30
11
17
65
10
113
61
19
Pri•
vate'
4
2
16
0
0
1
g
8
51
6
1
4
4
10
12
0
1
6
3
0
3
5
2
1
2
6
3
0
3
0
2
3
2
2
2
0
0
0
2
2
1
5
3
2
4
1
4
0
0
5
Action
Batis- Prov!• Prohlb- 'pendTotal factory
sional it.ed
inl
39
28
48
97
37
23
9
4
69
65
3
39
24
26
22
102
66
16
63
86
74
41
146
3
32
42
16
6
3
2
1
4
39
22
43
20
49
81
22
22
116
47
12
7
0
47
23
18
62
0
6
894
86
37
28
127
69
41
80
49
37
1156
1
7
66
36
17
12
62
48
0
0
3
4
16
4
33
3
3
200
3
0
0
86
49
31
10
20
16
67
0
7
8
6
1
0
3
16
0
1
38
66
24
0
0
2
2
0
66
74
61
49
45
22
6
111
3
II
4
40
39
80
0
71
31
22
73
50
0
3
12
34
43
65
72
17
0
114
0
0
13
82
32
113
16
4
2
0
0
7
89
13
0
38
Ill
17
11
62
43
48
64
16
0
8
2
107
0
1
0
3
6
7
1
0
0
0
0
2
0
0
0
0
2
6
0
0
0
0
0
0
3
1
1
0
4
0
0
0
0
0
6
0
B
2
1
0
1
0
0
0
a
0
0
0
0
2
1
1
2
2
0
0
0
2,683
1,947
477
41
0
1
0
0
0
0
0
0
0
0
0
3
0
0
3
0
3
0
0
0
0
0
10
0
0
0
0
0
0
6
0
'=
upon
100
ga
100
100
100
100
100
100
100
100
100
88
100
100
96
100
94
100
100
100
100
100
86
100
100
100
100
100
100
92
0
100
100
100
0
100
100
100
74
100
100
1~
100
99
100
100
100
100
100
100
100
100
118
1111.43
0
0
41
0
0
0
41
0
0
0
9
0
2
0
0
0
0
0
0
0
• The column headed "Public" includes supplies owned by munlclpe.litles as well as th099 med b:,
municipalities but owned by private companies.
• "Private" supply refers to a small well or spring used only by the carrier and the person owning It.
• Certiftcatlon based on watering point sanitation as well as source of supply.
RECIPROCITY WITH CANADA
Through reciprocity with the Department of Pensions and National
Health of Canada, inspection and certification of drinking and culinary water supplies used by international carriers, as well as supervision of drinking-water supply systems on vessels operating on the
Great Lakes and border waters, have been continued. Twenty-four
Canadian water supplies used by the United States carriers were inspected by the health authorities and certificates furnished. Sixty
United States supplies used by Canadian carriers were inspected and
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PUBLIC HEALTH SERVICE
certified. In addition, the Canadian authorities were furnished with
reports on 14 United States supplies used by the United States carriers crossing the international line.
SUPERVISION OF WATER SUPPLY SYSTEMS ON VESSELS
Sixty-one percent of the vessels in active service during the year
were inspected and certified, an increase over the previous year.
District No. 1 was called upon to a greater extent than usual to
exainine plans for drinking and culinary water systems for vessels
under construction and to inspect the vessels on their trial tri:ps.
Water-system plans for 19 vessels were subinitted to the distnct
offices for review and approval.
District No. 3 cooperated with the officials of the Twelfth Lighthouse District at Milwaukee in the development of a small but
-efficient treatment plant applicable to small vessels such as the lighthouse tenders and light ships. Treatment consists of superchlorination, filtration, and dechlorination and furnishes a safe, clear, and
palatable water at all times.
A total of 1,323 laboratory exaininations of water taken from the
-drinking-water supplies of vessels were made by the city health departments of cities on the Great Lakes and Misssisippi River system;
233 vessels were inspected for the first time during the year, and 452
were reinspected.
The following table shows vessel work done during the calendar
year 1932:
Vessels for calendar year 1932
District
Percent
Vessels or total
on active vessels In
district
status
1 •.•.•...........•.•..
:2•••••••••••••••••••••
....................·
4 •••••••••••.•••••••••
11 and 6•••••••••••••••
145
339
Total ••••••••••
1,652
~
651
114
400
39.4
6.9
24. 4
8.8
20.5
----------
Certification •
Perms•
nent
Tempo-
98
109
369
116
275
5
22
299
7
12
1
0
0
17
1
374
114
391
140
312
991
321
19
1,331
rary
Unap.
proved
Total
Percent Percent
or dis·
oUotal
trlct ves• vessels
sels cer• certified
tlfied
57.4
100
97
96.5
92
----------
22.6
6.11
23.6
8. Ii
18.9
80.6
1 Only the latest certlllcate Issued on a vessel was connted In case that vessel was both temporarl]y 1111d
permanently certified during the year.
Of 31 cases of typhoid reported among crews or passengers on
vessels during the year, only 2 occurred on vessels under the jurisdiction of the Interstate Quarantine regulations.
RAILWAY SANITATION
As time perinitted, inspections were made of coachyards, terininals,
.and watering points, 233 such inspections being made during the year.
The State health departments have been urged to include the inspection of these railroad properties when the water supplies are inspected.
Inspections of dining cars have been made from time to time, with
·
.special attention to the grade and source of the milk supply.
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PUBLIC HEAL TH SERVICE
SHELLFISH SANITATION
Assistance was given the State departments of health of Massachusetts and New Jersey in working out a process of conditioning
soft clams taken from sources not entirely free from pollution but not
grossly polluted; and the States of Georgia, Florida, and Texas in
planning and carrying out studies of certain oyster-growing areas.
Distribution of the list of certified dealers was continued throughout the year and constituted an important factor in maintaining
reasonable sanitary control. During the year 1,301 certificates issued
by the producing States were approved. In order to determine the
efficiency of control maintained by the producing States, 37 growing
areas and 807 shucking and packing plants were inspected.
COOPERATIVE WORK WITH STATES RELATIVE TO STREAM SANITATION
On account of the requests from States and groups of States for
assistance in formulating plans for stream pollution studies, methods
of procedure or assistance in correlating data, it was considered advissable to establish the Office of Stream Sanitation.
In compliance with Senate Resolution No. 44, an investigation
was conducted during the months of July to September 1932, inclusive, relative to pollution of the Potomac River, in the vicinity of the
District of Columbia. The results of this investigation, with recommendations for future sewage disposal, are available in Senate Document No. 172, second session of the Seventy-second Congress.
In cooperation with the State health authorities, through the engineering divisions of the several States bordering the Ohio River, a
study has been undertaken to ascertain the trend of the changes in the
sanitary quality of the river water at the several waterworks intakes,
due to increasing sewage and industrial-waste pollution and changes
in flow conditions as a result of canalization of the entire watercourses.
Subsequent to a period of disagreeable tastes and odors in the
Chicago water supply during the winter of 1932-33, the Public Health
Service was requested to cooperate with the States of Indiana and
Illinois and the city of Chicago in an investigation of the industrialwaste pollution of the southern end of Lake Michigan, with the end
in view of ascertaining the taste- and odor-producing wastes, and
studying possible methods of treatment for the removal of the offending substance prior to their discharge into the lake. Data previously
collected by the interested agencies have been subxnitted to this office
and reviewed; a memorandum has been prepared outlining methods of
procedure for the future investigations of the problem; conferences
have been held with representatives of industry.
COOPERATIVE PUBLIC HEALTH ENGINEERING WORK
The cooperative public health engineering work with other divisions of the Public Health Service and other Federal agencies was
continued. A total of 1,028 engineer days, or 25.8 percent of the time
of the engineers, was devoted to this work. Advice, surveys, reports,
and preparations of plans for the National Park Service and the
Office of Indian Affairs required 714 engineer days; assistance to the
Supervising Architect's Office in surveys and preparation of plans for
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PUBLIC HEALTH SERVICE
47
sanitary structures required 191 engineering days; 55 days were
devoted to the work for the Bureau of Prisons; 21 days to the Forest
Service; and 47 days to other agencies.
National Park Service.- In the eastern division of the National
Park Service a number of investigations were made and small sewage
treatment plants were designed for four areas.
In the western division, surveys and reports on sanitation were
made for 14 national parks and 3 national monuments, together with
preparation of plans, bills of material, and estimates for a number of
sanitary projects, and for improvements to existing plants. General
supervision was maintained over the sewage reclamation plant at
the Grand Canyon and sewage treatment plant in the Yosemite
National Park.
Office of Indian A_ffairs.-The district engineers continued to act as
advisers to the superintendents of the various agencies in matters of
environmental sanitation and made such surveys with plans and
estimates as were required. During June 1933 the personnel of
districts 3 and 5-6 devoted practically their entire time to sanitation
of the Indian emergency conse~·vation camps established on Indian
reservations within those districts.
Supervising architect's 0ffice.-Assistance was given the Supervising
Architect's Office in connection with water supply and sewage disposal
at various border and inspection stations. Plans were prepared in
the office of district 5-6 for the sewage treatment plant at the United
States Narcotic Farm, Lexington, Ky.
Bureau of Prisons.-The domestic quarantine division cooperated
with mental hygiene division in matters of environmental sanitation
and plans and operation of sanitary devices at the various Federal
penal institutions.
Forest Service.-At the request of the Forest Service, surveys were
made and plans prepared for camping areas. Advice was given
relative to water supplies, sewerage, sewage disposal, and general
sanitation.
Lighthouse Service.-Cooperation with the superintendent of the
Twelfth Lighthouse District relative to water treatment on small
vessels using Great Lakes water has been continued and a small
treatment plant developed. Advisory assistance has also been
rendered in connection with water supply and sewage disposal at
airway weather stations:
District of Columbia.-A short study was made to determine the
cffect upon the water of the Potomac River of the discharge of waste
at the disposal plant at Cherry Hill, Va.
Other Federal agencies.-Surveys and reports were made for other
dh isions of the Public Health Service, for the Coast Guard, Bureau of
Standards, Bureau of Plant Industry, and United States Army
Engineers.
MOSQUITO CONTROL, DISTRICT OF COLUMBIA
The Public Health Service continued the coordination and general
supervision of the mosquito-control work in Washington and vicinity
during the 1932 season; but since no funds were appropriated for the
work beyond July 1933, no attempt was made to institute active
control measures for 1933-34. Well coordinated control was carried
on during 1932.
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PUBLIC HEALTH SERVICE
SUMMARY OF
w ORK
CARRIED ON BY THE VARIOUS DISTBICTS
Distribution of time in days of the field personnel under the engineering section( exclusive of mosquito control in the District of Columbia and streams anitation),
fiscal year 1933
Interstate
quarantine:
Office __________________
_ Do111
Field:Water______________ _
Shellfish ____________ _
National
Service:
OfficePark
__________________
_
Field ___________________ _
OfficeOffice
of Indian
Affairs:
__________________
_
Field ___________________ _
1,591
678
385
201
53
294
166
Supervising
Architects' Office: _ Dar,
Office __________________
Field ___________________ _ 164
27
Bureau
of __________________
Prisons:
Office
_
28,
Field __________________ - 27
OtherOffice
agencies:
__________________ _
21
Field __________________ - 47
Technical
meetings
__________
_
51
Leave ______________________ _
248
Total days accounted for_ 3, 979'
TABULAR SUMMARY
TABLE
!.-Vessel water-supply supervision
FirstPassenger
inspections:
_______________ _
Freight _________________ _
Water boats ____________ _
Reinspections:
Passenger _______________ _
Freight _________________ _
Water boats ____________ _
<Jertificates issued:
Regular, favorable _______ _
Regular, not approved ___ _
Temporary, favorable ____ _
Plans for vessel water systems
examined:
Approval granted ________ _
Approval withheld _______ _
TABLE
102
126
5
160
286
6
991
19
321
uts~~~~o-iI~th-s;;~ice
quarantine stations ____ _
Health departments ______ _
On interstate vessels _____ _
26,
z
1
2
16
3
2.-Railroad sanitation supervision
Inspections:
Sources of water supply___
93
Coachyards______________
114
51
Terminals_______________
W.a~ering points__________
68
Dmmg cars______________
36
Certificates:
Data reports reviewed _____ 2,091
Certificates prepared ______ 3,693
TABLE
Major conferences:
With shipping officials____ _
65,
With others _____________ _
2&
Water examinations made:
U.S. Public Health Service
laboratories ___________ _
&
Other laboratories _______ _ 1, 323Typhoid-fever cases reported:
U.S. Public Health Service
Water examinations:
U.S. Public Health Service·
laboratories ___________ _
Other laboratories _______ _
Major conferences:
With railroad officials ____ With others _____________ _
78:
200
36
61
3.-Shellfish sanitation supervision
Inspections:
Areas __________________ _
Plants __________________ _
37
807
StateApproved
certificates:
_______________ _
1,301
Not approved ______ ._____ _
10
Approval withdrawn _____ _
0
Canceled _______________ _ 135
Laborator:y examinations:
U.S. Public Health Service
laboratories___________ _
85
Other laboratories _______ _ 3,330
Conferences _________________ _
35,
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TABLII
4.-Miscellaneous cooperation with governmental agencies
Public Health Service (other divisions):
Surveys __________________ _
5
Conferences_______________ _ 8
N a.tional
Park
Service:
15
Surveys
___________________
Conferences________________ 35
Affairs:
OfficeSurveys
of Indian
___________________
66
Conferences________________ 57
Bureau
of Prisons:
Surveys
___________________
Conferences________________
Supervising
Office:
SurveysArchitect's
___________________
Conferences________________
Other:
Surveys _________________.__
Conferences ________________
10
15
10
16
11
46
RURAL HEALTH WORK
The· universal experience of public health administrators is that.
modern J?Ublic-health service requires a permanent type of local
organization under the leadership of a trained and experienced health
officer. During the fiscal year, as for a number of previous years,
the main objective of the rural sanitation work, therefore, has been
to cooperate with States in demonstrating to local communities the
value of health d~artments organized along lines which have proved
to be effective. The assistance to States was threefold in character:
(1) Financial aid, (2) temporary assignment of experienced personnel, and (3) consultation service on special problems.
Financial aid was rendered to 172 local health units in 28 States.
The distribution of these units according to States is shown in the
following table:
State
.Alabama•••••••••• ···-··
Arizona .••.•••••••••••••
Arl<ansas-·········-·····
California•••••••••••••••
Florida._._ •••••••••.•••
r~~·················
Iowa••••••••••••••••••••
K811S8S••••••.•••••••••••
Kentucky•••••••••••••••
Num•
ber of
units
10
4
12
4
3
12
1
3
4
14
State
Louisiana •.•••••••••••••
Maryland•••.•••••••••••
Massachusetts ••••.••••.
Mlchlgan •••••••••••·••..
MlsslsslppL••••.•.•••••
Missouri.-••••••.•.•••••
Montana.. •••.•••••••••••
New Mexico •.••••••• - ••
North Carolina ••. ···-··
Ohio •••••••• ·-··········
Num-
ber
9
2
1
7
11
1
3
6
Num
0
or
State
units
Oregon •••..•.•••••••••••
South Carolina••••.•••••
South Dakota••••••••••.
Tenne81188.• -••••••.•.•••
Texas••• ·-·····-····-···
Virginia•••••••••••••••••
W ashlngton ••••••••• __ ••
West Virginia.. •• _•••••.•
11
5
Total •••••••••••••
berof
units
2·
13
1
9
9
6
2
7
112·
In two additional States, Nevada and Rhode Island, financial
contributions were made for special activities conducted through the
State health departments.
The Federal appropriation from which these funds were derived
amounted to $300,000 for the fiscal year ended June 30, 1933. Of
this amount, $264,854.56 was expended through specific allotments
to demonstration health units, and $18,917.64 was used for special
studies and administration.
Since the county is the predominant type of local governmental
unit for rural areas, most of these health units have been organize_d
on a county basis. The basic program provides the usual healthdepartment services, with special emphasis on the particular needs of
the local area.
Special surveys of State health administration were made in the
States of Was~ton, Iowa and Idaho, and of local health administration in the city of Omaha and Douglas County and the city of
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PUBLIC HEALTH SERVICE
Lincoln and Lancaster County, Nebr., to determine local health
problems and to advise local authorities on the best methods for their
solution.
A limited number of county health departments has been selected
for special study in order to determine in a more specific way the
special health problems of rural people living under different social
environmental and economic circumstances and to measure the effect
of the several items which comprise the health program.
According to information collected from the State health departments, 581 counties or comparable areas were provided with health
departments organized along the foregoing lines, a decrease of 35
over the preceding year. The total number of existing rural health
units, though small and serving only about 28 percent of the rural
population, represents a growth of approximately 15 years.
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DIVISION OF FOREIGN AND INSULAR QUARANTINE AND IMMIGRATION
In charge of Asst. Surg. Gen. F. A.
CARMELIA
During the fiscal year 1933 the various quarantinable diseases continued to have widespread prevalence throughout the world. Yellow
fever prevailed along the east coast of South America in Brazil and
along the Ivory and Gold Coasts of Africa and adjacent interiors.
Plague infection was reported from numerous parts of every continent
except Australia, and broke out at sea on four ships engaged in international commerce. Cholera prevailed in one of the most devastating
epidemics recorded in China, taking a death toll of nearly 34,000
persons in 312 cities and 23 provinces. Cholera continued to prevail
m India and in the rural districts of the Philippine Islands, particularly in the southern central portion. Typhus fever was widespread
in many parts of the world, with severe outbreaks occurring in
Egypt, Russia, and Chile. Smallpox continued to exist in all parts
of the world, but attained epidemic prevalence in Portugal, India,
Egypt, and China.
Reflecting the effect of the world-wide economic depression, the
volume of quarantine work performed during the year was approximately 60 percent of that performed in the fiscal year 1929, when it
attained its greatest volume. During the fiscal year, 13,917 maritime vessels, carrying 1,763,926 persons, arrived at United States
ports from foreign ports and were accorded inspection by medical
officers of the Public Health Service prior to entry, to assure freedom
from any of the quarantinable diseases. In addition, 4,186 airplanes arrived at airports of entry in the United States from foreign
ports, requiring quarantine inspection. These planes carried 25,767
persons. Of this number, only 2,209 airplanes, carrying 20,396
persons of whom 2,327 were aliens, were subjected to medical examination by medical officers of the Public Health Service prior to entry.
The remainder, comprising 1,977 airplanes, carrying 5,371 persons,
entered without the medical examination required by law, due to
permitting arrival at airports at which medical officers are not
available.
There occurred no instance of the introduction of any of the quarantinable diseases into United States ports during the fiscal year. One
vessel, carrying 31 persons, was detained on account of typhus fever,
and 25 vessels, carrying 8,883 persons, were detained on account of
cholera, while 1,567 vessels, in addition, were required to undergo
quarantine treatment for the prevention of the introduction of plague,
and 3,589 rats retrieved following fumigation of these vessels were
examined for evidence of plague infection. A total of 2,111 persons
was vaccinated against smallpox, and 5,278 persons were subjected
to laboratory examinations for evidence of cholera infection, while
3,400 persons were vaccinated a~ainst cholera and 867 persons were
subjected to laboratory examinations for infection with cerebrospinal
. meningitis. There were no detentions during the fiscal year on
51
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PUBLIC HEALTH SERVICE
account of yellow fever or smallpox. During the :year, it was necessary for the department to assess fines aggregatmg only $365 for
violation of the act of February 15, 1893, due to failure of masters of
vessels to present American consular bills of health, and for other
violations of the quarantine laws administered by the Public Health
Service.
The ratification of the International Sanitary Convention of Paris,
revised 1926, by practically all of the important maritime countries of
the world, is resulting in increased uniformity and better coordination
of quarantine procedures applied to international commerce, and this
has permitted considerable modification of the quarantine restrictions
heretofore enforced by the United States; for instance, the number of
ships required to undergo fumigation upon arrival at United States
ports has been reduced approximately 50 percent. During the fiscal
year, 2,356 vessels presented foreign international standard certificates
of deratization, of which only 180 were determined to be not acceptable, and 1,291 vessels presented foreign international standard
-certificates of deratization exemption, of which only 123 were determined to be not acceptable, while 1,007 vessels were granted international standard certificates of deratization exemption by United
States quarantine officers. This has resulted in a very large saving in
expense and has materialli reduced loss of ships' time through the
elimination of unnecessarily repeated independent fumigations by
the authorities of the various countries. There is noted a very
decided international tendency not only to reduce the number of
fumigations required, but also to improve the efficiency of such
fumigations. Special studies were continued throughout the fiscal
year at the New York Quarantine Station along these lines, in cooperation with the International Office of Public Hygiene in Paris, and
included investigation of the practicability of establishing an international standard for sulphur dioxide fumigations and the adaptability of liquid sulphur dioxide to ship fumigation, as well as special
problems presented in the fumigation of a loaded ship at the quarantine anchorage immediately upon arrival from a plague-infected
port, prior to entry and gomg to dock for discharge of cargo. Certain countries had raised the question as to whether the practice of the
United States in requiring the fumigation of loaded vessels under
these circumstances did not exceed the provisions of the International
Sanitary Convention; the quarantine commission of the Int~rnational
Office of Public Hygiene, at the May 1933 meeting, recognized the
justification of the procedure under special circumstances, and it was
agreed to extend the provisions of the convention, by amendment
if necessary, to include such practice.
The special regulations governing the importation of parrots into the
United States, prescribed in accordance with the provisions of Executive Order No. 5264, approved January 24, 1930, were revised on
October 6, 1932, to include all birds of the parrot family and to
require each commercial importation of such birds to be accompanied
by a certificate from the duly constituted sanitary authority at the
place of origin to the effect that, on inspection, all birds in the shipment had been found to be apparently well and in good sanitary
condition, and that the aviary or other distributing establishment
had been maintained in good sanitary condition and to the best
knowledge and belief of the said sanitary authority was, at the time of
shipment of the birds, free from psittacosis infection. The strict
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PUBLIC HEALTH SERVICE
-enforcement of these regulations has resulted in the infection beingfound during the past year in only one shipment of parrakeets-from
Colombia, South America-which was held upon arrival at the San
Francisco Quarantine Station and refused entrv.
During the fiscal year, the prevalence of cerebrospinal meningitis in
the Orient had decreased to such an extent that the danger of intro,ducin~ the disease into the United States could be controlled satisfactorily with ordinary quarantine procedure and facilities available
-at United States ports of arrival, and Executive Order No. 5143,
dated June 21, 1929, "Restricting for the time being the transportation of passengers from certain ports in the Orient to a United
States port" was accordingly rescinded by the President on March
3, 1933, and the special quarantine regulations promulgated thereunder became ineffective on that date.
Quarantine inspection service, regularly provided daily at United
States ports from sunrise to sunset was extended to a 24-hour basis at
the port of New Orleans, La., effective October 24, 1932, under the
provisions of the act of March 3, 1931. Application for similar extension of quarantine inspection hours after sunset has been filed for the
ports of Boston, New York, Philadelphia, Norfolk, Charleston, and
San Pedro, but consideration of these requests has been held in abeyance in view of the existing economic conditions and the lack of funds
.available for such extension of existing quarantine service at those
ports.
During the fiscal year, the construction of a new quarantine station
of modest capacity on the south side of the entrance channel at Miami,
Fla., was completed, and the station will soon be placed in commission.
A new diesel quarantine cutter of wrought iron construction, 60 feet
in length, was completed in the early part of the year and was named
T. B. McClintic. In addition, two diesel quarantine launches, 40
feet in length, designated as Q-19 and Q-20, were constructed of wood
during the latter part of the fiscal year, and the steam quarantine
cutter H. R. Garter, attached to the New York Quarantine Station,
was completely rebuilt and provided with a new boiler.
The rapid development of international aerial navigation, providing
commercial intercourse between areas infected with one or more of the
quarantinable diseases and infectible but noninfected areas, has accentuated the urgent need for some basis of international cooperation
and the coordination of quarantine practice as applied to aircraft, and
has culminated in the preparation of a draft convention under the auspices of the International Office of Public Hygiene in Paris, assisted
by the International Commission for Air Na~ation, set up under
the convention relating to the regulation of aenal navigation, 1919.
The -draft international sanitary convention for air navigation was
tentatively approved by the Second Pan American Conference of
Directors of Health at Washington in April 1932, and was adopted by
the permanent committee of the International Office of Public Hygiene
in Paris at its April-May 1932 session. Subsequently it was formally
submitted by the French Government to the United States for ratification, and the Government of the United States, through the State
Department, has signified to the Netherland Government, as the
depositary of the signed convention, its willingness to sign the convention with certain reservations similar to those made by the United
States in ratifying the International Sanitary Convention of Paris,
1926. Inasmuch as the convention provides that ratification or adDigitized by
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54
PUBLIC HEALTH SERVICE
hesion accompanied by reservations must be accepted by all prior
signatory countries, the Netherland Government is taking steps to
determine the acceptability of ratification with these reservations by
the United States. It is not anticipated that objection will be raised
by prior signatory governments, and the prompt ratification of the
convention by the United States subject to these reservations upon
receipt of notification from the Netherland Government that these
reservations are acceptable to prior signatory countries, is a matter of
urgent importance not only to facilitate the observation of measures
for the protection of the United States against the introduction of
quarantmable diseases throu~h air commerce originating in foreign
infected areas, but also to assist in the prevention of the international
dissemination throughout the world of the infection of such diseases
from infected areas, which ultimately would serve to reduce the exposure <ff the United States, as well as other noninfected countries to
possible infection. In addition, the convention permits the imposition
of only necessary coordinated and uniform restrictions in the various
countries, and this serves to promote international air commerce, in
the extension of which American companies are actively engaged.
Medical inspection of aliens.-During the fiscal year, 398,574 alien
immigrants were examined, and 805,028 alien seamen were inspected
at United States ports of entry by medical officers of the United States
Public Health Service for mental or physical defects or diseases in
accordance with the provisions of the m1migration laws, of whom
322,685 alien seamen were examined for immigration purposes at
quarantine stations in conjunction with quarantine inspection. A
total of 1,625 alien immigrants (about 0.4 percent) and 458 alien seamen (about 0.05 percent) were certified to be afflicted with one or
more of the defects or diseases requiring mandatory exclusion, and
10,157 alien immigrants (about 2.5 percent) and 392 alien seamen
(about 0.04 percent) were certified to be afflicted with a defect or
disease which was likely to affect their ability to earn a living.
As in the preceding year, there has continued a marked decrease in
the number of applicants medically examined for immigration visas
abroad, making possible still further consolidations in this work and
an additional reduction in personnel. There were 26,543 applicants
for immigration visas examined by medical officers in American consulates in foreign countries. Of this number, 549 (about 2.07 percent)
were reported by the medical officers to the American consuls as being
afflicted with one or more of the defects or diseases requiring mandatory exclusion, and 5,065 (about 19.08 percent) were reported as
afflicted with a disease or condition which was likely to affect their
ability to earn a living. Of 24,175 aliens to whom visas had been
issued following a satisfactory medical examination in American consulates in foreign countries, only four were certified subsequently upon
arrival at a United States port as being afflicted with a defect or disease requiring mandatory deportation.
Special arrangements were made during the year to facilitate the
medical examination of alien crews on board trans-Pacific vessels
stopping at Honolulu en route from the Orient to Pacific coast ports
of the United States, which provide for the issuance by the examining
medical officer at Honolulu to the immigration officers at that port of
a "medical hold" form in the case of any member of a crew suspected,
as a result of prelimii;iary general examination, of being afflicted with
any disease or defect enumerated in section 35 of the Immigration
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PUBLIC HEALTH SERVICE
Act of 1917, but whose examination, because of lack of time or facilities, cannot be completed while the vessel is in Honolulu. The alien
is permitted to remain on board the vessel to complete the voyage to
the Pacific coast port of destination for completion of his medical
-examination under an order upon the master of the vessel to segregate
-en route and hold such alien on board. There is no change in the
handling of alien seamen who are certified upon arrival at Honolulu
to be afflicted with any mental or physical defect or disease coming
within the immigration laws.
An order was issued on August 19, 1932, by the Commissioner of
Immigration at Ellis Island, changing the method of examining thirdclass aliens at New York. Previously, these aliens had been brought
to Ellis Island for a complete medical examination, but since that
date they have been examined on board the vessels on which they
arrived, where conditions and lack of facilities do not permit as
thorough medical examinations and accordingly result in the discovery
and certification of a reduced number of defects and diseases. During
the period January-June 1932 a total of 1,635 third-class passengers
was medically examined at Ellis Island, of whom 282 were certified,
.and during the similar period in 1933, a total of 1,103 third-class
passengers was examined on shipboard under the new procedure, of
whom 75 were certified. Assuming comparable conditions, these
results would indicate that the efficiency of the medical examinations
performed on shipboard is approximately only 40 percent of that
attainable when performed at the immigration station at Ellis Island.
TRANSACTIONS AT MARITIME QUARANTINE STATIONS
TABLE
!.-Summary of transactions at maritime stations for the fiscal year 1933
Station
.
Aberdeen, Wash ......••.. . ......
Angel Island, Calif. (San Fran·
cisco)_ .......•..•.......•......
Astoria, Oreg ....•.•.•........ . ...
Baltimore, Md .•..•...•..•...•...
Beaufort, S. C ...•......•........•
Boca Grande, Fla .....•..•..•....
Boston, Mass ..•........••..•.•..
Brunswick, Ga.... ..•...•........
Carrabelle, F la .. •.•.••.•.......•.
Charleston, S.C .....•..•... •.....
Corpus Christi, Tex.l •.....•••...
Eastport, Maine ..••.•....•. . ....
Eureka, Calif. .•.• -·········-- ...
Fall River, M ass ..... .•...... _•..
Fernandina, Fla. (Cumberland
Sound) ......• · · ·-·-·· ···-·-·-··
F ort Monroe, Va .•.•..•.•.•.•.•..
Freeport, Tex . •••. •.•...•.•..• ••.
Galveston, Tex ......•...•...•..••
Georgetown, S.C ..•. . •..........•
Gulfport, Miss ........... . . . . ....
;racksonville, Fla. (St. Johns
River) .. · ·····-·-·-·-·---- - ·--·
K ey West, Fla.··· ---·- - ..•.•..•.
Le wes, Del. (Delaware Break•
water) .•.... ... ........•.......•
M arcus Hook, Pa ...•.•.. ---· ..•.
M arshfleld, Oreg. (Coos Bay) .. .•
M lami, Fla ..•....•••..••.•...••.
M obile, Ala ••..••.•.•••.....••..•
1 Includes Port Aransas, Tex.
Vessels
Vessels grant·
ed free
in·
spected pra•
tique
7
Bills of
health Amount
Pas•
and
of bills
sen• Crew in• port rendered
sani• for quar•
gers
spected
tary
in•
antine
Sul•
state·
phur spected
ments services
issued
Vessels fumi•
gated
Cya•
nide
----1
0
6
0
327
293
-$75. 00
23
364
1
15
801
6
9
106
31
1
2
13
462
15
300
1
15
646
6
9
97
31
1
2
13
61
10
63
0
0
107
0
0
5
0
0
0
0
0
0
0
0
4
0
1
0
1
3
0
0
0
26, 092
5
423
9
4
32,708
2
0
169
6
0
0
0
38,239
999
11,706
531
500
56; 360
162
68
3,631
1,084
18
67
568
0
430
0
0
0
0
0
0
0
472
5
19
40
18,646.35
142. 37
0
1,185.17
474. 49
0
20.00
140.00
5
247
6
524
0
7
4
234
5
503
0
7
0
4
0
21
0
0
1
27
0
0
0
1
6
2,197
1
812
0
2
164
10,276
232
17,325
0
245
14
0
0
0
76
79
77.51
4,450.08
60.00
G,898. 67
0
127. 29
85
147
72
139
18
0
0
3
149
9,794
2,513
10,072
538
16
1,712. 65
2,029.61
1
1
539
2
571
151
0
41
0
29
15
0
0
0
0
0
0
570
0
11,093
156
7
20,416
92
15,600
5,235
0
3,806
10
653
0
5.00
9,250.55
25.00
4,462.00
2,451.97
504
604
2
571
178
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14,018. 97
611. 00
9,418.46
0
508. 73
56
PUBLIC HEALTH SERVICE
TABLE
1.-Summary of tramadiom at maritime atationa for th6 fi,cal 1160' 193$Continued
Station
Vessels
V~sels grantID•
spected
ed free
tf~~~
Bills of
health
and
Passen• Crew fn. port
gers
sanl·
spected
tary
In•
Sul·
etatephur spected
menta
IAued
Vessels fuml•
gated
Cya•
nide
--- --- - - -
3
2
0
0
3
New Bedford, M RBS ••••••••••••••
21
42
0
21
0
New London, Conn •.•.••••••••••
967
8,018
0
73
859
New Orleansf La .....•.•.•••••...
4
9
0
0
4
Newport, R ....•.• •••.•.••..•• •.
0 339,059
213
New York, N .Y.••.••.•••••••.••• 3,1 75 2,901
2
2
0
0
0
Ogdensburg, N .Y .....••••.•..•..
2
Z1
0
0
26
Panama City, Fla ..•..... ••.•••..
53
13
0
6
38
Pensacola, Fla . .••.••. ••...•.•.. _
7
0
0
0
6
Plymouth, Mass .....•..•..••.•..
8
29
0
0
8
Port Everglades, Fla......•.•••..
91
40
0
0
77
Portland, Maine ....•••.• . •• •. •.•
4
0
12
2
Portland , Oreg.••.......•..•.....
3
Port San Luis, Calif. (San Luis
29
0
29
0
0
Obispo) . . .•..••.....•.•••••••..
49
0
42
40
6
Port Townsend, Wash.• .•••••.•..
47
654
0
0
46
Providence, R .L •••.•.•.•••.•.•..
2Z7
201
105
0
8
Sabine, Tex.....................•
390
0 10,061
0
380
San Diego, Calif. (Point Loma) ..
0 19,994
96
906
San Pedro, Calif. ...•••••.••.••.. 1,138
67
18
58
0
50
Savannah, Oa ....••••.•••••••••..
10
10
0
0
0
Searsport, Maine ... •.•••.•...•.••
14
14
0
0
0
South Bend, Wash ....•...•.•.••.
41
44
34
2
0
Southport, N.C. (Cape Fear) •.•.
189
231
0
8
166
T ampa, Fla ............••..••••..
I
1
0
0
0
Vineyard Haven, Mass•..•.•••• •.
108
108
215
0
0
West Palm Beach, Fla....•.•.•..
--46462,668
852
Total ••..••.•.....•••••••.• JO, 935 9,771
=
--=
Alaska:
0
0
0
0
0
Ketchikan •.••• .•.••••.••••••
0
0
0
0
0
Wrangell . .•••. •.•. •...•••••• •
0
0
0
0
0
Total._ •••••..•.•••••.•••••
=
Hawaii:
0
0
0
0
0
Ahuklnl .•.•••••••.•••.•••••••
14
14
4
0
0
Hilo .•...•. •••••.•.•.•••••••••
145
156
6
0 26,010
H onolulu ..•..••••.•••.•.•••••
0
0
0
0
0
Kahului.. .•.•......•..•.•••.•
3
3
0
0
0
Port Allen .••.•.••••...•.•...
0
0
0
0
0
Lahalna ...• •.•.••••••••.•....
0
0
0
0
0
Makaweli ..•...•••.••••••••..
162
173
6
0 26,014
Total . •.•.•..•••••••••.•••••
-
70
623
38,709
183
511,847
0
922
1,631
194
31
2, 7Z7
201
1
4Z1
40
160
26
8
1,090
1
11
1, i64
::::: :::::::::::
J::~ft·.:::::
Olongapo ...•.••..•.•....••...
1
0
0
I
0
0
331
1
0
334
0
97
0
329
0
0
112
0
19
557
0
11,444
526
1,080
598
0
80,144
0
101
93,893
100.00
17,834.62
25.00
63,754. 91
20.00
(37.83
1, 087.09
0
40.00
965.00
1,243.20
409
852,622
40,383
0
0
0
0
0
0
0
0
0
33
183
629
152
67
48
0
1,112
0
120. 00'
3, 230.00•
0
30.00
0
------=
0
0
0
0
0
0
72
0
0
72
--$8.5.03
40
0
0
0
0
---
--- --- =
services
00
520. ◄
4, 620.(M
577. 00
2,660.4&
3,137.00
21,905.06
1,579.69
150.00
145.00
591.10
2,016.08
5.00
540. 00
200.820.00
1,128
3,445
2,094
7, 3.14
14.806
61,777
1,948
153
624
1,335
4,069
7
--- ------ ----=
Phll~[j~:'.'•. _. _...•• _•.. _. _••• __
Cebu ...•.. . ••.. •.•...•••.• •••
D avao ..••..•••.•..•.........
Iloilo .•.•....••............•..
J olo .•...• ••• ....•• ....••• •. •.
0
12
3,342
22
17,1185
2
52
833
0
0
65
2,504
Amoun&J
or bills
1'8lldered:
for quar•
antlne
29
1,192
37
0
l
7, 806
0
10
=-=
0
574
40, 437
0
96
0
0
41,107
()
3,380.00
-.c=
100
18,254
3,334
8,102
824
214
102,200
167
640
133,885
3
376
130
305
62
49
1,210
4
82
2,211
----------
----------------------------------------------------------------
Zamboanga • . ••••.. : ......• •.
---------o·
T otal. ..•.... .•.. . ........ .
--=
=
=
=
Puerto Rico:
0
234
0
0
0
0
0
0
Aguadllla .••.••.•...•.•••••..
0
0
0
0
0
0
0
95
Areclbo .....•.•.•..••••..••••
5
41
10
50. 00
148
5
0
0
Arroyo ... .. .... ..•...........
0
0
87
0
0
0
0
0
Central Aguirre ........••••..
59
331
1
310.00
397
59
0
0
FaJarrlo .. ....•.•.•...••••••••
121
167
7, 890
324
2
1,580.00
167
0
Ounnlca .......••....••••.••.•
10
161
9
70.00
85
10
0
0
Ilumacao .. •. •.• ••..••••••••.
309
2
166.00
0
428
33
33
0
Mayaguez ......••••.••••••..•
42
165.00
10
396
23
0
0
320
Ponce ... ..•..•..•..••••••....
6,811.BZ
26,148
9,121
1,145
396
457
0
8
San Juan ......•.•.•..••.•..•.
8, 151.BZ
35, Z76
9,509
2
8
3,060
689
754
Total .••.••.•.•...•.••.....
--- -- =
Virgin Islands:
138
75.00
12
12
5
0
0
285
Christiansted. ~ ....•.•..•••. .
3,053
1,980
625.00
40
40
0
0
69
Frederiksted ..•.•.....•.•••..
0
0
0
0
0
0
0
0
St. John .....•.... ••.•. •. •••••
8,759
2,045
1
2,726.46
103
230
23
537
St. Thomas .••..•......••••.•
3,426.46
4,030
291
23
1
891
215
11. 950_
T ot al •••...•.. ·······-······
- - - 939
628 596,114 1,074,840 ½7, 657 215, 778.2&
Total, all stations •.•••••••. 13,917 11, 171
=
--
-
• Includes Perth Amboy, N .J.
--- --·---
• Includes all ports on Puget Bound.
Digitized by
Google
57
PUBLIC HEALTH SERVICE
MEXICAN BORDER STATIONS
TABLE
2.-Summary of quarantine transactions on the Mezican border for the
fiscal year 19SS
Station
Number of
passen- Number Total
gers
or local number
or pasfrom
passeninterior
gers
sengers
Mexico inspected inspected
in-
spected
Total Total
Total number
numnumof
ber ol persons
ber or
perperpassed
sons
sons
disin- without
vaccitreatrested
nated
ment
Total
numher of
sick
held
for
observation
Total
number of
sick
refused
admission
Total
pieces
or
bag•
ga!(e
dismrected
- - -- - -- ---- - - - -- - Brownsville, Tex ___________
Calexico, Calif______________
Columbus, N.Mex _________
Del Rio, Tex _______________
Douglas, Ariz _______________
Efl!e Pass, Tex ____________
El aso, Tex.1______________
Hidalgo, Tex ___ ___ _______ __
Laredo,Ariz
Tex.•--------------Naco,
____ ______________
Nogales, Ariz _______________
Presidfo, Tex _______________
Rio Grande City, Tex ______
Roma, Tex _________________
San Ysidro, CaliL _________
Sasabe, Ariz ________________
Thayer (Mercedes),
Tex ____
Zapata,
Tex ________________
Total _________________
717,342
1,369
715,973
112
716, 376
854
9,992
397
10,398
10,398
0
0
117
218
120
236
353
0
54,275
54,819
622
53,534
544
705
3,550
5,252 5,133
1,702
0
467
4,737
540,279
545,016 0, 030
535,986 1,764
7,528 4,731,233 4,738, 761 24,623 4,700,542 13,561
192,268
194,054
188
191,563 2,261
1, 786
63,210 1,609,600 1,672,810 3,123 1,641, 799 31,011
5,198
5,198
0
4,576
518
0
21,473
18,497
22,189
9
707
3,692
21
31,555
31,576
55
31,010
501
10,380
271
10,575
10,846
4
462
44,498
4,116
41,258
45,374
7
876
3,374
8,350
11,724
0
JO, 623
895
346
262
608
608
0
0
68,678
68, 702
68,155
24
5
536
7,934
8,382
6,968 1,414
0
448
248
93,058 8,050,346 8,143,404 42,911 8,048,039 57,311
288
0
I
0
0
0
0
0
35
0
0
3
0
0
0
0
C
1
Includes the subports Fort Hancock, Guadalupe Gate, and Ysleta.
• Includes the subports Miners and San Ygnacio.
1
Digitized by
Google
0
8
15
0
60
0
35
7
0
104
0
7
0
0
206
0
6
0
0
0
0
349
0
9,949
1,039
11
3,635
0
9
8
1,213
8
0
0
0
0
448 16,221
C11
00
TRANSACTIONS AT UNITED STATES AIRPORTS OF ENTRY FoR AIRPLANES FROM FOREIGN PoRTS
TABLE
Location
3.-Summary of transactions at continental and insular stations for the fiscal year 1933
Name of airport
Distance
In miles
to nearest
Public
Health
Service
station
Date desig•
nated
I
Number
of air•
planes
arriving
from for•
eign ports
Num_ber Number Number Number
of au• of ne.rsons of persons or aliens
. planes d arriving inspected inspected
b~ruc:icl from for• by Public by Public!
n 1 h eign ports Health Healtb
Se~~i~e or places Service Service
Number
of aliens
certified
for dis•
ease
- - - - - - - - -- - - - - 1 - - - - - - - - - - - - - - - - - - - - - - - 1 - - - - 1 - - ----1-- - -, - - - - 1 - - -- 1- ---1----1--- Ajo, Ariz . .... . . ................ Municipal Airport......................................
6
0J'.t-:.==::::=:=:::::::: ·Mug~;paiifie1,i:::::::::::::::::::::::::::::::::::::::: ::::::::::
ti~~Y,
Bellingham, Wash ..........••. Graham Airport'················· ·· ·· ··•····· ···· •····· .... .•....
0
co·
;ac
N.
CD
D.
rr
-<
C"')
0
~
(?
Nov. rn, 1929
0
Apr. 18.1931
Brownsville, Tex ....•.......... Municipal Airport.. .. ...... ............................
5 Jan. 8, 1930
Buffalo, N.Y .•.... ............. .. .•. do .. . ................. ........................................ June IO, 1929
Calais, Maine .••..•......•....• P an American Airways Seaplane Base, St. Croix River• ........... July 23, 1931
Calexico, Calif..... . . . . . ........ Calexico Municipal Airport•............••.•..•................... Jan. 10, 1933
Caribou, Maine 1••••••••••••••• Caribou Municipal Airport'···························· .......... Oct. 31, 1932
Cleveland, Ohio....•...•....... Cleveland Municipal Airport• ........•..•.•.....•.•..•........... Sept. 23, 1932
Wayne County Airport:....•...•...•..•.•...•.•.•.. ......... ..••. Feb. 10, 1931
Detroit, Mich •........ ..•••.•. { Detroit Municipal Airport '·· ······················ · ••·• .......... June 19, 1931 f
Ford Airport 2•••••••••••••••••••••••••••••••••••••••••••••••••••• Aug. I, 1929 )
Douglas, Ariz .•....•.......•.•. Douglas Airport 2•••••••••• • •••••• ••••••• •••••••• ••••••••••• • ••.•• Jan. 8, 1930
Duluth Minn
{Duluth Municifral Airport 2 • • •••••••••••••••••••••••••• •• ••• ••••• Sept. 4, 1931 }
•
•················· Duluth Boat C ub Seapiane Base•........•.•.•........••........• , ....do ...... .
Ea~e P ass, Tex •.........•••.. . Eagle Pass Airport 2••••••••••••••••••••••••••••••••••••
Hi 1 Mar. 5, 1930
El aso, Tex............. ...... Municipal Afrport. . ......•..••. . .......•.•. •.•...•....•
9
Aug. 23, 1932
1
.-:.-:. : : : : : : : : : :
ii~~r~:::}~~~~~~:
Juneau, Alaska ...•...........•.
Ketchikan, Alaska ..........••.
Key West, Fla- .... -......•..•.
Laredo, Tex ...•••.........•....
Malone, N.Y ·--·············· ·
0
0
0
4372
0
0
0
01
2,8164
0
0
0
437
0
0
0
2,8 16
8
0
3070
0
0
0
110
0
0
0
o 1········0T······oT······or······or·······o
I}
'"d
§
t::
C
::i::
l,;J
>
1341
O
317
O
o
0
0
0
0
0
0
0
0
~
5
0
0
0
fll
l,;J
1
o
O
o
o
o
o
122
122
686
686
151
10
0
0
0
0
0
0
0
14
14
0
0
12
4
0
0
2
28
O
103
10
103
O
8
O
O
O
1,175
1,175
13,719
13,719
1,454
8
~~~~ t:~~:'l'lt~;r~~r:.'::::::::::::::::::::::::: :::::::::: .~~~o::~~~~. ········o· ··--····o· •··•••··o· ········o· ········o· ·········o
Juneau Airport 2•• ••••• ••••••••••••••••••••••••••••••••••••••••••• June 18, 1930
Ketchikan Airport 2•• •• •••• ••• •••• • •••••••••••••••••••••• •••••••••••••• do_......
Meacham Field .•••.....• ·-·······-···············-·····
4 Dec. 20, 1927
Laredo Airdrome '·············-··············-·········
3½ Jan. 24, 1930
Malone Airport'·-······································-····· ···· Apr. 18, 1930
Pan American Field.· ····-········· · ···················
8½ Oct. 16, 1928 }
Miami, Fla..•.•••........•..... { Dinn_er Key Seapla~e Base•---···········-·······-···-·
6 Mar. 7, 1930
·
Curtiss Air Station --------···························
¾ Apr. 22, 1930
• Minot, N.Dak. '-·············· Port of Minot'-··········-·······-·-··· ················ .......... Nov. 30, 1931
Nogales, Ari•······-··········· Municipal Airport'· · -·················-· ····-·-·······
9 June 27, 1929
Ogdensburg Ny
{Billings Field•--····· ········-· -· ·····-·····················-···· Nov. 30, 1931
.
' · -············· Ogdensburg Harbor•---·········-················-···· · •......•.• Mar. 1, 1932
,, Pembina, N.Dak .. ·-···-······ Fort Pembina Airport'·-···········-·-·········-·-····· •••...•.•. Feb. 2, 1930
Plattsburg, N.Y. '-·--··•····· Mohodo Airport'··-··············-················-········· ··-·· June 2, 1930
Portal, N .Dak . ................ Portal Alrr,ort •········-··············-·······-···· --··· ••••.•...• Jan . 8, 1930
Port Angeles, Wash .••••...... Port Ange es Airport•-···········-····-················
52 ••••. do .....•.
Port Townsend, Wash ••••••••• Port Townsend Airport•-····--=-· = ·=
···-='--=-·=· ····
12 June 18, 1930
I
0
tt;i. J: m~ ········o· ········o· ········o· ········o-i-· ······o· ·•·······o
0
2
28
1
o
3
~I 7:~ I ·-··Tr·····-r
g g ······n··----·n···--·-n········g
JI
I
0
0
0
1
;
C
l,;J
lfiti,;;
iGwJel,Poia', N,Y.~········•·· .RoU888 J>9int Seaplane Base'···························:•.......• luly 14, UIS!
o
o
. o
o
o
o
It T
. 1JJoalu...OaUf
ffill;I Illimda•.•• St. 'rhomas.Alnlort •. ·······;·······•·················· •••••••••• ····.·····~·····
51
51
407
4111
O
o
••••••••••••••• Ban Diego Munlolpal Airport •••••••••••••••••••••••..•••••••••• lan. 24, 1930
1,140
1
3, 601!
1
O
O
,.. ha
P.B~ •••••.•••••••••• Isla Grande• ••••••••••••••••.•••••• , ••••••.••••••••••••••••••••• lan. 19, 1929
222
222
2,124
2,124
345
4
St\D
Oblo 1•••••••••••••• Parker Field'··;·····················•·················· ••••••••.• luly .14; 1932 ••••••••••••••••••••••••.•.•••••••••••••••••••••••••••••••••
Soobq, ont.................. Scobey Airport .•••••.•••••••••••.•. :.................. •••••••••• June ; 1930
4
4
9
9
o
o
1 8eaWe Wash
{Boeing Mwrlolpal Air Field•••••••••..••••••••.•••.••••••••••••••• Sept. U, 1928
300
630
o
o
0
0
•
Lake Onion............................................ •••••••••• Dec. 27, 1928
Skagway Municipal Alrpott •••.•••••••.•.•.•.•.•••...•••••••.•.•• Nov. 30, 1931
1
"' Skagway, Alaska •••·•···•••••• {Skagway Seaplane Base• ••.....•...• , ...••••••.•.••••.•••.•••••••••••• do •••..•• ·••·••••• ••••••·••• ••••••••·· •··•••··•• •·•••···•• •••••••·••
Spokane, WR8b. '··············· Spokane Municipal Airport (Felts Field)•.••••.....•.••• ··········11une 2, 1931 ••..••••••.••••••••• •••••••••• •••••••·•• •••••••••· ••••••••••
Swanton, Vt.'················· Mlsslsquol Airport'································.···· ••......•. Jufy' lll,.·1930 ••••.•.•••••••••••••••••••.••••••••••••••••••••••••••••••.••
i
l
i
;:r,~:r::·feiJli.'ii1a::::::::: ::'C:::~'?~f':t~tir~,!irira:; icimiii·coiniiion·Piirii:ii: ::::::::::
{'::. 1~I~~ ······1ai· ······1si" ······43ii" ······4as· ·······43· ·······--o
o
o·
o
o
o
o
Wrangell, Alaska .•••••••••••••. Wrangell Seaplane Base• ••...••..•.. , •....•.•..••••••••••.•..•••. Nov. 30, 1931
Total ••••.•.•..••.••••••• /••••••••••••••••••••••••••.•••••..•.....••••...•.••••...•• /...••••••. /•••••••••••••.• :
l
No medics! officer or Public Health Service avall•1hle.
• Temporary permission.
• Authorized for use but not oilldnlly ,lesi.:n tc<l
1
4,186
2,2011
25,767
:IIJ,396
2,327
33
§
~
t:i::
l'iJ
>
~
gJ
0
co·
;ac
N.
CD
D.
rr
~
C
l'iJ
'<
C"')
0
~
(?
Cl
C0
60
PUBLIC HEALTH SERVICE
TRANSACTIONS AT FOREIGN PORTS
TABLE
4.-Summary of quarantine trarniactiona at foreign porta, ji,acal year 1988
Medical
Fumlga• PassenBills of eumlnatlouaof
tlon or gera in- Crews In- balth
Ve.,seJs
inspected vessels ............ llpected coanter- Service
observed , _ _
lfcned benefl-
Location
' clllriel
Amoy,
China Bay,
________
- -------------------Guantanamo
Cuba
__________________
Habana, Cuba __ ------------------ ________
Hongkong, China_________________________
Shanghai, China __________________________
73
8
0
0
18, 1136
0
G
41
~!:p<:~~M~fco~:::::::::::::::::::::::
Puerto Mexico, Mexico ___________________
270
226
2
1
0
9
0
2
Total ___ -------------------------- --
1,444
O
O
O
O
O
O
26
21
37
O
O
0
O
26
6
~
29
514
351
0
66,981
6,200
72
7,f!/11
30II
0
811, 87G
6,400
114
86
1,617
G73
0
0
0
0
712
270
0
0
0
0
6,G80
9,175
17,406
0
2211
80
63
87,693
130,0GII
a. 827
0
O
O
O
727
1, 788
201
2,102
283
O
8,864
O
O
O
O
O
O
llG
62
1
2,294
87
6,837
0
2
MG
O
O
O
l
12
12
O
O
102
0
24
7
8,411
16,463
7,691
321
0
O
0
O
1111
867
0
831
11
0
14
2
21
~
,lG
19
J:UROPJ:AN POBTS
AntwerpJ Belgium'----------------------Belfast, ueland ______ - -- -- -- -- -- __________
Bergen, Norway'------------------------Bremen, Germany'----------------------Copenhagen, Denmark•-----------------Dublin, Irish Free State_.------------____
Danzig Free City_________________________
Genoa, Italy_----------------------------O!asgow, Scotland-----------------------Hambnrg, Germany______________________
Liverpool, England•---------------------London, England_________________________
Marseille, France_________________________
f:f~o~tfJi1i:::::::::::::::::::::::::::
Piraeus (Athens), Greece__________________
Rotterdam, Holland'--------------------Southampton, England•------------------
o
O
O
O
O
gO
o
O
o
ll,
m
1,209
1,438
12,602
o
g
2,276
O
0
31
41
'1
198
29
117
147
1
o·
2
~E:!ft:.ai!::~ ,_::::::::::::::::::::: :::::::::: :::::::::: :::::::::: :::::::::: :::::::::: ::::::::::
Total_______________________________
Total, all stations_.--·-----·-·····--
179
191
69,801
4,570
2,470
!Gl
l====l====l====f===,l=====l====o=
1, 623
244 156,894 134, 633
6, 097
181
1 Work discontinued Aug. 31, 1932.
• Work discontinued Sept. 30, 1932.
• Work discontinued Feb. 28, 1933.
• Work discontinued Oct. 31, 1932.
• Medical officer on lmml;::ratloo duty reporta no quanntlne work dODe dW'lna &be ,ear,
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Google
61
PUBLIC HEALTH SERVICE
MEDICAL INSPECTION OF ALIENS
TABLE
5.-Alien-passengers and seamen inspected and certified at maritime ports
· in the United 8tates and possessions during the fiscal year 1933
Place
Alien seamen certified 1
Num- : Alie'n pas~ngers certified I
Number of
ber of , - - - - - - - ~ - ~ - alien
alien
11assen~ Class A
seaClass A
gersex1 ,_____ ,C lass Class To· men ex• 1_ _ _ __ 1Class Class To•
amine1
II
B
C
tal amined I
II
B
C I ta!
I
- - - - - - - ---1- -~ •1 - -
-1---1--- -
-
- - --- --- - - - - - - - -
ATLANTIC COAST
2
13
20
1 .. .•..
7,795
.Baltimore, Md ..... ... .
29
0
0
Beaufort, 8. C .. ....... .
0
12
41
279
2
106 55,433
88
Boston, Mass . . . ... ... . 4,297
162
2: •..... a • • • • • • • • • • • • • • • • •
0
.Brunswick, Ga...•.... •
2,455
5 ..••.. •••• •.
0
Charleston, S.C .• : . •.. •
I~ :::::. : ••••• '. •••••••••.•
0
568
' Fall River, Mass ...•...
2.
126
0
Fernandina, Fla ..... •.
2 ••••••
2
6,436
Fort Monroe, Va. 1 •••• •
324
0
0
· Fort Pierce, Fla . . . •....
0, ····•· ....... . ... . · · ····
0
0
_Georgetown, S.C •..••..
0 ------ ------ -'. ----- -----1
1
0
126 ...... ......
Gloucester, Mass ...... .
0
1,699
0
9 ••• • ••••••••
Jacksonville, Fla ...... .
33
1, 417
15 . .... .
16
Key West, Fla ........ . 3,672
0
7
Lewes, DeL ......•.....
0 .• ••••••••••• ·•···• ••••••
6,282
6
15
1 ••.......... .. ....
Miami, Fla ..•......... 2,815
42 ••..•. •• •... ......
1
1
1
New Bedford, Mass .•..
I
0
0
New London, Conn .•..
0
Newport, R.L . . .... .. .
0
0
0
New York, N .Y . (Ellis
4
116
Island) ..••... . ....... 123, 891
41
114 3,645
32 3,832 426,150
2 ••• •..
Perth Amboy, N .J.....
0 . ..... .....• ...... ......
0 1,180
Philadelphia, Pa.......
199' . ..... ... . .. . ..... ......
0 17,555
14 • ··• • • • • ••••
Plymouth, Mass.......
0 ...... ...... ...... ......
0
193
4 ••••• • · · •••• •••• .•
8
Port ~verglades, Fla...
O •••••• ••••. • •••••• ••••••
0
Portland, Maine.. .... .
38 ...•.• .••.. . ...... .... ..
0 2,728
5 ..•• ..... ...
2 •••• • • •• ••••
258
1
4
2
7 1, 371
Providence, R .L. . .....
Savannah, Ga.. .. ......
49 • .....• . ..... . . .... .... ..
0 1,323
2 ..••• • ••• •••
Searsport, Maine.......
0 ...•.. .. .. .. ...... ......
0
153
1 . •...... . . .. · ·····
Vineyard Haven, Mass.
0 .•... . ...... ...... ..... .
0
7
0
Washington, N.C. .....
O ••.•.• •••••• •••••• .•.•.•
0
170
West Palm Beach, Fla.
65 .,.... ...... ...... ....•.
0
825
Wilmington, N .C......
34 ...... ...... .•.•.. ......
0
2 • ••·•• .• : . :: ::::::
35
0
327
0
5
0
0
13
0
0
2
9
()I
(}I
:l
l!
QI
o,
122!
0,
14,.
4;
o,,
o•
2!
2'
1,
o,
06•
2'.
- --1---1----,1----1- - -,----,1----+---1--- - - - - - Total. ........... 135,728
45
121 3, 762
53 3,981 534,211
16
216
305
8
l===F==l===l===~==-==-===t===l===i===i===!===
GULF COAST
Boca Grande, Fla.. ....
O •. .... ...•.. .....• ..•.•.
Oarrabelle, Fla....... ..
0 . ..... ...... ...... ......
Oedar Keys, Fla.......
0 ...... .•.... ...... ......
Oorpus Christi, Tex... .
0 ...... ...•.. . ..... ..•...
Freeport, Tex......... .
1 ...... ...... ....•. .. .. ..
Galveston, Tex . . .... ..
130 ...... .••..•
1 ......
Gulfport, Miss. . . . ... ..
0 .... .• .•..•• . •.... ... ...
Mobile, Ala. ... ...... ..
59
1 ... . .. . .....
Morgan City, La . (At·
cbafalaya).... ..... ...
0 . • .... ...... ...... ... ...
New Orleans, La.. . .. .. 2,006
18
42
71
Panama City, Fla.... .
0 . ..... ...... ...... .... .•
Pascagoula, Miss. ......
0 ...... •... . . ...... ......
Pensacola, Fla.... . .. ..
3 ...... ....•• ... . .. ..... .
Port Aransas, Tex.. ...
0 ...... ...... ...... ......
Port St. Joe, Fla.. . ....
O .. .. .. ...... •... . . ......
Sabine, Tex ...... . ..... ~ · · ····..................
Tampa, Fla.. ..........
72 ..... . ...... .... . . . .....
O
1
0
1
165
39
0
742
232
12,782
153
3, 759
5 • ••••• · ·-· ··
0
132
0
21,651
------------ ------~-1
57
29
77
0
0
0
0
0
0
55
934
0
O
0
O
4,497
1,872
0
0
0
0
0
0
0
O
0,
0
2
2 .....•
()
[>
0164
0
0
4
0
0
9
7
7
7 ••••.••.••••
, - - · 1 - - - - 1 - - - - i - - - · 1- -- l - - - - - - - --
Total. .. .. ..... . .
2,298
1
19
43
71
134
46,881
78
32
78
189
1Class A•I: Aliens certified for Idiocy, imbecility, feeble-mindedness, insanity, epilepsy, chronic alcoholism. Class A-11: Allens certified for tuberculosis or other loathsome or dangerous contagious diseases.
Olass B: Allens certified for diseases or defects which affect ability to earn a living. Class C: Aliens
certified for diseases or defects of less degree.
•Includes Norfolk, Va., and Newport News, Va.
Digitized by
Google
62
PUBLIC HEALTH SERVICE
.5.-Alien passffl{lers and aeamen impeded and certified at mariti?M port.a
in the United States and possessions during the fiscal year 19.,.,-Continued
TABLE
Allen passengers certified
Number of
alien
Numher of
allen
AllenNB1118Daert111ed
1------,---..------.---
Cu.A
passen
Cl= A
-gers ex- _ _ _ _ ,Class Class To- men ex- _ __,_ _ 1Class Class Toamined
B
C
ta! amlned
B
C
'81
I
II
I
II
- - - - - - - - - 1 - - - - 1 - - - 1 - - - - - _ _ ,_ _ _ _ -
--·1---1---1--
PA□ FICCOAST
Aberdeen, Wash ______ _
0 ··---- ------ ------ -----Angel Island, Calif.
(San Francisco) _____ _
12
92
79
Astoria, Oreg _________ _ 4,3245
0
Eureka, Calif. •.. ---·-ll'ort Bragg, Calif. ____ _
0
Marshfield,
Oreg. (Coos_
Bay) ________________
0
Monterey, Calif _______ _
0
Portland, Oreg ________ _
6
Ban Diego, Calif_ _____ _
517
Ban Luis Obispo, Calif_
0
San Pedro, CaliL ··-·-· 3,794
Banta Barbara, Calif __ _
0
Seattle, Wash.•-···----- 2,306
.South Bend, Wash. ___ _
0
3 ------ --···· ·····-
3
9
4
2
2
M
10
0
19
4
0
0
0
0
3
18
0
98
13
28
106
11
36
167
179
393
15
9
17
42
l ····-1
16
864
0
0
0
6
l===l===i===
1 ·····-
0
0
0
0
0
0
0
92
0
201
6,098
908
43,926
0
11,191
491
3
48° ""1:i" ••
..,
1
·1- ••
0
10
0
73,333
4
97
0
°
4
o· ··s·
13
13
.
INSULAR
.Alaska:
Ketchikan ___ ····-·
0
Hawaii:
Honolulu __ ---·---·
327
9,676
0
161
0
0
Total_--····-··-- 10,957
0
163
2,303
0 -···-· ------ ------ ------
31,943
92
l====l==l==i===l==i===l===
2 ------
0
94
PhilJ:fer:f~':'._:____________
Davao_____________
IJoiJo_______________
60 ------ ·-·--- ------ -····0
4,009
0
0
39 ------ ------ ------ ••••••
0
3,299
0
937 -····· -···-· ------ ••••••
0
7,681
JoJo________________
182 -·-··· •••••• -····· -----0
750
0
0
Legaspi____________
0 -····- ------ ------ -----0
269
Manila _____________ 26,593
25
58
6
89 67,811
l .•.....•••.•
1
0
Zamboanga________
175 -·---- ------ -·---- -----0
656
'---l--+---l---t----t--+---t---t---l----t--+--89 84,375
25
58
9
0
0
0
0
TotaL-----····· - 27,986
Puerto Rico:
AguadiJ!a__________
Arecibo____________
Arroyo_____________
Central Aguirre
(Jobos)___________
Fajardo____________
Ouanica .•• ---·-·-Humacao__________
=
==•i===i===l,==i===c·== ==•i='==i===t==
0 -·-·-· -·-·-- -···-· --····
0 -·---- -·-·-- -·-··- -·····
10 -···-· -····· -···-· --····
0
0
0
0 -···-- --···· •••••• ••••••
0 -····- ------ •••••• ••••••
41 -·-··- --···· •••••• ••••••
0
0
0
0 -····- •••••• -····· -·····
0
0 --···· -·---- •.•••. .••••.
0
42 •••••. ---·-· ------ ···-··
0
265 ------ ------ ----·- .•••••
0
7 ·····- -····· ______ -----0
4,776
l ---··- .••..•
l
9 ____________ -····- ______
0
128 .•••.••••••••••.•• -----0
Mayaguez_________
0 ______ ------ ______ ______
0
189 - - ---·,,- -_-_-__·-_-__-_·_-_··_·_
0
Ponce______________
39 __________________ -----0
203
•
2
San Juan___________ 6,820
5
7 14,022
6 ------ ••.•••
9
l------,1---+---+---+----,l---+---·l----t---t---l'----l---Total_ ___ ______ __ 6,927
0
5
7 19,624
0
9
0
0
9
===l===l===l===l===l===l====!=,=1==11==1==-t==
Total, all stations_ 186, 199
58
217 4, 044
327 4, 646 700, 367
21
I 433
• Includes all ports on Puget Sound.
Digitized by
Google
352
99
905
63
PUBLIC HEALTH SERVICE
TABLE
6.-Aliena inapected and certified at international border stations, fiscal
year 1933
Place
Number of
persons
me.king
perme.nent
entry
examlned
Allen passengers certified
Number or
persons
making
tempore.ry
entry
examlned
Other
persons
examlned
0
58
73
236
0
0
12
4,363
9
640
0
4,486
2
0
0
816
3
0
0
70
335
9,766
9,822
122
3, 629
3, 550
2,446
10,701
1.696
9,769
5, 1511
13,490
743
282
293
10,170
602
556
666
187
Total
num•
Class A
ber of
persons
Class Cle.ss
exam- Total
C
B
ined
I
II
--- --- - - - --- - - - - - - - -
llEXIC.I.N BORDER
Alo, Ariz ________________________________
Brownsville, Tex __ ____ _____ ________ _____
Calexico, Calif___ ___________________ _____
Columbus,
N.MeX-------------------- Del Rio, Tex
____________________________
Douglas, Ariz _______ ___ _____________ ___ __
l:,!~~el~~~~:::::::::::::::::::::::
Hidalgo, Tex ____________________ , _______
0
819
181
0
41
I, 702
274
1,052
202
Laredo, Tex. ___ _______ -- ---- ----- "--- ___ 111,209
39
Naco, Ariz
__ ---------------------------Nogales,
Ariz
____________________________
521
Presidio, Tex ____________________________
4
Rio Grande City, Tex ___________________
3
Roma, Tex ______________________________
3
San Ysidro, Ce.lif _______________________ _
738
3
Base.be, (Mercedes),
Ari•- -- - ---- --------------- -•-•.
Thayer
Tex
_____ ______ ______
2
Tucson, Ariz ____ ____ ____________________
0
Zapate., Tex. ___ ____ _____ __ ; _____ --·-·-··
190
0
335
10,643
289
113
10,076
10
358
2
3,670
119
5. 252
32
2,732
16,116 2,727
1,907
368
287
29,518
5,198
292
631
18,m
109
11
285
37
296
11, 724
fi'J7
2
608
41
558
l&
666
7
447
55
0
4
10
11
4
0
0
7
0
2
16
0
0
0
13
209
76
i
2
5
2
0
41
12
19
4
2,
106
223
611
143
44
230
45
65
76
388
43
29
0
8
3
JO
61
4311
0
0
~
24
Iii
19
0
i
5,749
128
8fi3 3,694
0
0
10
16
4
0
63
0
2
0
0
5
0
3
5
0
3
3
47
12
8
0
5
2
0
1
0
19
2
4
Bellingham, Wash ___ _____________ _______
Blaine, Wash _______ ____ ____________ ____ _ , 3530
59
Buffalo, N.Y .. ----·------·------------·Calais, Maine
_____ ----·- _____ __ ·----· ___
126
Chicago, IIL __ . - ____ -----·-·--- ----·---·
0
Detroit, Mich _____ __ --- _________________
Duluth, Minn ___ _____ _____________ ______ 1,4752
Eastport, Idaho __ • -- ____________________
147
Eastport, Maine .. ____ _____ _________ ___ __
4
Erle, Pa ___________________________ ____ __
0
Halifax, Nova Scotia, Canada ______ __ ___
386
Havre, Mont _______ _____________________
0
Houlton, Maine _______ __________ _______ _
222
International Falls, Minn ____________ ___
39
42
Jackman, Maine-------·-···-·--··---·-··
Lewiston,N.Y.
143
N.Y__________________________
______ ·-·-·--- ---·--- -- ···_
Malone,
11
Montreal, Canada __ ______ _________ _____ _
931
Newport, Vt ____________________________
309
Nlage.ra Falls, N.Y ___ __ ___________ ______
179
Northport, Wash _________ ________ ; ______
0
Noyes, Minn ____________________________
24
20
3
30
Portal,
N.Dak
..
-······----·------···-·
Port Angeles, Wash __ ____ ___ ______ __ ____
0
Port Huron, Mich--._ .. ______________ . __
107
Quebec, Canada.. ___ ___ ____ _______ _____ _ 1,068
228
Rouses Point, N .Y--- --·---------- -- --- St. Albans, Vt ______ _____________________
35
St. John, New Brunswick, Canada ______
225
Sault Ste. Marie, Mich ___ ________ ___ ___:
13
Scobey, Mont_ __________________________
7
Sumas, Wash ____________________________
72
s~::Nr!iw.;...r~_:::::::::::::::::::::::
Sweetgrass, Mont _____ ._ .... _.. _____ ._ . .
63
Van Buren, Maine.--·----··-·---- -· ____
20
Vanceboro,
Maine ___ ___ ______________ ___
244
V1mconver, British Columbia, Canada.0
Victoria, British Columbia, Canada __ ...
183
Winnipeg, Manitoba, Canada _____ __ __ __
711
Yarmouth, Nova Scotia, Canada __ ______
34
Total ___ ____ ___ ___ _________ . _____ ._ 7,515
Total, all stations ... _. ___________ __ 32,498
1
4
0
61
29
3
0
58
6
343
I 66
9
172
156
33
3
24
0
2
7
13
0
---- - 1,074
- - - - - - - - - - - - - - - - --- - - - -
--- -10,-668- 83,984 1111,635
Total _______ - -- . - --- ----------·· --· 24,983
CANADIAN BORDER
0
6
1
0
0
8
0
0
623
0
0
2,064
600
338
1,310
0
201
5
0
2,602
0
166
17
0
117
314
15
JI
3
0
188
905
0
3
305
0
0
8
&6
II
378
437
0
242
16
11,543
0
303
34
0
0
2,187
1,264
30
38,238
0
119
0
0
20
46
14,984
23
0
403
813
30
59
0
656
716
126
0
5,726
1,866
515
39,552
0
706
5
222
2,661
l
29
11,742
34
0
397
0
350
82
0
0
0
32
0
12
28
0
0
2,418
33
73,682
88
15,293
51
931
829
1,306
45
83
11,766
67
0
692
1,973
578
120
85
121
20
0
760
6
88
0
0
277
0
4
21
46
38
14
242
139
63
6
32
9
0
19
0
173
2li6
53
22
a
37
4
3
0
2
I
1
I
8
2
8
5
112,740 3,547
252
530
36
13
7
112
719
43
6ro
437
183
3,371
83
6
0
39
I
2
I
96
38
799
22,211 157,666 212,376 9,296
=380
0
2
9
3
0
40
0
3
0
0
3
0
0
0
0
I
0
0
II
8
0
2
0
0
0
0
5
I
5
0
2
I)
0
5
0
0
0
8
I
i
I
16
6
21
1
173
15
39
5
22
4
0
18
0
121
214
42
10
20
2
0
28
0
I
0
74
12
675
31
0
45
14
2
0
63
0
38
0
0
177
0
0
0
40
13
10
22
101
8
0
a
a
0
0
0
28
311
2
g
10
0
0
4
0
0
0
6
23
109
0
117 2,419
--
1170 6, 113
1,833
-750
------
··--
Includes the subports Fort Hancock, Guadalupe Gate, and Ysleta.
Digitized by
0
28
82
II
0
604
6
45
0
0
92
0
I
Google
Pl;BLIC HEALTH SERVICE
T.uL& 7.-Alina uamen imp«Ud and eertipd at ~ bordtt- atatiou
peol..,-19:1:J
I
I
1
I
certified
.\lien -
s.•om'-,-------------
I
·-,
i
....,
C'--••A
eumaedl----:----i' ~
of alien
....,.
i
I
1
c~
Teal
0
I
t:~. ~:.:h.::::::::::::::::::::::::::::::::::I
I·,
':
:0
:,t
,tD
m
2111
121
0
0
O
0
0
0
0
O
0
0
0
0
O
0
0
4D
O
0
O
0
O
1K
0
0
0
0
0
H,esl
O
4
,tD
42
86
~::'"..,,. X.Y........................................
Ct..-=. ID.........................................
D-:iknt. lfinn......................................
~r,,,rt. Maine....................................
Ene. Pa............................................
~ - :S.Y......................................
lJ,2111
18
18
Tc;tal. .............•••...•.•.•..•.•••••••.•••.
:
:
:
~drm~.~~:::::::::::::::::::::::::::::::::1 - -u;
g :
:
:
i
- - ' - - - 1 - -.....- - - ' - - - " - - - -
TABLE
~.
8.-Number and d&arscter of t1ae inmadatoril11 adudable conditimu etrrtipd
at Uniud Stau. port. duriflll t1ae fiacal year 19:1:J
.:. ...
&j
?:a
="i
.h
a_a
,;;.!
8.0
:SJ
.Alien passengen.. · I
Allen 9eSillen •••••• ,
I
Ill
0
-aj
...
.f
""
..a
,ti)
0
g-
llj
a
I
i
!i
a 1I
1
...
I .!•
.:s
::l,.Q
a
o
o..Q
oo
72
•
110
1
~
0
"
0
139
13
.:I
=
--
252
•
15
0
Digitized by
i
,_
aQ
231
tn
1;1
Ii .
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aQ
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83
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I
.., ..,
g
5_!'Q 3
0
M.5
1112
Iii~!
0
0
f4
125
I.,t,t,t
118
3112
65
PUBLIC HEALTH SERVICE
TABLE
9.-Distribution, according to class, of applicants for immigration visas who
were medically examined during the fiscal year 1933
Total
numberof
appllcants
examlned
Country and consular office
Number or applicants
In each class
Nonquota
Quota
Nonlmmi-
Percentage or af,plicants In each c ass
Quota
grants
Nonquota
NonImm!grants
--- ---
WJ:STJ:BN l[J:JIISPBJ:BJ:
987
8,«ll
319
1, 1125
666
6,188
2
1,336
32. 3
22.8
67.5
61.4.
0.2
16.8
551
3
806
119
751
0
0
0
0
683
2
4.0
59.0
99.1
61.0
78.1
79.3
34.9
116.3
24.. 0
11
1,863
334.
837
4.25
1,069
397
263
17.0
.9
4.9.0
21.9
20. 7
13.7
~=o~~:::::::::::::::::::::::::::::::
3,165
337
1,643
5«
1,349
1,135
276
All countries, Western Hemisphere _____
11,436
2.2«
6,864
1,338
23.8
112.0
14.. 2
294
1,843
163
889
141
964
0
0
62.0
48.2
4.8.0
51.8
0
0
92
85
846
23
0
0
0
62. 0
47.8
64.9
48.0
62.4.
46.1
0
41. 3
60. 6
46. 4
0
0
66. 4
58. 7
39. 5
53. 0
33. 8
66. 0
63. 9
34. 0
38.1
0
0
Cubs: Habana __ ----------------------------Canada, totaJ ___ -- _-- - --_- --- -- -- -- -- -- - --- -- Montreal _________________________________
~=~::::::::::::::::::::::::::::::::::
Vancouver ________________________________
Windsor __________________________________
280
155
0
0
0
0
61 .•
.7
J:UBOPJ:
i=: ~~~~:::::::::::::::::::::::::::
r!~Tn} I:::::::::::::::::::::::::::::::
Botttbampton •--------------------------lrl8b Free State: Dublin _____ ---------------Northern Ireland: Belfast ______________ -----Scotland: Glasgow ____ -----------------------Germany, total_______________________________
1,
m
51
769
28
====l•===l====l===,J===I===
566
248
234
150
926
3, 249
429
2, 165
1, 210
72
809
Bremen•---------------------------------
Stuttgart_________________________________
1,077
~
764
2,518
394
437
1,415
218
210
22
415
479
199
213
Berlin_-----------------------------------
m
g~°\11~_::::::::::::::::::::::::::::::::
Holland: Rotterdam_________________________
Poland: Warsaw _____________________________
Denmark: Copenhagen_______________________
Norway, total________________________________
:Sweden, total_________________________________
Italy,
46
11
332
98
491
1,092
0
0
401
26
0
0
6
2
3~~
=
=
466
342
Bergen 1____ ---------------------- __ -----Oslo ________ - ---- -- - - - - - - - -- -- -- -- - - - - - -- Ooteborg_________________________________
Stockholm________________________________
0
0
311
122
1,101
176
227
g2 :::
ri::
70. 9
29. 0
11
216
266
2
0
56.2
65. 3
4.8. l
43.7
44. 7
51.9
.1
0
0
0
1511. 0
47. 9
1511. 0
52.1
0
0
0
0
0
44.5
55.5
0
229
250
79
134
150
116
0
0
34.5
53.6
65.5
4.6.4
0
0
4,921
1,375
3,546
0
27.9
- - - ---
-------------:--~1355
696
33.8
0
445
·321
72.1
0
0
0
0
0
0
2,642
208
0
80
!l
26.2
. 27.8
66.2
73.8
72.2
151
185
294
136
0
0
33.9
57.6
66.1
8, 119
8,976
12
47. 5
52. 4
940
Czechoslovakia: Prague _______ • ____ __________
.Austria: Vienna __________________________ ••••
g. 1
==
=
==
==
2
73.4
26.2
.4
---1----+---+---+----f-
total___________________________________
•6
•1
4.2.4.
=======~=====
All European countries_________________ 17, 107
!Closed Aug. 31, 1932,
Digitized by
Google
.1
66
PUBLIC HEALTH SERVICE
10.-Number and pereffltage of quota and nonquota applicants ezamined
who were notiji,«l for different claaaM of diaabililiu during the ji&cal year 1999
TABLJI
Quota
C011J1try
Nonquota
Percentage of
total exam• Total
Total Number not!•
lnedwho number
number fled forwere notified non•
quota
forquota
appll•
appli•
cants
cants
exam• Cl88S Class Cl88S Class exam•
lned Aoon• Boon• Aoon- Boon• lned
dltlons dltlons dltlons ditlons
Class Cl88S Claas Class
Aoon• Boon Aeon• Boon•
dltions ditions dltlona dltions
- - - - ---
--
Percentage of
ezam.
Number not!• total
lned who
fled forwere notlfled
for-
WEBTJ:BN Hl:IUBPBJ:BJ:
Cuba ..••.••.•.•••••.•.•.•.•
Canada.••••••••••••••.•••••
All countries, Western
Hemisphere •••••••••
J:UBOPJ:
319
1,925
2, 24-4
=
39
15
39
367
12. 2
.8
12.2
19.0
5,188
51
34
963
7. 7
•7
7. 7
18. 3
54
406
2.4
18.0
5,854
85
1,004
1. 4
17.1
141
954
332
98
491
1,092
122
1,101
176
227
266
3,546
294
136
2
3
4
2
4
18
1
13
0
0
0
210
3
6
23
161
77
33
62
210
15
173
34
32
13
578
44
29
1. 4
.3
1. 2
2.0
.8
1. fl
.8
1. 2
0
0
0
5.8
1.0
4.4
16.3
16.8
23.2
33.6
12. 6
19.2
12. 3
15. 7
19.3
14. l
4.9
16.3
15.0
14.0
8,976
266
1,484
2. 9
111.5
--
Belgium .•••.•••••••••••••••
Eniland ••••..••••••••••••••
Iris Free State •••.••••••••.
Northern Ireland ••••••••••.•
Scotland ••.•.•.•.•.•.••••••.
Germany •••••••••••••••.••.
Holland .••••.•.••.•....•.•••
Poland...•.•..••.••.••.•.•..
Denmark •••••.•.•..•..•••.•
Norway•••••••.•••.•...•••.•
Sweden •.••.•...•.•...•.••••
Italy ••••.•••...•••....••...•
Czechoslovakia ••••..•.. , ••••
Austria •••••.•.•.••••••• ~ •.•
153
889
234
150
429
2,155
342
1,415
218
210
213
1,375
151
185
2
8
0
3
8
16
1
36
0
4
3
50
3
3
31
172
52
41
67
483
48
350
49
37
8
662
48
38
1.3
.9
0
2. 0
1.9
.7
.3
2.5
1.9
1.4
3.6
2.0
1.6
20.3
19.3
22. 2
27.3
15.6
22.4
14.0
24. 7
22. 5
17.6
3.8
48.1
31.8
20.5
All European COUn•
tries •••••••.•.•••.•..
8,119
137
2,086
I. 7
25. 7
0
666
lll
11.-Percentage distribution of total quota and nonquota applicants of each
sex examined who were notified for different classu of disabilities during the fiscal
year 1933
TABLE
Quota
Country
Nonquota
Female
Male
Male
Female
ClassA C!assB Class A ClassB Class A ClassB C.lassA C!assB
- - - - - - - - - --- - - - --- --- --WEBTJ:BN HJ:IU8PHl:BJ:
Cnba ••••.•.•.••••••••••••••••••..•••
Canada ..............................
12.0
.5
9.3
17.8
12. 7
1. 2
19.1
20.9
9.9
.9
7.9
18.4
4.9
.4
7.3
18.3
All countries, Western Heml•
sphere ••.•••••••••••••••.••••
2.4
16.4
2.5
20. 7
2.1
16.9
.8
17.3
~~a3i-~ State .•••.•••..••••••.•••..
N ortbern Ireland ••.••.•••••••••.•••••
Scotland .•••••.••••••••••••••.••••••.
Germany ••••••••••••••••••••••••.••.
Holland ••••••••••.•••••••••••••••••••
Poland •.•.•••••.•••••••••••••••.•.•••
Denmark ••...•••••.•.•••••••••••••••
Norway•..•••.•••••••••••••••••••.••.
Sweden ••.•.•••••••••••.••••••••••.••
Italy •.•.....•.•••..••••••••••••••..•.
Czechoslovakia.•••...••.•••••••.•••••
Austria ••••.•.•••.•.•••••••••••.•••••
0
1.1
0
0
2. 7
.5
.5
2. 5
0
.9
1.8
2.8
3.3
2.1
22.2
19.6
19.8
27.1
14.4
21.2
15.4
24. 7
21.2
10. 5
1.8
42.1
20.0
13. 6
3.2
.8
0
2.9
1.4
.9
0
2. 6
0
2.8
1.0
4.3
1. 1
1.1
17.5
19.1
23.5
27.4
16. 2
23.3
12.5
24.8
23.8
24. 7
6.1
53.4
39.5
27. 7
0
.7
3.4
0
.5
2.2
0
.8
0
0
0
i.9
1. 5
2.0
12.5
16.1
20. 7
28.2
16.5
18. 2
10.1
16.3
22.2
11.4
5.8
16.1
15.4
15. 7
2.6
0
.4
3.4
1. 0
1.3
1.9
1.6
0
0
0
6. 6
.7
5.9
19.5
17.5
24.1
37.3
9.9
20.0
15.1
15.1
16.3
16.4
3.9
16. 5
14.5
24. 7
All European countries •••••••••
1.5
23. 7
1.8
27.3
2. 5
16.1
3.6
16.9
J:UBOl'B
Belgium •••••••••..•.••••••••••••••••
Digitized by
Google
67
PUBLIC HEALTH SERVICE
12.-Distribution according to sex of applicants for immigration visas
who were medically examined and notified for disabilities during the fiscal year
TABLE
193.'1
Number or
each sex
examined
Percentage or
each sex
examined
Percentage or Percentage of
males notified females notified
forfor-
Country and consular office
Male !Female
Class A Class B Class AIClaSI' B
Male Female condi• condl• condl• condl•
tlons
tions tions
tlons
--- - - WJ:STBBN HBMillmBRB
Cubs: Habsns •••••••••••••••••••••••
608
379
61.6
38.4
10.5
8.3
6.8
Canada, total ••.•.•••••••••••••••••.•
4,357
4,092
51. 6
48.4
.8
15.4
.6
17. 7
Montreal ..••.•.••••••••••••...•••
r::~~:.::::::::::::::::::::::
1,628
167
890
247
647
668
120
1,537
180
753
297
702
467
156
51.4
46.6
54.2
46.4
48.0
58.8
43.5
48.6
53.4
46.8
54.6
52.0
41.2
56.6
.6
0
1.2
1.2
.6
.9
1.6
18.6
14.0
3.0
14. 0
21.1
14. 9
41.6
.3
0
1.5
0
1.0
0
.a
23.4
22.2
4. 1
8.4
20.6
17.3
26.9
All countries, W estem Heml•
sphere ••••••.•.•.•••••••••••..
4,965
4,471
52.6
47.4
1.9
14.6
1.1
17.1
62.4
47.6
0
18.1
2. 9
18. 8
~:O~::::::::::::::::::::::::::
Vancouver •.•••••.•••••••••••....
Windsor •••.•.•••••••••.••••..•..
10.3
EUROPE
13elglum: Antwerp •••.•••••••••••.• -•
154
140
807
1,0!6
Liverpool 1•••••••••••••••••••••••
London ..•.•••••••••••.•.••••••••
Southampton ••••••••••••••••••.•
79
701
27
98
914
24
44.6
43.4
62. 9
65.4
56.6
47.1
2. 6
.6
3. 7
29.0
16.3
22.2
2. 0
.2
0
34.8
Irish Free State: Dublin.•••••••.•••••
Northern Ireland: Belfast .•••••..••.•
Scotland: Glasgow •.•••••.•••••••••••
168
87
347
398
161
679
211. 7
36.1
37.6
70.3
64.9
62. 6
LS
0
1.4
20. 2
27.6
16.1
.3
3.1
1.2
23.11
31.1
13. 8
Oennsny' total •••••••••••••••.•.••••.
1,392
1,857
Berlin•••••••••••••••••.••••••••••
Bremen• •••••••••••••••••••••••••
~~C\"8~·.·:::::::::::::::::::::::
Stuttgart•••••••••••••••••••••••••
544
31
53
361
413
666
41
78
408
664
44.9
43.0
40.6
46.2
38.3
65.1
67.0
69.5
53.8
61. 7
1.1
0
0
Holland: Rotterdam •••••.•••••••••••
Poland: Warsaw •••••••••••••••••••••
251
1,216
203
216
1,302
191
53.8
48. 3
51. 6
46.2
51. 7
48. 5
.4
L7
0
Norway, total••••••••.•••••••••••••.•
:1110
227
Bergen'··························
.••••••••••••••••••••••••••
9
201
13
214
Sweden, total ••••...••.••••.•••••••.•
252
227
~~1:fm.......................
127
125
102
126
Italy, total .•••.•..••...••.••••.••••.•
2,113
2,808
Genoa••••..••••••••.•..••.•••••••
462
1,547
114
599
2,036
174
43.0
43.2
39.6
67.0
66.8
60.4
3.1
3.9
13.1
27.2
2L9
36.8
1.8
0. 3
17.2
24.0
26.9
24. l
.Austria: Vienns••••••••••••••••••••••
196
146
249
175
44.0
46.5
56.0
64.5
2.0
2.1
16.8
14.4
.8
3. 4
23.7
26.8
All European oountries•••••••.•
7,642
9,565
44.0
56.0
2. 0
19.8
2. 6
21.8
England, total •••••••••••••••••••••••
Denmsrll:: Copenhagen•••••••••••••••
()sin
~~e!:o '························
Cr.echoslovall:la: Prague ••••••••••••••
I
=
--------- -------- -------- -----·-- -------- -------16. 7
12.11
-------- -·------ ---·---- -------- ................ -------.8
1.6
..
27.8
12. 9
11.4
12. 2
111, 1
.7
2. 4
0
1.2
L2
U.11
9. 7
20.6
16.2
:H. l
13.11
21.0
21. 7
.4
2.1
0
13.0
20.6
20.4
-------- -------- -------- -·------ ................. -------40.11
48.1
511.1
51.6
0
.II
83.3
11.9
0
1.4
38.6
111.2
-------- -------- -------- -------- -------·- -------65.6
60.0
44.6
60.0
.8
.8
3.9
4. 0
0
.8
3.11
5.6
-------- -------- -------- -------- -------- --------
Closed Aug. 31, 1932.
Digitized by
Google
68
PUBLIC HEALTH SERVICE
13.-Number and percentage of quota and nonquota applicant, of each ae:z:
who were refused visas for mental conditions during the fiscal year 1933
TABLE
Quota
Nonquota
Male
MIiie
Female
Female
Country
Number
examined
Num- Per• Num• Num- Per- Num• Num- Per- Num• Num• Per•
ber cent ber
ber cent ber ber cent ber ber cent
re- exam- re•
rere- exam- rerere- exam- refused fused ined fused fused ined fused fused ined fused fused
--
- - - - -- - - - - - - - - - -
WESTERN BEIUSPBERJ:
Cuba_ •••••••••••••••.•••••• 225
Canada ••••• ·-··-·-···-···· 1,170
2
5
0.9
.4
All countries, West•
ern Hemisphere_ ••• 1,395
7
.5
94
0. 8
755
0
7
381
0
.9 2,321
3
9
286
.4 2,867
0
10
849
7
.8 2,702
12
.4 3,152
10
.3
0
63
.8
522
0
153
0
102
2. 7
283
.3 1,221
0
160
.7
726
0
105
1. 0
105
1. 8
99
.6
738
0
91
1.1
90
2
4
0
2
4
7
0
0
2
3
0
0
8
0
1
0
0
0
12
2
0
2. 6
0
.4
3.4
0
3
0
8
0
1
3.2
64
.8
440
0
87
39
2. 0
199
1. 4
457
.6
69
0
1.4
526
90
0
2. 9
105
0
138
1.1 1,476
0
136
1.1
51
2
0
1
2
113
105
114
637
60
95
0
3
0
0
4
3
0
5
0
1
2
4
0
1
All European countries.••••••••••••••• 3,661
23
,6 4,458
41
.9 3,877
28
EUROPE
Belgium- ••····--·-·-----·-·
England._-----------······
Irish Free.State ______ ·--·-Northern Ireland ••••.•••.• _
Scotland ••••••• -·- .. _. _____
Germany •••••...••• -----·-'
Holland •••• -··-······--·--Poland_ .• _•••••••••..••••••
Denmark •• ·--------·······
Norway••••••.•••••••••••••
Bweden_·············-·····
Italy __ .. ___ -··············Czechoslovakia•••• ___ •••• _.
Austria.•••••••••••••••••••.
=
90
367
81
48
146
934
182
689
----
10
Digitized by
0
.5
3.5
0
0
1.8
0
77
514
245
59
292
635
3
6
1
7
0
.8
LO
.9
1.9
1.2
0
53
.2 57.'S
86
0
0
122
128
0
.8 2,070
1.5
158
0
85
0
0
46
0
1
0
.7 5,099
69
1.~
Google
0
0
2.2
0
1.2
69
PUBLIC HEALTH SERVICE
TABLE
14.-Number and character of the mandatorily excludable conditions notified
during the fiscal year 1933
WESTERN HEMISPHERE
Disease or defect
Canada
Cuba: , - - ~ - - ~ - ~ - - ~ - - - - ~ - - ~ - - - - ; T o t a l ,
Ha•
all sta•
bana Mont- Que- To- Van• Wind• Win• mYoaurt•h Total tions
real
bee ronto couver sor nipeg
- - - - - - - - - - - 1 - - - - - - - - ---1---1---1·-- - - - t - - Cllua A•l
Insanity......................
1 .......
1 ..••...
I ..••....••.•..
Mentally defective............
1
I ....•..
11 .........•..................
Epilepsy.......................................................................
1
Feeble-mindedness............
1 .•••••• •••••.• ••••••• .•.••••
4
1
2
Constitutional psychopathic
inferiority........•.•....••..
4 ...... .
4 ..•....
2 ••••••• •••••••
Imbecility .•........••.....•..
Total, class A·L ....... .
Claaa A·ll
4
13
1
3
12
1
7
8
10
11
1
0
16
0
7
33
\====l===l===\====l===i===\====i===!c==
3S
6
Trachoma..... .. .. . . .. . . ... . . .
7 .•.•....•.••.•.•.••...•....•
Tuberculosis, pulmonary......
4
2 ...••••
4
1
Ringworm................................................
1
Venereal diseases..............
1
3
2
1
11
8
13
1
12
0
22
34
3
55
72
1 ............. .
I
1 ..•....
1
9
1
4
Total, class A·IL _......
12
5
0
6
3
3
5
-==l===cl===l:,===s===t===is==
Grand total.............
17
11
o
22
3
10
6
EUROPE
~
00
Disease or defect
I. !
~
.,
.,.
~
:;;;.,
:,
0
A
'O
;!
'"§
-" -~
j ., ; 'O.,A ~ ., 'O"'A
t: g
""' '§ s
'E 0p. "' t "'~
A
lzl
z "'
al
A z r:n ~ 0 -< E-<
- - - - - - - - - - - 'O
;
~
3!...
11f....
I",
'O
.A
~
I
0
~
0
Claaa A•l
~ :::: ··5· :::: :::: :::: ·1a· ··1· ··2· a~
~~~~::::::::::::::::::::::::::::: :::: ··1· :::: :::: :::: ··1· ··1· ··1· :::: :::: ::::
:ti,~~1n<ieiiii~:.-::::::::::::::::: ··i :::: :::: :::: ::::
i
1i
Idiocy............................................................................ 1
M1inta.lly defective................... 1 2 3 4 9
8 .•.. 17 .•..••••.••. 47
Constitutional psychopathic Infer!·
1
93
~11?.iemeniia:::::::::::::::::::::: :::: .. ~...~. :::: ..~. ···· :::: :::: :::: .. ~...:. -·~- .... ....
Total, class A·I.................
4
9
4
4
11
24
23
0
4
2
70
Cla11A•ll
Trachoma............................ .•.. 2 .... .... ....
13 .•••.•••.... 164
Tuberculosis, pulmonary......................... 1 .•.. 5
3 ••••.•••.... 14
Tuberculosis, other forms ..•..........
2 •••• 1 ••.• •••• .... 1
Venereal diseases..................... .... .... .... .... .... 2 ••.• .•.. .•.. ..•• 1 6
Other loathsome contagious diseases.. .... .... .... .... 1 ..•. ••.. 9 .... ..•• .... 5
µ.···.... .... .... ....
Total, class A·II................
0
Grand total.....................
4
2lf
2
3
161
3
1
5
I
189
25
4
9
15
2 0
I
1 10 1 26
0 0 1 190 4 6 242
F==l==1===J,===========
11 4 5 12 34
2 49
0 4 3 260
6 9 403
Digitized by
Google
70
PUBLIC HEALTH SERVICE
15.-1\'umber and percentage of applicants examined wha were notified and
refused visas on medical notification for different classea of disabilities during the
fiscal year 1933
TABLE
Percentage of
Number noti- applicant.~ ex•
fled foramined notified
for-
Number of
visas refused
for-
Country and consular office
Percentage of
applicsnts examlned who
were refused
vises for-
I
f'lllSS CIIISS ClllSS Clsss
Class CIBIIS Class
A con• B con- Aeon• B con• AClass
COD· B con- A COD- B conrlitions ditions ditlons dltlons dltions dltlons ditlOD8 dltlons
--- - - - - - - ------ --- --WESTERN BEKISPHSB.S
Cuba: Habana_._ --· _--·· ·--· _·---· __
Canada, totaL------·-------------·-MontreaL ••. ___ -· ________ --· -· __
Quebec_.______
_______. --·--------·-----Toronto.
____ .• _________ .. _
Vancouver _________ ---------·-·-Windsor ______________ •••..•....•
WinnipeK---·-·-----------·---··Yarmouth_···- __ -·····-·-·······
All countries, Western Hem!sphere _____ --··············- __
90
56
90
1,398
9.1
.6
9.1
111. 5
12
0
664
62
22'
58
3
281
181
92
.3
0
1.3
.6
.7
.5
1.1
20.9
18.4
3. 5
11.0
20.8
15.9
33.3
146
1,488
1.5
4
1.3
lg I
6
60
= = ---
IIO
29
M
705
9.1
.6
2. 9
8.3
12. 2
9. 2
.9
2. 6
8.0
8.1
21.3
11
0
386
31
22
14
2
10
6
3
H
109
112
Si
.3
0
1.3
.3
.7
.5
1.1
15. 7
144
734
1. 5
7. 7
18. 4
4
11
1.3
8. 8
99
EUROPE
Belgium: AntwerP--·-·-·-·········- England, total._--·-·-·-··--·····-··-
11
M
333
Liverpool•-------·-··-····-····-·
London_·-·-------···--········-Southampton'···•···-·····-·-··-
4
6
1
57
267
9
2. 2
1.9
.4
32. 2
16.5
17.6
4
6
1
17
811
2. 2
.4
1.9
9.6
5.0
1.9
.7
2.0
1.3
22.8
29.8
H.6
4
5
12
20
37
70
.7
2.0
1. 3
34
244
3.5
14. 9
7.6
.D
1. 4
0
1.1
1.3
36.2
11.1
16.0
14.4
22. 2
11
1
0
8
H
1411
2
8
77
.9
1.4
0
1.1
1.3
12.1
2.8
8. 4
1.1
7.1
.4
1. D
0
13.5
20. 7
21.1
2
4D
0
33
178
211
.4
1.9
0
7.1
7.1
7.4
36.3
0
4
39
0
.9
0
8. 0
3
9
1
2
4
5
260
273
25
59
180
4
5
12
34
129
74
135
111H
Berlin .. ·-·-··---··--··-········-Bremen•------·-·-·-········-····
11
Stuttgart.·--·-·-·-···············
1
0
8
14
317
8
21
109
239
Holland: Rotterdam ___ -··--········Poland: Warsaw __ ··-··---·······-··Denmark: Copenhagen._ •.•••••••• __
Norway, totaL_._ -····-··· -········-
2
49
0
4
523
Bergen '·---- ----··········-······
Oslo·---··-------·-··············Sweden, total. ___ -·._ .•••••••.•.•. ___
0
4
8
61
3
21
Goteborg·-·-·-·················-Stockholm •• __ .-· ••••.••.•••.••..
1
2
9
12
Italy, total_·····················--··-
260
1,240
Genoa __ ····-·················-··Naples·--··-·····················
Palermo'·-······-··-·-··-······Czechoslovakia: Prague•••••••••• _•••
Austria: Vienna- •.••••••••••.•...•••.
25
190
45
267
889
84
6
9
92
67
403
3,577
~~~ig'~-: ::: ::::::::::::::::::::
I Closed
26
-------- --------
~
Irish Free State: Dublin •.•• ·-·····-·
Northern Ireland: Belfast..•.•••.. --Scotland: Glasgow_··-··-··········-·
Germany, totaL--····-··-········--·
All European countries•• -•.••..
-------- --------
=
63
83
-------- --------
6D --------
0
.D
-------i4.7
-------- -------.4
.8
3.9
4.8
-------- -------2.4
5.3
15. 7
25.4
24.8
29.1
4
190
45
------·- --------
11
36
-------- --------
0
34
-------- -------.4
.8
-------- --------
= == ==
6
2.8 . 3
20.9
1
~
2. 4
20.9
2.4
6.3
15. 7
11.8
5.6
5.0
23
9
11
1. 3
2. 8
5.2
3.4
403
1,087
2.4
6. 3
Aug. 31, 1932.
Digitized by
1.8
2.0
Google
71
PUBLIC HEALTH SERVICE
16.-Percentage distribution of the total quota and nonquota applicants
notified for each class of disabilities who were refused visas on medical grounds
during the fiscal year 1933
TABLE
Quota
Country
Number
notit!ed
Nonquota
Number
refused
visas
Percentage
or notified
cases refused visas
Number
notified
Number j Percentage
or notified
refused
cases revisas
fused visas
Class Class Class Class Class Class Class Class Class Class Class Class
A
B
B
A
A
B
B
A
A
B
A
B
-- -- -- -- ---------- -- -WESTERN HEIIISPHEBII
Cub&----·-----·---··-·····
Canada ____________________
All countries, Western Hemisphere ....
· 39
15
39
367
39
15
15
211
100
100
38. 5
57. 5
51
34
51
953
51
34
14
483
54
406
54
22.6
100
55.6
85 1,004
85
497
2
8
0
3
8
16
1
36
0
4
3
50
3
3
31
172
62
41
67
2
8
0
3
8
16
1
36
0
4
3
18
62
9
25
34
58. l
36.0
17.3
60.9
50. 7
46.2
62. 5
37. 4
36. 7
67.5
25.0
19.6
27.1
21.1
2
3
4
2
4
18
1
13
0
0
0
210
3
210
15
173
34
32
13
578
44
3
30
131
18
25
2
130
13
8
100
100
0
100
100
100
100
100
0
100
100
100
100
100
II
29
2
3
4
2
4
18
1
13
0
0
0
210
3
6
8
37
11
12
34
21
3
47
11
10
7
143
10
3
137
728
100
34.9
266 1,484
266
357
-- ----
EUROPE
Belgium ________ ··-·····---
f~iga:3~-siai.e::::::::::::
Northern Ireland ___________
Scotland. ____ ·-·--····· ....
i:i:::::r~:::::::::::::::::
Poland_·-·-·······-··-·····
Denmark
__________________
Norway____________________
Sweden ____________________
Italy _______________ ··-···-·
Czechoslovakia... __________
Austria. _______ ·---------··
Alltries
European
_________ .conn______
483
48
350
49
37
8
662
48
38
137 2,086
50
3
223
Digitized by
23
161
77
33
62
Google
100
2i. 5
JOO
50.6
----
JOO
49.5-
100
100
100
JOO
100
100
100
100
0
0
0
JOO
100
100
34. S22.9
14.3
36,3
54.8
10.0
20.0
27.2
32.3
31.2
--- -
53.8
24. 7
22. 7
10.4
- - -100
24. ()I
72
PUBLIC HEALTH SERVICE
17.-Number and percentage of male and female applicanu notified for claas
B disabilities who were refused visas on medical grounds during the fi,Bcal year
TABLE
1933
Percentage of
Number or ap- Number or ap- applicants noti•
plicants notl• pllcants refused lied who were
fled for class B visas ror class B refused visas
conditions
conditions
for class B condi•
tlons
Country and consular office
Male
Female
Male
Female Male
51
674
39
724
15
386
Female
WESTERN HEMISPHERE
Cuba: Habana .....•...•.•••••••••••••••••••••••••••..
Canada, total. .. _. _......•.•.•••••••••••••••••.•••••..
u
29.4
57.1
321
35.9
44.3
l-----1---11---1----1----1--M on tr eaL ............•.......•••...•.••..•••••••..
56.2
303
361
183
203
60.4
Quebec .....•... __ .........••.•..•.........•....•••
Toronto ....•.•.........•................•.........
Vancouver ____ ------------------------------------
~i~~fg:;g:::
:: :::: :::: :: ::::: :::::: ::: ::::::::::::
Yarmouth .•...•...•....••..••.•...........•...•..
22
'n
35
137
100
50
40
31
25
1-U
81
42
11
68
57
40
18
2
3
41
35
19
28
143
26
190
14
48
12
61
114
6
153
3
40
1
u
14
12
63.6
44.4
31.4
49.6
57.0
80.0
45.0
6. 4
12. 0
28.4
43. 2
45. 2
l===r-==:l==="==="==:I===
All countries, Wes tern Hemisphere .......••..•..
43.9
725
763
400
335
55.1
EUROPE
:Belgium: Antwerp .•.......•••••.••.••.•.•.......•.•.•
_England, total. ••.....••.•••...•.•••.•...........•.•.•
50.0
46. l
-------- --------
1---11----1---1---1---1---23
34
10
30.4
29.4
7
L iver pool'······••·•····••·••·····················
London ..........•.•..••.••••••....•.•.•..•..•.•..
Southampton'·························•··········
0
35.1
16. 7
26.8
0
l====l===F===f===f==I==
14
17.6
14. 7
21
66.6
42. 0
55_4
49.4
39
120
1---t------11----1----1---1---57
68.9
34.3
B erli n ..•....••••.....•....••••.•.•.•.•••....•....
151
166
89
4
1
1
25.0
25.0
Bremen 1••••••••••••••••••••••••••••••.•••••••••••
4
16
50.0
8
60.0
5
3
Cologne'··········································
4.5
Hamburg .......•.•...•.•.....•.•.............•..••
3
11.6
43
66
5
31.9
Stuttgart. ....•••.•.•.•••.•.•..••.........•.•.•.•••
160
51
32.9
79
26
Irish Free State: Dublin .•...........•.•....•........•
Northern Ireland: Belfast ......•.•...•••.........•....
Scotland: Glasgow ...•.•...............•.........•.•..
Germany, total .••...............•.•...........•.••••.
Holland: Rotterdam .•...•.•........•••••..••....••...
Poland: Warsaw ..•....•...••...••.•••.••...........•.
Denmark: Copenhagen ....•.•••.•.••..•....••........
Norway, total. ......••.••••••••••••••.•....•..........
34
24
56
282
95
50
79
412
6
16
31
124
-------- ------·-
l===ic==:l===l===l===:J=:==
35
28
20
256
267
44
23
39
46
109
20
8
13
69
9
27
3
5
41
0
8
0
'n
57.1
42.6
45.4
46.4
25.8
23.1
-------- --------
1-----<1-----<----'----'--_,__ __
Bergen 1•••••••••••••••••••••••••••••••••••••••••••
Oslo .••...•.•.....•.•.•.•......••.•.•.•••••••••••.•
Sweden, total. ••.•.•.••.•••••••••••.•..••..•••••••.•••
20
l===ic===l===II===
0
40.0
0
65.8
-------- --------
4
10
11
5
1----1-----<1----<----'---1----
Goteb org....•..••......•.................•........
Stockholm .................................•.•.•..
Italy, total. •...•...•...•.•...•.•••..••••••••••..••.•..
Genoa ..•...•••.........•...•.....•.•.•..........••
Naples .....•....•....•.•.•.......•...•............
Palermo'·········································
Czechoslovakia: Prague...•.•.••••...•...•.•.•........
Austria: Vienna ••......••••..••••..•........•.........
All European countries ..••••.•.•.•.•..••......•.
5
5
4
7
2
2
3
2
505
735
151
122
123
340
42
33
21
144
549
42
59
46
33
98
26
82
20
14
1,494
2,083
570
40.0
60.0
50.0
26.8
28.8
47.6
33.3
33.3
18.0
14. 9
33.3
20.3
8. 7
11
12
38.2
24. 8
7
4
r-====l===¼===r-===I===
517
• Closed Aug. 31, 1932.
Digitized by
Google
28.6
=
-------- --------
J=::==l====l===l===I:==
73
PUBLIC HEALTH SERVICE
TABLE
18.-Summary of medical impection of aliem, ji,8cal year 1999
MARITIME STATIONS
GROUP 1.-AL!J:N PASSENGERS NOT ELUIINED ABROAD, Ex.umrED ON ABBIVAL
Total examlned
Class
I
Certllled on arrival
lntenslvely
Passed
exam-
lned
A-I
First _____
- - --- -- --- -- -- -- -- -- -Second
_________________________
Third ______________ -- ---------Stowaways _____________________
Warrant cases.-- __ -------------
49,781
23,311
96,202
282
7,525
992
630
4,746
155
3,063
49,578
23,149
95,008
260
6,937
4
3
18
1
29
TotaJ. _------------------
177,101
9,586
174,932
55
C
B
A-II
8
137
170
145
985
5
271
127
8
151
217
1,576
321
4
4
64
25
Total
cert!•
tied
203
162
I, 194
22
10
588
2,169
GROUP 11.-ALIBN PASSENGERS EXAIIINED ABROAD, REEXAIIINED ON ARRIVAL
Class
Total
examined
First. _________ 1,286
Second ________ 2,153
Third _________ 5,659
Intenslvely Passed Passed
arexam- abroad on
rival
ined
A-I A-II
- ---- --- -
B
Total
cert!NumNum- tied
ber A-I A-II B C ber
C certicert!fled
tied
-- - -
-- - - - - - -
1,128
1,631
3,862
1
0
0
0
0
0
150
522
1,790
1
0
I
152
522
I, 791
0
Ill
1,134
1,631
3,868
239
6,633
6,621
1
0
2,462
2
2,465
101
27
Total---- 9,098
·--
on arrival
Certified on arrival (condi- Certified
(condition not
tion noted abroad)
noted abroad)
1
1
3
0
3
2
0
2
6
0
6
158
522
I, 797
2
0
6
4
12
2,477
GROUP 111.-ALIEN SEAIIEN EXAIIINED ON ARRIVAL
IntenTotal ex- slvelyexamined amined
Certified
Total
cert!tied
Passed
A-I
A-II
Alien crew _____________________
Workaways ____________________
804,798
230
241,650
32
803,810
227
21
0
434
3
Total_. ____ -- -- -·--- -·---
805,028
241,682
804,037
21
437
--
----
0
0
0
-
B
C
--- ---
392
0
141
0
988
3
392
141
991
CANADIAN AND MEXICAN BORDER STATIONS
GROUP 1.-ALIEN PASSENGERS NOT EXAIIINED ABROAD, EXAIIINED ON ARRIVAL
···-
Class
IntenTotal ex- sively
amlned examlned
Certified on arrival
Passed
A-I A·II
B
C
Total
cert!•
tied
- - - - - - -- I - - - - - - --Statistlcal, making permanent entry (bona
fl de Immigrants). __________________________ 31,693
Statlstical, making temporary entry__________ 21,590
Nonstatlstlcal, making entry 0ocal crossers,
e tc.) _______ •• _. _____ • _____ •• _••• _______ ••• _. 151,975
Warrant cases•• _________________________ -- ___
5,688
25,511
8,515
30,175
19,479
96
103
78
89
1,593
381
326
1,618
2,111
39,478
5,674
147,464
4,631
113
66
471
332
2,893
572
1,034
87
4,511
1,057
Total..·-·-·----· ••• _---··· ____________ 210,946
79,178
201,749
378
970
6,021
1,828
9,197
963
-
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PUBLIC HEALTH SERVICE
TABLE
18.-Summary of medical impeclion of aliem, fiacal year 19-'S-Continued
GROUP 11.-ALISN PASSENGERS ElUIIDll!:D ABROAD, RaaXAJIDISD ON AIUUVAL
Certified OD arrival
(condition noted
abroad)
Inten-
Class
Total
Passed Passed
exam- sively
on arexamlned lned abroad rival
Total
certiNum
Num- tied
ber
ber
A-I A-II B C
certl• A•l A-II B C cert!fled
fled
-- Statistical, making
permanent entry
(bona __
lmmifide
grants)
• __________
Statistical, making
temporary entry ____
N onstatistical, making entry (local
crossers, etc.).-----·
Certified on arrival
(condition not
noted abroad)
- -
- ---
- - --
-
806
801
803
745
0
0
2
0
2
2
0 M
2
88
60
..
621
621
621
585
0
0
0
0
0
0
0 3G
0
3G
36
3
3
2
0
0
0
0
1
1
0
0
0
2
2
a
Total ••• ·--·-•-· 1, 4211
1,425
1,426
1,330
0
0
2
1
3
2
0 90
4
96
w
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DIVISION OF SANITARY REPORTS AND STATISTICS
In charge of Asst. Surg. Gen. R. C.
WILLIAMS
The activities of the Division of Sanitary Reports and Statistics
were curtailed during the fiscal year because of the economic emergency.
Reports of the prevalence of diseases dangerous to the public
health were received throughout the year from the United States and
foreign countries, and these reports were compiled, tabulated, or
abstracted and made available to health officers and others who are
charged with the duty of protecting the health of the public.
MORBIDITY AND MORTALITY REPORTS
Four States were addedlto the number of those which have qualified
for admission to the morbidity reporting area. On June 30, . 1933,
29 States and the District of Columbia had secured the required
ratio~. Lack of funds has prevented the vigorous pressing of work in
secunng reports in the area, but there is a steady improvement in the
reports, and it is apparent that something is being accomplished.
CURRENT PREVALENCE OF COMMUNICABLE DISEASES
Current reports of cases made to the Public Health Service were
compiled by 4-week periods and published in the Public Health
Reports with comparisons with corresponding periods of preceding
years.
CURRENT STATE MORTALITY STATISTICS
The collection of statistics of deaths from communicable diseases
and. other ~portant causes of de9:th from ~tates w!rlch can supply
the mformatlo~ cu_rrently was con~m1;1ed du~ the ·~seal year. The
quarterly publication of these statistics was discontmued, but tables
showing the death rates by States for the years 1928 to 1932, inclusive,
were compiled and published.
COLLABORATING AND ASSISTANT COLLABORATING EPIDEMIOLOGISTS
The Public Health Service continued its plan of appointing collaborating and assistant collaborating epidemiologists in State and
local health departments to aid in collecting and forwarding to the
Public Health Service information as to outbreaks and the prevalence
of communicable diseases.
TELEGRAPHIC REPORTS
In Au~st 1932, Rocky Mountain spotted fever was added to the
list of diseases reported by State health officers by telegraph each
week. The figures given in the telegrams were tabulated, mimeo75
1~
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PUBLIC HEALTH SERVICE
graphed, and mailed promptly to State health officers. These
figures were also published weekly in the Public Health Reports with
the figures for the corresponding week of the preceding year.
MONTHLY STATE MORBIDITY REPORTS
Health departments of all of the States except Kentucky and Utah
sent to the Public Health Service monthly tabulations of the numbers
of cases of notifiable diseases which had been reported in their jurisdictions. A brief summary of the statistics was published in the
Public Health Reports, and the reports were compiled and filed
_for reference in the division.
ANNUAL STATE MORBIDITY REPORTS
The annual summaries of notifiable diseases in States for the years
1930 and 1931, the printing of which had been delayed owing to lack
of funds, were retabulated to reduce the expense of printing and were
issued during the fiscal year 1933.
WEEKLY AND ANNUAL CITY REPORTS
I
Weekly reports of morbidity and mortality of 18 diseases were
received from 700 cities of 10,000 population or over in the United
States. The reports from a selected list of 121 cities were published
weekly with the idea of showing currently a cross section of the urban
morbidity throughout the country. Data from cities not on this list
are kept for reference. Annual slHD.lllaries of the morbidity and
mortality of 25 diseases for the calendar year 1932 were received from
716 cities in the United States. Owing to lack of funds, these data
have not been published_.
FOREIGN REPORTS
Reports of the prevalence of quarantinable and other diseases in
foreign countries were received during the fiscal year from officers of
the Public Health Service stationed abroad, from consular officers of
the United States, international health organizations, foreign governments, and other sources. In accordance with the provisions of law,
these reports were tabulated or abstracted and published.
INTERNATIONAL EXCHANGE OF SANITARY INFORMATION
In accordance with the provisions of international sanitary conventions to which the United States is a party, the countries signatory
thereto have been notified through the Department of State of
cases of quarantinable diseases and the progress of epidemics in the
United States and its dependencies. There has been a constant
exchange of sanitary information between the Public Health Service
and the Pan American Sanitary Bureau and, by telegraph and mail,
with the International Office of Public Hygiene and the health section
of the League of Nations.
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PUBLIC HEALTH SERVICE
PREY ALEN CE OF COMMUNICABLE DISEASES DURING THE CALENDAR
YEAR 1932
Reports to the Public Health Service for the calendar year 1932
indicate a continuation of the generally good }iealth conditions in the
United States which have been noted for several years.
The accompanying tables give a comparison of the numbers of
cases of the principal communicable diseases and deaths from these
diseases in the United States for the calendar years 1930, 1931J and
1932:
..
CASES
Disease
Aggregate population
Cases per 100.000
Cases
population
(in thousands)
Num•
ber of
States 11-------,---...,.,---l----,---~---1------,------,---
---------[·-Chicken pox.-···-···•·····
D,ipuhetnhzean.·a....·.·•·.·•••·-_-_-.·.·.·.·.•.·.·.
1nf11
Ma.laria ..•..... _. __ ···----·
Measles ...... ·-·-··•·•···-·
Meningococcus meningitis.
Mumps·-•---·--·---------·
Pellagra.... •-·-·-·-···-·-··
Pneumonia (a.II forms)--···
Poliomyelitis... -•-·-·-·--·Scarlet fever.----·---·-·-··
Smallpox __ --·····--·-·-··Tuberculosis (all forms)_.__
Tuberculosis (respiratory
system).·-·····-·-··--···
Typhoid fever and para•
typhoid fever---··-·----·
Whooping cough ___ ·-······
42
46
46
45
46
35
36
44
44
39
46
46
45
l930
1931
107,317
119,048
119,048
112.380
119,048
102,471
80,209
99, 737
109,057
100,887
119,048
119,048
118,610
108,106
.119. 912
119,912
113,198
119,912
103,225
80,777
100,442
109,784
101,625
119,912
119,912
119,469
1932
1930
1931
1932
1930
1931
1932
- - - - - - - - - - ---- -- -108, 781 194,706 200,985 201, 161 181. 4 185. 9 184. 9
120,651 64,421 68,012 57,460 54. 1 56. 7 47. 6
120,651 ·····••· ·•·-•··· .•.................. ·-···113,8P8 .. -·-·-· ··-·-··· -·--·-·· ................. .
120,651 402,821 457,634 395,807 338.4 381.6 32Kl
103,874
7. 206
4,883
2,893
7. 0
4. 7
2. 8
81,263 92,691 96,089 89,130 115. 6 119. 0 109. 7
101,046 ·····-·· ·-·-·--· ·-··-··· ···--· ·-··-· ·-·-·110,407 ··-·-··· -·-··-·· ·---···· --···· ·---·· ···--102,257
8,475 15,673
3,568
8. 4 15. 4
3. 5
120,651 168,168 192,114 206,312 141.3 160.2 171.0
120,651 46,560 28, 755 10,887 39. 1 24. o
9. 0
120,203 •. ___ ·-· ----··-- ·-··-··- --···- ·---·· ··--·-
39 104,250 105,015 105,668 _____ . __________ ----·-·- ·-··-· ·----· -----·
46 119, 048 119, 912 120, 651 26, 301 25, 761 26, 013 22. 1 21. 5 21. 6
46 119,048 119,912 120,651 159,053 165,495 210,456 133. 6 138. 0 174. 4
DEATHS
Deaths per 100,000 Cases reported for each
population
death registered
Deaths
Diseases
1930
1931
1932
1930
1931
1932
1930
1931
-------------[--- - - - - -- ---- -----Chicken pox._. - ·---- -- -- -- -- -- --- --·
R!i~~~!ia-·---·-------·--·-····-···
104
5,842
22,311
3,296
3,399
3,253
49
7,074
91,212
1,147
2,146
Malaria ... ·-··------·--·--------·--·
Measles __ .·-------·
... ·---·-··--·-··
Meningococcus
meningitis_.
_________
Mump•····--···--•--·····•····-·-·Pellagra ... ··-·-·····-········ .......
Pneumonia (all forms) .•... -.........
Poliomyelitis __ ........ ·- .... _. ______
Scarlet fever.··---··-······-···-··--·
164
Smallpox .... --····-···-····•······-·
Tuberculosis (a.II forms)·-··--•-··--· 82,095
Tuberculosis (restratory system) ___ 65,852
Typhoid fever an paratyphoid fever_ 5,852
Whooping cough.···-·-··--·-----·-- 5,373
1
129
5,881
30,989
2,497
3,076
2,330
61
5,773
92,457
1,908
2,423
96
79,305
63,918
5,466
4,365
92
5, 7."iO
36,310
2,566
1,847
1,310
50
4,091
89,452
650
2,455
50
73,733
59,758
4,613
5,016
0.1
4.9
18. 7
2.9
2.9
3.2
.1
7.1
83.6
1. 1
1.8
.1
69. 2
63.2
4.9
4.5
0.1
4.9
25.8
2.2
2.6
2.3
.1
5. 7
84.2
1. 9
2. 0
.1
66.4
60.9
4.6
3. 6
0.1
4.8
30.1
2.3
I. 5
1.3
.1
4.0
81.0
.6
2. 0
(•)
61. 3
56.6
3.8
1932
--
1,872
11
l,5/i8
12
2,187
10
2
1,892
2
1,575
2
1,783
284
78
79
300
84
218
30
38
42
-------- -------- ------------------------119
214
149
-------- -------- -------------------------5
7
8
-----·--- -·-···-- ---·--------------6
-----·-4
5
4.2
In addition to the number or States given, the District of Columbia is also included.
• Less than 0.1 per 100,000 population.
During the calendar year 1932, 420 cases of cholera were reported
in the Philippine Islands. Four plague-infected rats and two plagueinfected ground squirrels were found in California. In the Territory
of Hawatl 6 cases of plague with 5 deaths were reported and 24
pla~e-infected rats were found. Yellow fever did not appear in the
Umted States during 1932.
.
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PUBLIC HEALTH SERVICE
SANITARY LEGISLATION AND COURT DECISIONS
Laws, ordinances, and regulations.-During the period 1911-28, the
Public Health Service published annual compilations containing the
text of State health laws and regulations. Owing to reduced printing
funds and to the increasing volume of the laws and regulations, it
was found necessary to present the material in a briefer and more
economical form. A record of the laws and regulations for 1929 and
1930 was, therefore, prepared in the form of citations arranged alphabetically according to subject matter, and issued as Supplement No. 99
during the fiscal year.
Another publication issued during the year was Supplement No. 100,
containing an analysis of the more important prov1s1ons of the State
laws and regulations on morbidity reporting.
The collection of public health ordmances and regulations adopted
by cities of over 10,000 population was continued, there being collected durin~ the year those ordinances and regulations which were
adopted durmg 1932.
.
Court decisions.-Continuing a practice of many years' standing,
current digests of decisions of State and Federal courts of last resort
were searched for decisions bearing on public health, and abstracts
of such decisions were prepared and published in the weekly Public
Health Reports.
PUBLICATIONS IssUED BY THE D1visION
The Public Health Reports was issued by the division each week
during the year. There were 53 issues (vol. 47, pt. 2, and vol. 48,
pt. 1), which contained 1,762 pages of text and tables, exclusive of
title pages and tables of contents, as compared with 3,008 pages in
the fiscal year 1932, 3,285 in 1931, and 3,143 in 1930. This reduction
in size was necessitated by a reduction in printing funds and was
accomplished by suspending the publication of certain statistical
tables, by condensing other tables, and by reducing the length of
text articles through extensive revision editorially and by the authors.
The mailing lists were carefully scrutinized and revised, resulting in
a reduction of several thousand copies in the number issued.
Durin_g the year, 43 important articles published in the Public
Health Reports were issued in separate form as reprints, providing
for a more extensive and economical distribution to persons mterested
in the various subiects and also providing for sale editions by the
Superintendent of Documents. The number of such reprints in 1932
was 35, while 97 were issued in 1931 and 94 in 1930.
In connection with cooperative work with official and unofficial
organizations designed to stimulate interest in community Negro
health activities, and to aid community leaders in their efforts
directed toward important local health problems, including" clean-up"
campaigns and the general dissemination of information relating to
individual hygiene and community sanitation, the division issued the
National Negro Health Week Bulletin and Poster for 1933.
NEGRO HEALTH
wORK
In keeping with the practice of the Public Health Service to aid
when possible public health activities directed to the control of special
health problems, it has assisted the work of the National Negro
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PUBLIC HEALTH SERVICE
Health Week and the National Negro Health Movement. The
campaign for the spring of 1933 undertook to emphasize the immediate
community problems produced or exacerbated by the economic depression. These activities reached directly over 500i000 persons and
mdirectly, it is estimated1 more than a million adu ts and children.
Nearly 500 clinics supplied examination and treatment personnel
and facilities for 50,000 persons of all ages. Lectures reached approximately 250,000, visual education-motion pictures, exhibits,
and plays-150,000, and over 150,000 pieces of health literature were
made available.
The National Negro Health Movement, in addition to the extensive
program connected with the National Negro Health Week, rendered
104 days of field service to 46 communities in 8 States, with lectures
and conference attendance of more than 35,000 persons, motion
picture audiences of over 12,000 people, the distribution of 10,000
special health publications, and the display of several health exhibits.
PUBLICATIONS DISTRIBUTED AND EXHIBITS PREPARED
During the fiscal year, 66 new publications were distributed by the
division, as compared with 68 during the preceding year. A total
distribution of 130,802 copies of new publications and of editions of
prenously published documents was made. Of these, 80,751 were
sent in response to individual requests for information and 50,051
copies were distributed to mailing lists.
In response to 30 requests for the loan of stereopticon slides 1,938
slides were loaned to universities, health officers, public health •lecturers, officials of the Public Health Service, and others. Two new
sets of slides were added during the year.
Durinl$ the fiscal year the appropriation for exhibits relating to
commumcable diseases was considerably reduced. However, an
extensive exhibit on poliomyelitis was prepared, in cooperation with
the Committee on Scientific Exhibits of the .Amencan Medical
Association, for display at the annual meeting of the association, and
several other exhibits were displayed. An extensive exhibit was
also prepared for display at the Century of Progress Exposition at
Chicago, for which an allotment of funds was received under the
act of Feotnaty 8, 1932.
The following is a list of publications distributed by the division
during the fiscal year:
REPRINTS FROM THE PUBLIC HEALTH REPORTS
1513. Agglutinin Absorption in Undulant Fever (Brucellosis). By Edward
Francis. October 9 1931. 21 pages.
1514. Sickness Among Male Industrial Employees in the Second Quarter of 1931.
By Dean K. Brundage. October 16, 1931. 4 pages.
1515. Mosquitoes Transported by Airplanes. · Staining Method Used in Determining Their Importation. By T. H. D. Griffitts and J. J. Griffitts.
November 20, 1931. 8 pages.
1516. Pathology of the Eastern Type of Rocky Mountain Spotted Fever. By
R. D. Lillie. November 27, 1931. 20 pages.·
1518. The Fumigation of Vessels. A Symposium. By C. L. Williams, B. E.
Holsendorf, and J. R. Ridlon. July 3, 10, 17, 24, 31; August 14, 28;
December 11, 1931. 74 pages.
1519. Scarlet-Fever Streptococcus Antitoxin in the Treatment of Scarlet Fever.
By M. V. Veldee, F. E. Stevenson, and A. Graeme Mitchell. December
18, 1931. 28 pages.
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PUBLIC HE •.\.LTH SERVICE
1521. City Health Officers, 1931. Directory of Those in Cities of 10,000 or More
Population. December 4, 1931. 17 pages.
1522. State ar.d Insular Health Authorities, 1931. Directory, with Data as to
Appropriations and Publications. December 4, 1931. 24 pages.
1523. Whole-Time County Health Officers, 1931. December 18, 1931. 9 pages.
1524. Typhus Fever: Typhus Virus in Feces of Infected Fleas (Xenopsylla
cheopis) and Duration of lnfectivity of Fleas. By E. T. Ceder, R. E.
Dyer, A. Rumreich, and L. F. Badger. December 25, 1931. 9 pages.
1525. Typhus Fever. Transmission of Endemic Typhus by Rubbing Either
Crushed Infected Fleas or Infected Flea Feces into Wounds. By R. E.
Dyer, E.T. Ceder, W. G. Workman, A. Rumreich, and L. F. Badger.
January 15, 1932. 3 pages.
1526. Public Health Service Publications. A List of Publications Issued During
the Period July-December 1931. January 29, 1932. 4 pages.
1527. The Health Officer's Viewpoint of Child Hygiene. By Taliaferro Clark.
February 26, 1932. 12 pages.
1528. The Impinger Dust Sampling Apparatus as Used by the United
States Public Health Service. By Leonard Greenburg and J. J.
Bloomfield. March 18, 1932. 22 pages.
1529. Rat Infestation Inspection of Vessels. By C. L. Williams. April 1, 1932.
3.'i pages.
1530. Relative Incidence of Typhoid Fever in rrban and Rural Areas of Tennessee. By D. F. Milam and Elbridge Sibley. April 8, 1932. 6 pages.
1531. Typhus Fever. The Experimental Transmission of Endemic Typhus
Fever of the l'nited States by the Rat Flea (Ceratophyllus fasciatus).
By R. E. Dyer, W. G. Workman, L. F. Badger, and A. Rumreich.
April 22, 1932. 2 pages.
1532. Typhus Fever. The Multiplication of the Virus of Endemic Typhus in the
Rat .Flea (Xenopsylla cheopis). By R. E. Dyer, W. G. Workman,
E.T. Ceder, L. F. Badger, and A. Rumreich. April 29, 1932. 8 pages.
1533. The Standardization of Scarlet Fever Streptococcus Antitoxin. A Method
Employing the Ear of the White Rabbit. By M. V. Veldee. May 6,
1932. 14 pages.
The Action of Colloidal Paris Green on the Larvae of Culex Apicalis. A
Preliminary Report. By H. G. Grant, Barclay M. Newman, and Pierce
D. Wood. June 3, 1932. 9 pages.
1535. Duration of Viability and Virulence of Bacillus Pestis. By Edward
Francis. June 10, 1932. 8 pages.
1536. The Preparation of a Vaccine from Fleas Infected with Endemic Typhus.
By R. E. Dyer, W. G. Workman, A. Rumreich, and L. F. Badger.,
June 17, 1932. 4 pages.
1537. Some Instances of Rapid Rat Infestation of Vessels. By C. L. Williams.
June 17, 1932. 5 pages.
.
1538. Acute Respiratory Diseases in University of Michigan Students, 1917-31.
Incidence of Cases Attended by University Physicians Among Students'
at the University Health Service. By Warren E. Forsythe. June 24,
1932. 12 pages.
1539. Epidemic of Mild Dysentery-Like Disease in Cattaraugus County, N.Y.,
Summer of 1930. By Dorothy G. Wiehl and Mary Gover. July 1,
1932. 8 pages.
1540. Observations on the Agglutination of Proteus X Organisms in Rocky
Mountain Spotted Fever. By Gordon E. Davis and R. R. Parker.
July 15, 1932. 12 pages.
1541. Postvaccination Encephalitis. With Special Reference to Prevention:
By Charles Armstrong. July 22, 1932. 16 pages.
,
1542. Report of Committee on Milk. Conference of State and Provincial
Health Authorities, June 2, 1932. August 12, 1932. 4 l)ages.
1543. The Metamorphoses of Streptococci into Spore-Bearing Rods and into
Filterable Forms. By Alice C. Evans. August 19, 1932. 16 pages.
1544. Relation of Oxidation to Proteolysis in Malignant Tumors. By Carl
Voegtlin and Mary E. Maver. March 25, 1932. 16 pages.
1545. The Incidence and Time Distribution of Common Colds in Several Group.s
Kept Under Continuous Observation. By W. H. Frost and Mary
Gover. September 2, 1932. 27 pages.
1546. Studies on Immunity Induced by Mouse Sarcoma 180. By H. B. Andei;vont. September 9, 1932. 19 pages.
1:i47. Biological Products. Establishments Licensed for the Propagation and
Sale of Viruses, Serums, Toxins, and Analogous Products. September 9,
1932. 6 pages.
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PUBLIC HEALTH SERVICE
1548. Etiology of Trachoma with Reference to Relationship of Bacterium Granulosis (Noguchi) to the Disease. By Ida A. Bengtson. September 16,
1932. 22 pages.
1549. Do Children Who Drink Raw Milk Thrive Better Than Children Who
Drink Heated Milk? By Leslie C. Frank, F. A. Clark, W. H. Haskell,
M. M. Miller, F. J. Moss, and R. C. Thomas. September 23, 1932.
10 pages.
1550. Public Health Education. The Functions of the University and of the
Private Foundation. By John·Sundwall. October 7, 1932. 16 pages.
1551. An Epidemic of Motor Neuritis in Cincinnati, Ohio, Due to Drinking
Adulterated Jamaica Ginger. History, Symptomatology, and Clinical
Report. By Charles E. Kiely, Murray L. Rich, A. R. Vonderahe,
T. J. LeBlanc, and W. E. Brown. October 14, 1932. 25 pages.
1552. Public Health Service Publications. A List of Publications Issued During
the Period January-June, 1932. October 21, 1932. 2 pages.
1553. Excess Mortality from Causes Other than Influenza and Pneumonia
During Influenza Epidemics. By Selwyn D. Collins. November 11,
1932. 21 pages.
1554. Plasmochin in Malaria Prevention. Experiments in Alabama. By
J. N. Baker and D. G. Gill. December 2, 1932. 6 pages.
1555. Recent Court Decisions on Milk Control. By James A. Tobey. December 2, 1932. 8 pages.
1556. Standardization of Morbidity Reporting and Development of the Morbidity Reporting Area. By R. C. Williams. December 9, 1932.
16 pages.
1557. Rocky Mountain Spotted Fever (Eastern Type). Virus Recovered from
the Dog Tick Dermacentor variabilis Found in Nature. By L. F.
Badger. December 30, 1932. 5 pages.
1558. Endemic Typhus Fever Virus Recovered from Wild Rat Trapped at
Typhus Focus in the United States. By R. E. Dyer, W. G. Workman,
and A. Rumreich. December 30, 1932. 5 pages.
1559. Trends of Health in the United States. By Rollo H. Britten. January 13,
1933. 15 pages.
1560. The Quantitative Determination of Quartz ("Free Silica") in Dusts.
By Adolph Knopf. February 24, 1933. · 8 pages.
1561. Seasonal Variation of Average Growth in Weight of Elementary School
Children. By Carroll E. Palmer. March 3, 1933. 23 pages.
1563. Causes of Illness in 9,000 Families Based on Nation-Wide Periodic Canvasses, 1928-1931. By Selwyn D. Collins. March 24, 1933. 26
pages.
1564. Production of a Malignant Growth in a Guinea Pig. By T. J. Glover and
J. L. Engle. March 31, 1933. 4 pages.
1567. The Prevention of Rocky Mountain Spotted Fever. May 5, 1933.i_ 3
pages.
1568. Mortality in Certain States During 1932, with Comparative Data for
Recent Years. May 5, 1933. 9 pages.
SUPPLEMENTS
99. Citations to Public Health Laws and Regulations, 1929-1930. 1933.
30 pages.
100. Laws and Regulations Relating to Morbidity Reporting. Prepared by
William Fowler. 1933. 29 pages.
103. Chemistry of the Opium Alkaloids. By Lyndon F. Small and Robert E.
Lutz. 1932. 375 pages.
104. The Notifiable Diseases. Prevalence in States, 1930. 1932. Hi pages.
105. The Notifiable Diseases. Prevalence in States, 1931. 1932. 14 pages.
PUBLIC HEALTH BULLETINS
202. Frequency of Pneumonia Among Iron and Steel Workers. By Dean K.
BrundageL Albert E. Russell, Roy R. Jones, J. J. Bloomfield, and
Lewis R. Thompson. 1932. 51 pages.
203. A Study of the Pollution and Natural Purification of the U_pper Mississippi
River. Surveys and Laboratory Studies. By H. R. Crohurst. 1932.
113 pages.
.
.
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PUBLIC HEALTH SERVICE
204. A Study of the Pollution and Natural Purification of the Ohio River. IV.
A Resurvey of the Ohio River Between Cincinnati, Ohio, and Louisville,
Ky., Including a Discussion of the Effects of Canalization and Changes
in Sanitary Conditions Since 1914-16. By H. R. Crohurst. 1933.
111 pages.
NATIONAL INSTITUTE OF HEALTH BULLETINS
160. Further Studies on the Pharmacology of Certain Phenol Esters with Special
Reference to the Relation of Chemical Constitution and Physiologic
Action. By Maurice I. Smith, E. W. Engel, and E. F. Stohlman.
The Histopathology of Some Neurotoitic Phenol Esters. By R. D.
Lillie and Maurice I. Smith. August 1932. 69 pages.
161. I. The Pathology of Psittacosis in Man. II. The Pathology of Psittacosis
in Animals and the Distribution of Rickettsia Psittaci in the Tissues of
Man and Animals. By R. D. Lillie. May 1933. 66 pages; 27 plates.
ANNUAL REPORT
Annual Report of the Surgeon General of the United States Public Health Service for the Fiscal Year 1932. 199 pages.
·
MISCELLANEOUS PUBLICATION
11. Official List of Commissioned and Other Officers of the United States Public
Health Service; Also a List of All Stations of the Service. January 1,
1933. 61 pages.
UNNUIIBERJ:D PUBLICATIONS
Indeit to Public Health Reports, Volume 47, Part 1, January-June 1932. 30
pages.
Indeit to Public Health Reportst...Vol. 47, Part 2, July-December 1932. 23 pages.
National Negro Health Week rrogram. This pamphlet is published annually,
usually about the middle of March, for community leaders in an effort
to suggest ways and means by which interested individuals and organizations may be organized for a concerted and effective attack upon the
community's disease problems. Nineteenth Annual Observance. 1933.
8 pages.
National Negro Health Week Poster. Nineteenth Annual Observance. 1933.
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DIVISION OF MARINE HOSPITALS AND RELIEF
In charge of Asst. Surg. Gen. F. C. SMITH
Out-patient and hospital treatment is furnished to American seamen
and other legal beneficiaries in 154 ports of the United States and
the possessions. Contracts are maintained with 183 hospitals located
chiefly in ports not served by the 25 marine hospitals. At the close
of the year 3,959 patients remained in hospitals, including 154 insane
in St. Elizabeths Hospital and 370 at the National Leper Home. The
policy of constructing and maintaining marine hospitals only in
large ports or where satisfactory hospital care cannot otherwise be
procured was established many years ago. The present number of
marine hospitals, exclusive of the Leper Home, is identical with that
in 1860 although locations have varied with shipping conditions.
The marine hospital at Port Townsend, Wash., was closed on February
1, 1933·, and the new one at Seattle was opened at the same time.
When construction, for which plans and specifications have been
finished, is authorized, the building program will be complete.
The volume of work, which for 135 years has faithfully reflected
the activities of the American merchant marine, was slightly increased
for old-line beneficiaries, and on June 30, 1933, there were 160 more
such patients in hospitals than a year ago. Bills have been introduced
to liberalize eligibility and include new classes of beneficiaries but
none such has recently been passed by the Congress. · Owners of
small vessels not previously documented have obtained registration
chiefly for the purpose of enabling the crews to become eligible for
treatment. Members of the Civilian Conservation Co:rys are
admitted as pay patients. For a complete statement of relief furnished at each station and the customary collateral functions performed by the marine hospitals for the Army, Navy, Civil Service
Commission, Steamboat Inspection Service, Coast Guard, Employees'
Compensation Commission, Post Office Department, Bureau of
Immigration, Coast and Geodetic Survey, Bureau of Fisheries,
Bureau of Lighthouses, Bureau of Industrial Alcohol, and Veterans'
Administration see pages 88 to 95.
By the act of March 20, 1933, and Executive order dated March
31, 1933, use of the marine hospitals for veterans was partially discontinued, and from a maximum of 1,056 on March 18, 1933, the
number of these patients was reduced to 37 on June 30, 1933. Complaints were numerous because of the removal of disabled veterans
from zones served by marine hospitals. It was necessary to close
whole floors of the marine hospitals in Cleveland and Seattle and to
discontinue many wards in other marine hospitals vacated by veterans,
although the capacity_ of these hospitals had been expressly designed
for all local needs. However, these marine hospitals are prepared at
any time to resume the admission of such veterans as are still legally
entitled to hospital treatment. In preparation also for drastic
economies required by a reduction in the appropriation "Pay of
83
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84
PUBLIC HEALTH SERVICE
Personnel and Maintenance of Hospitals, 1934 ", from $5,600,000
to $4,320,000, the personnel in marine hospitals and relief stations
was reduced on June 24, 1933, or shortly thereafter, by 476 persons,
including 100 nurses and 37 medical and dental officers. Other
expenditures were correspondingly reduced. It is evident that the
standard of hospital care will be lowered unless, indeed, some of the
legal obligations of the Public Health Service are to be rjjffidiated.
If commodity prices rise or demands for relief increase, the · culties
will be intensified.
CLASSES OF BENEFICIARIES AND AMOUNT AND CHARACTER OF
SERVICES RENDERED
Summary of services by class of beneficiary
Hospital days
Out-patient
treatments
Physical
examlnatlons (not
related to
treatment)
Class of beneficiary
Remarks
PerPerPercent Num- cent
Number cent
of Number of
ber
of
total
total
total
-- --- -----American merchant sea- 1,039,092 58.94 518,123 49.60 7,158 11.55 Communicable diseases are remen. __________________
ported to local health officers.
Veterans
.65
943 1.52 PatientsoftheVeterana' Admin·
316,298 17.97
6,760
lstratlon.
44 ______
Lepers ____________________ 134,846 7.65
19
.02 N atlonal Leper Home, Carville,
La.
Coast Guard personneL __ 106,126 6.01 214,805 20.56 9,557 15.42 All medical services and supplies,
ashore and afloat.
Injured Federal employ64,551 3.66 181,828 15. 49 19,764 31.89 Patients of the Employees'
Compensation Commission.
ees.
Immigrants
______•_________
32,816 1.86
23,769 2.28
427
.69 Patients of the Bureau of Imml
gratlon.
.21 Civilian employees on Army
36,811 2.08
15, 735 1.51
130
Seamen, Engineer Corps;
and Army Transport
vessels.
Service.
14
.02 Pay patients.
4,123
• 23
581
.05
Seamen from foreign vessels.
133
. 22 Medical supplies also furnished
9,974
.56
7,418
. 71
Seamen and keepers,
to lighthouse vessels.
Lighthouse Service.
312
5,031
8.12
Vaccinations and other preven•
.03
Alaska cannery workers --------- -----tlve measures.
leaving United States.
Pilots and other licensees __ --------- ------ ---------1------ 6,536 10. 55 For the Steamboat Inspection
Service.
the Civil Service CommisCivil-service applicants
------ --------- ------ 5,029 8. 11 For
and employees.
slon.
Shipping Board __________
1,414 2.29 To determine fitness for sea duty.
18,417 1.04
95,215 --fri 5,816 9.39 From Bureau of Fisheries, Army,
All others entitled to
Navy, Mississippi River Comtreatment.
mission, Coast and Geodetic
Survey, etc.
TotaL ______________ 1,763,054 100. 00 1,044,590 100.00 61,971 100.00
---------
--
The average per diem cost in marine hospitals reflects prevailing
prices of commodities and rates of salaries. For the past 11 years
1t has been as follows:
1923 ________________________
1924 ________________________
1925 ________________________
1926 ________________________
1927 ________________________
1928 _______ . ________________
$~08
3. 84
a8o
3. 71
3. 75
3. 80
1929 _______________________ _
1930 _______________________ _
1931 _______________________ _
1932 _______________________ _
1933 _______________________ _
$4. 03
4. 15
~ 05
3. 77
3. 34
Medical research to supplement investigations of the National
Institute of Health and coordinated with other functions of the
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PUBLIC HEALTH SERVICE
Service was conducted by the principal marine hospitals upon assigned
items, which include various phases of syphilis and its treatment
(assigned to 10 different hospitals), cardio-vascular disease. (5 hospitals), gonorrhea (4 hospitals), gastric ulcer, rheumatism, epidennophytosis, anemia, and leprosy.
DENTAL TREATMENT
The total cost of all dental treatment at marine' hospitals and
· ielief stations, including salaries, supplies, repairs, and overhead
expense was $280,754.57, or $709,758.80 less than its procurement at
authorized fees by contract dentists. At very few stations is the
dental personnel able to meet the full need of patients. The major
items were as follows:
1933
1932
Number
patients________________________________
treated- _______________ ------------------------------------Number of
or sittings
_____________________________ _
X-rays ____________________ --·- -- -- --- -_----- -- -- - -. - -- --- -- - --..... --- -- -- --·- -Prophylactic treatments (hours).-------------------------··---··-···---·.·-···Vincent's stomatitis treatments (hours) ______ .--------------------------- ______ _
Pyorrhea treatments (hours) ______________ . ________________ . ________ . __________ _
Extractions ________________________ --·-· ____________________________________ ····Alveolectomies ____________ . _____ . __________ . ___________________________________ _
a~'!ii~~;r'.::::::::::::::::::::::::::::::::::::::::::::::::::::::~::::::::::::
Porcelain crowns _______________ . ___________ . _____ -··· ______ . ___________________ _
Silicate cement llllings. ______ .. _.... _______________________ ····-··-- ___________ _
Dentures (full and partial)_------------------------·--.-·-······----·-------·--Fracture hours ______________ . __ . __________ . ______ -··· ____ -·····-----· _________ ..
Total number of treatments ______ . ____________________ ________ .. ····-- _________ _
116,952
203,271
39,635
11,363
6,101
4,264
71,206
3,686
37,355
2,266
53'
14,261
5,499
619
585,535
145,877
213,320
39,823
13,544
4,362
4,626
77,928
3,230
38,668
1,023
99
14,687
6,526
470
619,392
In addition, 3,586 patients were treated at 32 smaller stations by
contract dentists on a fee basis at a total cost of $29,120.78, or an
average of $8.12 per patient as compared with $1.92, the average
cost by full-time dental officers.
Semor Dental Surg. C. T. Messner is in charge of dental activities
in the field and bureau.
COAST GUARD
The average number of Coast Guard beneficiaries on active duty
and retired was 13,181. Medical services furnished in recent years
are shown in the following table:
Numerical strength of Coast Guard
and medical services given
Year
Number
of Coast Hospital
Guard
days
personnel
Outpatient
treatments
Average amount of medical
service per person
Physical
examina- Hospital
days
tions
Outpatient
treatments
Physical
examina•
tions
6. 7
9. 4
12.8
12. 7
14.2
11.0
13.2
15. 1
14. 4
15.1
16. 3
0.9
1. 5
1.9
1. 9
1.7
1. 4
1.4
I. 1
.6
.9
.7
-----1923--------------·----------···
1924- -----·---·-·--------------1925. ---------·-·--------·····-1926. --- - . -- . - . - ·-·- -- --- . -----1927 ..•. -·· _-- --·- ···-- -- -- . -- -1928.
·-·_________________________
_... -· ____ . -- ------- -- _.
1929 ...
1930•. -- --- __ -- . _-·- --- -- _-- ---1931. .. --- -----. _-- ------ _-- . --1932------·-·--····---·--------1933------·-----·········---·---
4,684
4,896
7,077
9,839
10,984
12,462
12,833
12,963
13,020
13,189
13,181
41,681
36,504
60,336
7,, 799
76,564
85,691
88,870
90,179
86,829
91,655
106,126
32,530
45,857
90,494
125,226
155,977
137,971
169,697
196,334
187,063
198,800
214,805
4,207
7,008
13,394
19,061
18,787
17,220
17, 748
14,382
8,262
11,481
9,557
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7. 3
6.9
6.9
6.9
6.9
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6. 9
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86
PUBLIC HEALTH SERVICE
Twenty-three medical and dental officers are assigned exclusively to
Coast Guard duty and 102 local physicians under appointment as
acting assistant surgeons furnish medical and surgical relief e.nd make
physical examinations of Coast Guard and Lighthouse Service
personnel at isolated units remote from any public health service
relief station.
Medical officers have been assigned, as usual, to the cutters on the
international ice patrol, to those on the cadet-practice cruise in
European waters, and to the Bering Sea patrol. A dental officer was
stationed at the patrol base at Unalaska during the cruising season.
A medical officer and a dental officer are assigned to the Norlhland on
its annual cruise to Point Barrow, Alaska. This cutter has a wellequipped dental unit and a specially appointed sick bay. In addition
to their care of Coast Guard personnel, the medical and dental officers
extend medical, surgical, and dental relief to a considerable number
of Alaskan natives and others to whom such relief is not otherwise
available. Valuable scientific observations have also been made of
medical, sanitary, and dental conditions among the natives.
The new Coast Guard Academy at New London, Conn., provides
space for enlarged and improved medical and surgical care. The
medical facilities have been expanded from a sick-bay status to a
well-equipped hospital unit of 20 beds, with complete operating room,
X-ray eqmpment, and dental clinic. Medical and dental officers and
nurses are detailed by the Surgeon General for duty there.
Instructions for medical examinations have been amended to provide more rigid requirements. A Wassermann test and blood-pressure
reading are now compulsory. In the absence of an individual health
record, abstracts are made of all hospital and out-patient treatment,
and this information is considered in connection with physical examination of special temporary enlisted men for entrance to the regular
establishment. An mdividual health record for all Coast Guard
personnel was agreed upon jointly by the Coast Guard and Public
Health Service to be in effect October 1, 1933.
A new system of compulsory treatment of syphilis now insures
adequate and continuous treatment for a minimum of 70 weeks.
The outline of future treatment with dates is made by the medical
officer in charge of the station concerned, and the Coast Guardsman is
given official orders to present himself for treatment on the specified
dates.
•
Medical Director A. J. McLaughlin is assigned to duty at Coast
Guard headquarters as representative of the Surgeon General and
chief of the medical section.
OPERATING COSTS
The total amount expended, including reimbursements from the
Veterans' Administration, classified according to the General Accounting Office Bulletin, is shown below:
01 Personal services ______________________________________ _ $3,934,362
0200 Janitors and sundry supplies, X-ray films, etc _____________ _
46, 757
1210 Medical and hospital supplies ___________________________ _
294,048
0220 Scientific and educational supplies _______________________ _
5,015
0230 Fuel (coal, oil, and gas) ________________________________ _
150, 158
0250
24,569
0260 ~~~!f~ons ____________________________________________ _
881,824
0280 Sundry supplies _______________________________________ _
59,674
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HOSPI TAL
COST i'Dl PA'IIDiT !l.lf
s.,lo.r!.u
OF
BOSi'lTALS
.....
!'oot
c:::::::=J
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ht.iou ~
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"d
~
t:
011'1:0..C.
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TtmDCULOSIS
f ort Stanton, W.li!.
56 , 92';
J,46
lWl.&fflllllll
'·"' I
C•nille, La.
l)ll,3J7
2.46
1.4<>
~
I
J.~
P.r din. cost !or all bospHa.h
1.55
Jlel1•f days for all ~O•?ltals
l , ~ , 127
Co,t
l,;J
. ;,i
I
, 67
IJJl,379, "3
Cost
ALL
I
1.59
$:,00, 266.5)
Cost
LlnOSWtlf
.6}
I
,J9
I
1.00
ss,!L.2,1L.2. 11
(a) Itt-?aHeot de!lfll'tlllel!t of ,t., Hc n clo.-4.
AVERAGE PER DIEM COST OF IN-PATIENT RELIEF, UNITED STATES MARINE HOSPITALS, FISCAL YEAR 1933
00
-l
88
03
04
0500
0510
06
07
10
1100
1110
• 1280
1290
1373
1375
1380
2250
3000
3010
3020
3040
3050
PUBLIC HEALTH SERVICE
Subsistence and support of persons (contract care) ________ _
Care of animals _______________________________________ _
Telegrams ____________________________________________ _
Telephone ____________________________________________ _
Travel expenses ______________________________________ _
Freight-------------··----------------·--------------Furnishing heat, light, power, and water _________________ _
Rent of·buildings and offices ____________________________ _
Other rents __________________________________________ _
Repairs and parts, motor vehicles. ______________________ _
Alterations and repairs, building equipment ____ . __________ _
Laundry service _______________________________________ _
Ash and garbage removaL ____ . ________________________ _
Miscellaneous services_. ___ ._. _________________________ _
Burials ______________________________________________ _
Motor vehicles. ______________________________ . ________ _
Furniture, furnishings, and fixtures ______ . _______________ _
Scientific equipment ________ . __________________________ _
Livestock. ___________________________________________ _
Other equipment ______________________________________ _
TotaL _______ .. _______ . _______ .. ____ . __________ .
$509,577
59
1,385
24,577
68, 91'
78, 77i
185,854
24,217
5,168
3,824
16,087
49,462
2,085
2,861
20,913
7,670
110,045
111,638
355
45,300
6, 665, 170
As a description of representative activities, the complete annual
report of the Marine Hospital, Baltimore, Md., will be found in the
Public Health Reports for the second part of 1933.
CONSOLIDATED AND DETAILED REPORTS
The following tables IP-ve consolidated and detailed reports for the
marine hospitals and relief stations:
TABLE
1.-Number of patients treated annually, 1868 to 1999 1
Fiscal year
Sick
and dis•
abled
patients
Sick
and dis•
abled
patients
fur•
nished
relief
Fiscal year
fur-
nished
relief
Prior to reorganization:
1868-· -· - ----· -· --- -1869_·····---·----·-1870__ _·-·- - -·-·-··--
11,535
11,356
10,560
187L·--···-········
1872--··· · ······· ··-·
1873 __.. --· ···- -·····
1874 .... -----·· · ·--··
1875.·-- ········-·· -1876. ___.... . ........
1877..•. •····-·····-·
1878... ••·-···--··-·1879..... .. ...... _.__
1880....... . .........
188L· -·· ···· ·--· ··1882......... ---·-· ·1883._ . . _. __ ... ... •..
1884.. .. _.............
1885. ..... . ....... -..
1886.. -·· ·----·-· -···
1887_····-·······-···
1888......... ...... ..
1889. •. ·-·-··-····· ·-
14,256
13,156
13,529
14,356
15, 009
16,808
15,175
18, 223
20,922
24,860
32,613
36,184
40, 195
44,761
41,714
43,822
45,314
48,203
49,518
After reorganization:
Sick
Fiscal year
and disabled
petients
fur•
nished
relief
After reorganizationContinued.
After reorganizationContinue<l.
1890·-·-·········-···
189L......... . . ....
1892-.. ····· · ·• •·•···
1893 ....... .• ......•.
1894......... •. . . .. . .
1895.... . ............
1806..... ·-··········
1897 ..... ·- -···· ·· ···1898.·-·· -·-·· --·-· · ·
1899.. _. •. __ . . ... _. . .
1900.. __ •. _.. _. _. _. __
190'--··· •·· · - · ······
1902·-·-·· -··· · ······
1903·-··········-····
1904. . ... ·-·-·-··-···
1905.. -·-··-···-·-· ··
1906 ___ ···· - · ··-·•··1907• . -·--·-·-· -···-1908._··· -·· ···· -·· ··
1009 ........ . . -.. ....
1910.... . ..... -·- ····
1911 .. -···· · ····--·--
50,671
52,992
53,610
53,317
52, 803
52, 643
53,804
54,477
52,709
55, 489
56, 355
58,381
56,310
58,573
58,556
57,013
54,363
55,129
54,301
53,704
51,443
52,209
1912..... .... . ... .••.
1013._ •. -... .........
1914••... ·-····· -····
1915.•..• ·-··········
1916. __ ······-·······
1917-._ .. _...........
1018•.• •...•.•.•..• __
1919••. · --· ··· -···--1920•• ·--······ .... -·
102L.- · · ···-·····-··
1922.·-- ···· -·- ·-····
1923 ' · ··· · ···-----·-1924·-···· · ·-· · -·-·-1925_.... ..... . ... . __
1926. •. ·-· ·········-·
1927 · - · ···· ···· · . . . ..
1928.. -········ ··-·-1929....••• _•...••...
1930.· -····-·· · · ····1031-. •.. _......•....
1932.•. •......... . . . 1933.................
51,078 ·
50,604
53,226
55,782
58,357
64,022
71,614
79,863
110,007
144,3«
153,633
126,956
159,686
204,944
245,140
249,978
240,592
260,552
279,350
259,364
257, 20!
294, IOI
1 These figures do not include patients treated in connection with veterans• relief activities of the se~ce
as follows: 1918, 192; 1919, 13,856; 1920, 279,036; 1921, 667,832; 1922, 242,379; 1923, 9,704; 1924, 3,(H; 1925, 4,860;
1926, 3,749; 1927, 2,830; 1928, 3,448; 1929, 4,907; 1930, 6,817; 1931, 9,278; 1932, 9,667; and 1933, 8,377.
1 In this year, and subsequently, the practice of recounting out.patients applying for treatment in more
than 1 calendar month was discontinued.
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89
PUBLIC HEALTH SERVICE
TABLE
2.-Tramactiom at United States marine hospital, and other relief statiom
Num•
Pa•
ber of Number
tients
pa•
remain• Number
of times
Ing in of days
omce reof pa• tients Died hosp!· relief In tients
fur•
lief was
tients treated
tals hospitals nished furnished
treated in hos•
office
June
pltals
relief
30, 1933
Num•
Total ber of
number pa-
Nmn•
berof
physi•
cal U •
amina-
tlous
----------- -1--- --- ·----- ____,___ ,____ ,
Grand total .•••••.•...• . .••.. 30'l, 47~
44, 436 I, 20'J
3, 1132 1; 763, 0!!4 258,043 I, Off, 690 , 61,_1171
=;==
l'IRST CLASS STATIONS
Marine ho,pital,
Baltim~Md .•.. .•. .. ..... .. . ... .
=i::.
8,007
8,891
3,678
1,303
33,527
5,371
3,092
12,388
473
1, 474
4,384
1,579
1,090
2,975
3,375
12,486
31,170
8,292
2,046
1,520
793
1,968
13,263
4,161
3,013
8,716
331
201
N~.~~: ::::::::: : ::::: ::: :
§[c:ltf~bhl~~~::::::::::::::::::
Detro~lch ....... .. ....•. . ......
d, N .Y . ...... ... .. . .. ...
Ellis
Evansville, Ind ...... ........ . ... ..
Fort Stanton, N .Mex ......... ... ..
Galveston, Tex.....••..•...........
Key West, Fla ... . . ••......... .. ...
~iirit~~-~====
. .... . ....•..=
. ============
New Orleans, La . . . . . =
NewYor~N.Y •.• •.•. ......•.. •. .
Norfolk, a .......•••............•.
Plttsburghila . •... . ..•.....•......
Portland, aine . . . . ....•.•......•.
Port Townsend, Wash.I ...•... . . .•.
St. Lou18, Mo. .. ..•. . ... ..... . ..••.
San Francisco, Calli.. •...•. .. . ..••.
Savann~ Ga ...........••... .. ..•.
Seattle, ash.• ..•..•.•..•••..•.....
Stapleton, N.Y ....•. . ..••........ .
Vineyard Haven, Mass .•.•.•.•• . ..
Contract overflow hospitals .... . .. .
Total . .........•... . •.....••. 180, 127
SECOND AND THIRD Cl.ASS STATIONS
l , 7611
1,717
700
#I
1,0ll
2,242
1,080
4,601
367
34~
1,726
879
727
828
800
4,300
2,039 •
634
633
664
476
3,718
1,235
852
3,701
149
201
38
38
197
148
60
370
134
57
21
24
21
100
64
98
17
18
35
13
23
10
29
137
64
.28
21
10
27
55
400
27
236,
110
43
32
6.1
103
308
51, 884
28,855
; 134, 837
48, 231
78, 149
42, 3118
163,733
20,854
86, 924
60, 930
36,180
24, 162
25, 365
33,218
162,546
6, i98
7,174
2,978
859
32,516
3,129
2,012
7,787
106
1,129
2,658
700
363
2,147
2,476
8,177
31,170
6,253
I, 412
887
229
1, 492
D,545
2,926
2,161
5,015
182
49,063
38,982
21,489
I, 706
67,181
10,336
_18,296
2'l, 824
342
3,549
16,665
5,123
1,779
16, 602
10, 767
2,MO
3,665
I, 126
.....638
325
815
342
61
41
703
84
304
410
1, 550
1,978
2,308
10,801
I, 100
439
270
85
I, 186
1,945
1,604
4,591
372
26
3, 6.'i6 1, 621,579 142, 281
659, 800
38,869
250
444
62
278
143
·· --201·
30
38
·····68·
367
113
183
264
20
95
57
26
63
3
3
37,846 1,083
61.l,833
i
30
79, 220
31,582
26,501
20, 536
30, 506
142, 0.59
. 56, 578
27, 465
108,631
8, 051
23,452
33,408
196,291
28,208
7,185
3,816
461
8,252
57,358
12, 792
5,261
24,654
----- --- ---------- ------- -
=-------- --------- - - - -
Aberdeen, Wash.. . .. .......... ....
Albany, N.Y.. ... .. . ... . ...... .. .. .
Anacortes, Wash. . . . .... ..... .... ..
Apalachicola, Fla.. . . . ... . .........
Ashtabula, Ohio. . ............. . . . .
Astoria, Oreg.... . ..................
Balboa Heights, Canal Zone.. . ....
:::::::
~:r:.:t:4fc~·:::::::::::::
Bellingham, Wash. • • . . • . . . . . . . . . . .
:=b!;iarbor; Maine::::::::::
272
91
184
69
221
622
595
1:
222
1 1
• :
1~::~;~~~~~~~~~~~~~~~~~~~ ~
Camhrldg11, Md.. ........ .... .. . . . .
Cape May, N .J. . ....... . ..... . .. ..
Charleston, 8.0..... .............. .
Chincoteague, Va... . ..............
Clnclnnatf, Ohio.... ... ....... . ....
Cordova.,_ Alaska.................. .
Corpus l ;hrfstl, Tex.... . . . ...... . . .
Crlslleld, Md... . ....... . ... . ......
Duluth, Minn.. . .... . .......... ...
Eastport, Maine... . ............ . ..
Edenton, N.C.....................
Elizabeth City, N.C . ..............
El Paso, Tex.... .. . ......... . . .....
Erle, Pa.......... . . . . . . . . . . . . . . . . . .
Escanabl!,_ Mich ......•.... _. . .. . .. .
Eureka, 1Jalif., ••.••• •• . • ... •.• •• ••
Everett, Wash...... . . .. ........ ... .
Fall River, Mass...... . ........... .
GalllPOils, 0 hio .. ... ........... . . ..
Gary, Ind......................... . 1
126
1,916
861
106
218
128
169
1, 000
623
31
22
156
155
320
21
181
170
117
137
28
I Cl~ Feb. l, 1933,
22 ...... ••·• ·• ··
16
1 •• • •• ...
25
14
22
3 ······-·
88
156
1
HI
14
71
10
2
••••• 1
198
IM
161
179
381
663
1,988
7
1,611
139
660
319
····ia· :::::: :::::::: · ·
148
3
3
2 • •• ••• ••
30
IOl •••. . . • ••• ••••
11
1
152
1 •••• 1
•• 40
2
1
45
45 . .•. .• ••• •• •..
7 .. • ... ·• • · •···
1 •••• • • ••
50
·2111·
1,916
543
429
2, 703
472.
898
671
70
734
2 -····· · · · ····-
12
382
120
2 •••• ••••
2 • • •••••.
354
413
315
1 ·· · -· · ··
691
18
19
1
30
33
8
46
1 • •• • ••••
9
1 ....... .
I
75
159
55
100
434
439
38
614
208
1,068
36
81
21
741
6
96
1,812
709
106
178
83
124
003
673
31
22
154
137
301
20
151
137
100
DI
28
Opened ~eb, 1, 1933.
Digitized by
Goog Ie
Ml
198
446
I, 120
514
75
3,655
838
3,258
66
140
29
2,025
5
26
7
13
DI
14
44
11
191
68
21
6
··-··m
II
455
4, 916
1,470
308
498
I
128
197
13
228
7
3
SIi
g
2
lf
84
306
5
10
125
1,710
1,229
58
130
607
I,
1,109
45
381
495
226
263
97
3.,.
l:M
23
~
19
1
7
90
PUBLIC HEALTH SERVICE
TABLE
2.-Tramactiom at United State, marine hoapital, and other relief ,tatiomContinued
---Total
number
ol patlents
treated
Num•
berof Number Num•
Number
berof
of times phymof days til:ts office
re- cal ex•
furrelief in
lief was amfna..
hospitals nlshed furnished
office
tlons
relief
30, 11133
Patlents
remainpatients Died Ing in
h:rsl·
treated
in hos1une
pltals
NumberoC
--- -IISCOND A.ND TlllltD CL.'811
STATI0NS-eontinued
Oeorgetown}J'.C ..•••.•...•.•••....
Gloucester, ass ..•..•.•.•••••••...
Grand Hav~ Mich ••.•.••••••.•..
Green Bay, Is •.•.••••••••.•••••..
Gulfport, Ml111 •.••••••••••.•••..••.
Hancock, Mich •.••••••••••••••••..
Honolulu, Hawaii.. •••••.••••.•••.•
HoustonHTex ..••••••••••••••••..•.
Indiana arbor, Ind ••••••••••••••.
Jacksonville. Fla •••..•••••••••.•.•.
Juneau, Alaska......................
Ketchikan, Alaska •••••••••••••••••
La Crosse, WL,.•..•••••••.••••••••.
Lewes, Del.. ......•.••••••••.•••••.
Los AngelesiJallL •.••••.•.••••••.
Ludington, !ch .•.•.•••••.•••••••
Machias, Maine ...•.•.•••••••.•.•..
Manila, P. I. .......................
Manlltee, Mich ..••.•.....•.•••..•.
Manltowac, Wis .•.••...•..••••....
Marriuette, Mich •••••..•.•..••.••.
Marshfield, Oreg .••••..••.•••••.•..
Menominee, Mich •••••.....•••••..
Miami, Fla .....•..••.•.••.•••••••.
Mllwaukee Wis .......•..•....•...
Morehead 0tty, N.C. •.••••••....••.
Nantucket, Mass .......•.••..••••.
Nashville, Tenn.·--··········-·····
Natchez, Miss ..••...••...•.•.•.•..
Newark, N.1. ....••.•.•.•..........
New Bedford, Mass .....•••..•..••.
New Bern, N.C ...•.•.•.•••...•....
New Haven, Conn ..•••.•.•.•...•..
New London, Conn •••..••••..•..•.
~::ro~i: i~r:::::::::::::::::::::
Newport News, Va ••••.•..•...•.•.
Ogdensbur~ N.Y .....••....•..•.••
Olympia, ash •••..........•.•.•..
Oswego, N.Y ••••.•..........•.....
Paducah, Ky •.•....••.••....•••...
Panama rity, Fla ...•......•......
Pensacola, Fla ....•......••..•.....
Perth Amboy, N.1. ...•.......•••••
Philadelphia, Pa...............•...
Ponce, P.R .•.......•........••....
Port Angele.•, Wash ..•.••.•.•.••.•.
Port Arthur, Tex .•................
Port Huron, Mich ...••.........•..
Portland, Oreg......•.•..•.........
Port Townsendf Wash.• .•..•.•.....
Providence, R ....•.....•.•.•......
Provincetown, Ma.'19 ......•..•.....
Reedville, Va .•••••••..••..•....•..
Richmond, Va .••...•....••........
Rock Island, Ill.. ..•.•••.••.•••••..
St. Thomas, V.I. •..•.•...•.•••....
San Dleo;o, Calif. ...•.••..•..•.••..
Sandusky, Ohio.·-············-····
San 1uan, P.R ...•...•....••..••.•.
San Pedro, Calif..•..•••.•••.....•.
Sault Ste Marie, Mich•.•.•.••..•..•
Seattle, Wa.qh .•.•...••.••.•.•..•...
Seward, Alaska .•••.•.•••••.....•..
Sheboygan, Wis ..•........•........
Sitka, Alaska ..........•........•..
South Bend, Wash •... ·-···········
Southport, N.C ••••...•.•....•.....
Superior, Wis •••.•.......•.•.•••...
Tacoma, Wash ...••.•...•••...•••.•
Tampa, Fla..••••..•...•......•....
117
602
2116
106
26
88
9M
------------I -------------------16
l
I
a ------ -------l
······2·
····4·
122
I
14
20
1,316
60
119
973
86
6.~
301
1,0t!6
42
1116
1,475
167
35
1, 4611
78
237
262
71
76
I, 156
1,013
679
101
61
418
16
286
a
189
12
26
646
10
····i15·
17
37
13
14
4
65
185
85
8
112
94
14
1,028
28
7
196
285
195
31
191
525
149
520
60
6,099
156
213
1,404
22
-----------l --------------11
--------·---------------3
1
2
I
------ --------
------------------------------ --------
30
10
l, 763
1,261
12
603
1,462
2, 724
133
294
--------
3
1
····•·i·
------------------------------ --------
2,295
104
347
113
474
122
2,526
51
174
2
31
------3 --------3
366
349
Ill
132
69
1
7
32
137
21
33
443
36
10
16
------------4
1
·-····s·
------ -------I
-----I
··--:i"
2
····;· ···•··-•I
87
833
1,197
16
l!O
M
1'
188
44
ID
1, 1178
3,260
67
12'
908
238
2,111111
877
30
140
283
1, 708
63
461
7,898
616
35
69
6,374
1, 2114
61
l, 717
92
282
182
179
47
167
200
643
426
239
688
67
72
1,091
2611
154
172
2,624
2,497
2,174
190
180
1,000
62
fi16
948
163
397
81
153
366
80
1,000
157
1,308
18
35
132
194
92
246
838
32
6,358
1,069
139
198
119
3,963
10
361
3,990
1,893
1,418
1,715
5
287
312
1,823
253
284
322
828
494
93
61
31111
12
79
174
285
30
171
rm
129
410
52
4,623
97
l!lO
1,362
198
2,121
102
316
113
474
113
2,511
46
353
55
752
3,399
979
3,539
156
74
82
33
759
223
333
407
• Third class relier station, opened Feb. 1, 1933.
Digitized by
239
1,603
461
930
-------------------- -------- --------------------------------------------9 ------ -------102
15 ------ -------73
117
5 ------ -------32
2
l
760
4 ------ -------42
2,266
126
2
7
1
1
116
488
248
811
23
7,843
87
1
I
3
........
10
38~
...... a"
2
6
------ ----------· ---I ------ -------1 ------ -------20
1 -------18 ----·· -------20
I ······2·
110
2
8 ··----- --·----476
6
6
59 -----3
33
-------42
2
208
59
877
3,748
1,090
3,671
225
75
89
65
896
244
3
207
640
......:i.
2,331
I,
110
-------36
------ --------------------------- ·--------40
l ------. 749
4
1 -------66
103
17
I
468
86
------2 ----------------------
16
94
198
Google
736
243
308
479
406
S4
650
1,145
364
1,4U
102
23,505
414
347
3, 6fll
663
6,274
403
884
341
1,486
233
9,527
I
31
IM
84
···--439
1911
166
27
18
MO
9
8
ll61
8
a
84
16
26
170
284
10
7
40
20
6
80
18
M
326
2
28
72
69
-------38
52
1
130
26
2,185
5
71
182
139
1,136
58
188
16
15
40
114
2,639
1
1,604
123
2,320
9,692
2,023
12,058
262
449
184
168
131
1,031
480
207
11
133
98
823
-------16
19
6
15
9
880
28
759
183
91
PUBLIC HEALTH SERVICE
TABLE
2.-Transactions at United States marine hospital8 and other relief stationsContinued
Total
number
or patients
treated
SECOND AND TBIBD CLASS
STATIONS-Continued
·Toledo, Ohio _______________________
475
Vicksburg, Miss ___________________
545
Washington, D.C __________________ 25,314
Washington, D.C. Dental Clinic... 1,141
Washington, N.c __________________
273
White Stone, Va ___________________
582
Wilmington, N,C __________________
520
Wrangell, Alaska ___________________
76
FOURTH CLASS STATIONS
Ashland,
Wis.------------------···
Bath,
Maine
.... ___________________
Bay City, Mich ____________________
Beaufort, S. C ______ • _.... __ •. __ . _. _
Bridleporb Conn __________________
Hart ord, onn ____________________
Nome, Alaska .. ____________________
Petersburg, Alaska_________________
Portsmouth, N.H __________________
S~lnaw, Mich _____________________
Wilmington, Del... ________________
103
12
48
13
33
4
27
290
8
6
15
PaNumtlents
ber of
remain- Number
paof days
tients Died ing in relief
in
ho:rsitreated
hospitals
t
s
in hosJune
pitals
30, 1933
-- --- ----
71
51
2M
4
1,596
212
------4 -----i2- 2,900
-----4i° ----2- -------493
-------------------- -------- ---------52 ------ -------564
12
3
193
10
106
-------- ------ -------- ----------
1,345
1,628
55,949
17,243
410
2,691
1,308
186
137
69
------i7
93
181
102
2,549
12,805
156
1,222
5,247
374
4,2Z7
4
111
13
5
J,010
154
56,370
-------- ---------- --------
979
801
2,670
1
23,102
61,971
4,774
15,481
29,508
119,314
507
35
98
141,475 115,762
384,790
276
3,932 1,763,054 258,043 1,044,590
------ ---------------
Beneficiary
404
494
25,060
1,141
226
582
468
64
12
61
------------- -------- ---------1 ------ -------47
6
176
13
24
2
------------- -------12
123
21
34
1 -------4 ------ -------47 -------- ---------- -------4
59
23
31
-------16
1 -------274
1,103
233
24
8
-------- ------ -------- ---------6
21
------ -------- --------------··-1 ------ ----·--27
7
14
MISCELLANEOUS
Curtis Bay, Md. (U.S. Coast
Guard) •.•. ___________ . __ .. ___ .... 2,549
,U.S Coast Guard Academy, New
London, Conn ___________________ 1,312
90
2
St. Elizabeth's Hospital, ,vash.,
D. C ______ .. __ . ___________ ........
176
176
5
Special acting assistant surgeons for
Coast Guard and Lighthouse
Service _________ ------- •.. --- ..... 4,947
173
U.S.
Coast Guard
Vessels
and
bases.
-----64Emergency
___________
._. ___
. ___
. ___ 29,508
89
-----Total ____ -----· _____ ---- _____ 122,351 6,589
119
Grand total __________________ 302,478 44,435 1,202
TABLE
Number of Number Numpaberof
of times physitients office
re- cal exfurlief was am.insDished furnished
office
tions
relief
3.-Medical services for various classes of beneficiaries
PaNum- Number Numtients
Total Numremain- Number ber or of times ber of
ber of
num- patients
patients
ing in of days
office
physiberof
Died hospifurrelief In nished
relief
cal
patients treated
in
hostals
hospitals
was
fur•
examtreated pitals
office
June 30,
nished !nations
relief
1933
American seamen ___ .•... ___ .. __ ... 135,868
Foreign seamen __________ . _...•....
411
Coast Guard _______________________
56,660
Bureau of Fisheries___ • _____ .... ___
36
Army_----------- __ . _________ . _____
370
Navy and Marine Corps ___________
188
Mississippi River Commission •....
13
Engineer Corps and Army Transport Service. __ .. _._._ ............ 5,231
Lighthouse Service..... __ ....... __ . 2,501
Coast and Geodetic Survey ________
991
Em~lo_yees'
Compensation Com- ·
m1ss1on .... ________________________
51,204
Veterans' Administration. _________ 8,377
Immigration Service._ .•........... 9,615
Publlc Health Service officers and
r:~semployees ___________________ 8,543
454
Miscellaneous ______________________ 23,016
Total ________________________
302,478
- - --- ---- --- ---- ----632
23,892
2,772 1,.039,092 111,976
518,123
7,158
186
4,380
7
47
48
3
19
13
281
1
5
I, 163
417
167
34
15
2
2,951
7,902
1,933
13
422
15
6
4,123
106,126
83
427
701
54
225
51,280
29
323
140
10
581
214,805
70
1,138
595
19
14
9,567
3
319
85
28
9
36,811
9,974
3,824
4,068
2,084
824
15,735
7,418
3,483
130
133
207
64,561
316,298
32,816
48,253
475
7,682
161,828
6,760
23,769
19, 764
943
41
12,812
7,691
56,999
134,846
370
44
8
14
516 22,975
33,223
3,932 1,763,054 258,043 1,044,590
1,531
19
21,410
61,971
--------------1
1
------ --------
852
15
446
24
41
3
44,435 1,202
40
66
15463-33--7
Digitized by
Google
23
2
538
427
92
PUBLIC HEALTH SERVICE
TABLE
4.-Cause of admission and condition on discharge, marine hospitals and
other relief stations
Number iltlving sredfled diseases or Condition on discharge of patients
injury I
for sµecified diseases or Injuries
Disease or condition
Total
number of
Major Condi- Condi- SeperCO!)dl- tion
tion quelae sons
hon second third
to
having
w~i~·h in im- in im- majo_r
admitted ,
t~~~
ea(:h
Im~ot
.
Other
Cured proved 1m- Died cond'·
proved
tions
tfi~, cie,~•- sh~~·
disease
or
injury
------------1--- - - - - - - - - - - - - - - - - - - - - - - Abnormalities and congenital
malformations ............. .
Blood and blood•lorming or•
42 ···•··· ..................... .
gans, diseases and injuries oL
83 •••••.•••.•••••••••••••..••.•
Bones and cartilages, diseases
and injuries oL... ..........
Circulatory system, diseases
and injuries of:
Heart disease, valvular....
Varicose veins.............
AU others ...••............
Communicable and infectious
diseases, not including tu•
berculosis and venereal:
Conjunctivitis, granular
trachomatous... .. .. . . ..
Dengue...................
Inll)1enza .••..............
Malaria...................
Rheumatic fever, acute...
Typhoid fever............
AU others.................
Dental........................
Digestive system, diseases and
injuries of:
Appendicitis ..............
Gastritis..................
Hemorrhoids..............
AU others.................
Ear, nose, and throat, diseases
and injuries of:
Deviation of nasal septum.
Otitis media ............. .
Tonsillitis.•............•..
All others ........•.......•
EndO<'rines, diseases and In•
juries of.....................
Eye and adnexa, diseases and
injuries oL..................
Oenito•urlnary system, dis•
eases and injuries of (exclu•
sive of venereal):
Nephritis.................
All others •...•...•••.•....
Hernia ...•.................•.•
Joints and bursae, diseases
end Injuries of:
Arthritis ................. .
All others ....•............
Leprosy •......•..•.•..........
Lymphatic system, diseases
and Injuries of:
Lymphadenitis. .•.•......
All others.................
Muscles, fasciae, tendons and
tendon sheaths, diseases and
Injuries of.. ......•......•...
·--------------------1
I, 950
8
3
51
275
978
291
220
61
8
580 ...... .
334
237
124
2
697
64
1,503 ··•···· ·•····· ....... ........
93
222
919
12
2
I. 081
m
2
3
99
17
17
3
I
1,197
1
30
4
262
2
77
14
6
99
32
5
2
39
968 ...............•.............
543 5, 400 4, 258
10 10,220
62
1
1,285
1,585
237
328
42
18
390
2
981
452
217
1,650
2,085 •..•..•..•..........•.....•..
464
510
252
258
2,413
172
1, 169
78
378
I, 226
I
4
509
3,964
851 ••.••.. ······• ...•... ····•···
1
I
345
30
17
21
8
2
13
16
39
692
9
3
61
33
187
271
595
5
158
3
1
6
135
3G
175
1
1
47
4
18
1
2
1
62
142
28
121
605
71
386
321
193
3
2
504
1,412
3
3
69
149
42
224
531
12
256
102
I, 147
480
12
5
78
1,052
44
2
9
396
320
487
46
3
59
85
271
o6
4
5
•
1
10
9
45
209
128
299 •••.•.•.•...••.••..••••......
15
201
6
22
55
689 •••.... ...•.•. ••••••• ••......
153
387
15
3
131
3
83
3
41
348
912
1,003
13
16
37
2, 734
15
270
203
1,767
53
61
690
247
22
29
6
154
273
96
30
148
547
38 ••...•. ....... ....... ........
89
11
136
12
I, 214 ..•.••• ....... ......• ........
221
718
161
1,671
1,974
174
78
563
197
932
438
174
422
9
223
444
70
828
17
24
3
I
31
119
24
2
5
45
8
23
3
249
m:t~e~<:"pt In the case of specific diseases, statistics are given only for the major condition for which ad•
' Represents number of discharges for each condition.
1 Where sequelae were given, no third diagnosis was recorded.
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93
PUBLIC HEALTH SERVICE
TABLE
4.-Cause of admission and condition on discharge, marine hospitals and
other relief stations-Continued
Number having specified diseases or Condition on discharge of patients
injury
for specified diseases or injuries
Disease or condition
Major
condition
for
which
admitted
Condition
second
in importance
Condition
third
in importance
Total
numberof
SeperOther
q uelae sons
Not
Died condito
having Cured ImImtions
major each
proved proved
condi- specition
fled
disease
or
injury
---Nervous system, diseases and
injuries of:
Epilepsy
without psycho- _
sis. ____________________
Neuritis __________________ _
All others ________________ _
Obstetric and gynecological
conditions__________________ _
Parasitic diseases:
Uncinariasls _____________ _
All others ________________ _
Poisonings and lntoncations:
Alcohol
(ethyl) poisoning _
acute. _________________
Alcoholism, chronic (without psychosis) __________ _
All others ________________ _
Psychiatric diseases:
Drug
addiction
without _
psychosis.
______________
All others ________________ _
Respiratory system, diseases
and Injuries of (exclusive of
tuberculosis)
:
Asthma __________________
_
Bronchitis
___
-------------_
Pleurisy _________________
Pneumonia ______________ _
All others ________________ _
Skin and its appendages, diseases and injuries of. _______ _
Tuberculosis:
Pulmonary ______________ _
46
23
8
1
78 ------276
101
23
7
407
23
519 ----··· ··--·-· ----·-· -------50
42 ·------ ----··· ------- -------37
196
102
40
13 ---·---
5
117
147
45
13
7
65
88 ------- ------- ------- --------
223
520
220
73
329
130
310
96
100· -------
14
102
31
77
-----ii"
11
27
310
960
392
510
------- ------- --------
951
143
52
· 72
22
57
39
46
275
1,049
66
356
74
Total ___________________ 38,789 -------
15
12
11
142
24
3
45
425
-------1-------1--------
11
2
24
127
------- ------
5
fl()
26
5
35
24
132
31
53
2
16
6
27
30
34
3
2
6
21
11
135
7
26
3
2
10
21
10
107
11
39
97
30
21
27
95
41
86
7
166
321
139
125
51
3
2
237
522
9
11
172
15
4
180
504
7
309
34
14
34
19
124
67
'lJY1
14
4
92
20
52
71
83
247
5
1
1
16
1
7
51
477
651
9
146
1,627
1,586
11
84
800
164
1,788
4
1,223
178
492
2, 724
3,717
2
1
23
11
23
14
5 ------42 ·-----288 ------- ------- ··----- -------·
15
1,008
Otherwise unclassified .. __
93
Tumors:
Carcinoma _______________ _ 244
All others ________________ _ 426
Venereal diseases:
Chancroldal Infections ___ _ 289
Gonococcus Infections.... _ 2,359
2,309
22
Inoculations. _________ -- _... __
1
580
Under observation_.---- .. -- -Miscellaneous:
Cellulitis________________ -294
All others ________________ _ 3,603
fJ.Jf~fg:ra::::: :::::: :: :: ::
67
33
190
295
-
8,188 21,136
4
4
5
6
78
11
------- ------
118
2
1
580
2
41
44
934
452 1, 190
7, 823
40
NoTJ:.-lmmigratlon patients at U.S. Marine Hospital, Ellis Island, N.Y., are not Included In this
table.
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TABLE
co
5.-Number of day3 in hospital for patients discharged from marine hospital3 and other relief atatioM
~
Class of beneficiary
SeaEmPublic
men
Healtb
Civil•
Engi•
Coast ploy•
Vet- Imm!- Service
ees'
neer Ligbt and Com•
Group
gra•
erans'
Ian Mis•
I
officers
Amer•
1
For·
1
I
I
sf;pl
House
Geoelgn Coast Army Ma• River c~ss
Lepers Con· cella•
Admln· tion
Total 1 lean
Serv• detlc pensa·
serva- neous
sea•
sea• Guard
rlne Com•
tion
lstra• Serv- and
em•
tlon
Army
lee
Sur•
men
men
Corps mlS•
lee
tlon
Corps
vey Co_m•
ploY•
WIS·
slon Trans•
ees
port
slon
Service
- -- - - - - - - - - - - - - - - 1 - - - l - - - 1 - --1 ---1---1---l---1---1---1---1---1---1--- 1---1---•-- - , - -
~r
0
co·
;ac
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CD
D.
rr
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0
0
-
00
(?
Abnormalities and congenital malforma•
tions ..•...•....•••........••••. . ..•.•.•••
Blood and blood-forming organs, diseases
and injuries or. ....••.......•••........••
Bones and cartilages, diseases and injuries
oL ...•••.•.... ......•••.•. .•...•...... . .
Circulatory system, diseases and injuries of.
Co=unicable and infectious diseases, not
including tuberculosis and venereal.. ....
Dental. ••••••.......•••••....•.•••..•...••
Digestive system, diseases and injuries of. •.
Ear, nose, and throat, diseases and injuries
oL •...••••..........••.••..•...•••....••
Endocrines, diseases and injuries oL .....•
Eye and adnexa, diseases and injuries of...
Genito•urlnary system, diseases and In•
Juries of (exclusive of venereal) ••.•••.....
Hernia..•..•.•........• ••••.......••.•. . ..•
Joints and bursre, diseases and injuries oL .•
Leprosy .•••...........•••.......•..•.•••..
Lymphatic system, diseases and Injuries of.
Muscles, fascire, tendons and tendon
sbeatbs, di~eases and injuries of. .......••
Nervous system, diseases and injuries of. ...
Obstetric and gynecological conditions..•..
Parasitic diseases ...•.. ..••.•....•...••....
Poisonings and intoxications.•.....•...••..
-: 1Psyoblatrio diseases .•....•........ ••..•.•..
- esplratory system, diseases and injuries of
(exlcuslve of tuberculosis) •....••......•••
, fSkln and Its appendages, diseases and in•
1
'Ti~~~~s1s·:.::::::::: ::::::::::::::::::::
1,081
771
-------------
60
348
-------
5,490
816
10,131
30 -----------------56-- ------------166
25
1,860
156
4,230
360
180
985
345
3
1,571
303
494
4,911
3,634
58, 792
278
33
186
1,246
28
1,577
8,281
516
1,198
------------- ------------15 ------------6 ------7
1,934
215
238
271
3,359
162
850
22,222
7,531
6,046
44
710
44
60
292
43
289
68,418
27,451
18,491
31,164
18, 704
9,905
66
6
11
3,605
1,075
2,664
··s;siii. ···29;;· ····259·
58,808
4,068
~~ :::::::: :::::::!
2,631
22,537
5,091
61,790
43,950
-------
4 1---- ----1-------1- ---- --
23,421
40,281
38,923
10,287
139,328
54
191
-------
4
19
12,973
40,765
323
3,377
1,903
35,222
236
17,505
597
4, 568
3,278
29,242
65,122
790
6,707
10
43
1,219
663
90
138
41
------- ------- ------- -------- ------- ------9 ..•..••
------- ------- ------- 859
600
1,585
2,279
44, 181
69, 777
38,244
36,880
30,653
I
1,147
1,650
244
6,124
92,794
119,205
69,578
60,214
65,230
128,311
11,806
Mis·
2,672
2,805
3
31
72
102
30
30
41
····s2·
2
27
10
------------------•.••...
-------
261
2,351
37
291
727
98
------- --------------------3 .•.••••
------610
32
-------------
1,287
1,006
767
306
363
332
------29
140
132
66
442
8,532
3,693
24,553
11,515
26,691
56
659
134
131
39
202 -------------------66 ------17
5
8,922
1,582
3
88
{,041
17,050
153
2,218
26
7 ···-···
601
209
115
329
19,602
212
2,305
3 •••••••
8,448 ••••·•• ••••••• •••••••
809
132
718
166
1,300
2,217
0, 954
19,277
165
249
1,716
27,578 15,504
213, 059 181, 749
21
72
13
-------
······r····
14 ........
--· ···· · . ......
820
19
,39 ........ .............
104 •••••••••••••••••••••
107
272
..............
983
3,308
97
20
-------- -------------------- ------
14
57
2
8
319
1,264
36,229
3 .•••.•
------------------61
42
206
321 •••••••••••••••••••••
78
104
3,869
:
30
51
20
--- -----
1
14
8,120
323
-------------------- ------------- ------------· ------------------ ------------- -------- ------14
g ••••••••
671 ••••••••
7
~
C
Ill
128,311
····252· ····29· ····12· ·····si· ··i;186· .... i,· ••••••••
186
6
4
280
213
87
298
71
§
1······
224 •••••••• ••••.••
11
l, 880 •••••••••••••••••••• ,
l:"J
>
~
Cll
l:"J
g
l'II
Tumors___________________________________ _
Venereal diseases _________________________ _
71,700
15,6871
Inoculations ______________________________ _ 267, 33li2 182,929
Under observation_______ ---------- ______ _
3,337 -i;3aa
Miscellaneous ____________________________ _ 97,211
47,170
TotaJ ________________________________ ll, 692,150 1954, 915
I
168
935
8
595
1,086
23,792
2
758
5,091
43
1-------1
-------1-------1-------1
24
19 _______
I 4,138 I 90,443 I
331
I 486
55
~ I ~ ~ r.:-026-
7691 4191
8,034 1,334
80
418
521
l, 718
4681
49741 H, 2931
506 26,088
131
676
741
106
---,----1------1--------------
2
31
381 ________
2931-------1
&IO
8
1833
291
878
I 34,5111 9,265 I 4,273 I 69,477 1378,ooa I 6,736 I l0,284 1128,665
60
I
512
NoTE.-Immigration patients at Marine hospital, Ellis Island, N.Y., are not Included In this table.
TABLE
6.-Classification of out-patient treatments furni8hed at United States marine hospitals and other relief stations
General
medical
Marine hospitals ___________________________ ,-------------------Other relief
stations.----------------···········-················
Special
acting
assistant surgeons _______________________________ _
Co9.8t Guard vessels and bases _________________________________ _
Emergency •• ___ •••• ___ .•••••• __ ••• ______ •. --- ••• -----. ----- ••••
I
InoculaSurgical I V~nereal tions and Arsenldiseases vacclnacals
tlons
I
I
Physioth:1y
X-ray
Eye, ear NeuroDental Inose, and psychlthroat
atric
Tuber•
culosls
101
404
86
22
121
327
121
166
107,634
55,668
2,631
21,412
79,884
15,808
511
5,731
3,245
5,422
1,405
5,994
19,852
7,261
62
706
103,873
22,622
121
1,976
659,800
244,650
15,481
124,561
98
613
735
187,345
101,934
16,066
71,881
128,592
1,044,590
86,154
89,609
9,036
62,494
98
224,445
32,493
479
12,455
34,491
15,036
1,029
13,605
Total .• _•..••. ___ ..• __ .•••••• ______ ••• -- ••. --- • ---- ••••• --1 247, 391
269,872
64,161
-------- ---·------ -------·-- ---------- ---------- ---------- ---------- ---------- ----------
I Total
""
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td
t::
(j
~
t"l
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~
tll
0
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01
DIVISION OF VENEREAL DISEASES
In charge of Asst. Surg. Gen.
TALIAFERRO CLARK
RESEARCH
STUDIES AT THE VENEREAL DISEASE LABORATORY, STAPLETON, N.Y.
The experimental resurvey in the field of personal prophylaxis in
syphilis has been continued, and two preliminary studies have been
completed and published. The first dealt with an experimental
method of contact infection suitable for prophylaxis work, and the
second with the time interval necessary for the penetration of the
intact mucosa by virulent syphilis organisms.
Experimental studies designed to test the possibilitr of a life cycle
of the spirochete were carried out. By use of specia dark field and
micro-manipulation equipment, intraocular inoculations of animals
with single spiral forms have been done, and also the corollary, the
inoculation with material known to be infectious but from which the
spiral form has been excluded.
The technique for a combination single cell and tissue culture study
has been worked out through which it is hoped to test the ability of
the Spirochaeta pallida to reproduce under controlled conditions. The
preliminary work has been carried out with chick heart cultures to
which is added a single spirochete taken from lesions of human or
experimental disease.
The influence of hyperpyrexia induced by ultra-short-wave radio
has been studied in rabbits with the object of determining the factor
in malaria and artificial fever therapy which is responsible for the
beneficial results noted in human disease.
STUDY OF UNTREATED SYPHILIS IN THE NEGRO
A project was started to study the late effects of untreated syphilis
in the Negro for comparison with treated groups of syphilitic individuals of this race. A county in a State of the far South, with a
large Negro population and with rather inadequate facilities in the
outlying districts for the treatment of syphilis, was selected so that
the greatest number of cases of untreated syphilis might be uncovered
with a minimum of effort and expenditure. About 400 persons with
untreated syphilis were found and were subjected to intensive clinical
and laboratory examinations.
Of 4,025 Negroes serologically tested, 907, or 22.5 percent, gave a
definite positive test for syphilis on 2 occasions and an additional 5.5
percent gave doubtful positive tests on 2 occasions or a single positive test at only 1 time. These figures include individuals of both
sexes, but only the previously untreated males with two positive
serologic tests are included in the study. A preliminary check up
indicates that syphilis of the cardiovascular system is extremely
common in this racial group and shows that any comprehensive
method for the control of heart disease among Negroes must give
96
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PUBLIC HEALTH SERVICE
97
thorough consideration to the influence of syphilis. Syphilis of the
skin and osseous system was also fairly common in the group studied,
and involvement of the central nervous system was not infrequent
but was usually of a vascular type.
The treatment of syphilis under ideal conditions is of the utmost
value in the control of this insidious disease, but, unfortunately, owing
to various social and economic influences, the ideal method of therapy
is seldom possible of attainment, and the vast majority of infected
people receive treatment which is generally regarded as inadequate, or
no treatment at all. It is highly desirable, therefore, to ascertain,
if possible, the relative benefits accrued from adequate and from
inadequate treatment.
STUDIES IN COOPERATION WITH SELECTED CLINICS
Work was continued in the cooperative clinical studies from the
case reports of five of the leading venereal disease clinics in the United
States, with the financial assistance of a large philanthropic foundation. A series of papers on latent syphilis was completed and published in "Venereal Disease Information." Much valuable information on the results of treatment in early latent and late latent syphilis
is contained in this treatise. The results of a study of reports of the
reactions following 177,360 injections of the arsenical drugs administered to 8,810 patients was completed and will be published.
STUDIES OF PREVALENCE OF VENEREAL DISEASES
Cooperation was continued with city and State health authorities
in an effort to determine the extent of the problem of syphilis and
gonorrhea in a number of communities. A prevalence and incidence
survey of venereal diseases was made in the city of Chester and
Delaware County, Pa., as a part of a general administrative study of
the medical facilities in this county. The results of this survey and
of those previously made in San Francisco, Calif., and in the city of
Birmingham and Jefferson County, Ala., will be published in the
official journals of the medical societies of these States.
· The results obtained in the 16 communities resurveyed last year
have been published. The trend of venereal diseases in these various
communities with a total population of 7,000,000 was so irregular that
a definite statement cannot be made concerning the increase or decrease of these diseases in the United States as a whole. The composite
rate for syphilis in these 16 communities is 11 percent higher. The
higher percentage of cases of early syphilis commg for treatment is a
hopeful sign for ultimate control of the disease. The trend for gonorrhea was slightly downward, although there were a number of small
cities and counties which showed a decidedly high percentage of increase. This lack of uniform decrease in the gonorrhea rate should
cause some hesitation in the acceptance of these lower rates as representing a true decrease in the number of individuals needing treatment.
THE VENEREAL DISEASE CLINIC, HoT SPRINGS, ARK.
There were 4,036 applicants for treatment at the Public Health
Service Clinic which is conducted for the treatment of indigent persons
infected with venereal diseases. Only 2,883 of these applicants were
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98
PUBLIC HEALTH SERVICE
found to be infected. This number, however, represented 4,485·
cases of venereal diseaae, since 1,602, or 56 percent, had both syphilis
and gonorrhea. A total of 73,446 treatments were given. (Seetables 5 and 6 for summary of clinic activites for the year.)
The study of 10,000 syphilis records obtained from patients treated
at this clinic was completed and will be published in the near future.
Seven physicians were given postgraduate courses at the clinic on
request.
COOPERATIVE ACTIVITIES
State Health departments.-Continued assistance has been extended
to the several States requesting aid in the organization of venereal
disease control measures when assurance has been given by the Statehealth department that venereal disease activities are to become a.
continuous and integral part of their health programs. Members of
the field staff have been engaged in the States of Tennessee, North
Carolina, and Alabama in working out the details of such a. program.
Activities previously undertaken in the States of Georgia, M1SSissippi,.
and Virginia have been continued by the States themselves.
Forty-seven States reported the prevalence of venereal diseases and
the measures employed for their control. These States reported
386,597 cases of venereal disease, 234,647 cases of syphilis, 149,527
cases of gonorrhea, and 2,423 cases of chancroid. Laboratory
examinations to the number of 2,118,038 were reported, including
1,742,569 serologic tests for the diagnosis of syphilis, 7,776 dark field
examinations, and 367,693 examinations for the gonococcus. A
total of 1,285,665 doses of arsphenamines were distributed, an increase
of 6 percent over 1932. The State activities are shown in table 1.
In 1933, 572 clinics reported the venereal diseases to the Public
Health Service through their State health departments, as compared
with 533 in 1932. These clinics reported 149,943 new admissions.
(See table 3 for detailed report.)
Office of Indian Affairs, Department of Interior.-Aid has been
extended to this office on request of the Commissioner. In North
Carolina a survey of the Cherokee Indian Reservation was made and
1,080 Indians were serologically tested for syphilis; approximately 6
percent were found positive.
Division of Marine Hospitals.-The maintenance of special caserecord forms, prepared several years ago to secure a continuity of
record in cases of SYJ>hilis treated in the marine hospitals and to
standardize therapeutic methods as far as practicable, was continued.
Nine additional hospitals expressed their desire to participate during
the year. It is now possible to give definite information regarding
the past treatment of a large group of the beneficiaries of the Service·
infected with syphilis.
A study of the records of 69,000 beneficiaries admitted to the marinehospitals in the past 2 years is being conducted to determine theoccurrence of syphilis among those admitted for hospitalization and
treatment under some other diagnosis. A preliminary study shows
that 12 percent of the patients in marine hospitals have syphilis.
The study should also determine the extent to which syphilis prolongs
hospitalization in cases in which it complicates some other illness and
may even indicate the importance of a syphilitic infection in the:
production of some puzzling diseases of unknown etiology.
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PUBLIC HEALTH SERVICE
Division of Mental Hygiene.-The special case record forms which
have been employed so successfully in the marine hospitals of the
Public Health Service were introduced,in cooperation with the Division
of Mental Hygiene, in the Federal penal and correctional institutions.
The use of these forms should yield manifold benefits in standardizing
the diagnosis and treatment of the venereal diseases and should be of
great value in furnis~ a continuous record when prisoners are
transferred from one institution to another.
VENEREAL DISEASE INFORMATION
The nu~ber of subscri~tions to the monthly abstract journal
Venereal Disease Information, published by this division, averaged
6,240. Curtailment of the appropriation for printing has made it
necessary to decrease the number of abstracts previously published
by more than 50 :percent. Venereal Disease Information is the
only publication which is devoted almost solely to the publication of
abstracts of the current medical literature pertaining to the venereal
diseases, and its value in placing the opinion of authorities before the
practicing physician is inestimable. The total mailing list, both paid
and gratis, to Venereal Disease Information averaged 8,943.
Requests for educational material on venereal diseases and sex
hygiene numbered 9,323. There were 85,203 publications distributed
to State health departments and private individuals, and 176 reels of
the film "The Science of Life" sent to 25 organizations and schools in
13 States.
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PUBLIC HEALTH SERVICE
1.-Report of State departments of health showing the number of cases of
syphilis and gonorrhea reported, the annual rate& per 1,000 inhabitants, the amount
of arsphenamine distributed, and the laboratory examinations made from July 1,
1932, to June 30, 1933
TABLE
Number of
ca.-
State
Syphilis
Oonor•
rhea
Laboratory examinations
Annual
rate for Doses of
syphilis
MicroMicroand gon• arsphen•
Wasser•
amines mann(or
: : : · SCOP!C ex•
orrhea
distrib·
per 1,000
other
tions for t:1t,;r
uted
similar)
inhabi•
:,:;::; gonococ•
tants 1
tests
pallida
cus
Total..................... 234,647
149,527
3. 2 1, 285, 665 I, 742, 569
7,776
367,693
1----1----+---Alabama.......................
9,943
2,643
4.8
70,303
68,643
133
10,556
Arizona........................
162
180
. 8 .•••••••...•••.•••...•.•..••..••••••••••
Arkansas.......................
3,998
1,645
3.0
20,039
33,559
454
9,298
California......................
10,587
13,430
5. 8
227,327
86,819
495
26,663
Colorado'·······•·····•········
370
246
I. 2
4,170
5,143
1,181
Connecticut....................
924
898
1. I
12,678
3, 265
16
1,367
Delaware.......................
1, -114
4M
8. 1
3,975
4,824
765
District of Columbia...........
2, 122
I, 335
7. I
11,694
6,327
33
4,089
Florida.........................
3, 769
815
3. I
17,210
12,006
52
867
Georgia.........................
12,134
6,036
6. 2
70,792
77,412
3,600
Idaho...................................................................
9,089
1,467
Illinois.........................
17,118
15,366
4.3
99,800
92,806
2,244
47,448
Indiana.........................
2,790
I, 817
I. 4
42. 811
105, 763
6,485
Iowa.... . . . . . .. . . . . .. . . . . . . . . . .
721
m1
.5
9, 762
2, 856
128
3, 193
Kansas.........................
I, 0.57
844
I. O
10,355
28,766
16
2,717
ti~i;~;~L~::::::::::::::::::::
Maine..........................
Maryland......................
. Massachusetts..................
Michi~an..... .. .. . .. . . . . . . . . . . .
Minnesota......................
t:~~~r.~'.:::::::::::::::::::::
im
460
3,951
4,392
10, 222
3,886
1
g: ~~
t~~
607
2, r,91
6,413
6, 584
4, 284
1
f:
n
1.3
4. 1
2. 5
3. 5
3. 2
1
m n
~u~
3,642
52,108
81,000
43, 242
9, 294
23. 031
t~::~
8,061
11,982
102,941
38, 876
115,363
~t ~~i
~}
71
145
1. 209
~:rJ
3,723
5,467
9,660
38, 396
12,092
1k
~~
Montaoo.......................
,523
340
I. 6 ....................................... .
Nebraska.......................
647
969
I. 2
7,793
23, 759
40
4,198
Nevada'·······················........................................
I, 200 ••........
306
New Hampshire................
143
143
.6
2,266 ,; 6,617 ••........
2,116
New Jersey.....................
6,894
3,703
2. 6
_39, 348
40,889 .•••......
5,007
New Mexico....................
328
263
I. 4
New York......................
53,834
17,778
6. 7
99,035
497,494
513
62,400
North Carolina.................
4, 317
2,095
2. O •
•
North Dakota'······•··········
391
717
1. 8
240
6,173
29
2,351
Ohio...........................
7,503
4,000
I. 7
62, 795
46,896
1, 141
13,871
Oklahoma......................
1,475
1,238
1.1 .............•...............•.........•
Oregon 3••••••••••••••••••••••••
440
592
1. 2
4,098
9,817
18
3,486
Pennsylvania•.................
3,858
3,684
.8
39,457
64,007
16,560
Rhode Island...................
1, 062
803
2. 7
12, 530
15, 500
42
3, 571
SouthCarolina..................
5,241
7,396
7. 3
• 2,561
• 589
• 2,057
South Dakota..................
221
491
I. o
5,806 ..................•.
Tennessee......................
13,471
6,392
7. 6
66,536
48, 153
185
7,013
Texo.s...........................
Ii, 551
672
I. 1
37,053
7,580
13
2,651
Utah• ............................•............................................................•......
Vermont.......................
281
365
2.1
• 1,827
• 4,367
•4
• 1,116
Virginia........................
4, 343
2, 647
2. 9
' 3, 763
' 10, 659
1 926
Washington....................
2,442
2,412
3. 1
9,212
41,745
190
22,058
West Virginia..................
2,071
1,056
1.8
37,368
8,769
80
2,062
Wisconsin......................
527
1,488
.7
7,268
10,985
57
10,381
Wyoming'······•··········•··· .....................................................................•
Excludes chancroid which formerly was Included In the annual rates.
For 6 months.
For 11 months, ,
• In the absence of reporting regulations In Pennsylvania only the reports received from the clinica
operated by the Pennsylvania State Health Department are included.
' For 10 months.
• Not reporting.
, For 2 months.
1
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PUBLIC HEALTH SERVICE
TABLE
2.-Report of 72 correctional and penal institutions cooperating with State
boards or departments of health
New cases admitted:
Number
7,586
3,619
77
Chancroid
_________________________________________________ _
~tn~~~ii.ea~~===============================================
Total ___________________________________________________ _
Cases discharged as arrested or cured _____________________________ _
Treatments given ______________________________________________ _
Doses of arsphenamines administered _____________________________ _
Wassermann tests made _________________________________________ _
Miscroscopic examinations for. gonococcus _________________________ _
TABLE
11,282
7,878
308,691
49,917
54,369
15,569
3.-Report of 572 clinics furnished through State health departments, July
1, 1932, to June 30, 1933 1
State
Tota!_ _________
Alabama _____________
Arkansas _____________
California ____________
Colorado•-----------Connecticut __________
District
of Columbia_
Florida _______________
Georgia ______________
Illinois _____________ -Indiana ______________
Iowa ______ . -- ----- --Kansas _______________
Kentucky ____________
Louisiana ____________
Maine _______________
Maryland ____________
Massachusetts _______
Michigan ____________
Minnesota ___________
Missouri_ ____________
Nebraska ____________
New Hampshire _____
New Jersey __________
New York ___________
North
Dakota•-----Ohio _________________
Oregon•------------Pennsylvania ________
Rhode Island ________
South Carolina e_____
Tennessee ____________
Virginia'-----------Washington __________
West Virginia ________
Wisconsin ____________
New cases admitted
Total
monthlyreports
Gon- ChanTotal Sypbreilis orrbea croid
celved
Cases
discharged
as ar-
rested
or
cured
Treatments
given
Mi•
croDoses Was- scopic
or ars•
ser- exampheninaamines mann
tests tions
admin- made
for
lstered
gonococcus
-6,024 149,943 89,849 57,522
124
49
385
24
125
12
36
82
282
191
120
36
293
21
96
332
300
154
47
92
36
60
305
772
8
498
11
550
72
6
527
11
36
100
132
11, 738
5,169
13, 131
493
1,830
3,468
3,203
3,827
12,923
3,435
1,297
824
8,483
625
689
6,804
6,140
6,414
765
I, 738
958
227
7, 715
10,070
51
12,472
334
6,002
840
221
10,425
744
1,679
2,954
1,355
9,309
3,733
7,905
290
925
2,122
2,348
2,270
6,627
1,985
721
434
3,531
354
310
3,933
3,028
3,033
368
I, 164
510
Ill
4,844
7,237
24
6,758
236
3,601
513
106
7,364
550
005
1,967
734
2,327
1,433
5,199
197
898
1,335
786
1,531
6,207
1,387
571
366
4,841
268
379
2,596
3,112
3,315
396
573
442
115
2,837
2,819
27
4,409
99
3,196
327
109
2,869
187
771
978
620
2,572
102
3
27
6
7
11
69
26
89
63
5
24
lll
3
------275
------66
I
I
6
I
34
14
-i;aos·
------105
-64,697 '3,209,073 864,714 540,526 221,714
5,217
5,165
3,037
300
1,353
104
267
1,618
9,855
2,185
680
267
1,928
116
246
2,167
1,368
3,066
279
605
69,837
19,393
69,095
4,170
12,678
11,694
17, 193
28,863
95,841
40,146
9,762
6,815
24. 611
2,895
3,642
52,256
11,313
33,079
48,934
I, 188
3,265
6,327
12,006
27,473
74,041
14,970
2,859
2,694
13; 406
1,678
I, 129
ll, 862
I, 531
10,031
22,931
488
1,367
4,089
594
1,032
40,597
4,289
3,193
I, 577
5,534
1,369
364
4,983
25,750
41,311
29,400
9,468
4,829
7,637
7,007
2, 160
38,245
68,456
2,596
11,471
5,321
805
22,289
30,668
999
3,100
2,445
491
5,388
13,370
149
12,341
------------------ -------- ------213,105 43,182 37,490 38,375
250
142
2,248
7,407
40
3,711
68
4,182
535
-------6 -------192
7
3
9
I
162,329
• 183,877
285,354
17,029
50,831
39,985
37,971
63,923
378,456
124,470
42,395
21,733
94,950
7,594
13,467
149,064
3,314
102
1,366
968
541
234,656
244,276
769
251,168
15,059
76,412
27,870
562
204,812
6,733
40,204
63,666
50,434
240
61,243
4,051
38,169
7,046
562
63,559
3,467
9,202
29,600
7,268
73
42, 150
I, 147
16,877
13, 717
109
46,254
2,455
21, 137
8,762
10,982
840
------3,571
321
6,232
187
17,927
2,062
9,947
1 States which did not report and those which bad no clinics have been omitted from this table: they are
Arizona, Delaware, Idaho, Mississippi, Montana, Nevada, New Mexico, North Carolina, Oklahoma,
South Dakota, Texas, Utah, Vermont, and Wyoming.
• Includes 95,489 baths given at the U.S. Public Jlealtb Service clinic, Hot Springs National Park, Ark.
a For 6 months
' For 8 months
1 For 11 month3.
• For 3 months
'For 2 months.
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102
PUBLIC HEALTH SERVICE
TABLE
4.-Report of cooperative clinic activitillB furni,Md through State health
departments from 1919 to 1933
Cues
TreatdlsNumber
Total
ments
New
chargedas
of clinics cases ad• treatments arrested per new
reporting mitted
given
case ador
m!tted
cured
Year
1919_ •••..............•.••...... •·•••·•·····•·•·•·.
1920_ .••.••.....•••.•.•••..••• ·••••••··•·••• ••.....
1921 ...••••..••...•.•••••••••••..••••••••••••.••••.
1922. ·····-········--·····························JQ?3 •••••••••••••••••••••••••••••••••••••••••••••••
1924. -· ..•••• _. _•••.......••••••• ··--·-·· .•••......
19?5. _•••••.•.•••.••••• ··-·· •• ··-···· •••••••••. -··.
1926 __ •. ·-·-···· .. ··-·· ··-····-·-·-·· .•.•.....•....
1927 __ ·-·-· ••••••.•.. ··-·-·-··-·-· ••..•...•...•.•..
1928 __ . ·•••••· •·••••••·· .••.....•..................
1929. ••••···• ··••••·· .••..••••••...•..•..•••....•..
1930 .• •••••••···• ....••.••••• •••·•·•··••·· ••••.....
1931 .• •••·••• ......•.••••••••••••••••...••••••...•.
1932. ············································-1933 .... •·•·• •.•• ·••••······•·••• .•••••••••••.•.•.•
167
383
442
541
513
504
495
416
425
451
445
477
512
533
572
69,092
126,131
140,748
141,279
119,217
118,023
110,372
100,776
107,688
110, 756
120,315
127,978
142,915
148,933
149,943
527,392
1,576,542
2,108,003
2,045,232
1,992,631
2,147,087
2,088,494
1,881,380
1,964,233
2,174,832
2,128,417
2,547,162
2,833,790
2,954,130
3,209,073
14,278
34,215
65,467
60,169
65,503
51,658
47,828
44,329
44, 701
49,487
52,136
65,592
57,414
63,906
64,697
8.92
12.50
14. 98
14. 48
16. 71
18.19
18.92
18.67
18. 24
19.64
17.69
19.90
19.83
19.84
21.40
5.-Report of the United States Public Health Service clinic at Hot Springs
National Park, Ark.,from July 1, 1932, to June SO, 1933 1
Total applicants ____________
4,036 Gonorrhea (new cases). _____
1,097
TABLE
Venereal_ ______________ '2,883
Non venereal. __________
1,153
Syphilis. __________________
2,850
New cases. ____________
Readmitted cases _______
2,124
726
Gonorrhea _________________
New·cases _____________
Readmitted cases ______ .
Syphilis (new cases) _________
2,124
Primary _______________
Secondary _____________
Tertiary
•. ____ ..... ___ .
Neuro _________________
188
290
1,525
86
35
Congenital. ..... _. _____
Acute _________________
Chronic _______________
245
852
Total treatments given ______ 168,955
1,635
Arsphenamines _________
Mercury and bismuth ___
Other syphilis __________
Gonorrhea _____________
Baths _________________
1,097
538
14,351
28,422
717
29,976
95,489
Laboratory examinations_. __
59,946
Complement fixation
tests _______ ._._. ___ . 13,321
Precipitation tests ____ .. 13,316
Icterus indices ____ .. _... 13,350
Darkfields .. _•........ _
429
Gonococcus smears._ ...
7,901
Urine analyses ... ____ .. 11,629
From the annual report of the cllnlc.
• The 2,883 patients represent 4,486 cases; 1,802 patients had both syphilis and gonorrhea.
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103
PUBLIC HEALTH SERVICE
TABLE
6.-Report of the United States Public ·Health Service clinic at Hot Springs
National Park, Ark., from July 1, 1922, to June SO, 1999
Number of cases
Number, _ _ _ _ _ _ _ _ _ __
Year
of applicants
Total
venereal
diseases
Syphilis
Gonorrhea
Treatments
given•
- - - - - - - - - - - - - - - - - + - - - f - - - - 1 - - - - -------Total•.•••••... _________ • __________ .___________
51, 982
43,661
27,376
16,285
760,343
1-----+----+-------<f-----1----
1922_______________ ---------------------------------1923 __ •• --- -------- ------. ------- ---- -------- ---- -- -1924 ___ • _------------- --- _. ----- --- _----------- _-- -- _
1925 ___ --- -------------- ---- -- -------- --- --- _---- _-- _
1926 ___ ------ -------- --- • -- ------- _---------- ------- _
1927 ____ ------- -- ---- ---- ---- -- _--------- _---- --- _--1928 ____ ---- --- _------- ------ ---- __ -- -- __ -------- --- _
1929 _______________________ -------------------------1930 ____ --------------------------------------------1931. __ -- -- --- ----- ----- _---- ---- -- ---- ---- ___ ---- ___
1932 _____ --- • ----- -- --- ----- --- ------ -- -- --- --- _--- -1933 ____ -- ------ -- ----- ----- --- -------- -- ------- --- -1
2, 720
3, 389
3, 676
3, 411
3, 570
4, 757
5,467
5,265
5, 704
4,881
5, 106
4, 036
1,775
1,854
2,186
2,782
3,064
3,682
4,134
3,986
4,441
5,088
6,184
4,485
1, 182
1,326
1,447
2,011
2,211
2,504
2,626
2,512
2,743
2,776
3,188
2,850
593
528
739
771
853
1,178
1,508
1,474
1,698
2,312
2,996
1,635
43,830
41,559
50,683
50,608
64,590
58,489
72,466
75,519
79,180
66,246
93, 707
73,466
Baths not Included.
TABLE
7.-Statistical summary of activities in the control of venereal diseases for
the fiscal years 1932 and 1999
19321
1933
KBDICAL ACTIVITIES
A. Cases
of venereal
diseases reported
to State• ________
health departments:
I. Syphilis
_____________
._ ••• ___________
• ______ -- ________ -- __ - • - • _
II. Gonorrhea.. ____________________________________________________________ _
III. Chancroid _____________________ ----------- ______ • _________________ •• _•• -
234,647
149,527
2,423
242,128
154,051
3,465
Total_ • ________ • -- ___ • ________ ---- ----------- __________________ • _____ -- - - -
386,597
399,644
B. Doses ol arsphenamlnes distributed by State health departments. ·---------C. Clinics:
I. Clinics
established during the year __ ----------------------------------11.
Clinics reporting to State health departments _________________________ _
III. Report
clinics:
a. Newfrom
cases
admitted _______________________________________________ _
1,285,665
1,215,025
58
47
572
633
149,943
64,697
b. Cases discharged a,.q arrested or cured ____ -------------------------c. Treatments given _______ ------------------------------------------ 3,209,073
864,714
d.
Do,,e.s
of
arsphenamines
administered
-----------------------------e. Wassermann (or other similar) tests made _________________________ _
540,526
221,714
f. Microscopic examinations for gonococcus_ -------------------------
150,906
64,645
2,979,730
753,742
521,438
197,266
BDUCATIONAL ACTIVITIES
A. Pamphleta:
I. Requesta for pamphlets received by the Public Health Service_________ •
9,323
13,112
II. Pamphlets distributed:
a. Byothers
the Public
Health Service••to
State
health departmenta
and _
______________________
_. ___
•• __________________
• _______
b. By State health departments ____________________________________ _
85,203
462,986
121,126
697,252
Tote.I_ • ___ •• ____________ • ____ • ___ • _____ • ____ • ________ • ____ • ___ • __ •
548,189
818,378
2
8
III. Venereal disease pamphlets Issued by the Public Hee.Ith Service _______ _
l====I=
B. Lectures,
exhibits
and film showings reported by State health departments: _
I. Number
________________________________________________________________
II. Average attendance _______________________________ • ________ • ___________ _
2,~I
2,726
83
1761
191
C. Motion picture films loaned by the Public Health Service __________________ _
1 Data for 1932 were changed from previously published ftgurell because of corrections or the reoeipt of
additional reports.
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DIVISION OF MENTAL HYGIENE
In charge of Asst. Surg. Gen.
WALTER
L.
TREADWAY
The year ended June 30, 1933, marks the third full 12 months'
activities of the Division of Mental Hygiene. The administrative
and investigative functions of the Division continued unchanged
during the year.
NATURE AND TREATMENT OF DRUG ADDICTION
The Division has continued to receive individual reports of persons
apprehended for violation of the narcotic laws. Important epidemiological data concerning drug addiction is obtained from these
reports and also information for determining the potential needs.
respectin~ the treatment of this condition. Studies of the nature of
drug addwtion with reference to the mental and psychiatric status
of those addicted have been continued at the United States penitentiary annex, Fort Leavenworth, Kans. Special studies with
reference to the treatment of conditions seen when such drugs are
abruptly discontinued, were inaugurated during the year. Special
observations were also undertaken concerning the value of possible
substitute drugs. These studies and observations were incomplete
at the close of the year.
Besides the special studies being conducted at the institution
mentioned, the personnel of the Public Health Service detailed there
supervises and furnishes the medical and psychiatric services for the
pnson population.
DISSEMINATION OF INFORMATION
Further data concerning the epidemiological factors in drug
addiction was assembled for publication. Other articles were published relating to medical administrative problems with which the
Division is concerned.
STUDIES OF ABUSIVE USES AND THE MEDICINAL AND SCIENTIFIC
NEEDS
Special studies for determining the annual medicinal and scientific
needs of the country concerning narcotic drugs have been continued
during the year. This work has been in cooperation with the Bureau
of Narcotics of the Treasury Department.
•
ADMINISTRATION OF NARCOTIC FARMS
Construction of the superstructure for the first United States
Narcotic Farm at Lexington, Ky., was begun on March 25, 1933.
Arrangements were made to lay the cornerstone with formal cere104
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PUBLIC HEALTH SERVICE
105
monies early in the next fiscal year. The institution will be completed and ready for the reception of inmates in the early part of the
calendar year 1935. Estimates were prepared for the furnishings
and equipment required for the efficient operation of the instit:ution.
Title to the property selected as a site for the second United States
Narcotic Farm near Fort Worth, Tex., was acquired by the Government on May 26, 1933. Plans are being formulated for the development of that institution.
MEDICAL AND PSYCHIATRIC SERVICES IN FEDERAL PENAL AND
CORRECTIONAL INSTITUTIONS
The Public Health. Service continued for the third year the work
of supervising and furnishing the medical and psychiatric services
for Federal penal and correctional institutions under the policies
originally adopted.
The medical and psychiatric services at the United States Northeastern Penitentiary, Lewisburg, Pa., were assumed by the Public
Health Service on July 1, 1932, the institution being formally opened
for the reception of inmates on November 12, 1932. An officer was
assigned to duty as superintendent and chief medical officer for the
Hospital for Defective Delinquents, Springfield, Mo., on November
15, 1932, incident to the preparation of the institution for the reception of inmates, which will take place early in the next fiscal year.
It will provide facilities for the care of the criminal insane, the tuberculous, and the chronically ill and physically infirm. The Public
Health Service assumed the medical services at the United States
Detention Headquarters, New York City, on November 15, 1932;
and at the United States Detention Fann, Milan, Mich., and the
United States Southwestern Reformatory, El Reno, Okla., on April
1, 1933.
Thus, during the fiscal year ended June 30, 1933, this work expanded to include 5 additional institutions, making a total of 15
medical units brought within the scope of these activities since their
inception July 1, 1930.
OTHER INVESTIGATIONS
Due to lack of funds and personnel, no specific field studies dealing
· with the causes, prevalence, and means for the prevention and treatment of nervous and mental diseases have been undertaken, except
those incident to correctional procedure. They include the 5 penitentiaries at Atlanta, Ga., Leavenworth, and Fort Leavenworth,
Kans., McNeil Island, Wash., and Lewisburg, Pa.; the 2 reformatories at Chillicothe, Ohio, and El Reno, Okla., respectively; the jail
in New York, N.Y., New Orleans, La., El Paso, Tex., and Milan,
Mich.; the women's prison at Alderson, W.Va.; the prison camps
at Fort Eustis and at Petersburg, Va.; and the hospital at Springfield, Mo.
·
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DIVISION OF PERSONNEL AND ACCOUNTS
In charge of Asst. Surg. Gen. C. C.
PIERCE
As heretofore, the Division of Personnel and Accounts has supervised all operations_ of the service relating to personnel, finances, and
the maintenance of property records. The organization of thedivision has remained unchanged during the year. Through a personnel section, a finance section, and a property-record section, all
matters relating to appointments, separations, and other changes in
status of personnel, estimates of appropriations, allotments, and
encumbrances, records of expenditures, including administrativeaudit, and all records of nonexpendable property are administered
under the supervision of the Assistant Surgeon General in charge of
the division.
The public health district directors continued to function duringthe year as heretofore, but no report of their activities is being included herein by reason of the necessity for conserving space.
PERSONNEL
COMMISSIONED OFFICERS
On July 1, 1932, the regular crops consisted of the Surgeon General;.
8 Assistant Surgeons General; 42 medical directors, 1 pharmacologist
director in the grade of medical director; 29 senior surgeons, 1 senior
dental surgeon, and 1 senior sanitary engineer in the ~rade of senior
surgeon; 88 surgeons, 13 dental surgeons, and 11 sarutary engineers
in the grade of surgeon; 66 passed assistant surgeons; 7 passed assistant dental surgeons, and 5 passed assistant sanitary engineers in
the grade of passed assistant surgeon; 52 assistant surgeons, 18 assistant dental surgeons, 4 assistant sanitary engineers, and 10 assistant
pharmacists, all in the grade of assistant surgeon. Of this number,
aggregating 357, 4 medical directors, 12 senior surgeons, 8 surgeons,.
2 passed assistant surgeons, and 1 assistant surgeon were on waiting
orders. During the fiscal year the following changes occurred in the·
,s~veral grades: 17 candidates for appointment as assistant surgeon
and 2 candidates as assistant dental surgeon, in the grade of assistant
surgeon, and 1 assistant sanitary engineer in the ~ade of assistant
surgeon, were successful in the entrance examinat10n prescribed by
law and regulations of the service and were commissioned in that
grade; 1 senior surgeon was promoted to the grade of medical director,
4 surgeons were promoted to the grade of senior surgeon, 8 passed assistant surgeons to the grade of surgeon, 15 assistant surgeons to the
grade of passed assistant surgeon, 4 passed assistant sanitary engineers
to sanitary engineer in the grade of surgeon, and 1 assistant dental
surgeon to the grade of passed assistant dental supgeon; 4 assistant
surgeons were separated from the service and 3 assistant surgeons
resigned; 2 medical directors, 1 surgeon, and 1 assistant pharmacist
in the grade of assistant surgeon were placed on waiting orders because of physical disability.
106
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PUBLIC HEALTH SERVICE
107
On July 1, 1933, after these changes had occurred, the regular corps
consisted of the Surgeon General, 8 Assistant Surgeons General, 43
medical directors, 1 pharmacologist director in the grade of medical
director, 32 senior surgeons, 1 senior dental surgeon, 1 senior sanitary
engineer in the grade of senior surgeon, 92 surgeons, 13 dental surgeons, and 15 sanitary engineers in the grade of surgeon; 73 passed
assistant surgeons, 8 passed assistant dental surgeons, and 1 passed
assistant sanitary engineer in the grade of passed assistant surgeon,
47 assistant surgeons, 20 assistant dental surgeons, 5 assistant sanitary engineers, and 10 assistant pharmacists, all in the grade of assistant surgeon-a total of 371 officers. Of this number, 6 medical
directors, 12 senior surgeons, 9 surgeons, 2 passed assistant surgeons,
and 1 assistant surgeon were on waiting orders.
At the close of the fiscal year 1933, 3 medical directors, 2 senior
surgeons, and 3 surgeons were serving by detail as assistant surgeons
general in charge of divisions of the bureau in accordance with acts
a:pproved July 1, 1902, July 9, 1918, and April 9, 1930; 5 medical
directors were on duty as directors of the public health districts, 1
surgeon was serving on detail to the Bureau of Mines, Department
of Commerce; 2 surgeons, 1 passed assistant surgeon, and 1 assistant
surgeon were serving on detail to the United States Employees'
Compensation Commission; 2 medical directors were assigned as
assistants to the director, Pan American Sanitary Bureau, Washington, D.C.; 1 medical director, 1 senior surgeon, 5 surgeons, 2 passed
assistant surgeons and 1 assistant pharmacist were serving on detail
to the Bureau of Indian Affairs, Department of the Interior, in
connection with the control of communicable diseases among the
Indians; 1 surgeon was serving (as alienist and medical officer) on
detail to the Mornin~side Hospital, near Portland, Oreg., which
cares for the Alaska msane under contract with the Department
of the Interior; 1 passed assistant surgeon was serving on detail
with the Bureau of Standards; 1 medical director, 1 surgeon, 1 dental
surgeon, 5 assistant surgeons, and 2 assistant dental surgeons were
serving on detail with the United States Coast Guard; 1 senior surgeon, 4 surgeons, 4 passed assistant surgeons, 1 passed assistant
dental surgeon, 5 assistant surgeons, and 1 assistant dental surf:eon
were assigned for duty at various penal and correctional institutions.
RESERVE OFFICERS
On July 1, 1932, the reserve commissioned officers on active duty
numbered 29, consisting of 6 surgeons, 1 dental surgeon, 11 passed
assistant surgeons, 1 passed assistant dental surgeon, 6 assistant surgeons, and 4 assistant dental surgeons.
On July 1, 1933, the number of reserve officers on active duty was
30, consisting of 5 surgeons, 1 dental surgeon, 10 passed assistant
surgeons, 5 assistant surgeons, and 9 assistant dental surgeons.
ACTING ASSISTANT SURGEONS
On July 1, 1932, there were 732 acting assistant surgeons in the
Public Health Service, and by July 1, 1933, this number had decreased to 672.
_
Of the 672 acting assistant surgeons, 95 were on duty at marine':
hospitals; 398 were engaged in immigration, relief, and maritime,
1~
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108
PUBLIC HEAL'.rH SERVICE
border, insular, and foreign quarantine work; 5 were engaged in the
prevention of trachoma; 6 were on duty in connection with field investigations of public health and rural sanitation; 111 were on detail
with the United States Coast Guard; 2 were serving with the Bureau
of Mines by detail; 20 were serving at various penal and correctional
institutions; 35 were engaged in anti-venereal disease activities as
part-time employees at nominal compensation. Fourteen of the 35
acting assistant surgeons engaged in anti-venereal disease activities
held appointments as collaborating epidemiologists.
ATTENDING SPECIALISTS
On July 1, 1932, there were 426 attending speciali_sts in the service,
.and during the year this number increased to 454, of which number
245 were consultants to marine hospitals, while 42 were available for
call at second and third class relief stations; 11 were engaged in antivenereal disease activities; 43 were serving at various penal and
.correctional institutions; 113 were consultants in connection with
.quarantine, immigration, and scientific research activities.
INTERNES
On July 1, 1932, there were 99 internes in the service; on July 1,
1933, there were 93, of which number 18 were dental and 6 students.
Internes are appointed for temporary periods of 1 year for duty at
marine hospitals.
PHARMACISTS AND ADMINISTRATIVE ASSISTANTS
On July 1, 1932, there were 18 pharmacists and 31 administrative
.assistants in the Public Health Service. During the year 1 chief
pharmacist was retired and 1 chief pharmacist died; an addition of 5
. was made in the administrative assistant corps, making a total at the
end of the fiscal year of 16 pharmacists, and 36 administrative
assistants, as follows: 12 chief pharmacists, 4 pharmacists, 11 administrative assistants first class, 4 administrative assistants second class,
13 administrative assistants third class, and 8 administrative assistants
fourth class.
NURSES, DIETITIANS, AND RECONSTRUCTION AIDES
On July 1, 1932, there were on duty with the Public Health Service,
558 nurses, 29 dietitians, and 38 reconstruction aides. The new
hospital at Seattle, Wash., opened in January 1933, and has on duty
28 nurrns, 2 dietitians, and 1 nurse acting as reconstruction aide.
The infrmary at the new Federal prison at Lewisburg, Pa., bas 3
nurses on duty and additional federal jails have been opened, each
with 2 guard-attendants on duty. Due to the provisions of the
economy act, the reduction in available funds and the withdrawal
from marine hospitals of patients from the Veterans' Administration,
drastic reductions in this personnel has been necessitated at all stations
throughout the service. On July 1, 1933, there we.re on duty 449
nurses, 35 reconstruction aides, 27 dietitians, and 2 social workers.
The usual contacts with nursing and public health organizations
were maintained throughout the year.
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PUBLIC HEALTH SERVICE
109
CONTRACT DENTAL SURGEONS
On July 1, 1932, there were 42 contract dental surgeons employed
at marine hospitals and second, third, and fourth class relief stations.
These part-time employees are appointed for local duty and receive
fixed and uniform fees for dental work performed for service beneficiaries.
At the close of the fiscal year 1933, this number had increased to 47;
8 were at marine hospitals, 30 were at second, third, and fourth class
relief stations, 4 were serving at various penal and correctional institutions, and 5 were detailed to the United States Coast Guard for duty.
EPIDEMIOLOGISTS
During the year the number of assistant collaborating epidemiologists was increased from 4,606 to 4,640. These employees are health
officers or employees of State, or local boards of health, who receive
only nominal compensation from the Federal Government, arid who
furnish the service with reports of communicable diseases received by
State or local health organizations. The number of collaborating
epidemiologists decreased from 46 to 32; these appointees are on duty
in the different States.
NATIONAL INSTITUTE OF HEALTH
The National Institute of Health continued under the administration of Director George W. McCoy and Assistant Director R. E.
Dyer. The scientific staff comprised 60 members, of whom 20 were
commissioned officers, 26 other research workers, and 14 consulting
experts. The staff was assisted by 17 technicians and 70 other
subordinates, making a total of 147. Of this total, 131 were on fulltime schedule.
PROPERTY RECORDS
The property return section has accounted for all property of the
service, and 337 property returns have been audited during the year.
Sales of unserviceable property, including boats, hides, cattle, etc.,
aggregated $1,647.03. Surplus property not desired by any other
Government department was sold for $219.25. Property surplus to
the Public Health Service valued at $13,194.82 was transferred to
other Government departments. Surplus property of other departments valued at $34,337.89 has been received by the Public Health
Service. Property valued at $56,275.65 has been transferred from
Public Health Service stations, where it was surplus, to other service
stations where it could be used.
ACCOUNTS SECTION
The accounts section of the Division of Personnel and Accounts
conducts all bookkeeping and accounting in connection with the
expenditure of Public Health Service appropriations. This includes
also accounts of miscellaneous collections, allotments, records of
encumbrances, cost accounting, and the ad1ninistrative audit. A
statement of appropriations, expenditures, and balances, with
miscellaneous receipts, is published as an appendix to this report.
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110
PUBLIC HEALTH SERVICE
PERSONNEL STATEMENT
The accompanying tabular statement shows the personnel of the
service as of July 1, 1933. Of the 9,952 employees shown in the table,
4,640 listed as collaborating epidemiologists and assistant collaborating epidemiologists receive only nominal compensation. They are
mainly officers or. employees of State and local health organizations
who collaborate in the collection of morbidity statistics by furnishing
the figures collected by those organizations relating to cases of communicable disease. The personnel statement also includes all parttime employees, those employed on a per diem basis, and those whose
compensation is on a fee basis. The decrease of 892 employees was
caused mainly by a necessary reduction on June 30, 1933, because of
a lack of funds for payment of their salaries during the fiscal year 1934.
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Consolidated quarterly personnel report /or the quarter ended j uly 1, 1933
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Hudson Street, N.Y --------- - ---- - ------ ---- --------------- - _____ _ ______ ___ ___ _____ _
Key West, Fla__ __ ______________ __ ______ ______ __ ________ __ ____ ____ _______ __ _________
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Louisville, Ky___ _____ __________ __ ___ ______________________ __ ______
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Memphis, Tenn_____________________ ___ _____ __ ____________________ __ _______ _________
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______ ______ ______ __ __ __
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Quarantine stations1
Baltimor•, Md ·-····-·· ····· -- ---------------------·--·---- - __ __ ___ ___ __ ---···
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Fort Monroe, Va_ _______________ ____ ______ ___________ _____________
2 ____ ____ ___ _ -----·
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Galveston, Tex. ___________________________________ ____ ____ __ ···--·-- ····______
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Laredo, Tex. ____________ _____ ___ ____ ____ _______ __ __ _________ ----- - --···· ____ __ ··-· -·______ __ ________________ _____ _ __ __________ __ ____
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Total quarantine and Immigration............................................................. ······i······i······i······i······i······i······1······1······1······1······
Domestic quarantine dlvi'llon:
Interstate.......................................................................... ·····6 ......
3 ........................................•.................••
Trachoma ................................ ·-····················· ...... ...... ...... ......
1 ............ ·•-··· ·-···· ...... ...... ......
5
5 ................. .
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2
1 ...... ...... ...... ...... ...... ......
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1 ................. .
1
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Total, all activities .......································· ........................ , _ .............................. ··-·•• ................................... .
Scientific research division:
.
National Institute of Health...........................................
4 ......
2
8
5
2 ...... ...... ...... ...... ...... ......
5 ...... ......
1
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f~=~~~t~:iiian<isa.iiiiiiiioii:::::::::::::::::::::::::::::::: :::::: :::::: :::::: :::::: ~ ····a· ~ :::::: :::::: :::::: :::::: :::::: :::::: 3! :::::: :::::: ::::::
37 ................. .
Total, all activities ... _......................................................................................................................................... .
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1 L..... 1...... 1...... 1...... 1...... 1...... L..... I
---•------1-- ----1-- --- -1- - --- Division of mental hygiene:
Alderson, W.Va ................................................................... -····· .............................. ·-···· ·····- ..... .
Atlanta, Ga...................................................................................
1
1 ...... ...... ...... ......
1
Chillicothe, Ohio..............................................................................
1 ...... ...... ...... ...... ......
1
Fort Leavenworth, Kans................................................................
1
2 ................................... .
J
1 ...... ...... ...... ......
1
Leavenworth, Kans...........................................................................
Petersburg, W.Va ............................................................................. ···-·· ................................... .
McNeil Island, Wash....................................................................
1 ...... ...... ...... ......
1 ......
1
All other stations..................................................................
1
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4 ...... ..•... ...... ......
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Detailed to other offices...............................................
3 ......
1
8
4
1 ....•. ......
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Coast Guard..........................................................
Perry Point, Md. (supply station)...................................................................
Public health dlst.ricts_.......................................... .•....
5 ••.••. ...•.. .••... ......
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4
4 ........... .
...•........................................................
.............................. ·····- ...... ·····- ........... .
.... ~. :::::: :::::: :::::: :::::: ::::::
····i· ....a" ····i· :::::.......
Total miscellaneous .............................................................................................••.........................•.. ··-··· .......•••..
Grand totaL ............................................. .
(")
>
Sanitary reJ)Orts and statistics __________ - - --- - - - - -- - - -- - - - - - - - - -- - - - -1- - - - - -1- -- -- -1- - - -- -1-- - - - -1- -- - -- 1- -- -- -1- - -- - -,- - - - - -1- - - - -- •-- - - - - r- - - - - - , __ - - --
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~~:!ti~l~~ce······················•·····•···················· ...... ······ ................1.............. ····· .................. ······ ······
All other stations......................................................
1 ......
1
4
2 ...... ...... ...... ...... ...... ......
2
0
~
82 ,______ , _____ _
6
10
14
I
672
I
454
I
47
93
16
C4
....
Consolidated quarterly personnel report /or the quarter ended July 1, 1933-Continued
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______
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______ ______
______ ______
______ ______
______ ______
______
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______
______
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______
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___ ___
___ ___
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______
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______
______
______
______
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5 ______ ______ ______ ______ ______ ______
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6 _____ _ _____ _ ______ ______ ______ ______
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10
13
3
1
2 ______ ______ ______ ___ ___
1 ______ ______ ______ ______
6 ______
1
1 ______ ______
6 ____ __ ______ ______ ______ __ ___ _ ______
70
61
15
194
______
______
____ __
______
58 ______
44 ______
36
182
16
111
__ ____
-----______
___ ___
42 ______
40 ___ ___
10 -----18 ------
42
47
~
286
35
~....
C
109
18
10
151
115
27
90
29
203
90
19
69
213
117
78
77
136
147
63
64
86
105
18
24
40
25
24
29
12
11
22
41
6
16
63
257
23
25
;Js~;~~~:i==:::::::::::::::::::::::::: :::::::: :::::: ---T i !! ---T ::::i: :::::: ::::i: :::::: :::::: J 1~ :::::: i! 2ii J!
(?
Norfolk, Va_____ _______ ____________ _____________________________
Pittsburgh, Pa______ ____________________________________________
:~_,
~
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~~~1¥:,';Ji!~g~wiis!i ______________________ -------- ------ ____
i:r:
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FIELD
Hospital division:
Marine hospitals:
1
1
Baltimore, Md________ ___________________ ________ ___ ______
Boston, Mass_____________ _______________ __ _______________
1
1
Buffalo, N .Y____ ____________________________ ________ ___ ___ ______ ______
Carville, La________ ___________ ___ ___________ _____________ _
1
1
Chicago, IlL __ _________ ____ ____ ____ ___ ______ ________ ______
1 ______
Cleveland, Ohio______ ____________________ _________ __ ____ __
2 ______
Detroit, Mich_____________________________________ ___ _________________
Ellis Island, N .Y-- ------------ ------------- ______ __ ______
2
1
Evansville, Ind ___________ __ __ ____ ________________ __ __________________
Fort Stanton, N.Mex_ ___________ ___________ ________ ______
1 ______
Galveston, Tex________________ ____________________________
1
1
Hudson Street, N .Y _____________ ______ ___ __ ___ ____ _ ______ ______
1
Key West, Fla____________ ________________________________ __ ________ __
Louisville, Ky___ _________________________________________________ ____
1
26
1
2
1
1 ______ ____ __
1
7 ------ __ ___ _ ___ ___ ______ ______ ___ ___
1_ -- ---- ____
84 ___ ___
15 ------
6_ ------ __________________________________ 2______19 ____________
st. Louis, Mo___ ________________ __ ____________________________________
San Francisco, CaliL___________ _______ _____ ___ __ ___ ______
1 ______
~::t~~i:::::::::::::::::~::::::_:_~:::::: :::::::: :::::: ~
8
3
9 ____ __
47
3
~I ~
~
1
2
~
1 ______ ______ ______
1
1 ______ ______
11
:::::r:::: ::::::
~
::::::
4
26 ______
136 ______
:i ::::::
28
124
152
10
26
42
11 _ ___ __ 21 _ ___ «_i-------22
41
63
263
61
202
~
l~~ l~~
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l?!l
l?!l
N.Y---------------,--------,------1 21
Stapleton, Staten Island,
1
Vineyard Haven, Mass •••• ·-·-··-·····-·-·· ····-·-· ··-··- •..•.. ··-···
I 3412 ••••••••••••••••••
31 31------1······1···-··1·-····
-····· ••••••••.•••
8
1
i 1::::::
Total hospitals __________ ............... -........ --- - -1- .. - - - - --1- - .. - - -1- - -- --1-- - - - - ,--- - --1- ...... --1- - - - - -1- - - ---1- - - - - -•- .. - - - -1-- - - --1----.. -•-.. ------•------
Relliiit~····-·················-·-········1·······-i-·····1···· ·1······1···· ·I···· ·l······1······1···· ·I······1······I
1
3
l
1
li
I.....
.1······
16
Total relief stations••. -·-················· ••••.•.•.•.•••......••••..•• --- - --- --- ------ ·--··- -··-- - ------ --· ---,------,--------•·- ··-·
Foreign quarantine division:
Quarantine stations:
1 ··-··· -·---- -····- ____________ -····1
1 --··-Baltimore, Md-···········-··--······-··-·····-··-··......
Boston, Mass------·---·-·-··-·-·-·--·---··-______________
1 ______
1 -·---- ______ -·---- ··-·-2
2
1
Ellis Island (also !mmigratlon)_ •• ______ • __ • _________ ---·-· ______ ----·- ______ -·---- ···--- ------ -·-·-- -··--- -·---2
El Paso, Tex______ ·-·---·-------·--·--·-------·-··-·--·-·-·----- __________ ._---··· ______ -·---- ______ --·---·----1
Fort Monroe, Va _______________ ·-·----------··--·--- ______ ------ ______ -·------·-·----·------·------2
2
1
Galveston, Tex·----·---·--------------··------·-·--------- ______ -·-·------·- ----·· ______ -·-·-- -----1
3 -----Honolulu, T.H_··-·----·-----·-·---·-····--- ---·---- ------ -----· -·---- -·---- ------ ------ ··-·-- -----2 -·-···
1
Laredo, TeL.·------·---------------··---·-· -·------ ------ ---··- -···-- --·--- ------ -·---· ·----- ----·- ----·· -·-·-- -----Marcus Hook, PB--·-··-----------·---·------·-···-·______
1 -·-·-2 ------ -·-·-- ------ ----··
2
2
1
New Orleans, La••• _________________________ -·--··--··-·-· ______ ---··--··----·-··- ___ :_.·--·--______
3
3
1
Rosebank,
3 --·--·
1 ---·-- ______ -·---- ______
6
6
7
San Francisco, Calif. (also Immigration). ____ ------·· ______ ---·--·---··
1 -·-·-- ______ ______ ______
4
2
2
San Juan, Puerto Rico_·--···----·-------·-- -------· ______ ·----- ----·- -·-·-· --·--- ·----- -·---- -----· -·---- ______
2
Foreign ports ________ ·---···-·-----------·--------·---·----··-----··---·---·-·-------·-----·-- ______ ---·--______
4
All other stations-------·--------------·----·--------·-··1
1
2 ______ --··-- ------ --·--15
15
12
N.Y--------------·-------------- --·--·-- ----··
14
19
0
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233
-
43
17
26
11
12
20
13
24
13
29
3
3
2
10
21
13
21
18
91
43
21
6
1
6
12
5
3
51
187
23
201
107
169
276
-----
2
9
2,877
361
7
71
162
23
15
UM
14
586 I 2,201
4
9
11
19
30
34
15
23
15
34
19
30
31
25
114
52
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23
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1======
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======
l\i~.:::i::.!-..,, .. ................~······ -······_- ····
247
I
653
I
~
11
-· -·1 91 501
~ ====-- ===·--1-·----1____________
--··-- i61 441-======
1
-·---·1·
Total, all activities--···--·-···-··--------· --·--·-- --·--- --·-·- ---·-- ·----- ---·-- -·---- -·---- --··-- -·-·-- --····1------1
Scientific research division:
National Institute of Health--·-·-·---·----·--·· ----·--- 33 ·-···- ------ -----· ·----- --·--· ------ ---·-· ______ -·---- 12
Leprosy Investigations __ ·---·-·-·---····----·--- ______________ ---·-- ______ ---·-··-·-·-·-···--··--- ____________ -·---1
Malaria Investigations. __ • ____________ • _________ -····-·--····· ---··· ·----- -·-·-- ··-··· --···- --·-·· ----·· ----·- -·---3
Nutrition studies---·---··--····---------·-·-·--- --·--•·- --·--- ---··· --·--- ---·-- -··--· ---·-· ------ -----· ------ -·-·-· -----Stream pollution __ • ___ • __ ·_·_·-··--·-·····-·-- ·_ ·-----·- ·--·-· ---··· ____________ -··--- --·--- ____________ -·--·- -·--·2
Industrial hygiene and sanitation_ •••• ___ •• _._._-----·-- ------ -·-·-- -·---- ______ -·---· ______ ------ ------ ---··· ·----6
~~~tr~~lli8ce:::::::::::::::::::: ·:::::::::::: :::::::: :::::: :::::: :::::: ----1- ___ •1• :::::: :::::: :::::: :::::: :::::: g
All other stations. •••••• ·-··----···-·-·--·····-·- ---··--· ----··
318
1 -·---- ·-···· ··--·· -·--·- -·----
2 -·-·-- -···--
12
I
~
~ l =30II=101 -----·I
76
4
9
2
14
12
1
3
51
971
========
59, _______ _
~ ---··~- -·-~-
-
27
3
6
3
8
40
8
9
47
121
5
12
2
16
18
8
12
66
=
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-,-~-- i = · ·_- · ·-·· == '. . .~.. . . . " . . . ..
Total quarantine and Immigration_ - -----·i---·----1-·-· --1--··--1------1------1------1---· ·-1-·-·--1-·---·1------1---- --i-·----i- -------i-- ·---1
co·
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10
29
11
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131
148
8
17
5
24
58
16
21
113 ____ , ___
410
150
260 -----Total, all actlvltfes_._ •••• ----·-------··-1--··--·-1-·---·1-·-··•l-·--··1---·--1·-·---1---·--1------1-----·1-·-·--1===1='====~1=1=i=a==I=
C?".
....
-
Consolidated quarterly personnel report/or the quarter ended July 1, 1933-Continued
0 :,
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All other stations________________________________ ______ __ ______
0
2 _____ _
.0
5
- - r- - - - --1 -- -
~
~
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12 --- ---
1------1------1------1------i------1------1 · 1--------1------
~ :::::: :::::: :::::: ::::::1:::::: :::::: ::::::
3
3
1
2
3
C..
-----=1 1=
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- - -
A ::::::
f 1::::::
10 , _____ _
f-
Total, all activitieL---------------------1·- - - ----1------1------1------i-----r----1 ------1------1 -
i
·
:
Rr]re!?.1~~1~tt;::::::::::::::::::::::::::: :::::::: :::::: ______
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- 1- -- - - - 1- - - - - - 1-- - -- -1 - - - -
Division
of mental
Alderson,
w.vahygiene:
_______________________________________ ______ _______ _,_ ____ _
Atlanta, Qa____________________________________ _ _____ ___ ______
1
Chillicothe, Ohio____________ ____________ ____________ ____ __ ____
1 _____ _
Fort Leavenworth, Kans _____________________ ___________ -- ·-"1 _____ _
Leavenworth, Kans ___________________ ~---------_______ _ ______
1
1
05
-
-
-
" ~" P..-:o: .a..,. U~""' =
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- - -- -- - - - - - - - - --- --- ---- ---- --- ----
._.
z"
ftELD-Continued
Sanitary reports and statistiCS---------- --- ---- ----- -1 4,640 , ______ , _____ _,_ ___ __, ______ , _____ _, ___ ___ , ______ , ___ ___ , ______ , ______ , _____ _
Division of venereal diseases_ - - - -------- -- -- -- - - --- -i;;;;;-_-1- • • • -
-
a,)
"
~
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8
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Totals
.
1:-<
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I
I
-1 -
-===== :::::- ------ --- --- ------
4,642
17
64
7
12
9
7
12
5
9
42
6
5
-----2,435
195
....
=
>
7
4
8
2
2
15
~
=
13
17
16
lJl
tzj
11
20
7
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11
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<
....
57
tzj
152
=i=
=----- ------ ------ :::::: ·::::::: ::::::
ti:,
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471
103
49 --------r----1==!=
M"5"ii•,.,_'.~'."'::::
:::::::::______________
: : ::::: ::1::::::::1
Perry Point, Md. (supply station)
····: 1---···-2- ------1··------, ------···1····
--------------·--~
.:::-:~
::::::~
---- -l
-- ---------------- ::::::~
---- -- ::::{·~---·::i:
7 ________ ::::::
-----Total miscellaneous _______________________ ------------------------------------ - ------------------------------- -Grand totaL _______ _
12
38
36
291
·----- 4,640 33 36 16 470 34 29
4,641
"tl
q
19
133
1
7
31
15
0
2
8
g
0
0
19
135
g
16
31
15
206
19
------1
1,683
8,269
____ J
225
9,962
'
CHIEF CLERK'S OFFICE
NEW ADMINISTRATION BUILDING AT WASHINGTON
An event of special interest in the history of the Public Health
Service occurred in May 1933, when the administrative offices were
moved to the newly completed Public Health Service administration
building at Nineteenth Street and Constitution Avenue. Actual
transfer of the offices from Temporary Building C on Seventh Street
:SW. began on May 11 and was completed on May 16.
This splendid marble structure was authorized by Congress in the
act of July 3, 1930, which appropriated $865,000 for its construction.
·This authorization was subsequently increased by 5 percent, and the
actual cost proved to be approximately $908,250, exclusive of the
•cost of the site. Ground was broken for the foundation on July 21,
1931, and erection of the superstructure began early in December of
that year. On May 7, 1932, the cornerstone was laid with appropriate ceremony by the Hon. Ogden L. Mills, Secretary of the Treasury, in the presence of a large gathering of officials and the public.
ln a sealed copper box within the cornerstone were placed copies of
books of Public Health Service regulations, annual reports, current
health publications, and other data pertaining to the Public Health
.Service from its inception to the present time.
The building contains 1,505,940 cubic feet, with a gross floor area
·of 79,931 square feet and net office space of 59,081 square feet. The
frontage on Constitution Avenue is 261 feet, while the wings have a
present depth of 141 feet. The design of the building contemplates
its possible extension to the north, for which space is available on
the present site.
The building was planned with a special view to facilitating administrative work and promoting the health .and efficiency of the headquarters force. In its occupancy, the hopes of many years have been
realized, and it is observable that the working personnel is showing
increased efficiency as a result.
DEPARTMENTAL PERSONNEL
During the fiscal year 2 telephone operators were released and
the positions abolished because of the installation of the dial system,
1 employee resigned, 2 were retired for physical disability, and
1 was separated from the service. These latter vacancies were
not filled because of the limitations placed upon expenditures for
the fiscal year 1934. For the same reason further curtailments
were necessary, and early in July 1933, 12 additional employees
were rnparated from the service under the provisions of the Economy
Act. This reduction of 18 positions decreased the total force on duty
in the Bureau to 183, of which number, 164 are paid from the
appropriation "Salaries, office of the Surgeon General", 10 from
the appropriation for the division of venereal diseases, and 9
from the appropriation for the division of mental hygiene.
117
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118
PUBLIC HEALTH SERVICE
The average sick leave was 7 .8 days per employee, a small decrease
from the preceding year. P~nctuality on the part of the force was
virtually perfect, there having been less than one case of tardiness per
employee for the year. No administrative promotions were made.
Mr. Arthur M. Wheeler, chief of the accounts section, died on
December 10, 1932. He had been in this service since May 6, 1899.
Mrs. Honora Gable, an employee since May 1, 1919, died December
28, 1932. Miss Ella C. Brehaut, chief of the voucher audit unit,
retired voluntarily on September 1, 1932, after reaching the age
prescribed by law. She had served for 39 years.
PRINTING AND BINDING
The available fund for printing was reduced from $93,000 to
$50,000 for the year. The Public Health Reports, a weekly publication, was necessarily reduced to half its former size and reports of
research and health publications generally were curtailed more than
50 percent. As a corresponding cut could not be made in the printing
of blank forms, record books, and letterheads, essential to official
operations, most of the saving had to be absorbed in publications
and binding.
PUBLIC HEALTH SERVICE LIBRARY
Additions to the library consisted of 420 bound volumes and 250
pamphlets, making a present total of 13,192 books and 7,050 pamphlets.
Medical and scientific journals to the number of 226 were received
and circulated; only 36 represented paid subscriptions, the others
having been received ~ratuitously or by exchange. A number of
periodical health bulletms issued by State, city, and foreign governments suspended publication, thus decreasing the total number
received by our library. The demands upon the library continue
to grow, and the small available staff is at times not equal to the
needs of the work. However, the splendid library quarters in the
new building, affording improved facilities, compensate somewhat in
this respect.
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APPENDIX
FINANCIAL STATEMENT
The following is a statement of expenditures from appropriations
of the Public Health Service for the fiscal year 1933:
Obligations
Appropriation
Appropriated
Incurred
.Salaries, Office of Surgeon General••.
Pay, eto., commissioned officers and
pharmacists ••••.•••••.•••.••.•••••
Pay of acting assistant surgeons••••..
Pay of other employees.•..•.••••••.•
Freight, transportatio~ etc. .••..•••.
Maintenance, Nation Institute of
Health ••••••••••••........••••••••
Books ••••••••••.•.•••..•...••.••••.•
Pay of Jl8!'SODDel and maintenance of
hospitals ••.•••.•••••••••••••••.•..•
Quarantine service.. •••.•.............
Preventing the spread of epidemic
diseases••.•••••••••••• _._ ...••.••..
Field Investigations of public health.
Interstate quarantine service ••.•••••
Studies of rural sanitation •• _•..•.•.•
Control of biologic products.··--- .••
Expenses, Division o! Venereal Dis·
Unobll•
gated
balance
Liquidated Outstand
Ing
----------
$41,179. Sil
$340, 000. 00
$298, 820. 11
1, 730, 000. 00
389,984.00
1, 100, 000. 00
38,000.00
1, 482, 064. 12
318,125.74
897,450. 79
35,204.76
48,000.00
500.00
41,945. 77
487.80
6, 786, 570. 50
420,000.00
6, 173, 206. 09
331,902.26
350,000.00
400,000.00
39,214.00
300,000.00
46,000.00
271,900.95
359,848.60
29,825.14
252,149.44
40,098.35
266,356.12
356,002.64
29,315.32
250,910.48
38,909.50
5,544.83
3,845.96
509.82
1,238.96
1,188.85
78,099.05
40,151.40
9,388.86
47,850. li6
5,901.65
eases••..••••••••••••••••••••••••.•.
llO, 000.00
78,638.96
77,730.07
908.89
11,361.04
E E , Division of Mental.Hy-_
E ucatlonal exhibits•••••••••••••••• _
48,215.00
1,500.00
42,048.24
1,414.34
41,949.94
1,302.21
98.30
112.13
6,166.78
85.66
I
$298, 820. 11
1, 478, 156. 78 $3,907.34
317, 181.45
944. 29
896,941.72
509.07
27,547, ll 7,657.65
40,851.02
478.46
247,935.88
71,858.26
202,549, 21
2,795.24
1,094.75
9.34
6,054.23
12. 20
6,165,399.08 7,807.01
312,134.86 19,767.40
613,364.41
88,097.74
Total •••••••••••••••••••••••••• • 12, 127, 983. 50 10, 655, 131. 46 10, 599, 986. 87 55,144.59 1, 472, 852. 04
1 Includes $1,106,570,50 reimbursement for care and treatment or beneflclarles or the Veterans' Admln•
. lstratlon.
• Statement does not Include expenditure of $4,812.42 from trust fund "National Institute of Health,
- Conditional Gift Fund."
119
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120
PUBLIC HEALTH SERVICE
Quarantine 1errlice-Ezpmditur• btf ,tations
Pay oroffl•
cers and em•
ployees
Name or station
Operation
Expenses
Total
CONTINENTAL QUARANTINE STATIONS
Baltimore, Md...............................................
$28,326.21
Beaufort, S.C.................................................
577. 50
Biscayne Bay (Miami), Fla..................................
16,529.93
Boca Grande, Fla.............................................
2,087.50
Boston, Mass.................................................
41, 254. 09
Brownsville, Tex.............................................
16,035.71
Brunswick, Ga...............................................
3, 703. 73
Cape Fear (Southport), N.C.................................
8,501.75
Charleston, S.C..............................................
17,859.37
Columbia River (Astoria), Oreg..............................
5,072.31
Corpus Christi, Tex..........................................
I, 800. 58
Cumberland Sound (Fernandma), Fla........................
1,984.40
Delaware Breakwater (Lewes), Del.. ...................................... .
Del Rio, Tex.................................................
5, 286. 26
Eagle Pass, Tex..............................................
13,830.20
El Paso, Tex.................................................
25, 722. 29
Eureka, Calif.................................................
1,404.44
Freeport, Tex ..... : .................................. -........
364. 23
Galveston, Tex...............................................
26, 558. 27
Gulfport, Miss...............................................
5,297.59
Hidalgo, Tex..................................................
6,364.27
Key West, Fla...............................................
3,624.611
Laredo, Tex..................................................
25, 904. 24
Marcus Hook, Pa............................................
52,521.25
Mercedes, Tex................................................
2,552 15
Mobile, Ala..................................................
24,942.31
New Bedford, Mass..........................................
577. 50
New Orleans, La.............................................
51,708.14
Newport, R.L ............................... . ........................•.....
New York, N.Y ......................... -· ........ ...........
200,735.77
Nogales, Ariz ...... _·-........................................
10,226, 67
Norfolk (Fortress Monroe), Va...............................
33,373.17
Olympia, Wash.......................... . ........... . .......
288. 75
Pascagoula, Miss.............................................
1,079.94
Pensacola, Fla................................................
14,993.18
Perth Amboy, N.J. ..........................................
1,439.76
Port Arthur, Tex.............................................
8,162.62
Portland, Maine..............................................
14,205.64
Portland, Ore.g... .. ............ ........ .... ..................
3,356.10
Port Townsend, Wash........................................
12,8/l!l.58
Presidio, Tex.................................................
4,211.01
Providence, R.L. .. ....... . . ..... .... ........ ... .............
1,673.94
Rio Grande, Tex.............................................
4,198.35
Roma, Tex ....... _...........................................
4,424.34
Sabine, Tex................................. . ...... . .........
12,703.16
St. Andrews (Panama City), Fla. ...........................
1,081.92
St. Georges Sound (Carrabelle.), Fla_.........................
288. 72
St. Johns River (Jacksonville), Fla...........................
7, 2-33. 02
San Diego (Point Loma). Calif...............................
13,827.02
San Francisco (Angel Island), C'nliL.........................
63,438.24
San Pedro (Los Angeles), Calif...............................
31,883.56
Savannah, Ga.................................................
16,586.68
Seattle, Wash......................................... . ........
ll, 123.01
Tampa, Fla..................................................
13,103.73
Vineyard Haven, Mass .................................................... .
Ysleta, Tex ................................................................ .
Zapata, Tex..................................................
2,105.88
Freight and miscellaneous ................................................. .
Travel of medical directors within districts .................................
.
._
_,_
$17,401. ll
$45, 726. 32:
577. 50
10,470.25
162.89
19, 128. 74
3,006.22
1,046.72
2,585.38
3,800.03
1,567.93
56. 73
2.63
25.00
1,059.55
1,037.00
4,961.70
1200
27,000.18
2,250.39'
60,382 8319,041.93.
4,750.45
11, 087.1321, 659.40
6,640.24
1,857.31
1,987.03
25. 006,345.81
14,867.20'
30,683. 991,416.44
364. 2337,839.64
5,993.37
7,209.52
3,971.01
28, 32,5.14
86,311. 953,281, 6333,059. 71
587.50
65,164.48
11,281.27
695. 78
845. 25
346. 35
2,420.90
33,790.70
729.48
8,117.40
10.00
13,456.34
10. 00
84,317.49
I, 618. 98
7,331.65
1,599.53
1,200.00
113. 72
4,716.34
1,494.00
3,404.39
341. 95
,525. 00
170. 60
680.69
1,090.32
145. 81
1,409.58
5,127.13
19,536.17
5,4/ili. 95
4,540.87
2,622.81
6,275.58
10.00
18. 45
3R2. 00
20,132.00
282.35
10.00
285,053.26
11,845.65
40,704.82
288. 76
1,079.94
16,592.71
2,639. 768,276.34
18,921.88
4,850.10
16,272.97
4,552 962, 198. 94
4,368.95
5,105.0S
13,793.48
1,227.73
288. 72
8,64260
18,954.15
82,974.41
37,339.51
21,127.55
13,745.82
19,379.31
Io.00
18.45
2,467.88
20, 13200
28235
____ _____ ,_____
Total, continentnl quarantine st.ations ................. ·1==8=7=9=,002=·=5=4=1==3=12=•=5=50=·=7=1=?==1=,1=9=1=,5=53=·=25=
••
INSULAR QUARANTINE STATIONS
Hawan ...................................................... .
Puerto Rico ................................................. .
Virgin L'liands ............................................... .
36,067.87
33,463.86
11,208.18
8,749.31
8,067.24
2,535.00
~----·'------!------
I
I
so, 130. 91
19,351.55 1
Total, insular quarantine stations.•..................... '============
Total, all stations.....•.••••.•.•..•..•..................
44,817.18
41,531.10
13,743.18
959, 742. 45
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100,091.46
1,291,644.71
121
PUBLIC HEALTH SERVICE
Savings-Funds impounded under the economy acts
Furlough
and com•
pensatlon
deductions
Appropriation
Salaries, Office of Burgeon General..........................................
Pay, etc., commissioned officers and pharmacists............................
$34,500.40
131,185.97
1
f~!]Jt~~~:gi:rEr:l~t~~~~============================================= rt
Vacancy
savings
$4,733.89
2,682.00
~t; .....~!:~~~~
Maintenance, National Institute of Health .............•.................•......•••.•..........•.......•
Books•••...•.•.......•.•......•...•..............•.•.•..••.•.•.•.....•.•.............•....... · .•.......•
Pay of personnel and maintenance of hospitals..............................
488, 766. 62
97, 282. 14
Quarantine service •.....•.....................................•...•...........•..............•..........
Preventing the spread of epidemic diseases..................................
21, 866. 05
5, 513. 84
Field investigations of public health.........................................
28,865.02
3,452.33
Interstate quarantine service................................................
987. 47 .•.......•....
Studies of rural sanitation...................................................
14,481.04
480.00
Control of biologic products.................................................
2,279.24 .•.•••.......•
Expenses, Division of Venereal Diseases.....................................
7,776.85
670. 55
Expenses, Division of Mental Hygiene......................................
4, 364. 76
1, 064. 4S
Educati9nal exhibits........................................................
61. 27 ............. .
Total, Public Health Service appropriations ....................... ~ .. .
Medical and hospital service, penal Institutions ............................ .
Mosquito control. ....•................ _.................................... .
T ot al funds by transfer .............................................•..
Grand total ........................................•.•................
886,253.56
179,133.61
l=====l=====
20,456.09
2,671.03
270.99 --------------
1------1------
20,727.08
2,671.03
l=====i=====
906,980.64
181,804.64
FUNDS TRANSFERRED FROM OTHER DEPARTMENTS
Expenditures from allotments of funds from other Bureaus and
Offices for direct expenditure during the fiscal year 1933 were as
follows:
Appropriation title
Allotted
Expended
Veterans' Administration: Salaries and expenses ........................
District of Columbia: Mos:liuito control In District of Columbia...•....
Department of Justice: Me ical and hospital service, penal institutions.
$1, 124, 294. 20
5,600.00
340,560.00
$1, 124, 294. 20
3,195.95
297,589.73
Total ••..•.......•.•.•.......•.....•.•............ ·•••··••·•··•·••
1, 470, 454. 20
1, 425, 079. 88
MISCELLANEOUS RECEIPTS-COVERED INTO THE TREASURY
The revenue derived from operations of the Public Health Service
during the fiscal year 1933 are as follows:
Amount
Source
GENERAL FUND RECEIPTS
Quarantine charges........................................................................
Hospitalization charges and expenses......................................................
Sale of subsistence............................... _................. . .......................
Laundry service...........................................................................
Sale of occupational therapy products......................................................
Sale of obsolete, condemned, and unserviceable equipment.................................
Rents ....•.................................. _....· ................ .. ............... . ... ...
Reimbursement for Government property lost or damaged................................
Commissions on telephone pay stations installed in service buildings......................
Bale of refuse, garbage, and other byproducts..............................................
Sale of livestock and livestock products_...................................................
Other revenues .................... : ....... _................... __ ..........................
$211,759.63
19,537.99
12,057. 73
33. 00
334. 21
1,479.30
1,933.00
477. 39
1,475.91
904. 49
397. 73
618. 22
>-----
Total, general fund receipts..........................................................
251,008.60
TRUST FUND RECEIPTS
Effects of deceased patients................................................................
Grand total. .......••.•.................................................... __ .. .
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l. i77. 62
>-----
252, 78f. 22
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INDEX
.
A
Page
Accounts section__________________________________________________
109
Acting assistant surgeons, number on duty_________________________ 107-108
Air navigation, regulations for ______________________________________ 53-54
Airplanes, inspection oL __ __ __ _ _ __ _ _ _ __ __ _ _ __ _ _ _ __ _ __ __ _ _ _ __ __ _ _ __ _
51
Airports of entry, United States, for airplanes from foreign ports, summary
of transactions at _______________________________________________ 58-59
Aliens:
Medical examination of________________________________________
5-6
Medical inspection of_ _________________________________________ 54-55
Summary of ______________________________________________ 61-74
Appendix (financial statement)___________________________________ 119-121
Arsenical studies__________________________________________________
36
Attending specialists, number on duty_______________________________
108
B
Bacterial variants, or mutants, studies of _____________________________ 11, 34
Bacteriophage studies______________________________________________ 11, 34
..
I
I
I
Birth rate in the United States_____________________________________
3
Building, new administration___________________________________ 14-15, 117
C
California, plague-suppressive measures in _______________________ ·_____ 40-41
Cancer, studies oL _ __ _ ___ __ _ _ ___ __ _ _ _ __ _ __ _ __ _ __ _ __ __ _ _ __ _ __ _ _ 7-8, 17-19
Cerebrospinal meningitis, prevalence of (see also Meningococcus meningitis)__________________________________________________________
53
Chemistry, report of division of_ ____________________________________ 38-39
Chief clerk's office, report of______________________________________ 117-118
Child hygiene investigations________________________________________ 9, 27
Cholera, prevalence of_ ________________________________________ 1, 4, 51, 77
City reports, weekly and annual____________________________________
76
Coast Guard beneficiaries_ _ _ __ _ _ __ _ __ _ __ _ _ __ _ __ _ _ __ _ _ __ _ __ _ _ __ _ _ __ _ 85-86
Commissioned officers, number on duty ____________________________ 106-107
Communicable diseases:
Current prevalence of__________________________________________
75
Prevalence during calendar year 1932___ _ __ _ ____ _ __ _ _ _ __ _ ______ _ _
77
Conjunctivitis. (See Granular conjunctivitis.)
Cooperation of Public Health Service with other agencies______________
14
D
Death rates in the United States ___________________________________ _
2-3
Dental studies ___________________________________________________ _
10
Dental surgeons, contract, number on duty __________________________ _
109
Dental treatment at marine hospitals _______________________________ _
85
Diphtheria toxoid, alum-precipitated, studies of_ _____________________ _ 12,36
Diseases:
Communicable:
Prevalence during calendar year 1932 _______________________ _
77
Contagious
and infectious, prevention of the spread in interstate_
commerce _________________________________________________
6-7
Frqm abroad, prevention of the introduction of ___________ . ______ _
4-5
Venereal, prevention and control of. ____________________________ _ 12-13
Domestic quarantine, report of division of_ ____________ ------------ __ _ 40-50
Drug addiction, nature and treatment of_ ___________________________ _
104
15463-33-9
123
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124
INDEX
E
Pap
Engineering work__________________________________________ 6-7, 46-4 7, 48
Epidemiologists:
75
Collaborating and assistant collaborating_________________________
Number on duty______________________________________________
109
F
Federal penal and correctional institutions, medical and psychiatric services in- statement
-- - --- - - - _____________________________________________
- - ---- -- -------- ---- --------------~----------- 119-121
105
Financial
Foreign and insular quarantine and immigration, report of division of_ ___ 51-74
Foreign ports, summary of quarantine transactions at_________________
60
Foreign reports___________________________________________________
76
Fort Worth, Tex., site for narcotic farm at___________________________
l0i
Fumigation and inspection of vessels ______________________________ 5, 51, 52
G
Granular conjunctivitis, studies of___________________________________ 11, 34
H
Health conditions:
United States_________________________________________________
2-4
World_______________________________________________________
1-2
Heart disease, studies of_ ________________________________________ 8, 19-20
Hot Springs, Ark., Public Health Service Clinic at_ ________________ 13, 97-98
I
Immigrants. (See Aliens.)
Industrial studies__ _ ______________________ _____ ____ _______________
10
Infant mortality__________________________________________________
3
Influenza, prevalence of____________________________________________
1, 3
In-patient relief at Marine hospitals, chart showing average per diem cost
of_____________________________________________________________
87
Inspection of vessels. (See Fumigation and inspection of vessels.)
International exchange of sanitary information________________________
76
Internee, number on duty__________________________________________
108
Interstate carrier supplies, 1932, table showing________________________
44
Int1;rstate ?ommerce, prevention of the spread of contagious and infectious
d1seases1n______________________________________________________
6-7
Interstate quarantine. (See Domestic quarantine.)
Introduction of diseases from abroad, prevention of_ _ _ _ _______________ 4-5
Investigations (see also Studies):
Cancer_______________________________________________________
7-8
Childhygiene _________________________________________________ 9,27
Heart disease _________________________________________________ 19-20
Malaria ____________________________________________________ 8,21-23
Milk _____________________________________________________ 10, 28-21>
Nervous and mental diseases___________________________________
105
Psittacosis___________________________________________________
24
Public health problems ___________________________________ .____ 7-12
Statistical____________________________________________________ 30-31
Stream pollution ______________________________________________ 31-32
Typhus fever _________________________________________________ 11, 33
L
Legislation, sanitary, and court decisions ___ - _- _- ___________ - _______ - _
78
Leprosy, studies of______________________________________________ 8, 20-lH
Lexington, Ky., narcotic farm at____________________________________
105
Library, Public Health Service _____________________________________ ·_
118
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125
INDEX:
M
Page
Malaria-control measures, investigations of_________________________ 8, 21-23
Malignant growths. (See Cancer.)
Marine hospitals:
Beneficiaries,
summary of services by class of__ _ __ _ __ __ _ _ ___ __ __ _ _ 85-86
84
Coast
Guard _________________________________________________
Cost of per diem______________________________________________
84
Dental treatment_____________________________________________
85
In-patient relief, chart showing average per diem cost of"__________
87
Operating costs _____________________________________________ - _ 86, 88
Recommendations for__________________________________________
16
Reports, consolidated and detailed ______________________________ 88-95
Research work at _____________________________________________ 84-85
Marine hospitals and other relief stations, beneficiaries treated at_______
12
Marine hospitals and relief, report of division oL _____________________ 83-95
Maritime quarantine, recommendations for___________________________
16
Maritime quarantine stations, summary of quarantine transactions at___ 55-56
Medical and psychiatric care of Federal prisoners _________________ 13-14, 105
Medical examination of aliens (see also Medical inspection of aliens)_____
5-6
Medical inspection of aliens (see also Medical examination of aliens) _____ 54-55
Medical inspection of aliens, summary of_ ____________________________ 61-74
Meningitis. (See Meningococcus meningitis.)
Meningococcus meningitis (see also Cerebrospinal meningitis), studies oL _ 12, 36
Mental hygiene, report of division oL _ _ _ __ __ __ __ __ _ __ _ __ _ _ _ __ __ _ __ 104-105
Mexican border stations, summary of quarantine transactions at ____ - _ _ _
57
Milk investigations _____________________________________________ 10, 28-29
Morbidity and mortality reports____________________________ __ __ _ __ _
75
Mor~~~~afC~;:~-----------------------------------------------Monthly State________________________________________________
Morbidity studies_________________________________________________
Mortality statistics, current State___________________________________
Mosquito control, District of Columbia______________________________
76
76
31
75
47
N
Narcotic drugs, studies oL _ __ _ _ _ __ __ _ _ _ __ _ __ _ __ _ _ _ _ __ _ __ _ _ __ _ _ _ __ _ _
104
Narcotic farms, administration oL ________________________________ 104-105
Narcotic farms and medical and psychiatric care of Federal prisoners __ ·__ 13-14
National
Institute
of _____________________________________________
Health:
Number
on duty
_
109
Report of ___________________________________________________ _
33-39
Negro health work __________________________________________ - _ - - - - 78-79
Nurses, dietitians, and reconstruction aides, number on duty __________ _
108
Nutritional diseases, studies of_ _______________________ --- _ - - - - - - -- - - 23,34
0
Operating costs of marine hospitals __________________________________ 86, 88
p
Pathology and bacteriology, report of division oL _ _ _ _ __ ___ _ _ _ __ __ _ _ _ __ 33-35
Pellagra:
Prevalence of_________________________________________________
4
Preventive value of various foodstuffs___________________________
8
Personnel
(see also ______________________________________________
Personnel and accounts):
Departmental
117-118
Recommendations for _____________________________ - __ - ________ 16
Statement of _______________________________________________ 110-116
Personnel and accounts, report of division of_ ______________________ 106-116
Pharmacists and administrative assistants, number on duty____________
108
Pharmacology, report of division of_ _________________________________ 36-38
Plague:
In ground squirrels ___________________________________ - _ __ __ _ __
40
Laboratory, Public Health Service ______________________________ 40-41
Prevalence of_____________________________________________ 2, 3, 51, 77
Studies of_______________________________________________ __ _ __ 9, 24
Suppressive measures in California _______________ - - - __ - - ________ 40-41
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INDEX
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Post-vaccination complications, studies oL ___ .. ______________________ _
36
Printing and binding _____________________________________________ _
118
Property records section, report of_ ________________________________ _
109
Prophylactic and therapeutic agents, special studies on _______________ _ 35-36
Psittacosis:
Control of_ ___________________________________________ 7, 42-43, 52-53
Studies of______________ ___ _________ _______ _____ _ ___ _ _ __ _ _ _ _ _ _ 9, 24
Publications issued and distributed _______________________________ 78, 79-82
Public health:
Engineering work ______________________________________ 6-7, 46-47, 48
Methods, studies of___________________________________________ 29-30
Problems, investigations of_____________________________________ 7-12
Sanitary legislation and court decisions relating to_________________
78
Public Health Service:
Cooperation with other agencies________________________________
14
Plague laboratory _____________________________________________ 40--41
Q
Quarantine inspections ____________________________________________ _
5
Quarantine transactions at:
Airports of entry United States ________________________________ _ 58-59
Foreign ports ________________________________________________ _
60
Maritime stations ____________________________________________ _ 55-56
Mexican border stations ______________________________________ _
57
R
Railroad sanitation supervision, summary of_ ________________________ _
Railway sanitation _______________________________________________ _
Rats, measures taken against ______________________________________ _
Recommendations for:
Mar!n.e hospitals_: _______ -,- __________________________________ _
Maritime quarantme _________________________________________ _
Personnel ___________________________________________________ _
Scientific research ____________________________________________ _
State and local health work ___________________________________ _
Reports:
City, weekly, and annual ______________________________________ _
48
45
40
16
16
16
15
16
76
Collaborating and assistant collaborating epidemiologists __________ _
75
Communicable
diseases, current prevalence of_ __________________ __
75
Foreign _____________________________________________________
76
Marine hospitals, consolidated and detailed ______________________ _ 88-95
Morbidity:
_
Annual State _________ -------- __ ----------------__________
76
Monthly State____________________________________________
76
Morbidity and mortality reports________________________________
75
Mortality statistics, current State _______________________________ ·
75
Personnel __________________________________________________ 111-116
Telegraphic reports _____________________ - ___________ __ ________ 75-76
Reserve officers, number on duty____________________________________
107
Respiratory studies _______________ - - _- __ - - _- _- - - _- - - - _- - - __ - - - - _- __ 11, 31
Rocky
Mountainofspotted
fever:
Prevalence
____________________________
- __________________ - _
4
Studies of _______________________________________________ 9, 24-26,33
Vaccine, amount manufactured ______ ----------_________________ 9, 25
Rural health work _________ - ____ - _- - __ - __ - ___ - - - - - - - - __ - ___ - - - _. _- - 49-50
s
Sanitary information, international exchange of_ _____________________ _
76
Sanitary legislation and court decisions _____________________________ _
78
Sanitary reports and statistics, report of division of_ __________________ _ 75-82
Sanitation, rural. (See Rural health work.)
Scarlet fever prophylactic, method for manufacture of_ _______________ _
12
Scientific
research:
Recommendations
for _________________________________________ _
15
Report of division of_ _____________ ---------------- ___________ _ 17-39
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Shellfish sanitation________________________________________________ 6, 46
Supervision of, summary showing_______________________________
48
Sickness and mortality studies ________________________________ 10-11, 30-31
Smallpox, prevalence of_ ______________________________________ 1-2, 3, 4, 51
Stapleton, N.Y., venereal disease studies at___________________________
96
State and local health work, recommendations for_____________________
16
Statistical investigations ___________________________________________ 30-31
Stream pollution studies ________________________________________ 11, 31-32
Stream sanitation, office of (see also Stream pollution)_________________ 6, 46
.Studies (see also Investigations):
Arsenicals_ ___________________________________________________
36
Bacterial variants, or mutants __________________________________ 11, 34
Bacteriophage ________________________________________________ 11,34
Cancer ___________________________________________________ 7-8, 17-19
Dental_______________________________________________________
10
Diphtheria toxoid, alum-precipitated ____________________________ 12, 36
Granular conjunctivitis_________________________________________ 11, 34
Heart disease _______________________________________________ 8, 19--20
Industrial____________________________________________________
10
Leprosy ____________________________________________________ 8,20-21
Meningococcus meningitis______________________________________ 12, 36
Morbidity____________________________________________________
31
Narcotic drugs________________________________________________
104
Nutritional diseases ___________________________________________ 23, 34
Pellagra-preventive
value of foodstuffs___________________________ .9,24
8
Plague _______________________________________________________
Post vaccination complications__________________________________
36
Prophylactic and therapeutic agents, special ______________________ 35-36
Psittacosis___________________________________________________ 9, 24
Public health methods _________________________________________ 29--30
Public health
practices_________________________________________ 11,31
10
Respiratory
__________________________________________________
Rocky Mountain spotted fever _____________________________ 9, 24-26, 33
Sickness and mortality ___________________________________ 10-11, 30-31
Stream pollution___________________________________________ 11, 31-32
Trachoma
~------------------------------ 26,34
34
Tularaemia_____________________
___________________________________________________
Tumor (see also Cancer) _ _ _ ____________________________________ 17-19
Venereal diseases ______________________________________________ 96-97
T
Tables:
Airports of entry, United States, for airplanes from foreign ports,
transactions at______________________________________________ 58-59
Beneficiaries of Marine hospitals, summary of services by class of___
84
Foreign ports, quarantine transactions at_________________________
60
Marine hospital transactions ____________________________________ 88-95
Maritime quarantine stations, transactions at _____________________ 55-56
Medical inspection of aliens ____________________________________ 61-74
Mexican border
quarantine transactions at_______________111-116
57
Personnel
reportstations,
____________________________________________
Venereal diseases____________________________________________ 100-103
Telegraphic reports ________________________________________________ 75-76
Trachoma:
Eradication activities _________________________________________ _
7
Prevalence of ________________________________________________ _
Prevention work _____________________________________________ _ 41-42
Studies oL _-~ _______________________________________________ _ 41-42
34
Tularaemia:
Prevalence of ________________________________________________ _
Studies of ___________________________________________________ _ 4, 11
26,34
Tumor, studies of (see also Cancer) _________________________________ _ 17-19
Typhoid fever, prevalence of_ _________ -~ ___________________________ _
45
Typhus fever:
Investigations of______________________________________________ 11, 33
Prevalence of_ _______________________________________________ 2, 4, 51
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128
INDEX
U
Undulant fever, prevalence oL______________________________________
United States, health conditions in__________________________________
Page
,f
2-4
V
Vaccinations. (See Post vaccination complications.)
Vaccine, Rocky Mountain spotted fever, amount manufactured_________ 9, 25
Venereal disease information, journal oL______________________________
99
Venereal diseases:
Clinic, Hot Springs, Ark ____________________________________ 13, 97-98
Control measures ______________________________________________ 98-99
Prevalence of_ _____________________________________________ 96, 97, 98
Prevention and control of_ ________________________._____________ 12-13
Report of division of__________________________________________ 96-103
Studies of ____________________________________________________ 96-97
Tables relating to___________________________________________ 100-103
Vessels:
·
Fumigation and inspection of_ ________________________________ 5, 51, 52
Water-supply supervision, summary of___________________________
48
Water-supply systems, supervision of____________________________
45
w
Water, drinking, on interstate carriers, inspection of_ _________________ _
6
Water supplies used by common carriers, supervision of_ ______________ _ 43-45
Water-supply systems on vessels, supervision of_ _____________________ _
45
World health conditions ______________________ :.._ - -- - --- __ -- - ------- _
1-2
y
Yellow fever, prevalence of------------~--------------------------- 2, 4, 51
Zoology, report of division
z
of.______________________________________
0
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