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ANNUAL REPORT
OF THE
u
SURGEON GENERAL of the
:) .PUBLIC HEALTH SERVICE
of the UNITED STATES
FOR THE FISCAL YEAR
1934
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UNITED STATES
GOVERNMENT PRINTING OFFICE
WASHINGTON: 1934
For oale by the Surerintendent of Dac:uments. Washington, D. C. •
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TREASURY DEPARTMENT
Document No. 3064
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LETTER OF TRANSMITTAL
TREASURY DEPARTMENT,
OFFICE OF THE SECRETARY,
Washington, January 3, 1996.
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
1934.
.
Respectfully,
H. MoRGENTHAU, Jr.,
Secretary.
The SPEAKER OF THE
Hous:m OP REPRESENTATIVES.
m
432826
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CONTENTS
Foreword _______________________________________________________ _
Division of Scientific Research _____________________________________ _
Cancer ______________________________________________________ _
Epidemic encephalitis _________________________________________ _
Heart disease ______________ · _________________________________ _
Leprosy _____________________________________________________ _
Malaria _____________________________________________________ _
Nutrition ___________________________________________________ _
Psittacosis __________________________________________________ _
Rocky Mountain spotted fever _________________________________ _
Tularaemia __________________ . _______________________________ _
Colorado tick fever ___________________________________________ _
Child hygiene investigations ________________ . __________________ _
Dental studies _______________________________________________ _
Dermatoses investigations _____________________________________ _
Industrial hygiene and sanitation ______________________________ _
Milk investigations ___________________________________________ _
Studies of public health methods _______________________________ _
Statistical investigations ______________________________________ _
Stream pollution investigations ________________________________ _
National Institute of Health. __________________________________ _
Miscellaneous ________________________________________________ _
Division of Domestic (Interstate) Quarantine ___________________ -.- ___ _
Plague-suppressive measures in California _______________________ _
Plague-control measures in the Territory of Hawaii_ ______________ _
Trachoma prevention. ________________________________________ _
Supervision of water supplies used by common carriers ____________ _
Railway sanitation ___________________________________________ _
Shellfish sanitation ___________________________________________ _
Reciprocity with Canada __________________ .____________________ _
Cooperative work with States relative to stream sanitation ________ _
Cooperative public health engineering work _____________________ _
Summary of work carried on by the various districts _____________ _
Rural health work ________ ___________________________________ _
Preventing the spread of psittacosis _____________________________ _
Federal civil works projects of the Public Health Service __________ _
of the
Surgeon General with the State and Territorial_
Conference
health officers
______________________________________________
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Division of Foreign and Insular Quarantine and Immigration __________ _
Transactions at maritime quarantine stations ____________________ _
Mexican border stations ______________________________________ _
Transactions at United States airports of entry for airplanes from
foreign ports _________________________________ ---- ____ ------_
Canal Zone __________________________________________________ _
Medical inspection of aliens ___________________________________ _
Division of Sanitary Reports and Statistics __________________________ _
Morbidity and mortality reports _________________________ ------_
Prevalence of communicable diseases in the United States, 1933 ____ _
Sanitary legislation and court decisions _________________________ _
Negro health work _________________________________ ---- ______ _
Publications issued by the division _____________________________ _
Publications distributed and exhibits prepared ___________________ _
Division of Marine Hospitals and Relief_ __________________ ----------_
Classes of beneficiaries and amount and character of services rendered_
Dental treatment ___________ ________________________________ _
Coast Guard ________________________________________________ _
Operating costs _______________________________ - - - _____ - _- -- - __
Consolidated and detailed reports ______________________________ _
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CONTENTS
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Division of Venereal Diseases_______________________________________
Cooperative clinical studies_____________________________________
Health survey in the South_____________________________________
Research_____________________________________________________
Prevalence studies_____________________________________________
Work in cooperation with State health departments_______________
Venereal disease clinic, Hot Springs, Ark_________________________
Prevention of spread of venereal diseases by interstate tra veL ___ ___
Venereal disease information____________________________________
Proposed serologic conference___________________________________
Tabular summaries____________________________________________
Division of Mental Hygiene________________________________________
Studies of the nature and treatment of drug addiction_____________
DiMemination of information___________________________________
Studies of abusive uses and medicinal and scientific needs__________
Narcotic farms________________________________________________
Medical and psychiatric sen, ices in Federal penal and correctional
institutions_________________________________________________
Other investigations___________________________________________
Cooperative activities__________________________________________
Division of Personnel and Accounte_ _ ____ __ __ __ ____ ____ ____ ____ ____ _
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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J36
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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. 0., October 15, 1934.
Srn: In accords.nee with the act approved July 1, 1902, I have the
honor to submit for transmission to Congress the following report of
the tr11nsactjon,s of the Pµblic Health Service of the United States for
the fiscal year ended June 30, 1934. This is the sixty-third annual
report of this service, covering the one hundred and thirty-sixth year
of its existence.
One of the important duties imposed upon the Public Health Service
by law is the prevention of the introduction and spread of infectious
dISeases from foreign countries into the United States. The connection between the spread of communicable diseases and commercial
traffic has been known for many centuries. In order to effect adequate protection to our territory from the introduction of disease
from without in accordance with the requirements of law, it is necessary to keep currently informed as to the prevalence of disease
throughout the world msofar as possible. The greater use of aerial
transportation and the increasing speed of ships make it especially
necessary today that current information relati: :· to the prevalence
of disease in all parts of the world be available; for the time of passage from many countries to our shores now falls within the incubation period of many dangerous communicable diseases.
WORLD HEALTH CONDITIONS
No wide-spread epidemic of influenza was reported during the year
1933, and general health conditions throughout the world, as shown in
the reports, were good in spite of unfavorable economic conditions.
Cholera did not gain a foothold during the calendar year 1933
outside of Asia and the adjacent islands. About 100,000 cases and
48,000 deaths were reported as compared with 75,000 cases and 39,000
deaths for the year 1932. About 2,000 cases of cholera, with more
than 1,200 deaths, were reported in the Philippine Islands during the
calendar year 1933.
Plague caused more than 77,000 recorded deaths in 1933 as compared with 50,000 in 1932. The disease appeared in all of the great
land subdivisions of the world except Australia. Two cases of plague
were reported in the Territory of Hawaii during the calendar year 1933,
and 18 plague-infected rats were discovered during plague-prevention
work. Plague did not appear in the Philippine Islands during the year.
Smallpox caused more than 75,000 recorded deaths in 1933. Many
thousands of deaths from smaUpox are not recorded, as the disease is
prevalent in densely populated regions in which the occurrence of
diseases and deaths is not reported.
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PUBLIC HEALTH SERVICE
The world prevalence of typhus fever increased in 1933 as compared with 1932, but the numbers of cases and deaths were small in
comparison with the figures published for several years just after the
World War. About 25,000 cases of typhus fever, with approximately
3,000 deaths, were recorded for the calendar year 1933. The actual
figures are much larger, as many cases are never reported.
Yellow fever appeared during the calendar year 1933 in Brazil,
South America, French West Africa and French Togo, the Gold
Coast, Portuguese Guinea, and Nigeria, Africa.
HEALTH CONDITIONS IN THE UNITED STATES
Studies of the effect of the depressed economic conditions upon the
health of the people were continued. There is as yet no apparent
evidence either in the Service studies or in the death rates that the
general health has been lowered, which seems also to have been the
experience in other countries. However, data collected in 10 localities
where the depression has been most severe point to hi~her sickness
rates in those families most acutely affected by the economic conditions,
that is, in the class rated as in comfortable circumstances in 1929 but
subsequently reduced to the lower economic groups. The most
important reasons for the continuation of good health conditions are
probably the vast work of the relief agencies and the absence of any
wide-spread epidemics.
The general death rate in the 27 States for which data are available
at the time of this report for the calendar year 1933 was 10.5 per 1,000
population. This is the lowest death rate ever recorded for these
States. The next lowest rate was 10.8 per 1,000 in 1932. Preliminary reports for the first 6 months of 1934 show a somewhat
higher death rate than that for the first he.Jf of 1933 in many localities.
In the United States as a whole in 1933 there were 58.2 deaths of
infants under 1 year of age per 1,000 live births. This is equivalent to
1 death in the first year of life for each 17 children born. Putting
the figures in another light, if the infant death rate for 1915 (100 per
1,000 births) had prevailed in 1933, there would have been 86,000
more infant deaths that year than actually occurred.
The birth rate in the United States continued to decline. In 1933
there were 16.4 births per 1,000 population in the United States. In
1932 the birth rate was 17.4 per 1,000 population.
Neither cholera nor yellow fever appeared in the United States
during the year, but cholera was present in the Philippine Islands.
Two cases of bubonic plague were reported in California during the
fiscal year and one case in Oregon. Two hundred and forty-five
plague-infected rodents were found in California. One case of human
plague was reported in the Island of Hawaii in June 1934, and 10
:plague-infected rats were found on the Island of Hawaii and 2 on
Maui Island during the fiscal year.
In spite of economic conditions, tuberculosis deaths continued to
decrease. The tuberculosis death rate in 47 States for 1933 was 59
per 100,000 population, 5 percent below the previous minimum rate for
these States.
The typhoid fever death rate for the 47 States was also the lowest
ever recorded-3.5 deaths per 100,000-8 percent below the lowest
earlier rate.
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PUBLIC HEALTH SERVICE
The diphtheria death rate dropped to 3.9 per 100,000 population.
This is also the lowest rate for this disease ever recorded by the
Public Health Service.
During the summer and fall of 1933 an unusual outbreak of epidemic
encephalitis occurred in St. Louis, Mo., and the surrounding territory.
About 1,100 cases with more than 200 deaths were reported.
An outbreak of amoebic dysentery in Chicago in 1933, during the
Century of Progress Exposition, attracted much attention. Visitors
who stopped at Chicago hotels where the disease had appeared
became ill after returning to their homes in all sections of the country,
but no epidemic prevalence of the disease has bean reported outside
of Chicago. Amoebic dysentery outbreaks of this nature are unusual,
although cases of the disease are reported in the United States every
year. It has been estimated that approximately 690 cases originated
from this source.
Nearly 400,000 cases of measles were reported in the United States
during the calendar year 1933, with more than 2,000 deaths. During
the last 6 months of the fiscal year 1934 there was a large increase in
the incidence of measles which affected all sections of the country and
nearly all of the States. During the half year 656,000 cases of measles
were reported to the Public Health Service, and the reports of this
disease are always incomplete. The increased incidence of measles
became evident late in the calendar year 1933, and continued until
the close of the fiscal year. The greatest number of cases was reported
in April.
An outbreak of poliomyelitis (infantile paralysis) in California in
May 1934, extended beyond the fiscal year. It bevan in Los Angeles
County and later spread northward, involving V\ ·ashington, Idaho,
and Montana in August 1934. In May and June more than 1,500
cases of poliomyelitis were reported in California.
Less than 7,000 cases of smallpox were reported in the United States
for the calendar year 1933. Smallpox was the principal scourge of
mankind early in the last century. Last year it caused more than
75,000 deaths in countries which are sufficiently advanced to keep
vital statistics, but less than 40 of these deaths occurred in the United
States. Several of the European countries have advanced so far that
they did not have any cases of smallpox during 1933.
PREVENTION OF THE INTRODUCTION OF DISEASES FROM ABROAD
During the fiscal year no instance of the imJ?ortation into the United
States or its dependencies of any quarantmable disease occurred.
Several cases discovered on board vessels upon arrival at continental
or insular ports were effectively dealt with at quarantine.
Cholera, however, was present in certain islands in the Philippines
during a large part of the year. It was necessary at various times to
declare interisland quarantine in order to prevent the spread of the
disease from infected to noninfected islands, and to take special precautionary measures to prevent vessels destined to continental Uruted
States or foreign ports from becoming infected. During the occurrence of the disease, all steerage passengers embarking at Philip_pine
ports were required, prior to sailing, to comply with the regulations
covering steerage passengers leaving cholera-mfected ports and, in
addition, were given anticholera vaccine.
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PUBLIC HEALTH SERVICE
During the year, 11,576 vessels, 524,283 passengers, and 852,749
seamen were inspected by quarantine officers on arrival at domestic
ports; 3,220 vessels, 135,125 passengers, and 225,259 seamen were
mspected at insular ports; and 211 vessels, 51,574 passengers, and
8,198 seamen were inspected at foreign ports prior to departure for
the United States. In addition, 3,668 airplanes, carrying 26,951 persons, arrived at 57 airports of entry in the United States from forei~
ports, requiring quarantine inspection. Of this number, 2,456 arrplanes, carryin~ 23,899 persons, of whom 4,364 were aliens, were
medically exammed by medical officers of the Public Health Service.
Of the passengers who embarked at European ports for United
States ports, 18,417 who originated in infected areas were vaccinated
and 7,226 wAre deloused under the surveillance of medical officers of
the Public Health Service at ports of embarkation, and 17,818 pieces
of baggage were disinfected to safeguard particularly against the introduction of smallpox and typhus fever into the United States.
A total of 1,289 vessels was fumigated at United States ports either
because of the occurrence of disease on board or for the destruction of
rats as a plague-preventive measure. Of the 6,070 dead rats retrieved
following fumigation, 4,229 were examined for plague infection.
The regulations governing the importation of birds of the parrot
family into ports of the United States were revised to provide for the
laboratory examination of susP.ected shipments of birds upon arrival
at ports of entry, and to prohibit the importation of birds under the
age of 8 months, as yov.ng birds have been found to be especially likely
to transmit parrot fever (psittacosis) .
The International Sanitary Convention for Aetjal Navigation was
signed on behalf of the United States by the American Minister at The
Hague on April 6, 1934. On April 12, 1934, the latest date on which
the convention was open for onginal signatures, 23 countries, including the United States, had signed the convention, and its ratification
by the signatory countries is now pending. The ratifications of 10
countries must be deposited with the Government of the Netherlands
before the convention can become effective.
MEDICAL INSPECTION OF .A.LIENS
During the year under report, 680,152 alien passengers and 783,377
a.lien seamen were examined by medical officers at the various United
States ports of entry. Of this number, 1,502 passengers and 507 seamen were certified to the immigration officials1 in accordance with the
act of February 5, 1917, as being afflicted with one or more mental
or physical defects or diseases excluded under the immigration laws.
A total of 35,539 applicants for immigration visas was examined
by medical officers of the Public Health Service attached to American
consulates in foreign countries. Of this number, 22,420 were examined in American consulates in Europe, and 13,119 were examined in
American consulates in the Western Hemisphere. Mental or physical
defects were found in 5,049 of the .applicants examined in Europe, and
in 1,955 of those examined in the Wes tern Hemisphere; 1,446 of those,
examined in Europe and 881 of those examined in the Western Hemisphere were refused visas for medical reasons. None of the aliens who
had been given a preliminary medical examination in American consulates in foreign countries and to whom visas had been issued was
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PUBLIC HEALTH SERVICE
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certified ·upon arrival at a United States port as being afflicted with a
defect or disease requiring mandatory deportation.
The work of the medical officers of the Public Health Service on duty
in the Philippine Islands was increased by the acceptance by the
Philippine Legislature on May 1, 1934, of the Philippine Islands
Independence Act, which provides for the application of the immigration laws of the United States to citizens of the Philippine Islands and
for the administration of such laws by Foreign Service officers of the
United States.
In order to facilitate the entry of Mexican citizens desirous of temporarily visiting the United States, officers of the Public Health
Service on duty at quarantine stations on the Mexican border were
authorized to pass without formal examination all persons holding
identification cards issued to them by American consular officers in
the interior of Mexico, provided they show no evidence of quarantinable disease at time of entry.
PREVENTION OF THE SPREAD OF CONTAGIOUS AND INFECTIOUS DISEASE&
IN INTERSTATE TRAFFIC
The State health agencies continued their cooperation with the
Public Health Service m· connection with the certification of sources
of drinking and culinary water used on railroads, busses, vessels, and
airplanes. Of the 2,241 supplies listed by the carriers, 94 percent
were inspected and certified. This required the issuing of 2,157 certificates. During the year it was necessary to prohibit the use of
28 supplies, while 392 supplies were provisionally certified.
Of the 1,681 vessels engaged in interstate traffic on active status,
52.6 percent were inspected and certified as complying with the regulations governing drinking and culinary water systems. Reduced
shipping activities interfered somewhat with the efficiency of the
inspection service, since inspections must be made while vessels are
operating.
For the first time since inspection of vessels was inaugurated, no
cases of typhoid occurred among members of crews of Great Lakes
vessels. The records show a continued downward trend from 70
cases in 1916 to none in 1933.
Assistance was rendered to the district superintendents of the
Lighthouse Service and the Engineer Corps, United States Army, in
the design and installation of proper type of water treatment devices
for their vessels on the Great Lakes.
Sufficient surveys and inspections of shellfish areas and establishments were made to determine the efficacy of the State control.
Assistance was rendered the States in studies of areas as in the past.
Publication and distribution of lists of approved shellfish shippers
were continued.
In addition to assistance rendered to the States on problemt,1 of
stream pollution, a study was made of the J?Ollution of the Hampton
Roads area in the lower Chesapeake Bay with funds allotted for this
pul'J?ose to the Public Health Service by the Public Works Administration. The study was made at ~he request of the Chesapeake Bay
Authority.
Through the use of funds made available by the Civil Works
Administration a start was made in the control of acid mine wastes
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PUBLIC HEALTH SERVICE
in the bituminous coal mine areas in cooperation with the State
health authorities.
The public health engineering services rendered other Federal
agencies increased greatly over the aid given in previous years, 43
percent of the time of the engineering field force having been devoted
to this work. This has been due in part to new construction made
possible with the funds made available to such agencies for sanitary
work through the Public Works Administration, and to the enlargement of the National Park Service. Water treatment and sewage
disposal plants have been designed for the National Park Service,
Indian Service, and the )3ureau of Animal Industry.
As in previous years, assistance was rendered the Bureau of Prisons,
the Procurement Division of the Treasury Department (formerly the
Supervising Architect's Office), the Lighthouse Service, the sanitary
engineering division of the District of Columbia, and others in
connection with sanitary _problems.
According to information submitted by the States, 533 counties
were cooperating under the direction of whole-time health service on
December 31, 1933, as against 581 for 1932. The decrease has been
due in part to the discontinuing of financial aid to local health units
from the Public Health Service and partly .due to the reduction of
State and county revenues.
Trachoma eradication activities were continued in Tennessee,
Kentucky, and Missouri in cooperation with the State authorities.
Cooperation with the California State Health Department in preventing the spread of psittacosis infection in interstate commerce,
and in the eradication of ground-squirrel plague was continued.
Rodent plague of a virulent type appeared in Kern, Tulare, and
Modoc Counties in California.
To protect the port of Honolulu from plague infection, the Public
Health Service began work in cooperation with the Territory of
Hawaii in the eradication of rodent plague on the Island of Maui.
The participation of the Public Health Service in the Civil Works
program was an outstanding activity during the year. Through the
use of work-relief labor, made available by the Civil Works Administration, the Public Health Service was able to assist 14 States with
a malaria-control drainage project under which more than 6,000
miles of ditching was carried out. More than 225,000 sanitary outdoor toilets for rural homes were constructed in 22 States, the materials being furnished by the home owners. The Civil Works Administration projects of the Public Health Service also included the
sealing of abandoned mines to remove acid wastes from streams and
a rat-fl.ea survey in various areas in connection with typhus fever
control.
Cooperation was continued in special Negro health activities,
particularly the National Negro Health Week, which had its twentieth anniversary in the spring of 1934. These activities included a
number of comprehensive community health surveys, educational
and clinical projects, and the publication of the National Negro
Health News, a bulletin devoted to helpful reviews of pertinent data
on Negro health problems.
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INVESTIGATIONS OF PUBLIC HEALTH PROBLEMS
The program of cancer research was conducted both at the laboratory located in the Harvard Medical School, Boston, Mass., and at
the National Institute of Health, Washington, D. C. At the Boston
laboratory the followin~ investigations were pursued: Studies of the
biological effects of radiation, studies of resistance and susceptibility
to malignant growths, biochemical studies (chiefly- of cellular biochemistry), and cytological studies. At the National Institute of
Health particular emphasis is placed on the biochemical aspects of
the _problem, without, however, ignoring important physiological,
cytological, and pathological conditions.
D11rin~ the summer of 1933 there appeared in St. Louis, Mo., and
its vicinity a type of encephalitis which had not before made its
appearance in the United States in serious epidemic form. Epidemiological and laboratory studies were undertaken by the Public Health
Service, including extensive studies upon laboratory animals and man,
to determine whether mosquitoes acted as vectors in the transmission of this disease.
Laboratory and field investigations of heart disease have been
directed toward attempts to determine the factors predisposing to
rheumatic fever. Experiments were conducted to ascertain whether
subclinical scurvy is a contributory factor in the etiology of rheumatic heart disease.
Observations on the attempt to control malaria in tropical climates
by the use of atabrine have been brought to a conclusion with findings
that indicate that atabrine alone does not materially affect the
infection rate. Further studies are in progress using atabrine in
combination with plasmochin, and the results to date are encouraging.
Researches in the malaria therapy of paresis have been continued,
and studies in connection with retaining the viability of sporozoites
after dissection of infected mosquitoes have proved successful.
Many phases of Anopheles behavior are being investigated, as
well as the effectiveness of mechanical traps and of sound and light
attractivity for Anopheles at the Reelfoot Lake (Tenn.) station.
Detailed and critical examinations of a group of children of leprous
parents over a period of several years have indicated that minor
but definite olinical evidence of pathological changes in the peripheral
nerves and in the blood capillary system may be detected well in
advance of confirmatory clinical and microscopical manifestations of
leprosy.
Experimental investigations of rat leprosy to determine the mode of
entrance of the leprosy bacillus are in {>rogress. It has been demonstrated that a generally disseminated mfection, with the production
of typical lesions in the skin and in the viscera, can be accomplished
by the instillation of a suitable inoculum on the nasal membrane.
These findings may be of significance as indicators of the mode of
invasion of human leprosy in man and of its pathogenesis.
The correlation between human pellagra and blacktongue (canine
pellagra) having been worked out thoroughly enough to obtain sufficiently reliable results in the study of the pellagra-preventive value
of foods from experiments with dogs, the studies at the Milledgeville
State Hospital, Milledgeville, Ga., were discontinued. Considera.ble
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PUBLIC HEALTH SERVICE
attention is being given to the development of a satisfa.ctory rat
method for testing pellagra-preventive activity.
The production of cataracts in rats by deficient diets is being investigated in order to determine whether this condition is due to a
deficiency in vitamin G, the present accepted hypothesis.
A total of 32 cases of psittacosis, with 11 deaths, was reported during
the year. A rather extensive epidemic occurred in a Pittsburgh department store during this period. It is now apparent that psittacosis can be controlled by adequate control of breeding and the
commercial handling of psittacine birds.
Construction work on the new laboratory building for the study
of Rocky Mountain spotted fever and related diseases has been completed except for mechanical installations. Plans are in progress
for the building of officers' and attendants' quarters, a garage, and
general storage space.
Two hundred and twelve liters of Rockv Mountain spotted fever
vaccine were manufactured for the 1934 season, and of this amount
approximately 80 percent was suitable for use. In addition, 40.8
liters were manufactured for the Civilian Conservation Corps for
administration to the personnel located in those camps where the
danger of infection is greatest or the disease most fatal. The demand
for the vaccine continues to increa.i;e and exceed the supply so that
it has been necessary to refuse many requests. The greatest demand
comes from Montana, Oregon, Wyoming, and Idaho, although considerable amounts are sent to other Rocky Mountain States.
The continued occurrence of cases of spotted fever of high case
fatality rate in various parts of northern Idaho and new points in
western Montana have furnished further evidence of a tremendous
extension of the known regional area in which the highly fatal type
of infection is endemic.
The data collected in the study of hearing of school children are
being analyzed with reference to the incidence and degree of hearing
defects as well as the causative factors and the progress of hearing
loss which might furnish a basis for determining preventive measures
in relation to loss of hearing.
Other studies being undertaken in connection with investigations of
child hygiene include physical status, growth, development, and child
health, development in relation to the economic crisis, and dental
caries.
The dental health survey undertaken in cooperation with the
American Dental Association included a survey of existing facilities
in State departments and institutions and a survey to determine the
dental needs of children of school age.
Studies were made of processes of manufacture, with special reference
to the skin hazards involved, in 27 plants employing 19,483 workers.
About 8,000 workers were examined for the occurrence of occupational
skin diseases, and the sickness records of these plants were examined
in order to determine the frequency of skin diseases and their causes.
A series of injections of dusts of known chemical composition have
been made intraperitoneally into guinea pigs to determine the
physiological response. The investigation has shown that the
response is uniform and constant for a single dust, but different for
each of three groups of dusts, and sufficiently differentiated to afford
a means of classifying them from the standpoint of biological reaction.
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Other dust studies have included health of anthracite coal miners,
silicosis among granite quarriers, pulmonary infection in pneumoconioses, effect of inhaled marble dust as observed in Vermont
marble finishers, and a study of talc workers.
The study of atmospheric pollution in 14 American cities made to
determine the average conditions and various fundamental relations
which might prove of importance in programs for smoke abatement
has been completed and a report of this study is in progress.
Research activities in connection with milk investigation,; have
included laboratory studies on the chlorine and thermal resistance of
the B. coli communior test organism, the bactericidal treatment of
milk coolers, design of air- and foam-heating equipment, and the
washin~ and bactericidal treatment of milk cans and milk bottles.
Studies to determine the basic needs of the people in matters pertaining to public health practices in county health departments are
being continued. The information thus gained will be of value in
planning future rural health organizations. Three counties now being
studied contain large towns or are adjacent to cities; thus it will be
pos-3ible to determine the influence of medical facilities found in urban
centers on the health of the people in adjoining areas.
The analysis of the data collected on sickness and mortality among
families of the unemployed was continued. Fourteen reports on
various phases of this subject have been published. Statistical
studies also included work on influenza and other respiratory diseases
and the analysis of a mass of records on sickness and medical care
obtained by special surveys of families in 19 States with a total of some
80,000 person-years of life.
The efficiency of the activated sludge method of sewage purification
is being studied in an endeavor to determine factors which disturb the
optimum biological balance, and which, if they could be controlled,
would insure the uniform efficiency of this process. In connection
with studies of stream oxidation an extensive series of measurements
of the rates of atmospheric reaeration in streams of deaerated water
flowing in expeiimental channels has been completed during the year
in preparation for further observations of the rates of oxidation of
sewage sludge deposits under stream flow conditions.
Studies of typhus-Rocky Mountain spotted fever are being conducted to determine any changes which rr:ight arise from residence of
the viruses in various species of arthropods. Four species of native
rodents have been fou'nd to be susceptible to the virus of typhus.
In connection with the work on the etiology of epidemic encephalitis
a virus has been isolated at the National Institute of Health which is
distinct in its animal ,;ymptomatology, pathology, and immunology
from the six viruses which were isolated from fatal cases of the disease
occurring during the St. Louis epidemic.
A comparative study of straina of hemolytic streptococci is in
progress, directed particularly toward finding characteristics by which
human infections derived from animal sources may be traced to their
origin.
Investigations of relapsing fever have demonstrated the survival of
virulent infection for 2½ years in naturally infected adult ticks of the
spooi,es Ornith<>d-Orus turicata. .
An outbreak of amoebic dysentery which originated in Chicago in
the summer o,f 1933 haa been studied both from an epidemiological
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and a laboratory viewpoint. Investigations of this disease are still in
progress.
The histologic-diagnostic service to marine hospitals and other
agencies has been continued, over 1,500 specimens being examined
and reported upon.
Special studies on prophylactic and therapeutic agents have included
standardization of gas gangrene antitoxins and studies of hemolytic
streptococcus, meningococcus, alum precipitate antigens, staphylococcus, and the therapeutic activity of neoarsphenamine in experimental
syphilis in rabbits.
On the basis of animal experiments, a chemical method was discovered for the treatment of bichloride poisoning in human cases.
The study of the chemical structure of sugars has been continued.
As a result of the isolation of the four-carbon sugar threoae as a crystalline triacetate, it is now possible to study practical application,;; o,r this
sugar in biological and medical investigations. The basic problem of
carbohydrate nutrition is being advanced by these studies and is
opening the way for a rational understanding of this nutrition and its
derangements.
THE MARINE HOSPITALS AND OTHER RELIEF STATIONS
Hospital and out-patient care was furnished to American seamen
and other legal beneficiaries in 154 ports, 305,155 accredited persons applying for treatment and other medical service. The Coast
Guard, for whose personnel of 10,401 the Public Health Service has
sole medical responsibility, was served at the regular relief stations
and 102 other placesj 15 medical and dental officers were also assigned
to Coast Guard ships and shore stations. The usual assistance was
rendered the Employees' Compensation Commission in treating
injured Federal employees, to the Civil Service Cominission in
examining applicants and employees, and to other Government
agencies that utilize the Public Health Se1vice facilities. There
were 599 more patients of all classes in hospitals on June 30, 1934,
than on June 30, 1933; the total on June 30, 1934, was 4,531.
On April 3, 1934, amendments to the regulations were approved,
liberalizing the conditions governing the admission of seamen to the
effect that intervals in excess of 60 days, because of econoinic conditions resulting in inability to ship, or where the seaman has been
receiving treatment at his own expense and has not changed his
occupation, shail not bar him from relief. Office treatment was also
authorized at first-, second-, and third-class relief stations for the
families of officers and enlisted men of the Coast Guard.
The Veterans' Administration has increased its patients in marine
hospitals from 37 on June 30, 1933, to 99 on June 30, 1934, and has
requested and received an allocation of 200 beds in marine hospitals
for the ensuing year. During the year certain injured employees
from the Civil Works Administration were added to the list of Public
Health Service beneficiaries; 24,649 received out-patient and hospital
care. Two thousand eight hundred and ninety-six patients from the
Civilian Conservation Corps were hospitalized during the year.
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PREVENTION AND CONTROL OF -VENEREAL DISEASES
Activities directed toward the control of venereal diseases were
conducted in cooperation with the State and local health departments. Forty-seven States submit reports as to the _prevalence of
venereal diseases. A total of 385,953 cases of syphilis, gonorrhea,
and chancroid was reported, showing a slight decrease from the
preceding year. These reports are made to the State departments
of health by physicians in private practice and by institutions and
clinics. State health officers have been enlisted in a campai~n to
urge more complete reporting on the part of the physicians administering treatment. An educational campaign to interest the general
practitioner in the need of adequate treatment for patients with
syphilis and gonorrhea has also been undertaken.
In two States control activities were directed by Public Health
Service officers. The North Carolina State Department of Health
appointed 33 physicians as cooperatin~ clinicians and supplied them
with free drugs for the treatment of mdigents carried on the relief
rolls of the State and others who were, in the opinion of local relief
officers, unable to pay for treatment. Special work was also carried
out in Tennessee, work with industries of the State being of particular
interest.
The clinic at Hot Springs, Ark., which is maintained by the Public
Health Service, has cared for a greater number of patients than ever
before, due to the many homeless transients who have poured into
Hot Sprin~ during the year. In the fiscal year 6,682 applicants
were exammed and treated.
For the past several years the Public Health Service and five of
the leading syphilis clinics of the United States have cooperated to
study the effects of the modern treatment of syphilis. This undertaking is part of an international investigation of the clinical aspects,
diagnosis, and treatment of syphilis which is sponsored by the Health
Organization of the League of Nations. During the year an important phase of the study was completed and a standard treatment
procedure for early syphilis published.
Information to syphilologists, general practitioners, health officers, and others interested in the many phases of venereal-disease
control has been furnished through the monthly publication "Venereal
Disease Information", pamphlets, exhibits, and films. Requests for
references or bibliographies on special subjects were furnished from
the files of "Venereal Disease Information." Physicians and health
officers avail themselves of this service to a greater extent each year.
NARCOTIC FARMS AND MEDICAL AND PSYCHIATRIC CARE OF FEDERAL
PRISONERS
In general, the work in connection with mental hygiene activities
has embraced studies of the nature and treatment of drug addiction
and _dissemination of ~formation up~n th~ subject; stu~e~ of the
abusive uses of narcotic drugs; adi:nuustrative functions mcident to
the establishment of narcotic farms; supervising and furnishing the
medical and psychiatric services for the Federal penal and correctional system; and cooperating with other agencies interested in
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the various phases of mental-hygiene work with which the Service
is concerned.
Progress has been made in the construction of the first United
States Narcotic Farm, Lexington, Ky., and it is anticipated that it
will be completed and ready to receive admissions by April 1935.
Funds were made available through the Public Works program for
beginning construction of the second institution at Fort Worth, Tex.
Two additional medical units were established during the year in
connection with the Federal penal and correctional system, one at
the United States Penitentiary, Alcatraz Island, Calif., and one at
the Federal Prison Camp, Tucson, Ariz.
COOPERATION WITH OTHER AGENCIES
Durin~ 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 econoxnical and efficient adxninistration.
By means of this cooperation, similar or related activities are coordinated and the duplication of effort is avoided. The cooperative
activities during the fiscal year have been, in general, similar to those
of the preceding 6 or 7 years.
The Public Health Service desires to acknowledge assistance received from the following agencies:
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; 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; Harvard University Medical School for laboratory space for field investigations of cancer; Roscoe B. Jackson
Memorial Laboratory, Bar Harbor, Maine, and New York University
Department of Biology in cancer research; Milledgeville State
Hospital, Milledgeville, Ga., in conduct of pellagra studies; Tennessee
Academy of Science for quarters for studies of mosquito control;
Health Department of Pasadena, Calif., for laboratory space for field
investigations of psittacosis; State Hospital, Columbia, S. C., for
laboratory space for studies of malarial inoculation in paresis therapy;
Bureau of the Census for tabulation of material collected in the
dental health survey.
Other cooperative activities included: Go~as Memorial Institute
in malaria-control studies; Johns Hopkins Umversity, department of
biostatistics, in connection with studies of physical status, growth, and
development of school children; Milbank Memorial Fund in a study
of health in the depression; American Dental Association in a dental
health survey.
RECOMMENDATIONS
It has long been a recognized axiom that upon the health of a nation
depends its success. Recommendations as to measures and means of
maintaining and improving the- public-health. are.necessary from time
to time.
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PUBLIC HEALTH SERVICE
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New problems in the field of public health constantly present themselves. As recent examples may be mentioned the outbreak of
epidemic encephalitis in St. Louis in 1933 and the increased prevalence
of this disease in several adjacent States during the following year;
the unusual occurrence of amoebic dysentery with Chicago as the
source; the outbreak of poliomyelitis in the Los Angeles area this
year. Constant vigilance is required for the detection and prevention
of new dangers to the public health that constantly arise. The
recommendations submitted herewith constitute the more important
needs at the present time.
SCIENTIFIC RESEARCH
With the opening of distilleries in the United States the necessity
for making studies of the control of distillery wastes which are being
emptied into already heavily overtaxed and polluted streams has become apparent. There are several problems con_nected with the disposal of these wastes that very seriously affect the water supplies of
this country, and should be carefully studied.
An investigation should be made to determine methods for the elimjnation of :fluorine from drinking water supplies. Fluorine has been
found to be present in drinking waters locat(,ld in nearly every State
in the Union and is responsible for the dental condition known as
mottled enamel.
With the completion of the anthracite coal dust study-, which for
the first time gives definite facts with regard to anthro-sil1cosis among
hard coal miners and which .forms the basis of compensation laws for
that condition, it is evident that a similar study should be made in
the bituminous field.
STATE AND LOCAL HEALTH WORK
It is desired to point out again that 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, as a part of the national defense against
disease, enter into cooperation with States for the support of local
health organiza:tions on a more substantial basis than in the past.
MARITIME QUARANTINE
It is recommended that the quarantine regulations of the Government of the Panama Canal Zone be made entirely uniform with the
quarantine laws and re~ulations of the United States administered by
the Public Health Service in all other United States ports in order to
remove a factor complicating the proper observation of ihe latter bv
shipping and to conform to the requirements of the Pan American
Sanitary Code of Ha.bans., 1924, and the International Sanitary Ccr.-
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PUBLIC HEALTH SERVICE
vention of Paris, revised 1926, both of which tree.ties have been ratified
by the United States.
It is recommended that the Convention for the Sanitary Control of
Aerial Navigation of The Hague, 1933, which was signed on behalf of
the United States on April 6, 1934, be ratified by the United States at
the earliest practicable date.
VENEREAL DISEASE PROBLEM
For the past several years activities of the Service in the control
of venereal diseases have been curtailed on account of diininishing
appropriations. Work within the States is limited on this account;
and smce cooperation with local health organizations is especially
desirable, the restoration of a. more adequate appropriation is
recommended.
MARINE HOSPITALS
Appropriations should be restored in amounts that will permit
manne hospitals and relief stations to continue to render adequate
professional service to legal beneficiaries. New hospitals should be
erected at St. Louis, Mo., and Miami, Fla.. The hospital at Fort
Stanton, N. Mex., should be thoroughly repaired.
PERSONNEL
Increasing difficulty in conducting its work is experienced by the
Public Health Service on account of the inadequate number of comInissioned officers available for assignment to duty as req_uired. The
past year has been the occasion of many unusual and exactmg demands
upon the Service. Various matters have arisen in connection with the
regular work of the Service as well as with the emergency activities of
the Government which have required the assignment of experienced
officers who, in many cases, had to be detached from therr regular
duties and assigned to meet the emergencies. In many cases this
left the regular duties to be inadequately conducted by untrained
personnel. It is essential for the proper conduct of the work of the
Public Health Service that an increase be made in the number of
cominissioned officers. It would appear most desirable that a definite
number of additions to the career corps be made each year.
H. S. Cm.1M1No,
Surgeon General.
Hon.
HENRY MoRGENTHAu, Jr.,
Secretary of the Treasury.
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DIVISION OF SCIENTIFIC RESEARCH
Asst. Surg. Gen. L. R.
•
THOMPSON
in charge
CANCER
Field investigations of cancer have been continued under Medical
Director J. W. Schereschewsky wit,h headquarters at the Harvard
MedicallSchool, Boston, Mass.
STUDIES OF THE BIOLOGICAL EFFECTS OF RADIATION
Biological action of X-rays-Absorption coefficient of Xenon.-By
means of the measured absorption coefficient of Xenon, a calculation
was made of the intensity of homogenous beams of X-rays reflected
from the calcite crystal. The result showed that the available
intensity with this apparatus would be insufficient for biological
experiments.
Mitogenetic radiation.-A preliminary report on this work was
published in the Public Health Reports for October 27, 1933.
A detailed paper entitled "Search for Mitogenetic Radiation by
Means of the Photoelectric Method" was prepared for publication
in the July (1934) number of the Journal of Geoeral Physiology.
Data have been assembled also for another paper on the mode of
action of countertubes.
Spectroscopic study of carcinogenic substances.-The primary aim
of this investigation is to determine whether carcinogenic substances
like dibenzanthracene play a part, e. g., as metabolites in the genesis
of tumors generally.
Preliminary tests with dibenzarithracene in various solvents have
already shown that this substance is detectable l>y spectrographic
methods when present in amounts of 1 part per million.
Since dibenzanthracene is fat-soluble, attention has been directed
to the lipoid extracts of normal and malignant tissues.
This work is still in progress.
Electromagnetic radiation.-A paper on The Heating of Animal
Tissues by High Frequency Fields (6.4Xl0 7 to 3Xl0 8 cycles per
second) appeared in the Public Health Reports for July 21, 1933.
The suggestion was made that the range of frequency in question
(about 6 X 107 cycles per second) might be more useful as an auxiliary
in the treatment of local inflammatory processes in the lung, such as
pneumonia, than diathermy with conventional ap:paratus, because of
the better heating characteristic for pulmonary tissue.
In the case of guinea pigs it was found that when the thorax of these
animals was placed in a condenser field excited at frequencies of
from 70,000,000 to 80,000,000 cycles per second, when the rectal
temperature of the animal was 39.6° C., the pulmonary temperature,
as indicated by a thermocouple, inserted into the nght lung, was
42.1° C.
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In this connection an attempt was made to determine the fre9.uency
at which pneumococcus would be subject to selective heatmg by
means of the determination of the conductivity and the approximate
dielectric constant of this organism. The conductivit;v- of wet organisms, as determined on a Grinnel-Jones conductivity bridge,
proved unexpectedly high, corresponding to that of an N /35 KCI
solution.
In view of the high conductivity, any accurate determination of
the dielectric constant of the organism was impracticable with the
apparatus at hand, but a rou~h test showed that the dielectric constant of moist pneumococcus is less than that of water and probably
somewhere between 60 and 70. A trial was made of the respective
survival times of a culture of pneumococcus in serum water heated to
50° C. in a condenser field excited at this range of frequencies and a
similar culture immersed in a water bath at the same temperature.
The results were inconclusive, as the difference in the times of survival of both cultures was too small to be significant.
STUDIES OF RESISTANCE AND SUSCEPTIBILITY TO MALIGNANT GROWTHS
Gross-immunity studies.-The result of the observations which
showed that immunity induced in mice against one type of transplantable tumor would also induce immunity against other types of
such tumors were summarized and a paper was prepared and published
in the Public Health Reports of December 8, 1933.
Immunization of pure-strain mice against transplantable tumors.,The results of these experiments were prepared for publication and
appeared in the Public Health Reports for January 12, 1934.
E.ffects of immunity to a transplantable tumor upon resistance to spontaneous tumor.-An interesting point to determine was whether
mice immunized in the usual fashion against a transplantable tumor,
such as S 37, would present the resistance against implants of spontaneous tumor originating in their own stock which they show against
other stock transplantable carcinomas, such as M 63, 206, and A.
An experiment was undertaken with this end in view. Although the
mice were shown by repeated inoculations to be resistant to the transplantable tumor, nevertheless, the spontaneous tumor implant grew
m all the immune mice, as well as in the controls.
Production of dibenzanthracene tumors in pure-strain mice.-Burrows, Reiger, and Kennawav have shown that· the compound 1:2:5:6dibenzanthracene dissolved in lard and injected subcutaneously is
capable of producing sarcomas in mice. In their experiments, tumors
were induced in 31 out of 93 mice. Seven primary growths were used
for serial transmission, of which two were carried at least as far as
the 12th and 16th generations, respectively. Because of certain
inconsistencies in their transmission experiments, and because no
particular strain of mice is mentioned, the assumption seems justified
that these experiments were not performed with pure strains of mice.
Therefore, it appeared pertinent to ascertain first whether this compound will induce tumors to the same extent in pure-strain mice
having a low incidence of spontaneous tumors as in those in which the;
incidence of such tumors is high, and second, whether these tumors,
induced in pure stocks, would follow the rule of the genetic theory
of transplantation, namely, that a spontaneous tumor arising in an
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PUBLIC HEALTH SERVICE
individual of a particular strain can be transplanted to members of
the same strain, but not to those of other strains.
The results of the transplantation experiment were prepared for
publication and appeared in the Public Health Reports of May 25,
1934.
The second experiment of this kind, involving approximately 1,000
mice, was undertaken later in the year. The reasons for undertaking
this experiment were as follows: First, to determine whether 1, 2, or
3 injections give a higher tumor yield; second, to study the relative
susceptibility of different strains of mice; and third, to investigate the
effect of combining an irritant, such as kaolin, with the lard and
dibenzanthracene.
This experiment is still in progress.
Effect of trypan blue upon resistance to hete-rologous tumor strains.Dunng tli.e year ex_penments were carried out in pure-strain mice to
determine whether mjections of trypan blue would affect the normal
resistance of such mice to the transplantation of fragments of spontaneous tumors arising in heterologous strains. Positive takes and
pr_ogressive growth were evident in about 40 percent of the treated
nnce.
Cooperation with the Roscoe B. Jackson Memorial Laboratory .-These
studies are concerned with the variation m resistance to transplantable
tumors, and the production of concomitant immunity in various
strains of mice. Information as to the genetic characteristics of cells
from different strains of mice is being obtained by transplantation of
normal tissue grafts, derived from one strain of mouse, subcutaneously
into mice of other strains and then studying microscopically the fate
of the implant.
BIOCHEMICAL STUDIES
During the fiscal year, work was pursued along three major lines:
(a) Investigation of the physicochemical behavior of tumor and of
normal cells; (b) chemo-theraeeutic experiments on tumor-bearing
animals; and (c) studies with d1benzanthracene.
The voluminous literature bearing upon the chemistry of cancer
cells was critically reviewed and brought together in a paper which
appeared in the August (1933) number of the American Journal of
Cancer.
.
Effect of calcium upon t1tmor growth.-The results of this investigation appeared in the Public Health Reports for September 8, 1933.
Osmotic behavior of tumor cells in vitro.-The results of this study
were reported in a paper entitled "Volume Changes of Tumor Cells
in Vitro" which appeared in the Public Health Reports of February
16, 1934.
Animal experiments on fluid exchange.-In the animal expenments,
tumor-bearing mice were variously treated in attempts to disturb
fluid exchange in the living animal and thus possibly to influence
tumor growth. Deprivation of water, diuretics, bleeding, capillary
injury, lipoid solvents, fibrin, anticoagulants, high protein diets,
and injections of protein, serum, and other colloids were the measures
employed.
Althou~h some of these procedures seemed to give promising results
at first tnal, repetition of the experiments failed consistently to confirm initial observations.
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CYTOLOGICAL STUDIES
Cytological studies have included tissue culture work, liquefaction
of culture media by malignant cells, and the effect of liquefied medium
on cells and commensal bacteria.
EPIDEMIC ENCEPHALITIS
Late in July 1933 there appeared in the suburban area of St. Louis
Mo., a type of encephalitis which had not before made its appearance
in the United States in serious epidemic form. The number of cases
rapidly increased during the summer months to reach a peak in the
late summer, and decreased gradually to cool weather. The seasonal
incidence of this disease was strikingly similar to that of poliomyelitis,
as was also its tendency to increased incidence in the less densely
populated portions of the metropolitan district. The age most
affected was distinctly different from poliomyelitis, older :r.eople
being more frequently and severely attacked. Outbreaks similar to
that in St. Louis, but less extensive, occurred also in Independence,
Kansas City, and St. Joseph, Mo., and in Louisville, Ky.
An epidemiological study was conducted by Service officers under
the direction of Senior Surg. J. P. Leake. Early in the epidemic,
because of their unusual prevalence in the St. Loms area, mosquitoes
were considered possible vectors, and extensive studies were conducted
upon laboratory animals and man relative to this question. Ex:periments with various species present in the epidemic area were entirely
negative.
A total of approximately 1,100 cases was reported during the
epidemic, with a general mortality of about 20 percent, which was
much higher in the older age groups. This type of encephalitis differs
from the older, better recognized disease principally in that there was
practically a complete absence of eye signs; and recovery, when it
occurred, was complete and not followed by sequelae. The onset of
symptoms was sudden and did not follow other infections.
HEART DISEASE
Investigations of heart disease have been continued under the
direction of Medical Director A. M. Stimson.
Experiments were conducted as suggested by Rinehart and Mettier,
to ascertain whether subclinicai scurvy is a contributory factor in the
etiology of rheumatic carditis. Following the technique employed
by these workers, guinea pigs were rendered scorbutic by maintaining
them on an appropriate diet, and then inoculated intracutaneously
with hemolytic streptococci obtained from spontaneous lymphadenitis of guinea pigs. Cardiac lesions somewhat comparable to
Aschoff bodies, the most typical lesion of rheumatic carditis found
in man, were obtained.
Other guinea pigs were rendered scorbutic and inoculated intracardially with hemolytic streptococcal toxin from the N. Y.-5 strain
of scarlatina! streptococci. Similar lesions were again obtained
among the scorbutic animals so treated, but not among controls.
Expenments in which animals have been subjected to other forms of
avitaminoses and in which other strains of streptococci and streptococcal products have been used have thus far given negative results.
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While it cannot be stated that scurvy is a factor predisposing to
rheumatic infection, it is felt that encouraging results have been
obtained by the production of rheumatic-like lesions in guinea pigs.
A survey of cardiac deaths occurring in Washington, D. C., has
been conducted to determine the accuracy with which heart disease
is certified as the cause of death and the extent to which deaths actually
due to heart disease are tabulated as such. As a result of this study
it is estimated that about 25 percent of deaths reported and tabulated
as being due to heart disease are really due to other conditions. On
the other hand, of the actual deaths due to heart disease only about
60 percent are so tabulated. Many deaths due to heart disease,
especially those due to cardiovascular syphilis, congenital. malformations, diseases of the thyroid gland, arterial hypertension, and acute
and subacute rheumatic carditis are listed for purposes of vital statistics under other categories. The suggestion is made that deaths due
to heart disease be reported and classified on an etiological basis.
LEPROSY
The studies of leprosy at the Leprosy Investigation Station,
Honolulu, and the care and treatment of patients in the adjoining
Territorial receiving station have been contmued under the direction
of Senior Surg. N. E. Wayson.
Clinical studies.-Studies have been continued for the purpose of
learning the early manifestations of leprosy. It has been concluded
from detailed and critical examination of a group of children of
le_prous parents over a period of several years that one may detect
mmor but definite clinical evidence of pathological changes in the
peripheral nerves and in the blood capillary system well in advance
of confirmatory clinical and microscopical manifestations of leprosy.
It has also been observed that both recession or arrest of suggestive
neurological changes may occur without the development of the findings accepted as characteristic of the disease. This observation is a
further contribution to the belief that individuals may be infected
with leprosy without developing the disease.
Comparisons have been made of the course of the disease through
several years in patients who are affected with both leprosy and
tuberculosis. During these observations it has been found that acute
exacerbations of leprosy with eruptions occur very much more
frequently among patients with tuberculosis, and on the other hand
a very high percentage of those patients who show some findings
suggestive of tuberculosis develop acute leprous exacerbations within a
given period.
.
For the past 9 months a series of from 25 to 40 patients have been
treated by injecting the esters of cotton-seed oil intradermally. No
significant difference in the benefits to be obtained by this method of
treatment has been noted as opposed to that in which the esters of
chaulmoogra oil were used. There seems to be a definite correlation
between the severity of the local reaction and the rapidity and degree
of healing of the lesions treated. There was significantly less local
reaction to the injections of esters to which iodine had been pre. viously added. The treatment of a small series of patients by intradermal injections of nonspecific bacterial antigens is in progress; and
among a group of patients affected with nodular leprosy, there have
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PUBLIC HEALTH SERVICE
been some who showed unusually rapid improvement following
re~ated intramuscular injections with bismuth preparations.
The remarkable results reported of the treatment of lupus vulgaris
by a dietary which was very low in mineral salts and especially low
in sodium chloride led to a trial of this form of dietary in leprosy.
However, there were so few patients who were willing to cooperate
in this treatment over a long period that conclusions as to its value
are not warranted.
Experimental investigations.-It has been previously determined in
this laboratory that the infection of the neighboring lymph glands
may• be produced in rat leprosy by the instillation of a suitable
inoculum on the nasal membrane. During the pa.st year it has been
demonstrated that a generally disseminated infection, with the production of typical lesions in the skin and in the viscera, can be secured
by this method.. It has also been found that the injection of material
from the lesions of rat leprosy into the tissues of the face about the
nose of the animal is followed by a generalized dissemination of
lesions in a large percentage of cases, woile such injections into other
superficial tissues rarely produce this condition within a comparable
period. However, it has been established during the year by a
number of experiments that inoculations at any site result subsequently in a bacteremia, though even microscopic lesions may not
be clearly demonstrable at the time of examination. Experimental
evidence has also been obtained which shows that a local alteration
in the tissues favors the development of lepromata at the site. The
nature of the precipitating alterations has not been determined, but
may be as shght as the apparently moderate circulatory changes
induced by the subcutaneous injection of sterile starch.
These findings in rat leprosy may be of important significance as
indicators of the mode of invasion of human leprosy in man and of
its pathogenesis.
Investigations of the effects of crowding, of high humidity, and of
vitamin deficiency of dietary on the development of rat leprosy are
being continued. A number of experiments have indicated that
these factors play some role, either singly or collectively, in the
rapidity or degree of the extension of the disease.
Efforts to cultivate the organisms of human and of rat leprosy
were made through the use of embryonic tissues and extracts, Lowenstein's media, Long's synthetic media, Corper's blood media, and
collodion sacs in the peritoneal cavities of rats. Findings suggestive
of growth occur occasionally in such media, but conclusive evidence
of successful cultivation has not been obtained.
In consequence of a report of the efficacy of the intravascular
administration of solutions of trypan blue in the treatment of human
leprosy, a series of rats infected with rat leprosy were similarly
injected. No beneficial results were observed. This observation is
similar to that previously made in this laboratory after the use of
eosin in this manner.
The cultivation of the tubercle bacillus from materials which are
contaminated with other organisms has been facilitated by exposing
the material to the action of dilute sulphuric acid. Experiments
have shown that the exposure of tissues of rat leprosy to this chemical,
or the drying of the material at a temperature of 0° to 0.4 ° C. does
not prevent the development of typical lesions in animals subsequently
inoculated with the treated material.
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MALARIA
Investigations of malaria continued under the direction of Surg.
L. L. Williams, Jr.
Atabrine studies.-Sanitary Engineer W. H. W. Komp, in cooperation with the Panama Department of Health and the Gorgas Memorial Laboratory, last year began a study to determine whether
atabrine alone would control the malaria rate in the Panamanian
population. The findings confirm the conclusion that atabrine alone,
though controlling the clinical attack of malaria, does not materially
affect the infection rate.
Following these observations a combination of drugs was tried,
namely, plasmochin (which reduces the viability of the gameocyte)
combined v.ith either atabrine or quinine. One town was left' untreated as a control, the population voluntarily using a certain amount
of quinine; another town under voluntary quinine was given plasmochin in addition; and four other river villages already under
atabrine treatment received plasmochin in addition. Where plasmochin was added to existing atabrine treatment, the plasmochin
was given over a 7-day period commencing after the completion of
the 5-day atabrine treatment. It was observed that plasmochin,
although somewhat toxic alone, was rendered much more toxic when
given with atabrine.
The results have been very encouraging. However, the study will
be continued for two purposes: (1) To determine whether the beneficial results will continue, and (2) to determine, under conditions of
comparative freedom from malaria parasites, whether the population will so lose its tolerance to the infection as to allow the occurrence
of an epidemic with severe cases.
A study of the supposed long-range flight (12 to 15 Iniles) of Anopheles albimanus from Gatun Lake to the sanitated area has been
commenced. These observations, and those of others (reported by
Curry) show an unexplained heavy influx of albimanus into the samtated area approximately 2 weeks before commencement of the rains.
At this time there are no known albimanus-producing areas closer
than Gatun Lake. This study shows that Gatun Lake has a heavy
growth of giant alga, Ohara, which normally never reaches the surface of the water, being anchored on the bottom in shallow water.
During the last few years when the waters from Gatun Lake have
been used in greater quantity for the canal, the drawdown has
allowed thousands of acres of Ohara to be slightly exposed. This
provides ideal breeding grounds for Anopheles.
Catching stations and traps have been placed throughout the area
of sanitation and nt rather regular intervals between there and Gatun
Lake.
The start of the flight of Anopheles from Gatun commenced on April
14, 1934, was heavy by the 23d, and reached its peak on May 2;
but it does not as yet appear that the influx into the area under
sanitation is from Gatun.
Rural malaria-control studies.-These studies were begun in two
counties in central western Florida, where accurate blood indexes
were taken in Citrus, Dixie, and Levy Counties. A siinilar study
was begun in Virginia. Before these activities were well under way
they ~ere stopped by the Civil Works Administration emergency
malana-control program.
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Researches in malaria therapy of paresis.-Special Expert Bruce
Mayne, in Columbia, S. C., continued his excellent work at the
laboratory established at the Columbia State Hospital. The hospital
authorities have built an insectory where Anopheles have been propagated throughout the winter. This work was suspElnded for the
period of the encephalitis epidemic in St. Louis. However, studies in
connection with retaining the viability of sporozoites after dissection
of infected mosquitoes have been continued. With specially prepared
culture medium and with low temperatures it has been possible to
maintain relatively low bacterial infection with viable sporozoites for
varying periods, the longest of which is 21 days outside of the mosquito. This culture was clean enough for intravenous injection and
produced infection with tertian malaria.
Memphis office activities.-During the summer of 1933 arrangements
were made with the Tennessee Academy of Sciences whereby the use
of the society's biological station at Reelfoot Lake for the studies of
Anopheles' habits was secured. An experimental house was built for
the study of the behavior of Anopheles. This study will be continued
during the coming year.
Studies are also being made of the effectiveness of mechanical
traps· for Anopheles and of sound and li~ht attractivity. These
studies were not completed and will be contmued.
An investigation of the color preference of Anopheles for day-time
resting places was made. Data on over 12,000 Anopheles were accumulated from widely scattered sections of the South and West. A
report of this work shows that, contrary to the observed habits of
foreign Anopheles, those of the United States do not seem to exhibit
any marked preference for any particular color as day-time resting
places.
A report has also been made on the study of the electrical charges
developed on dust when they are blown from a blower for larvicidal
purposes. Heavy electrical charges developed on dust when blown
and the polarity of these charges seem to explain some of the peculiar
phenomena noted in the behavior of paris green dust clouds.
During the winter months a study was made of the correlation
between high temperature, humidity, and the length of life of 01!1,ex
and Aedes mosquitoes.
These studies were made of mosquitoes reared in captivity. Aedes
aegypti showed a very marked ability to withstand high temperatures
compared to Oulex.
Microscopic examinations.-Microscopic examinations have been
made of 11,516 blood specimens from Alabama, Florida, Georgia,
Mississippi, Pennsylvania, and Tennessee. These gave an average
of 12 percent positive.
Commencing in March 1934, a blood index was taken over a large
part of the malaria belt as a Civil Works Administration activity.
In this index more than 150,000 blood specimens were taken, approximately 131,000 of which were forwarded to our laboratory and
stained. Twenty-five thousand of these slides have been examined
to date.
•
NUTRITION
Following the retirement of Surg. G. A. Wheeler on Se:ptember 1,
1933, the nutrition studies were continued under the direction of
Passed Asst. Surg. W. H. Sebrell.
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It was felt that the correlation between blacktongue (canine
pellagra) and human pellagra had been worked out thoroughly enough
for sufficiently reliable results on the study of the pellagra preventive
value of foods to be obtained from experiments with dogs. Therefore,
the studies at the Milledgeville State Hospital, Milledgeville, Ga.,
were discontinued on March 1, 1934.
The final tests conducted at Milledgeville were on the pellagrapreventive value of green onions, lettuce, pork shoulder, and peanut
meal. The results of these tests were published in the Public Health
Reports for June 22, 1934.
The pellagra-preventive value of 15 foodstuffs studied in the dog,
the study of the pathology of blacktongue, the report of the condition
in dogs which has been called "yellow liver", due to a deficient diet,
and a study of the pathology of the condition were published in
National Institute of Health Bulletin 162.
A table showing the pellagra-preventive value of all the foods which
have been studied up to the present time was compiled and published
in the Public Health Reports for June 29, 1934.
During the year ~ests of the blacktongue-preventive value of
cottonseed meal, rabbit meat, and lean smoked pork were completed.
The results indicated that the rabbit meat and lean smoked pork are
good sources of the pellagra-preventive factor, while cottonseed meal
1s a poor source of the factor. Tests of canned beets, evaporated
peaches, lima beans, and two liver concentrates are in progress at the
close of the fiscal year.
Further studies were carried out on the changes in the teeth of
experimental animals produced by sodium fluoride in the drinking
water. It was found that 150 parts per million of sodium fluoride
in the drinking water of young dogs produced dental hypoplasia but
no mottling of the teeth. Gross changes were produced in the teeth
of rats with as little as 25 parts per million of sodium fluoride. It
was found that neither an increase in calcium in the diet nor an excess
of iron in the water had any effect on the changes in the teeth, and that
500 parts per million of sodium fluoride in the drinking water exerts
an appreciably more toxic effect than the same amount in the diet.
Considerable attention was given to developing a satiofactory
rat method for testing pellagra-preventive activity. Several extracts
were prepared from yeast and tested by the rat method, but confirmaatory tests in the dog are necesoary before final evaluation of their
pellagra-preventive potency.
The production of cataracts in rats by deficient diets was investigated in order to determine whether this condition is actually due to a
deficiency m vitamin G, the present accepted hypothesis, and also in
order to determine the effect of various substances on the prevention
and treatment of cataracts. These studies are in progress at the close
of the fiscdl year.
Ps1TTAcos1s
Psittacosis investigations continued under the general supervision
of Senior Surg. H. E. Hasseltine, with Passed Asst. Surg. V. M.
Hoge in immediate charge.
The incidence and mortality of psittacosis in the United States
proved to be greater for the fiscal year ending June 30, 1934, than for
the preceding year, a total of 32 cases with 11 deaths having been
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PUBLIC HEALTH SERVICE
reported. This increase, however, was caused by a rather extensive
epidemic in a. Pittsburgh department store, in which 25 cases, or suspected cases, and 10 deaths occurred, and not by a generalized spread
of the disease.
Prior to March 1, 1934, 52 California. aviaries had been found by
the State or United ~tates Public Health Service laboratories to be
infected with psittacosis.
It is now apparent that psittacosis can be controlled by adequate
control of breeding and commercial handling of psittacine birds, and
that existing regulations and procedures now being enforced are
adequate to effect this control.
Personn(ll at the laboratory were enga~ed in routine diagnostic
tests, studies on the nature of the psittacosis virus, the susceptibility
of various animals and birds, and bedside consultations.
It has been found that tiesues containing virus of psittacosis may be
preserved for man:r, days with little ioss of virulence in a solution of
equal parts of sterile glycerine and standard buffer solution of pH7.
ROCKY MOUNTAIN SPOTTED FEVER
The study of Rocky Mountain spotted fever and other tick-borne
diseases of the western United States has been continued at the
laboratory located at Hamilton, Mont., under the direction of Special
Expert R. R. Parker.
Construction work on the new laboratory unit, authorized by the
71st Congress and started in April 1933 has been completed except
for mecha,nical installations, and rather extensive alterations have
been made in the old laboratory building. The Public Works Administration made funds available for the construction of officers' quarters and of a two-story building to contain a garage, ~eneral storage
space, a,nd accommodations for the rearing of guinea pigs. The plans
for these buildings have not yet been completed.
Vaccine.-The total amount of vaccine manufactured for the season
of 1934 was 212 lit~rs. Of this amount, 171 liters, or approximately
80 percent, were swtable for use.
The year-by-year increase in the demand for vaccine, noted in
previous reports, continued during the season of 1934. There has
been a, marked rise in the number of requests for vaccine for Federal
scientific personnel engaged in field work and for men employed on
Government projects of various kinds. The greatest demand continues to come from the States of Montana, Oregon, Wyoming, and
Idaho, although considerable · amounts are sent to other Rocky
Mountain States. The area of greatest use is the Bitterroot Valley
section of western Montana, where over 24 liters were used and approximately 6,000 persons were vaccinated. A relatively small
amount has been used in the eastern States.
About the middle of December 1933 an allotment of Civilian Conserva,tion Corps funds was made to the Rocky Mountain Laboratory
for the purpose of m11.nufacturing vaccine for the C. C. C. camps for
the season of 1934. A total of 123 liters of vaccine was prepared, of
which only 40.8 liters were sufficiently potent for administration.
Experimental studie8.-The following observations relative to the
interrelations of Rocky Mountain spotted fever and other tvphuslike diseases h11.ve been made; (1) Rocky Mountain spotted fever
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PUBLIC HEALTH SERVICE
vaccine affords a high degree of protection against-Sao Paulo "exanthematic typhus"; (2) there is a reciprocal, complete cross-immunity
between Rocky Mountain spotted fever and boutonneuse fever
of southern Europe and northern Africa; but in spite of this fact,
Rocky Mountain spotted fever vaccine h1ts essentially no protective
value against the virus of boutonneuse fever; (3) convalescent animal
serums of the "W" and "K" types of tropical typhus in the Federated Malay States and of tick-bite fever of South Africa do not neutralize Rocky Mountain spotted fever virus.
Studies of an apparent, fixed, low-grade Rocky Mountain spotted
fever virus, which is of frequent occurrence in the rabbit tick (Haemaphysalis leporispalustris), have been continued in cooperation with
Dr. R. G. Green of the University of Minnesota medical school. A
similar low-grade virus in rabbit ticks from central Manitoba (Canada) has been demonstrated.
The survival in Dermacentor andersoni in nature, under western
conditions, of the tick parasite (Hunterellus hookeri) to the second
year after the original release has been shown. This has occurred
only when the parasites have first been liberated under such conditions and at such time of the year that they pass the winter as latent
parasites in the unfed nymph.
Epidemiology.-Rocky Mountain spotted fever and the Rocky
Mountain spotted fever tick (D. Andersoni) have been reported west
of the Cascades in Oregon for the first time. All local ticks received
for identification have been D. occidentalis, a proved potential carrier
of spotted fever virus. In California, D. andersoni has similarly
been reported from points far west of previously lmown occurrence.
The continued occurrence of cases of spotted fever of high case
fatality rate in various parts of northern Idaho and new points in
western Montana has furnished further evidence of a tremendous
extension of the known regional area in which the highly fatal type
of infection is endemic.
TULARAEMIA
A tularaemia epizootic among sheep near Ringling, Mont., was
studied in May 1934, in conjunction with representatives of the
laboratory of the Montana Stt1,te Livestock Sanitary Board. Over
200 fatalities, attributable in part to tularaemia; occurred among a
band of about 1,300 yearlings. Tularaemia was also epizootic in the
local rodent population, especially among the jack rabbits. Bacterium
tularense was recovered extensively from sheep tissues and from ticks
infesting the sheep, as well as from rabbit tissues and corresponding
tich. These observations afford the first definite confirmation of the
occurrence of tick-caused epizootic tularaemia in sheep as originally
reported by the Public Health Service. in 1928.
COLORADO TICK FEVER
A temporary sub-station for the study of the so-called Colorado
tick fever was established at Casper, Wyo., late in May 1934. The
research for this season is not vet comp]eted, but thus far it has been
impossible to reproduce the disease in mice, white rats, guinea pigs,
rabbits, or monkeys.
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P'CBLIC HEALTH SERnCE
CHILD HYGIENE L"iVESTIGATIONS
The actinties of the Office of Child Hygiene ln'\""estigations during
the year were under the direction of Surg. Estella Ford Warner, who,
as medical officer in charge, succeeded Acting Asst. Surg. E. Blanche
Sterling.
871:'DIES I:S HE:.\RI:SG, PHYSIC.\L STATUS, GROWTH AXD DEYELOPYENT I:S SCHOOL
CHILDREN
Hwr;ng.-Tbe study of hearing of school children begun in 1931
considers not only the incidence and degree of hearing defects but
also the causati-rn factors and the progression of the hearing loss
which might furnish a basis for determining pre,entive measures in
relation to loss of hearing. Some tabulations ha,e been made from
the data obtained from the 14,000 4-A audiometer tests, and preliminary reports are being prepared. The 2-A audiometer tests are
to he repeated on the children manifesting a loss of 9 or more sensation
units and the degree of regression or progression of hearing loss
determined.
Pl1yfSical sfatWJ, gro1L-th, and derelopment.-A study on growth in
height was completed during the year and a report prepared. It was
shown that at certain ages children grow in height regardless of
attained stature, like other children of the same age; while at other
ages, notably the adolescent period, children gain in height, regardless
of age, like other children of the same height. A second study considers growth in weight, wherein it is shown that children from 6 to
15 years of age gain in weight more like other children of the same
weight than like those of the same age. These two studies have been
made jointly with Johns Hopkins University, Department of Biostatistics, and the Office of Child Hygiene, of the Public Health
• Service.
From the data obtained in Hagerstown, Md._, 1921-28, an interesting study has been made on the relationship between heights and
weights of brothers and sisters. A report of the study is in preparation.
A third study concerns the association between the height and
weight of children or the annual gains in height and weight, and
absenteeism from school due to sickness. A report on t.he use of
height-weight tables as an index of physical fitness in the light of this
finding is in preparation.
STUDIES OF CHILD HEALTH AND DEVELOPMENT IN RJ!ILATION TO THJC ECONOMIC
CRISIS
A statistical analysis of the weights of about 3,000 school children
obtained in May 1933, compared with the average weight for age
and sex obtained during the years 1923-28, was made in an effort to
determine the effect, if any, of the economic depression upon growth
in weight of school children. A report of the study was published in
the Public Health Reports for October 20, 1933. A continuation of
this study includes (1) a comparison of annual increments in weight
of school children in 1922-23 to 1927-28 and in 1933-34; (2) a comparison of actual weights of school children in 1921-28 and in 1933
and 1934; and (3) observations on the differences in weights of
children from families of different economic status.
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PUBLIC HEALTH SERVICE
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As a part of the extensive study of the depression undertaken in
1933 by the Public Health Service and the Milbank Memorial Fund,
an analysis was made of the height and weight records of approximately 6,000 school children from families surveyed in 7 cities. It
was found that the average height and weight of the children of the
families that had suffered a drop in economic status from "comfortable" to "poor" during the 4-year period was less than the
average weight of children whose families had remained on either
the "comfortable" or "poor" economic level throughout the period.
This result is consistent with the findings of the general depression
study as to the incidence of illness and death among these economic
groups.
STUDIES IN DENTAL CARIES
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During the year the two studies relating to dental caries were completed. The first study concerns the prevalence of dental caries
among Negro and white children in the same community. The
second study represents an investigation of the incidence of dental
caries among Indian children. The data were obtained from the oral
examination of over 8,000 Indian school children living under varying
climatic conditions and Indian triba.l habits. Five papers have been
prepared which consider the rela.tionship of dental caries to climate,
tribal habit, and diet.
IIIISCELLANEOUS
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The study of the mental status of children of various tyPes of birth
was discontinued on April 1, 1934, and the field office m Baltimore
closed.
DENTAL STUDIES
Dental studies were continued under ·the direction of Senior Dental
Surg. C. T. Messner. Dental studies have been confined almost
exclusively to the dental health survey, a cooperative project with the
American Dental Association. The dental health survey is divided
into two parts; namely, the survey of existing facilities, and a survey
to determine the dental needs of children of school age.
Facilities.-The survey of State departments and institutions was
completed at the close of the fiscal year. Information covering the
5-year period 1928-33, which was obtained in each Sta.te, showed
(1) whether or not there was a dentist on the State board of health,
or equivalent advisory body, (2) full or part-time dental personnel
employed, (3) organization of the State department of health, (4)
appropriations or expenditures, (5) "break-down" of the dental budget, (6) dental program and changes therein, (7) educational campaign,
(8) amount of remedial treatment and policy, and (9) dental diseases
reportable by State law. In addition all dental activities in State
departments of education and public welfare (institutions) were
subjected to the same analysis when possible.
Survey of dental needs for chudren of school age.-Twenty-five
States and one county of West Virginia cooperated in the study by
making the necessary examinations. Practically all cooperative examinations were made by members of the Amencan Dental Association working through their State and component or district societies.
Mottled enamel.-In order to determine whether or not there is a
seasonal variation of fluoride content of endemic waters in endemic
· 90167~34-3
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PUBLIC HEALTH SERVICE
localities, monthly samples have been received from 6 cities where
tnottled enamel is endemic, and 5 cities used as controls. Analyses
of these waters a.re being made by the division of chemistry, National
Institute of Health.
DERMATOSES INVESTIGATIONS
During the fiscal year, the Office of Dermatoses' Investigations,
under the direction of Senior Surg. Louis Schwartz, continued its
studies in industrial dermatoses.
Studies were made of processes of manufacture with special reference
to the skin hazards involved in 27 plants, employing a total of 19,483
workers, of which number about 8,000 were actually examined for the
occurrence of occupational skin diseases.
The sickness records of these plants as kept by the plant physicians
were also examined in order to determine the frequency of skin
disease and their causes.
SPECIAL STUDIES
In compliance with a request received from a firm manufacturing
tacks, a study was made of dermatitis which was prevalent among
their tack makers for a number of yea.rs. The study showed that the
lime on the plates used in tack making was the exciting cause of the
dermatitis. Recommendations were made for certain changes in the
manufacturing process and in the selection of workers for the purpose
of preventing the occurrence of further cases.
A study was made of an outbreak of dermatitis occurring in a nut
and bolt plant. The women engaged in placing nuts on bolts wrapped
friction tape around their fingers in order to protect the skin from
friction. Patch tests showed that most of the ingredients used in the
manufacture of friction ta:pe were skin irritants. It was recommended
that some bandage matenal be wrapped around the fingers, over this
a layer of cellophane, and then the friction tape, so that the irritants
in the friction tape could not seep through the cellophane and come
in contact with the skin. This recommendation was carried out and
no new cases occurred.
The attention of this office was called to four cases of dermatitis
occurring among men wearing dyed socks. A study of these cases
was made and it was found that in only one of them the dye was the
actual cause of the dermatitis. In the other three the actual cause was
found to be the finish used on the socks in order to make them more
attractive for selling. As a result of this study it was recommended
that all new socks having a finish on them should first be washed
before they are worn.
INDUSTRIAL HYG~ENE AND SANITATION
Studies of industrial hygiene and sanitation were conducted under
the direction of Surg. R. R. Sayers.
DUST STUDIES
Health of anthracite coal miners.-On request of the Governor of
Pennsylvania, an invest,igation has been made of the effect of the dusts
of hard-coal mining on the health of the workers. Studies. W~6 .
made of the occupational environment, including determinations of
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PUBLIC HEALTH SERVICE
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the dust concentrations for different operations. Twenty-seven
hundred persons, the entire number at 3 mines located in the 3 dis"'.
tricts of the anthracite fields, were given medical examination and
X-rayed. A supplementary study was made of disabled miners.
The physiological response of the peritoneal tissue to dusts introduced
as foreign bodies.-A series of injections of dusts of known chemical
composition (some definitely known to produce and others not to
produce silicosis) was made intraperitoneally into guinea pigs to
determine the nature of the response. The first part of the study
was completed during the year and appeared in the Public Hea1th
Reports for January 19, 1934.
It was concluded that dusts of the absorption group could be considered least harmful, those of the proliferation group as being productive of silicosis, and those of the inert group as responsible for,
the various other pneumoconioses in which there is a large deposition
of mineral material in the lungs with comparatively little fibrosis.
Silicosis among granite quarriers.-The effects of the inhalation of
granite dust generated in granite quarrying were studied and a report
published in the Public Health Reports for June 8, 1934.
Pulmonary injection in pneumoconioses (other than tuberculosis).Fusospirochaetal lung infections have been reported in increasing
numbers during the past 10 years, and routine examination of hardrock miners in the zmc and lead district of Oklahoma, Kansas, and
Missouri has shown such infections to be quite prevalent among
them. These infections were found to be initiated l?y the symbiotic
action of anarobic organisms commonly found in the upper respiratory
tract. .
Effect of inhaled marble dust as observed in Vermont marblefinishers.-:The clinico-roentgenographic findings in 80 marble finishers from a
typical plant in Vermont have been studied to determine the effects
of inhaling marble dust. Observations of the content of the air at
the breathing level and analyses of the dust were recorded. A report
was published in the Public Health Reports for June 22, 1934.
Talc workers.-A total of 66 workers was examined in 2 talc mines
and mills in Georgia. Pneumoconiosis was found in certain of these
workers. The dust concentrations to which the workers were exposed were similar in many respects to those found in the New York
study of tremolite talc, previously reported. The nature of the dust,
however, was different, because it contained less tremolite.
POLLUTION OF AIR AND ILLUMINATION STUDIES
Air pollution in American cities.-The study of atmospheric pollution in 14 cities was made to determine the average conditions and
various fundamental relations which might prove of importance in
programs for smoke abatement.
A report on this study is in progress of publication.
Determination oj the effect of the yellow light of sodium vapor lamps
on eyesight.-An investigation was carried on in New York to determine the effect of the yellow light of sodium vapor lamps upon the
e-yes of persons performing intensive clerical work.
In carrying out the tests two similar groups of men, most of them
young, performed intensive clerical work under sodium and tungsten
lamps, respectively.
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No permanent effect of the sodium light upon the eyes of the subjects, beneficial or detrimental, was observed during the course of
the tests, and no significant difference in the a.mount of work performed by the two groups was observed.
A paper summarizing the finding is being published in the Public
Health Reports.
Natural illumination of factories, schools, hospitals, etc.-Determinations of the distribution of daylight within an experimental building have been completed, the distribution of the light. having been
determined for white walls and ceiling, for black walls and white
ceiling, and for black walls and black ceiling. Measurements of the
brightness of the sky were made concurrently with measurements of
the illumination. The results have been analyzed, and the final
report is practically completed.
STUDIES OP SICKNESS AND MORTA.LITT
Incidence of illness among industrial workers.-The study of the
frequency of disabling sickness among industrial employees was
continued for the thirteenth consecutive year. During 1933 the
sickness-incidence rates were the lowest of any year of record. Current sickness rates are presented quarterly, and the results for each
year in comparison with earlier years appear annually in the Public
Health Reports.
Mortality rates in different occupational classes.-Publication of
mortality rates by occupation for 10 States (1930) has ma.de possible
an analysis of the rates m different economic classes and a comparison
with the rates for corresponding classes in England. A paper on
these comparisons is being published in the Public Health Reports.
SPECIAL LA.BOB.A.TOBY STUDIES
Studies in asphyxia.-Experiments have been carried out by the
United States Bureau of Mines in cooperation with the United States
Public Health Service to determine the reaction of dogs, and in some
cases of re.ts, to asphyxia by carbon monoxide and by atmospheres
deficient in oxygen. The report, published in Public Health Bulletin
No. 211, covers neuropathology and blood chemistry.
Acute response of guinea pigs to vapors of some new commercial
organic compounds.-The seventh report in this series was published
during the year, in Public Health Reports for November 17, 1933.
The work was carried out by the United States Bureau of Mines in
cooperation with the United States Public. Health Service, and has
related to ethylene dichloride, ethyl benzene, cellosolve, ethylene
oxide, vinyl chloride, dioxan, and dichloroethyl ether.
Estimation of basophilic cells (reticulor:ytes) in blood).-A simple
method of estimating juvenile red blood cells (basophilic cells or
reticulocytes) from ordinary blood films stained with an aqueous
solution was developed during the study of plumbism among a group
of storage-battery workers. This study was published in Public
Health Reports, for August 18, 1933.
Spectroscopic study of silica.-An investigation of the detection of
silica in :fluids by spectroscopic methods was begun.
Benzol poisoning.-Studies are being made on the pathology due to
inhalation of benzol vapors. No definite statement of results is as
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PUBLIC HEALTH RESEIA
yet available. This study is in connection with one carried out in
cooperation with the United States Bureau of Mines and the producers
of benzol.
COOPERATIVE ACTIVITIES
Preliminary industrial appraisal of St. Louis.-In cooperation with
the city department of health, a preliminary appraisal of the industries
of St. Lows was made to determine the extent of welfare and health
provisions and the potential hazards to which the workers are exposed.
Six hundred and fifteen plants were included from the manufacturing
and mechanical industries, employing 28,686 workers.
MILK INVESTIGATIONS
The activities of this office were continued under the direction of
Sanitary Engineer Leslie C. Frank.
Chlorine resistance of criterion organism.-The laboratory studies
on the thermal and chlorine resistance of the B. coli communior test
organism (strain 11-B) were continued. The initial chlorine concentration produc~ a 99.99-percent reduction of approximately
1,000,000 test orgarusms per cc and the average killing rate were
determined for each of 10 chlorine compounds at different temperatures and in different concentrations of milk. With no milk present,
the chloramines require from 3 to 600 times as high a chlonne concentration as the hypochlorites to produce a 99.99-percent reduction
in 2 minutes. The addition of 1-percent milk increases the required
chlorine concentration of hypochlorites markedly, but of chloramines
only slightly. On the other hand, lowering the temperature from
room to refrigerator temperature increases the required concentration
of chloramines markedly, but of hypochlorites only slightly.
In connection with these studies 1t was found possible to adapt the
chlorine precipitation test to the testing of chloramine compounds.
Thermal resistance of criterion organism.-Tests were continued to
determine the time and temperature combinations required to produce
a 99.99-percent reduction of the test organism, when treated in fullscale ·pasteurization equipment.
The test organism was cultured in whole milk, skim milk, standard
broth, lactose broth, beef infusion broth, and on the surface of
standard agar. The last was selected as the most satisfactory.
The procedure used gave a concentration of organisms in the pasteurizer of about 2,000,000 to 3,000,000 per cc.
When tap water, buffered at approximately pH 6.9, was used in the
pasteurizer, the average time required for 99.9-percent reduction of
the test organism, at a temperature of 145° F., was about 55 minutes.
With distilled water, buffered at the same pH, substituted for tap
wa~~t the corresponding reduction time averaged about 18 minutes.
Distiued water has the advantage of decreasing considerably th-e
extent of the variation in the reduction time for the individual runs.
It has the disadvantage of decreasing the reduction time so that the
reduction time at higher temperatures may be so low as to make
difficult the securing of properly mixed samples. Methods are, therefore, being tried for increasing the time required for 99.99-percent
reduction which will at the same time keep at a minimum the variations in the results of individual runs.
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Bactericidal, treatment of milk coolers.-Tests were continued to
determine the concentrations of different commercial chlorine preparations required to produce a 99.99-percent reduction of a culture of
the criterion organism upon a commercial milk cooler by means of a
2-minute rinse with the chlorine solution. It was necessary to discontinue this work before completion, but the results showed that the
available chlorine required varied greatly with the source of chlorine,
with the presence or absence of detergent substances, and possibly
with the hardness and the hydrogen-ion concentration of the rinse
water. A considerable reduction of the criterion organism was also
effected by the 1- to 2-hour drying period used in the tests and by the
mechanical action of the water used in rinsing the cooler.
Design of air and foam heating equipment.-Studies were made of
various designs of air and foam heating equipment in order to develop
a design which would give dependable operation and reduce to a
minimum the amount of condensation added to the pasteurizer.
Washing and bactericidal treatment of milk cans.-The results of this
work indicated that in raw-to-plant dairies where chlorine is used for
bactericidal treatment of containers and equipment, it is practicable
to require only a two-compartment wash tank, with one tank being
used for washing and the other tank for a combination of rinsing and
bactericidal treatment.
Washing of milk bottles.-At the request of the chairman of the Committee on Milk of the American Public Health Association, and in
conjunction with several State health department laboratories, studies
were made of the bactericidal efficiency of simple washin~ of milk
bottles. Although in every washing method studied some of the bottles
(based on a 5-bottle average) satisfied the criterion of 1 per cc. of
capacity with simple washing and rinsini alone, there was not a single
method in which every group of 5 bottles met this criterion.
Survey of milk-borne disease outbreaks for the year 1933.-The following outbreaks of milk-borne disease were reported to the Office of
Milk Investigation by State and city authorities for the year 1933:
typhoid fever 25; paratyphoid fever 1; diphtheria 2; septic sore throat
7; scarlet fever 3; miscellaneous 4; total 42.
Advisory assistance to State and local health departments.-During the
fiscal year cHies in the following States were visited at the request of
the State health departments and given advisory assistance: Arizona,
California, Georgia, Kansas, Kentucky, Maryland, Mississippi, Missouri, New Mexico, North Carolina, Oklahoma, Tennessee, and
Texas.
Milk sanitation ratings submitted by the several St~tes for 249
cities were computed.
STUDIES OF PUBLIC HEALTH METHODS
- The Office of Investigations of Public Health Methods, under the
direction of Surg. Joseph W. Mountin, in cooperation with the Division
of Domestic Quarantine, continued its studies of public health practices in county health departments. The work begun in the Brunswick-Greenville health district of Virginia was completed the earl_y
part of the fiscal year 1934. This study determined the basic needs
of the people in matters pertaining to health and the extent to which
these needs were met by the local health department and other
agencies.
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PUBLIC HEALTH SERVICE
Three additional counties now being-studied contain large towns or
are adjacent to cities; thus it will be possible to determine the influence
of medical facilities found m urban centers on the health of people in
adjQinip,g areas. The health department program of the counties
under study contains a large element of personal service in addition
to the usual educational and regulatory measures.
During the past year public health surveys were made in Cincinnati
and Hamilton County, Ohio, Portland, Oreg., in California, and of
numerous Indian agencies for. the Indian Bureau of the Department of
Interior.
STATISTICAL INVESTIGATIONS
'
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
The analysis of the data on sickness and mortality among families
of the unemployed continued throughout the year. These data were
collected near the end of the la.st fiscal year by special canvasses of
families in the poorer sections of 10 localities where the depression
had been severe. Income and unemployment estimates and mortality
records were obtained for the 4-year period 1929-32 and sickness was
recorded for the 3 months in the winter and early spring of 1933 which
immediately preceded the canvasser's visit.
The causes and durations of the illnesses were recorded and the
extent and kind of medical ca.re received, includin~ that by physicians, clinics, hospitals, and nurses, with differentiation as to whether
it was private service or ca.re furnished free by public or other agencies.
The 4-year record of income and employment permitted the comparison of sickness rates not only between "comfortable" and "poor"
families but, of even more significance, between the recent or "depression poor" and those who were poor even in the prosperous year 1929,
the "chronic poor." Briefly, the results indicate higher sickness
rates among the recent poor class, the families who were comfortable
in 1929 but had become poor by 1932. Poor as used in this study
indicates an annual per capita fainily income of less than $150. Those
who had been poor the entire 4 years had the next highest rate and
those who had been comfortable throughout the 4 yea.rs had the lowest
sickness rate. Although the data were not sufficiently extensive for
final results, they suggest a rising mortality from 1929 to 1932 in the
class most severely affected by the depression ("comfortable" in
1929 and "poor" m 1932) in the face of a downward trend in the
death rate m the general population. Fourteen reports on various
p_!:i.ases of the study have been published as follows: The Public
Health Reports for October 13, 1933 (reprint 1598); American Journal
of Public Health, February 1934; Proceedings of the American Statistice.l Association, supf,lement to March Journal of American Statistical
Association; Quarter y Publication of the Milbank Memorial Fund,
October 1933, January, April, and July 1934; Quarterly Publication
of Health Section of League of Nations, March 1934; and Modern
Hospital, March 1934.
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PUBLIC HEALTH SERVICE
RESPIBATOBY STUDIES
Work has continued on influenza and other respiratory_ diseases.
Two papers were published during the fiscal year (Public Health
Reports for Sept. 22, 1933, and Jan. 5, 1934), and two others have
been submitted and accepted for publication.
MORBIDITY STUDIES
The analysis of a mass of records on sickness and medical care
obtained by special surveys of families in 19 States, with a total of
some 80,000 person-years of life, was continued durin&" the year. Two
papers were published, one on the extent of physical or check-up
examinations (Public Health Reports for Mar. 9, 1934) and another
on the extent of eye examinations for glasses (Public Health Reports
for June 1, 1934).
CUBREN'r PREVALENCE OF DISEASE
The 4-week reviews of the prevalence of diseases have been continued throughout the year.
The usual semiannual and annual summaries of mortality in the
various States wereJ're_pared and published (Public Health Reports
for Dec. 1, 1933, an May 4, 1934).
STREAM POLLUTION INVESTIGATIONS
The headquarters station for research in stream pollution, including
the allied fields of water purification and sewage treatment, has been
maintained at Cincinnati, Ohio, with Sanitary Engineer J. K. Hoskins
in charge.
Sewage-treatment studies.-The efficiency of the activated-sludge
method of sewage purification, being a biological process, is dependent
upon the maintenance and proper functioning of various forms of
organic life in the treatment tanks which have the property of adsorbing or coagulating and oxidizing the colloidal and suspended matters
in the sewage liquor and facilitating their removal through sedimentation in the form of flocculated particles or sludge. Factors at
present little understood which disturb this optimum biological
balance, and which, if they could be controlled, would insure the
uniform efficiency of the process, have been under study throughout
the year. An experimental sewage-treatment plant has been maintained in continuous operation as a source of material for laboratory
research and in which numerous lapses in efficiency of purification
or "sludge bulking" have occurred as a result of improper biological
functioning. Continued observations of these changes in biological
life throughout the treatment process have indicated procedures for
determining the approach of such adverse conditions, but further
research is needed to forestall and overcome them. It appears that
other practical tests must be devised for their control. One such
test-the rapid determination of the amount of dissolved oxygen in
the sewage-sludge mixture in the aeration tank-has been perfected
and described in the Sewage Works Journal for May 1934. Another
test, the determination of the adsorptive capacity of the sludge for
organic matter, is in process of development.
In confirmation of the work of previous observers, it has been noted
that when activated sludge is most efficient the sludge particles are
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PUBLIC HEALTH SERVICE
largely composed of zoogleal masses of bacterial formation. Isolation
of this bacterium in pure culture has permitted a stud;Y' of its cultural
and biochemical characteristics. Under such conditions, both in
synthetic media and in sterilized sewage, it reproduces the zoogleal
masses which are .observed in goQd activated sludge and forms a
rather coarse, granular floe which settles rapidly. Tests of this pure
culture sludge have shown that it will adsorb as much as 85 percent
of the oxidizable matter in a polluted water during a 3-hour aeration
period. Comparisons are being made of the efficiency of this zoo~leal
sludge with sludges produced by other organisms in pure and mixed
culture.
Study of stream oxidation.-An extensive series of measurements of
the rates of atmospheric reaeration in streams of deaerated water
flowing in experimental channels has been completed during the
year, preparatory to undertaking further observations, in the same
channels, of the rates of oxidation of sewage sludge deposits under
stream flow conditions. A method has been developed and successfully applied for measuring rates of reaeration of zero oxygen saturation, usmg weak solutions of sodium sulphite as the oxygen-absorbing medium, which preliminary tests have indicated may be readily
applied in comparing the efficiency of different aeration devices commonly used in biological sewage treatment. Trial experiments in
determining rates of oxidation of sewage sludge deposits under conditions simulating those in natural streams have indicated that this
rate is considerably lower than that of normal biochemical oxidation
of sewage under laboratory conditions, but that it apparently is governed by the same general law.
An analysis of data obtained from previous laboratory surveys of
the Ohio and Illinois Rivers has afforded the development of a general
method for calculating the deo~genating effect upon flowing water of
underlying sew~e sludge depoS1ts in stream channels. The detailed
application of this procedure is dependent, however, on more definite
knowledge of the influence exerted on this effect by such factors as
temperature, age, and depth of these sludge deposits.
NATIONAL INSTITUTE OF HEALTH
The National Institute of Health continued under the administration of Director George W. McCoy and Asst. Director R. E. Dyer.
DIVISION OF PATHOLOGY AND BACTERIOLOGY
Typhus-Rocky M()'IJ,ntain spottedjever.-The investigations of typhus
and Rocky Mountain spotted fever were curtailed during the year,
due to the requirements of other activities.
Studies were continued to determine any changes in the viruses of
these diseases which might a.rise from residence of the viruses in various species of arthropods. This investigation is still being carried on.
It was found that four species of native rodents (woodchucks, whitefooted mice, meadow mice, and house mice) were susceptible to the
virus of typhus fever.
Serum from a recovered case of suspected typhus fever in Honolulu, Hawaii, was found to contain protective bodies against typhus
virus isolated in the United States.
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PUBLIC HEALTH SERVICE
Studies have been begun on the cultivation of the virus of endemic
typhus fever. This work has not progressed sufficiently to warrant
drawing conclusions.
Epidemic enceplwlitis.-Work on the etiology of epidemic encephalitis, which prevailed at St. Louis, Mo., in the summer of 1933, undertaken in conjunction with Dr. Ralph S. Muckenfuss and Dr. Howard
A. McCordock, both of Washington University Medical School, led
to the isolation, in monkeys, of viruses from six fatal cases of the
disease. These various strains are similar in their major characteristics
and a.re neutralized by the sera from recovered cases. Another virus
has been isolated at the National Institute of Health in the course of
the studies of material brought back from St. Louis. The latter virus
is pathogenic for Rhesus and Oebm monkeys1 white mice, and guinea
pigs. The rabbit is resistant. This virus IS distinct in its animal
symptomatology, pathology, and immunology from the other six
viruses. ·
N eutra.lization tests have been carried out on over 600 human sere.,
chiefly from recovered cases of encephalitis, from various parts of the
United States in an effort to gain information as to the distribution
of the virus throughout the country.
Bacteriophage.-Two lines of study were continued from the previous year. A comparative study of the strains of hemolytic streptococci 1s in progress, aimed :particularly at finding characteristics by
which human mfactions denved from animal sources m.ay be traced
to their origin. Sensitiveness to various races of phage IS the character serving as the basis for this comparative study.
A comparative study of four serologically distinct races of streptococcus phage is in progress.
Immunization experiments which have been conducted to compare
the value of streptococcus vaccines in the form of phage-lysed bacterial substance with that of whole cells killed by heat failed to reveal
any superiority of the phage-lysed substance.
Relapsing fever.-Investigations have demonstrated the survival
of virulent infection for 2½ yea.rs in naturally infected adult ticks of
the species Ornithodorus turicata collected in Texas.
Tularaemia.-This disease was reported by State health officers
from 38 States and the District of Columbia in 1933, a total of 892
cases being reported as compared with 933 in 1932. The disease was
recognized in Maine for the first time, and was recognized in gray
foxes for the first time (in Minnesota).
Poliomyelitis.-Studies are being conducted on the possibility of
producing an active immunity to poliomyelitis in monkeys. Formalin-killed virus emulsions are being combined with potassium aluminum sulphate, which combinations are absorbed very slowly. Injections have not yielded a degree of immunity sufficient to modify
the severity of the infection following intracerebral inoculation.
Studies of bacterial variants or mutants.-By the irradiation of bacterial strains with the beta and ~amma rays of radium it has been
shown that the beta rays are definitely bactericidal. The gamma rays
have not been shown to have any definite effect upon bacteria, but
results suggest that bacterial growth may be stimulated.
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PUBLIC HEALTH SERVICE
Trachoma.-Studies on trachoma were continued to a limited
~xtent. The question of the possibility of developing a culture medium more suitable than those hitherto used for the isolation of Bact.
gran'lllosis has been under consideration.
Amoebic dysentery.-An outbreak of amoebic dysentery which had
certain unique features originated in Chicago in the summer of 1933.
The more important of these features, from the public health point
of view were (1) the fact that the outbreak was on a rather large scale;
(2) it was of a rather explosive quality; and (3) it appears to be the
first outbreak in which a well-defined mode of transmission can be
establi::1hed with reasonable certainty. The majority of cases occurred
in guests of two hotels which were located across the street from one
another and had, in part, a common water supply. Epidemiological
evidence pointed to contamination of the drinking water in these
hotels as the most probable source of infection. Approximately
1,000 cases were reported. There is reason to believe that a considerable number of cases was not reported.
'
The United States Public Health Service, in conjunction with the
Chicago City Health Department, undertook an epidemiological
study 'which is still in progress.
Two laboratory investigations have been completed up to the present time. The first indicates that the cysts of E. histolytica do not
survive long on the hands of individuals, even when liberally contaminated under experimental conditions. The aecond shows that chlorine is wanting in effectiveness against E. histolytica cysts when used
in any quantity practical for water purification; on the other hand,
filtration is very effective in removing the cysts from contaminated.
water supplies.
In May 1934 a few cases of amoebic dysentery and a considerable
number of cases of typhoid fever developed among persons who had
drunk contaminated water.
The investigations of amoebic dysentery are being continued.
Pathology.-The histologic diagnostic service to marine hospitals
and other agencies has been continued, over 1,500 specimens being
examined and reports submitted thereon.
In addition to this diagnostic work, specimens from about 3,200
experimental animals were examined histologically and reports submitted to various workers in• the National Institute of Health and
to others.
Reports have been prepared and published 011 the histopathology
of poisoning by phosphorous acid phenol esters; paraffin imbedding
in vacuo; multiple branchiogenic acanthoma; the pathology of experimental blacktongue in dogs and of "yellow liver" in dogs (National
Institute of Health Bulletin 162); the bone marrow in tularaerria,
and the incidence of syphilitic aortitis in seamen and landsmen.
Data on the incidence of various types of tumors in seamen and
other beneficiariea of the service are in the course of compilation.
Studies on the clinical association of discrepancies between the Kahn
and Wassermann tests, on the glucose metabolism in relation to
malignant tumors, and on the pathology of tularaemia in man and
laboratory animals are in progress.
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PUBLIC HEALTH SERVICE
There follows a tabulation of the specimens examined during the
fiscal year:
Humanpathology
__ ~---------------------------------------------_ 1,552
Anima.I pathology _______________________________________________
Miscellaneous·prepsrations _______________________________________ _ 3,300
166
Total tissues prepared _____________________________________ _ 5,018
Blood and spinal fluid for Wassermann and Kahn tests ___ ----------- 14,926
Blood for other diagnostic tests____________________________________ 2, 265
Other specimens.________________________________________________
293
Total _____________________________________________________ 17, 48!
Biologic products.-At the close of the fiscal year 48 establishments
held licenses to engage in the interstate sale of the products; of these,
10 were foreign and 38 domestic concerns. The _licenses cover 147
different preparations.
SPECIAL STUDIES ON PROPHYLACTIC AND THERAPEUTIC AGENTS
Standardization of gas gangrene antitoxins.-Tests were carried out
in cooperation with certain European laboratories looking toward
the development of an international standard for measurin~ the
potency of Vibrion septique antitoxin. A unit one-half the size of
that in use in this country was recommended by the National Institute for Medical Research, London (under whose direction the international testing was done) as the basis for testin~.
Some progress has been made on the standardization of Cl. oedematiens and Cl. histolyticus al}titoxins.
Hemolytic streptococcus studies.-These studied have been extended
to include approximately 250 strains of hemolytic streptococci which
include strains from scarlet fever, erysipelas, septic sore throat,
puerperal fever, acute rheumatic fever, and a wide range of miscellaneous streptococcus infections. Other strain'3 will be added in
the future.
Meningococcus meningitis.-A study of the toxins produced by the
meningococcus has been undertaken. A study of the effect of various
therapeutic sera upon the meningitis produced in guinea pigs by these
toxins ia now under way.
A study of the viability of meningococci kept at -15° C is being
made. The maximum maintenance period and the optimum conditions for below-freezing storage are under investjgation.
Alum precipitate antigens.-A study was made of the value of
various antigens when combined with different amounts of potassium
aluminum sulphate. The sensitizing effect of pollen extracts is greatly
enhanced in animals when the extracts are precipitated with alum.
Small amounts of alum-less than 0.3 percent-do not inhibit the
desensitizing effect of extracts, and the addition of small amounts of
extracts for human use is indicated for experimental trial.
Abscesses following alum-precipitated diphtheria toxoid have been
studied. Commercial products have been found to vary widely in
aluminum content, and probably also in bacillary protein. Standard- ization of these factors will probably result in a less irritating product.
Staphylococcus studies.-Further studies have been carried on with
staphylococcus toxin, toxoid, and antitoxin. The two latter products
are now being prepared by concerns manufacturing biological products.
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PUBLIC HEALTH SERVICE
Tentative standards have been established and manufacturers'
products have been tested for potency and innocuity.
Arsenicals.-Studies of the effect of the pH of neoarsphenamine on
toxicity are being made in collaboration with the Division of Pharmacology.
DIVISION OF PHARMACOLOGY
The work of t.his division was continued under the direction of
Pharmacologist Director Carl Voegtlin.
Ganeer research.-The plan of cancer research in the Division of
Pharmacology places particular emphasis on the biochemical aspects
of the problem without, however, ignoring important physiological,
cytological, and pathological considerations. Considerable progress
was made during the present year.
Fundamental research on cell growth was continued. The report
for 1933 announced the discovery of the enzymatic synthesis of cell
protein; This discovery has now been confirmed by work in other
laboratories. A systematic study was made of the influence of variations in hvdrogen-ion concentration upon the synthesis of tissue
proteins. The results clearly show that an increase in hydrogen-ion
concentration has an inhibiting effect upon protein synthesis. Theoretically, this observation indicates the possibility, if not likelihood,
of the coupling of at least three types of fundamental biochemical
processes, namely, (1) proteolysis-protein synthesis, (2)· glycolysis,
and (3) oxidation reduction. Experiments were also made to ascertain whether the resynthesized protein has the same composition
as the original one. Quantitative estimations of the cystine content
confirm this view. It was also shown that the observed resynthesis
of protein is due to presence of an intracellular enzyme (proteinase)
and that it is not due to a nonenzymatic oxidation of protein cleavage
products.
Work on the chemistry of cell division in Amoeba proteus was
continued. A method was discovered which permits direct visual
observation of the dividing nucleus in the living cell. This method
was applied to a study of the action of various chemicals of physiological and pharmacological interest upon the process of mitosis.
Continued work on the cultivation of the Walker rat carcinoma
in vitro has led to the production of an apparently pure culture of
malignant epithelial cells, which, when inoculated into rats, produced
typical tumors. Pure cultures of normal rat fibroblasts were .also
obtained. Mixed cultures of these two cell types showed that the
malignant cells apparently destroy the normal cells in vitro.
Based on these fundamental researches further efforts were made to
discover chemicals with therapeutic action on malignant tumors ..
Definite indication of a therapeutic effect was obtained with an
organic sulphur-containing compound.
Treatment oj acute bichloride oj mercury poisoning. -On the basis
of animal experiments a chemical method was discovered for the
treatment of bichloride poisoning in human cases. Death from fatal
doses of bichloride can be prevented when formaldehyde sulphoxylate
is given by mouth and vein within a reasonable time after the poison
has been swallowed.
Studies on phenol and compounds of phenols.-A method was
worked out for the quantitative estimation of free and conjugated
phenol and of the three isomers of cresol in the body tissues and
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PUBLIC HEALTH SERVICE
fluid. Application of this method yielded information as to which of
the body tissues are concerned with the detoxication of phenols.
Continuing the work on the action of the neurotoxic phosphoric
esters of the phenols the pharmacology of the phosphoric mono-, di-,
and tri-esters of orthocresol was studied. These investigations disclosed separate mechanisms determining the fate of each of these
types of compounds in the body. The experiments showed specific
phosphatases capable of hydrolyzing the mono- and di-esters, respectively. No such mechanism could be found for the tri-ester, with its
selective action upon the nervous system.
Vitamin studies.-Studies were made on the characterization of
the biochemical properties of some of the vitamins of the B group,
more especially the antineuritic Bi, the growth of B 2, and the antidermatitis factor. The effects of ultra-violet irradiation, acid and
alkaline hydrolysis, and differential precipitation at various pH
values have been examined. It has been possible to effect by some
of these procedures a partial separation of B1 and B 2 • The observations have generally indicated a close association of the antidermatitis
and B2 vitamins.
Organic arsenicals.---Physicochemical studies were made of neoarsphena.mine, sulpharsphenamine, and other arsenicals in relation to
toxicity. Recent claims made in the literature to the effect that
fatal poisoning results from the use of commercial neoarsphenamine
and sulpharsphena.mine with an acid reaction were not confirmed.
DIVISION OF CHJDllISTRY
The work of the Division of Chemistry was continued under the
direction of Prof. Claude S. Hudson.
Sugar researches.-The sugar researches were carried out mostly
along the lines of the last report. Studies were continued which may
throw further light on the chemistry of the biologically important
uronic acids and their derivatives, with special reference to the
oxidation of sucrose, a-methyl-d-xyloside, and a-methyl-d-mann~side.
A detailed study was made of the oxidation of a-methyl-d-mannoside.
It was shown that both the methyl hexuronic and penturonic acid
may result from its oxidation. The conditions for the control of the
formation of the different products were investigated. The work on
the methyl penturonic acid is of further interest in that evidence was
obtained to show that it contains a hemiacetal group, which is rather
unusual in this class of compounds.
Studies were continued on the four-carbon sugar threose. As a
result of this work, it is nowJ'ossible to study practical applications
of this sugar in biological an medical investigation.
Enz11me researches.-A relatively convenient method was developed
by which the enzyme invertase present in yeast was greatly purified
by adsorption on colloidal lead sulphide.
The methods which proved successful in the purification of invertase from yeast have also been applied in an attempt to concentrate the diphtheria antitoxin contamed in the usual commercial
preparation. Although the active immunizing agent, was adsorbed
b_y colloidal lead sulphide, parallel determinations of the total solids
srmultaneously removed from solution showed that the adsorption was
not selective. This observation, in conjunction with the poor yields
obtained when the lead sulphide adsorption complex was subsequently
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decomposed, suggested that lead sulphide probably could not be used
to advantage in attempts to purify diphtheria antitoxin.
Mottled enamel.-A comparatively simple and convenient method
was developed for estimatmg small amounts of fluorides in drinking
water in connection with the chemical work incident to the study of
mottled enamel (Public Health Reports, Oct. 6, 1933).
DIVISION OF ZOOLOGY
Bulletins.-The key catalog of parasites reported for Carnivora,
with their possible public health importance, 1s in press and will be
published as National Institute of Health Bulletin No. 163.
Survey of ectoparasites.-Over 120,000 ectoparasites, including
fleas, lice, and mites of rats and other mammals, have been identified.
Charts and graphs relating to rat density, flea indices, etc., have been
prepared. A guide to the ectoparasites of rats in the United States
was prepared for use by field workers engaged in surveys of rodent
ectoparasites.
Examination of parasites for diagnosis.-Approximately 200 specimens have been examined for various Government hospitals, State
health departments, universities, and for practicing physicians.
MISCELLANEOUS
During the year 144 articles, 4 public health bulletins, and 1
National Institute of Health bulletin, dealing with scientific or public
health subjects, were reviewed and approved for publication.
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DIVISION OF DOMESTIC (INTERSTATE) QUARANTINE
Asst. Surg. Gen. C. E. WALLER in charge
PLAGUE-SUPPRESSIVE MEASURES IN CALIFORNIA
Plague-suppressive measures have been continued in cooperation
with the California State authorities in Alameda, Contra Costa, San
Francisco, and San Mateo Counties. No plague was reported from
any of these counties. One fatal case of human plague occurred in
Los Angeles in August 1933, and one human case was reported from
Tulare County in June 1934. Rodent plague in ground squirrels was
reported in San Benito, Santa C]ara, Kern, Tulare, and Modoc
Counties. The outbreak in Kern and Tulare Counties is the largest
one that has occurred in recent years, 199 ground squirrels from these
counties having been found p]ague infected. It extends over about
800,000 acres of sparsely populated land. One case of human infection has been reported from this area. The low incidence of human
infection is presumably attributable to the small number of people
residing within the infected district. The Tule River Indian Reservation lies within the infected area, and infected rodents have been
found on the reservation.
In June 1934 rodent plague was found in Modoc County, Calif.
This focus is at lea.st 250 miles from the nearest previously known
plague focus. At the end of the fiscal year approximately 25 rodents
from Modoc County had been proved to be plague infected.
On May 21, 1934, a human death from plague occurred at Lakeview, Oreg., about 15 miles north of the California State line. This
case was not definitely proved until June, when information of the
presence of plague in Modoc County suggestea the possibility of
plague. This is the first recorded occurrence of plague in Oregon.
Measures taken against ground squirrels.-Public Health Service
activities in this work have been confined to the maintenance of a
squirrel-free zone around the cities on San Francisco Bay. These
measures have been in cooperation with the city or county authorities.
They include inspection of areas for evidence of ground-squirrel infestation and appropriate measures to destroy the rodents when
found. The following tabulation shows the extent of these activities:
Number ofInspections_______________________________________________
Reinspections_____________________________________________
Acres
inspected ___________________________________________
Acres reinspected ______________________________ -- _------- Acres treated with waste balls______________________________
Acres treated with poisoned grain ___________________________
Burrows treated ________________________________ - - - ___ -- - Materials used:
Carbon
bisulphide
(gallons) ______ - - - ---- - - -- --- - - - - --- - --- -_
Waste balls
______________________________________________
Poisoned grain (pounds), strychnine_
- - -- - - - - _______________ __
thallium __________________________
phosphorus _______________________ _
Poison mixed for landowners under supervision of Public Health
Service (pounds) __________________ - - - --- - - - - - - ____ - _____ - ~-·~
42
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1,249
2,278
215,739
630, 834
29,233
138,217
66, 680
1, 177¼
66,680
11,876
16,409
11,030
1, 100
PUBLIC HEALTH SERVICE
43
MeaSU,res taken against rats.-These activities are almost entirely
in the city of San Francisco, where work has been continued in cooperation with the local department of public health. City and
Federal efforts are combined, as in previous years, under the general
control of the Public Health Service. All complaints of rat infestation in the city are reported to the Public Health Service, and these
are investigated and such action is taken as is deemed proper. The
trappin~ of rats and the examination of trapped rats for evidence of
plague mfection has been continued. Assistance to the city department of public health in abating rat nuisances and rat harbora~es
through cpndemnation proceedings has been rendered in a few mstances. A total of 1,954 rat complaints were investigated in San
Francisco.
During January and February the office cooperated with the
Typhus Fever Control Research Project carried on by the Public
Health Service with Civil Works Administration funds and personnel. This project covered the entire county of San Francisco and the
cities of Alameda, Oakland, Berkeley, Piedmont, Emeryville, Albany,
and San Leandro in Alameda County. The sudden termination of
the J?roject on February 15, 1934, by withdrawal of Civil Works
Admmistration funds, prevented the extension of the work into the
smaller places in Alameda County. All rats trayped during the life
of this project, as well as those trapped at other trmes, were examined
for evidence of plague at the Federal laboratory. No plague-infected
rat was found.
An officer of the Public Health Service visited the newly discovered
plague-infected areas in Kern, Tulare, and Modoc Counties, where
the work of determining the presence and extent of the infection· is
being carried on by the State department of public health, and squirrelcontrol measures have been applied by the rodent-control division of
the State department of agriculture or b:v the United States Biological
Survey. He also saw, in consultation, the 2 human cases of plague
occurring in California, and assisted in the laboratory diagnosis of
1 of these.
Public HeaUh Service laboratory.-The laboratory activities were
moved to the new laboratory building in June 1933. The new building and equipment have made the work of the laboratory more extensive and more easily carried out. The work of the laboratory consists
chiefly of examination of rodents for plague infection, the examination of samples of water used on interstate carriers, serological work
for other Service stations, and bacteriological work, including animal
inoculations for various stations of the Public Health Service or
other departments of the Government.
The application of the Kahn precipitation test to all sp~cimens
submitted for the Wassermann test has been made a part of the
re!?ular routine of the laboratory.
During January and February the laboratory was used for the
laboratory operations of the typhus fever control project carried out
by Civil Works Administration funds, under supervision of the medical officer in charge.
90167-34----4
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44
PUBLIC HEALTH SERVICE
The following table gives a summary of the operations of the
laboratory:
Received
Examination of rodents for plague:
Rats from
from Ban
Francisco_--------------------------------------------------Rats
Oakland
and Alameda County __________________________________ _
Examined
24, 1184
5,423
21,690
5,322
195
19li
Rats fromfrom
fumigated
ships County
___ -----------------------------------------------'
Squirrels
Ban Mateo
__________________________________________ _
2
2
Rats combed for ectoparasites:
·
Rats from Ban Francisco County___________________________________________ _
302 -----------Rats from Alameda County______________________ ----•---------- ___________ _
818 -----------Ectoparasites
From San collected:
Francisco County rats ___________________________________________ _
5,448 -----------From Ale.meda County rats ________________________________________________ _
16, 744 -----------Serological examinations:
Wassermann reactions:
Blood ____________ --- - -- - ---- -- -------- __ ------ -------- _____________________________ _
7,283
Spinal fluid ________________________________________________________________________ _
ue
Kahn tests:
Blood ___
-- -________________________________________________________________________
-- -- - --- --- --- -- ----- --,--------- ------ __ -------------------- ___________ _
6,838
Spinal
fluid
ffll
Agglutination test (typhoid lever) _______________ ---------------------------- ___________ _
1
Bacteriological examinations (culture and microscopic):
Water
______________
-------------------------------------________________________
_
653
Culture for diphtheria _____ -" ___________________________________________________________ _
2
tuberculosis __________________________ ----------------------------- ___________ _
_
Urine for________________________________________________________________________________
8
Leprosy
1
Bacteriological
examinations
(with animal Inoculations):
___ ------ __________________________________________________________________
_
Tuberculosis
811
B.
pestls_
- ------------------ ---------- ---- --------------------------------------- ------_
well
disease
_________ - _-- -- -- -_
-- - --- -- __
_____ ---------------- _______________________
'
1
Rat leprosy.-During the year 38 rats suffering from rat leprosy
were found in San Francisco, and 29 were found among rats from
Oakland. From October 31, 1933, to January 31, 1934, 26 leprous
rats were caught in San Francisco. As the number of rats suffering
from rat leprosy has rarely exceeded five in any previous year, this
unusual prevalence of the condition is noteworthy.
PLAGUE-CONTROL MEASURES IN THE TERRITORY OF HAWAII
Plague-control measures were continued on the islands of Maui,
Hawaii, and Oahu in cooperation with the Territorial board of
health. Neither human nor rodent plague was found on the islands
of Maui and Oahu. On the island of Hawaii there was 1 human case
and 9 plague rats were found.
Major parts of time and funds were spent in connection with control measures on the island of Maui, in view of the fact that an outbreak of plague occurred on this island a few years ago in a zone
fairly close to the Port of Kahului, one plague rat having been found at
that time at a point a.bout 6 miles distant from the docks. Kahului
is the only port on the island where ships dock.
·
On the island of Hawaii, plague has been confined for many years
to the Hamakua section, about 40 miles from the port of Hilo. Ships
dock only at Hilo. The opportunities for plague to spread from this
island are considered much more remote than on the island of Maui,
in view of the greater distance between the infected zone and the port
and the differences in transportation facilities.
The work on the islan\i of Oahu was carried out in conjunction
with a rodent ectoparasite survey for typhus-fever control, financed
by the Civil Works Administration and the Federal Emergency Relief
Administration. No plague has been found on Oahu since 1910.
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PUBLIC HEALTH SERVICE
.
of Maui.-Control measures on
45
Island
Maui were financed by
appropriations from the Territorial board of health, the Maui Quarantine Tax Commission, Federal relief organizations, and the Public
Health Service. The quarantine tax commission receives its funds
from taxes levied on all freight entering and leaving the island, and
it also receives a sum annually from the county.
The program which was in force when the work was taken over in
the latter part of September consisted of (1) distribution of packages
of poisoned grain in the fields and buildings with the object of rat
destruction; (2) trapping and laboratory examinations of rats to
serve as an index of plague infection; and (3) inspecting for rat infestation the outgoing freight and ships at Kahului. This program was
broadened by adding (4) inspection of all buildings and premises in
the area being worked, for ratproofing and elimination of rat harborages; (5) destruction of rodents by shooting from nests in trees, and
increasing trapping activities to such an extent that the rodent population might be materially reduced; (6) inspection of paclcing of vegetables and other farm produce in the fields to preclude the possibility
of carrying rats from the zone formerly plague infested, or elsewhere,
to the wharf at Kaluhui, and requirement of the use of rat guards on
local ships which carry interstate shipments as well as on ships plying to the mainland; (7) cage experiments to determine the effectiveness of the poison bait on rats under caged conditions; and (8) field
experiments to determine the effect of placing poison bait in the fields
and buildings on the rat catch, by trapping before and after placing
poison.
The following table gives a summary of the results of the control
work for the fiscal year:
Classification of rodents trapped and killed
R. alexandrinus ______________ 11, 205 R. hawaiiensis_·--····--·--·- 10, 502
R. rattus ___ • ___ ·- ________ • __ 3, 935 R. noroegicus_. __ ·- ____ ·- _. __
25
M. musculus·-·-·---·---··-· 16,237 Mongoose.-------·--·-···-241
Number
Number
Number
Number
Number
Number
Number
Number
Number
Number
Number
Number
Number
Number
Summary of work
of rats trapped. ____ ._ .•.• -···-··_ ..••...•••••••••••••
24,654
431,332
of trap days•.•····-·······-········-·················
of rats per 100 traps per day .•.•...•.•.•.••.•......•.••
5,716
1,130
of rats killed by shooting, etc .....••........ ·-·········
of pieces of poison bait placed.···················-···· 10,499,024
of rats found dead_ ... _.• _•...... ·-·_ ••••• _.•• _._-· •••
102
41,904
of rodents received at laboratory ....•.•• ·-··-··-··-··-·
25,667
of rats examined macroscopically.•.. ·-·················
of rats examined microscopically •.•........ _.........•.
11
414
of mass inoculations made.·-·······--··-········-··-··
6
of single inoculations made ............... --·········-·
2,212
of buildings and premises inspected_····-···············
0
of cases of human plague.·-·-··-·-·-··············--··
0
of cases of rodent plague ..... --·········-·-···-···--··
Sanitary inspections of buildings and premises were made in all of
the built-up sections of the area being worked. Special attention was
given to eliminating the rat's food supply and removing rat harborages.
Inspections were entered on a specially prepared form, listing defects
and corrections required. These reports were turned over to the
Territorial health officer, who referred them to the proper local
authorities for action.
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PUBLIC HEALTH SERVICE:
The inspection of outgoing freight and ships for· rat :infestation wa.scarried out by a sanitary inspector of the Public Health Service, who,
was detailed to the port of Kahului for this purpose. This inspector
was also charged with enforcing the requirement of placing rat guards
on ships.
In order to increase the efficiency of the trapping organization one
trapper was made foreman; and since this change, the rat catch has.
materially improved. At the close of the fiscal year there were s:
trappers and 1 foreman, whose salaries were being paid by tne PublieHealth Service.
Funds for operating and maintaining the laboratory were furnished
by the Territorial board of health. The emplcryyees eensisted of t
supervisor and 2 laboratory assistants.
Funds for paying laborers for making and distn'butingpoison packages were furnished by the local quarantine tax commission for a.
time, and later labor was furnished by Federal relief organizations_
Funds for purchasing materials used in makin~ the packages- werefurnished by the Public Health Service according to an agreement
made at the beginning of the fiscal year.
The inspection of the procedure in packing produce in the fields and!
delivering it to the docks was earned out by the regular sanitary
inspectors of the board of health stationed on the island.
Cage experiments to obtain information concerning the extent to
which rats will eat the prepared poison under these conditions were
carried out in cages about 10 feet long by 18 inches wide by 18 inches
high, and later also in a cage about 12 feet long by 6 feet wide by 6" feet.
high. The cages were so arranged that natural food was mad& available in the same compartment with the poison, in order to simulateconditions in the field as nearly as possible. On an average, 10 rats:
were used per experiment, all rats being placed in the eage at thesame time. These experiments were carried out during the latterpart of the fiscal year and are being continued. Preliminary results:
tend to show (1) one or two and occasionally more rats will eat some
of the poison package the first night and die shortly thereafter; (2)
after one or more rats have died from eating poison, the remainder of
the rats in the cage refuse to eat it even if food and poison are replacedl
with fresh material each day; and (3) the foods most abundant on the
island, namely, sugarcane and pineapple, a.re not eaten by rats when
certain other natural foods .are available.
Field experiments were carried out in various sections of the area.
being worked, the procedure being to trap a limited area for 1 week,.
then placing poison and again traJ?ping for a week, the object being to
determine the effectiveness of placmg poison by comparing the rate of
rat catch before and afterplacing poison. The results of 11 experiments
completed at the end of the fiscal year, taken as a whole, show practically the same rate of rat catch after placing poison as before. These
experiments are being continued in order to obtain data from all
sections of the area being worked.
Island of Hawaii.-Control measures on the island of Hawaii were
carried on by the Territorial board of health, and consisted of trappingand examining rats and placing poison. Public Health Service
activities were--0onfined to an inspection trip and the providins of
certain materials used in connection with trapping and making poison
bait. Plantation employees were used to some extent, as well as labor
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PUBLIC HEALTH SERVICE
47
ifurnisbecB. b,-y Federal relief organizations. Conditions on this island
are quite ..different from those on Maui, and the control measures
·found effective in the latter place may not necessarily apply to the
:island of Hawaii ·except in a general way.
Plague ~ases were discovere1 as follows during the fiscal year, all
-occurring m the H:amakua sect:t:on, where plague has occurred sporad:ically for many years: 1 case of rodent plague in September 1933;
'.2 cases in November 1933; 5 in December 1933; and 1 case in January
1934. There was only one case of human plague, which occurred in
June 1934.
Island of Oahu.-The plague-control measures on this island were
-confined to trapping and laboratory examination of rats caught in
Honolulu and rural sections adjacent to the city. This work was
-carried on as an adjunct to a typhus fever control ectoparasite survey,
and relief labor was used throughout. The work was begun on January 5, 1934. Rats were trapped simultaneously in all s'ections of the
area. In the laboratory all rats were examined macroscopically for
plague and daily mass inoculations of guinea pigs were made. At the
.e_nd of th~ fiscal year no plague rats had been found. Both cage and
-snap traps were used in this work, since it was necessary to have live
-rats for the ectoparasite survey. Following is a summary of results
,of this work:
Number of rats caught with cage traps ___________________________ _ 3,763
52
Number of mice caught with cage traps--------------------------~Number of other rodents caught with cage traps ___________________ _
105
.Number of cage rat trap-days ___________________________________ _ 64,333
:Number of ra'ts per 100 cage traps per day ________________________ _
5.85
Number of rats caught with snap traps ___________________________ _ 3,794
.Number of mice caught with snap traps ___________________________ _ 2,107
Number of other rodents caught with snap traps ___________________ _
39
Number of snap rat trap-days ___________________________________ _ 61,317
Number of :cats per 100 snap traps per day ________________________ _
6. 19
'Total rats caught (cage and snap traps) ___________________________ _ 7,557
'Total rat trap-days (cage and snap traps) _________________________ _ 125,650
:Rats per 100 ,traps per day (cage and snap traps) __________________ _
6.01
TR.A.CHOMA PREVENTION
During the pa-st year, because of reduction in the Federal allotment
ior this work, it was necessary for the States cooperating with the
United States Public Health Service in trachoma-control activities to
:increase their financial contributions. As a result, the States con-<)erned met a-pproDroately one-half the cost of this work within their
borders.
It seems wise to draw attention again to the fact that trachoma is
not an acute disea-se with a more or less characteristic course in each
individual case. On the contrary, it is often very insidious in its
,development, and an individual may not realize for several months
that there is :anything seriously wrong with his or her eyes. A
-physician ma-y be compelled to watch a person over a long period
before being certain tbat trachoma is really present.
It has been observed repeatedly that the earlier a case can be
brought undei:_ treatment the better the response and the more
likelihood of the disease remaining arrested. Those interested in the
_public-health aspects of trachoma as well as in the disease in the
mdividual often,see people who have had trachoma and in whom the
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48
PUBLIC HEALTH SERVICE
disease has become arrested without any treatment. Such cases
might be called "aborted trachoma ". Usually such individuals have
no impairment of vision; and it is probable that there are aborted
cases that do not leave behind any signs of previous trachoma, such
as scar tissue and pannus.
The experimental work on the use of copper thiosulphate intravenously as a means of therapy in trachoma was brought to an end.
No particular benefit was discovered from such therapy. A summary
of this work was published in the Public Health Reports for May 4~
1934.
A Japanese product known as yataconin (Calcium salt of phosphoric
ester) was tried out in 14 cases of trachoma on the recommendation of
a prominent ophthalmologist. No particular benefit was seen from
its use.
Missouri.-The hospital facilities at Rolla have been extended, as
in the past, to those suffering from trachoma. Not so many patients
were admitted during this year as in past years, on account of the
reduction in funds for rations. The policy has been to reserve beds
available for young individuals with a very active condition. The
extent of field work has been about the same as formerly. More.
clinios were held and more people were contacted than in the preceding
year.
The trachoma film produced at this hospital was shown to many
lay audiences in the State and to public-health workers and nursing
groups.
The hospital has cooperated with two groups doing research on
trachoma, serving as a source of supply of trachomatous material.
Kentucky.-The hospital facilities at Richmond were so used to
take care of a greater number of trachoma patients than in the
preceding year. This was gratifying, in view of the fact that funds
for rations were reduced. There were fewer field clinics and a much
smaller number of people was contacted in the trachoma area of the
State than during the year before.
The medical officer in charge of the hospital appeared on the
program of the Kentucky State Medical Society and showed tbe film
entitled "Trachoma in the Native White Population of the United
States."
A more severe type of trachoma still presents itself quite frequently
at the Richmond hospital. For this reason, this unit has been useful
in serving as a source of supply of trachomatous material for trachoma
research.
Tennessee.-Trachoma in this area has never seemed to be as severe as
in Kentucky or Missouri. Many of the active cases seen do not impress
one as being of a very serious nature. The active work of trachoma
control is centered at Gainesboro, and an area of 13 counties has been
very systematically covered. So far, slightly over 1,600 cases of trachoma have been registered in these counties, and the majority of the·
cases have received various degrees of treatment. The medical officer
estimates that 150 of them still retain quite active trachoma patholog;y. Later, it may be necessary to establish the clinic at some·
point m the State other than Gainesboro.
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PUBLIC HEALTH SERVICE
Diapenaary and hospital relief, operations, etc.
Dispensary relief:
Number examined ________________________________________ _
5,030
Old cases ______________________________________________ _
2,334
New cases _______________________________________________ _
508
Total attendance _________________________________________ _
5,030
Average daily attendance _________________________________ _
13. 78
Combined dispensary and field clinic data:
Total
number
of
new
individual
trachoma
cases
discovered
____
_
1,193
Pannusinnewcases ______________________________________ _
1,043
Entropion in new cases ___________________________________ _
218
Corneal opacities in new cases _____________________________ _
356
Ulcers arising in all cases, new and old ______________________ _
56
Hospital relief:
Hospital capacity ________________________________________ _
77
Cases admitted during the year (total) ______________________ _
726
Number of cases first admission ____________________________ _
474
Days relief furnished _____________________________________ _
19,845
Rations furnished ________________________________________ _
23,839
Cost of rations ___________________________________________ _ $6,381.90
Operations: Total number of operat_ions ________________________ _
1,439
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 health talks given _____________________________________ _
Attendance (estimated) ______________________________________ _
Homes visited _________________________________ ---- -- --- ____ _
Peop]e. examined. in homes _______ ~-- __________________________ _
Susp1c1ous cases m homes. ___________________________________ _
Number of pupils examined in schools _________________________ _
Suspicious cases in schools ____________________________________ _
Number of treatment clinics, nurse onlY------------------~----Number of treatments by nurse _______________________________ _
SUPERVISION OF
w ATER
355
7,912
2,405
685
1,354
3,785
259
8,650
3,478
7,752
880
11,973
314
11
105
SUPPLIES USED BY COMMON CARRIERS
Notwithstanding the added duties imposed upon the State departments of health and the Public Health Service due to the emergency
activities, the inspection and certification of water supplies used for
drinking and culinary purposes on interstate carriers, carried on in
cooperation with the State health departments, was continued without
loss of efficiency. Of the 2,241 supplies listed by the carriers, 94 percent were inspected and certified.
In addition to assistance rendered the States in the preparation of
certificates of inspection, 94 actual inspections of water supplies were
made, chiefly in States having no engineerin~ division. A comparison
of completeness of the certification work with that of previous years
is shown in the following table:
,
Percent or completed certifications
Nature or supply
1929
1930
1931
Railroad supplies____________________________________
81
87. 6
Vessel supplies_------------------------------------78
88. O
Airplane supplies __________ ------ ______________ -- ---- ______ -- ______ -- ----
Digitized by
1932
92.8
96.9
86.8
Google
96.1
97.2
97.4
1933
94
97
113
50
PUBLIC HEALTH SERVICE
Statm of work by States.-The accompanying table summarizes the
work of the calendar year 1933 and shows the status of the work by
States.
Interstate carrier water supplies for calendar year 19!1!1
CertlJlcatlon status
Source classlJlcation
State
Alabama___________
Arizona ____________
Arkansas ___________
California __________
Colorado. __________
Connecticut________
Delaware __________
Dlat.
or_____________
Columbia __
Florida
Georgia ____________
Hawaii _____________
Idaho ______________
llllnols. ____________
Indiana ____________
Iowa ______ _________
Kansas _____________
Kentucky __________
Louisiana __________
Maine .. ___________
Maryland •.. - __ ....
M8898Chusetts __ ___
Michigan __________
Minnesota .. ______ .
~~~~I:::::::::
Montana ______ _____
Nebraska __________
Nevada __ __ ___ _____
New Hampshire ___
New Jersey ________
New Medco _______
New York _________
North Carolina ____
North Dakota ______
Ohio. __ -----------Oklahoma
__________
Oregon _____________
Pennsylvania ... __ .
Rhode Island_. ____
Bi,uth Carolina _____
South
Dakota_______
__ ____
Tenn____
Texas ___________ ___
Utah _______________
Vennont ___________
Virginia__ ... ____ •.•
w
West V ~-----_____ _
Wisconsin---------Wyoming __________
Total ________
Publie I
Private 1
Rallroad
Total
16
19
37
58
27
17
6
1
37
47
3
17
68
2
7
0
0
10
2
18
311
39
11
26
2
0
0
0
7
2
0
2
3
6
0
0
1
10
2
0
6
7
0
7
6
6
6
6
3
0
7
16
5
8
7
11
11
1
8
@
69
73
34
26
34
15
39
M
43
30
48
21
23
9
17
46
13
98
46
14
69
42
211
122
3
30
20
25
111
11
9
47
211
30
51
14.
1,785
Batisfao.
tory
18
11
31
74
28
16
6
2
M
311
3
• 21
62
19
37
71
28
311
311
20
311
77
Provialonal
0
24
8
18
6
2
0
0
0
12
0
1
24
34
21
Probib-
lted
4
1
6
2
9
9
1
1
8
3
32
173
15
10
66
33
43
66
18
46
31
38
61
5
0
3
4
0
0
0
0
0
0
0
0
0
0
3
0
0
2
0
2
4
0
0
0
0
0
0
0
0
3
0
3
0
1
0
0
2
1
0
2
0
1
0
0
0
0
0
0
0
0
0
2
0
1
1
128
318
2,241
1,685
392
28
4
2
0
3
6
0
3
0
6
0
2
0
1
0
1
0
6
1
4
4
6
2
2
0
2
1
0
0
2
20
0
0
3
2
4
7
11
10
1
16
10
2
1
8
0
1
10
6
42
911
34
17
6
2
M
61
3
26
78
63
68
79
43
37
39
21
39
77
. 58
37
M
211
34
21
28
M
25
112
l!O
34
71
46
30
132
4
31
30
32
34
42
27
g
20
16
63
26
lOII
311
14
62
13
27
97
4
14
1
2
1
3
0
19
2
11
2
18
0
1
0
0
4
12
UI
7
8
4
31
20
30
76
2
0
0
0
0
2
97
11
4
4
Action
pend•
Ing
0
1
0
3
0
0
0
0
0
0
0
3
0
0
8
0
1
0
1
0
0
0
7
1
0
0
4
1
0
1
0
0
1
4
0
25
Percent CertlJl.
80urcell
cates
acted Issued
upon
100
97
100
97
100
100
100
100
100
100
100
88
100
100
88
100
118
100
97
100
100
100
88
97
100
100
88
911
100
98
100
100
118
88
100
46
100
73
100
100
0
35
0
0
10
0
0
0
0
6
0
2
0
12
100
100
100
100
80
100
113
100
33
126
94
~
'Ill
41
66
280
58
43
~
6
lOII
100
12
25
1118
103
f¥1
lOII
69
98
77
78
108
133
83
61
105
40
40
22
22
126
28
262
74
33
162
31
104
1311
32
70
33
51
2118
'II
UI
1211
200
112
100
6
4,167
1 The column headed "Public" Includes supplies owned by municipalities as well as those used by
municipalities but owned by private companies.
• A "private" supply refers to a small well or spring used only by the carrier and the person owning It.
SUPERVISION OF WATER SUPPLIES ON VESSELS
During the year 52.6 percent of all vessels in active service, including_ all passenger-carrying vessels, were inapected and certified.
District no. 3 extended cooperation to the officials of the Eleventh
Lighthouse District at Detroit by preparing plans for the installation
of small water-treatment plants on their tenders. Five lighthouse
tenders have now been equipped with the water-treatment :plants developed in the district office in addition to the hypochlonte feeder
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PUBLIC HEALTH SERVICE
installed on the United States Lake Survey vessel. This equipment
has functioned satisfactorily in all cases.
A total of 1,012 laboratory examinations of water taken from
several drinking-water supplies have been made by the health departments of cities on the Great Lakes and the Mississippi and Ohio
Rivers. Of the samples collected from Great Lakes vessels 87 percent conformed to the Drinking Water Standards of the Treasury
Department.
The following table gives the status of the inspection work carried
on during the year:
Vessels for calendar year 1933
f
District
l_ ____ ------ ----------
2_____________ -- -----3 _____________ - -------
-- -- 6
- -___
- - _-___________
- - -- -- ---- -54_and
Total __________
PercentVessels
age of
on active total vesstatus
sels In
Pennadistrict
nent
616
92
430
147
396
1,681
36.6
5.5
26.6
8. 7
23.6
----------
Certlftcation 1
TempoNot
rary approved
75
264
369
109
243
61
884
88
1
Total
0
0
7
5
6
1
330
92
430
331
8
1,223
4
Percent- Percentage of
age or
district
total
vessels
vessels
certlfted certlfted
63.6
100
100
120
251
81.6
63.4
----------
19.6
5.6
26.6
7.1
14.9
72. 7
1 Only the latest certlftcate Issued on a vessel waa counted In case that vessel was both temporarily and
permanently certified during the year.
Forty-six cases of typhoid fever were reported as occurring among
crews and passengers on all vessels during the year. Very few occurred
on vessels coming under the interstate quarantine regulations, and in
no case was the water supply implicated. For the first time since
inspection by the Public Health Service was inaugurated no cases
occurred on vessels operating on the Great Lakes. The records show
a constant downward trend from 70 cases in 1916 to O for 1933.
RAILWAY SANITATION
One hundred and thirty-five inspections of coachJ ards, terminals,
and watering points were made during the year; and 129 inspections
of dining cars were made with particular reference to grade and source
of milk supply and source of shellfish. Cooperation of the carrier companies is excellent in correcting unsatisfactory conditions found.
SHELLFISH SANITATION
Assistance has been rendered the several shellfish-producing States
in their control work, particularly in matters pertaining to growing
areas. A study was made jointly with the Food and Drug Administration and the State Department of Health of New Jersey of the conditions under which oysters have been floated in the Maurice River
section in New .Tersev.
·
Publication and distribution of the list of dealers certified by the
producing States were continued. Shellfish shippers are finding that
maintenance of markets is dependent upon their being on the approved
list. During the year 1,498 certificates issued by producing States were
approved and listed. Thirty-two areas and 536 shucking and packing
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PUBLIC HEALTH SERVICE
plants were inspected in connection with surveys to determine the
efficiency of State control.
RECIPROCITY WITH CANADA
Inspection and certification of drinking and culinary water supplies
used by international carriers, supervision of drinking water-supply
systems on vessels operating in the Great Lakes and border waters.r
and certification of international shellfish shippers were continue<J.
through reciprocity whh the Department of Pensions and National
Health of Canada. Seven Canadian water supplies used by United
States carriers were inspected and certified by the Canadian health
authorities; 71 United States supplies used by Canadian carriers were
inspected and certified; and, in addition, the Canadian authorities
were supplied with reports on 11 United States supplies used by United
States carriers crossing the international line.
•
The Canadian authorities were supplied with copies of all certificates issued to shellfish shippers bv the producing States and approved
by the Public Health Service. They, in turn, have furnished certificates on all Canadian shippers desiring to ship to the United States,
51 such certificates having been received.
COOPERATIVE WORK WITH STATES RELATIVE TO STREAM
SANITA-TION
The greater part of the activity of the Office of Stream Sanitation
during the year has been concerned with a study of the pollution of
the lower part of Chesapeake Bay. This work was financed through
a grant of $25,000 to the Public Health Service from the Public Works
Administration, made at the request of the Chesapeake Bay Authority
for the purpose of determining the practicability of removing sewage
pollution from the Hampton Roads area by the construction ofsewagedisposal works for the North Shore communities and for other neigh:.
boring cities. The State department of health cooperated in this
study by providing some of the personnel and laboratory and boat
service. The investigation has included a review of data obtained
through studies carried on during the past several years by the Public
Health Service and the State Department of Health of Virginia;
bacteriological examinations to supplement the data already available; a study of sewerage of the various municipalities and Government· reservations within the area, with the development of general
plans for collection and treatment of sewage; and an economic study
to ascertain if possible the effect of increasing pollution on the shellfish
industry and recreational facilities in the district.
As trme has permitted, the Office of Stream Sanitation has cooperated with the Ohio River Board of Engineers in a study of the
pollution of the Ohio River in the vicinity of waterworks intakes;
with the Minnesota State Department of Health and the Provincial
, Department of Health of Ontario in planning a survey of the Rainy
River, an international boundary stream; and with the Tennessee
health authorities in planning a sanitary survey of a stream in that
State. On several occasions officers also have conferred with the
Board of Consulting Engineers studying methods of sewage treatment for the District of Columbia relative to the bacteriological and
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PUBLIC HEALTH SERVICE
~hemieal results obtained by the Public Health Service during an
investigation of the Potomac River in 1932.
At the request of the Governor of Colorado an investigation was
made of the use of water polluted by sew~e from the city of Denver
for-irrigating vegetables and farm crops m the South Platte River
Valley.
With funds and labor made available by the Civil Works Administration, cooperative work was undertaken in the States for protection
-of public water supplies through sealing abandoned coal mines to
l)revent pollution of streams with acid mine wastes.
COOPERATIVE PUBLIC HEALTH ENGINEERING
w ORK
The cooperative public health engineering work with other divisions
-of the Public Health Service and other Federal agencies has been greatly
increased during the year on account of the increased construction
made possible through the emergency activities. A total of 1,866
engineer-days, or 43 percent of the tune of the field engineers, was
devoted to this work. Of this time, 1,146 days, or 26.5 percentt was
for the National Park Service and the Office of Indian Affairs.
Natwnal Park Service.-With the reorganization of the National
Park Service the cooperative work in the eastern division was gr~atly
increased. This division now has jurisdiction over 53 reservations
of all kinds, including the National Capital Parks and 71 Federal
buildings in the District of Columbia. In the eastern division,
surveys were made of 14 areas, in 7 of which studies were carried on
in connection with water supply and sewage disposal. At the close
of the year plans were being made for more effective cooperation in
-connection with the sanitary work necessary in the National Capital
Parks and in the inspection of Federal buildings in the District of
Columbia.
In the western division, surveys were made of the 19 national parks,
and plans and specifications for water supply and sewage disposal
were prepared for 10. General supervision over the operation 'of the
sewage treatment plants at the Grand Canyon and Yosemite Parks
was maintained.
On May 26, 19341 the treatment plant at Yoseinite was awarded
the medal given yearly by the California Sewage Works Association
to the most efficiently operated treatment plant in California.
Under the direction of the district engineer, a building code was
prepared for the Park Service. This code contains 13 sections, with
a total of 381 pages.
Office of Indian Affairs. -With the establishment of Civilian Conservation Corps camps on many of the reservations and the allotment of funds from the Public Works Administration, much additional
work has been required in cooperation with this agency. Service
rendered has included advice as to the location and sanitary features,
as well as inspection of the camps. Over 250 surveys were made,
and plans and specifications were prepared for 19 sewa~e treatment
plants and 9 water treatment plants. Additional engineering personnel has been supplied by the Office of Indian Affairs to assist in
the design of treatment plants when necessary.
Bureau of Prisons.-Inspections have been made and advice relative to sanitation and operation of water-treatment or sewage-disposal
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PUBLIC HEALTH SERVICE
plants has been given at the Lewisburg, Atlanta, and McNeil Island
Penitentiaries, Fort Eustis and Camp Lee prison eamps, and theLa Tunajail.
A small sewage tank was designed for the Atlanta Penitentiary,.
and advice and assistance were given in the design of a water supply
at McNeil Island Penitentiary.
Bureau of Agrim.dtural Engineering.-A sewage-disposal plant was
designed for the Beltsville (Md.) homestead development. On account of the uncertainty and variability of load it was necessary to
design a plant providing unusual flexibility of operati6n. Someunusual features therefore were incJuded.
Procurement Division, Publw Works Branch.-Adviee was given
relative to water supplies at several of the border inspection stations,.
with recommendations as to chlorination in several eases. Inspection
of water supplies and water systems were made at. two new postoffice buildings.
Forest Service.-Data were furnished the regional forester, intermountain district, for desi~ of laundry, shower, and comfort station,
and for design of sewage-disposal plants.
Lighihouse Service.-Water-treatment plants were designed and
their installation supervised on three Lighthouse Serviee tenders in
the Eleventh Lighthouse District. Advice was given relative to
water supplies at airway stations.
Distrwt of Columbia. -The Division of Sanitary Engineering was
assisted in a study of the amount of chlorine necessary to control odor
nuisance at the main outfall sewer of the municipal system. during
the summer low-water period.
Publw Health Service.-A survey of sanitary conditions was made
at the United States marine hospital at Fort Stanton,, N .. Mex., for
the hospital division.
'lnited Sta.tes Army.-Advice has been given> when i:e<iuested,.
relative to sanitary problems at the Civilian Conservation. <Oorpscamps.
SUMMARY OF
wORK
CARRIED ON BY THE
V AB/IOl!TS,
DlsmRroTS
Distribution of time, in days, of the field personnel und61' the engi,neB'ri,ng section,
. (ezclusive of engineering personnel employed on Publie- Worka- Administration,
projects), fiscal year 1994
Interstate quarantine:
Dav,
Office ___________________ 1,378
Field:
Water_______________
Shellfish_____________
National Park Service:
Office___________________
Field____________________
Office of Indian Affairs:
Office___________________
Field____________________
590
277
299
132
Chesapeake Bay stu~:
Office and field..__________
Other agenci'es:
Office___________________
Field____________________
Technical meetfngs_ _ _ ________
Leave_______________________
Dav,.
424-
109•
187
23-
194,.
TotaL day.s-a.c.counted.foi:_ 4, 328,
389
326
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PUBLIC HEALTH SERVICE
TABULAR SUMMARY
TABLE
1.-V easel water-aupply supervision
First inspections:
Passenger _______________ _
Freight ___ • _____________ _
Water boats ____________ _
Major conferences:
Da111
With shipping officials __ .__
69
70
With others______________
13
114
10 Water examinations made:
Reinspections:
U.S. Public Health Service
Passenger _____________
laboratories____________
5
198
Freight _________________ _ · 383
Other laboratories ________ 1, 007
Water boats ____________ _
10 Typhoid fever cases reported:
Certificates issued:
U.S. Public Health Service
Regular, favorable _______ _ 856
hospitals_______________
23
Regular, not approved ___ _
U. S. Public Health Service
1
Temporary, favorable ____ _ 413
quarantine stations_____
2
Health departments_______
21
Plans for vessel water systems
examined:
Approval granted ________ _
6
Approval withheld _______ _
1
Da11,
J- _
TABLE
2.-Railroad sanitation superviaion
Inspections:
Sources of water supply __ _
Coachyards _____________ _
Terminals ______________ _
Watering points _________ _
Dining cars _____________ _
94
20
11
104
129
Certificates:
Data reports reviewed _____ 1, 959
Certificates prepared ______ 4,062
TABLE
50
928
20
40
3.-Shellfiah sanitation supervision
Inspections:
Areas __________________ _
Plants __________________ _
32
536
State certificates:
Approved _______________ _
1,498
Not approved ___________ _
0
Approval withdrawn _____ _
1
Canceled _______________ _
174
TA.BLID
Water examinations:
U. S. Public Health Service
laboratories____________
Otherlaboratories ________
Major conferences:
With railroad officials_____
With others______________
Laboratory examinations:
U. S. Public Health Service
laboratories____________
542
Other laboratories ________ 3,142
Conferences__________________
106
4.-Mi8cellaneous cooperation with Governmental_agenciea
Public Health Service (other
divisions):
Surveys_________________
Conferences______________
National Park Service:
Surveys_.--------------Conferences______________
Office of Indian Affairs:
Surveys_________________
Conferences______________
4
26
47
42
Bureau of Prisons:
Surveys ______ •• _________
Conferences______________
Other:
Surveys_________________
Conferences______________
210
82
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14
13
77
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PUBLIC HEALTH SERVICE
RURAL HEALTH
wORK
For a number of years the Public Health Service has given financial assistance to States for the establishment of health organizations
to serve the population living in rural areas and the smaller cities.
Owing to reduction in appropriation, it has not been possible to continue these grants in aid dunng the fiscal year 1934.
While the withdrawal of aid came at a time when State and local
governments could least afford to assume -the added burden, nevertheless the discontinuance of health units has not been so great as
might be expected. At the close of the calendar year 1932, 581
county health departments were in operation; during the calendar
year 1933, 48 were discontinued, leaving a. total of 533 at the close
of the year. The distribution of thei:1e health organizations by States
is shown in the accompanying table:
State
Alabama••••••••••••••
Arizona ••••••••••••••.
Arkansas .•.••••••••••
California •••••••••••••
Connecticut •••••••••••
Delaware ••.•••••••...
Florida •.••••••••••..•
Georgia ••••...•.•..•..
Dllnols•••••••••••.••••
Iowa ••••••••.••••.••.•
Kansas .•••..•••••..•••
Kentucky •••••••••••••
Louisiana •••••••••••••
Number
ofunlta
46
4
21
15
2
3
2
30
1
1
4
73
I
State
Maine .••.•...•.•.••.•
Maryland ....•.•...•••
MBSSBChusetts .••...•.
Michigan •• _••••.•.•••
Minnesota •.••.•.•.•.•
Mississippi••.•••••.•••
Missouri.. ••••••.•••••
Montana .•••.•••••••••
New Mexico ••.•••••••
New York ••.•.•••••••
North Carolina •••.•.•
Ohio ••••••••••••••••••
Number
or units
5
22
3
30
1
24
9
4
6
5
37
40
State
Numba\
otanfta
Oregon.•••••••••••••••
P811D8Ylvanla•••••••••
South Carolina. •••••••
South Dakota•••••••••
Tennessee•.•••••••••••
Texas •••••••••••••••••
Utah ...•••••••••••••••
Virginia•••••••••••••••
W aahlngton•••••••••••
West Vlrglnla. ••••••••
Total ••••••••••• - - - - -
31
The reduction in service has been more marked than the figures
suggest, since a number of employees in county health units nave
been dismissed and sufficient funds a.re not available for necessary
operating expenses. This condition is almost certain to be reflected
in a lower level of health in the communities affected at a later date.
Since the sum of $25,068 actually made available out of the Federal
appropriation for rural health work was not sufficient to permit contributions toward the support of local health organizations, this
amount was devoted to special studies of rural health and the maintenance of a consultation service to State and local health departments on organization and procedure.
In cooperation with the Division of Scientific Research 4 representative countie.i with health departments were selected for intensivestudy with a view to assembling more information on the health needs
of rural families and the suitability of prevailing practices to existing
problems. These studies are discussed more fully in the section of
this report devoted to the Division of Scientific Research.
Three regular commissioned officers, 2 acting assistant surgeons,
and 1 scientific aasistant were on assignment with State health
departments for the purpose of promoting the establishment of rural
health organizations and assisting in the supervision of their activities.
One public health nurse with extensive training and experience in
rural health work has been added to the staff of the central office for
corumlation with State and local authoritiea on rural public health
nursing work. By drawing on the resources of the Division of
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PUBLIC HEALTH SERVICE
Scientific Re3earch, technical advice was rendered to a number of
State and local health departments in such matters as general administration, problems in sanitation, and the control of specific
diseases. On the re9.uest of State and local authorities, complete
surveys covering public health organizations and services were made
in Columbus, Georgia, Cincinnati city and Hamilton County, Ohio,
and the State of Oregon. Similar surveys were made on a representative of Indian reservations on the request of the Co_mmissioner
of Indian Affairs.
PREVENTING THE SPREAD OF PSITTACOSIS
The Public Health Service continued its cooperation with the
State health authorities in the application of measures directed
toward preventing the interstate spread of psittacosis through shipment of infected birds of the :parrot family.
As a result of the continumg occurrence of outbreaks of human
psittacosis it became necessary to apply more rigid control measures
during the past year, both by the several States and by the Public
Health Service. At the :present time, four States and one Territory
have regulations forbiddins the importation of parrakeets within
their borders. No J?sittacme bird may enter the United States
without first undergomg, in addition to other sanitary requirements,
a 15-day period of quarantine detention. The wisdom of requiring
this detention in ~uarantine has been shown repeatedly. Many
shipments of such hITds, although apparently in perfect health upon
an'l.Val, have, while in detention proved to be infected with psittacosis. On December 20, 1933, the interstate quarantine regulations
were amended to require that psittacine birds shipped in interstate
traffic must be not less than 8 months of age, and that existing State
requirements for a certificate of health be supplemented by such
laboratory examination as the certifying authonty may deem necessary. It was subsequently decided by the State Health Department
of California, the center of the parrakeet-breeding industry in the
United States, that a 10 percent sample from such aviary would be
practicable for laboratory testing. Smee it developed that infected
birds might be missed by a 10 percent test, a triple test later was
decided upon, 10 percent of the birds from each aviary to be tested
on the first survey, and the aviaries found negative to be retested by
taking a second 10 percent sample. If, after the second testing the
aviary is still found to be negative, the owner is permitted to resume
breeding activities, provided that he agrees not to import new stock.
When the newly hatched stock has reached the age of 8 months, it
also must undergo a 10 percent test, and if negative, the aviary is
certified as being free from psittacosis and birds from this aviary may
then be sold within the State for breeding purposes or shipped in
interstate commerce.
On February 1 the shipment of birds from California was suspended
pending a State-wide test of aviaries for psittacosis. From February 1
to the end of the fiscal year only a ve-ry few birds under special
circumstances have been cleared for mterstate shipment from
California.
Prior to March 1, 1934 52 California aviaries had been found by
the State or the Public Health Service . la~oratories to be infected
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PUBLIC HEALTH SERVICE
with psittacosis. During the first 3 months of the State survey
begun on March 1, 1934, 112 aviaries were tested by the State
laboratories. These 112 aviaries, in which 10 percent of the birds
were tested, comprised a total of approximately 36,000 birds. Of
the 112 aviaries tested, 24, or 21 percent, were found to be infected.
They were for most part small, involving only 1,428 birds.
FEDERAL CIVIL
w ORKS
PROJECTS OF THE PUBLIC HEALTH SERVICE
In planning the work program to be undertaken in the several
States, the Civil Works Administration considered it desirable that
the projects be in the interest of the public welfare and community
improvement as far as possible. Accordingly, the Public Health
Service was asked, along with other Federal agencies, to suggest
projects on which beneficiaries of the Civil Works Administration
might be profitably employed. Four projects were recommended by
the Public Health Service, namely, an intensive malaria-control
drainage program in the 14 States where malaria. has prevailed most
extensively; the construction of sanitary privies in the small towns
and villages and in the unsewered outskirts of larger cities; surveys
to determine the extent of endemic typhus fever in rodents in important seaports and in certain inland areas where the disease now
prevails; and the sealing of abandoned coal mines to reduce the acid
wastes being discharged into streams used for water supplies.
In order that these projects might be given proper technical
direction, they were placed under the general supervision of the
Public Health Service, and special allotments were made to the
Office of the Surgeon General for the employment of additional
technical supervisory personnel, traveling expenses, purchase of
tools, and the like.
The health officers of the States participating in the several programs were made the agents of the Public Health Service for technical
supervision of the work. Special allotments were reserved for the
Public Health Service projects out of the funds given to the several
States for the employment of labor and local supervisory personnel.
The sums set aside for labor amounted to approximately $4,500,000
for malaria control, $5,000,000 for community sanitation, $1,000,000
for typhus-fever surveys, and $1,500,000 for sea.ling abandoned coal
mines. However, difficulties encountered in securing local allotments
of labor and some unavoidable loss of time in organizing the work
prevented the actual expenditure of the entire amounts allotted
before the Civil Works program came to an end on February 15, 1934.
It is estimated that not more than one-half of the funds tentatively
allotted for labor on the malaria-control and sanitation projects
actually were expended and not more than one-third for sealing mmes.
MALARIA CONTROL
In each of the States selected for this work, malaria is the major
public-health problem in much of its territory. In the malarious
sections of these States the school".child infection rate (the rate for the
only accurately measured group) varies from 10 to 60 percent, and
in some places is as high as 95 percent. .The effect.i of the infection
are such that the school children not only do not make reasonable
progress in their studies but are not able to put forth on an average
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PUBLIC HEALTH SERVICE
more than two-thirds of the effort normally to be expected of them.
This result of illness is reflected not only in the schools, but on the
farms and plantations and in the industries of the South. In the
area affected there are approximately 2,000,000 cases of malaria each
year, and the annual loss is estimated at half a billion dollars. Although the death rate from malaria is not high in comparison with
the rates for some other diseases, it does, in a num her of States, exceed the death rate for typhoid fever and causes more deaths than
smallpox.
.
The program was inaugurated in early December 1933 and was
approaching its maximum of development by early January 1934.
When the work commenced, the malaria projects were designated as
Federal projects, and an allotment of laborers was made for this purpose to each State. At the height of labor employment (Jan. 20,
1934) there were 28,000 laborers at work daily on Federal malaria
projects. The work proved so popular and the benefits accruing
from it were so apparent that the State directors of the Civil Works
Administration supplemented the Federal projects by creating State
and local projects of similar type. At the labor peak, reports showed
the employment of 53,000 people on State and local yrojects, a total
actually much greater than the number on the Federa projects. The
reported nllffiber at work on malaria drainage at the height of employment was over 130,000 laborers.
The results of the work can only be estimated. Drainage commenced after the last malaria transmission season had ended, and the
new season has not yet arrived. We cannot at this time even approximate the number of persons living within possible flight range of
those areas now drained which heretofore have produced Anopheles
mosquitoes. However, in view of our knowledge of the general areas
coV'ered by the drainage program, it is conservatively estimated that
not less than one-fifth of the population will be removed from the
hazard of malaria if the draina~e effected should be properly maintained in the future. It is believed that the economic benefit derived from the removal of this hazard will represent an annual saving
of not leso than $100,000,000. The actual saving probably will be
considerably greater than the estimates here given.
A project for establishing the malaria index by blood examination
in the areas where the work has been carried on is now under way.
This will furnish a "base-line" for measurement of the results of tne
work in the future, as well as an excellent measure of the endemicity
of malaria in the United States. Over 150,000 blood specimens have
been taken and more than 40,000 of these have been examined to
date.
COMMUNITY SANITATION PROJECT
The community sanitation project was selected as a profitable
means of employment of civil works labor because of the opportunity
afforded to perform a service of value to the whole population of
rural and semirural communities and because the project was well
adapted to the use of the type of labor predominating in such communities.
The work was carried on in 24 States, including all of the Southern
States, and Delaware, Pennsylvania, Ohio, Indiana, Illinois, Kansas,
901G7-M-5
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PUBLIC HEALTH SERVICE
and Washington. The health officers of all of the States were informed of the possibility of using work-relief labor on privy construction and were given an opportunity to ,ngmfy their willingness to
participate in the project. The States selected were those which
responded to the invitation.
The program in each State was set up under and administered
through the State department of health. The supervisory personnel
consisted of a State director, in general charge of the whole program
in the field; district supervisors, selected from the reemployment
rolls, each having responsibility for the work in a group of counties;
and a county supervisor for each county, selected from the local
reemployment rolls. It was the function of this force to promote
local adoption of the program, sell the project to individuals, and
train and supervise labor engaged in construction. Labor was assigned for the construction of sanitary privies only where materials
were furnished by the property owner or by some public agency such
as the county board of education, county supervisors, or the municipal
government. Some municipalities purchased the materials in one
lot for the sanitation of the entire community, the privies constructed
being regarded as a public utility. Others purchased the materials
and offered to furnish what was needed for the installation of a
sanitary privy in any home in the community where the property
owner would pay a certain proportion of the cost. Others purchased
the material in order to take advantage of wholesale prices and expedite the work, and assessed the cost against the property on which
the sanitary privies were erected, or provided other means for reimbursing the municipality. In some sections the labor was used to construct privies for farm homes throughout the county, but for the most
part the work was confined to unsewered towns and villages, and the
unsewered sections surrounding the sewered areas of the larger communities. The work was concentrated in these more congested areas
because the health menace of an insanitary privy is proportionate to
the number of persons who live within fly range of it, because typhoid
fever is most prevalent in small towns and villages, and because more
effective supervision could be exercised where the labor could be
used in large groups.
Only a small number of men could be used at the very beginning,
because materials for the project could not be furnished from Federal
funds. However, the number employed increased steadily from the
time the work was begun in December, reaching a total of 35,000 at
the peak of activities. All materials had to be furnished by individual
property owners or local public agencies. It was therefore necessary
to make arrangements for materials and to develop sufficient interest
in each community to create a demand for the work in advance of the
assignment of labor. The local interest that developed in this program exceeded the most optimistic expectations of everybody connected with it. It is estimated that at the peak of activities there
were enough materials on hand and commitments made by :property
owners to furnish materials to make work for at least five tunes the
number of laborers available.
Accomplishments.-(1) Incomplete reports show more than 200,000
privies constructed. It is believed that the complete report will show
at least 25,000 more constructed or partially compl~ted by the end of
March 1934.
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PUBLIC HEALTH SERVICE
(2) While it will be impossible for aome time to measure the result
of the work in terms of actual prevention of disease, it is believed that
there will be both immediate and remote benefits which will thoroughly
justify the undertaking.
(a) As to immediate benefits, in communities where the program
proceeded far enough to effect complete elimination of inaanitary
privies, it ia expected that a noticeable reduction in the prevalence of
excreta-borne diseases will occur.
(b) As to future benefits, even in communities where the program
did not proceed far enough to accomplish a complete or almost complete elimination of insanitary privies, the community has been made
"sanitation conscious" and there has been provided a standard of
sanitation which will induce further progress on the part of both the
public and the local governmental agencies. Modern standards of
sanitation have been introduced into hundreds of communities and in
several States which heretofore have given little attention to practical
sanitary privy construction.
3. The supplying of materials by property owners and local governmental agencies has helped private industry. These purchases of materials by private individuals and agencies other than the Federal
Government involved a total expenditure at least equal to the amount
paid by the Civil Works Administration to labor employed on this
project. It is estimated that the materials purchased included
approximately100,000,000 board feet of lumber;
40,000 barrels of cement;
1,000,000 pounds of naila; and
6,000,000 square feet of roofing.
Most of the materials were purchased from local dealers.
TYPHUS FEVER CONTROL
Although formerly not an important cause of illness in this country,
endemic typhus fever has been increasing steadily and markedly in
prevalence in certain areas of the United States during the past 3
years. While in 1931 only 332 cases were reported in the entire
country, the number rose to 995 in 1932, and to 2,043 in 1933. This
increasing prevalence had emphasized the necessity that measures be
undertaken for reduction and limitation of the spread of the disease.
The Federal Emergency Relief Administration desired to employ
people on docially useful projects, and an attack upon this form of
typhus through the medium of a restricted and properly directed
campaign against disease-carrying rats and their parasites appeared to
fulfill this requirement.
At the request of the Civil Works Administration, the Public Health
Service indicated areas harboring the greatest amount of infection.
The Biological Survey undertook a campaign of destruction of the
rats in these areas by means of trapping and poisoning. At the same
time it was planned that groups of men recruited from the ranks of
the unemployed, and working under the supervision of the Public
Health Service, would test the efficacy of these control measures and
make tests on new areas to ascertain where additional control measures would be required in order to secure effective redults. Unfortunately, the time of actual operation of the project was so short that
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PUBLIC HEALTH SERVICE
very little progress could be made in that part of the control program
which was to be carried out by the Public Health Service.
However, the Service was able to make considerable progress with
another part of the program, that consisting of a rodent ectope.rasite
survey and having for its objective the determination of the vulnerability of our principal seaports and a few inland cities with respect
to endemic typhus fever and bubonic plague.
Originally, a program was laid out to cover 7½ months' operation.
Later, with the inauguration of the Civil Works Administration, this
plan was revised for a 2½-month period. Actually, however, less
than a month of scheduled operations re,mlted, because of the delays
in the initiation of the project and its sudden unforeseen curtailment in
January. At the height of the work, a total of 3,757 men were employed. The control work was carried on in three Southern States,
and the rodent ectoparasite surveys were made in 30 seaports. The
surveys are being continued in several of the cities as work-relief
projects.
.
In spite of the very short time of unrestricted operations (1 month
from the time of approval of the/.roject), it is felt that some worthwhile results were accomplishe . In several communities where
rapidly increasing prevalence of typhus fever had created wide-spread
apprehension on the part of the citizens, it was possible to locate the
exact sources of infection and promptly institute intensive control
measures. In other parts of the infected areas, where the early
termination of the projects precluded complete achievement of the
desired objectives, the partially completed work has at least been of
substantial educational value, and the people have been awakened
to the need of continued effort on their own part if a permanent
reduction in the incidence of this disease is to be effected.
SEALING ABANDONED COAL MINES
This project was undertaken to provide work for unemployed
miners to protect the public health through the safeguarding of
water supplies from the effects of acid mine drainages. The action
of oxygen, pyrites, and water in abandoned or idle bituminous coal
mines brings about the formation of acid salts and sulphuric acid.
In many sections the amount of acid thus formed and discharged
into streams is sufficient to bring about an acid condition in these
streams and in the larger rivers into which they discharge. This
condition has been increasing in intensity in recent years and is
materially affecting the efficiency of treatment of many public
water supplies and in some instances has made it impossible to
use the water from these streams for smaller supplies.
This problem has been one of considerable concern to the health
authorities in several of the soft-coal Inining States for many years.
In spite of the extent to which abandoned mines have contributed
this acid water, little had been done in interesting mine operatives
in an attempt to care for sections of mines properly as they became
worked out.
Experimental work by the United States Bureau of Mines and the
State Health Department of Pennsylvania had demonstrated that
if air could be eliminated from abandoned workings, oxidation would
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PUBLIC HEALTH SERVICE
cease and the water in, and flowing from, these openings would remain
alkaline.
Two methods were possible by which this could be brought about:
(1) Floodin~ of the workings, and
(2) Air sealing.
In either method the flow of water w,mld not be interrupted. Certain dangers existed in the flooding method which made it practicable
only under certain conditions. Air sealing in general appeared more
satisfactory, although requiring more careful attention to insure that
all openings, however small, were closed.
Funds were made available by the Civil Works Administration for
the actual starting of operations on December 17, 1933, for carrying
on the project in 10 States.
In Pennsylvania, West Virginia, and Alabama, where certain
information was already available, permitting work in certain sections to start immediately, a considerable amount of actual sealing
was effected. In other States, surveys were completed and work
had just been started on the sealing when the restrictions on the
employment of labor became effective, January 19, thus preventing
any_extensive construction.
While it was not possible to complete the project as planned, sufficient work was done to accomplish the following results:
The furnishing of records to State departments of health covering
the location of mines discharging acid water and the extent of this
discharge; demonstration of the practicability of air sealing for
control of acid mine water; develo_pment of methods for air sealing
under varying conditions; the traming of a considerable group of
coal-mining engineers and others in the methods of acid mine water
control; and creating in the mine operators an interest in the work.
The maximum number of persons were employed in this work during
the week ending February 15, when 2,927 men and 24 women were
on the pay roll. Of this number, approximately 2,700 were employed
in Alabama, Pennsylv1mia, and West Virginia.
At the termination of the work on February 15, approximately
7,000 openings of various types had been closed, and several hundred
additional openings were being closed.
After the Civil Works program was terminated, the relief administrators in a number of States elected to continue the malaria-control
and community-sanitation projects as work-relief activities. The
Public Health Service was able to contmue its assistance by providing
a liznited number of technical supervisors in each State. The work
therefore was being continued at the close of the fiscal year in most
of the States where it had been inaugurated.
CONFERENCE
OF THE SURGEON GENERAL WITH
TERRITORIAL HEALTH OFFICERS
THE
STATE
AND
In accordance with the act of July 1, 1902, the Thirty-second
Annual Conference of State and Territorial Health Officers with the
Public Health Service was held June 7 and 8, 1934, in Washington,
D. C. Delegates from 41 States and the District of Columbia were
in attendance. An interesting program was arranged and participated in by the members and delegates.
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DIVISION OF FOREIGN AND INSULAR QUARANTINE AND
IMMIGRATION
Asst. Surg. Gen. F. A.
CAHMEI,IA
in charge
The various quarantinable diseases were prevalent in many parts of
the world during the fiscal year. Plague wus present in the island of
Hawaii, on the western coast of South America, in many parts of
Africa, m :\1adagascar, in l\:Iarseille, ]Trance, and in several Asiatic
ports. Cases also occurred in the interior of California and in Oregon.
Cholera was confined to Asia and adjacent islands, including the
. Philippme Islands. \\11ile smallpox decreased in England and Wales
during the year, it was prevalent in many ports in all parts of the
world except Australia. Typhus fever was also widespread; an extensive outbreak of the virulent type occurred in Chile, and it was also
present in :Mexico. In eastern Europe, where typhus fever was
epidemic dming and following the World '"'ar, it is now endemic.
In Egypt and in other parts of Africa, the disease causes many deaths.
¥ ellow fever was reported as having occurred in Brazil, in the States
of Para, Anrnzonas, Ceara, Pernambuco, Acre Territory, Bahia, and
::\1atto-Grosso; and in Africa it was reported rn Senegal, Guinea,
Niger Territory, Ivory Coast, Gold Coast, Togoland, and Nigeria.
During the year, 14,796 vessels from foreign countries, carrying
1,737,416 persons, were inspected by medical officers of the Public
Health Service prior to entry at United States ports to prevent the
introduction of any of the quarantinable diseases. 11,576 vessels,
524,283 passengers, and 852,749 seamen were inspected upon arrival
at ports in the contmental United States, and 3,220 vessels, 135,125
passengers, and 225,259 seamen were inspected upon arrival at insular
ports. In addition, 3,668 airplanes carrying 26,951 persons, arrived at
airports of entry in the Umted States from foreign ports, requiring
quarantine inspection. Of this number, only 2,456 airplanes, carrying
23,899 persons, of whom 4,364 were aliens, were exanuned by medical
officers of the Public Health Service. The remainder, comprising
1,212 airplanes, _carrying 3,052 persons, entered the United States
without undergoing the medical examinations required under the quarantine and immigration laws due to the designation of airports of
entry at which medical officers of the Public Health Service are not
available for duty.
None of the quarantinable diseases was imported mto the United
States or its dependencies during the year. A British ship arnved at
the port of South Bend, Wash., with a case of smallpox contracted in
Shanghai; one case of typhus fever arrived at New York, N. Y., on a
small passenger vessel from the Mediterranean; one case of typhus
fever was present on a vessel which arrived at Jacksonville, Fla., and
a vessel carrying two cases of human plague arrived at San Pedro,
Calif. Effective measures taken at the respective quarantine stations,
however, prevented the introduction of these diseases into the United
States. No detentions of vessels were made during the year because
of the presence on board of yellow fever or cholera.
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65
A total of 120,800 persons was vaccinated against smallpox, and
2,157 persons were vaccinated against cholera; 1,297 laboratory examinations were made for evidence of cholera infection, and 1,263
laboratory examinations were made to determine infection with cerebrospinal meningitis.
The weekly sanitary reports issued by the American consuls at the
various ports in the Orient and the Eastern Bureau, Health Organization, League of Nations, at Singapore, regarding the occurrence of
quarantinable and communicable diseases continued to be of great
value and assistance to the medical officers detailed for duty in the
Philippines in carrying out the quarantine functions. Because the
Philippine Islands are so close to oriental foci of one or more of the
quarantina.ble diseases, it is necessary for the quarantine officers on
duty there to take all of the recognized precautions in connection with
vessels coming from infected districts, in order to prevent the transmission of such diseases into the Philippines.
Due to the almost universal application of the provisions of the
International Sanita.ry Convention of Paris (revised 1926), and to the
rat-proofing of old ships and the modern type of construction of new
ships, in which rat harborage is reduced to a minimum, the number of
fumigations of ships performed in recent years hns greatly decreased.
During the past year, only 1,289 vessels were reqmred to undergo
fumigation upon arrival at United States ports. Of the 6,070 rats
retrieved following fumigation, 4,229 were examined for evidence of
.plague infection, ·with negative results. One thousand seven hundred
and ninety-one vessels from foreign countries presented international
standard certificates of deratization, of which only 195 were determmed to be not acceptable, and 1,457 vessels presented foreign
certificates of deratization exemption, of which only 139 were refused.
International standard certificates of deratization exemption were
hsued to 1,676 vessels by quarantine officers at United States ports.
ln accordance with an informal agreement reached between the
delegate representing the United States and the other delegate members of the Quarantine Commission of the International Office of
Public Hygiene, Paris, quarantine officers of the United States were
authorized to accept a foreign certificate of deratization or deratization exemption which had not been visaed by the American consular
officer at the port where it was originally issued when the certificate
is otherwise acceptable and the quarantine officer is satisfied that the
vessel at the time of obtaining it was not scheduled to proceed to a
United States port. Quarantine officers were also inform_ed that
visa of foreign certificates of deratization or deratization exemption
will not be required when there is no American consular officer listed
in the Foreign Service list of the State Department at the foreign port
where the certificate was issued.
While the International Sanitary Convention of Paris (revised 1926)
permits requiring that vessels obtain bills of health at foreign ports of
departure and specifically enumerates the requirements to be observed
at such ports, facilities for the proper observation of the measures
prescribed in the convention at ports of departure are not universally
available, and it is therefore not practicable to limit the issuance of
bills of health to vessels which have complied with such requirements
in those ports of departure at which such facilities are not available.
Recommendation was there£ore made to the Secretary of the Treasury
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PUBLIC HEALTH SERVICE
that the quarantine regulations administered by the American consular service and the Public Health Service in foreign ports prescribed
under the authority contained in the Quarantine Act of 1893, as
amended, be revised to prescribe that the master of a vessel bound
for a port of the United States shall make every effort to observe the
specific measures enumerated in the International Sanitary Convention for observation at ports of departure and that, at ports in which
facilities are not available for the observation of such measures, or the
master is unable to observe such measures, the consular bills of health
shall be notated accordingly, setting forth in brief the circumstances
involved. The quarantine treatment at the port of arrival of vessels
carrying such bills of health would be based then upon the nature of
such qualifying endorsement. This recommendation was approved
by the Assistant Secretary of the Treasury, subject to the Secretary's
approval of the revised regulations.
During the year, the Department assessed penalties aggregating
only $510 for violations of the quarantine laws of the United States
by masters of vessels coming from foreign ports.
Special research in the fumigation of ships for the destruction of
rats as a plague-preventive measure was continued throu~hout the
year. The studies included the possible adaptation of liqmd sulphur
dioxide to the fumigation of ships; further improvement in hydrocyanic acid gas fumigation, particularly in methods of fumigating the
bilges on loaded vessels; the use of chloropicrin as a warning ~as, with
particular reference to its use before hydrocyanic acid gas 1s placed ,
m the spaces to be fumigated which cannot be searched; and the use
of calcium cyanide in dust form as an intensive preliminary treatment
of concealed structural space in cargo holds which are then to be
fumigated with liquid hydrocyanic acid gas. Experiments were also
made in the use of carboxide gas as an insecticidal fumigant, particularly in the treatment of airplanes, and in the use of amyl nitrite
in the treatment of hydrocyanic acid gas poisoning.
The work of many of the quarantine stations was materially
increased during the year by the rodent-control surveys which were
undertaken, in cooperation with the recovery program of the President
under Service supervision with funds supplied by the Civil Works
Administration. A large number of rats collected as a result of the
surveys were examined macroscopically to determine the presence
of plague, or inoculated into guinea pigs to determine the presence
of endemic typhus fever. All ectoparasites found were classified.
These sYrveys, in addition to furnishing much needed employment,
resulted in the collection of much interesting data of quarantine
import.
On December 20, 1933, the regulations governing the importation
of birds of the parrot family into ports of the United States, prescribed
in accordance with the provisions of Executive Order No. 5264,
approved January 24, 1930, were revised to permit such laboratory
examinations of birds selected b;v quarantine officers from suspected
shipments arriving at the respective ports of entry as might be deemed
necessary to assure that the birds are free from psittacosis infection.
Further revision also was made in order to prohibit the entry at
United States ports from foreign ports or ports in the possessions and
dependencies of the United States of birds of the parrot family under
8 months of age. This latter provision was considered advisable
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PUBLIC HEALTH SERVICE
67
because it had been found that psittacosis is more likely to be transmitted by young birds.
The reservations subject to which the United States had indicated its
willingness to sign the International Sanitary Convention for Aerial
Navigation were accepted by all prior signatory governments, and
the convention was signed on behalf of the United States by the
American Minister at The Hague on April 6, 1934. The latest date
on which the convention was open for original signatures was April 12,
1934, at which time 23 countries had signed; namely, United States
of America, Germany, Australia, Austria, Belgium, Egypt, Spain,
France, Great Britam and Northern Ireland, Greece, Irish Free
State, Italy, Morocco, Monaco, New Zealand, Holland, Poland,
Rumania, Sweden, Syria, Lebanon, Tunis, and the Union of South
Africa. The convention will become effective 120 days after the
ratifications of 10 countries have been deposited. with the Government of the Netherlands. A number of countries have already
taken the necessary preliminary steps to secure ratification. The
convention embodies provisions which have received world-wide
approval, and it is evident that it represents a code of general applicability which many governments are ready to accept in order to
reconcile the interests of international air traffic with legitimate
requirements for the protection of the public health. The advantage,
both in the interests of aerial navigation and of international public
health, of having the convention become effective as soon as possible
cannot be stressed too strongly.
.
During the fiscal year there was completed the construction of a
stone breakwater and 1 double set of junior medical officer's quarters
at the Boston (Mass.) Quarantine Station; 1 set of senior medical
officer's quarters at the Reedy Island (Del.) Quarantine Station; 1
set of senior medical officer's quarters and a disinfecting plant at the
Baltimore (Md.) Quarantine Station, and 2 sets of junior medical
officer's quarters at the New Orleans (La.) Quarantine Station.
During the latter part of the fiscal year, two Diesel wrought-iron
q_uarantine launches, 41 feet in length, designated as the Q-25 and
(,/;-26, were constructed, respectively, for the Marcus Hook (Pa.)
Quarantine Station, and the Portland (Maine) Quarantine Station.
Medical inspection of aliens.-During the fiscaf year 680,152 alien
immi~ants were examined and 783,377 alien seamen were inspected
at Umted 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 immigration laws. A total of
1,502 alien immigrants (about 0.2 percent) and 507 alien seamen
(about 0.06 percent) were certified to be afflicted with one or more
of the defects or diseases requiring mandatory exclusion, and 15,131
alien immigrants (about 2.2 percent) and 569 alien seamen (about
0.07 percent) were certified to be afflicted with a defect or disease
which was likely to affect their ability to earn a living.
A total of 35,539 applicants for immigration visas was examined
by medical officers in American consulates in foreign countries. Of
this number, 573 (about 1.6 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 6,431 (about
18.1 percent) were reported as afflicted with a disease or condition
which was likely to affect their ability to earn a living. None of the
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PUBLIC HEALTH SERVICE
aliens who had been given a preliminary medical examination in
American consulates in foreign countries and to whom visas had been
issued was certified upon arrival at a United States port as being
afflicted with a defect or disease requiring mandatory deportation.
In order to facilitate the entry of native-born and naturalized citizens of Mexico desirous of temporarily visiting the United States, the
Department of State and the Department of Labor arranged, for
immigration purposes, to have American consular officers in the interior of Mexico issue to such persons identification cards, bearing the
photograph and signature of the holder. These cards are to be issued
by American consular officers only to bona fide temporary visitors
coming to the United States briefly for business or pleasure who at
the time of issuance are apparently free from any communicable disease and who have either previously had smallpox or have been successfully vaccinated against that disease. Quarantine officers were
accordingly authorized to pass the holders of these identification cards
upon presentation at the United States ports of entry on the Mexican
border provided they then show no evidence of quarantinable disease.
The Philippine Islands Independence Act, which was approved
March 24, 1934, and accepted by the Philippine Legislature on May
1, 1934, provides for the application of the immigration laws of the
United States to citizens of the Philippine Islands and for the detail
of Foreign Service officers of the United States to Manila for the administration of the immigration laws. In accordance with a request
made by the State Department, the medical officers of the Public
Health Service on duty in Manila were authorized to perform the
medical examinations of citizens of the Philippine Islands who apply
for immigration visas under the Philippine quota.
The Philippine Islands Independence Act also specially authorizes,
without reference to quota restriction, the temporary migration of
Filipino laborers to the Hawaiian Islands under regulations approved
by the Secretary of the Interior. These regulations, which were
issued June 15, 1934, provide for the issuance of permits following
the examination of such laborers by the consular officer of the State
Department stationed in Manila, with the assistance of medical
officers of the Public Health Service, for the purpose of determining
whether or not such applicants are members of one or more of the
classes of aliens who are inadmissible into United States territory
under the provisions of the Immigration Act of 1917. At the request
of the Secretary of the Interior, the medical officers of the Public
Health Service on duty at Manila were also authorized to perform
the medical examinations required in connection with the issuance of
such workers' permits to laborers destined to the Hawaiian Islands,
when requested to do so by the American consular officer on duty in
Manila.
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PUBLIC HEALTH SERVICE
TRANSACTIONS AT M .ARITIME QUARANTINE STATIONS
TABLE
!.-Summary of transactions at maritime stations for the frJcal year 1934
Bills of Amount
Vessels
Veshealth
sels fumigated
of bills
Pasand port rendered
sels grantsengers
Crew
insanitary
in~
ed
for quarinspected
statespect- free C'ya- Sul- spected
antine
ments
prat- nide phur
ed
services
issued
ique
Ves-
Stat.ion
--- --- --- ---
- - --Aberdeen, Wash _____________________
5
5
Angel Island, Calif. (San Francisco) __
301
448
Astoria, Oreg ________ . ________________
42
42
Baltimore, Md _______________________
320
386
Beaufort, s. c __ _____________________
0
0
Boca Grande, Fla ____________________
1
19
Boston, Mass ____________________ . ___
611
799
Brunswick, Ga _______________________
13
13
Carrabelle, Fla_______________________
Charleston, s. c _____________________
130
138
Corpus Christi, Tex.1 ________________
37
36
2
2
East~rt,
Me_----------------------Eure a, Calif________________________
1
1
Fall River, Mass _____________________
9
9
Fernandina,
Fla.
(Cumberland
Sound) _____________________________
3
3
Foct Monroe, Va _____________________
293
306
Freeport, Tex ________________________
7
8
Galveston, Tex_______________________
524
534
Oeo~etown, s. c ____________________
0
l
Gulfport, Miss _______________________
9
9
Jacksonville Fla. (St. Johns River) __
107
116
Key West, Fla _______________________
132
136
Lewes, Del. (Delaware Breakwater) __
l
1
Marcus Hook, Pa ____________________
507
640
Marshfield, Oreg. (Coos Bay) ________
7
7
645
645
Miami, Fla
---------------- -----· -Mobile,
Ala__
__________________________
117
138
New Bedford, Mass __________________
4
6
New London, Conn ____________ ___ ___
10
9
New Orleans, La _____________________
846
901
Newport, R. r_ _______________________
9
9
New York, N. Y,•-------------------- 3,358 2,951
Ogdensburg, N. y ___________________
0
0
31
Panama City,
32
Fla-------------------Pensacola,
Fla _______________________
36
45
Plymouth, Mass _____________________
7
9
Port Everglades, Fla_________________
Portland, Maine _____________________
96
114
Portland, Oreg _______________________
15
17
Port San Luis, Calif. (San Luis
TotaL _________________________
Alaska:
Ketchikan _______________________
Wrangell. _____________________ • __
TotaL. _______________________ •
Hawaii:
AhukinL ______________ __________
Hilo ______________________________
Honolulu_____ . __ . _________ . ______
KahuluL.. _____ .•.•• _____________
Port _.\lien _____________________ __
0
12
181
3
3
0
601
61,635
0
0
0
0
210.00
18,085.07
155.00
0
1,939.33
365.00
0
0
85
0
117
12
0
0
0
4,889
1,232
0
0
5,536
31
0
0
393
0
0
0
JO
0
39
0
9,747
3
0
0
508
0
1
0
0 14,542
0
156
2
72
1
0
8,419
0
0
26
0 394,328
0
0
14
0
13
0
36
0
115
16,998
326
16,683
5
282
2,617
9,367
19
21,025
272
19,991
4,480
119
291
37,530
2,047
481,470
0
1,151
1,317
0
0
0
15
0
0
0
0
0
0
6
0
27
0
0
14
0
0
0
0
377
n
30
342
530
543
4
25
94
24
0
0
0
7
90
0
0
10.00
130.00
30.00
4,943.45
76. 00
6,976.96
5.00
90.00
1,609.38
1,98 1.05
10.00
12,143.15
75.00
5,064.00
1,972.61
59.04
80.00
14,922.87
00.00
68, 714. 77
0
375.00
570. 00
120. 00
238
601
60
0
4,219
28
559
0
0
39
3,602
20
18,790
0
60
839
0
0
17
0
0
41
19
3,363
632
60
2,310
1,240.00
1, 725, 46
0
36
0
0
0
0
0
0
0
0
0
2
7
0
17
681
97
9,446
24, 791
67
0
0
2
347
0
59
I, 101
3,186
1,672
11,312
17,884
69,025
1,771
476
676
1,595
5,143
0
0
), 716
li6
0
0
i, 986
0
22
61
0
0
0
0
520-00
4,651.23
537. 00
3,578.86
3,738.37
24,652.18
913.00
215.00
198.00
714. 84
3,021.54
0
360.00
4r, 524,283
852,749
0
0
77
0
31
8
0
0
44
0
211
0
0
0
0
796
=
0
19
33,665
9
20,783
5
266
0
0
0
0
11,576 10,021
--0
0
$60. 00
11,498.37
420. 00
9,404. 78
0
47
4
53
4
91
JO
0
0
0
17
0
0
0
0
271
0
0
29
20
39
295
415
972
53
22
16
47
214
0
72
29
Pi~~n.-;end,
73
Providence, R . !_Wash.•-------------__________ __ ____ ____
40
Sabine, Tex __________________________
346
San Diego, Calif. (Point Loma) ______
431
Ban Pedro, Calif _____________________ 1,239
Savannah, Ga _______________ : ________
57
Searsport, Maine _____________________
22
South Bend, Wash ___________________
17
Southport, N. C. (Cape Fear) ________
50
Tampa, Fla __________________________
247
Vineyard Haven, MRss _______________
0
West Palm Beach, Fla _______________
72
198
34,692
1,558
12,887
0
5
.o
0
0
288
42,616 208,221.31
---
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
12
176
3
3
0
0
9
0
0
0
0
0
0
0
0
30,565
0
0
0
919
42,810
104
107
31
189
622
143
87
539
1 Includes Port Aransas, Tex.
• Includes Perth Amboy, N . 1.
Includes all ports on Puget Sound.
1
Digitized by
Google
0
140. 00
3,733. 00
30.00
30.00
70
PUBLIC HEALTH SERVICE
TABLE
1.-Summary of transactions at maritime stations for the fiscal year 1984Continued
Ves•
Vessels
Bills of Amount
Ves•
sels
fumigated
health
Passels grantand port of bills
sengers
Crew
in•
rendered
ined
sanitary
inspected
for quar•
spect• free <:ya• ~Ill•
state•
spe<'led
antine
prat• nide plmr
ed
ments
services
ique
issued
Station
- - - - - - --
Hawaii-Continued.
Lahaina .....•...•.............•.•
Makaweli.. ...•.......•.....•.•••
0
0
0
0
0
0
M
0
199
194
9
0
31,104
43,940
I, 126
PhilipplnM:
2
Cavite ..•••...•...•.•.•.•••••••.•
Cehu ...•.••.......•.......•.•.•..
664
Davao ....................•.••...
59
149
lloilo .•............•....•..•.•••..
Jolo..............................
2i
Legaspi. •..........•...•.........
19
Manila........................... I, 044
Olongapo... •.... .... .... .•...•..
1
Zarnboanga ...............••.•.... ,
36
2
0
0
4
0
I
202
I
0
0
0
0
0
0
0
0
Ill
0
106
0
0
133
0
0
18,324
li2
19,325
3,926
7,572
982
714
97,222
122
3,045
Total.. •..••••••.•.•.........•..
01
o,
0
0
0
0
- - - - - -- - - - -
= =--
0
0
$3,933.00
11
I, 2il
617
22
66,656
0
534
88
0
0
0
0
0
0
0
0
0
2IO
50
361
88,224
133,080
2,418
0
3
0
2
0
34
89
8
27
44
427
0
0
0
0
0
2
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
296
0
37
51
10,456
175
0
31
0
144
3,816
87
496
1,025
2i, 611
169
74
131
78
406
90
64
262
371
795
~5.00
0
15.00
0
175. 00
790. 00
50.00
175. 00
415. 00
6,300.12
634
9
0
10,840
33,385
2,440
7,975.12
5
47
220
0
0
0
0
0
18
12
2,313
2,631
69
3,064
11, 721
297
93
370
40.00
667.00
3,498.60
4,956
14,854
760
4,206.60
Total, all stations ••......•.•••• 14, 796 11,331
864
!
I
-----
Total.. .•............. _._....... 2,001
Puerto Rico:
A~narlilla ........................ i
Areciho .........................•
Arroyo ...........................
Central Aguirre ..................
Fajardo ... , .....•.............•..
Ouanica __________________________
Humar90 ________________________
Mayaguez ........................
Ponce.................•.•.....•..
San Juan ..•...••.••.•....••.•....
3
0
2
0
35
89
9
27
45
479
Total. ..•........•.•.......••...
689
Virgin Islands:
Christiansted ..•.••.•...•••......
Frederiksted ••••.•••••.•..•...•..
St. Thomas .•..••••••.•..........
6
47
2i9
Total. .....••..••.•.•...•...•..
TABLE
--
50
0
0
900
0
0
-- --331
- -272
18
0
425 659,408 1,078,008
2
436
138
301
65
93
1,295
0
49,360 224,335.03
2.-Statement of quarantine services rendered at maritime quarantine stationa
during the fiscal year 1BS4
Station
Inspection
i,ervices
Detention
services
Aberdeen, Wash ....•.•••••.•.•.•.•.•••••.•
Angel Island, Calif. (San Francisco) •.••.•.
Astoria, Oreg ...•.•••••••.•••..••.•........
Baltimore, Md ••••.•••••••••.•••.•.•.•.•.•
Beaufort, S. C •..••••••••••••••••.•...•.•••
Boca Grande, Fla.••••.•.......•......•.••
Boston, Mass .••.••••.•.•......•••...•••..•
Brunswick, Ga ••••••••...•.....•••.•.•..••
Carrabelle, Fla .•••••.........•.•...•...•••
Charleston, S. C .•.••..••••••••••••••••.•••
Corpus Christi, Tex.I ••••••••••••••.•....••
Eastport, Maine•.•••••••.•••.••••.••••.••.
Eureka, Calif.. ••••••••••••••••••.••••••••.
Fall River, Mass •..•••.••..•••.....•..•...
Fernandina, Fla. (Cumberland Sound) .••.
Fort Monroe, Va ......................... .
Freeport, Tex •••••••••.•...•...•••.•••••••
Galveston, Tex ••..••••.•.•.....•.•••••••••
Georgetown, S. C .•••••...•...•.•.•••••••••
Gulfport, Miss •••.••...•••..••.•••••••••••
Jacksonville, Fla. (St. Johns River) .•..•••.
$60.00
6,061.00
420.00
4,005.00
0
210.00
10,070.00
155.00
0
1,440.00
365.00
0
$62.00
0
0
0
0
0
0
0
10.00
90.00
25.00
3,220.00
711.00
5,480.00
5.00
90.00
1,025.00
0
0
0
0
0
0
0
0
0
0
0
0
0
Speclal
services
Fumigation
services
0
$1,370.00
0
1,M0.00
0
0
370.00
0
0
60.00
0
0
0
40.00
0
200.00
0
615.00
0
0
lt0.00
0
$4,005.37
0
4,069. 78
0
0
7,645.07
0
0
439.33
0
0
0
0
5.00
1,523. "6
0
881.96
0
0
«4.38
• Includes Port Aransas, Tex.
Digitized by
Google
Total
charges
$60.00
11,498.37
420.00
9,to4. 78
0
210. 00
18,085. f11
155. 00
0
1,939.33
365.00
0
10.00
130.00
30.00
4,943.46
76.00
6,976.96
5.00
90.00
1,609.38
71
PUBLIC HEAL1'H SERVICE
TABLE
2.-Statement of quarantine services rendered at maritime quarantine stations
during the fiscal year 1934-Continued
I
Station
Inspection Detention
services
services
Special
services
Fumigation
service.,
Total
charges
-------------1----1Key West, Fla............................
Lewes, Del. (Delaware Breakwater).......
Marcus Hook, Pa.........................
Marshfield, Oreg. (Coos Bay).............
Miami, Fla................................
Mobile, Ala...............................
New Bed!ord, M111111.......................
New London, Conn.......................
New Orleans, La..........................
Newport, R. 1.............................
New York, N. Y.•.........................
Ogdensburg, N. Y•••••••••••••.••••••.•.•.
P81l81118 City, FIB.........................
Pen.'!BCOla, Fla.............................
Plymouth, Mass..........................
$1,937. r>(;
10. on
6,895.00
o
0
$20. 00
O
830. 00
$21. 05
O
4,418.15
iO. 00
O
O
5. 00
0
0
0
290. 00
0
15.5. 00
262. 61
29. 04
1~...................... ···
~~:1!i"J~:.:
Portland, Oreg............................
345. 00
41i0. 00
110. 00
1,110. oo·
175. 00
520. 00
825. 00
477. 00
2,945.00
2,995.00
15,934.00
650. 00
215. 00
1~.1. 00
'i00.00
I, 895. 00
0
360.00
Total................................ 133, 260. 00
Alaska:
Ketchikan. ..•.....••.•................
Wrangell •..•....•••..•.••• , .......... .
-i~. 00
4, 009. 00
I, 420. 00
30. 00
80. 00
10,100.00
60. 00
45,185.00
o
Port San Luls, Calif. (San Luis Obispo)...
Port Townsend, Wash.•...................
Providence, R. 1...........................
Sabine, Tex...............................
San Diego, Calif. (Point Loma)............
San Pedro, Cali!...........................
Savannah, Ga.............................
Searsport, Maine..........................
South Bend, Wash.......................
Southport, N. C. (Cape Fear).............
Tampa, Fla...............................
Vineyard Haven, Mass....................
West Palm Beach, Fla....................
.
0
0
0
0
0
0
521. 00
1,395.00
2,810.87
O
O
78.00
0
O
0
0
7,406.25
0
30. 00
110. 00
IO. 00
O·
16,045.52
0
0
0
0
$1,981.05
IO. 00
12, 143. 15
75. 00
5, 064. 00
1,972.61
59. 04
80. 00
14,922.87
60. 00
68,714.77
0
375. 00
570. 00
120. 00
·······o···· ······ 10. oo· ··•··•·o •·· •··· 1,240. oo
O
O
o
o
o
288. 00
0
0
0
0
O
0
o
O
952. 00
0
0
80. 00
1,470.46
O
300. 00
60. 00
470. 00
340. 00
1,980.00
30. 00
0
8. 00
O
390. 00
0
O
3,526.23
0
163. 86
115. 37
6,738.18
333. 00
0
5. 00
214.84
736. 54
0
O
17, 954. 25
1,725.46
520. 00
4,651.23
537. oo
3, 578. 86
3,738.37
24,652.18
913. 00
215. 00
198. 00
714.84
3,021.54
o
O
56, 055. 06
0
0
360.00
208, 221. 31
0
0
0
0
0
Total. ...•.. _..••......•........ -....
0
0
0
0
l=====l====l====t====~==
Haw,1il:
t\Juklni...............................
O
0
0
0
0
Hilo...................................
140. 00
0
0
0
140.00
Honolul11..... ....•..•••.•...•.... ..... 3,723.00
0
10.00
0
3,733.00
KBhulul ...•.••.....•••........•.....• _
30. 00
0
0
0
30.00
Port Allen •...•.•.•.•.••.••••..•••••.. _
30. 00
0
0
0
30.00
Lahalna. ...•••••••.•••••••••••.•••..•.
O
0
0
0
0
Makawell.. .•.••.•.....•.••.•••••...•.
O
0
0
0
0
Total.............. ..•.....•.•.......
Puerto Rico:
t------t----01------1-----1-3,923.00
0
10.00
0
3,933.00
0
0
0
0
0
0
0
0
80.00
273.00
0
56. 00
10.00
0
0
0
70.12
0
15.00
0
175. 00
700.00
60. 00
175.00
415.00
6,300.12
7,975.12
l====l====l====t-===al==
f~g~1a.... ..........................
i&. 00
Arroyo................................
Central Aguirre.......................
Fajardo......••........•..•........••. _
Ouanlca.. .. ......... .. ..•... .. .. .. .. . .
Humacao........ .. ..•... .. .. ... . . . .. ..
Mayaguez.............................
Ponce.................................
San 1uan..............................
15. 00
175, 00
780. 00
50. 00
175. 00
335. 00
5,957.00
0
0
0
0
0
0
0
0
0
0
Total................................
7,542.00
0
353.00
80.12
3, 456. 00
40. 00
667.00
0
0
0
0
0
0
42.60
40.00
667.00
3, 4118. 60
4,163.00
0
0
42.60
.. 206. 60
Vlrgln Islands:
Chrlstlansted....... .•. .. •..... •. .. ....
Frederlksted...........................
St. Thomas............................
T otal................................
O
0
0
0
·o
t------t-----+-----1-----1--
l=====li====i=====t====~=0
0
t-----1----------1-----1--
1====1====1====1'===•1===
Total, all stations.................... 148, 888. 00
18,317.25
66,177.78
952. 00
224,336.03
• lnclud..s Perth Amboy, N. J.
'Include& all ports on Puget Sound.
Digitized by
Google
72
PUBLIC HEALTH SERVICE
MEXICAN BORDER STATIONS
TABLE
3.-Summary of quarantine transactions on the Mexican border for the fiscal
year 1934
Station
Number
Total
Total number
Total
of persons Number Tots! number
from in- of local
number of per• of persons number
of
terior
persons of persons
passed sonsper•
dis• without
vacMexico inspected inspected sons
infested
inspected
treatment clnat.ed
--Brownsville, Tex •••.••••.
Calexico, Calif. ••...•...•
Columbus, N. Mex .••.•.
Del Rio, Tex .•••••••••.•.
Douglas, Ariz ..••••....••
Eagle Pass, Tex .•••••....
El Paso, Tex., ••••••••••••
Hidalgo, Tex .•••.•••.....
Laredo, Tex.• •..••••••.•.
Naco, Ariz _______________
Nogales, Ariz .•..•••••.•.
Presidio, Tex .....•..••.•.
Rio Grande City, Tex ....
Roma, Tex _______________
San Ysidro, Calif.. .....••
Thayer (Mercedes), Tex.
Zapata, Tex••••.•••••.•••
Total ..••••••.•••••
--- - - -
Total
Total
number pieces
of sick of bag•
refused gage dis·
sdmis• infecM!d
slon
2,005
745,041
747,046
18,126
18,126
0
133
904
1,037
459
80,055
80,514
2,973
1,222
4,195
578,752
5,482
584,234
6,920 4,721,338 4,728,258
193,404
1,999
191,405
74,044 1,755,151 1,829,195
4,589
46
4,543
4,918
15,628
20,546
30
38,934
38,964
231
10,216
10,447
2,186
44,782
46,968
9,256
3,150
12,406
79
56,019
56,098
347
7,745
8,092
6
747,485
0
17,002
742
0
79,152
783
0
3,837
7,647
567,707
25,119 4,658,774
24
191,615
2,141 1,810,005
3,995
0
19,885
1
39
38,378
10,011
1
17
46,154
11,003
0
55,830
8
6,592
0
453
1,124
299
758
322
8,873
44,344
1,764
19,100
580
660
540
436
812
1,403
260
1,500
2
142
0
1
36
7
21
1
0
14
0
7
0
0
0
0
0
8,385,019
35,786 8,268,167
83,318
231
-103,251
- - 8,281,768
Includes Fort Hancock, Guadalupe Gate, and Ysleta.
' Includes Miners and San Y gnacio.
1
Digitized by
Google
0
0
0
390
0
8,011
775
2
2,515
0
1
0
39
0
0
0
0
11,733
TRANSACTIONS AT UNITED STATES AIRPORTS OF ENTRY FOR AIRPLANES FROM FOREIGN PORTS
TABLE
4.-Summary of transactions at continental and insular stations for the fi,Bcal year 1934
Location
0
co·
N.
"'
~
c;?"
C;
0
~
,...._
(i)
Name or airport
Distance
in miles to
nearest
Public
I Health
Service
station
Date desig•
nate<l
Number of N=Wo< Nam""°' N=OO,o< Ns.m>~o< r=>~o<
airplanes
persons
persons
aliens In•
aliens
airplanes
inspected
arriving
inspecte? spected by certlfled
arriving
by
Public
from
for•
by
Public
Public
ror
dis•
from for•
Health
eign r.orts
Healtb
H ealth
ease
eign ports
Service
or p aces
Ser vice
Service
Alo, Ariz ........ . ... . .. .. . . . Municipal Airport... . . ............... . . . . . . ..
6 Nov. 15, 1929
0
0
0
0
0
0
Akron, Ohio'·· ············· Municipal Airport• .••••...••.. •. ...••.... . •... ... . . ... . .. Apr. 8, 1929
Albany, N. Y ••...•...•..••• Municipal Field ..•. ••••.•. •..•. ...•... ... .... . . ... ....... Sept. 28, 1928
0
·· · ·0· 1···· ·
01
01
01
0
Bellingham, Wash ..•..••.••• Graham Airport• ••...••••••.• ••••.•.. .... •... . ......... . . Apr. 18, 1931
2
0
5
0
0
0
Brownsville, Tex ..•••••••••. Municipal Airport . . ...................... . . . .
473
473
5 Jan. ij, 1930
3, 101
3, 101
395
7
Buffalo N y
{Municipal Airpor~ ••.. .••••• ••••••••••.. .•. . •• ..... ... .... June JO, 1929}
0
0
0
0
0
0
' · ··········•·•·· Buffalo Marine Airport'················ ·· ·· ·· . . ........ .• Jul y 29, 1933
Burllngto1:!_, Vt.• •.......•.•.• Burlington Municipal Airport'· ·····•· ·•·· ··· .. ...... .•.. June 29, 1934 1
············1
············1
············1
············1
············1···········
Calexico, valJL ..•.....•.••. Calexico Municipal Airport• ...••••..•... . ....... ..• . . ..•• Jan . 10, 1933
11
11
35
35
8
0
Cape Vincent, N. Y.• .•..•••. Cape Vincent Harbor •......•....•..••. . .. .•••. •• • . ... . ... Apr. 25, 1934
Caribou, Maine• ••••. ••..•. • Caribou Municipal Airport• •.....•.•... ...... •..• •.• •.• •• Oct. 31 . 1932
·· ····or······ ··or·••·· ···or········o·1
oI
o
Cleveland, Ohio.••••........ Cleveland Municipal Airport •...... •• .•.. . ... .... .. •.... . Sept. 23, 1932
Crosby, N. Dak.t ••. •........ Crosby Municipal Airport '······· ···· · · · · · ·· · . .. . . ....... June 28. 1934
Wayne County Airport. . . .................. . .
20
Feb. 10, 1931 }
9;
Detroit, Mich .••. . .•........ {Detroit Municipal Airport'···················
0
212
OI
0
JO
0
June 19, 193 1
Ford Airport• ••.•••.•••••...•.......•.......... . . .. ..... . Aug. 1, 1929
0
Douglas, Ariz ••............• Douglas Airport'······ ······ ······· ·········· . . . ......... Jan. 8, 1930
0
0
0
0
0
Duluth Minn
{Duluth Municipal Airport •.................. . . ... .. . . .•. . Sept. 4, 1931 }
2
0
0
0
0
6
'
••···••··••·••· Duluth Boat Club Seaplane Base •.•.......•.. . . ... ...... ...•. • do . ... ..•.
0
0
0
Eagle Pass, Tex •••••.... . ... Eagle Pass Airport'·· ······ · ················ ·
0
0
0
1½ Mar . 5, 1930
El Paso, Tex.. . . .. .......... Municipal Airport. . . ................. . ... . ...
II
194
21 5
19-1
9
Aug. 23, 1932
I, 180
I, 180
g~~~;~inr~~~:•.·-~::::::: g~~te t~~~~l~:J:re:~.'::::::::::::::: :::::::::::: .~~cto.~·.'.:~~.•·····-······•
0 ··········-·•
0
0 ············•
0
0
0 ············•············•···········
1
0
0
0
0
0
0
~~~k!.
,a.l~!sii:a.~:::::::::
k~~~S:~
~i~ri·•:::::::::::::::::::::::::::
::::::::::::
.~~.~ct1.
~
·
.
'
.
:!~.
0
0
0
0
0
0
Key West, Fla.............. Meacham Field. . . ............................
4 Dec. 20. I927
0
l0
IO
5
5
"C
0
tXl
t'
....(")
::::
l"'.l
~
gj
~
(")
l"'.l
0
I
Laredo, Tex ..•..••.•.•.•.•.• Laredo Airdrome '······ ················ ···· · ·
3½
Malone, N. Y •...•....••..•. Malone Airport• ............................ ...... . . ..... .
Pan•American Field. . ........... ............ . .
8½
Miami, Fla.....••••• .••••••. {Dinner Key Seaplane Base'· · ················
6
Viking Airport and Seaplane Base •...........
2
Jan.
Apr.
Oct.
Mar .
May
24, 1930
18, 1930
!fl, 1928 }
7, 1930
JR, 1934
fu°n:
1,095
21
0
I,
095
47
0
0
0
0
14,939
3,085
10
47
17
14, 930
m~ ········w2·1········w2·1········501·1 ·······
i~~J!s~~~\:iiia"i"X'1ri.iort~::::::: : ::::::::::: · ········o··
~~;
Ogdensburg N y
{Billings Field• . •••....••.•••. •.•.•••••••...... . ... . . . ... .. Nov. 30, 1931 }
' · •··•··• •••• Ogdensburg Harbor ' ·-····· ··· ········· · · ···· .... . .. •.. .. Mar. 1, 1932
1 No medical officer of Publlc Health Service on duty.
~:~fes~,J?.~~:~·.~::::::::::
21
7
6
0
14
• Temporary permission.
591 1
o
147 1
o
0
o
o
--t
CA)
TABLE
Location
0
co·
N.
"'
~
c;?"
CJ
0
~
~
4.-Summary of.transactions at continental and insular station, for the fiacal year 1934-Continued
Name of airport
Distance
in miles to
nearest
Public
I Health
Service
station
Date desig•
nated
~
.i:,.
Number of Number or Number or Number or aliens in• Number of
persons
persons
airplanes
airplanes
aliens
arriving
inspected spected by
arriving
inspected
Publlc
certill~d
from
!or•
by
Public
from for• by Public
Health
for d!S·
eign
~rts
Health
eign ports
ri~i~
Service
ease
or p aces
Service
N••'""'I
Pembina, N. Dak ........... Fort Pembina Airport• •••••..•.. . .•.•.• . .••.• ..•••••.•... Feb. 2, 1930
334
0
650
0
0
0
Plattsburg, N. Y.1 ...•....•.. Mobodo Airport'········ -·· ······-··········· ...•.•••••.. June 2, 1030 .•.. •....• .. ........ •.• ••.......•• • ••. . . .... .... ...... .................
Portal, N . Dak .....•.•.•••.. Portal Airport'·· ······-·············· ·-···•·· ...•.••••••. Jan. 8, 1930
0
0
0
0
0
0
Port Angeles, Wash ..•.••••. Port Angeles Airport'·--······-·· ···-········
52 .•••. do........
0
0
0
0
0
0
Port Townsend, Wash....... Port Townsend Airport '······················
12
June 18, 1030
0
0
0
0
0
0
1
Put•in•Bay, Ohio ••••..•.•. Put•in•Bay Airport• ••••.......•••••.••...•..•..•••••.•••• Mar. 12, 1934 ...... ... . .. •... • •• •. . .... .. .....•.. ........... . ...•.... •• . . ...........
Rouses Point, N. Y. .•...... Rouses Point Seaplane Base•................. .••.•••.•••• July 14, 1032
0
0
0
0
0
0
St. Thomas, Virgin Islands.. St. Thomas Airport•. ............ ............. .....••..... •.•.•.•.••.•••.
52
52
538
538
O
0
San Diego, Calif.. •.......... San Diego Municipal Airport•................
6 Jan. 24, 1930
658
47
I, 951
164
17
o
San Juan, P.R.•.........•.. Isla Grande•...•.......••••••••.•.........••...•.......... Jan. 19, 1929
243
218
2,408
2,445
390
1
Sault Ste. Mario, Mich...... Sault Ste. Marie Airport•..................... ••.......... Aug. 4, 1933
0
O
o
O
o
O
Scobey, Mont .••..•.....•••. Scobey Airport'······························ .•..••.•••.. June 2, 1930
O
O
o
O
o
O
Seattle, Wash ..•...••••.•••• !Boeing Municipal Air Field •.•..•............. ....•...••.. Sept. 11, 1928 }
128
0
308
0
0
0
Lake Umon........... . ....................... .....••••••. Dec. 27, 1928
Skagway Alaska I
Skagway Municipal Airport• .•••...... : ..........•.••.... Nov. 30, 1931 }
'
•··•·•··•·· Skagway Seaplane Bruse'··················· ·· ...••••••••...••. do ........ ·· ··· · ····
Spokane, Wash.I ••... .•..... Spokane Municipal Airport• •.•.••••••.....•.....•.•••.•.• June 2, 1931
Swanton, Vt.1. .•...... ...... Missisquol Airport 1 • •• ••• •••••••••••••••••••• •••••••••••• July JR, 1930
79 I
79 I
664 I
661 I
..~,
o
Tampa, Fla..........•...... International Airport'············ ····••· ··••·
7 Dec. I, !033
Watertown, N. Y.1 ..••••.... Watertown Municipal Airport'·· ············· .••......••• June 2, 1930
West Palm Beach, Fla ..•••. Roosevelt Flying Service Base••....•.•.....•.........••.. Mar. JO, 1031
51)
179
110
26.,...
59
0
Wrangell, Alaska ....•.....•. Wrangell Seaplane Base• .••...•......................... . Nov. 30, 1931
0
0
0
0
0
0
I
Total. ••...•...•.......
• Authori1.ed for use hut not. officially de•ignate<l .
3,668
2,456
I
26,051
r ······
I
23,899
4,364
20
"d
~
t<
c=;
:i::
t;,J
>-
~
r:ri
t;,J
~....
(")
t;,J
75
PUBLIC HEALTH SERVICE
CANAL ZONE
TABLE
5.-Quarantine activities of the government of the Canal Zone during the
fiscal year 1934 1
Balboa
Activities
Vessels boarded and passed •....••..•.•.•••..•.•...•.•••.••••••..••.
Vessels granted pratique by radio ••.....•....•...•...•....•.•.......
Total number of vessels passed...............................
Crew passed at quarantine.........................................
Crew passed by radio...............................................
T otal number of crew passed.................................
Passengers passed at quarantine •.•.•••••...•.••. ~..................
Passengers passed by radio.........................................
T ot al number of passengers passed............................
Cristobal
2,852
138
3,483
60
Total
6,335
188
1------1-----+---2,990
6,523
3,533
l=====l====I====
135,444
367, 548
232, 104
43,527
15,439
58,966
1-----+-----+---426,514
178,971
247,543
1=====11====1====
122,186
33,637
88,549
9,430
7,929
1,601
1-----1-----1----41,566
131,616
90,060
Supplementary sanitary Inspections of vessels •••........•.•.•••••••
Vessels fumigated with HCN gas..•.•••.•.•.•.......•.•.•.•.•.••••.
Box cara fumigated with HCN gas ••••.•••.•...•...•.•.•...•••.•.•••
l====l====I====
736
9
90
Fumigation oertllicates issued to vessels .•••..............••....•.•.
Deratlzatlon exemption certificates issued ...........•....•.•..••.•..
Rodents recovered after fumigation .•..•••...................•.•...•
9
8
6
2,689
47
3,425
39
137
30
39
30
6
57
14
63
Airplanes Inspected and passed .•••••••.•••....•........•••••.•.••..
13
484
• 497
Crew of airplanes inspected and passed ..........•.•..•.....•.••.••.
Passengers or airplanes inspected an<l passed ..................•...•.
26
57
1,546
2,125
I, 572
2,182
Vessels detained in quarantine •••.............•..•..•........•.•••••
Crew detained on board ship for quarantine .•••.....•.•.••••••••••.
1
57
0
0
1
57
I
Senior Burg._ C. V. Akin, U. 8. Public Health Service, detailed as chief quarantine officer.
::\1EDICAL INSPECTION OF ALIENS
TABLE
6.-Alien passengers and seamen inspected and certified at maritime porta
in the United States and possessions during the fiscal year 1934
Alien passengers certified •
berof
alien
passen• Class A
Class Class Total
gers
examB
C
ined
I II
Num•
Place
Allen seamen certified 1
Num•
berof
alien
sea• Class A
men
Class Class Total
examB
0
ined
I II
----------1--- - - - - - - - - --- ------- --- --ATLANTIC COAST
Baltimore, Md ••.........•
73
0
8,545 . •.• 32
20 •••••••
52
Beaufort:§. C .•..••.•.•..
0
0
0
0
Boston, Mass ••..•.•••••.• 5,392 •••. 5
104
2<J
138 56,568
4 40
317
43
404
Brunswick, Ga••••••••.•.•
0
0
377
0
Charleston, B. 0 .•........
22
0
2,765 .••• 5 .•••••••••••••
5
Fall River, Mass••••••••..
0
0
236
0
Fernandina, Fla ..•..•••..
0
0
111
0
Fort MonroeL Va.• •••.•...
421
25 .....
25
7,084
16 ...•...
3 23
42
Fort Pierce, J<'la ...••..••..
0
0
0
0
Georgetownl ~- C ••••.•••.
0
0
2
0
Glouces~!z Mass.••••.•••.
0 ·······1·.·.·.·. -· ···•·····•·
0
170
1 ................. .
I
lacksonvme, Fla•.•.•••...
4
0
I, 516 •••• 3 ••••••• •••••••
3
Key West, Fla.••...••..•. 4,208 .
39 ...... .
39
1,035
0
Lewes! Del. ••••.•.•.•.•••.
0
0
19
0
Miam, Fla •••........•.•. 5,232
15 12,319
0
New Bedford, Mass •••.••.
28
0
42
0
New London, Conn ••...••
0
0
0
0
Newport, R. L .......... .
0
0
0
0
1 Class A-I: Aliens certified for idiocy, imbecility, feeble-mindedness, insanity, epilepsy, chronic alcoholism. Class A-II: Aliens certified for tuberculosis or other loathsome or dangerous contagious disease.
Class B: Aliens certified for diseases or defects which affect ability to earn a living. Class C: Aliens cer•
tilled for diseases or defects or less degree.
• Includes Norfolk, Va., and Newport '.'<ews, Va.
::6:1···· :: ::~: :::::~:
::::I::·:::::.:::::::::
90167-34--6
Digitized by
Google
76
PUBLIC HEALTH SERVICE
6.-Alien passengers and seamen inspected and certified at maritime porta
in the United States and possessions during the fiscal year 1984-Continued
TABLE
Alien passengers certified
Allen seamen certified
NumNumber or
ber of 1----,---..---.----alien
alien
passen- Class A
sea- Class A
gers
Class Class Total
e~a~- , _ Total
examB
C
ined
I II
ined
I n
Place
c1:8 c~
--
ATLANTIC COAST-contd.
New York, N. Y. (Ellis
Island) __________________ 124,967
Perth Amboy, N. J.______
2
Philadelphia, Pa__________
228
Plymouth, Mass__________
3
Port Everglades, FJa ______________
41
Portland, Maine__________
Providence, R. !._________
200
Savannah, Ga_____________
38
Searsport, Maine__________
O
Vineyard Haven, Mass...
Washington, N. c________
o0
West Palm Beact Fla____
35
Wilmington, N. u________
0
Total _______________ 140,894
29
----------
47
----------
4,868
34 4,9i8 403,693 ____ 131
3
2
------- ------0
1,125
------- ------0 19,120 16 30 _______ _______
_______ ------O
133
2 ____ _______ _______
136
O
46
2
---- _________________________________ ---- _______________________ _
---- ___________ ------O
3,363
8 _______ _______
8
6
1 ---------- ---- ---------- ---- -------
------------_______
_______
---- ---- ------- _______
6
1
O
0
O
O
---- ---- ------- _______
0
________ ------- _______
35
53
5,049
64
1, 4:14
4
3 _______
1,136
8
1
3
476
1 ____ _______ _______
0 ---- ____ ••••.•• _______
o ____ ____ _______ _______
126 ____ ____ _______ _______
O ---- •••• _______ _______
5, 201 521, 384
27 284
360
48
7
12
1
O
O
O
O
719
e==l==l ==,l===I===
0
COAST
Boca.Grande, Fla_________
o ____ ____ _______ _______
o
168 ____ ____ _______ _______
o
Ci,rrabelle, Fla ____________________________________________________________________________________ _
o ____ ____ _______ _______
o
o
_____ _______
o
Cedar Keys, Fla__________
Corpus Christi, Tex_______
6 ____ ____ _______ _______
O
801 ____ ____ _______ _______
o
Freeport, Tex_____________
0 ---- ____ _______ _______
O
326 ____ ____ _______ _______
O
Galveston~:rex____________
108 ____ ____ _______ _______
o 11,710 ____ ____ _______ _______
o
Gulfport, miss____________
o ____ .... _______ _______
o
95
o
Mobile, Ala_______________
40 ---- ---- ------- _______
0
3,049
6 _______
7
Morgan
City,
La.
(Atchafalaya) ______________________________ ---- ________________________________________________________ _
New Orleans, La__________ 2, 723 6 12
22
78
118 20, 716 ____ 36
12
17
65
Panama City, Fla_________
0 ---- ---- _______ _______
O
161 ____ ____ _______ _______
O
Pascagoula, Miss __________________ -------- ________________________________________________________ _
7 ---- ---- _______ _______
O
892
1
1 _______
2
Pensacola, Fla____________
Port Aransas, Tex________
O ____ ____ _______ _______
o
o ____ ____ _______ _______
o
Port St. Joe, Fla__________
0 ---- ____ _______ _______
O
O ____ ____ _______ _______
o
Sabine, Tex_______________
29 ---- ____ _______ _______
O 8,417
8 _______ _______
8
Tampa, Fla_______________
222 ---- ---- _______ _______
O 2,012
8 _______ _______
8
GULF
Total .•. _________ .__
3, 135
6
12
22
78
118
48, 347
0
198
0
59
13
18
90
f=-=!==i==l===!===i===i===l===!c=ll===l===I==
PACIFIC COAST
Aberdeen, Wash _________ _
0 ---Angel Island, Calif. (San
Francisco). ____________ _ 6,009
Astoria, Oreg _____________ _
7
Eureka, Calif. ___________ _
0
Fort Bragg, Calif________ ._
0
Marshfield, Oreg. (Coos
Bay)____________________
0 ---Monterey, Calif___________ -----------22
Portland, Oreg____________
San Diego, Calif..._______
482
2
San Luis Obispo, Calif____
0 ---San Pedro, Calif..________ 4,292 6
Santa Barbara, Calif._____
0 ---Seattle, Wash.•____________ 2,031 22
South Bend, Wash________
0 ---Total.. _____________ 12,843
30
---- ------- ------8
184
29
221
0
0
0
0
32 ---- 27
1,558
3
1 ------1 -------
0 ---- ---- ------- -------
34 ---- ---- ------- ------272 ---- ____ _______ _______
28
4
0
0
0
O
__________________ ------- ___________________________________ _
---- ------- -------
2 _______
11
6 _______
---- _______ _______
3
70
8
---- _______ _______
6
18
51
---- ------- _______
28
279
88
2
18
500
4,213
1 _______ _______
4
4 _______
O
803
-:u -----.:
87 45,912
8 66
0
0
97 10,008
7 _______
2
O
676 ____ ____ _______ _______
425
64, 206
8 108
27
6
1
8
o
o
9
o
99
149
f===!==i==i===l===i===i===l==~=ll===l==l==
INSULAR
Alaska:
Ketchikan ___________ _
0 ---- ---- ------- ------Hawaii:
Honolulu_. __________ _ 2,596
12
7
12
I
0
0 ---- ---- ------- -------
0
32
30,980
0
0
0
0
6,318
3,926
0
7,106
788
0
11 -------
13
I
Philippines:
Cebu _________________ _ 2,000
Davao. _______ ... --- -503
IloiJo _________________ _ 1, 120
Jolo __________________ _
248
• lnclurles all ports on Puget Sound.
Digitized by
Google
0
0
77
PUBLIC HEALTH SERVICE
6.-Alien passengers and seamen inspected and certified at maritime ports
in the United States and possessions during the fiscal year 1934-Continued
TABLE
Alien passengers certified
Num•
hero!
alien
passen• , Class A
gers
Class Class Total
emm•
B
C
ined
I
II
__
Place
Allen seamen certified
Num·
ber of
alien
sea• Class A
men
Class Class Total
examC
B
ined
II
I
--
INSULAR-continued
Phillpplnes-Contlnued.
1'egaspi_______________
6 ____ ____ _______ _______
Manila................ 21,984 .... 36
33 ..••..•
Zamboanga...........
152 .... .•.. .•....• ..•..••
O
280 ____ ---- ------- -------
O
69
69,340 ...•...• --··--- .•..•..
2,664 ...• ..•. ..••... ••.....
o
o
o
l---l--l--+---+----1----1---l--+---!I---I----I--
TotaJ •..•........... 26,013
Puerto Rico:
Aguadllla ••••... -- ....
Areoibo ••.•••.•••.••.•
Arroyo .•••••••.•.•.•..
Central Aguirre (1o-
33
0
90,422
0 ••••••••••••••••••••••
0
0
0
0
0
0
0
0
0
173
2,246
51
219
375
15,561
26
25
0
0
0
Ponce................ .
San Iuan•••.•••••..•..
12
25
6,505
Total...............
6, 593
0
2
Total, all stations ••. 192,074
73 141
5,392
TABLE
69
0
0
0
0
0
l===l==i===l====t==e!===l===e!==l==II===!===!===
bos) .•...............
Fajardo •••••.•.•...•.•
Guanlca.............. .
Humacao .•....•.•....
Mayaguez ........... .
O 36
0
0
4
2
71 .•.• ···- ····--- --·---0
31
0
0
0
0
0
4 ••••••• ··-····
2
418,727
243
5, 849 774, 066
0
0
0
0
4
2
6
0
0
6
36 468
400
73
977
7.-Aliens inspected and certified at international border stations during the
fiscal year 1934
Aliens certified
Number
of persons ofNumber
Total
persons Other
makiug making
number
Class A
perma• tempora• persons
exam- of per•
nent
sons ex- Total
Class Class
ry
entry
ined
entry examined
amined
B
C
examined
I
II
Place
--- ---
--
HEXICAN BORDER
Alo, Ariz .......................
Brownsville, Tex .••••.•••••.•..
Calexico, Calif...•••••••••••.•.•
Columbus, N. Mex••.•••.•.•••.
Del Rio, Tex ••.•••..••••••.•...
Douglas, Ariz ..•••••••.•.•••••.
Eagle Pass, Tex •••••••.••••••••
El Paso, Tex. 1.•••••••••••••.•••
Hidalgo, Tex .•.••..••••.••••.••
Laredo, Tex ..•••••••••••.•••..•
Naco, Ariz ......•••••••.•••....
Nogales, Ariz •.•.•••••.•••••••••
Presidio, Tex .••....•.•.•.•••...
Rio Grande City, Tex ..•
Roma, TeX-------···---··---·--i
Ban Ysidro, Calif.•••••• ·------·,
Thayer (Mercedes), Tex-·----··
·------1
r~:i~·.t~:::::::::::::::::::i
TotaL _______
·-----------1
0
282
195
0
40
1,222
184
690
55
28,348
46
247
3
0
3
588
O·
4:
1151
32,022
J
0
33
28
0
0
0
0
7,618
3
771
1
5,149
18
0
0
738
0
1,050
8,134
18,126
1,038
4,876
4,195
3,026
25,456
1,697
42,193
4,589
15,766
512
450
256
12,406
337
291
347
2
397
210
0
3
96
50
3,392
259
469
303
704
80
26
68
207
26
83
95
1,050
7,819
17,903
1,038
4,836
2,973
2,842
17,147
1,539
13,074
4,542
10,370
491
450
252
11,080
337
264
137
14,477
98,144
144,643
23
0
24
135
0
1
4
2
3
7
0
0
7
6
44
6
6
18
8
1
0
1
3
0
15
0
6,369
127
780
.
1=.=1=
1
Includes Fort Hancock, Guadalupe Gate, and Ysleta.
Digitized by
Google
0
218
6
0
2
22
10
0
18
2,698
109
368
57
389
32
254
53
79
39
64
4
12
8
32
2
51
0
8
31
172
12
10
0
152
62
0
0
57
26
396
91
6
189
243
43
6
28
0
12
7
2
2
4,142
1,320
78
PUBLIC HEAL1'H SERVICE
TABLE
7.-Aliens inspected and certified at international border stations during the
fiscal year 1934-Continued
Plare
Chicago, Ill--------------------Detroit, Mich_----------------Duluth, Minn __________________
Eastport, Idaho ________________
Eastport, Maine ________________
Erie, Pa ________________________
Halifax,Mont.
Nova __________________
Scotia, Canada __
Havre,
Houlton, Maine ________________
International Falls, Minn ______
Jackman,
Lewiston, Maine_-------------N. y ________________
Malone, N. y __________________
Montreal, Canada ______________
Newport, Vt. __________________
Niagara
Falls,
N, _______________
y _----------Northport,
Wash
Noyes, Minn ___________________
Ogdensburg, N. y ______________
Oroville, Wush __________________
Portal, N. Dak _________________
Port Angeles, Wash ____________
Port Huron, Mich ______________
Quebec, Canada ________________
Rouses Point, N. Y ____________
St. Albans, Vt __________________
St. John, New Brunswick,
Canada ______ -- _. - -- -- -- -----Sault Ste. Marie, Mich _________
Scobey, Mont __________________
Sumas, Wash ___________________
Sweetgrass, Mont_ _____________
Van Buren, Maine _____________
Vanceboro, Maine ______________
Vancouver, British Columbia,
Canada _____ ------ --- _---- ---Victoria, British Columbia,
► Canada ___ ------------------Winnipeg, Manitoba, Canada ___
Yarmouth, Nova Scotia, Canada ____________ - . _-----------TotaL ___________ --------Total, all stations _________
TABLE
Number
Total
'lf person~ Other number
making persons of pertempora- exam- sons exry entry
ined
amined
examined
0
'1:17
44
99
0
1,487
0
60
6
0
345
0
43
119
19
8
1,453
280
175
5
25
2
33
0
163
Sol
180
28
i
Aliens certified
Class A
Total
I
Class Class
B
C
II
--- --- ---
i
CANADIAN BORDER
Bellingham, Wash ______________
Blaine, Wash ___________________
ButJalo, N. y __________________
Calais, Maine __________________
'
Number
of persons
making
permanent
entry
examined
0
0
689
0
0
2,219
0
152
0
0
275
0
0
300
49
18
12
1,009
1,494
0
617
782
117
12
5,615
1,494
11
223
48,244
48,238
0
74
3
144 232,106
0
83
127
17,452
6'
43
0
0
102
289
285
832
- -·-o4
242
0
0
237
I, 216
0
0
35
1
17,996
17
0
461
572
475
67
0
694
3
232,293
202
17,598
57
1,453
671
1,292
40
30
18,240
50
0
861
2,639
655
95
.
0
91
143
10
12
850
4
59
0
0
319
0
0
11
0
2
6
2
16
0
4
103
0
0
0
0
3
0
33
16
366
125
5
35
7
8
48
-----iii"
1
8
1
6
0
179
465
2
1
1
0
25
44
8
l
2
706
0
0
0
0
3
0
4
9
89
0
49
36
7
2
4
40
0
26
0
29
85
l
4
0
13
0
0
228
0
46
0
0
85
0
0
2
4
0
0
1
1
19
14
13
0
300
21
0
0
0
0
0
6
···-·a
64
16
11
30
96
29
10
3
4
0
2
0
0
5
0
0
106
377
35
2
86
20
8
2
2
1
0
3
0
I
0
0
0
0
0
1
1
0
34
0
0
0
0
49
4
5
0
0
6Zl
7
0
2
l
266
316
7
0
24
I, 0051
10
600 I
23
0
7
16
99
1,070
23
50
0
6
882
4
1
4
1
5
0
3
3
0
376 '
0
376
140
14
4
121
1
0
3,173
234
6,082
53
1,172
5
12
1
11
12
960
35
189
6
4
46
8,712 ~ I a25, 892
56
343,435
42
4,415
4
292
3
89
34
3,076
1
958
488,078
10,784
419
869
7,218
2,278
311
0
2
52
65
6
234
2, 118
40, 734
0
791
~!
424,036
30
6
l
0
11
0
3
0
8.-Alim seamen inspected and cert-ified at international border stations
d1tring the fiscal year 1934
Allen seamen certified
Place
Number of
alien
seamen
examined
r-------~---~--~--Class A
II
Class B
Class C
631
Total
Bellingham, Wash______________________
0
0
0
0
0
Buffalo, N. y___________________________
8, 197
o!
o
~
62
92
Chicago, Ill_____________________________
256 1
0
7
0
3
Duluth, Minn__________________________
83:
0 i
O
O
O
O
Eastport, Maine________________________
0 i
O
O
O
O
Erie, Pa_________________________________
19
Of
O
O
O
0
Lewiston, N. y_________________________
114
O,
o
O
O
0
Ogdensburg, N, Y __ -------------------165 I
O
O
O
O
0
Total ••••• ·-·---------------···-··'--9-,-31-1-l:---o 1---3-1_ _ _34_ _ _ _6_2 ---9-9
~
4141
Digitized by
Google
79
PUBLIC HEALTH SERVICE
TABLl!I
9.-Number and character of the mandatoray excludable conditions certified
at United States ports during the fiscal year 1934
I
Idiocy
lmhecd. Epl•
lty, or leP-
~~t
8Y
edness
Const!•
Tu•
In• tutlonal
psycho- Chron•
ber• Tra•
le alco- culochoSllll·
pathlc
ity Infer!• hollsm sis
ma
orlty
Other
dan•
gerous
Gon•
Soft
or
Fa• Syph•
or• loath• Total
vus ilis chan•
ere rhea some
conta•
gious
diseases
--- - - - - - - - -- -- - - - - - Alien passen•
.&i'seaiiieii:
TABLE
148
1
31
0
86
2
1)6
0
39
0
80
1
258
1)
2
0
194
87
327
181
26
77
38
74
1,345
434
10.-Distribution, according to class, of applicants for immigration visas who
were medically examined during the fiscal year 1934
Number of applicants Percentage of afapllcants
in each class
in each c ass
Total
number
olappli•
Non•
Non•
cants
Non• lmmi•
Non• lmml•
Quota quota
examined Quota quota
grants
grants
Country and consular office
WESTERN HBMIBPHBRE
Cuba: Habana •.•.•.....•.•.•.•............
884
355
529
0
40.2
59.8
0
Canada, total ...••••••••••••••••.•••••.•...•
12,235
2,912
7,939
1,384
23.8
64.9
11.3
Montreal ........•••••••••••....••...•••
3,641
766
2,134
836
2,594
1,994
270
675
2
1,095
2,328
764
1,039
611
1,971
964
262
638
18. 5
.3
51.0
26.9
24.0
14.3
2.9
64.0
99. 7
49.0
73.1
76.0
48.3
07.1
17.5
0
0
0
0
37.4
0
24.9
64.5
10.6
~~:i~o::::::
::::::::::::::::::::::::::
Vancouver ••••.••••••••••••••.••.•.....
Windsor••.••.••••..•.•.••••••••.•. _.•. _
f::J:t\-.:::::::::::::::::::::::::::::
225
622
285
8
- 13,
-119
- --3,267
All countries, Western Hemisphere .••
8,468
EUROPE
0
0
0
1
745
0
=
1,384
------ =
Belgium: Antwerp •••••••••••••••••••.•....
England: London ••.•••••••••••••••••••••..
Irish Free State: Dublin ••••••••••••••••••.
Northern Ireland: Bellast. ••••••••••••••••.
=:i;, ?~:fl.~:'.:::::::::::::::::::::::::
697
2,167
583
312
744
~.586
476
1,264
229
189
382
5,548
221
903
354
123
362
1,035
0
0
0
0
0
3
63.3
58.3
39.3
39.4
51.3
84.2
31. 7
41. 7
60. 7
60.6
48. 7
15. 7
0
0
0
0
0
•1
Berlin •.••••••••••••••••••••.•.•.••.••••
Hamburg.••••••••••••••••••••••••••••••
Stuttgart .••••••••••••••••••..•.••.••.•.
2,410
1,073
3,103
2, l12
752
2,684
295
321
419
3
0
0
87.6
70.1
86.0
12. 2
29.9
14.0
0
0
Holland: Rotterdam ••.••••••••••••••••.•••
616
508
Poland: Warsaw ••••••••••••••••••••••••••.
1,267
2,346
Denmark: Copenhagen•••••••••••••••••••••
344
221
Norway· Oslo ••••••••••••••••••••••••••••••
487
294
Sweden, total •••••.•••••••••••••••••••••••••
260
567
1----+-G oteborg •••••••••••••.•.•••••••••••••••
278
87
Stockholm.•••••••••••.•••••....••••••••
173
289
108
1,079
123
193
306
0
0
0
0
1
54.0
64.0
60.0
45.8
17.6
46.0
36.0
40.0
54.0
Italy,total.................................
Genoa•.................................
- - -- - -- - -=
==
5,638
1,519
=
--83.4
190
116
1
68.4
31.3
0
40.0
60.0
===l,===I==
4,105
14
72.8
27.0
All European countries...............
1
151
223
O
40.3
59. 7
26.0
73. 7
1,368
3,882
14
=====1•===1==
829
336
493
O
59.5
40.5
504
332
172
o 65.9
34.1
22, 420 112, 825
--0
0
0
0
.2
.3
0
-~
--- --0
374
Naples •••••••••••••••••••••••••••.••••. ~ 5
264,
Czechoslovakia: Prlll(Ue. • ••• •• ••• ••• • • • • ••
Austria: Vienna............................
.2
9, 577
18
57.2
Cl06ed Sep&. 30, 19331
Digitized by
Google
.3
0
0
-----42. 7
.1
80
PUBLIC HEALTH SERVICE
11.-1\Tumber and percentage of quota and nonquota applicants ezamined
who were notified for different classes of disabilities during the fiscal year 1934
TABLE
Quota
Nonquota
-
Country
----
Percentage of
examNumber noti- total
Total
lned who
Total
fled forwere notified number
number
nonforquota
quota
appliappli•
cants
cants
exam- Class Class Class Class examB
ined
A
B
A
condl- condi• condi- condi- ined
tions tlons tions tions
Percentage of
examNumber not!• total
lnedwho
fled forwere notified
forClass Cl8SS Class Class
B
A
B
A
oondi- condl- condl• condltlons tlons tions tions
-- -- -- -- ----- -- -- --
WESTERN HEMISPHERE
Cuba. ____________________
Canada. _____ ---···-·- ....
355
2,912
32
49
386
9.0
.9
13.8
13. 2
7,939
18
<l6
53
1,081
3.4
26
.6
10.0
13. 6
3,267
58
435
1, 7
13. 3
8,468
64
1,134.
.8
13.4,
476
1,264
I, 519
336
332
27
0
3
4
56
3
6
3M
123
362
1,035
108
1,079
123
193
306
4,105
493
172
1
1
2
0
1
14
2
22
0
2
1
235
8
3
30.3
I, 267
221
26.9
17.6
17.0
9.0
15.2
22. 4
25. 2
2. 5
26. 2
15.6
21.5
41. 7
17. 6
15. 5
.4
5
.6
.1
.4
.1
I. 5
.7
9.8
.2
0
1.0
1.5
3. 7
.9
I. 2
67
107
52
25
35
508
128
222
39
17
58
I, 241
128
327
58
221
189
382
5,548
3
1
1
1
6
37
12,826
153
1.2
24. 1
9,577
292
All oountrles, Westem Hemisphere•. _
529
EVROPE
Belgium.--·-··---·- __ ....
England ..................
Irish Free State ...........
Northern Ireland .... _....
Scotland .•...........•....
Germany ••••........•....
Holland ............ '. ••....
Poland ••...........•••••..
Denmark .. _-· .....••..••.
Norway·····-···········Sweden .. -·--······•······
Italy. -......... -·. -·•··••·
Czechoslovakia •.......•..
Austria ... ·--·············
All European countries .•••.•......•.
229
294
260
<l6
56
633
59
78
--
3,090
903
46
.1
.6
0
.3
I. 3
1.8
.2
0
1.0
.3
5. 7
I. 6
.6
I, 513
3.0
209
26
182
26
29
53
5Qli
63
10.8
14. 7
20-3
9.6
20-1
24.1
1.6
20-3
15..0
17.3
H.6
12.8
8.9
15.8
12.-Percentage distribution of total quota and nonquota applicants of each
sex examined who were notified for different classes of disabilities during the fiscal
year 1934
TABLE
Quota.
Country
Male
Nonquota
Male
Female
Female
Class A Class B Class A Class B Class A Class B Class A Class B
WESTERN HEMISPHERE
Cuba.·-···-·-··-·--·-····-··
Canada.-· ....... _.-······· ..
9. 2
.9
11. 9
12.8
8.6
.9
17. 3
14.0
a. s
.7
11.6
15.4
2.9
.6
All countries, Western
Hemisphere.--·-··--
I. 8
12. 6
1. 7
14. I
.9
16, 1
.6
t~ila::ioo•
Northern Ireland ..•....•....
Scotland .. _..•.. _... ··-._ ....
Germany ......... _..........
Holland ............ ·-········
Poland •.•.•..•....•....•.....
Denmark ... ·-···············
Norway •....•..........•....
Sweden ... _..................
Italy .•............ _... ·- .....
Czechoslovakia ..... --·-·····
Austria .•.. _.. __ . ___ ... _...••
.7
.2
0
0
2.3
.9
1.3
1.6
0
1.2
1.0
2. 6
.6
1.2
22. 4
18.6
14. 8
6.0
16. 5
21.8
23.1
2.2
24.1
15.9
18. 2
36.6
9. 1
19. 5
.5
0
.7
.9
1.2
.4
.5
2. 7
0
.7
.7
4. 8
1.2
2.4,
33. 5
16. 7
18.2
11. 3
14. 5
22.9
27.9
2. 8
28. 7
15.2
18. 2
44.8
25. 7
27.4
0
.2
1.0
0
.9
1.5
3.2
2.2
0
I.I
.4
3.6
2.4
1.6
36. 2
13.2
10.2
23.2
6.3
20.2
22.6
1.9
10. 3
20.2
17. 7
13. 0
12. 8
27.4
9.0
0
.4
0
0
1.2
0
1.8
0.9
.7
7.1
1.0
1.8
26. 7
10.6
16.4
17.9
11.1
20.1
26.1
1.5
32. 7
10. 5
13.3
15.4
12. 7
25.4
All European countries.
1.0
22. 7
1.3
27.1
20-0
1. 7
23.8
EUROPE
Belgium ...•.•...•...... -•-··
siaie::::::::: :: :::
---2.9
Digitized by
Google
8.0
16.1
=
15. 7
81
PUBLlC HEALTH SERVICE
13.-Distribution according to 8/JZ of applicants for immigration visas who
were medically examined and notified for disabilities during the fiscal year 1994
TABLE
Numberol
each sex
examined
Percentage ol
each sex
examined
Oountry and consular office
Male
Female
Percentage ol Percentage or
males notified females notified
forforClass
Class
tlons
tlons
Class
Class
A
B
B
A
Male Female condicondi- condi- condi-
tlons
-
tions
---
; WESTERN HEYISPHEEE
Cuba: Habana ______________________ .
520
364
58.R
41. 2
6. l
11.7
5.0
11. 2
6,539
5,690
53.5
46.5
.6
13. l
.5
15.2
Montreal.
___ .·-------------------.
Quebec ______
____________________
Toronto ____________________ -----Vancouver _________________ .. ____
Windsor _________________________
Winnipeg _________________ - __ . __ .
Yarmouth _________ ------.----. - __
1,837
430
I, 246
382
1,434
I, !OR
102
1,804
336
49. 6
43.9
41. 7
56. 7
44. 7
44.5
62.3
.6
0
1. 7
.3
l, 160
886
168
50.4
56. I
58.3
43. 3
55.3
55.5
37. 7
12. 9
17. 2
6.6
9.4
18.5
11.4
37.0
.3
.3
1.1
0
.5
.3
.6
18.0
27. 7
5.9
8.4
21.0
7. 7
26.6
All counties. Western Remisphere _____________ -- ----- -- . -
7,059
6,060
53. 7
46.3
1.0
13. 0
.8
15. 7
304
43.6
52. 5
69.3
5..'i.4
68.0
52.1
.5
.1
.6
0
l. 7
1.0
25. 7
.6
30.6
14.2
17. l
13.9
48.3
48. 7
59.4
1.3
1.5
.1
22. 4
15. 5
23.1
.3
22.8
21.4
22. 5
1. 8
0
1.2
1.0
23. 3
21.6
13.0
17.4
20.3
.4
2. 3
0
.8
I. 3
21. 7
30.1
13.2
18.3
Canada, totaL _________________ .....
888
4M
----.4
.6
1.0
EUROPE
Belgium: Antwerp ___________________
~-
Germany, total. ______ -------------Berlin _________________ . ___ • ______ - - Hamburg ________________________ 1,24i
550
Stuttgart _______________ ._. _______ 1,361
3,428
&.. 4
47.5
30. 7
44.5
32.0
47.9
I, 163
523
I, 742
51. 7
,51. 3
40.6
Holland: Rotterdam _______ . _____ . __ .
369
Poland: Warsaw _____________________ 1,086
Denmark: Copenhagen. ______ . ____ ...
188
Norway: Oslo _______________________ .
252
Sweden, total. ________ -------- _______
271
Ooteborg •.... ________________ .. __
140
Stockholm •. __________ . ___ .. _... _
131
Italy, total. ______________________ .... 2,237
247
1,260
156
235
296
59.9
46. 2
54.6
51. 7
47.8
138
158
50.3
45.3
49. 7
54.6
2. l
0
IS. 6
22.1
1.4
1. 3
18. 8
17. 7
3,401
30. 7
60.3
3.2
20.2
6.5
22.8
Genoa'-------------------------·
Naples
___________________________
IM
2,086
223
3,178
40.4
30. 7
59. 6
60.3
1.3
3.3
20. ,5
20.1
2.2
6.8
23. 7
22. 7
Czechoslovakia: Prague ______________
Austria: Vienna ______________ .. ______
367
226
462
278
44.2
44.8
55. 7
5fi.2
1.6
1. 3
11. 2
21. 5
1, 1
2.2
15.4
26.8
12,287
45. 2
54.8
1. 5
19.8
2. 4
21.1
England: London. ___________________
Irlsb Free State: Dublin _____________
Northern Ireland: Belff\St ____________
Scotland: Glasgow __________________ .
393
1,030
179
139
238
3.158
All European countries _________ =10,133
1
Closed Sept.
31),
1,137
404
173
li06
=
40.1
53.8
45.4
4~.3
1\2.2
--1.6
16. 2
12. 3
12. 9
11. 7
21. 5
1933.
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PUBLIC HEALTH SERVICE
14.-Number and percentage of quota and nonquota applicants of each se:r:
who were refused visas for mental conditions during the fiscal year 1934
TABLE
Nonquota
Quota
Male
Country
"'"d
a.
"'"
s
z"
.. "'~
."
:0
.a
.a
8
P..
------
"'.9"
=
.
.a~
8
.,
.,"
8
t,1
f
f
~
.a
s s =
J
z= z=
-- ------
:0
's
z"
P..
J . J 'i'i.
}
~
t.l
~
z
Female
ald
.E
~
8
z"
Male
a. "'5!
"'5l
~
C)
=
..,
.a
z"
"'
"
.9
8
"'"
.2
~
1:0
t.l
:0
.a
8
:
Female
z"
8
:0
i:,..
P..
WESTERN HEMrsrHF.RE
Cuba ______________________ 228
Cansda ____________________ I, 242
2
1
1271
0.9
.I !, 070
2
5
292
J.6
. 5 3,778
0
18
0
237
.5 4,161
11
.3
3
. 2 I, 197
7
. 6 4,070
18
.4 4,398
11
.3
191
1
6S9
29
0
.5
108
45-,
1. 2
98
0
56
.9
2. 3
111
3.4
395
fi2
.5
I. 4
433
0
68
.7
89
1. 4
118 I
1. 2 1,578
0
202
I. 2
62
0
11
1
0
2
12
0
1
9
1
0
2
15
0
8
0
1. 2
0
0
0
0
2
0
113
0
2.4
448
256
1.0
67
0
1. 8
251
640
3.0
46
0
1.1
646
65
0
104
0
158
0
.6 2,527
291
1.0
0
110
0
0
1
77
3
2
0
0
3. 2
1.0
1.8
2.4 3,865
33
I.I 5,712
119
2.0
- - - - - - --- - - - - - - - -
All rountries. Westom Hemisphere ____ I, 470
EUP.OrE
I
Belgium ___________________ 285
England ____________________ 575
Irish Free State ____________
81
Northern Ireland __________
83
Scotland. __________________ 127
Germany __________________
Holland ____________________ 2,752
307
Poland ____________________ 653
Denmark __________________ 120
Norway ____________________ 163
Sweden. ___________________ 122
Italy _______________________ 655
Czechoslovakia _____________
..Austria ____________________ 1R5
164
1
35
0
0
•4
6. 1
0
g_ 5
7
l.'.H
2
5
0
1
1
6
94
1
9
101
131
138
86-1
171
168
0
1
2
10
0
2
3. 3 6,573
15~
0
.5
1.6
I
.I
209
I 25-5
614
.7
-
14~
106
5.6 2,796
:,JI
1. 7
2
0
1
All European
conntries _______________
6,252
TABLE
II
.1
.6
5
0
0
.8
2.0
.4
0
.s
2.3
0
15.-Number and character of the mandatorily e:,;cludable conditions notified
during the fiscal year 1934
WESTERN HEMISPHERE
.f;l
.
= .i I
~
~
Dl-wase or defect
i!!
Canada
~
:=
0
f
iii
!Iii
.cl
'=
~
0
1 l
§ "'
:a O'" 8~ >
~
8
8
><
- - - - -, _
-----0
0
:
Cla.!aA-1
Chronic alcoholism._______________________________________________
I ______ _______
Imbecility_______________________________________
l ------ _______
Insanity_________________________
Mentally defective_______________
4 ______
2 ______
1
2 _______
11 ______
6 ______
1 ______ _______
Epilepsy_________________________________
I ______ _____ ______
2
I _______
Feeble-mindedness_____________________________________
3 ______
4 ______ _______
Constitutional
psychopathic
Inferiority._______________________
I
8 ______
3 ______ _______
2 _______
Total class A-L___________
2
1
_____ ______
I
9
18
4
7
1
11
19
4
7
13
H
2
2
- - - - - - --·1--l---1------1---1---J.---+---
4
Clan A-II
~:~~a::::::::::::::::::::::::
Tubercu1os1s, pulmonary_________
1
5
24
14
Ringworm_______________________
Total class A-JJ._ _________ _
Grand total _______________ _
33 ________ ______
6
10
6
0
54
------ii-::::
__ :::::::::_::::::::
----1· -----1- -----88 ______
2
2
2 _______
16
Tuberculosis, other forms______________________________
Venereal diseases_________________
0
9
46
23
50
47
0
2
1
2 ______ _______
1 ______ -----·-
12 ______ ------· ______ _______
17
6
3
31
15
8
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2
21
58
1
9
20
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83
PUBLIC HEALTH SERVICE
TABLE
15.-Number and character of the mandatorily excludable conditions notified
during the fiscal year 1934-Continued
EUROPE
"".,"'
:ii
"'
Disease or defect
.,
.
:;;;
i
2l
p,
0
1l .,
"" I'<!l !a"' ""j .,"'El ""s:I., "".,s:I ~El ~ .,.,s:I
s:I
i 8 c:,!a '~2i 'op.. A., z~ ""Ii: ....3 0~.,... i-< E-<~
.i
Pa IS'1 ! z
"'
"'
CluaA-I
14
Insanity ••.•...••.••••••••••••.•••.••. -···.... 1 •••.
5 .••. ••.• ••.. •••• 5 2
Mentally defective................... 1 1 1 .••• 2 2 1 21 .••.•••...•. 58 3 ---- 90
El
:,
bl,
I>,
I
I>,
-
Epilepsy............................. •••• .••• •••• ••.. •••• 2 •••••••••••••••••••• 2
Feeble•mlndedness. ••••••.••... .•.•.• 1 .• •• 1 ... . 1 •• .. .• .. 4
1 .... 29
Constitutional psychopathic inferiority ••....•.•.•.•••••••••••••••••..•. ···-........ 1 1 4 2
...• 1
3
Imbecility ••••••••••••••••••••••••••..•.••..••.•.•.•.. ···- ....•••.
1
Total class A-1.................
2
5
3
13
3
Z1
0
2
6
95
4
2
4
43
H
2
6
4
167
3
1
1
199
=--==--------=-
Cla11 A-II
Trachoma............................ .... •••• .••• .••• .... •••. 1 19 ••••••••••.. 173 3
Tuberculosis, pulmonary............. 1 •• . . . • • . • ••• 1 9 3 1 . • • • 1 . • . • 6 ••.•
Ringworm....................................................... 2 .••• 1 .••. 2 ..••
Venereal diseases..................... •• •• •• • • • • . . • • . • . . • . 1 . . . . • • • . . . • • 1 ..•• 6
Total class A-II................
1
0
10
422
l==l==f=,t==i==i==i==
Grand total.................... 3
623
749
3
O
O
23
6
7
0
3
0186
3
6235
0
6
6281
8
9402
16.-Number and percentage of applicants examined who were notified and
refused visas on medical notification for different classes of disabilities during the
fiscal year 1934
TABLE
Number not!•
fled for-
I applicants
Percentage of
ex•
amined who
were notified
for-
Country and consular office
I
Percentage of
applicants ex•
amined who
were refused
visas for-
Number of
visas refused
for-
Class A ClassB Class A ClassB Class A ClassB Class A ClassB
condi• condi· condi- condi- condi• condi• conditions
tions
tions
tions
tlons
tlons tions
1. condi1 tions
-----WESTERN HEMISPHERE
Cuba: Habana••.•••••••.••.••••.....
Canada, total •..••.•••..........•....
50
77
Montreal ••••..•••••••••••••••••.
~:::rutti:::::::::::::::::::::::
18
1
32
1
15
8
2
All countries, Western Hem!•
sphere .•....•••••.•••........
1Z1
~~:~:0..........................1
Vancouver •..•••.•.•.••.•••.•..••
Windsor •••.••..••.••••••••.•••••
102
1,726
563
167
135
74
509 I
196 i
82 I
1,828
5. 7
.6
11. 5
14.8
76
15
740
5. 7
.6
1. 7
6.0
.5
.1
1.5
.1
.6
.4
.8
16.4
21.8
6.3
8.8
19.6
1.0
30.3
17
1
3~
1
15
8
2
250
83
7
.5
.1
1.5
.1
.6
.4
.8
6.6
10.8
.3
.6
9.2
5.2
15.5
1.0
13. 9
126
7551
1.0
6. 7
.6
.1
.3
.3
.9
.7
58.4
.4
.9
3.8
1.3
4.1
1.1
I. 1
.4
9.8
2.0
1.1
50
=,,,_..,
5
239
114
42
I
EUROPE
Belgium: Antwerp •••••••.•••••••••••
~and: London ••.•...••••••••••••.
Free State: Dublin •••••••••..••
N orthem Ireland: Belfast•.•••••.••.•
Scotland: Glasgow•••..•.•.•..•.•••• _
Germany, total ••••••••...•••...••••.
4
2
3
1
7
51
195
329
91
42
93
1,450
.6
.1
.5
.3
.9
.7
Z1.9
15.1
15.6
13. 5
12.5
22.0
4
2
2
1
7
51
Z13
Berlin•••.••••••••••••••••••••••••
Hamburg ••••••••••••••••••••••••
Stuttgart••.••.•.••••..••.••••••••
Z1
12
12
646
1.1
1.1
.4
22.6
Z1
236
197
707
18.4
22. 8
12
12
114
82
5
12
10
4
33
=====3
Digitized by
Google
84
PUBLIC HEALTH SERVICE
16.-Number and percentage of applicants examined who were notified and
refused visas on medical notification for different classes of disabilities during the
fiscal year 1934.-Continued
TABLE
Percentage of
applicants ex•
amined who
were notified
for-
Number noti•
fled forCountry anii consular offire
Percentage of
applicants examined who
were refused
visas for-
Number of
visas refused
for-
Class A Class B Class A Class B Class A Class B Class A Class B
condi· condi• coudi· condi• condi· condi· condi• conditions
tions
tions
tions
tions
tions
tions
tions
---------
_______, ____,_____ ,____ - - - - - - --- - - - - - -
EUROPE-continued
Holland: Rotterdam ........ _···- .. _.'
Poland: Warsaw ..........•.....• _...
Denmark: Copenhagen_ ..•.•.•••....
Norway: Oslo ..•.•.•.•.• -.....•......
Sweden, total.·····••···············-
i
49
0
5
15-l
500
83
25.0
7
85
I.I
55. 2
21. 2
49
2.0
159
6. 7
24.1
0
33
0
39.8
75
1.0
15. 4
1.0
5
35
6.9
100
1.0
19. 2
6
35
1.0
6.1
6
- -- - - · - - - - --- --- --- - - 52
18. 7
Goteborg ........•............ -· ..
5
1.8
16
1.8
5.
7
5
1
Stockholm_ ..... _... _..... ····- ..
5i
.3
19. 7
I
.3
19
6.5
Italy,
total.1 _________________
................ -··________
.... _.. ._
Genoa
Naples ..•. ·- •••..•...•....•......
2<Jl
7
284
1,228
84
I, 144
5. 3
1.8
5. 4
11
9
122
123
446
4. 603
Czechoslovakia: Prague............. .
Austria: Vienna ..................... .
All European countries ....•••.
1
I.I
2.0
0
---- - - -
21.8
22.5
21. 7
291
7
284
I. 3
1.8
14. 7
24. 4
l.ll
20. 5
j
9
102
5. 3
1.8
5.4
1.8
2.4
1.9
11
9
38
9
1. 3
1.8
3.4
1.8
445
1,001
1.9
4.4
lll
Closed Sept. 30, 1933.
17.-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 1934
TABLE
Quota
Country
Number
notified
Number refused visas
Nonquota
Percentage
of notified
cases re-
Number
notified
fused visas
Percentage
Number re• of notified
fused visas
cases refused visas
Class Class Class Class Class Class Class Class Class Class Class Class
A
B
B
B
A
B
A
B
A
B
A
A
---- ---- -----WESTERN HEMISPHERE
Cuba .•••.•.•.........•••..
Canada •••••..........••...
32
26
49
386
32
26
6 100
168 100
12. 2
43. 5
18
53
46 1, 151
46
9
553
100
100
16.9
48.0
All countries, West•
ern Hemisphere_ .. _
58
435
58
174 100
40.0
64 1,204
64
562
100
46.6
Belgium .....••............
England ......•.•.........•
Irish Free State_ .•••.•..•.•
Northern Ireland ••• -.. ·-·-·
Scotland .... ·- .•••••......•
Germany ..•....•.•.•.•....
Holland ••..... - .•.•••••....
Poland ••.......•...•.•.•.•.
Denmark ......•.•.•. ·-•···
Norway••.•.....•...•.•.•.•
Sweden •..•...............•
Italy .•.•............ -······
Czechoslovakia ••••..••.....
Austria .... -············· ..
2
128
1
222
1
39
1
17
6
58
37 1,241
128
5
327
27
0
58
3
46
4
56
56
633
3
59
6
78
2
1
0
1
67. 7
28.3
5.1
41.2
12. 1
20.2
59. 4
34.2
3
6
67
107
52
26
36
209
26
182
25
29
53
696
63
46
2
1
2
0
1
14
2
22
0
2
1
235
8
3
6
10
14
61
28
2
100
100
100
100
100
100
100
100
100
100
100
100
100
100
40.0
17. 7
6.8
54.3
37.5
7.8
16.9
8.9
2
0
1
14
2
22
0
2
1
236
8
3
27
19
37
5
27
0
87
63
2
7
7
251
76
112
27
26
21
60
10
7
All European COUD•
tries •••••.•.•.•.•...
162 3,090
151
745
21.9
293 1,613
293
256
100
18
EUROPE
6
3
4
56
100
100
0
100
100
100
100
100
100
100
100
100
100
100
99. 3
46.6
2
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3
22
9
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20.0
8.6
10.6
34.6
25.8
24.0
36.6
26.4
10.2
44.4
4. 4
16. 9
85
PUBLIC HEAL'.rH SERVICE
18.-Number and percentage of male and female applicants notified for
class B disabilities who were refused visas on medical grounds during the fiscal
year 1934
TABLE
Country and consul,1r office
Number of
Number of
applicants
applicants
notified for
refused visas for
class B conditions class B conditions
Percentage of
applicants
notified who
were refused
visas for class
B conditions
Male
Female
Male
Female
Male
Female
------------------11--- ----------- --- ---WESTERN HEMISPHERE
61
41
8
7
13.1
17.0
34. 5
860
450
299
52. 3
866
1---,-----1---+----1---,----237
326
121
51.0
129
MontreaL .• -·-·------··- --···--- ___ -· ---·-·
39. 5
74
93
53
30
71.6
Quebec ...• ·--···----·--·-·-·-···---·-_______
32. 4
Toronto ....... _________________ -·-------·--3. 8
2
52
83
5
6.0
36
2
6. 1
38
3
Vancouver-······----····---------·-·------7. 9
266
243
166
73
62.
4
Windsor_·-·····•--------····-----·-·------30. O
127
78
45
69
61. 4
Winnipeg_-·········-·--------------------··
65. 2
37
45
25
17
67. 5
Yarrnouth ••••..•... ·--------····-·-·-·-----37. 7
Cuba: Habana .• ··-·-·-·-----------------------Canada, totaL -··-·---- ______________ --------·--
All countries, Western Hemisphere .•. ·-···
921
907
458
306
49. 7
33. 7
102
167
22
18
93
162
69
24
65
770
62
44
1
7
5
158
52
38
4
5
5
115
61.0
26.3
4. 5
38. 9
17_3
23.2
55.9
23.4
5. 8
20. 8
7. 7
14.9
EUROPE
Belgium: Antwerp •........ ·-·-·····-···········
England: London ..........•........... -........
Irish Free State: Dublin........................
Northern Ireland: Belfast._···-·-·······---·····
Scotland: Glasgow .. -····--···-····-- · · --···-···
Germany, total. .•. -·-----···-·-------- · -----...
28
680
280
266
141
95
50.3
35. 7
85
112
2
2
2.4
1.8
315
392
15
18
4.8
4.6
i===t====;===t====t===!====
86
68
48
Holland: Rotterdam .•••.. ·--·-·······-·--······
37
62.5
55.4
235
274
95
Poland: Warsaw ......••........ ·-••·-·-········
64
40.4
23. 7
36
47
19
Denmark: Copenhagen .• ·•·············--·-····
14
52.8
29.8
44
31
25
55
54
20
1---t-------,1----1----11----t---Goteborg ....•.......................... -....
26
8
30. 7
30. 7
26
8
29
12
28
Stockholm ..••...... ---······-······--······
7
41.4
25.0
===F===f===!====e===l====
451
777
70
Italy, total .•. •-·•·······-··-•-····------·········
41
15.5
5.3
l---t-------,1----t----l'----+---31
53
5
Genoa '···········•-·-·-·-·············-•···
4
16.1
7.5
Naples .•••..•..•••••..••.•.......•.•. ·-··-··
420
37
15.4
5.1
724
65
Berlin •... ·-•·····•····-·-·-············•····
Hamburg ...•.••......•.•.... -·---·····-····
Stuttgart. ........ •····--·-···--------·-·····
ii
~~r:,rt~t~t::::::::::::::::::::::::::::::::::
~t~
~n
41
81
19
9
46.3
11.1
3
12. 2
4. 0
49
74
6
F==i'===F==t====I====
All European countries.................... 2,014
2,589
412
28. 7
15.9
579
Czechoslovakia: Prague •..•••••.•.•••. ·-········
Austria: Vienna.................................
1Closed
Sept. 30, 1933.
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PUBLIC HEALTH SERVICE
TABLE
19.-Summary of medical inspection of aliens, fiscal year 1994
MARITIME STATIONS
GROUP !.-ALIEN PASSENGERS NOT EXAICINKD ABROAD, EXAICINED UPON ARRIVAL
Total
examined
Class
First_ ___________________________________ _
Second ___ - - _----- ------ - ----- -- -- -- - ---- Tbird- _- ______ - - -- - - - - • - - - - - - - - - - - - -- - - - -
t:;r~~es:::::::::::::::::::::::::~::
61,649
22,255
00,259
399
4,420
Total. _____________________________ 178,982
Intensively
exam..
lned
Passed
796
304
3,414
261
2,114
61,367
21,973
88,578
365
4,069
6,889
176,362
Certified on arrival
1--.----.---..----1
A-I A-II
8
0
B
Total
certified
282
282
4
4
1
256
266
12
66
2
47
8
62
1,530
10
132
15
11
73
110
u
1,4181
34
361
73
Hl
2,193
223
2,630
GROUP ll.-ALIEN PASSENGERS EXAICINED ABROAD, REEXAICINED ON ARRIVAL
Total
exam-
Class
ined
First_ __________________________
Second __ • __________________ ---Tblrd ___ ------------- - ----. -- -Total.------ ______________
Intensively
Passed
abroad
exam•
lned
Passed
on
arrival
Certified on arrival (condition noted abroad)
A-I
A-II
B
Number
certified
C
---1,325
1,959
9,808
169
36
74
-13,092
- -- -279-
1,126
1,481
7,269
1,123
1,481
7,269
0
0
0
0
194
0
476
0 2,526
5
199
2
13
2,539
9,876
9,873
0
0 3,196
20
3,216
Certified on arrival (condition not noted abroad)
Class
A-I
First______________________________________________
Second ____ -----------------_______________________
Third_____________________________________________
A-II
Number
certified
0
B
o
O
3
O
0
0
0
0
0
0
0
0
478
Total
certified
20'l
478
3
0
0
2,539
1---.....Jl-----l'----1----4----+-0
0
3
0
3
T otaL. _____________________________________
3,219
GROUP III.-ALIEN SEAICEN EXAMINED ON ARRrvAL
Certified on arrival
Intensively
examlned
Passed
Allen crew ___
---------------------------- 783,165
Workaways
______________________________
212
231,942
53
782,089
212
36
0
Total. ______ ---- - - - ------- --- ---- -- 783,377
231,995
782,301
36
Total
examlned
A-I A-II
--------
Total
cert!•
fled
B
C
471
0
434
0
136
0
1,076
0
471
434
135
1,076
---- -- --
CANADIAN AND MEXICAN BORDER STATIONS
GROUP !,-ALIEN PASSENGERS NO'II EXAICINED ABROAD, EXAlllNED UPON ARRIVAL
Total
Class
examlned
Statistical, making permanent entry
(bona fide Immigrants) ________________ 40,649
Statistical, making temporary entry ______ 22,577
Nonstatistical, making entry (local crossers, etc.)_------------------------------ 420,495
Warrant cases __________ ---------------- -2,969
Total._ - - - -- - - - - - - - -- ---- ---- - --- -- 486,600
Certified on arrival
Intensively
examlned
Passed
36,069
6,922
Total
certifled
,-
A-I
A-II
B
38,611
20,328
115
89
r,7
106
1,389
1,700
477
354
2,038
2,249
41,365
2,838
414,938
2,196
113
102
489
217
3,630
332
1,325
122
6,567
87,194
476,073
419
869
7,0lll
2,278
10,617
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773
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PUBLIC HEALTH SERVICE
TABLB
19.-Summary of medical inapection of alien,, fi,Bcal year 1984-Continued
CANADIAN AND MEXICAN BORDER STATIONS-Continued
GROUP II,-ALIEN PASSENGERS EXAlUNED ABROAD, REEXAIIINED ON ARRIVAL
Total
exam•
ined
·c1ass
Statistical, making permanent
entry (bona tide Immigrants)_
Statistical, making temporary
entry ..••. _•••• __ •.•• ____ ._ •••
Nonstatistlcal, making entry
(local crossers, etc.) •••••••••••
Total ..•....•..•.•....•••. ,
Inten•
sively
exam.
ined
Passed
on
arrival
Passed
abroad
Certified on arrival (con•
dltion noted abroad)
A-I
A-II
B
Number
certified
C
85
85
63
63
0
0
22
0
22
731
731
731
638
0
0
0
0
0
572
572
572
520
0
0
0
0
0
1,388
1,388
1,366
1,221
0
0
22
0
22
I
Certified on arrival (con•
dition not noted abroad)
Class
""'-~
·~~:/"...."".'."""'' . "'-"'--"""'- !
Total ........................... ........... i
A-II
B
Number
certified
C
0
0
0
0
93
52
22
93
52
0
145
0
145
167
Statistical, making temporary entry .••.•.•••...•.•
&
0
93
0
0
52
0
Nonstatistical, making entry (local crossers, etc.) .•1---0-+----+---+----l
1
0
Total
certified
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DIVISION OF SANITARY REPORTS AND STATISTICS
Asst. Surg. Gen. R. C. Williams in charge
During the fiscal year the Division of Sanitary Reports and Statistics continued to act as a clearing house for the reports of outbreaks
of diseases dangerous to the public health and of the prevalence of
quarantinable and other communicable diseases in the United States
and foreign countries.
MORBIDITY AND MORTALITY REPORTS
Reports were received from officers of the Public Health Service
at home and abroad, from consular officers of the United States, from
the International Office of Public Hygiene, the Pan American Sanitary Bureau, and the health section of the League of Nations, from
foreign governments, and from all other reliable sources. The data
were arranged, compiled, abstracted, or tabulated and published for
the information of health officers and others interested in the protection of the public health.
During the fiscal year reports of cases of quarantinable diseases
were forwarded to foreign governments, to the International Office
of Public Hygiene, and to the Pan American Sanitary Bureau in
accordance with the provisions of international sanitary conventions
to which the United States is a party.
Indiana and Tennessee were added to the list of States which have
qualified for admission to the morbidity reporting area. Thirty-two
States have now reached the standard set for admission.
At the close of the fiscal year there were 4,674 collaborating and
assistant collaborating epidemiologists on the rolls of the Public
Health Service. These men are officers of State and local health
departments and their appointments as Federal officers are made at
the nominal salary of $1 per annum. Their duties are to collect and
forward to the Public Health Service information as to outbreaks of
diaeases dangerous to the public health and reports of the cUITent
prevalence of communicable diseases.
Telegraphic reports of the current pi evalence of diphthe1ia, influenza, measles, meningococcus meningitis, poliomyelitis, Rocky
Mountain spotted fever, scarlet fever, smallpox, typhoid fever, typhus
fever, and undulant fever were received each week from the health
officers of nll States except Nevada. The reports were published in
the Public Health Reports, and mimeographed copies of tabulations
were sent to all State health officers.
Monthly reports of the prevalence of notifiable diseases were received from all of the States, and weekly tabulations giving m1mbers
of cases and deaths in cities of over 10,000 population were received
during the year. Brief summaries of these reports were published
in the Public Health Reports, and the datn were compiled and filed
for reference.
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PUBLIC HEAL'l'H SERVICE
The annual summary of notifiable diseases in State,,i for the calendar
year 1932 was issued and the volume for 1933 was nearly ready at
the close of the fiscal year. Similar data for cities were collected,
tabulated, and filed. The summaries for cities have not been printed
since 1930.
PREVALENCE OF COMMUNICABLE DISEASES IN THE UNITED STATES,
1933
The following table gives a comparison of the numbers of cases of
the principal communicable diseases and deaths from these diseases
reported in the United States for the calendar years 1931, 1932, and
1933:
('.\SES
Num•
Disease
Chicken pox •. _____________
Diphtheria_. _______________
Influenza___________________
Malaria ____________________
Measles ____________________
Meningococcus meningitis.
Mumps ____________________
Pellagra ____________________
Pneumonia (all forms) _____
Poliomyelitis _______________
Scarlet fever ________________
Smallpox ___________________
Tuberculosis (all forms) ____
Tuberculosis (respirat.ory
system) _______ .. _________
Typhoid fever and paratyphoid fever ___ .. _______ --Whooping cou~I!
-------·-- -- -
ber of
States 1
Aggregate population
(in thousands)
1931
1932
1933
Cases per 100,000
population
Cases
1931
1932
1933
1931
1932
1933
- - --- - - - - - - --- - - - - - - - - - - - 42
47
47
46
47
35
39
45
45
40
47
47
47
108,067
123,558
123,558
116,844
123,558
106,428
87,063
104,088
113,430
105,271
123,558
123,558
123,558
108, 744
124,307
124,307
117,554
124,307
107,082
87,603
104, 702
114,063
105,913
124,307
124,307
124,307
43 114,139 114,833
109,529 201,860 201,492 223,486
125, 175 70,671 59, 784 50,378
125,175
-------118,377
125, 175 474,549 403,294 396,941
2,971
107,839
5,076
2,606
88,228 98,858 97,002 83,179
105,412 -------- -------- -------114, 795 -------- -------- -------106,656 15,756
3,588
4,855
125, 175 200,607 210,014 210,982
125, 175 30,151 11, 194
6,460
125, 175 -------- -------- --------
------- --------
186.8 185. 3 204.0
57. 2 48.1 40. ~
------ ------ ------
384.1 324.4 317. l
4. 8
2.8
2.4
113. 5 110.7 94.3
------ ------ --------------------15.0
3.4
4.6
162. 4 168. 9 168. 5
24.4
9.0
5.2
------ ------ -----115,638 -------- -------- -------- ------ ------ ------
47 123,558 124,307 125,175 26, 4591 26, 61S 23,287 21.4 21.4 18. 6
47 123, 5581 124,307 125,175 169,283 214,310 177,233 137. C 172.4 141. fi
DEATHS
reported for
Deaths per 100,000 Cases
each death regpopulation
istered
Deaths
Disease
1931
Chicken pox _____________________________
Pi1K!!~:!~~::::::::::::::::::::::::::::::
Malaria_ •. ______________ . ____ .. _________
Measles ________________ ..... ____________
Meningococcus meningitis ___ . __ . ________
Mumps. ____________ .. __ . ______ ___ . ____ .
Pellagra ________________ . ____ ... __ . ______
Pneumonia (all forms) _____ . __ ._ .. _______
Poliomyelitis ______________ -------------Scarlet fever _____________________________
Smallpox ________________________________
Tuberculosis )all forms). __ -------·-----Tuberculosis respiratory system) _______
Typhoid fever and paratyphoid fever ___ .
Wliooping cough_. __________ . _______ .. _.
1932
1933
1931
1932
1933
1931
1932
1933
- -- - - 128
6,132
32,356
2,643
3,345
2,378
65
5,808
96,109
1,926
2,618
104
83,137
68,801
5,721
4,508
94
6,017
37, S74
2,682
1,881
1,343
52
4,120
92, 1155
662
2,568
52
77,222
64,360
4. 822
5,265
127
4,852
31,706
4,463
2,167
1,105
45
3,781
84,239
657
2,438
35
73,809
61,510
4. 373
4. 162
0.1
5.0
26. 2
2. 3
2. 7
2. 2
.1
5.6
84. 7
1.8
2.1
.1
67. 3
60.3
4.6
3.6
0.1
4.8
30.5
2. 3
1.5
1.3
.1
3.9
81.5
.6
2.1
(1)
62.1
56.0
3.9
4. 2
0.1 1,577 2,144 1,760
12
10
3.9
10
25.3
-·---- -----3.8 ------ ------ -----1. 7
142
214
183
2
2
2
1.0
.1 1,521 1,865 1,848
3. 6 ------ ------ -----73.4
-----7
.6
8
5
82
87
1. 9
77
(1)
215
185
290
59.0
------ -----63.2 ------ ------ -----ff
5
3.5
5
41
43
3. 3
38
-----------
------
1 ln addition to the number of States dven, the District of Columbia is also inclncled.
' Less than 0.1 per 100,000 population:
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PUBLIC HEAL'l'H SERVICE
SANITARY LEGISLATION AND COURT DECISIONS
Legislation.-There was prepared during the fiscal year a publication (Supplement 111) containing citations to the various State and
Federal laws and regulations on public health enacted and adopted
during the calendar year 1931. Copies of J?Ublic-health ordinances
and regulations, adopted during 1933 by cit10s in the United States
of over 10,000 population, were secured for the purpose of ma.king
available sample municipal requirements on various health subjects
to assist those desiring to draft municipal health legislation.
Court decisions.-Supplement 110, containing a review of those
court decisions on :pubhc health which had appeared in the Public
Health Reports dunng the 3-year period 1930-32, was prepared and
published. There was continued throughout the year the abstracting
and publication in the Public Health Reports of current decisions on
public health handed down by State and Federal courts of last resort.
NEGRO HEALTH
w ORK
The Public Health Service rendered assistance in many Negro
health activities during the year. Cooperation was effected through
the State departments of health, and work was conducted in several
counties and communities with local health departments and various
voluntary health and civic agencies, including professional and lay
groups.
Field service reached 26 communities in 11 States in 84 days of
special activities, during which 203 interested organizations participated in 612 lectures and conferences and 25 motion-picture showings
and exhibits, with total attendance of 49,945 persons.
The twentieth anniversary of the National Negro Health Week
for which the Public Health Service issued informative materials and
provided field service, produced reports showing 41,004 homes
engaged in clean-up projects for sanitary and other improvements,
3,090 health lectures to 322,500 persons, 105 radio talks, 809 health
articles in newspapers, 128,627 health pamphlets, 218 motion-picture
programs, 411 exhibits, and 885 pageants and games attended by a
total of 167,629 people. Five hundred and two clinics for babies,
children, and adults served 61,109 applicants.
The intensive health-week campaign stimulated year-round activities that produced a number of comprehensive community health
surveys and many practical undertakings for constructive use of the
health-week experiences and the data of the surveys.
The National Negro Health News, a quarterly bulletin of data on
Negro health problems and projects, was issued during the year by
the Public Health Service.
On March 1, 1934, supervision of this work was transferred from the
Division of Sanitary Reports and Statistics to the Division of Domestic (Interstate) Quarantine, which division maintains cooperative
relations with the States on adininistrative health work.
PUBLICATIONS IssuED BY THE D1v1sION
The Public Health Reports, issued by the Division each week, is one
of the oldest of regular Government publications. It was first
printed in 1878 under the title of "Bulletins of Public Health", later
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PUBLIC HEALTH SERVICE
as "Abstracts of Sanitary Reports", and since 1895 has gone out
under the present title. It was issued regularly each week during
the year, the 52 issues covering volume 48, part 2, and volume 49,
part 1. These issues contained a total of 1,578 pages of text and
tabular matter, exclusive of title pages and tables of contents, as
compared with 1,762 pages in the fiscal year 1933, 3,008 pages in
1932, and 3,285 pages m 1931. The reduction in the years 1933 and
1934 as compared with prior years was necessitated by the reduction
in printing funds and was accomplished by suspending publication of
certain statistical matter and revising and condensing the text
articles as much as possible. The value of the Public Health Reports
as a medium of reporting the results of important current research
work and as a means of presenting current morbidity reports was
retained to the greatest extent possible in the face of greatly reduced
printing funds.
During the year 50 important articles published in the Public
Health Reports were issued in separate form as reprints, providing a
more extensive and economical distribution to persons interested in
the subjects and allowing the printing of sale editions by the Superintendent of Documents. In 1933, 43 such articles were reprinted, 35
in 1932, and 97 in 1931.
Four supplements to the Public Health Reports were issued during
the year as follows: No. 107, Malaria Treatment of Parenchymatous
Syphilis of the Central Nervous System; No. 108, The Sanitary
Privy; No. 109, The Notifiable Diseases in States, 1932; and Supplement No. 110, A Review of Court Decisions on Public Health, 1930-32.
Supplement No. 108, which contained numerous detailed drawings and
specifications, proved exceedingly valuable in the construction of over
200,000 sanitary privies under the Public Works Administration during
the latter part of the fiscal year.
New editions of a number of previously printed publications were
issued during the fiscal year, as the demand for such publications justified going to press again. Some of these new editions required
revision to bring them up to date.
The Division also issued three National Negro Health Week publications during the year--the National Negro Health Week Bulletin,
the health week poster for the 1934 observance, and a health leaflet for
school and home, containing in attractive form some fundamental
health precepts for children and adults. This work is in keeping with
the practice of the Public Health Service, under legislative authority,
of aiding in special public health problems. It is designed to stimulate
interest in community Negro health activities and aid community
leaders in their health campaigns to improve individual hygiene and
.community sanitation.
PUBLICATIONS DISTRIBUTED AND EXHIBITS PREPARED
During the fiscal year, 76 new publications were distributed by the
Division, as compared with 66 during the preceding year. A total
distribution of 179,370 copies of new publications and of editions of
previously published documents was made. Of these 115,818 were
sent in response to individual requests for information and 63,552 were
distributed to service mailing lists.
90167-34-7
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PUBLIC HEALTH SERVICE
There were 36 requests for the loan of stereopticon sli~es, and in
response to these requests, 2,003 slides were lent to universities, health
officers, public-health lecturers, officials of the Public Health Service,
and others.
During the fiscal year the appropriation for exhibits relating to
public health was further reduced. Although the funds appropriated
for exhibit purposes were inadequate, an exhibit on encephalitis was
prepared, in cooperation with the committee on scientific exhibits of
the American Medical Association, for display at the annual meeting
of the association at Cleveland. Other exhibits of the service were
displayed in various cities of the United States. The exhibit of the
service at the Century of Progress Exposition at Chicago was reconditioned and displayed during the continuance of this exposition.
The following is a list of publications distributed by the division
during the fiscal year:
REPRINTS FROM THE PUBLIC HEALTH · REPORTS
1562. The objectives in public health nursing and minimum qualifications for
those appointed to positions in public health nursing. March 10, 1933.
8 pages.
1565. Experimental studies of water purification. VI. General summary and
conclusions. By H. W. Streeter. April 14, 1933. 24 pages.
1566. Inactivation of antistreptococcus bacteriophage by animal fluids. By
Alice C. Evans. April 21, 1933. 16 pages.
1569. Protective value of convalescent sera of Sao Paulo exanthematic typhus
against virus of Rocky Mountain spotted fever. By R. R. Parker and
Gordon E. Davis. May 12, 1933. 7 pages.
1570. Rocky Mountain spotted fever and boutonneuse fever. A study of their
immuniological relationship. By L. F. Badger. May 12, 1933. 4
pages.
1571. Relationship between Rocky Mountain spotted fever and "exanthematic
typhus of Sao Paulo." By R. E. Dyer. May 19, 1933. 2 pages.
1572. Maternal, fetal, and neonatal mortality among 1,815 hospitalized American
Indians. By E. Blanche Sterling. May 19, 1933. 14 pages.
1573. Rat harborage and its relation to the spread of bubonic plague. By B. E.
Holsendorf. May 19, 1933. 4 pages.
1574. Preparation of a scarlet fever streptococcus toxoid and its use in active
immunization. By M. V. Veldee. May 26, 1933. 17 pages.
1575. Observations on heart disease in Marine Hospital practice. A study of
organic heart disease in the United States Marine Hospital, Stapleton,
N. Y., during the fiscal year 1931. By 0. F. Hedley. May 26, 1933.
11 page~.
1576. Heterologous experience (immunization) as a factor in resistance to disease.
By Charles Armstrong and W. T. Harrison. June 2, 1933. 13 pages.
1577. Malaria in the irrigated regions of New Mexico. By M. A. Barber and
Louis R. Forbrich. June 2, 1933. 14 pages.
1578. Public Health Service publications. A list of publications issued during
the period July-December 1932. June 2, 1933. 3 pages.
1579. The Shwartzman phenomenon. Factors complicating its use in the testing
of antimeningococcic serum. By Anna M. Pabst and Sara E. Branham.
June 9, 1933. 13 pages.
1580. Experimental studies of natural purification in polluted waters. VII.
The selection of a dilution water for bacteriological examinations. By
C. T. Butterfield. June 16, 1933. 11 pages.
1581. Distribution of mottled enamel in the United States. By H. Trendley
Dean. June 23, 1933. 32 pages.
1582. The pellagra-preventive value of green cabbage, collards, mustard greens,
and kale. By G. A. Wheeler and D. J. Hunt. June 30, 1933. 5 pages.
1583. Rocky Mountain spotted fever: susceptibility of the dog and sheep to the
virus. By L. F. Badger. July 7, 1933. 5 pages.
1584. An outbreak of dermatitis among workers in a rubber manufacturing
plant. By Louis Schwartz and Louis Tulipan. July 14, 1933. 6 pages.
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PUBLIC HEALTH SERVICE
1585. Whole-time county health officers, 1933. July 14, 1933. 9 pages.
1586. Dermatitis from chemicals used in removing velvet pile. By Louis
Schwartz and Louis Tulipan. July 28, 1933. 4 pages.
1587. The injection of mosquito sporozoites in malaria therapy. By Bruce
Mayne. August 4, 1933. 7 pages.
1588. Physical impairment and weight. A study of medical examination records
of 3,037 men markedly under or over weight for height and age. By
Rollo H. Britten. August 4, 1933. 19 pages.
1589. Zinc in relation to general and industrial hygiene. By Cecil K. Drinker
and Lawrence T. Fairhall. August 11, 1933. 7 pages.
1590. Relation of arsenoxide content to toxicity of fresh and old samples of
arsphenamine. New chemical tests upon the arsphenamines. By
Sanford M. Rosenthal and T. F. Probey. August 11, 1933. 8 pages.
1591. Variations of growth in weight of elementary school children, 1921-28.
By Carroll E. Palmer. August 18, 1933. 13 pages.
1592. Estimation of basophilic cells (reticulocytes) by examination of ordinary
blood film. By R. R. Jones. August 18, 1933. 10 pages.
1593. Bone marrow in tularaemia. By R. D. Lillie and Edward Francis. September 15, 1933. 10 pages.
1594. Incidence and clinical symptoms of minor respiratory attacks with special
reference to variation with age, sex, and season. By Selwyn D. Collins
and Mary Gover. September 22, 1933. 24 pages.
1595. Public Health Service publications. A list of publications issued during
the period January-June 1933. September 29, 1933. 4 pages.
1596. Estimation of fluorides in waters. By Elias Elvove. October 6, 1933.
4 pages.
1597. Extent of rural health service in the United States. January 1, 1929, to
December 31, 1932. October 6, 1933. 17 pages.
1598. Sickness and the economic depression. Preliminary report on illness in
families of wage earners in Birmingham, Detroit, and Pittsburgh. Bv
G. St. J. Perrott, Selwyn D. Collins, and Edgar Sydenstricker. October
13, 1933. 14 pages.
1599. Growth and the economic depression. A study of the weight of elementary
school children in 1921-27 and in 1!)33. By Carroll E. Palmer. October
20, 1933. 16 pages.
1600. Encephalitis: studies on experimental transmission. By Ralph S. Muckenfuss, Charles Armstrong, and II. A. McCordock. November 3, 1933.
2 pages.
1601. Experimental studies of natural purification in polluted waters. VIII.
Dissolved oxygen in the presence of organic matter, hypochlorites, and
sulphite wastes. By Emery J. Theriault and Paul D. McNamee.
November 10, 1933. 15 pages.
1602. Acute response of guinea pigs to vapors of some new commercial organic
compounds. VII. Dichloroethyl ether. By II. H. Schrenk, F. A.
Patty, and W. P. Yant. November 17, 1933. 10 pages.
1603. Biological products. Establishments licensed for the propagation and sale
of viruses, serums, toxins, and analogous products. November 17, 1933.
5 pages.
,
1604. State and insular health authorities, 1933. Directory, with data as to
appropriations and publications. December 22, 1933. 17 pages.
1605. Experimental studies on acute mercurial poisoning. By Sanford M.
Rosenthal. December 29, 1933. 21 pages.
1606. The influenza epidemic of 1928-29 in 14 surveyed localities in the United
States. An analysis, according to age, sex, and color of the records of
morbidity and mortality obtained in the surveys. By Selwyn D.
Collins. January 5, 1934. 42 pages.
1607. The use of pure strain animals in studies on resistance to transplantable
tumors. By H. B. Andervont. January 12, 1934. 6 pages.
1608. The physiological response of the peritoneal tissue to dusts introduced as
foreign bodies. By John W. Miller and R. R. Sayers. January 19,
1934. 10 pages.
1609. Sulphur dioxide for the fumigation of ships. Methods of tise and prospects of improvement. By C. L. Williams. January 19, 1934. 12
pages.
1610. Milk-sanitation ratings of cities. Cities for which milk-sanitation ratings
of 90 percent or more have been reported by the State milk-sanitation
authorities during the period January 1, 1932, to December 1, 1933.
January 26, 1934. 5 pages.
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PUBLIC HEALTH SERVICE
1611. Amoebic dysentery. Problems presented by the outbreak in 1933. By
G. W. McCoy. February 2, 1934. 4 pages.
1612. Gas hazards in sewers and sewage-treatment plants. By R. R. Sayers.
February 2, 1934. 11 pages.
1613. City health officers, 1933. Directory of those in cities of 10,000 or more
population. February 2, 1934. 17 pages.
1614. The sensitivity, in Yitro, of bacteria to the beta and gamma rays of radium.
By H.. R. Spencer. February 9, 1934. 10 pages.
1615. Liquid sulphur dioxide as a fumigant for ships. By C. L. Williams.
February 9, 1934. 17 pages.
1616. Effect of flea passage on epidemic typhus virus. By R. E. Dyer. February 16, 1934. 2 pages.
1617. Studies on the standardization of vibrion septique antitoxin. By Ida A.
Bengtson. February 23, 1!)34. 12 pages.
1619. Control of amoebic dysentery. By G. W. McCoy. March 16, 1934.
2 pages.
1620. Viability of endamoeba histolytica and endamoeba coli. Effect of drying.
By Bertha Kaplan Spector and Florence Buky. March 23, 1934.
7 pages.
1621. Most probable numbers for evaluation of coli-aerogenes tests by fermentation tube method. By J. K. Hoskins. March 23, 1934. 13 pages.
SUPPLEMENTS
106. Whooping cough: its nature and prevention. Information concerning a
wide-spread disease for which familiarity has bred contempt. By Floyd
C. Turner. 1933. 4 pages.
107. Malaria treatment of parenchymatous syphilis of the central nervous system.
By R. A. Vonderlehr. 1933. 70 pages.
108. The sanitary privy. 1933. 45 pages.
109. The notifiable diseases. Prevalence in States, 1932. 1933. 13 pages.
110. Court decisions on public health. Review of decisions published in the
Public Health Reports during 1930-32. Prepared by William Fowler.
1934. 17 pages.
PUBLIC HEALTH BULLETINS
205. Lead poisoning in a storage-battery plant. By Albert E. Russell, Roy R.
Jones, J. J. Bloomfield, Rollo H. Britten, and Lewis R. Thompson.
June 1933. 55 pages.
206. The intelligence of the prospective immigrant. I. A study of the mental
ability, measured by language and nonlanguage tests, of applicants for
immigrant visas at Warsaw, Poland. By J. D. Reichard. July 1933.
35 pages.
207. The health of workers in a textile plant. By Rollo H. Britten, J. J. Bloomfield, and Jennie C. Goddard. July 1933. 26 pages.
208. The health of workers in dusty trades. General statement and summary
of findings. By Lewis R. Thompson, Albert E. Russell, and J. J. Bloomfield. III. Exposure to dust in coal mining. By Dean K. Brundage
and Elizabeth S. Frasier. (Section on pathology contributed by L. U.
Gardner.) IV. Exposure to dµst in a textile plant. By J. J. Bloomfield
and W. C. Dreessen. V. Exposure to the dusts of a silverware manufacturing plant. By Jennie C. Goddard. VI. Exposure to municipal
dust (street cleaners in New York City). By Rollo H. Britten. July
1933. 37 pages.
209. Osteitis deformans. A review of the literature and report of 11 cases. By
J. W. Kerr. September 1933. 122 pages.
210. Mortality of coal miners. By Dean K. Brundage. July 1933. 17 pages.
NATIONAL INSTITUTE OF HEALTH BULLETIN
162. I. The blacktongue (canine pellagra) preventive value of 15 foodstuffs.
By G. A. Wheeler and W. H. Sebren. II. Pathology of experimental
blacktongue. By R. D. Lillie. III. "Yellow liver" of dogs (fatty
infiltration) associated with deficient diets. By W. H. Sebren. IV. The
pathology of "yellow liver" of dogs. By R. D. Lillie and W. H. Sebrell.
September 1933. 45 pages.
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PUBLIC HEALTH SERVICE
ANNUAL REPORT
Annual Report of the Surgeon General of the United States Public Health
Service for the fiscal year 1933. 1933. 128 pages.
MISCELLANEOUS PUBLICATION
11. Official list of commissioned and other officers of the United States Public.
Health Service. Also a list of all 11tations of the Service. January 1,._
1934. 58 pages.
UNNUMBERElD PUBLICATION'S
Index to Public Health Reports, vol. 48, part 1, January-June 1933. 24 pages.
Index to Public Health Reports, vol. 48, part 2, July-December 1933. 1934.
21 pages.
National Negro Health Week poster. Twentieth annual observance. 1934.
National Negro Health Week program. 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. Twentieth annual observance. 1934. 8 pages.
National Negro Health Week leaflet . 1934. 2 pages.
The United States Public Health Service. A descriptive pamphlet. 1934. 4
pages.
Insert entitled "Industrial hygiene and sanitation." To be· inserted in the
Annual Report of the Surgeon General for the fiscal year 1933. 1934. Pages
32A-B.
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DIVISION OF MARINE HOSPITALS AND RELIEF
Asst. Surg. Gen. S. L.
CHRISTIAN,
in charge
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 181 hospitals
located chiefly in ports not served by the 25 marine hospitals. At
the close of the year 4,531 patients remained in hospitals, including
154 insane in St. Elizabeths Hospital and 361 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 volume of work, which for 136 years has faithfully reflected the
activities of the American merchant marine, was slightly increased
for old-line beneficiaries; and on June 30, 1934, there were 157 more
such patients in hospitals than a year ago. Many owners of small
vessels not previously documented have obtained registration chiefly
for the purpose of enabling the crews to become eligible for treatment. The regulations governing the medical treatment of merchant
seamen were liberalized by an amendment approved by the President
on April 7, 1934, as a partial measure of relief for those seamen who
have been thrown out of employment in great numbers by the sharp
decline in shipping during the depression, thus causing a considerable
increase in the cost of operating the hospitals. Recent liberalization
of the medical treatment benefits extended to war veterans since the
passage of the Economy Act has contributed to an increased number
of patients from that source. Pursuant to the act of March 31, 1933,
enrolled members of the Civilian Conservation Corps were furnished
hospital care and out-patient treatment during the fiscal year. The
cost of hospital care for this class of patients was reimbursed by the
War Department at $3.25 per day, but no allowance was made available for the cost of their out-patient care, which entailed considerable
additional expense for medications, dressings, dental supplies, and
services. Persons engaged in civil-works projects under the Civil
Works Administration were also furnished hospital care and outpatient treatments in great numbers, for the extra cost of which no
reimbursement was authorized, although the sum of $120,000 was
released on this account about June 15, 1934, from the cash reserve
of the appropriation "Pay of Personnel and Maintenance of Hospitals, Public Health Service, 1934." Owing to the continued rise
in prices of all commodities, especially foodstuffs, it is believed that
it will be impossible to continue to operate throughout the fiscal year
1935 on funds now available, unless the standard of hospital care is
lowered, which would be seriously detrimental to the established
standards of the Service.
For a complete statement of relief furnished at each station and the
customary collateral functions performed by the marine hospitals
96
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PUBLIC HEALTH SERVICE
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, Veterans' Administration, Civilian Conservation Corps,
and Civil Works Administration, see pages 100 to 108.
CLASSES OF BENEFICIARIES AND AMOUNT AND CHARACTER OF
SERVICES RENDERED
Summary of services by class of beneficiary
Hospital days
Out-patient
treatments
Physical examinations
(not related
to treatment)
Remarks
Class of beneficiary
PerPerPerNumber ~rt Number ~rt N6!,1:1" ~rt
total
total
total
___________
- - - - - - - - - - , - - - - - - - - - - - - __ ,
American merchant seamen. 1,108,097 68. 16
Veterans ___________________ _
Lepers _____________________ _
;20, 890
1. 29
130,118
8.00
Coast GuardpersonneL ___ _
88,896
5. 47
Injured Federal employees __
Immigrants ________________ _
72,598
4.47
22,039
1.36
Seamen, Engineer Corps
andArmyTransportService.
Seamen from foreign vessels_
Seamen and keepers, Lighthouse Service.
Civilian Conservation
Corps.
Civil Works Administration
39,667
2. 44
5,491
11, 703
. 34
. 72
511, 056 49. 93 8, 465 10. 32 Communicable diseases are
reported to local heAlth
officers.
·
342
1,859
. 18
.42 Patients of the Veterans'
Administration.
7 ···--4 ------ National Leper Home, Carville, La.
172,510 16.85 6,367 7. 76 All medical services and supplies, ashore and afloat.
115,543 11. 29 24,018 29.26 Patients of the Employees'
Compensation Commission.
10,519 1.03
183
.22 Patients of the Bureau of
Immigration,
15, 747 1.54
413
. 50 Civilian employees on Army
vessels.
684
7,149
56, 708
3. 49
1,912
48,797
3. 00
77,425
.07
. 70
15
89
.19
633
7. 56 7,039
Alaska cannery workers ______________ _
444
.04 6,424
leaving United States.
Pilots and other licensees __________________________________ 7,014
Civil-serviceapplicantsand ______________________________ 14,459
employees.
Shipping Board ___________ _
2,479
All others entitled to treatment.
20, i32
1. 26
108, 763 10. 62 4, 131
. 01 Pay patients .
. 11 Medical supplies also fur•
nished to lighthouse vessels.
. 77 Patients of the Civilian Conservation Corps.
8. 58 Patients of the Civil Works
Administration.
7.83 Vaccinations and other preventive measures.
8.55 For the Steamboat Inspection
Service.
17.62 For the Civil Service Com•
mission.
3.02 To determine fitness for sea
duty.
5. 03 From Bureau of Fisheries,
Army, Navy, Mississippi
River Commission, Coast
and Geodetic Survey, etc.
Total.-----·--·-·----- 1,625,736100.001,023, 618 100. 00 82,075 100. 00
The average per diem cost in marine hospitals reflects prevailing
prices of commodities and rates of salarie;;, For the past 12 years it
has been as follows:
1923 ________________________ $4.08
1924 __________________________ & 84
1925 ________________________ 3. 80
1925 ________________________ a 11
1927 __ -- --- __ -- _-- ______ ---- 3. 75
1928 ________________________ 3. 80
1929 ________________________
1930 ________________________
1931 ________________________
1932 ________________________
1933 ___ -------- ---- ------ ___
1934 ________________________
$4.03
4. 15
4.05
a 77
3. 34
3.00
The per diem cost wa;; forced down to the low figure of $3.00
during the fiscal year 1934 because of insufficient appropriations, but
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PUBLIC HEALTH SERVICE
this was not done at the expense of services rendered patients. It was
accomplished by keeping the personnel at the lowest practicable
number and foregoing, for the time being, the replacement and
repair of equipment in normal amount. Such a policy cannot continue very long without seriously breaking down the equipment of
the hospitals.
DENTAL TREATMENT
Due to curtailment in appropriations, it was necessary at the
beginning of the year to discontinue 17 dental internes, 3 dental
technicians, and 3 oral hygienists. As a result of this reduction in
personnel, the dental clinics throughout the various stations of the
Service were less able to handle the demand for dental treatment
than in previous years. The demand for this class of treatment
seems to be constantly on the increase. During the year, 144,835
patients were given dental treatment. This is practically the same
number that requested treatment during the preceding year. However,
it will be noted that the number of treatments actually given was
materially reduced.
The total cost of all dental treatment at marine hospitals and relief
stations, including salaries, supplies, repairs, and overhead expense,
was $250,033.39. This makes an average cost per patient of $1.73.
Had this amount of treatment been purchased on a fee basis, it would
have cost the Service $946,604.69, computed according to a fee table
of the Service. This would have cost the Service $6.54 per patient.
There is urgent need for additional dental personnel to meet the needs
of patients. The major items of treatment were as follows:
1038
Number of patients treated ___________________________ _
Number of sittings __________________________________ _
X rays _____________________________________________ _
Prophylactic treatments (hours) ______________________ _
Vincent's stomati tis treatments (hours) ________________ _
Pyorrhea treatments (hours) __________________________ _
Extractions _________________________________________ _
Alveolectomies ______________________________________ _
Alloy fillings ________________________________________ _
Gold inlays _________________________________________ _
Porcelain crowns ____________________________________ _
Silicate cement fillings _______________________________ _
Dentures (full and partial) ___________________________ _
Fracture hours ______________________________________ _
10~4
145,877
213,320
39,823
13,544
4,362
4,626
77,928
3,230
38,668
1,023
99
14,687
5,525
470
144,835
197,192
32,278
15,733
4,274
3,832
65, 671
2,163
32,835
610
65
14,134
6,203
719
Total number of treatments _____________________ 619,392
541,895
In addition, 2,476 beneficiaries were treated at 32 smaller stations
by contract dentist., on a fee basis, at a total cost to the Service of
$11,466.80, or an average of $4.63 per patient. This is a decrease of
two-thirds in the expenditure for this class of treatment, and a decrease
of one-third in the number of beneficiaries treated during the preceding year. This was made necessary because of the shortage of
funds for this class of treatment. As a result, a limit was placed on
the amount of treatment to be rendered at almost every station where
a contract dentist was on duty; and in order to come within the limit
it was found that only emergency treatment for the relief of pain could
be administered in most cases.
Senior Dental Surg. C. T. Messner is in charge of dental activities
in the field and Bureau.
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PUBLIC HEALTH SERVICE
COAST GUARD
The average number of Coast .Guard beneficiaries on active duty
and retired was 10,401. Medical services furnished in recent years
are shown in the following table:
Numerical strength of Coast Guard and medical services given
Year
1923 ______________
1924 __ -- ---------1925 __ -----------1926. _ ------- ----1927 __ -----------1928 __ -- ----- _-- -1929_ ------------1930 _______________
----- ------1931_
1932 ______________
1933 __ -----------1934_ -------------
Number of
Coast
Guard
personnel
4,684
4,896
7,077
9,839
10,984
12,462
12,833
12,963
13,020
13, 189
13,181
10,401
Physical
Hospital Out-patient examinadays
treatments
tions
41,681
36,504
60,336
71,799
76,664
85,691
88,870
90,179
86,829
91,655
106, 126
88,896
32,530
45,857
90,494
125,226
155,977
137,971
169,697
196,334
187,063
198,800
214,805
172,510
4,'Jffl
7,008
13,394
19,061
18,787
17,220
17,748
14,382
8,262
11,481
9,557
6,367
Average amount of medical service
per person
Physical
Hospital Out-patient examina•
days
treatments
tlons
8.9
7.6
8.6
7.3
6.9
6.9
6.9
6.9
6. 7
6.9
8.0
8.6
6. 7
9.4
12.8
12. 7
14. 2
11.0
13. 2
15.1
14. 4
15.1
16. 3
16. 6
0.9
1.6
1.9
1.9
1. 7
1.4
1.4
1, 1
.6
.9
.7
,6
Fifteen medical and dental officers are assigned exclusively to Coast
Guard duty, and 102 local physicians under appointment as acting
assistant surgeons furnish medical and sur~cal relief and 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 medical officer and a
dental officer were stationed at the patrol base at Unalaska during
the cruising season. A medical officer and a dental officer are assigned
to the Northland on its annual cruise to Point Barrow, Alaska. This
cutter has a well-equipped 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 on medical, sanitary, and dental conditions
among the natives.
,
Eight medical officers were assigned to Coast Guard destroyers
operating under the special service squadron during the Cuban
emergency.
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 and Civilian Conservation Corps, classified
according to the General Accounting Office Bull~tin, is shown below:
01
0200
Personal services _______________________________________ $2,783,846
Janitor and laundry supplies, X-ray films, etc______________
48,057
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100
PUBLIC HEALTH SERVICE
Medical and hospital supplies ___________________________ _
Scientific and educational supplies _______________________ _
Fuel (coal, gas, oil, and wood) __________________________ _
0210
0220
0230
0520
0260
0280
03
i~~:fs1ons_~~==========================================
Sundry
supplies _______________________________________ _
Subsistence
and support of persons (contract hospital care,_
etc.) _______________________________________________
04.
0500
0510
06
07
10
1100
1110
1280
1290
1373
1375
1380
2250
3000
3010
3020
3040
3050
Care of animals and vehicles (service) ___________________ _
Telegraph service _____________________________________ _
Telephone service _____________________________________ _
Travel expenses _______________________________________ _
Freight ______________________________________________ _
Furnishing heat, light, power, and water (service) _________ _
Rent of buildings and offices ___________________________ _
Other rents ___________________________________________ _
Repairs and parts, motor vehicles _______________________ _
Repairs and alterations, other equipment _________________ _
Laundry service _______________________________________ _
Ashes and garbage removal_ ____________________________ _
Miscellaneous services _________________________________ _
Buria~----------------------------------------------Passenger-carrying vehicles _____________________________ _
Furniture, furnishing, and fixtures ______________________ _
Scientific equipment ___________________________________ _
Livestock ____________________________________________ _
Other equipment _______________________ .. ___________ . __ _
$192,707
4,030
154,168
24,605
814,569
54,766
291,915
36
1,143
26, 122
61,910
65,487
180,149
11, 159
5,179
3,387
9,352
27,391
2,306
1,075
21,548
3,193
126, 142
57,446
717
26,774
TotaL_ __________ ______________ _____________ ____ 4, 999, 179
CONSOLIDATED AND DETAILED REPORTS
The following tables give consolidated and detailed reports for the
marine hospitals and relief stations:
TABLE
!.-Number of patients treated annually, 1868 to 1934
Sick
Fiscal year
and dis•
abled
patients
I
Sick
and
dis•
abled
patients
fur•
nished
relief
Fiscal year
fur•
Dished
relief
- - -- - - --
I
Sick
Fiscal year
and dis•
abled
patients
fur•
nished
relief
- - - -· - - - - - - - -
Prior to reorganization:
1868 ....... ·- · ·······
18RO .. - . . .. ·- ..... .. .
1870- -·· -· - · · ··· ···· ·
11, 5~5
11, 356
10,560
187L. .. - .. ···-·····1872...... - - •···· ····
1873. . · --· - ···-··· ···
1874 . . . ·-·····-······
1875 . .. .. .. ·- · ····· · ·
1876 .. ·-·-···········
1877 ······· · ······ . ..
1878 . . ... _........ - .
1879. . . .. .. . . . . . . . . . .
1880... . . .. . . . . . . . • . .
1881.. ... ... -···· -···
1882.._·········· ··-·
1883 . .. ·-····-·······
1884 ......• · -··-···-·
1885.. ......... . ... _.
1886 ....... _.. . ... . ..
1887 ..... ········ ··-·
1888. . . .... ... .. .....
1889 . . .... . . . .... -...
1890. .. ... . . .. .. . ...•
14,256
13,156
13,529
14,356
15,009
16,808
15, 175
18,223
20, 922
2<[, 860
32,613
36,184
40, 195
44,761
41,714
43,822
45,314
48,203
49,518
50,671
Alier reorganization:
1
After reorgaoizationContinued.
Alter reorgaoizationContinued.
1891.. ...... - . ...... .
1892 .. ·· ··· · ···--····
1893.... . ..... ... .. . .
1894... ·-·····-·-····
1895 . .. ·- · ·· ··-··-·- ·
1896'··-·-····· · · ··-·
1897 .. ·-·-···········
1898 .........• ·-···-·
1899.. . . .. . .... .. . ...
1900.... . . ...........
1901.. .... . . . . - ..... .
1902 .. .. ·-····· · ·····
1903._ __ . . ....•..... .
1904 .... .. ........ -..
1905 ........... ·-·· ··
1906.. ... ······· -· ···
1907·-····-·-··· ··-··
1908 ... _... . _... _.. ..
1909·-· ---····--·-···
1910. . . . .. ... _.......
1911 .... . ......... . ..
1912 . .. .. . -·-·· ........
1913......... . .......
52,992
53,610
53,317
52,803
52,643
53,804
54,477
52,709
55,489
56,355
[,8, 381
56, 310
58. 573
58,556
57, 013
54,363
55,129
5<[, 301
53,704
51,443
52,209
51,078
50,604
1914.. . ... ...... . ....
1915.·-···-··········
1916._...............
1917·-·- · ·-· · ······ ·1918._...............
1919 ....... _... .... . .
1920.... . ... .. . ... --•
192L. ·-· ·····•·-·-·
19?2 ····-······ ·-·-·
1923 '-··········- · ··
1924 .......... •-·-···
1925.·-····· --·· ·····
1926.................
1927•... •· - ··-·······
1928·-·······-· ···· · 192\L .... _......... 1930.. ·-··--·······-·
1931.. ........... ·-·1932.. .. ·-·······---·
1933.... . ...... ·-· ·-·
1934..... .... · - --·· ..
53,226
55,782
58,357
64,022
71, R14
79,863
110,907
144, 344
153,633
126,956
159, 686
204, 944
245, 140
249,973
240,592
260,552
279,350
259,364
257,208
294,101
304,439
t These figures do not include patients treated in connection with veterans' relief activities of the Service
as follows: 1918, 192; 1919, 13,856; 1920, 279,036; 1921, 667, 832; 1922, 242,379; 1923, 9,704; 1924, 3,414; 1925, 4,360;
1926, 3,749; 1927, 2,830; 1928, 3,448; 1929, 4,907; 1930, 6,817; 1931, 9,278; 1932, 9,667; 1933, 8,377; and 1934, 716.
2 In this year, and subsequently, the practice of recounting out.patients applying for treatment in more
than l calendar month was discontinued.
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00ft Pa PillaT llil
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79,496
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1.26
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130,109
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bo ■pitala
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1.73
$J.9l16,liOIJ,67
.57
1.3'
$255,578, 33
.Jl
. 52
$277,514.56
.)8
.89
.ILL
l•lht 4&:J• for all hospt \&11 1,492,451
Coit
$4 , 479,,01. 56
(a) ID-p&UHt. department of ataiioa cloud.
Average per diem cost of in-patient relief, United Statell Marine hospitals, fiscal year 1934.
Digitized by
Google
101
PUBLIC HEALTH SERVICE
TABLE
2.-Tranaactiona at United States Marine hospitals and other relief stations
Patients
Number Number' Number
Total Number
of pa•
orpa•
remain- Number
of times or physnumber tlents
of days
Ing in
office
tients
ical exof pa• treated Died hospitsl
furnished
relief
relief
in
tients
was fur- aminaoffice
June 30, hospital
hostions
treated in
1934
nished
relief
pltals
- - --- ---- - - - - - - - - --Grand total. ...........• 305, 155
42,611
926
1,863
1,562
589
434
1,328
1,546
1, 137
3,200
505
342
1,662
4'!0
463
902
1, Z15
3,422
40
38
20
23
30
28
40
93
4
16
30
9
9
15
28
4,531 1,625, 736
262,544 1,02.1, 618
82,075
44,507
32,179
23,624
1,338
21,038
22, 143
21,685
10,305
1,524
3, 449
15,746
6,631
2,228
9,810
11,143
Zl,933
206, 106
30,696
4,925
4,504
16,823
57,020
9,775
22,529
Zl, 265
2,692
3,457
1,505
- - -- - - - - - - - -
PIRST<I ASS STATIONS
Marine ho8pital8
Baltimore, Md ................
Boston, Mass ...•.•.....•.. .. .
Buffalo, N. Y .................
Carville, La ....•..•...........
Chicago, Ill._ . .... •.•........ .
Cleveland, Ohio.•.•...•.......
Detroit, Mich ..•.••...•.......
Ellis Island, N. Y •............
Evans ville, Ind ........... _...
Fort Stanton, N . Mex ...... ...
Gnlveston, Tex ...•.•..........
Key West, Fla................
Louisville, Ky ...•............
Memchis, Tenn .•............ .
Mohl e, Ala... . ••.....••......
New Orleans, La. ••.......•...
New York, N. Y •••...........
Norfolk, Va .....••..•.........
Pittsburgh, Pa...•...........•
Portland, Maine .. . ...........
St. Louis, Mo .....••..........
San Francisco, Calif...........
Savannah, Ga .... ......•......
Seattle, Wash .. .. .. . ..... . . .. .
Stspleton, N . Y . ... ...........
Vineyard Haven, Mass .•.....
Contract overflow hospitals .. •
10,070
8,633
4,907
I, 139
4, 700
8,068
5,324
6,989
1,028
1,302
4,692
1,748
961
3, 118
4,334
10,797
33,926
9,341
2,647
1,524
4,366
15,998
4,060
10,302
8,895
392
126
Total .....• . ••••......•. 169,486
211
124
47
3lll
164
153
129
419
45
204
159
40
47
67
126
344
---52
i3,298
51,224
20,665
130, 109
54, 747
51,165
35, 6fi8
152,043
18,921
79,496
51,252
13,724
16,292
23,382
40,874
122,1 39
2Z1
----79,559
------
222
126
10
9
21
100
26
63
54
1
4
53
72
82
416
150
232
301
23
38
19,684
28,888
147,523
53,870
90, 3Zl
108,864
8,344
12.142
37,050
823
2,081
605
484
679
4,042
1,636
2,343
4,023
60
20,400
4,234 I, 504,600
~- 207
7, 071
4,318
705
3,471
6,522
4,187
3,690
523
960
3,030
1,268
498
2,216
3,059
7,375
33,926
7,260
2,042
1,040
3,687
II, 956
2. 424
7,959
4,872
170
----------
-- -- 1,0!IZ
----640
1,065
164'
45
22'
844·
gg;
556'
1,307
1,653
3,520
11,936
1,230
654
348
4,067
2, 055
1, 415
6,681
334
5
284
---------- ---------
132. 436
635,210
47,385
.1====
SECOND- AND TJIDID-CLASS
STATIONS
Aberdeen, Wash ..............
Albany, N. Y ....•.•......... .
Anacortes, Wash .•.... ....... .
Apalachicola, Fla . .......... . .
Ashtabula, Ohio ... ..... ......
Astoria, Oreg...............•..
Balboa Heights, C. Z..........
Bangor, Maine ...••.........•.
Beaufort, N. C ...•............
Bellingham. Wash .........•..
Biloxi, Miss . ....•••........• ..
Boothbay Harbor, Maine .....
Brunswick, Ga........•.•.....
Burlinllton, Iowa .•............
Cairo, Ill ........••............
Calais, Maine ....•........... .
Cambridge, Md ...•........•..
Cape May, N. J. .•. - ••. ..•. ...
Charleston, S. C ..............
Chincoteague, Va .............
Cincinnati, Ohio.......•.•....
CordovaC Alaska .•......•.....
Corpus hrlsti, Tex ...........
Crisfteld, Md ...••.........•..
Duluth, Minn ....•...........
Eastport, Maine . . ..... ... . ...
Edenton, N . C ... • .. ...... ....
Elizabeth City, N . C ...•.•...
El Paso, Tex ......•...........
Erle, Pa ..................•.•..
Escanab'6 Mich ...............
Eureka, allf ... .......... .. . .
Everett, Wash .••.. •. .•. .... ..
Fall River, Mass ••............
Gallipolis, Ohio .•.•......•....
Gary, Ind ..... .• ............ ..
Geor,etown. 8 . C .............
Gloucester, Mass ••...........
Grand Haven, Mich ... •. •...•
Green Bay, Wis .•••.•.•••.....
376
114
172
64
300
563
754
53
442
281
476
33
80
166
743
I
153
1,884
880
143
113
140
273
869
518
24
30
166
422
375
35
217
153
164
132
112
20
510
202
gr
17
8
13
12
7
31
143
4
71
15
4
4
· ·25·
123
1
--------- ------------- ----- ---------------l --------3
1
1
2
-----
254
179
M
48
137
280
2,082
5
--------l
30
456
98
19
37
----- ------------- ------------- -- ----------- --------I
2
297
1,016
3
----- --------- ---- -- --- --------21
3
155
68
I
261
112 ···2·
3
2,584
-------------------------11 ----- ------- -140
36 ----2
607
48 ----- --- -----355
1
7 ----38
2
1
40
558
--------- ----- -- ------- --- --- -- ---------- ----- --------- ----------
. ··23·
1
4
-
392
I --------133
28
----332
2
I
19 ---- - --------62
17 ----1
200
I
4Zl
36 --------- -- ------- ---- ---- ---------- --------·-------- ---- .. 47
12
1 --------7 ----- --------38
12 ----81
1
16
4
41
Digitized by
359
106
159
52
293
532
611
411
371
266
472
29
80
141
620
I
132
1,816
768
143
102
104
225
862
478
24
30
166
300
359
31
176
134
147
96
112
20
498
1115
815,
Google
83
639
2f!I
388
12
382
1
197
852
9
47
925
663 --------56
70
1,926
27
841
9
15
530
13
49
6
125
330 ······200
1,698
g
1
358 •••• 159
4, Z19
323
17
156
16
10
6i
161
l
l
13,
354,
73'
I, 531
313
218
152
366
1,364
824
52
95
633
l,S71
1,3~
58
478
214
a:
r
10
Z12
289
365
32
l,.611
«5
1-k
16i
'
7
12!
16
76
67
17
102
TABLE
PUBLIC HEALTH SERVICE
2.-Transactions at United States Marine h01J-pital8 and other relief stationsContinued 1
ber
Pa tients
T ota l N um
pa•
remain•
number of
ients D . 1 ing in
of pa• t treated
iec hospitals
t ients
hos·
June 30.
treated in
p ita ls
1934
-
- - - - -- - --
- -1·- - -· - - - -
-
Number Number Number
N umber
of times of phys•
of PB·
of days
tients
office
ical ex•
relief in furnished
relief
hospitals
was fur• aminaoffice
tioos
nisbed
relier
- --- - --- -
-
-
---- ----
S ECOND· AND TIDR n -C LA SS
STATIONS-conti nued
Gulfpor t, Miss _______ _____ ___ _
H ancock , Mich __ __ ___ _______ _
llonolulu, H a waiL __ _________ _
H ouston, T ex_ ____ ___ _______ __
lndiana H ar bor, Ind ____ ____ __
J acksom- ille, Fla ____ ____ _____ _
Ju neau , Alaska ______ _____ ___ __
Ketch ikan. Alaska _____ ____ ___
La Crosse, Wis ____ _____ _____ __
L ewes, DeL ______ ___ ______ __ _
Los An gelesl 9 ali L ___ _____ __ _
Lud ington , Mich ____________ _
l\lfac hias, Maine __ ___ ________ __
M a nila, P . !_ _ _____ _____ ___ __ _
Manistee, Mich __ __ __ ·· ·- -- --Manitowoc, ,vis __. __ ________ _
M arq uette, Mich ______ __ ____ _
M arshfield , Oreg ___ ________ . __
M enominee, Mich . __ ______ ___
Mia mi , F la ___ _· --- -· - - -- - · - -Milwau kee, Wis __ _________ ___
M orehead City, N . c __ ____-- ·
N an tucket, M ass ________ . ___ _
N ash v ille, T enn ______ ___ . ____ _
N a tchez, Miss __ __ ___ ___ _. __ __
Newa rk, N_ L -·-- --·- · - ----- ·
New Bedford , M ass _____ ____ __
N ew Bern , N . C ___ . ________ __
N ew H aven , Conn _____ __ ____ _
New L ondon , Conn ___ ___ __ ___
N e wport, Oreg __. ___. --- - - - -N ewport, R . L -- · ------- ----Newp ort Ne ws, Va __ ___ __ ___ _
Ogd ensburg, N . Y- -- - --- -- -·Oly mpia, W ash ---· ·-·-·- - -·Oswego , N . Y.--- --·- ·- · · · ··-·
P a du cah , Ky __ ····-·- -·-·- -·
Pana ma City, Fla . .. -- - -·
Pensacola, Fla .· · · · · ·-··-·- -· ·
Perth Amboy , N. J _- -· · ·· --· ·
P etersburg, Alask a .. -.... - -...
Philadelphia , P a - - · ·-· · · ·--- - Pooce, P . R -·· · ·---- -·· - -·- · -Port Angeles, W ash --··---··-Port Arthur, T ex .... ··- - ----Port Huron , :Mich ._ . ·-- - -· -·
Port land, Oreg-- · -·· · ···-· · ·· Port T ownsend, W ash. ---· · ··
Pro vidence, R. L ... . . . • •· --··
Prov incetown , M ass ___ _______
R eed ville, Va . . · - · ·· · ··· · ···· ·
Ric hmonrt , Va . . --··--·····- · ·
Roc k Island, Ill --·- - · -· ··· - - · ·
St . Thomas, Virgin Islan ds ...
Sao Diego , Calif. ·--- · · -- - - -·San dusky, Ohio. ·- -· -···-- · · -·
San J u an , P . R - ·- ----·· · · -···
San Pedro, Calif. __ .. _... . . .. .
Sault Ste. M arie, Mich ....... .
Seward, Alas ka_ .•..... .. . . ...
Sheboygan , W is· ---· ······· -· Sitka, Alask a __. __ _....... ... .
Sout h Bend , W ash ... ..... .. . •
Southport, N . C . __ . ..... .. .. Superior, V{is __ _______ ____ ___ _
rr acoma, Wash _____ _______ ___ _
T a mpa, Fla . . . . .. . .. ...... ---T oledo, Ohio .. ... . . . ·-· -· ·-·-·
Vicksburg, Mi88 . . - - •· ·-·· ·· · ·
W ashington, D. c ---·· -·· ··· ·
W ashington, D . C ., dental
chnIC . . .... -··-·· -······· · · · ·
Washington, N . C ... . ...... .. .
39
58
993
I , 314
11 3
844
329
776
59
175
4,920
164
37
826
68
28Q
289
62
53
1, 234
1, 020
443
llO
122
673
17
320
419
586
1,281
11 5
270
279
241
69
154
790
129
550
61
272
7,558
124
193
1,578
357
2, 839
384
532
137
501
212
6,488
61
806
85
930
4, 280
1, 143
254
79
458
51
581
320
355
' 761
584
560
40, 8.'i8
3 - --· - · -- -- --··
8
126
4
5
l ---- ----61
2 -- -- - ----- ---49
2
1
3i
I
2
98
3
2
ll -- --- -- ---- --16
1
l
766
5
8
12 ----- -- -------
1,544
244
12
374
619
1, 053
147
189
12,681
158
54
1
4
7 · -·- · -· - --·-- -
1
1
1
1
4 · ·- - ·
2
1
1
26
13
0
73
108
35
7
2
61
4
2
3
l · ··-· --· ··
2 -- - - -- -- -
1 · -· · ·····
1
15
59 - · ...
39
24
3
32
9
3
11
16
13
52
3
l
1 -·· · · · -· ·
n
118
136
17
146
674
723
260
36
18
3UO
28
61
438
485
262
9
484
2 • • ••• • •• •
10
238
10
5,~
204
244
7,185
108
170
1,535
348
2,626
376
490
137
501
175
6,484
57
785
81
816
3,978
1,072
116
4,241
392
81
201
23
fi3
66
2,231
3,427
159
2,319
388
1,263
83
571
17, 719
425
72
1,254
504
435
755
122
157
2,759
2,396
1,468
234
305
], 462
24
596
1,002
1,181
2,352
288
452
481
495
260
497
2,038
263
1,363
146
871
24,441
409
303
4,024
g39
7,443
1,661
I, 082
----- -- 4-------- 6--
30
681
56
1, 795
3,604
882
931
12
96
188
1,412
495
185
280
604
95
5,096
40,511
322
I, ~85
302
19,420
114
2,487
152
2,037
JO, 217
2,016
350
167
675
91
577
626
754
1,523
1,282
1,764
81,259
10 ••••• ······· -·
53
1,080
236
15,385
386
2
2
37
1
4 ----4 ---- - -- --- ---21 - ---2
4 --- -1
114
1
3
302
4
19
71
1
4
2
48
2
2 ----·- -- --- -- --
9
14
122
37
16
36
58
22
347
--- 1-- ------- ------ -- 1-2
1
3
2
4
2
4
2
2
252
22
1,080
246
276
57
49
l, 161
912
408
109
120
612
13
305
360
547
1,257
112
338
i9
59
61
2,796
44
719
2
254
279
232
66
143
774
116
498
131
28
373
16
23
43
9
213
8
42
1,286
36
58
867
I, 253
111
795
292
678
48
159
4,154
152
37
772
61
Digitized by
206
77
449
37
459
283
339
725
526
538
Google
3
26
341
840
---- ----529
194
315
34
9
448
13
8
948
51
3
64
14
3
269
571
3
5
84
133
11
65
13
70
86
3
14
35
49
-- ------23
58
8
74
16
24
2,638
3
31
199
169
2,060
58
208
23
12
12
7,175
--------40314
145
682
103
--------10
142
6
9
9
30
154
175 '
355
9,617
---------6
103
PUBLIC HEALTH SERVICE
TABLE
2.-Transactions at United States Marine hospital, and other relief atations-Continued
Patients
Number Number
Total Number
pa•
remain- Number
ofpa•
of times
number of
ingin
tients
tients
of
days
office
ofpa• treated Died hospitals relief In furnished
relief
tients in hos•
June
30,
hospitals
was
fur.
office
treated pitals
1034
nished
relief
Number
of phys•
ical ex•
amlna•
tions
SECOND• AND THIRD CLASS
STATIONS-Continued
White Stone, Va •.•.••..•••.•.
Wilmington\ N. 0 ...••.•.••..
Wrangell, A aska ............. .
643
516
78
59
11 .....
485
144
2
1
643
457
67
2,802
1,105
176
13
112
15
l'OURTH<LABS STATIONS
Ashland, Wis •••••............
Bath, Maine .•••..............
Bay City, Mich •.•.........•..
Beaufort, S. 0 ..••............
Bridgeport, Conn ..........•..
Hartford, Conn ••.•.•.•.•.....
Nome, Alaska..•.•••.•.......•
Portsmouth, N. H ••••.....•..
Saginaw, Mich ...•.•••.•.•.•..
Wilmington, Del .••••.••••.••.
115
'%1
78
15
44
2
20
4
16
37
194
131
47
13 ···-·
1
2 -···· ··-······
7 ·-·-· ··•·•····
20 .•... ·--·•···-
192
15
1 ....• ···••·-·6
······-· ····- ········· ··········
2 ..... ·········
14
2 ·--•· ·•·- ····•
21
2 ····- ········-
102
188
92
25
129
71
315
15
47
24
38 -······-·
··•··•···• ·•·•·••··· -········
19
31
4
7
14
64
35
65
MISCELI..1.NEOUS
Curtis Bay, Md. (U.S. Coast
Guard) ••••••••••••.••......•
U. S. Coast Guard Academy,
~ New London, Conn ........ .
St. Elizabeth's Hospital,
Washington, D. c_ ......••.
Special acting assi~tant sur•
goons for Coast Guard and
Lighthouse Service.....•....
U. S. Coast Guard vessels and
bases..••.....•.•.......•.•..
Emergency•••.................
2,502
1,902
264
6
3,942
175
175
154
54,458
3,8'%1
914
87 --·-· -········
18,403
202
60
17 ·••·· ......•..
- - - - - - - --·>----t----Total ••••.•...•.•..•••.. 135,669
5,561 103
297
121,136
1===1===1==1'===1
Grand totaL . • . • •. • • . . . . 305, 155 42, 611 926
4, 531 1, 625, 736
TABLE
2,502
10,646
176
1,638
7,286
324
3,740
11,768
621
18,403
43
90,310
132
1,226
1
130, 108
388,408
34,690
262,544 1,023,618
82,075
3.-Medical services for variouB classes of beneficiaries
Beneficiary
Patients
Total Number
remainnumber o!pa•
Ing in
tlents
o!pa• treated Died hospitals
tients In hos•
June
30,
treated pitals
1934
Number Number
of times
Number o!pa•
of days
office
tients
relief In furnished relief
hospitals
office
was fur•
nished
relief
Number
or phys•
ical ex•
amlna•
tions
--American seamen .............
Foreign seamen ............•..
Coast Guard .•................
Bureau of Fisheries............
Army .........................
Navy and Marine Corps ......
Mississippi River Commission.
Engineer Corps and Army
Transport Service ..•...•.•••
Lighthouse Service........•.•.
Coast and Geodetic Survey ..• _
Employees' Compensation
Commission ............•.•••
Veterans' Administration .....
Immigration Service .... _.... _
Public Health Service officers
and employees ..........••..
Lepers ......................•.
Civilian Conservation Corps ..
Civil Works Administration ..
Miscellaneous •................
145,958
494
42,061
49
340
331
25,167
244
671
11
23
3,040 1,108,097
16
5,491
191
88,896
139
------------2
1
953
1,885
2
9
32
----- ---------
120, 791
250
38,597
42
263
216
10
511,056
684
172,510
97
892
639
17
8,465
15
6,367
--------306
14
3,464
7
77
115
4
6,068
2,412
1,013
1,281
399
162
34
15
3
129
32
7
30,667
11,703
3,934
4,787
2,013
851
15,747
7,149
4,160
413
89
376
26,421
716
4,660
3,411
591
1,260
25
53
8
215
99
50
72,598
20,890
22,039
23,010
125
3,400
115,543
1,859
10,519
24,018
342
183
7,835
437
4,052
24,649
37,645
691
435
2,896
2,370
37
13
23
33
361
230
113
5
13,015
130,118
56,708
48, 797
774
7,144
51, 737
7
1,912
77,425
51,665
1,238
4
633
7,039
32,673
Total. .•................ 305, 155
42,611
926
262,544 1,023,618
82,075
11
29
3
4,531 1,625, 736
Digitized by
2
1,156
22, '%19
37,608
Google
14
---------
104
PUBLIC HEALTH SERVICE
T .ABLE 4.-Cauae of admis,ion and condition on discharge, marine hos'f)ital8 and
·· other relief stations
Condition on discharge of patients for specified diseases or
Number having specified diseases
or injury 1
Disease or condition
injuries
Total
Major Condi- Condinumber
condi- tion
of persons
Sequelae
tion
Other
Not
I
tion second third to major havi ng
for
Cured pr~~d 1m- Died condi·
each
in
condiin
t10ns
proved
which importion specified
admit- tance impordisease
tance •
ted•
or injury
- - - ------- -1--- - - - - - - ---- ---- --- --- ----1---1 --Abnormalities and congenital malformations ________
Blood and blood-forming
inorgans, diseases and______
juries of. ___________
Bones and cartilages, diseases and injuries oL _____
Circulatory system, diseases and injuries of:
Heart disease, valvular.
Varicose veins ____ ______
All others ______________
Communicable and infectious diseases, not including tuberculosis and venereal:
Conjuncti vitis, granular trachomatous _____
Influenza __ _____ ___ ____
Malaria ______ __________
Rheumatic fever, acute_
Typhoid fever. ________
All others __ ____________
Dental. _-- - --- -- ----- -----Digestive system, diseases
and injuries of:
Appendicitis ___________
Gastritis ____ ___________
Hemorrhoids _______ . ___
All others _______ _______
Ear, nose, and throat, diseases and injuries of:
nasal
Deviation
____ _
____ sep____
tum _____or
Otitis media __ . ____ ____
Tonsillitis _______ _____ __
All others __ ___ ________ _
diseases and
Endocrines,
injuries of.. _____ __ __ _____
Eye and adnexa, __diseases
and injuries oL __ ______
Genito-urinary system, diseases and injuries or (exelusive or venereal):
Nephritis ___ ___________
All others __ ____________
Hernia ___ ___ ___ ____________
Joints and bursae, diseases
and injuries of:
--Arthritis ___ ___ __- --All others ____ _____ _____
Leprosy ____ _
Lymphatic system, diseases and injuries of:
Lymphadeniti s ________
All others _____________ _
Muscles, rasciae, tendons,
and tendon ~heaths, diseases and injuries of. _____
Nervous system, diseases
and injuries of:
without psyEpilepsy
cbosis ____ ___ ______ ___
Neuritis ___ _____________
All others __ ____________
--- --- -- ------ -- ---- -----
43
---- ----
55
2,360
--- -- --- --- ---- - -------- ----------- --- -- --- ----- - - . --- -- ---------
171
225
1,176
-- ------ ------ -- --- ----- --- ------
15
326
415
43
36
I, 292
318
155
198
5
27
72
7
6
1
6
12
2
2
I
38
1
21
360
537
53
42
196
313
50
650
1,806
321
76
9
176
4
1,470
376
1, 147
-------- -------- -------- --- -- ---582
135
1,081
504
68
423
9
4
1,477
458
3,787
781
---- ---- -------- -------- ---------------- --- -- --- ----- --- ------------ --- - ---- -- -- ------ -- --- --- -- -
92
1,473
2,091
-------3-- ---------------------2,738
200
444
230
641
537
71
248
2
28
1, 159
1
55
96
686
128
58
9
18
564
6.1
109
129
8
164
313
11
2
7
18
18
35
868
2
22
29
1
147
32
38
225
-- --- -- ----3
5
28
1
10
625
151
3
585
51
282
352
494
229
307
1,134
2
1
3
12
125
40
842
241
162
1,242
522
9
157
188
390
15
5
14
2
7
31
39
5
3
86
102
18
99
32
2
62
246
14
2
3
6
61
39
186
128
4
7
204
1
3
6
56
53
187
97
73
2
264
2
316
1,089
49
861
735
2
8
11
21
29
21
18
259
235
298
98
155
1,192
37
453
293
21
17
19
7
3
23
127
1411
'Z1
Ill
34
85
478
68
II
137
21
319
756
17
2
1
18
50
22
113
216
6
3
21
3
25
74
------ -- -------- ------- - -- ----- --------- -------- ----- --- -- ------ - ----- --
45
-------- ---- --- - ---- --- - ---------
1,575
------- - ---- -- -- ------- ----------
39
170
435
22
280
384
505
-------- ------------------------------------9,227
3
5,197
3,709
1, 198
391
246
2,279
911
56
82
8
14
46
3
14
---- -"ii"
56
238
42
12
481
10
38
1:.18
----- --- -- -- -- --- --- ----- -------admitted.
which
for
major condition
1 Except In the case of specific diseases, statistics are given only for the
' Represents number of discharges for each condition.
• Where sequelae were given, no third diagnosis was recorded.
Digitized by
Google
105
PUBLIC HEALTH SERVICE
TABLE
4.-Cause of admission and condition on discharge, marine hospitals and
other relief stations-Continued
Cond ition on discharge or patients for specified diseases or.
Number having specified diseases
or iniury
Disease or condition
Total
Major Condi- Condinumber
condi- tion
tion
Sequelae
of
persons
tion second third tomajor having
ImNot
. Othe_t
for
Cured proved 1m- Died c~nd1in
condieach
in
which impor- impor- tion specified
proved
t10ns
admit- ta nce tance
disease
ted
or injury
- -- ---- --- - -- --- - - - -
- - - - - - - - - - - ] - - - - - - - -Obstetric and gynecological conditions _______ ___ __
P arasitic diseases:
Uncinariasis ____ _______ _
All others ________ ___ __ _
Poisonings and intoxications:
Alcohol (ethyl) poisoning, acute ___________ _
Alcoholism, chron ic
(without psychosis) __
All others _____________ _
Psychiatric diseases:
Drug addiction without
psychosis ____ _____ ___ _
All others ___________ __
Respiratory system, diseases and injuries of (exclusive
of tuherculo~is)
: _
Asthma
__ _____________
Bronchitis _______ _____ _
Pleurisy. ___ ____ __ _____ _
Pneumonia ___ ___ _____ _
All others _______ ___ ___ _
Skin and its appendages,
diseases and injuries oL -Tuberculosis:
Tuberculosis,
pulmo• _
nary _______ _________
Tuberculosis (otherwise unclassified) ____ _
Tumors :
Carcinoma ____________ _
All others __ ___________ _
Venereal diseases:
Chancroidal infections.
Gonoooccus
infections
Syphilis
____________
______
All others __ __ __ _______ _
Inoculations __ __________ ___ _
Under observation _______ __
Miscellaneous:
Cellulitis ________ ______ _
All others __ __ _________ _
injuries
60 ---- ---- ·- -- ·--- - --- --- - ------- -72
161
378
111
37
52
112
26
40
330
6
145
476
201
307
68
60
251
79
96
16
---- -
1
50 ------- ----·
105 ------- -----
4
21
35
2
542
18
35
7
155
33
59
18.
14
92
5
51
39
38
22
5
26
143
4
79
32
101
10
111
317
133
Ill
31
1
2
I
280
535
10
4
243
887
254
10
148
324
138
29
92 ---- -· --
2 - ------·
10
69
23
51
48
4
215
800
5
308
35
489
1, 072
736
99
52
54
62
14
199
43
23
303
2. 346
1, S.12
21
5
449
51
323
1, 055
53
324
311
4, 558
103
8
11
16
104
295
9
28
9
266
7
128
60
191
469
3,017
3,220
78
188
7
6
3
185
1, 722
1,343
12
87
967
4JO
458
- -- - - - - - - - - - - - --TotaL _______________ 37,128 __ _______ _____ __ ________ _______ __ 8,148
7
1
44
I
11
8
3
9
59
11
11
3
24
106
21
75
26
36 '
15
11
13.
77
9
44
79
- --- ------2
5
40
429
443 ·
3
16
23
159
2, 113
1
36
54
59
I, 388
19,736
360
921
7, 963
2
------ - --------- --- -- --- ----449
5
in
NOTE.-Immigrationpatientsat United States Marine Hospital, Ellis Island, N. Y., are not Included
this table.
'-
90167-34-8
Digitized by
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TABLE
5.-Number of days in hospital for patients discharged from marine hospitais and other relief stattons
i--
0
0:,
Class of beneficiary
e
d
"~
~
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0
or ........•..............................
0
co·
"'
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~
c;?"
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0
a
~
Circulatory system, diseases and injnries of.
Communicable and infectious diseases, not
including tuberculosis and venereal. .... .
Dental. .................................. .
Digestive system, diseases and injnries of..
E~r, . nose, and tbroat, diseases and in·
Junes or.. ............................... .
Endocrines, diseases and injnries of. ...... .
Eye and adnexa, diseases and injnries of. ..
Genito-nrinary system, diseases and inju•
ries of (exclusive of venereal) ............ .
Hernia...................•.......•........
Joints and bnrsae, diseases and injuiries of..
Leprosy..........•........... .............
Lymphatic system, diseases and injnries of.
Mnscles, fasciae, tendons, and tendon
sheaths, diseases and injnries of. ........ .
Nervous system. diseases anr! injuries of..
Obste.tr}c a_nd gynecological conditions....•
Paras1t1c diseases ......................... .
Poisonings and intoxications .............. .
Psychiatric diseases.....•.•.....• ... .......
Respiratory system, diseases and injnries of
(exclusive of tuberculosis) ............... .
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-- - - - - - --- - - - - - -- -----1,084
910 - -- --39 .... ------ ------ -------- ------ -----124 ---- ---- ------ -------- -------11 . ······ ---- ---d
Abnormalities and congenital malforma•
tions ......................... •........•..
Blood _aJ?d _blood•forming organs, diseases
and m1nr1es of. ....... .................. .
Bones and cartilages, diseases and injnries
.,...
-"~ iii-2d
;:g
d
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a
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... 0
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<n=
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130
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3,279
2,528
104,471
99,832
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41
57,636 1,038
83,946
30
134 ----
8 ......
271
4,475 164
4,577 99 ......
-------- --168 -----28 ..... .
-
0
0
O,U)
0
.d
bl)
0
-------- ------ ------
' 136
979
968
2,683 1,653
96
73
22,265
916
4,228
547
3,143
219
17
960
· 31
14
538
375
554
454
2, 2651
351
245
433
378
315
522
75
23
491
23
1,589
300 -----953
2,991
8
49
117 --------
-- -----
757 -------1,514 --------
15 ....
----
3,343 11,497 ---675
603 ----
21
23
38,274
4,514
98,957
16,529
2,091
70,499
53, 738
14,066
17,952
33,738
170
11,581 -----10,918
35
51,636
59,
772
68
22
1094......
......
2,492
7101
321 10,693
32311, 5711
3471
3031·····
2641 3, 6721··-·132
41,243
38,968
21 2,448
1,244 69
1,460
425
128
55 ...•.•
340
··· ······11,
.. 2,931
434. ...... .
«. 170 ... 194 . . 3,688 .... .•.• 28 .. . . .......
244 ... 114 ... 5,432 ... 1, 4.93 .......... . 452
1, 100 .. 2,590 ....... .
374
595 18
44 ......
300 ......
28
92
39
45
15 ...•....
467
248 .•.•....
7,161
lff: Jig ...
9,426
469
JO
783
2,402 60
583 22
9,696 166
7,588
819
1,823
98
461
3
: :: 1041· ·····
1
11
162
24 ......
2,574
163
~1 ...
i:
605 ...
13, 107
32 2, 248
1
5
1
28, 869
57 2, 690 ............... .
878 ...... ······· ............. .. .
3,512 ......
925
6 ........... .
2,415
l
108
6
9 .....•
61,501 ·• ···- 5,201 .......... ···•··
548
29
36
5,317
212
201
1,801
319
40
2, 192
492
29
13 . .. ... ···•·· ·······- .......•
2
269
37
31
50
89
6
249
11 ......
121 ········ ···--16
362 . . .. ..
3, 233
314
111
42, 7641
3 I, 784[
1, 0281
2, 207[
7
97 •....•.
7941·· ······
86 ........
322 ........
108 ---53 ....
161 ----
---74
44
64 ....
7, 169
1131
267 ..
721 1,776 ----
30
28
28
.iii;ooo ..
29,073
37,635
1,234
5,796
3,417
71,055
2631
938 -------- 12,530
547
24 ·····•··
1,543 -------- 7,739
251
122
1731
1, 721
511
147 ········ 1, 155
80 .... ....
658
335 .. ............ .
33 ....... .
802
44 ······-·
235
28 ·····-··
266
1, 4591........ I 3,065
6,215 ....... .
408 ....... .
6 •••••• ••
11 25 . ...
194 .... 24
23 ......•.
439 ....
97
"d
C:1
ti:,
~
a
=
~
~
rJl
l"1
g
l"1
ilidn and its appendages,
diseases and ln•
139
410
863
197
174
675
5
Z7
302 2, 641 M
16,888
Juries oL ....•....•.•••...........•..... _ 26, 721
3,264 1, 123
3,592
74
420
8,121
91 9, '07 •••. ····-- ·--·-·
Tuberculosis..••..•. .•••••... ---.••........ 203,594 174,083
1
311
449
38
187
683
Tumors .... _...... _._ ..• ··-- __ .. _._. __ ... .
64 2,337 14. .. •• . · --·-17,444
22,074
1,621 5,260;
248
415
738
5,288
19
Venereal dlseaBes. ········-·-··-·····- ••••. 218, 167 184, 104 510 17, 128 26 130
Inoculations_ .•.•.•.••••••••.............••
30 .•••.•.••• ··---- -··· -·- · ---··· ---·-- ··-··-- - -···-·-- ··---37 •........ --····
65
91
322
4
83
57
1 ··-·-·
6Z7 ••••
9
1,050
2, 678
Under observation..•••.•••.•••••....••.. ••
74
1,327
259 15,912
729
1, 141
Mlsoellaneous •.•••.•••••••••••.•...•••.•.• 101,535 55, OM 1, 159 5,186 123 385 .. ....
TotaL ••••••••••••••••••••••••••.•••
h, 493,911 1,012,607
6, 721 90,666 956 1,879
189 -·--··-3, 192 --··--··
135 ---··-·121 --·----·
4 ····---206
42
802 .•......
1,524
401
236
2,414
2,633 - -·- ---·
6 ·--- ·--·
120 ---- 51\
1
117 Z7
3 ••••• •• •••• ··--
1
60 ..••
oo
4,166 15,041 ··-- 177
1
1
281 39, 1761 9, 6731 2, 8901 75, 9391 20, 4931 7, 798 13, 8161 111, 2261 53, 5951 46, 761 I 521 635
NOT11:.-Immigratlon patients at Marine Hospital, Ellis Island, N. Y., are not Included In this table.
'tJ
q
b:I
t<
.....
C
t:::
l:'.l
i>
t<
1-3
0
co·
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0
0
=
r:JJ
l:'.l
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108
PUBLIC HEALTH SERVICE
TABLE 6.-Classification of out-patient treatments furnished at United States marine ·
hospitals and other relief stations
General
medical
Marine hospitals ...... ··-·--· ... ··----·-- ..
Other relief stations ................. _._ ....
Special acting assistant sur~eons ..... -···-··
Coast Guard vessels and bases .... _... _....
Emergency...................... ··-·-·-· ...
Total. .. _... ·---.·--··-··-······-··-·
Eye, ear, Neuronose, and psych!throat
atrlc
Dental
80,414
199,913
112,916
18,521
6,903
135
36,955
16,071
132 ----------
237,320
Venereal
diseases
Tuberculosis
Surgical
34,443
16,310
928
12,597
298
49
22
31
225
321
30
79
97,373
73,387
2,031
19,295
64,278
400
655
192,086
---------- ---------- ---------- ---------
234,640
Inoculations and
vaccinations
Arsenicals
Physiotherapy
and X-ray
Marine hospitals .. ---·-·····-·-··--·-·-····
75,245
4,263
18,909
124,394
Other relief stations .................. _..... _
14, 153
7, 637
5, 273
30, 096
Special acting assistant surgeons............
182
1,250
88
172
Coast Guard vessels and bases __ .. _.. __ ._...
5, 885
3, 116
1, 309
2, 267
Emergency_··---·-···---··--·•·····-···-··-·····-·-···········-·-·····---··-··· ___________ _
Total ___ . ____________________________ _
25,li79
lli6, 929
95,465
16,266
Digitized by
Google
Total
635,210
278,912
11,768
97,596
132
1,023, 61S
DIVISION OF VENEREAL DISEASES
Asst. Surg. Gen.
JOHN McMULLEN
in charge
The Division of Venereal Diseases was established by law to study
the cause, treatment, and prevention of syphilis, gonorrhea, and
chancroid; to cooperate with the State departments of health in the
control of these diseases; and to prevent their spread through interstate travel. For the fiscal year ended June 30, 1934, the appropriation for the work of the Division, after deductions required by law,
amounted to $58,000. This sum, however, does not represent the
entire amount of money available to cover all activities of the Division. Grants have been made by two philanthropic organizations in
order that special pieces of work might be continued.
COOPERATIVE CLINICAL STUDIES
For the past several years the Division has participated in studies
of the clinical aspects of syphilis and the results of treatment. These
studies are sponsored by the League of Nations Health Organization
and carried on in this country by the combined efforts of the Public
Health Service and a group of five of the leading clinics, with the
financial assistance of the Milbank Memorial Fund. During the past
year a procedure of treatment for early syphilis was formulated and
published in· Venereal Disease Information and tpe Journal of the
American Medical Association under the title "Standard Treatment
Procedure in Early Syphilis. A Resume of Modern Principles."
Two other studies growing out of this cooperative undertaking were
~ompleted. The subjects were "Arsenical Reactions" and "Syphilis
in Pregnancy." The findings reported in the latter confirm the
observation that transmission of syphilis from mother to infant can
be prevented in almost every case if the pregnant woman is treated.
An exhibit was prepared by the American Social Hygiene Association and the Public Health Service, with the permission of the five
cooperating clinics, to illustrate the findings of these cooperative
clinical studies. This exhibit was shown at the annual meeting of
the American Medical Association held in Cleveland and also at the
meeting of the National Medical Association held in Nashville. Miniature reproductions of the exhibit were made in the expectation that
these charts might be of value for the instruction of medical students
and talks before medical societies. Reprints of the published articles
coming from the cooperative group, and mimeographed articles by
some of the participating clinicians were distributed at the Cleveland
exhibit.
HEALTH SURVEY IN THE SOUTH
The effects of treatment have also been studied from another angle.
At the suggestion of a representative of the Julius Rosenwald Fund,
.surveys have been set in motion to go over the ground covered a few
109
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110
PUBLIC HEALTH SERVICE
years ago by the health demonstrations in various Southern communities. The major interest at the outset of these projects was the
development of more effective medical service to persons infected:
with syphilis as a means of curing and preventing the spread of the
disease. An evaluation of that work in Macon County, Ala., Glynn
County, Ga., Pitt County, N. C., and Albemarle County, Va., was
undertaken during the past year, but has not yet been completed.
RESEARCH
Experimental studies have been continued at the laboratory of the
Stapleton Marine Hospital. A study of the role of old and latent
syphilis in the dissemination of the disease, designed to determine
the frequency and importance of the syphilis carrier, was continued
during the year. Animal experimentation was employed in the evaluation of mercury in the prevention of infection and the testing of
several substances which are apparently capable of exerting a definite
spirocheticidal influence before the infecting organism has penetrated
the exposed integument. The conclusions were published in Venereal
Disease Information. The life cycle of the Spirochaeta pallida has
been the subject of experimentation. A study of the effect of temperature elevation upon experimental disease in the rabbit has been completed. The results indicate that a considerable sterilizing effect can
be obtained from either intermittent or continuous hyperpyrexia.
PREVALENCE STUDIES
Prevalence studies have been continued, a survey having been made
in Miami and Dade County, Fla., and a State-wide survey in New
Mexico. Results of a survey of San Francisco which was made during
the preceding year were published during this fiscal year. A resurvey
to determine the trend of venereal diseases was completed in Cleveland. In that city the case rates per 1,000 population were as follows:
Syphilis, 5.3; gonorrhea, 2.8, showing a decrease from the estimate of
several years ago.
Statistical analyses of the prevalence of syphilis among in-patient
hospital beneficiaries of the United States Public Health Service
hospitals were begun in the preceding fiscal year. Preliminary
figures show that 17 percent of all patients admitted to the marine
hospitals were infected with syphilis.
·
\YORK IN COOPERATION WI'IH STATE HEALTH DEPARTMENTS
Preventive measures were carried forward in cooperation with State
and local health departments. Forty-seven States are now reporting
cases of venereal diseases to the Division. The total numbers of
cases reported were 230,890 cases of syphilis, 153,255 cases of gonorrhea, and 1,808 cases of chancroid. These figures show a slight
decrease from last year. Doses of arsphenamine distributed by State
health departments ~mounted to 1,279,690. Reports from 616 cooperating clinics were furnished through the State departments of
health. From this source, 76,089 new cases of syphilis, 51,254 of
gonorrhea, and 1,419 of chancroid were recorded. There were 55,710
cases discharged as arrested or cured, 3,068,685 treatments given,
and 824,626 doses of an arsphenamine administered. During theDigitized by
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PUBLIC HEALTH SERVICE
111
preceding year only 572 clinics reported; the total number of cases of
venereal diseases was about 20,000 less this year.
In an effort to arouse the interest of the private physician in reporting his cases of syphilis and gonorrhea to the health authorities,
mimeographed copies of morbidity reports and prevalence rntes for
the two diseases by States have been distributed to all health officers.
Medical iournals have also been asked to publish these reports.
State departments of health were requested to cooperate in more
efficient distribution of information to the practicing physicians of
the country. One hundred thousand copies of a leaflet describing
the publication Venereal Disease Information have been sent to 28
States for distribution to physicians and others interested in the
control of venereal diseases. The assistance of the State medical
journals has also been enlisted.
Public Health Service officers were detailed to direct venerealdisease control activities in two States, North Carolina and Tennessee.
In North Carolina the cooperative clinician plan was put into practice.
The State department of Health appointed 33 physicians and furnished them with free drugs for the treatment of patients who were
carried on the active relief rolls and others who, in the judgment of
the local relief officers, were unable to pay for treatment. While
only a few new clinics were established, there was a marked improvement in the management of many of the clinics operated by full-time
county health departments. An exhibit arranged for the State fair
held in Raleigh was attended by approximately 11,000 persons.
Talks to college and high-school students, parent-teacher associations,
civic clubs, and industrial groups reached 20,000 persons. Radio
talks were broadcast from the Raleigh station. The newspapers have
published much information, and in several instances special articles
were given publicity. Addresses were made to 12 medical societies.
In Tennessee the director of control activities was detailed to assist
in the formulation of a venereal-disease program for the Norris Area
of the Tennessee Valley Authority, at the request of the medical
director of the Tennessee Valley Authority. The program included
all means at the command of health authorities-educational, medical,
legal, and epidemiological. In one plant in the State, affected by
the National Recovery Act code, it was found necessary to employ
1,000 additional men. All applicants were examined serologically,
and treatment was given to the men as well as to the members of
their families found to be infected. In this group 4.1 percent gave
positive reactions to the blood examination. Blood and spinal fluid
examinations of inmates of penal institutions were made and uniform
records and reporting systems installed.
At the request of the State health officer of New Mexico, a 1-day
census of venereal diseases was taken, the New Mexico State Department of Health and the American Social Hygiene Association
cooperating.
.
The Florida State Department of Health and the Florida Medical
Association requested an officer to give a series of lectures on the
venereal diseases to physicians of the State during a postgraduate
course at the University of Florida. Ninety doctors registered for·
the course. The director of the Hot Springs Clinic was detailed to•
this work.
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112
PUBLIC HEALTH SERVICE
VENEREAL DISEASE CLINIC, HoT SPRINGS, ARK.
. The only clinic which is maintained by the Public Health Service
is the one at Hot Springs, Ark. The tremendous influx of transients
into the city has added greatly to the volume of work in the clinic.
Six thousand six hundred and eighty-two persons applied for treatment, an increase of 65.6 percent over the preceding year. Four
thousand six hundred and nmety-two were found to be suffering from
a venereal disease, 62.7 percent more patients than in 1933. The
increase in the number of cases of venereal disease was, however,
only 25.0 percent-16.8 percent increase in cases of syphilis and
39.3 percent increase in cases of gonorrhea. Injections of arsphenamine amounted to 25,072-74.8 percent more than last year. All
of the different forms of treatment were increased in the same proportion. Treatment for this group of patients has been rendered
more effective by the fact that the stay of many of these patients in
Hot Springs has been considerably prolonged through the cooperation
of the Transient Bureau, which provided maintenance for patients
unable to pay their own living expenses.
One Public Health Service officer was detailed to the Hot Springs
.Clinic for 6 months' training.
PREVENTION OF SPREAD BY INTERSTATE TRAVEL
.An interesting example of the prevention of spread of venereal
•disease by interstate travel is seen in the case of the men of the
Conservation Corps Camps who are discharged on account of venereal
infection.
To prevent these men from being returned to their homes in an
infectious stage, the Army amended its regulations governing the
-discharge of infected men to provide that they be hospitalized until
the acute stage of the disease is over and the danger of transmission
of infection is past; and when patients are transferred to hospital,
a Government ambulance or conveyance other than common carrier
is used.
VENEREAL DISEASE INFORMATION
The division carried on its educational work through Venereal
Disease Information, a journal of abstracts of interest primarily to
practicing physicians and health officers, pamphlets on venereal
-diseases and sex instruction, and exhibits and films, all of which are
.available to the public. Subscriptions to Venereal Disease Information have shown a gradual gain in the past 6 months, due in part at
]east to the circularization of the State and county medical societies
·and fourth-year students of the medical schools. Reprints of six
-of the special articles have been widely distributed. The information service which is maintained in connection with Venereal Disease
Information has grown during the year, an increasing number of
requests for information being received by the Division from syphilologists, general practitioners, and others interested in the treatment
and control of syphilis and gonorrhea. Bulletins found most useful
in the program of sex education have been reprinted. Two-Keeping
Fit and Healthy Happy Womanhood-have been revised and will
be ready for distribution shortly. State departments of health have
.-distributed 385,743 bulletins and pamphlets. The Public Health
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113
PUBLIC HEALTH SERVICE
Service has distributed to State health departments and others
106,536 pamphlets. Lectures, exhibits, and film showings reported
by State health departments numbered 1,530. The one educational
film" Science of Life", which is furnished by the Division on request,
has been sent to 29 schools and other organizations. The film was
lent 208 times.
PROPOSED SEROLOGIC CONFERENCE
The American Association of Clinical Pathologists has proposed to
the Public Health Service, Division of Venereal Diseases, that a
North American serologic conference be held, such as the conferences
held in previous years in Paris, Copenhagen, and Montevideo. This
conference is to be Nation-wide, however, instead of international.
Preliminary arrangements have been made and it is expected that the
conference will be held in the coming year.
1.-Report of State departments of health showing the number of cases of
syphilis and gonorrhea reported, the annual rates per 1,000 inhabitants, the amount
of arsphenamine distributed, and the laboratory examinations made, from July 1,
1933, to June 30, 1934
TABLE
Number of cases
State
Syphilis
Gonorrhea
Laboratory examinations
Annual
rate for
Doses of
syphilis
MicroMicroarsphenaand gonor- mines
dis- Wasser- sc~p1c _ex- scopic exrhea per
mann for am1nat~ons aminations
tributed
I.000 inother s1m• for Spiro- for gonohabitants t
1lar) tests
cha~ta
coccus
pa/l1da
Tota!__ ____________
230,890
153,255
3. 1
1, 279, 690
1, 716, 489
6,040
342,935
Alabama________________
3,714
1,379
1.9
23,115
66,132
301
13,467
Arizona__________________
265
789
2.3 ____________________________________________ _
Arkansas________________
3,326
2,118
2.9
30,852
33,388
261
11,343
California_______________
18,229
14,293
5.4
239,900
77,693
605
27,568
Colorado'--------------41
22
. 7 ____________
748 ___________
218
Connecticut_____________
2,105
1,561
2.2
'8,750
'4,537
'14
'1,265
DJlaware________________
1,259
363
6. 7
3,856
5,863 ___________
627
District of Columbia____
1, 770
1,366
6. 3
11,439
6, Ill
76
5, 782
Florida__________________
5,047
632
3. 7 ____________________________________________ _
Georgia__________________
5,960
4,569
3.6
67,953
84,578 ___________
4,562
Idaho_______________________________________________________________
14,761 ___________
1,907
Illinois__________________
15,487
14,563
3.8
92,953
101,441
2,874
47,802
Indiana__________________
2,263
I, 475
I. I
48,873
125,164 ___________
5,112
Iowa____________________
1,689
2,136
1.5
5,677
1,482
40
1,954
Kansas__________________
I, 177
846
I. I
9,821 .
36,532
13
2,615
Kentucky_______________
2,812
4,192
2.7
21,227
9,214
344
5,679
Louisiana________________
2,229
1,279
1.6
13,791
22,680
86
3,696
Maine___________________
514
522
1.3
4,196
10,597 ___________
3,424
Maryland_______________
7,145
2,842
6.0
48,416
13,176
70
5,757
Massachusetts___________
4,488
6,678
2.6
87,466
113,099 ___________
8,888
Michigan________________
6,026
6,085
2.4
44,208
35,968 ___________
30,373
Minnesota_______________
4,002
4,057
3.1
9,476
127,312 ___________
13,692
MlsslssippL.____________
11,421
18,494
14.6 ____________
29,804 _______ ____
10,494
182
Missouri•--------------5,625
3,391
3.0
5,048
22,812
4,163_
Montana________________
443
346
1.5 ____________________________________________
Nebraska________________
588
976
I. I
5,725
27,313
5
4,989
Nevada•--------------------------------------------------------------------------------------------New Hampshire_________
173
264
.9
2,348
6,989 ___________
2,426
NewJersey______________
7,135
3,478
2.5
ffl,335
50,375 ___________
9,426
New Mexico_____________
420
319
I. 7 ____________________________________________ _
New York_______________
59,414
16,996
5.9
96,604
310,720 ___________
33,661
North Carolina__________
10,426
4,213
4. 5
44,429
81,925
99
I, 874
North Dakota•---------279
600
I. 4 ____________
6,774
4
I, 702
Ohio _____________________
7,752
3,382
1.6
54,241
36,689
580
10,764
Oklahoma_______________
1,840
1,620
1. 7 __________________________________ ----------•··
t Excludes chancroid which formerly was included In the annual rates.
1 For 1 month.
• For 10 months.
• Not reporting.
• For 11 months.
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PUBLIC HEALTH SERVICE
!.-Report of State departments of health showing the number of cases of
syphilis and gonorrhea reported, the annual rates per 1,000 inhabitants, the amount
of arsphenamine distributed, and the laboratory examinations made, from July 1,
1933, to June 30, 1,934-Continued
·TABLE
Number ol cases
State
Syphilis
Gonor•
rhea
Laboratory examinations
Annual
rate !or
Doses ol
syphilis
Micro·
Micro•
arsphena·
and gonor• mines
dis- Wasser• scoprn _ex· scopic ex•
rhea per
mann ~or am1n:t!ons aminations
tributed
l,OOOin·
~ther stm· !or ~piro· !or gono·
habitants
chaeta
coccus
1lar) tests
pa/Iida
·Oregon..................
554
729
1. 3
12,882
27
4,512
5,531
14,610
40,129
Pennsylvania'··········
3,398
2,942
.7
69,262 --·--···--·
3,438
Rhode Island............
947
616
2. 2
9,778
14,214
47
South Carolina..........
4,630
6, 149
6. 2
South Dakota...........
134
351
. 7 ............
5,853 -·······--76
Tennessee __ ·--······--·_
12,482
6,220
7. O
71,490
57,343
157
7, Oil
Texas ..... ---·--····-·-3,413
725
.7
56,245
9,693
7
1,334
Utah'···--------····-·----···-·--· .......... ---···---·-·-----·-·-·-·---·-·---·--··--·-------·-··-····
1,320
5,597
1,706
7
Vermont._ __ ···--····-·-241
371
I. 7
3,499
13,320
12
17,097
Virginia_-·-·---······.·4,844
3,312
3. 3
Washington __ ..•...... __
2, 000
2, 516
2. 8
20,679
46,019
10,407
137
3,276
9,031
37,411
19
West Virginia_.·-·····-2,714
1,384
2. 3
7,950
9,398
9,197
73
Wisconsin.-·-----···-··1 459
2,076
.9
·Wyoming'···----·······
10
18
.5
•Not reporting.
• In the absence ofreporting regulations in Pennsylvania only the reports received rom the clinics operated
; by the State health departments are included.
' Only cases of syphilis in the infectious stage are reported.
• For 3 months.
2.-Report of 127 correctional and penal institutions cooperating with State
departments of health 1
Number
. New cases admitted:
Syphilis _____________________________________________ . _____ _ 8,479
Gonorrhea __________________________________ , _____________ _ 3,824
110
Chancroid ___________ ·----·----·---------·-----------------Total ___________________________________________________ _ 12,413
'TABLE
'Cases discharged as arrested or cured _____________________________ _
7,289
· Treatments given ______________________________________________ _ 335,947
Doses of the arsphenamines administered ____________ ...... _.. _ . __ . 57,422
, Serologic tests made .. ___ . _____ ._ .. __ .... __ .. _____ .. ___ ._. __ . __ ._ 57,934
Microscopic examinations for gonococcus. _____ . __ ._ ...... _... ___ .. . 14,764
1 Includes 49 prison camps.
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PUBLIC HEALTH SERVICE
'TABLE
3.-Report of 616 clinics, furnished through State health departments, July 1,
1933, to June 30, 1934 1
New cases admitted
Cases
disTotal
monthly
charged
reports
88
GooSyphChanreceived Total ihs orrhea croid arrested
or cured
State
--
TotaJ _______
-Alabama __________
Arkansas __________
·California _________
Connecticut_ ______
District
or Colombis______________
·Georgia ___________
.Illinois ____________
Indiana ___________
.Iowa•------------Kansas ____________
~::!~!::::::::::
.Maine ____________
Maryland _________
Massachusetts ____
Michigan _________
Minnesota ________
Nebraska _________
New Hampshire __
New Jersey _______
New York ________
·North Carolina • __
·Ohio ______________
·Oregon ____________
Pennsylvania _____
Rhode Island _____
Tennessee _________
Virginia ___________
Washington _______
West Virginia _____
·wisconsin _________
Micro
Doses of
scopic
Treat- arsp_hen- Wasserexami..
m8DD
ments ammes
nations
tests
given admin- made
for gooistered
ococcus
---
--- - ---
6,309 128,762 76,089 51,2M
1,419
4,885 3,571
21 4,941 3,148
421 11,275 6,274
156 1,476
731
1,247
67
1,793 -------4,991
10
745 --------
1,254
1,376
4,895
1,247
12 3,146 1,770
84 3,475 1,765
233 12,709 6,680
165 2,568 1, 3721
57
629
308
718
26
4131
247 6,974 2,764
12
401
245
107
786
396'
417 6,002 3,385
294 5,895 2,939
147 5,011 2,336
36
820
367
473
46
879
100
60
253
343 7,120 4,539
923 8,901 6,529
348 6,011 4,537
439 8,174 5,118
12
402
297
620 5,799 3,224
72
451
675
535 10, 127 6,969
53 3,066 2,071
36 1,630
734
182 2,714 1,906
132 1,300
687
1,366
10
1,705
5
5,940
89
1,153
43
1
320
305 -------4,167
53
156 -------1
389
2,292
325
2,956 -------2,615
60
452
1
1
405
152
1
2,541
40
2,355
17
1,402
72
2,662
394
105 -------2,641
34
222
2
3,024
134
960
35
893
3
788
20
612
1
156
1,188
9,309
2,053
345
224
1,992
28
224
2,326
1,503
2,436
182
289
155
2,529
6,869
1,686
2,528
146
4,207
557
3,281
332
1,121
745
527
73
824,6211
551,147
210,750
304,672
50,106
20,807
30,013
74,726
11,599
3,870
32,720
48,258
5,944
731
11,125
23,787
1,775
46,062
49,856
328,724
119,726
26,391
15,448
89,144
6,601
15,408
138, 55~
11,439
87,156
40,643
5,677
5,259
21,035
2,076
4,196
47,267
6,111
28,284
83,191
12,938
1,482
2,417
8,915
5,782
1,077
42,646
3,047
1,964
1,469
5,568
1,425
203, 81~
21,279
23,107
11,638
239,483
252,357
60,642
206,804
14,718
76,275
25,673
230,866
34,934
36, 729
60,969
53,954
44,071
4,295
5,664
2,302
39,672
74,906
36,167
52,506
5,052
38,707
7,649
64,179
17,097
9,748
28,492
9,197
55,710 3,068,685
60,683
1
264,065
23,029
4,294
1,463
12,524
34,647
2,299
4,983
657
29,173
31,847
22,256
32,292
1,382
17,575
14,103
64,249
13,320
21,856
8,705
9,392
450
5,352
30,343
1,183
2,686
507
7,886
8,910
1,036
9,181
837
3,438
6,450
3,499
17,418
3,258
7,930
1 States which did not report and those which had no clinics have been omitted trom the above table:
"They are Arizona, Colorado, Delaware, Florida, Idaho, Mississippi, Missouri, Montana, Nevada, New
.Mexico, North Dakota Oklahoma, South Carolina, South Dakota, Texas, Utah, Vermont, and Wyoming.
2 Includes 135,498 baths given at the U. S. Public Health Service Clinic, Hot Springs Nat ion al Park, Ark.
3 For 8 months.
• For 10 months.
'TABLE
4.-Report of cooperative clinic activities furnished through State health
departments from 1919 to 1934
Year
1919 ______________________________ _
1920 ______________________________ _
1921. __ ---------------------------1922
___ ----------------------------_
1923 ______________________________
1924 ___________ -- _--- -- ___ --- _____ _
1925 ______________________________ _
1926 ______________________________ _
1927 _-- ---------- -----------------1928 ___ --------- ·- -----------------1929 ___ -------·------------ -------1930 _______ --- --- --- - -- -- -- -- -- -- -1931 _____ -- -- --- - --- ---- - ---- -- -- -1932 ___ ---------------- -----------1933 ___ ------ ---------------------1~34- ___ --- ---- --------------------
Number of
clinics
reporting
167
383
442
641
513
504
495
416
425
451
445
477
612
533
672
616
New cases
admitted
59,092
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
128,762
Total treatments given
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
2,647,162
2,833,790
2,964,130
3,209,073
3,068,686
Digitized by
Cases discharged as
arrested or
cured
14,278
34,215
55,467
60,169
55,503
51,658
47,828
44,329
44,701
49,487
52,136
Treatments
per new case
admitted
8.92
12.50
14.98
14.48
16. 71
18.19
18.92
18.67
18.24
19.64
17.69
57,414
63,906
64,697
19.00
19.83
19.84
21.40
55,710
23.83
55,592
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PUBLIC HEALTH SERVICE
TABLE
5.-Annual report of the United States Public Health Service clinic at Hot
Springs National Park, Ark., from July 1, 1933, to June 30,.1934 1
Total applicants ____________
4,692
1,990
Gonorrhea (new cases) ______
Acute _________________
Chronic _______________
Syphilis ___________________
3,330
Total treatments given ______ 259, 502.:
New cases _____________
Readmitted cases _______
2,407
923
Gonorrhea _________________
2,277
New cases _____________
Readmitted cases _______
Arsphenamine __________ 25, 072'
Mercury and bismuth ___ 46,724
Other intravenous ______
2,985,
Gonorrhea _____________ 49,223;
Baths _________________ 135,498,
1,664
613
Syphilis (new cases) _________
2,407
Primary _______________
Secondary _____________
Tertiary _______________
Neuro _________________
Congenital_ ____________
220
317
1,722
114
34
VenereaL ______________
NonvenereaL __________
1
1
6,682
2
1,664
362
1,302
Laboratory examinations ____
70,311
Complement fixation
tests ________________
Precipitation tests ______
Icterus indices __________
Dar kfields _____________
Gonococcus smears _____
Urine analyses _________
15,144
15,144
15,144
244
10,812'
13, 823;
From the annual report of the clinic.
The 4,692 patients represent 5,607 cases; 915 patients had both syphilis and gonorrhea.
TABLE
6.-Report of the United States Public Health Service clinic at Hot Springs
National Park, Ark., from July 1, 1922, to June 30, 1934
Number of cases
Year
Number of
applicants
1-------.-------,-------1 Treatments
Total venereal diseases
Syphilis
Gonorrhea
given,
Total __________ ------------
58,664
49,268
30, 706
18,562
884,347
1922 ____________________________ _
1923 ____________________________ _
1924. ____ -- - - _. - - - - - - - - - - -- - - - - - 1925. __________ --- _______ -- _____ _
1926. ____ --- ------- __ --- . __ -- _--1927 ____________________________ _
1928 ___ -- _-- _____________ ---- ---1929 __ . _-- . -- __ --- - - - -- - ---- -- - -1930. __ -- _--- _-- - --- - -- - - -- -- ---1931_____________________________
____ ---- __ -- -- -- ____ ------ ___
1932
1933 _____ --- _-- -- __ -- . . . . --- ---- .
1934. ____ . _______ ---- ___ -- _-- ----
2,720
3,389
3,676
3,411
3,570
4,757
5,467
5,265
5,704
4,881
5,106
4,036
6,682
1,775
1,854
2,186
2,782
3,064
3,682
4,134
3,986
4,441
5,088
6,184
4,485
5,607
1,182
1,326
1,447
2, Oil
2,211
2,504
2,626
2,512
2,743
2,776
3,188
2,850
3,330
593
528
739
771
853
1,178
1,508
1,474
1,698
2,312
2,996
1,635
2,277
43,830
41,559
50,683
50,608
54,500
58,489
72,466
75,519
79,180
66,246
93,707
73,466
124,004
J
Baths not included.
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PUBLIC HEALTH SERVICE
T Al!LE 7 .~Statistical summary of' activities in the control of venereal diseases
Jor the fiscal years 1933 and 1934
1934
1933
I
MEDICAL ACTIVITIES
.A. Cases.of venereal disease reported to State health departments:
L Syphilis __ ---- -____ - ______ -____________________________________________ _
II. Gonorrhea ____________________._________________________________________ _
UL Chancroi<L ____________________________________________________________ _
Tota]_ _________ .___________________________________________________________ _
230,890
153,255
I, 808
238,656
149,823
2,453
385,953
390,932
B. Doses of arsphenamines distributed by State health departments ___________ _ I, 279,690
,C. Clinics:
I. Clinics established during the year ____________________________________ _
97
II. Clinics reporting to State health departments ____________________ . ____ _
616
III. a.Report
from
clinics:
New cases admitted _________________________________________________ _
128,762
b. Cases discharged as arrested or cured ________________________________ _
55,710
c. Treatments given ________________________________ . _________ . ________ _ 3,068,685
d. Doses of arsphenamines administered ________________________________ _
824,626
e_ Serologic tests made _________________________________________________ _
551,147
210,750
f. Microscopic examinations for gonococcus __ ---------------------------
I, 306, 150
58
572
154,302
65,116
3,263,927
888,985
556,060
224,506
EDUCATIONAL ACTIVITIES
.A. Pamphlets:
I. Requests for pamphlets received by the Public Health Service __________ _
12,227
9,323
II. Pamphlets distributed:
a. By the Public Health Service to State health departments and others._
b. By State health departments ________________________________________ _
106,536
385,743
117,637
463,085
l====ac=
1-----1·-
TotaL ____________________ ---------------------- ________ . ____________ _
III. Venereal disease pamphlets issued bythe Public Health Service _______ _
B. Lectures, exhibits and film showings reported by State health departments:
I. Number ______ -- _-___ - __ -- ___ - _-_______ ---- -___________ . - -- -- -- --- --- -- -II. Average attendance ____________________________________________________ _
C. Motion-picture films lent by the Public Health Service _____________________ _
492,279
9
580,722
1,530
91
208
2,838
81
176
2
2
t Data for 1933 were changed from previously published figures because of the receipt of additional reports.
• Exclusive of an unknown number of film showings with a total attendance of 30,000, reported by the
Rhode Island State Health Department.
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DIVISION OF MENTAL HYGIENE
Asst. Surg. Gen.
WALTER
L.
TREADWAY
in charge
The year ending June 30, 1934, marks the fourth full 12 months'
activities of the Division of Mental Hygiene. The administrative
and investigative functions of the Division continued unchanged
during the year. In general, the work embraced studies of the nature
and treatment of drug addiction and the dissemination of information
upon the subject; studies of the abusive uses of narcotic drugs; administrative functions incident to the establishment of narcotic farms;
the supervising and furnishing of medical and psychiatric services forthe Federal penal and correctional system; and cooperation with
other agencies interested in the various phases of work with which
the Division is concerned.
STUDIES OF THE NATURE AND TREATMENT OF DRUG ADDICTION
Studies of the nature of drug addiction, with special reference tothe mental and psychiatric status of addicts, have been continued at
the United States Penitentiary Annex, Fort Leavenworth, Kans.
Some progress has been made in those studies dealing with the fundamental nature and therapy of addiction. Investigations pertaining·
to changes in carbohydrate metabolism and the value of intravenous
administration of glucose were instituted during the year.
Special studies regarding the habit-forming properties of possible
substitutes for morphine were continued during the year. One of
these investigations has demonstrated that codeine possesses addiction liability. Similar studies were made of other substances, including dihydrodesoxymorphine-D, made from opium by a/rocess dis-covered by Dr. Lyndon F. Small, consultant in alkaloi chemistry,
of the Public Health Service, at the University of Virginia. Application for patenting this process was made by Dr. Small, the patent
to become the property of the United States and to be lodged with
the Secretary of the Treasury as ex-officio .custodian thereof.
In addition to the special studies of the nature of drug addiction
conducted at the United States Penitentiary Annex, Fort Leavenworth, Kans., the personnel of the Public Health Service detailed
there supervises and furnishes the routine medical and psychiatric
services for that prison population.
Individual reports of persons apprehended for violation of the narcotic laws were continued during the year. Their analysis has provided important data concerning the incidence and distribution of
drug addiction in the United States and information of value for
determining the potential needs respecting the treatment of this
situation.
DISSEMINATION OF INFORMATION
Further data concerning the incidence and other factors in drug·
addiction were assembled for publication, and several articles relating
to the work of the Division were published, including, "A Method for·
Testin~ Addiction, Tolerance, and Abstinence in the Rat", "The
Addiction Liaqility of Codeine", "Drug Addiction in Its Relation.
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to Extraversion, Am bi version, and Introversion", "Annual Physical
Examination Study at the Atlanta Federal Penitentiary", and "Individual Study and Treatment at the United States Industrial Reformatory.''
STUDIES OF ABUSIVE USES AND THE MEDICINAL AND SCIENTIFIC NEEDS,
Studies to determine the annual medicinal and scientific needs of
the country concerning narcotic drugs were continued during the
year.
NARCOTIC FARMS
Progress was made in the construction of the first United States
Narcotic Farm at Lexington, Ky., and it will probably be completed
and ready to receive admissions by April 1, 1935. Funds were made
available through the Public Works program for beginning construction of the second institution at Fort Worth, Tex.
MEDICAL AND PSYCHIATRIC SERVICES IN FEDERAL PENAL AND CORREC-.
TIONAL INSTITUTIONS
The Service continued, for the fourth year, the work of supervising
and furnishing the medical and psychiatric services for the Federal
penal and correctional systems under policies originally adopted. At.
the close of the fiscal year, the Service was operatmg 17 medical
units in connection with the various institutions under the control
of the Department of Justice. The Hospital for Defective Delinquents was formally opened on September 22, 1933; a medical unit.
was established on October 1, 1933, in connection with the Federal
Prison Camp at Tucson, Ariz.; and on April 17, 1934, the Service
assumed responsibility for the medical services at the United States
Penitentiary, Alcatraz Island, Calif. A chief medical officer was
assigned to duty at that institution, and subsequently additional
personnel were provided.
During the course of the year the medical service of the Federal
Correctional Camp, Fort Eustis, Va., was materially curtailed, due
to the policy adopted by the Department of Justice of no longer
using that unit for the chronic infirm. The large hospital formerly
operated in connection with that camp was closed in April 1934, and
a barracks building was equipped as a sick bay or infirmary for the
temporary care of medical cases. The medical service at Fort Eustis
is practically reduced to the handling of out-patient work.
The routine physical examination of prisoners adinitted to the
United States Penitentiary Annex, Fort Leavenworth, Kans., was
extended to include an X-ray examination. Paper X-ray films were
used for this purpose and the pictures were found to be of very great
aid in detecting chest pathology and in the assignment and disposition of prisoners. The medical service at that institution continued to render advisory assistance to the classification cominittee
organized and developed during the year.
The out-patient clinic m connection with the hospital at the
United States Penitentiary, Lewisburg, Pa., undertook a special
study with reference to painful conditions of feet among prisoners,
a pressing administrative and medical problem in all such institu-.
tions. Data are being collected upon the subject for further study
and the development of a more scientific approach for the relief of
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PUBLIC HEALTH SERVICE
this problem. The psychiatric and psychological departments of
that institution commenced a statistical study of the material collected thus far in an effort to evaluate the various mental factors
involved in antisocial behavior.
The psychiatric service at the United States Reformatory at Chillicothe, Ohio, has been broadened appreciably through cooperative
efforts with the administration of the institution, the psychiatrist
sitting as a member of the Classification and Assignment Board and
on the Disciplinary Board also.
During the year experimental studies were undertaken with reference to the treatment of common colds among prisoners at the Atlanta
Penitentiary. Approximately 2,000 cases of common colds were
treated in the eye, ear, nose, and throat clinic, resulting in the recovery
of approximately 83 percent within 1 day of the onset of symptoms.
No cases of lobar or lobular pneumonia developed from the cases of
colds treated.
Three sets of medical officers' quarters were constructed at the
above-mentioned institution during the year and occupied by the
chief medical officer, the assistant chief medical ofp.cer, and the
psychiatrist. The building of these quarters has not only resulted
in a financial saving to the Government, but has more closely knitted
the interests and activities of the medical service to that of the
administration of the institution.
The policy adopted by the Department of Justice with reference
to the admission of female prisoners to the United States Detention
Farm at Milan, Mich., resulted in the installation of additional
medical facilities for this class of prisoners. A gynecologist was
added to the staff and a consultant psychiatrist was appointed.
During th,e course of the year a new policy was adopted whereby
the medical services in the Federal penal and correctional system was
extended to periodical surveys of the sanitary condition of prisons.
· The chief medical officer of each institution, upon request of the
Bureau of Prisons, was assigned as the sanitary officer of his respective institution. This policy has resulted in greatly improving the
sanitary condition of the various institutions involved.
Some idea of the magnitude of the scope of activities of the Service
may be gathered from the statement that during the year there were
furnished 194,848 hospital relief days and 385,636 out-patient relief
,days.
OTHER INVESTIGATIONS
A request was received from the Governor of one State to conduct
a survey of mental health administration of that jurisdiction with the
· object of bringing about improvements in the public care of the
mentally ill. Plans are being rerfected to undertake such studies in
the early part of the next fisca year.
COOPERATIVE ACTIVITIES
Effective and mutually advantageous cooperation was continued
•during the year with other national official and unofficial agencies
and international committees and organizations interested in various
phases of the work of the Division, especially those relating to
narcotics and psychiatry.
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DIVISION OF PERSONNEL AND ACCOUNTS
Asst. Surg. Gen. C. C.
PIERCE,
in charge
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 the Division remained unchanged during the year, Asst. Surg. Gen. C. C.
Pierce, in charge of the Division, was relieved on July 9, 1934, and
was succeeded by Asst. Surg. Gen. W. F. Draper. 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, estimatei,1 of appropriations, allotments, and encumbrances, records of expenditures, including administrative audit,
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 during
the 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, 1933, 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 sur~eons, 8 passed
assistant dental surgeons, and 1 passed assistant samtary engineer in
the grade of passed assistant surgeon; 47 assistant surgeons, 20 assisttant 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. During the fiscal year the following changes occurred
in the several grades: 1 of the pharmacists in the service was commissioned a passed assistant pharmacist in the regular corps and the
assistant surgeon on waiting orders returned to active duty, but 2
assistant pharmacists, 1 passed assistant surgeon, 6 surgeons, 1
senior surgeon, 9 medical directors, and 1 Assistant Sur$eon General
with the grade of medical director were placed on waitmg orders; 1
senior surgeon and 1 surgeon on waiting orders died during the year,
and 1 assistant dental surgeon was separated from the corps; 26
assistant surgeons were promoted to passed assistant surgeons, 8
assistant dental surgeons were promoted to passed assistant dental
surgeons, 4 assistant sanitary engineers were promoted to passed
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PUBLIC HEALTH SERVICE
assistant sanitary engineers, 2 passed assistant surgeons were promoted to surgeons, 11 surgeons were promoted to senior surgeons,
and 5 semor surgeons were promoted to medical directors. Because
of several changes made in the assignment of Assistant Surgeons
General in charge of divisions of the Bureau, 1 Assistant Surgeon
General reverted to a medical director and 1 medical director and 1
surgeon were detailed as Assistant Surgeons General.
On July 1, 1934, after these changes had occurred, the regular
corps consisted of the Surgeon General, 8 Assistant Surgeons General,
49 medical directors, 1 pharmacologist director in the grade of medical
director, 37 senior surgeons, 1 semor dental surgeon, 1 senior sanitary engineer in the grade of senior surgeon, 81 surgeons, 13 dental
surgeons, and 15 sanitary engineers in the grade of surgeon; 97
passed assistant surgeons, 16 passed assistant dental surgeons, 5
p_assed assistant sanitary engineers m the grade of passed assistant
surgeon, and 1 passed assistant pharmacist in the grade of passed
assistant surgeon; 21 assistant surgeons, 12 assistant dental surgeons,
I assistant sanitary engineer in the grade of assistant-surgeon, and
10 assistant pharmacists in the grade of assistant surgeon-a total of
370 officers. Of this number, 16 medical directors, 12 senior surgeons, 14 surgeons, 3 passed assistant surgeons, and 3 assistant pharmacists in the grade of assistant surgeon were on waiting orders.
At the close of the fiscal year 1934, 2 medical directors, 4 senior
surgeons, and 2 surgeons were serving by detail as Assistant Surgeons
General in charge of divisions of the Bureau in accordance with acts
approved July 1, 1902, July 9, 1918, and April 9, 1930; 4 medical
directors were on duty as directors of the public health districts; 3
surgeons, 2 passed assistant surgeons, 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
senior surgeon, 5 surgeons, 1 dental surgeon, 3 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
senior surgeon was servin~ (as alienist and medical officer) on detail
to the Morningside Hospital, near Portland, Oreg., which cares for
the Alaska insane, under contract with the Department of the Interior; 1 medical director, 2 surgeons, 1 dental surgeon, 1 passed
assistant surgeon, 2 assistant surgeons, and 2 assistant dental surgeons, were serving on detail with the United States Coast Guard;
2 senior surgeona 3 surgeons, 8 passed assistant 8urgeons, 2 passed
assistant dental surgeons, and 1 assistant surgeon were assigned for
duty at various penal and correctional institutions.
RESERVE OFFICERS
On July 1, 1933, the reserve commissioned officers on active duty
numbered 30, consisting of 5 surgeons, 1 dental surgeon, 10 passed
assistant surgeons, 5 assistant surgeons, and 9 assistant dental
surgeons.
On July 1, 1934, the number of reserve officers on active duty was
37, consisting of 4 surgeons, 1 dental surgeon, 10 passed asSistant
surgeons, 11 assistant surgeons, and 11 assistant dental surgeons.
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ACTING ASSISTANT SURGEONS
On July 1, 1933, there were 672 acting assistant surgeons in the
Public Health Service, and by July 1, 1934, this number had increased
to 695.
Of the 695 acting assistant sur~eons, 101 were on duty at marine
hospitals; 418 were engaged in llllmigration, relief, and maritime,
border, insular, and foreign quarantine work; 5 were engaged in the
prevention of trachoma; 5 were on duty in connection with field
mvestigations of public health and rural sanitation; 105 were on
detail with the United States Coast Guard; 2 were serving with the
· Bureau of. Mines by detail; 23 were serving at various penal and
correctional institutions; 36 were engaged in antivenereal disease
activities as part-time employees at nominal compensation. Fourteen of the 36 acting assistant surgeons engaged in antivenereal
disease activities held appointments as collaborating epidemiologists.
ATTENDING SPECIALISTS
On July 1, 1933, there were 454 attending specialistsia the service,
and during the year this number increased to 481, of which number
252 were consultants to marine hospitals, while 41 were available for
call at second- and third-class relief stations; 12 were engaged in
antivenereal disease activities; 61 were serving at various penal and
correctional institutions; and 115 were consultants in connection with
quarantine, immigration, and scientific research activities.
INTERNES
On July 1, 1933, there were 93 internes in the service; on July 1,
1934, there were 118, of which number 31 were dental and 7 students.
Internes are appointed for temporary periods of 1 year for duty at
marine hospitals.
PHARMACISTS AND ADMINISTRATIVE ASSISTANTS
On July 1, 1933, there were 16 pharmacists and 36 administrative
assistants in the Public Health Service. During the year 1 pharmacist was commissioned in the regular corps and 1 died; an addition
of 2 was made in the administrative corps and during the year 2 died,
1 resigned, and 1 retired. The total corps at the end of the fiscal
year was 14 pharmacists (10 chief and 4 junior) and 34 administrative
assistants (9 first class, 5 second class, 13 third class, and 7 fourth
class).
NURSES, DIETITIANS, AND RECONSTRUCTION AIDES
On July 1, 1933, there were on duty with the Public Health Service
449 nurses, 27 dietitians, 35 reconstruction aides, 2 social workers,
and 15 guard-attendants. On July 1, 1934, there were on duty 498
nurses and 37 guard-attendants. In the Hospital Division there
were 27 dietitians and 31 aides. The increase in personnel was due
partly to the opening of the Hospital for Defective Delinquents at
Springfield, Mo.; the United States Southwestern Reformatory at
El Reno, Okla.; the United States Detention Farm at Milan, Mich.;
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PUBLIC HE.ALTH SERVICE
and the United States Penitentiary at Alcatraz Island, San Francisco
Harbor, Calif. Forty-one junior nurses were placed on duty during
the year. One nurse completed a course in the use of the heat boxes
in pyretotherapy at the factory in Dayton, Ohio. One hundred and
eleven nurses were assigned to the Public Health Service under the
Civil Works Administration with salaries ranging from $12 to $30
a week for a 30-hour week. These nurses performed valuable service.
They have been discontinued.
CONTRACT DENTAL SURGEONS
On July 1, 1933, there were 47 contract dental surgeons employed
at the marine hospitals, second-, third-, and fourth-class relief stations, and the various penal and correctional institutions. 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 1934, this number had increased to
52; 8 were at marine hospitals, 32 were at second-, third-, and fourthclass relief stations, 6 were serving at various penal and correctional
institutions, and 6 were detailed to the United States Coast Guard
for duty.
EPIDEMIOLOGISTS
During the year the number of assistant collaborating epidemiologists was increased from 4,640 to 4,674. These employees are health
officers or employees of State or local boards of health, who receive
only nominal compensation from the Federal Government and who
furnish the service with reports of communicable diseases received by
State or local health organizations. The number of collaborating
epidemiologists increased from 32 to 33. 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 62 members, of whom 18 were
· commissioned medical officers, 29 other research workers, and 15 consulting experts. The staff was assisted by 19 technicians and 68
other subordinates, making a total of 149. Of this total, 134 were
on full-time schedule.
PROPERTY RECORDS
The property return section has accounted for all property of the
Service and 336 property returns have been audited during the year.
Sales of unserviceable property including boats, hides, cattle, etc.,
aggregated $5,193.54. Surplus property not desired by any 'Government Department was sold for $246.25. Property surplus to the
Public Health Service valued at $29,625.94 was transferred to other
Government Departments. Surplus property of other Government
Departments valued at $45,660.57 was received by the Public Health
Service. Property valued at $41,393.01 was transferred from service
stations where it was surplus to other service stations where it -could
be used. By the exchange value on old typewriters and adding ma-
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PUBLIC HEALTH SERVICE
125
chines turned in on the purchase price of new machines; $585.25 was
saved. By the same method, $347 was saved on old automobiles.
ACCOUNTS SECTION
The account 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. acoounts of . m.iscell11,neous collections, allotments, records of
encumbrances, cost accounting, and the administrative audit. . A
statement of appro].>riations, expenditures, and balances, with miscellaneous receipts, 1s published as an appendix to this report.
PERSONNEL STATEMENT
The accompanying tabular statement shows the personnel of the
Service as of July 1, 1934. Of the 10,727 employees shown in the
table, 4,674, listed as collaborating epidemiologists and assistant collaborating epidemiologists, receive only nominal compensation. The.v
are mainly officers Qr 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 diseases. The personnel statement also includes
all part-time employees, those employed on a per diem basis, and
those whose compensation is on a fee basis. The increase of 775 employees is caused mainly by the temporary personnel placed on duty
m connection with Civil Works' Administration projects undertaken
by this Service.
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Consolidated quarterly personnel report Jor the quarter ended July 1, 1994
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Portland, Maine . •...... · -· ·-· -· · - · -·- · -· · ···---- · --· · . •.... ·- · ··--···- ·
1 -···-- ··-·-·
I -·-·· · -···•· ··--··
l
1 • •.••.
12
Port Townsend, Wash ·-··········· · ···-···-······ -· ··-······ · ·· · -··-· · ·· · -· ·- · ·· ·-- ····-·-···-- ............ ···-··-·· -·-····-·-······- · ··St. Louis, Mo •..... ·--···· ······--·····-·············· ...... -···---······ -· ···
I
1 -····- ··--·· · ···-- ••.........• ··-·-·
3
16
San Francisco, CaliL.·-· · -···-···· · ···············-·· ··--··
I ··--·· -·· · ··
3
0
2 ·· - ··· -- · ··I
1 ·· ·--·
7
19
~til~a{v~t:.-.::::::::::::::::::::::::::::::::::::: :::::: :::::: ::::::
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Hospital division:
Marine hospitals:
·•····
....•.
· ····--· · ·-
10
7 .. ...• · -- -··
3 ·· -·-· ·· · --·
1 · · · · -- ··--··
..•... ··- · · · ·····-····-·
1 ·-···· •···· • ··-· ··
··- · -·
12 ··-···
I
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51··-···j 10 1······1
3
2
7 1- - ----1------1------ 1-- ---- 1----- -1- ---- Stapleton, Staten Island, N .
1
l
1
Vineyard Haven, Mass .... ••··· ······· · ··-······-···-· .... ........ . ..... ···-·· ..... .
I
l -····· . ......... . 1
.
- - 1 - - 1 - - + - - - t- --l
, - - , - - , - - , - - , - - , - -,- -,- - - • - - • - - • - Total hospitals ___ ------- ___ - . ____ ------ --- ___ -- - ---- •· - - - - - 1 - - - - - - 1 - - - - - -1---- --• - - - - ·- • - - -- - - •-- - -- -1---- - -1 - - - - - - 1 - - - • -- • - - - - --1- - - - - - • - - - - - -,- - - - - - 1------1_ --- -1 - - - - - - 1- - - - - Relier stations:
32
9
1
····
·· •···········
···l······I ···-··
l l· ·····I
1 I 18
Second
class·-·······-············
Third class
. ..•.•... . •..............
- .....
. ........•...•.....
...•............... . ......,. ......... . ... ........ . ... .......
145
9
23 I···-· · . . ..... .... .
1- -1---1-----1---1
1--1---1--1--1- - ; - --t---1- - - 1 - - , - - , - - , - Total relief stations. _______ . ___ . ____ ______ __________ , ___ __ _, __ . - - - 1- _ •• _ -1- - __ -- •- ____ - • --·- __ -1 - - . - --,- - -- -- • - - - - - - 1- - - - -- • - - - - -- • -- - - . - • . - -- -- • - - - ---•- - - - --1---- - -1- - - -- -1 - - - - - -
21 21 41 21······1······1······1······1
1·•-···1······
Foreign quarantine division:
Quarantine stations:
Baltimore, Md_············-····· ·· · ···· ····-····· ··· · ····-·..... . .... ..
J ···-·· ••. ...•• • •••.•••.. ··· - ·• •• •••• •. • • •• ••••••
J
Boston, Mass . . ••· · ···-···-··· · ··········•··············-·-·............
1 -··· ··
I ·-···· ...•.. ...... .•.... . ...•• . ...•.
3
Ellis Island (also immigration) ....... . .............. _.......
3 ....•............. ·-· ··· ·-·· ·· . .... . ·····- ·-···· . .. .. . . .. ...
1~
El Paso, Tex . .. •················· · · ·····- ···········-· ...... ··· ··-··--·-···-·· ...... ·-··· · .... .... ... . ····- ·. .......... .. . ....
3
Fort Monroe, Va .... _._ ·· ·-·········-······-··········......
l ........................ . ........... ·-··- · ..•. • . ............... . .
Galveston, Tex.... •····· ···············-············-···-·····-··- .. -,. ..
l ..... . ............ ·-···· . . . .... ..... · -···· ... .. .
J
Honolulu, HawaiL .......... ..... .... ····· ·· ···-·-··· ............ ··- ·- · -·····
I
2 ···-·· ···-·· ...... .. .... .... . . ......
9
Laredo, Tex . .. . ..... ......••. ....•.• . ···········--···· ... ... ... ........... ................... . ............. ..... ........ ·-····
4
Marcus Hook, Pa.. . ... ..... •-····················-···...... .
I .......... .. ···--·
l ... .. ............ . ·-··· · ...... ... . ..
J
New Orleans, La .............. . ·-·-·-··· ·· ·····--·····.......... ........
I ..... .
I
1 ...... ...... ...... ... ... . .....
3
Rosebank, N. Y ... .. •-·-· ··-·· ··············•·- ······ . .....
I . ... . . ...... ......
3 .................. ·--··· ...... .. .. ..
6
San Francisco, Calir. (also immigration) ....... - . . . .......... . .... . ...... ····-·
J
I ...... ... .. . ...... .... .. . .. ... ......
3
San Juan, P.R ... · -·················· · ·····-··· ·· ···· .. .... ··- · ··............
I ...... . .. . .. .. . ... ·-·-· · ·-·-·· ...... ......
2
If{~ifu~f~[~ions·.~~::::::::::::::::::::::::::::::::::: ::::::
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... •.. . ..••...•.•..•.....•.. . .
. ........... ... ......... ···-· ·
.................. ·-···· .....•
···- · · .... . ............. ····-·
••••....••• •..••. . ··---· ••.•.•
............................. .
................... .......... .
...•••.••••.••••••• • ••.•••• • ..
..... . ...... ...... . . .... ····-·
l ...... ............ . .... .
................. ............ .
·-···· . ............. .......... .
...• ~. :::::: :::::: ::::::
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Total quarantine and immigration ... ... .................. ·····- .......................................... ·· ·-······-· ...... ····-· ........................ ·····I
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Domestic quarantine division :
~:1~~~Jl:~~~~··~~~~~·· · · ·:· • :• . . .
Scientific research division :
National Institute of Health . · -· · ••·-····· · ·········-···· .... .....
····•·I·•····:•••;•••.•1•••• :. •:•··· •••••• :•···· •••••••••••• ·····1···•f
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:::::: :::::: ::::::
Nutrition studi~.s .... -·-··-····· · · ······ ···•··············· ·-···· ............ ·-···· ........................ ···-·· ·-···· ···- ·· .. .... ... ...
···-·· ·····- ···-- · ..... .
k;£~~1! 1~;::H::tli~::::::::::::::::::::::::::::::::::::: :::::: :::::: ::::::
Stream pollution•...... -. . ········ ·· ····· ·--··-············ ............ ... ... ·-····
2
J ...••.•.•... ·-···· •....• ..•.•. ...... .•••••
4 ....... . .... ···--· ·-····
Industrial hygiene and sanitation . . ····· -······ · ···· ··· ··· ...... ·-···· ...... ... ...
I
2
2 ............ ·-···· . ··-·· .... .. ......
31 ....... . .... ····-· ..... .
Child bygiene .. . . ... ........... · -·-····-··· · ······· •···--·· ...... ...... ...... ......
1 .............................. ·· ·-·· ...... ......
7 .................. -·····
Statistical Office................ . ---······················· ...... ·-·-·· .............................. ·-···· ........................ -·····
9 ..................... . . .
I ......
I
5
3 ... ...... .. ............. ···-·· .....
2
38 ....... ... ............. .
All other stations.··· ········ ·- ····· · · · -··············--···... ...
Total all activities . .... - ... . ....................... . ........... · · · -· · .... . . . ... ........... ... ....... . ........... ... ........ ·-·-··-····· .......... .. ............ -·····
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Division of Mental Hygiene:
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Alderson,Ga_______________
W. v, -------------------- __ __ ____
____ _______
_______
_____
_______ __ _______ ______ ____I _ 6
2 ----- - ---- - - --- - - - ---- - Atlanta,
__ __ __-------------------------_____ __ __ ___________________________
______
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2 ______ ______ ____ __ ____ __ _____ _
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Kans__________________
_________________________________
___ _____
______________ I__ 22 ______l ________
_____ _____ __ ____ --- - -,
1 ------ -----3 --- - - - - - - - - Leavenworth,
Kans________
___________________________________
____ ____
______ __ ____ ___ __ _ ______
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3 -- -- -3 -- ---- -- - --~~~!t {s~J. Wash.. __ ______ _____ _____________________ ____ __ __ ______ ______
____ __ --- -! - __ _____ _________________ - - -- 1- ______ ____I _ 2 2 1 --- -- - ------- ----- -------- - - AU other stations ___________:_____ _______________________ ____ ____ ______ ___
___ 2 I 4 ____ __ ______ _____ _ _____ _ ___ ___ 3 11 414 - ----5- 61 ---l'.'!I
-- - --- - Total all activities ______ _________________________________ \_ ___ --1- ____ -1 -____ -1- ____ -1- ____ -1- ____ -1 -- ___ -1- __ ---1- ___ _-1--___ _j____--1-- __ --1-- __ --1--_·__ ,__ ____ ,______ ,___ ___ ,____ __
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Detailed to other offices_________ ______ _________ ________________ _ 2 ______ 2 9 5 I ______ ____________ ________ ____ 2 ____________ ____________ ______
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Total miscellaneous. __ -- ____________ -- . ____ _-- -- . _-- . . . - 1- --- • _, __ -- - -• -- - ---•-- ----1- - - - --•--. - --1 - - - - - -1-- - - - -1-- -- - - 1- - --- - •-- - ---1 - - -- - - •- - ---- •-- - ---• - -- -- - •- - - - --• - - - - - -• - - - - - -
Grand totaL ________ ____ ________ ____ ---_______ ____ _____ _
50
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39
I 100 I 119
44 1-- - ---1------
5
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695
I
481
62
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368
14
Consolidated quarterly per&onnel report for the quarter ended July 1, 1994-Continued
General and technical
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Hospital division:
Marine hospitals:
Baltimore, Md ..........·. ...... .. ............... . ........
Boston, Mass...... .......................................
Buffalo, N. Y ....... cc....... . .. . ........... ........ ......
Carville, La..... ........... ... . ..... . ..... . ..... ..........
Chicago, Ill . ... . .................... . .....................
Cleveland, Ohio. ...................................... ...
Detroit, Mich... ................ ....... ... . ...............
Ellis Island, N. Y.. .. ... . . ... ... ........ ... . . . ...... ......
Evansville, Ind ... . ..... . . , ... ... . ... . ........ ... ....... . .
Fort Stanton, N. Mex. . . . . .. . ... .... . . ...... ... . . ...... ..
Galveston, Tex... ... . . . ..... . . . . . ... ............... . . .. . .
1
1
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1
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18
8
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16
18
54
6
11
15
4
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1
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15 .... .. ...... ...... ...... ...... .... ..
47
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29
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1 ...... .... . .
6
9
4
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8
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49
186
26
113
49
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. .. . . .
80
15
12
25
121
92
30
264
94
77
73
256
35
136
71
4
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19
8
23
43
142
101
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39
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217
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64
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19
10
27
56 .. . ...
24
24
!Ii~~:it~=t::::::::::::::::::::::: :::::::: ::::::::::::: : ~: i :::t :::::: ::::~: ::::~: :::::: :::::: i .g:::::: :i
Memphis, Tenn. ...................... . ...... ............... . . .
Mobile, Ala...............................................
1
New Orleans, La... ..... .. ...... . ..................... ... .
1
Norfolk, Va........ . .. . ...... ....... ..... . .......... . ...........
1
1
1
1
i~~i~~~hJ.lJiia:::::::::::::::::::::::::::: :::::::: :::::: ····i· ....~. i :::::: :::::: :::::: :::::: :::::: ::::::
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117
49
274
121
101
97
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Consolidated quarterly personnel report for the qaarter ended July 1, 1934-Continued
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Rospltal division-Continued.
· Marille hoepltals-Continued."
Stapleton,
Staten Island,
. Y---... ---·---..... - --___________ __ ____________1_
Vlneyard Haven,
Mass- --N---
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7 -- -- -- - -1--·-·Total relief stations_ - ---------------------•---- ----• -- __ --•--- _--1- ____ -1 - - - - - - 1- ____ • 1- - - - • - 1____ --• - - - - - - • - ___ --1- _ - • - - 1- ____ -1- • • - - - - - 1- - - - - -
29
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10
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Baltimore, Md______________________ _____ ____ ___ __ _____________________________ ___ __ __ ___ ______ _____
1
1 -·-·--
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Marcus Hook , PB----·---·- ----------- ------ -- --- ---___ ___
__ ____
______ ___ _, __ _____ ----·2
20 ______
:8.":ifs1~.fcaisci1mmigraii<iii5:::::::::::::: :::::::: :::::: __._'._ :::::: :::::: :::::: :::::: :::::: :::::: ____:_____ :.
El Paso, Tex ______________________ ______ _. ____ ____ ___________ ___ -·- --- ______ · - --- - __ ____ ----·-----·-____________
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Fort Monroe, VB--------------·--··-·------- __ ___ _________ ---·---·--·- ______ ·--- --___ ___ ____ ____ ____
Galveston, Tex--------- ----- -·-·-·--·------- ____ ____ ---· -l ______ ·-·--- __________________ -·--- New Orleans, La---·------------------ --- -- - _____ ___ __ _____ _____ ________ _______ ____ ____ _______ -·--·Rosebank, N . Y---------------- -·---·------ -- - - -- -- ______
2 __ ___ _ ___ __ ___________________ -- -·-BanFranclaco,Callf.(alsoimmigration) ____ __ ________ ___ ___ _____ _ ______
l ___ __ _ __ ____ ______ ______
Ban 1uan, P. R----·---------- ---·· •- -·-·- ·-- _____ ________ _______ --·-- - ___ _____ ____ __ __________ -·----
2
l
2
l
20
14
21
16
4
3
6
6
4
2
1 __ ____
2
7
2
2
~
:::
25
103
48
24
31
114
53
27
~
::::::
2
1
;
16
82
39
21
----·______
----•·
______
6
11
5
3
3
28
3,135
113 --------
184 -- ------
------
=l=l=l=l=l=l=l===l===cl==I
Foreign quarantine division:
Quarantine stations:
~b:j
C".!
:kellef~:1o~~p!tals ___ . ___ ·_··---···-···-·-----i--------i------1-----r----1-·--- -1-1-1-l-l-l-l-i--i-l--l 2, 524
o·
0
Totals
-
297
31
!: :~==~~~~~~~~~~i; ~;i~:~: : : : : : : ::: : : : : '.: : : '.: :::?: :::::: :::::: :::::: :::::: : :'.~: : :'.~: ___ '.~- ----~~- :::::: ~!: : --~'._!-·---~;;
1
I
I
1--1- -1 - - 1 -- 1 ---1--1
I
1---1--1---1---1--1---
i:z:
t<J
i
!:JI
~
C".!
t<J
······i······i···•··i
Do1¥n~~~tlne
dlvilllon: ••••••••.••...........••......•.•...........•....•..•..•...•............
Trachoma............... •.............•....••.. .... ... ...... ...... .•.•..
5 .•..•. .•.... ...... ...•.• ...•.. ......
591......
1 ............. .
Rural sanitation (regular}.................................................
5 •••••• •••••• •••••• .••••• •••••• ••••••
10
11 ••••••
Civil Works Administration projects.-.....•.•...•......•.......................................••..............................•...
All other stations................................ ...•.•.. ...•.. ...... ...... ...•.. ...... ...•.. .•.•.. .•...• ...... ......
1
22 .•.•..
61
72
65
6
26
7
11
6
17
32
350
27
350
4
23
378
120
Selent:~~~::1:::~:·························· .•.........•...•.......... ~ ..•••..•.... ······ ·•···· .................. · · · · · I ·····1===!===!-----
--
National Institution of Health..........................
35 ••.... .•.... ...... ..•... .•.... ..••.. .•.... ....•. ......
72 ..... .
11
~!~!~:i~J{EHg::.~==:::::::::::::::::::::: :::::::: :::::: :::::: :::::: :::::: :::::: :::::: :::::: :::::: :::::: :::::: ....1.......:.1::::::
5
1
7
39
8
9
50
t}liii~tt~f~tt//))~l ~~tt t? ~~\ II It;;}; tI II~~\~!( II J····}[t
= · · · · · · · · · · · · · · · ·•·••· · · · · · ·
Total all activities.....•........................................•...•...................................•................ •··•····••····
1
co·
N.
"'
~
c;?"
CJ
0
i3~~i+:m:(=:+tt ?':.Ji;'
254
402
4,675
~
7
5
2 .•••••
8
11
1 ······
5
8
7
2
2
7
64 •------
8
73
79
Total all activities ••.••................•....... I••· ••••• 1•••••• , •••••• , •••••• , .••••• , •• •• •• , •••••• , •• •• •• , •••••• , •• •• .. , •.•••• , •• •• • ·•·•···· ··• • •• • · •
135
117
All other stations................................ .•...... ......
a
2
11
1
=
68
I· -
~t<
....
n
i::i::
t,;J
>
~
14
18
17
16
18
i::i::
!1l
t,;J
~
7
~
10
152
n
t,;J
252
=I=
a ~~ - - ························ ········1······1······1·····1····1······r····1······1·····1·····1···· ·1·· ····1········ ······
~
51
'"d
4.675
=
=
17
10
51······
1
73
7
13
3
2
3
10
·•····1········§
l
3
3
144
8
17
1
23
52
15
19
123
16
13
7
148
Sanitary Reports and Statistics..................... 4,674 ·····• ···•··
Dlvililon of Venereal Diseases...........................................................................................
4
13 ······,
Division of Mental Hygiene:
= ==,l===l===F===l,
.Alderson, W. Va .••.•••.•....••......•.•..••.....•.•.....•.......... ,•.....
6 1------1---- --1------1---- --1--- -- -1-- ---0
118
5
12
26
3
498
Coast Guard..............................................................
1 ••..••...•................••.......................•.•..
Perry Point, Md. (supply station) ......................•..•..•••.•.... _
....•............................ ••·•·~......
4
5 ..•••.
Public health districts.........................................
2 ...... ...... ...... .•.... .•.•.. .•.•.. ...... ...... ......
6 ...•..
Waiting orders •..•............••...•................••...•.... •···································•·····································
.A.II others •••••..•••..........•...........................•.•.....•.....•.........•.•...•.....•.....•..........••........................
21
131
1
5
48
15
Total miscellaneous ...••.•.......•••.•.....•.......•......••.•....•................. •····· ........................ ····•· ········•······
221
Grand total ........•............ ............. \
4, 6741
351
34
18
I
a15
30
26
4
10
41
34
I
283
I
2,100
I
119
I
2, 135
21
1 1132
10
8
13
9
48
15
239
18
I
s, 592
1..•••. 1
10,121
-~
CHIEF CLERK'S OFFICE
DANIEL MABTBBSON 1
Chief Clerk
DBPARTMENTAL PERSONNEL
On account of the reduction in the available funds for salaries in
the Bureau, a decrease in force became unavoidable. Accordingly,
in July 1933, 12 employees were separated from the service under the
p_rovisions of section 213 of the act of June 30, 1932, known as the
Economy Act. In addition, 4 clerical vacancies existing at the beginning of the year, and 1 occurring during the year, were not filled,
making a total reduction of 17 positions. This decreased the total
civil-service force on duty in the Bureau to 182 employees, of whom
163 were 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.
During the fiscal year two positions were reallocated by the Civil
Service Commission to higher grades, but under existing law the
incumbents could not receive increased compensation. No administrative promotions were made during the year.
Sick leave avera~ed 8.4 days per employee as compared with 7.8
days for the precedmg year. Leave of absence without pay averaged
4.2 days per employee, due partly to the recent reduction in the
amount of annual leave allowed by law. The record for punctuality
on the part of employees was substantially perfect, the actu'al com
puted promptness in reporting for duty being 99.8 percent.
PRINTING AND BINDING
The sum of $50,000 was made available for printing and binding
by allotment from the Treasury Department appropriation, as compared with an allotment of $93,000 for 1932 and prior/ears. In
spite of the utmost efforts for economy, this fund prove sufficient
only for the most urgent printing needs, much material of value in
health work remaining unpublished or being issued in greatly reduced
form. If additional funds were available, they could be used to great
advantage.
PUBLIC HEALTH SERVICE LIBRARY
The librarian reports the addition of 526 volumes and the discarding of 125 obsolete works, so that the collection now numbers 13,593
volumes. A large portion of the additional books was obtained without cost. Several hundred pamphlets were also added, this collection
now numbering approximately 7,250. Two hundred and twenty-eight
periodicals relating to medical and public-health work were received
and cqculated, only 34 of which represented paid subscriptions.
132
Digitized by
Google
PUBLIC HEALTH SERVICE
133
The capacity of the small library staff was taxed throughout the
year, but their work was considerably facilitated by the improved
library quarters and facilities in the new building.
NEW ADMINISTRATION BUILDING
The new administration building in Washington, which was occupied in May 1933, has proved to be of great advantage in the administration of the service. During the year the rear courts and driveway were paved with reinforced concrete, providing a much-needed
improvement. The construction of terraces and approaches and the
grading of the grounds are now under way from funds provided by
the Public Works Administration, as the original appropriation proved
insufficient for this purpose.
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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 1934:
Obligations
Appropriation
Appropriated
Balaries, Office or Surgeon GeneraL
$307,800.00
$266, 314. 09
$266,314.09.
Pay, etc., commissioned officers...•. 1, 528, 39.1. 00 1, 372, 666. 42 1,371,348. 21
Pay or acting assistant surgeons ••••.
325,400.00
253,227.61
253,227.61
801,194.25
801,194.25
Pay or other employees......••••••. 1,017,750.00
36,175.00
25,161.00
Freight, transportation, etc •....••..
22,551.63
M aintenance, National Institute of
54,775.00
H ealth ••...•••••.•••.••.••••••.•.
.w, 982. 32
.W,982.32
Books .•.•.••...•..•..••.•......•...
500.00
406. 00
398. 78
Pay of personnel and maintenance or
h osp1tals •....••..•..•••....•••••.• 1 5, 844, 259. 00 5, 048, 3"°. 85 5, 009, 749. 56
Quarantine Service .•............•..
475,000.00
308,621.46
295,838.08
Pre_venting the spread or epidemic
333,650.00
206,893.60
201,972.11
d -···························
353, 5M. 00
210,020.00
Fi eld investigations of public health.
210,020.00
38,454.00
33,255.21
32,005.54
Interstate Quarantine Servioe•••....
lb0,000. 00
24,544.94
Btudies or rural sanitation ••..•.••..
24,454.93
Control of biologic products ••.•...•
43,000.00
39,657.50
39,657.50
Expenses, Dltislon of Venereal Dis•
eases
------------------------------
Ex vensel', Division of Mental Hy.
ene .•..•.•.•..•..•.•...........•
ucational exhibits.••.•......•....
Eft
Outstand•
ing
Liquidated
Incurred
Unobli·
gated bal•
ance
------------
-----------2,609.37
$41,575.91
155,726.58
72,172.39
216,555.75
11,014.00
-----------8.12
13,792.68
93.10
38,591.29
12,783.38
795,918.15
166,378.54
4,921.49
126,756.40
143,544.00
5,198.79
125, 455. 06
4,242.50
$1,318.21
----------·349.67
00.01
---------·--
75,000.00
58,268.71
58,083.51
185. 20
16,731.29
44,377.00
1,500.00
30,938.50
957.64
30,756.31
792.14
182.19
165. 50
13,438.50
542.36
Total. ....••••...•..••..•..... ' 10,630,587. 00 8, 721, 451. 00 8, 660, 246. 57
61,204.43 1, 909, 136. 00
1 Includes $244,259 reimbursement for care and treatment of beneficiaries of the Veterans' .Administration
and Civilian Conservation Corps.
2 Statement does not include expenditure of $4,177.01 from trust fund "National Institute of Health,
Conditional Gift Fund."
Quarantine Service--Expenditures by stations
Pay of offi•
cers and em• Maintenance
ployees
Name of station
Total
CONTINENTAL QUARANTINE STATIONS
Aransas Pass, Tex.............................................
$89. 25
Baltimore, Md................................................
27,423.03
Beaufort, S. C.................................................
458. 30
Biscayne Bay (Miami), Fla...................................
17,912.84
Boca Grande, Fla.............................................
1,137.07
Boston, Mass..................................................
34,701.97
Brownsville, Tex •••••. ·-················-·-···············---H, 805. 80
Brunswick, Ga •••••.•. ·-·-······-···-·····-·······-···-···;···
1,840.63
Calexico, Calif •• ···-· •.•.•••••• -················ -· .•• ····-· •.•••••••.•••..
Cape Fear (Southport), N. C·---··-··-······-···-·········--··
5,286.68
Charleston, s. c-··-·-·-··--···········-····-·············--··16,869.65
Columbia River (.Astoria), Oreg.·-··················-·····-···
4,954.15
Columbus, N. Mex_·-··········-······-···········-········-··
1,327.42
Corpus Christi, Tex...........................................
1,972.66
Del Rio, Tex.·························-·············-·-···-···
4,913.87
Eagle Pass, Tex •• ·········································-···
11,306.91
El Paso1 Tex •. ······················-·············-··········25,844.68
Fernanaina (Cumberland Sound), Fla•.••..•••·-······-···-···
565. 00
Fall River, Mass ••••••••••••••••••••. ·-·············-···-··-··
1,306.16
Freeport, Tex ••.•••.•••••.••••••••....•.••••••••• ·-···········
348. 71
&~I:o~~u~::::::::::::::::::::::::::::::::::::::::::::::::
Hidalgo, Tex .•..••••••••.••••••••••••• ·-······················
Key West, Fla.•..•••••••••••••••••••• ·-····················-·
~ ~::
5,847.64
2,264.10
$:13,549.09
8,804.77
83.66
17,144.14
3,630..13
472. 32
99.00
2,360.65
7,005.64
1,104.82
51.84
1,087.52
1,164.15
5,643.65
16.M
6,993.77
418. 72
809.98
13. 66
134
_Digitized by
Google
$89.25
50,972.12
458.30
26,717.61
1,220.73
51,846.11
18,435.93
2,312.95
99.00
7,647.33
24,775.29
6,058.97
1,327.42
2,024.50
6,001.39
12,471.06
31,488.33
580.54
1,306.16
348. 71
29,916.39
4,501.77
6,657.62
2,277.76
135
PUBLIC HEALTH SERVICE
Quarantine Service-Expenditures by stations-Continued
Pay of offl•
cers and em• Maintenance
ployees
Name of station
Total
C0NTINIINTAL QU ARANTINII STA TI0Ns-ntinued
Laredo, Tex...................................................
$21,874.64
$3,114.17
Marcus Hook, Pa.............................................
37,747.00
17,165.55
Mobile, Ala...................................................
21,883.90
6,445. 14
New Bedford, Mass...........................................
522. 51
20. 00
New Orleans, La..............................................
41,614.60
20,579.14
Newport, R. L......... ......... .............................. ........ ......
40. 00
New York (Rosebank), N. Y..................................
159,301.62
73,862.34
Nogales, Ari1........................ .. . ........................
8,398.49
1,642.10
Norfolk (Fortress Monroe), Va................................
29,384.08
8,194.50
Pascagoula, Miss..............................................
1,045.00 •••..... ......
Pensacola, Fla.................................................
14,425. 78
1, 191. 72
$24,988.81
64,912. 5.5
28,329.04
642. 51
62, 193. 74
40. 00
233,163.96
10,040.59
37,578.58
1,045.00
15, 617. 50
1
•~::
1,860.61
1,638. 70
1,455.33
289. 97
407. 04
276. 13
743. 08
678. 45
93. 66
.••••.........
1,609.80
5, ~19. 56
17,705.20
8, 661. 95
13,774.93
3. 520. 48·
13,645.28
4, 264. 66
407. 04
3, 482. 23
4,819.92
12,665. 25
1,138.66
261. 16
7,959.35
20,627. 53
75,340.81
32, 530. 00
~~th~~~.YT:~~::::::::::::::::::::::::::::::::::::::::::::
Portland, Maine...............................................
~::t :~
11,914.32
1,881. 78
12,089.95
3, 974. 69
Portland, Oreg................................................
Port Townsend, Wash.........................................
Presidio, Tex..................................................
Providence, R. 1............................................... ..............
Rio Grande, Tex..............................................
3, 206. 10
Roma, Tex....................................................
4,076.84
Babine, Tex...................................................
11,986.80
St. Andrews (Panama City), Fla..............................
1,045.00
St. Georges Bound (Carrabelle), Fla...........................
261.16
St. Johns River (Jacksonville), Fla............................
6,349.55
Ban Diego, Calif...............................................
15, 307. 97
Ban Francisco, Calif...........................................
57,635.61
Ban Pedro, Calif...............................................
23,868. 05
i: m: t~
H:m:; ~: i~: ~ u:~t*
t¥:1rt1~~===:=:==========================================
Thayer
(Mercedes), Tex.......................................
1,522. 70
697. 93
West Palm Beach, Fla........................................
1,567.50 ..............
Ysleta, Tex •.••..••.........•......••....••............••....•............ ·..
24. 25
i~:tt
i~mlsoolianoous::::::::::::::::::::::::::::::::::::: ..... ~.~~~~~~.
Travel of medical directors within districts.................... .......•... ...
2,220.63
1,567.50
24. 25
2
'
16,231.19
m::
~~: :l!?
16,231.19
1------1------>-----Total, continental quarantine stations...................
743,899.16
288,789.66 1,032, 6&'!. 82
..
INSULAR
QUARANTINE
l=====l=====l====
STATIONS
Hawan. .. .. . ............................................. .....
Philippine Islands.............................................
Puerto Rico...................................................
Virgin Islands.................................................
37,762.05
13,364.50
28,577.52
12,122.05
8,062.07
-------------9,094.49
2,675.24
45,824.12
13, 364. 50
37,672.01
14,797.29
T otal, insular quarantine stations........................
>-------1------t----91, S26.12
19,831.80
111,657.92
Grand total, all stations.................................
l=====l=====I=====
835,725.28
308,621.46 1,144,347.04
Savings-Funds impounded under the economy' acts
Furlough and
compensation
deductions
Appropriation
Vacancy
savings
Salaries, Office of Burgeon General...........................................
$14,075.35
$22,369.03
Pay, etc., commissioned officers..............................................
57,245.74 .••••...•..••
Pay of acting assistant surgeons..............................................
15, 735. 23
19, 058. 62
Pay of other employees......................................................
47,301.99
55,859.28
Freight, transportation, etc..................................................
302. 91 •••••••.•..••
Maintenance, National Institute of Health ..•........•..........•••.............................•..•..••
Books•..•....••..•.•.••.•.......•............•..•............•.•.•..•...•...................•.•...•...••
Pay of personnel and maintenance of hospitals...............................
222, 899. 59
110,078. 49
Quarantine-118?Vice ..•....•.................•••..•....................•..........••.........•........•••.
Preventing the Bpread of epidemic diseases ....•. ,............................
6,737.34
6,294.90
Field investigations of public health..........................................
8, 811. 93
23,680. 76
Interstate quarantine service.................................................
845. 92
260. oo
Studies of rural sanitation....................................................
417. 97
2,934.50
Control of biologic products..................................................
1,288.60 •••••......••
Expenaes, Division of Venereal Diseases......................................
2, 701. 22
3, 514. 50
Expenses, Division of Mental Hygiene.......................................
1,548. 30
4, 005. 67
Educational exhibits.........................................................
7. 91 .........••.•
Total, all appropriations...............................................
Digitized by
379, 9ll0. 00
Google
248,065.75
136
PUBLIC HEALTH SERVICE
FUNDS TRANSFERRED FROM OTHER DE)'ARTMENTS
Expenditures from allotments of funds from other bureaus and
offices for direct expenditure during the fiscal year 1934 were as
follows:
Appropriation title
Allotted
Expended
Veterans' Administration: Working fund ............•.•.•............•...... $72,65().00
$72,650.00
Department or Justice: Medical and hospital service, penal Institutions..... .
8113, 278.00
393,278.00
Public Works Administration: National Industrial Recovery ....••........•.• 1, 726, 863. 00 1, 726, 863. 00
Civil Works Administration: Working fund ....................••...........• 131,124.88
131,124.88
Agriculture Department: Working fund_ .••. __ .. __ .................•........
1,800.00
1,800.00
Total ••••.•.••••.•..•.•...•••.•••••. -············-·-·-·-·.............. 2,325, Gl5. 88
2,325, Gl5. 88
MISCELLANEOUS RECEIPTS-COVERED INTO THE TREASURY
The revenues derived from operations of the Public Health Service
during the fiscal year 1934 are as follows:
Source
Amount
GENERAL FUND RECEIPTS
j=\:t1~~r[~ges and expenses......................................................
Sale of subsistence.........................................................................
Bale 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 or refuse, garbage, and other byproducts ...........•.•.•••...•.•...•.••.•..•...•.•... _
Sale of livestock and livestock products....................................................
Other revenues............................................................................
Total, general fund receipts..........................................................
'l'BU8T J'UND BKaIPT8
Effects of deceased patients................................................................
0rand total..-......................................................................
Digitized by
Google
•~:
=:
~
10,334.31
431. 02
Ii, 112. 21
2, 1582. 26
G2. 67
1,070.14
712. 72
362;16
125. 78
1----21K, 23l. li6
1,418.09
1----266,649. 66
and
H!
INDEX
,nde,J
SID.00 '
2i8.00 1
,u:
!Ml
800.00
615.~
I
-I
VIC0
mt
A
Page
Abandoned coal mines, sealing of_ __________________________________ _ 62-63
Accounts section, report of_ _______________________________________ _
125
Acting assistant surgeons, number on duty __________________________ _
123
Aerial navigation, International Sanitary Convention for ______________ _ 4, 67
Aides. (See Nurses, dietitians, and reconstruction aides.)
Airplanes, quarantine inspection oL ________________________________ _
64
Airports of entry, United States, for airplanes from foreign ports, summary showing transactions at _____________________________________ 73-74
Aliens:
Medical inspection of_ __________________________________ 4-5, 64, 67-68
Summary of medical inspection of_ ______________________________ 75-87
Amoebic dysentery:
Epidemic of__________________________________________________
3
Studies of_ _________________________________________________ 9-10, 37
Appendix (financial statement)___________________________________ 134-136
Atabrine studies__________________________________________________
21
Attending specialists, number on duty_______________________________
123
B
11.M
=
Bacterial variants or mutants, studies of_____________________________
Bacteriophage studies______________________________________________
Biochemical studies_______________________________________________
Biologic products _________________________________________________ .
Birth rate in the United States_____________________________________
Building, new administration_______________________________________
39
36
17
38
2
133
C
California, plague-suppressive measures in ____________________________ 42-44
Canada, reciprocity with, in water supplies--------------~-----------52
Canal Zone, summary of quarantine activities at______________________
75
Cancer studies _______________________________________________ 7, 15-18, 39
Chemistry, report of division of _____________________________________ 40-41
Chief clerk's office, report of______________________________________ 132-133
Child hygiene studies ____________________________________________ 8, 2&-27
Cholera:
Prevalence of______________________________________________ 1, 2, 3, 64
Vaccination against___________________________________________
65
Civil Works Administration, co_operation of Public Health Service with__
6
Civil Works projects of Public Health Service________________________
58
Coal mines, sealing abandoned ______________________________________ 62-.63
Coast Guard beneficiaries__________________________________________
99
Colorado tick fever, studies oL _ _ __ ____ _ _ __ __ __ _ _ __ __ __ _ _ __ __ ___ _ __ _
25
Commissioned officers, number on duty____________________________ 121-122
Communicable diseases, prevalence in the United States, 1933__________
89
Community sanitation project _________ ----------------------------- 59-61
Conference of the Surgeon General with the State and Territorial health
officers__________________________________________________________
63
Contract dental IJUrgeonB, mimber on duty____________________________
124
Cooperation of Public Health Service with other agencies________________
12
Cytological studies________________________________________________
18
137
90167-34-10
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INDEX
D
Pa&1t
Death rate in the United States ____________________________________ _
2
Dental studies ___________________________________________________ _
27-28
Dental treatment at marine hospitals and relief stations ______________ _
98
Dermatoses investigations _________________________________________ _
8,28
(See
Nurses,
dietitians,
and
reconstruction
aides.)
Dietitians.
Diptheria death rate ______________________________________________ _
3
Diseases:
Communicable:
Prevalence in the United States, 1933 ______________________ _
89
Contagious and infectious, prevention of the spread of in interstate
traffic______________________________________________________
5--6
From abroad, prevention of the introduction of__ _________ _________ 3-4
Skin, studies oL _____ _____ ___ _______ _______ ________ __ ___ ______
8
Venereal, prevention and control of_ ________________________ 11, 110-111
Domestic quarantine, report of division of ___________________________ 42-63
Drug addiction:
Publications relating to______________________________________ 118-119
the nature and treatment of___________________________
118
DustStudies
studiesof
__________________________________________________
8-9, 28-29
Encephalitis:
E
~:~::i~
ffj~;~~cof::::::::::::::::::::::::::::::::::::::::::::::::
Engineering
work:
Cooperative
_________________________________________________ _
Summary of _________________________________________________ _ 53-54
Epidemiologists, number on duty __________________________________ _ 54-55
Exhibits prepared ________________________________________________ _ 124
92
F
Federal
and correctional institutions, medical and psychiatric
servicespenal
in ____________________________________________________
119-120
Financialstatement _____________________________________________ 134-136
Foreign and insular quarantine and immigration, report of division of ____ 64-87
Fumigation and inspection of vessels ________________________________ 64, 65
66
Fumigation of vessels, studies of____________________________________
G
Gainesboro, Tenn., trachoma activities at____________________________
Ground squirrels, measures taken against____________________________
48
42
H
Hawaii, plague-control measures in __________________________________ 44-47
Health
conditions:
United
States _____________________________ · ____ __ __ ___ ________
2-3
World ___________________ --------------------_. ___ --------- __
1-2
Heart disease studies of_ ________________________________________ 7, 18-19
1
Hot Springs, Ark., venereal disease clinic at____________________________
112
I
Illumination studies ____________________________________________ - - _ 29-30
Immigrants. (See Aliens.)
Industrial hygiene and sanitation, studies of_ ________________________ _ 28-29
Infantile paralysis. (See Poliomyelitis.)
Inspection of vessels. (See Fumigation and inspection of vessels.)
International sanitary convention for aerial navigation ________________ _
67
Internes, number on duty _________________________________________ _ 123
Interstate carrier water supplies, inspection of_ ______________________ _
5
Interstate quarantine. (See Domestic quarantine.)
Int~rstate
~raffle,
prevention
of
the
spread
of
contagious
and
infectious
d1Seases1n _____________________________________________________ _
5-6
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Paee
Introduction of diseases from abroad, prevention oL _______________ - __ 3-4
Investigations
(see also Studies):
Cancer _______________________________________________________
15-18
Child hygiene _________________________________________________ 26-27
Dermatoses__________________________________________________
28
Heartdisease
_________________________________________________ 18-19
Milk ______________________________________________________ 9,31-32
Psittacosis ___________________________________________________ 23-24
Public-health problems _________________ • _____ .________________ 7-10
Relapsing fever ______________________________________ • _____ ._. 9, 36
Statistical.- _______________________________________________ .__ 33-34
Stream pollution ______________________________________________ 34-35
L
.
Laboratory:
Public Health Service, in California, activities at _________________ _ 43-44
Studies, speciaL. ________ • ________ ~ ______ --- - • - - - -- -- -- - - --- - - 30-31
Legislation, sanitary, and court decisions ____ ----~ _____________ - _- - - - 90
Leprosy:
Rat_________________________________________________________
44
Studies of. _________________________________________________ 7, 19-20
Library, Public Health Service____________________________________ 132-133
M
Malaria, control of ________________________________________________
Malaria-control studies ___________________________________________ 7,
Malaria therapy of paresis, studies of________________________________
Malignant
growths, studies of resistance and susceptibility to (aee also
Cancer) ________________________________________________________
58-59
21, 22
7, 22
16-17
Marine hospitals:
Beneficiaries, summary of services by class oL __ • _________________
97
Coast Guard beneficiaries._____________________________________
99
Cost per diem. _______________________________________________ 97-98
Dental treatment_____________________________________________
98
Operating costs __________________ • ___________________________ 99-100
Recommendations for__________________________________________
14
Reports, consolidated and detailed ____________________________ 100-108
Marine hospitals and other relief stations, beneficiaries treated at______
10
Marine hospitals and relief, report of division of______________________ 96-108
Maritime quarantine, recommendations for ___________________________ 13-14
Maritime quarantine stations, summary of transactions at ______________ 69-71
Measles, prevalence of.____________________________________________
3
Medical and psychiatric care of Federal prisoners on narcotic farms ____ ._ 11-12
Medical
psychiatric services in Federal penal and correctional insti-119-120
tutionsand
_______________________________________________________
Medical examination of aliens. (See Medical inspection of aliens.)
Medical inspection of aliens____________________________________ 4-5, 67-68
Medical inspection of aliens, summary of_ ____________________________ 75-87
Mental hygiene, report of division oL _____________________________ 118-120
Mexican border stations, summary of quarantine transactions at________
72
Milk investigations ____________________________________________ "_ 9, 31-32
Morbidity and mortality reports ____________________________________ . 88-89
N
Narcotic farms and medical and psychiatric care of Federal prisoners ___ 11-12,
119-120
Narcotic farms, construction oL _______________________________ • ____ 119
National Institute of Health:
Number ondutY--------------------------~------------------124
Publications__________________________________________________
41
Report of. ________________________________________ . __________ 35-41
Negro health work _______________ .________________________________
90
Nurses, dietitians, and reconstruction aides, number on duty_________ 123-124
Nutrition, studies of. ______________________________ . _______________ 22-23
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0
p~
Operating costs of marine hospitals _____________________________·____ 99-100
p
Parrots, regulations governing the importation oL _________ • _ _ _ __ _ __ 4, 66-67
Pathology and bacteriology, report of division of_ _____________________ 35--39
Personnel (see also Personnel and accounts):
Departmental________________________________________________
132
Recommendations for__________________________________________
14
Statementof _______________________________________________ 125--131
Personnel and accounts, report of division of. ______________________ 121-131
Pharmacists and administrative assistants, number on duty____________
123
Pharmacology, report of division of_ _________________________________ 39-40
Plague:
Control measures in HawaiL ___________________________________ 44-47
Laboratory, Public Health Service ______________________________ 43-44
Prevalence of__---------------------------------------------- 1, 2, 64
Suppressive measures in California ______________________________ 42-44
Plague-infected rodents, discovery of________________________________
2
Poliomyelitis:
Epidemic of__________________________________________________
3
Studies of____________________________________________________
36
Printing and binding______________________________________________
132
Property records section, report of________________________________ 124-125
Prophylactic and therapeutic agents, special studies on ________________ 38-39
Psittacosis:
Controlmeasures _____________________________________________ 57-5~
Investigations of ______________________________________________ 23-24
Prevalence of.________________________________________________
8
Publications issued and distributed _______ ~ __________________________ 90-95
Publications relating to drug addiction _____________________________ 118-119
Public health:
Civil Works projects of________________________________________
58
Engineering work, cooperative __________________________________ 53-54
Methods, studies of_ ________________________________________ 9, 32-33
Problems, investigations of_____________________________________ 7-10
Sanitary legislation and court decisions relating to_________________
90
Public Health Service:
Beneficiaries of ____________________________ - - - - - - -- -- - -- - - -- - 11
Cooperation with other agencies _______________________________ _ 6, 12
Exp.ibits of_ _______________ --- __ - - -- - - -- -- -- - - -- - - - - - - - - - - -- -92
Laboratory in California ______________________________________ _ 43-44
Q
Quarantine transactions at:
Canal Zone, summary of_______________________________________
75
Maritime quarantine stations, summary of_ ______________________ 69-71
Mexican border stations, summary of____________________________
72
United States airports of entry for airplanes from foreign ports, summary of_____________________________________________ ______ 73-74
R
Rad~tion, studies of the biological effects of_ ________________________ _
Railway sanitation _______________________________________________ _
Rat leprosy _____________________________________________________ _
Rats, measures taken against __________________________________ - __ - _
Recommendations for:
Marine hospitals______________________________________________
Maritime quarantine__________________________________________
Personnel____________________________________________________
Scientific Research. _______________________ --- _ _ _ __ __ __ _ _ __ _ _ __
State and local health work____________________________________
Venereal disease problem ____________________ - - _ _ _ __ _ _ __ _ _ __ __ _ _
Regulations governing transportation of parrots _____________________ 4,
Relapsing fever investigations______________________________________
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15--16
51
44
43
14
13-14
14
13
13
14
66-67
9, 36
141
INDEX
Reports:
Page
Marine hospitals, consolidated and detailed _____________________ 100-108
Morbidity and mortality _______________________________________ 88-89
Personnel __________________________________________________ 126-131
Reserve officers, number on duty____________________________________
122
Richmond, Ky., trachoma activities at_______________________________
48
Rocky
Mountain
spotted fever:
Studies
of ___________________________________________________
_
Vaccine _____________________________________________________ _ 24--25
8
Rodent-control surveys ___________________________________________ _
66
Rolla, Missouri, trachoma activities at ______________________________ _
48
Rural health work _______________________________________________ _
56-57
s
Sanitary legislation and court decisions _____________________________ _
90
Sanitary reports and statistics, report of division oL _________________ _ 88-95
Sanitation project, community ____________________________________ _ 59-61
Sanitation, rural. (See Rural health work.)
Scientific research:
Recommendations for_________________________________________
13
Report of division of_ _________________________________________ 15-41
Sex information publications and exhibits __________________________ 112-113
Shellfish sanitation________________________________________________ 51-52
Sickness and mortality studies______________________________________
30
Skin diseases. (See Dermatoses.)
Smallpox:
Prevalence of________________________________________________ 1, 3, 64
Vaccination against___________________________________________
65
Stapleton, N. Y., venereal disease studies at__________________________
110
State and local health work, recommendations for ___________ ~_________
13
.State and Territorial health officers, conference of the Surgeon General
with___________________________________________________________
63
State health departments cooperating in venereal disease work ________ 110-111
Statistical investigations ___________________________________________ 33-34
Stream pollution studies_________________________________________ 9, 34--35
Stream sanitation, cooperative work with States relative to ____________ 52-53
Studies (see also Investigations):
Amoebic dysentery __________________________________________ 9-10, 37
Atabrine_____________________________________________________
21
Bacterial variants or mutants___________________________________
36
Bacteriophage________________________________________________
36
Biochemical__________________________________________________
17
Cancer _______________________________________________________ 7,39
Child hygiene_________________________________________________
8
Colorado TicK Fever__________________________________________
25
CytologicaL___ _ ___ _ __ _ _ __ __ ___ _ _ ___ ____ __ ____ ____ _ ___ _ ___ _ ___
18
Dental ______________________________________________________ 27-28
Drug
addiction_______________________________________________
118
Dust ____________________________________________________
8-9,28-29
Encephalitis ________________________________________________ 7, 18, 36
Fumigation of ships___________________________________________
66
Heart disease_________________________________________________
7
Illumination __________________________________________________ 29-30
Industrial hygiene and sanitation _______________________________ 28-29
Laboratory, special _____________________________._______________ 30-31
Leprosy ____________________________________________________ 7, 19-20
Malaria controL ____________________________________________ 7, 21, 22
Malaria therapy of paresis_.,___________________________________ 7, 22
Mali~nant____________________________________________________
growths, resistance and susceptibility to ________________ 16-17
Nutntion
22-23
Occupational skin diseases______________________________________
Poliomyelitis__________________________________________________
Prophylactic and therapeutic agents_____________________________
Public-health methods _______________________________________ 9,
Radiation, biological effects of_ _________________________________
Rocky Mountain spotted fever __________________________________
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8, 28
36
38-39
32-33
15-16
24--25
142
INDEX
Studies-Continued.
Pan
Sickness
and _________________________________________________
mortality_________________________________________ 8, 28
30
Skin diseases
Stream pollution ____________________________________________ 9, 34-35
Trachoma____________________________________________________
37
Tularaemia ___________________________________________________ 25, 36
Typhus-Rocky Mountain spotted fever ________________________ 9, 35-36
Venereal diseases ___________________________________________ 109,110
Surveys:
Rodent-control_______________________________________________
66
Venereal diseases in the South ________________________________ 109-110
T
Tables:
Airports of entry, United States, for airplanes from foreign ports,
transactions at ______________________________________________ 73-74
Canal Zone, quarantine activities at_____________________________
75
Communicable diseases in the United States, 1933, summary of
prevalence of_______________________________________________
89
Engineering workt ~ummary of_ _________________________________ 54-55
Inspection of drinldng-water supplies on vessels___________________
51
Interstate carrier water supplies, 1933___________________________
50
Marine hospital transactions __________________________________ 100-108
Maritime quarantine stations, summary of transactions at __________ 69-71
Medical inspection of aliens____________________________________ 75-87
Mexican border stations, summary of quarantine transactions at____
72
Personnel report____________________________________________ 126-131
Trachoma control work________________________________________
49
Venereal diseases____________________________________________ 113-117
Trachoma:
Control activities ____________________________ ---- _________ - - - Studiesof ___________________________________________________ _ 47-49
37
Summary of control work ______________________________________ _
49
Tuberculosis death rate ___________________________________________ _
2
Tularaemia, studies of _________________________ -----------. ______ - _ 25, 36
Typhoid fever death rate__________________________________________ _
2
Typhus
fever: ____________________________________________________ 61-62
Controlof
Prevalenceof_________________________________________________ 2,64
Typhus-Rocky Mountain spotted fever studies ______________________ 9, 35-36
u
United States, health conditions in__________________________________
2-3
V
Vaccinations against smallpox and cholera ___________________________ _
65
Vaccine, Rocky Mountain spotted fever ____________________________ _
8
Venereal disease information, journal of _____________________________ _
112
Venereal disease problem, recommendation for _______________________ _
14
Venereal rl.iseases:
Clinic,
Hot
Springs,
Ark_______________________________________
112
Controlmeasures ___________________________________________ 110-111
Cooperative clinical studies of__________________________________
-109
Health survey in the South ___________________________________ 109-110
Prevalence studies _______________________________ -- __ ___ ___ _ ___
110
Prevention and control of_ ________________________________ 11, 110-111
Prevention of spread by interstate travel_________________________
112
Report of division oL _________________ .: ______________ • ____ __ 109-117
Research at Stapleton Marine hospitaL__________________________
110
Tables relating to___________________________________________ 113-117
Vessels:
Fumigation and inspection of_ _________________________________ _
4
Inspection of drinking-water supplies on, table showing ____________ _
51
Quarantine inspection of ______________________________________ _
64
Supervision of water supplies on _______________________ _______ _ 50-51
~
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INDEX
w
Pap
Water supplies inspected and certified, reciprocity with Canada ____ _
52
Water
supplies on
interstate carriers:
Inspection
of ________________________________________________
_
5
Summaryof,1933 ____________________________________________ _
50
Water supplies on vessels, supervision of _____________________________ _ 50-51
Water
supplies
used by common
carriers, supervision of__---------------_ 49-51
World health
conditions
___________________________________________
1-2
y
Yellow fever, prevalence of__________________________________________
2, 64
z
Zoology, report of division of________________________________________
0
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41
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